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A known neurologic complication of third molar surgery is lingual nerve injury. Certain risk factors can cause lingual nerve injury during the extraction of mandibular third molars. This article will review the existing literature regarding lingual nerve injuries and related risk factors, and it attempts to study lingual nerve vulnerability during extraction of lower third molars, particularly in cases of distoangular impaction. The case report describes exposure of the lingual nerve during the extraction of the lower third molar. Also poresented are 4 specific risk factors of lingual nerve injury. Recommendations are given to avoid lingual nerve trauma during removal of mandibular third molars.