Lingual access for third molar surgery: a 20-year retrospective audit

We describe a technique for obtaining lingual access for the insertion of a wide metal retractor to protect the lingual nerve from accidental damage d uring third molar surgery. We also report an audit of a single practice ove r a 20-year period using the technique described. The approach involves rai sing soft tissues on the lingual side of the lower third molar tooth to all ow insertion of a broad Hovell's lingual retractor. We conclude that raisin g lingual tissues to form a wide tension-free flap and inserting a specific ally designed retractor does not increase the incidence of lingual nerve mo rbidity, Indeed, the overall incidence of lingual nerve damage was particul arly low compared with those in other published series.