Evolving Paradigms in the Management of Trigeminal Nerve Injuries Post Oral Surgery: A Comprehensive Narrative Review.

Trigeminal nerve injuries are among the most challenging complications encountered in oral and maxillofacial surgery, often resulting in significant sensory and functional deficits. The present narrative review explores the evolving paradigms in the diagnosis and management of these injuries, focusing on conventional microsurgical techniques as well as recent advancements in regenerative therapies. Common causes include surgical trauma, chemical insults, and implant-related complications. Diagnostic modalities such as qualitative and quantitative neurosensory testing, cone-beam computed tomography (CBCT), and magnetic resonance neurography are discussed. Management options range from early microsurgical intervention and nerve grafting to the use of nerve conduits, stem cells, growth factors, and electrical stimulation. Despite these advancements, anatomical complexity, timing of intervention, and individual biological variability pose significant limitations. Emerging technologies, including AI-based imaging, soft tissue-driven planning, and virtual surgical simulation, offer promising prospects for improving patient outcomes. The review emphasizes the need for timely, individualized, and multidisciplinary approaches to optimize functional recovery and quality of life.