Int J Stomatol

Int J Stomatol ›› 2023, Vol. 50 ›› Issue (4): 479-484.doi: 10.7518/gjkq.2023071

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Research progress on the postoperative inferior alveolar neurosensory disturbance

Liu Yuntong(),Liu Chang,Gao Lichao,Luo Yuxue,Cao Yubin,Hua Chengge.()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of General Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2022-12-12 Revised:2023-04-05 Online:2023-07-01 Published:2023-06-21
  • Contact: Chengge. Hua E-mail:847814755@qq.com;huacg@163.com

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Abstract:

Neurosensory disturbance (NSD) is a common complication after mandibular orthognathic surgery, mandi-bular posterior teeth implant surgery and mandibularthird molar extraction. Although in most cases the incidence is low, some patients suffer fromobvious discomfortin a long term. Clinicians and patients have paid great attention to this pro-blem. NSD of the inferior alveolar is often manifested as hypoesthesia and abnormal sensation, and sometimes hyperesthesia of the chin and lips on the surgical side, as well as discomfort of the mandibular dentition on the affected side. Most patients can recovery within 6 months after the occurrence of NSD, whereas a small number of patients were reported failed to recover from disturbance after 6 months or even longer. This article attempts to review symptoms and prognostic characteristics during NSD of the inferior alveolar nerve after different types of operations, and try to analyze the differences and correlations among them.

Key words: inferior alveolar nerve, neurosensory disturbance, orthognathic surgery, tooth implant surgery, third molar

CLC Number: 

  • R 782.1

TrendMD: 

Tab 1

Comparison of NSD for different reasons"

