Inferior Alveolar Nerve Injuries Associated With Mandibular Fractures

Bede, Salwan Y; Ismael, Waleed Khaleel; Al-Assaf, Dhuha A.; Omer, Saad Salem

doi:10.1097/scs.0b013e318266fda3

Cited by 22 publications

(33 citation statements)

References 5 publications

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“…Almost one third of the study population showed postinjury preoperative mental nerve hypoesthesia and over 45% suffered from purely postoperative hypoesthesia without pre-existing posttraumatic nerve injury. This finding correlates with other studies that analysed the IAN function after mandibular fractures (Schultze-Mosgau et al, 1999;Halpern et al, 2004;Renzi et al, 2004;Bede et al, 2012).…”

Section: Discussionsupporting

confidence: 92%

“…However, literature shows several risk factors for IAN damage. Two studies, one performed by Bede et al, 2012, the other by Boffano et al, 2014, analysed that highly displaced fractures, such as comminuted fractures and fractures in close proximity to the inferior alveolar nerve (angle, ramus and body) are associated with higher posttraumatic inferior alveolar nerve injury rates. The present study supports similar results with worse recovery rates in patients with multiple fractures in the IAN area and especially high rates of hypoesthesia in mandibular angle fractures.…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for posttraumatic IAN dysfunction are highly displaced fractures, such as comminuted fractures, and fractures with close proximity to the inferior alveolar nerve (angle, ramus and body) (Bede et al, 2012;Boffano et al, 2014). Literature shows postinjury (preoperative) hypoesthesia rates of up to 81% (Halpern et al, 2004;Bede et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Literature shows postinjury (preoperative) hypoesthesia rates of up to 81% (Halpern et al, 2004;Bede et al, 2012). When preoperative alveolar nerve function is intact, the literature demonstrates postoperative hypoesthesia rates around 30% (Schultze-Mosgau et al, 1999;Renzi et al, 2004) caused by intraoperative irritation during ORIF.…”

Section: Introductionmentioning

confidence: 99%

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Inferior alveolar nerve function after open reduction and internal fixation of mandibular fractures

Schenkel

Jacobsen

Rostetter

et al. 2016

Journal of Cranio-Maxillofacial Surgery

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a b s t r a c tPurpose: Mandibular fractures are amongst the most common facial fractures and are usually treated by open reduction and internal fixation (ORIF). Inferior alveolar nerve (IAN) injuries are seen frequently in mandibular fractures as well as after ORIF of these fractures due to the exposition and the close proximity of the nerve during fracture reduction. Therefore the continuity of the IAN can be disrupted. Permanent injury to the IAN can result in diminished quality of life. This retrospective study was designed to objectively analyse the incidence and the outcome of pre-and postoperative mental nerve hypoesthesia after ORIF of mandibular fractures. Results: 340 patients met the inclusion criteria. 27% of the study population presented with postinjury (preoperative) mental nerve hypoesthesia, 46% suffered from purely postoperative hypoesthesia and 27% showed no nerve damage. Complete recovery was seen in 70% of all cases, partial recovery in 20% of the cases and less than 10% suffered from a permanent (>12 months) IAN damage. Mandibular angle fractures were accompanied with significantly higher rates of hypoesthesia (79% vs. 68%). Recovery rate was significantly worse in older patients, when preoperative hypoesthesia was present (66% vs. 73%) and in patients with multiple fractures in proximity to the IAN (36% vs. 52%). Mandibular body fractures showed worse recovery rates than fractures that did not affect the body (44% vs. 52%).Conclusion: The present study shows that IAN injury is seen frequently in mandibular fractures. Mental nerve hypoesthesia may influence quality of life. Nerve continuity may not be preserved due to the initial trauma or may result as a postoperative complication. Nevertheless the results of this study show a high potential for full recovery.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Inferior alveolar nerve function after open reduction and internal fixation of mandibular fractures

Schenkel

Jacobsen

Rostetter

et al. 2016

Journal of Cranio-Maxillofacial Surgery

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“…In a study conducted by Bede et al [40], they found that linear displacement and comminuted fractures were which caused more nerve lesions and with a longer period of recovery. However recovery of nerve function in 91% of cases was obtained.…”

Section: Other Causes: Mandibular Fracturesmentioning

confidence: 99%

Prevention and Treatment of IAN Injuries: A Literature Review

2014

J Interdiscipl Med Dent Sci

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The inferior alveolar nerve (IAN) is one of the most important structures in dentistry. It is a terminal branch that originates from the mandibular root of the trigeminal nerve. This branch courses through the inner aspect of the mandible and innervates teeth and some muscles as the mylohyoid or digastric ones and the gums or lips by its mental branch.Although the main cause of IAN lesion occurs during third molars extractions, IAN can be injured during implant surgery, especially in cases with an atrophic posterior mandible. It is difficult to sever the nerve due to its large caliber. On the contrary, nerve compression or laceration constitute more common complications.Diverse preventive methods to avoid IAN injury have been reported such as using a precise diagnostic procedure as computerized tomography (CT), guided implant surgery, or placing short implants.We may classify nerve injury effects ranging from a light tingling (dysesthesia) to temporary or permanent loss of sensibility (hypoesthesia) or to increased sensibility. These cases require a careful management as these events may increase the patients' and dental practitioners' anxiety. When the IAN has not been totally interrupted, healing occurs in the next 3 to 6 month even spontaneously.Sometimes we can alleviate patients giving them some painkillers or vitamin complexes to minimize symptoms or to improve healing. The use and utility of this kind of treatment is controversial however we should not underestimate its placebo effects.

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Post-traumatic Neuropathy and Burning Mouth Syndrome

Renton

Laat

2016

Pharmacological Management of Headaches

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Inferior Alveolar Nerve Injuries Associated With Mandibular Fractures

Cited by 22 publications

References 5 publications

Inferior alveolar nerve function after open reduction and internal fixation of mandibular fractures

Inferior alveolar nerve function after open reduction and internal fixation of mandibular fractures

Prevention and Treatment of IAN Injuries: A Literature Review

Post-traumatic Neuropathy and Burning Mouth Syndrome

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