病因发病率主要症状预后
阻滞麻醉1∶13 800 970~ 1∶26 762麻木感及感觉减退发病率极低，预后不明
第三磨牙拔除术0.4%~13.4%患侧颏部、面颊和下唇的麻木感、感觉迟钝；异常疼痛、烧灼感或感觉过敏等1%~43.5%的患者在术后6个月仍有明显症状
种植手术1.4%~43.5%患侧颏部、面颊和下唇的感觉减退5%~15%的病例1年后仍未完全恢复；伴蠕虫爬行感者预后较好，伴紧绷感者预后较差
正颌手术6.8%~95%患侧颏部、面颊和下唇的感觉减退；电击样感、疼痛感、针刺感、紧绷感、烧灼感、压迫感、僵硬感、患侧下颌牙列牙齿疼痛等异常感觉多在6个月后完全恢复；11%的下颌支矢状劈开术后1年仍未完全恢复；异常感觉/减退的恢复顺序为：冷觉、触觉>热觉、痛觉、牙列感觉异常>主观不适、两点辨别
1 Pogrel MA, Thamby S. Permanent nerve involvement resulting from inferior alveolar nerve blocks[J]. J Am Dent Assoc, 2000, 131(7): 901-907.
2 Aquilanti L, Mascitti M, Togni L, et al. A systematic review on nerve-related adverse effects following mandibular nerve block anesthesia[J]. Int J Environ Res Public Health, 2022, 19(3): 1627.
3 Garisto GA, Gaffen AS, Lawrence HP, et al. Occurrence of paresthesia after dental local anesthetic administration in the United States[J]. J Am Dent Assoc, 2010, 141(7): 836-844.
4 Kipp DP, Goldstein BH, Weiss WW Jr. Dysesthesia after mandibular third molar surgery: a retrospective study and analysis of 1 377 surgical procedures[J]. J Am Dent Assoc, 1980, 100(2): 185-192.
5 Daware SN, Balakrishna R, Deogade SC, et al. Assessment of postoperative discomfort and nerve injuries after surgical removal of mandibular third molar: a prospective study[J]. J Family Med Prim Care, 2021, 10(4): 1712-1717.
6 Arora A, Patil BA, Sodhi A. Validity of the vertical tube-shift method in determining the relationship between the mandibular third molar roots and the inferior alveolar nerve canal[J]. J Korean Assoc Oral Maxillofac Surg, 2015, 41(2): 66-73.
7 Yamada SI, Hasegawa T, Yoshimura N, et al. Prevalence of and risk factors for postoperative complications after lower third molar extraction: a multicenter prospective observational study in Japan[J]. Medicine (Baltimore), 2022, 101(32): e29989.
8 George AL, Panicker P, Johny J, et al. Reliability of cone beam computed tomography in comparison with panoramic radiography to predict the anatomical relationship of inferior alveolar nerve with mandibular third molar: a radiological and clinical study[J]. J Pharm Bioallied Sci, 2020, 12(): S367-S372
9 Buyuk C, Akkaya N, Arsan B, et al. A fused deep learning architecture for the detection of the relationship between the mandibular third molar and the mandibular canal[J]. Diagnostics (Basel), 2022, 12(8): 2018.
10 Wang DM, Lin TY, Wang YL, et al. Radiographic features of anatomic relationship between impacted third molar and inferior alveolar canal on coronal CBCT images: risk factors for nerve injury after tooth extraction[J]. Arch Med Sci, 2018, 14(3): 532-540.
11 Chen YF, Liu JY, Pei J, et al. The risk factors that can increase possibility of mandibular canal wall damage in adult: a cone-beam computed tomography (CBCT) study in a Chinese population[J]. Med Sci Monit, 2018, 24: 26-36.
12 Scarano A, Sinjari B, Murmura G, et al. Neurosensory disturbance of the inferior alveolar nerve after 3 025 implant placements[J]. Implant Dent, 2017, 26(5): 735-743.
13 Na JY, Han SS, Jeon K, et al. Prognosis in case of nerve disturbance after mandibular implant surgery in relation to computed tomography findings and symptoms[J]. J Periodontal Implant Sci, 2019, 49(2): 127-135.
14 Jamil FA, Mohammed JA, Hasan TA, et al. The relia-bility of surgeons to avoid traumatic insertion of dental implants into high-risk regions: a panoramic radiograph study[J]. BMC Oral Health, 2020, 20(1): 96.
15 Kan JY, Lozada JL, Goodacre CJ, et al. Endosseous implant placement in conjunction with inferior alveo-lar nerve transposition: an evaluation of neurosensory disturbance[J]. Int J Oral Maxillofac Implants, 1997, 12(4): 463-471.
16 Deryabin G, Grybauskas S. Dental implant placement with inferior alveolar nerve repositioning in severely resorbed mandibles: a retrospective multicenter study of implant success and survival rates, and lower lip sensory disturbances[J]. Int J Implant Dent, 2021, 7(1): 44.
17 Ylikontiola L, Kinnunen J, Oikarinen K. Comparison of different tests assessing neurosensory disturbances after bilateral sagittal split osteotomy[J]. Int J Oral Maxillofac Surg, 1998, 27(6): 417-421.
18 Kuhlefelt M, Laine P, Suominen AL, et al. Nerve manipulation during bilateral sagittal split osteotomy increases neurosensory disturbance and decrea-ses patient satisfaction[J]. J Oral Maxillofac Surg, 2014, 72(10): 2052.e1-2052.e5
19 Monnazzi MS, Real Gabrielli MF, Passeri LA, et al. Inferior alveolar nerve function after sagittal split osteotomy by reciprocating saw or piezosurgery instrument: prospective double-blinded study[J]. J Oral Maxillofac Surg, 2014, 72(6): 1168-1172
20 Khan M, Sattar N, Erkin M. Postoperative complications in genioplasty and their association with age, gender, and type of genioplasty[J]. Int J Dent, 2021, 2021: 8134680.
21 Song GD, Yu PX, Huang GQ, et al. Simultaneous surgery of mandibular reduction and impacted mandibular third molar extraction: a retrospective study of 65 cases[J]. Medicine (Baltimore), 2020, 99(15): e19397.
22 Sharifi R, Fekrazad R, Taheri MM, et al. Effect of photobiomodulation on recovery from neurosensory disturbances after sagittal split ramus osteotomy: a triple-blind randomised controlled trial[J]. Br J Oral Maxillofac Surg, 2020, 58(5): 535-541.
23 Burian E, Sollmann N, Ritschl LM, et al. High resolution MRI for quantitative assessment of inferior alveolar nerve impairment in course of mandible fractures: an imaging feasibility study[J]. Sci Rep, 2020, 10(1): 11566.
24 Consolo U, Setti G, Tognacci S, et al. Histological changes in odontogenic parakeratinized keratocysts treated with marsupialization followed by enuclea-tion[J]. Med Oral Patol Oral Cir Bucal, 2020, 25(6): e827-e833.
25 Niu ZX, Li Y, Chen WT, et al. Study on clinical and biological characteristics of ameloblastic carcinoma[J]. Orphanet J Rare Dis, 2020, 15(1): 316.
26 Qiu JY, Huang KM, Lin NC. Use of the cover-lif-ting technique in mandibular cemento-ossifying fibroma excision to preserve the inferior alveolar nerve[J]. Medicina (Kaunas), 2021, 57(12): 1383.
27 Nogami S, Yamauchi K, Shiiba S, et al. Evaluation of the treatment modalities for neurosensory disturbances of the inferior alveolar nerve following retromolar bone harvesting for bone augmentation[J]. Pain Med, 2015, 16(3): 501-512
28 Gianni AB, D’Orto O, Biglioli F, et al. Neurosensory alterations of the inferior alveolar and mental nerve after genioplasty alone or associated with sa-gittal osteotomy of the mandibular ramus[J]. J Craniomaxillofac Surg, 2002, 30(5): 295-303.
29 Qi W, Wang YG, Huang YY, et al. Photobiomodulation therapy for management of inferior alveolar nerve injury post-extraction of impacted lower third molars[J]. Lasers Dent Sci, 2020, 4(1): 25-32.
30 Kazancioglu HO, Ezirganli S, Demirtas N. Comparison of the influence of ozone and laser therapies on pain, swelling, and trismus following impacted third-molar surgery[J]. Lasers Med Sci, 2014, 29(4): 1313-1319.
31 祝颂松, 王旭东, 杨学文, 等. 下颌支矢状骨劈开术并发症防治的专家共识[J]. 华西口腔医学杂志, 2022(3): 247-254.
Zhu SS, Wang XD, Yang XW, et al. Experts’consensus on precaution and treatment for complications of sagittal split ramus osteotomy[J]. West China J Stomatol, 2022(3): 247-254
32 Al-Bishri A, Rosenquist J, Sunzel B. On neurosensory disturbance after sagittal split osteotomy[J]. J Oral Maxillofac Surg, 2004, 62(12): 1472-1476
33 Seo K, Tanaka Y, Terumitsu M, et al. Efficacy of steroid treatment for sensory impairment after orthognathic surgery[J]. J Oral Maxillofac Surg, 2004, 62(10): 1193-1197.
34 Pourdanesh F, Khayampour A, Jamilian A. Therapeutic effects of local application of dexamethasone during bilateral sagittal split ramus osteotomy surgery[J]. J Oral Maxillofac Surg, 2014, 72(7): 1391-1394
35 Semper-Hogg W, Fuessinger MA, Dirlewanger TW, et al. The influence of dexamethasone on postoperative swelling and neurosensory disturbances after orthognathic surgery: a randomized controlled clinical trial[J]. Head Face Med, 2017, 13(1): 19.
36 Firoozi P, Keyhan SO, Kim SG, et al. Effectiveness of low-level laser therapy on recovery from neurosensory disturbance after sagittal split ramusosteotomy: a systematic review and meta-analysis[J]. Ma-xillofac Plast Reconstr Surg, 2020, 42(1): 41.
37 Bittencourt MAV, Paranhos LR, Martins-Filho PRS. Low-level laser therapy for treatment of neurosensory disorders after orthognathic surgery: a systematic review of randomized clinical trials[J]. Med Oral Patol Oral Cir Bucal, 2017, 22(6): 780-787.
38 Kushnerev E, Yates JM. Evidence-based outcomes following inferior alveolar and lingual nerve injury and repair: a systematic review[J]. J Oral Rehabil, 2015, 42(10): 786-802
39 Weyh A, Pucci R, Valentini V, et al. Injuries of the peripheral mandibular nerve, evaluation of interventions and outcomes: a systematic review[J]. Craniomaxillofac Trauma Reconstr, 2021, 14(4): 337-348.
40 Bagheri SC, Meyer RA, Cho SH, et al. Microsurgical repair of the inferior alveolar nerve: success rate and factors that adversely affect outcome[J]. J Oral Maxillofac Surg, 2012, 70(8): 1978-1990.
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