Neuropathy of Trigeminal Nerve Branches After Oral and Maxillofacial Treatment

Abstract

Objective To report the incidence of trigeminal neuropathy seen among new patients in a referral center within a period of 1 year (2013). The cause of damage, method of management and treatment outcome was assessed after 1-year follow-up. Materials and Methods The records of all new patients visiting the oral and maxillofacial unit of the University hospital of Leuven in 2013 were screened for a history of damage to branches of the trigeminal nerve. The selected records were examined and the duration of nerve damage, received treatment as well as the outcome of the neuropathy after treatment was noted after 1-year follow-up. Results 56 patients (21 males, 35 females) from 7602 new patients had symptoms of damage to the trigeminal nerve branch. These symptoms persist in more than onethird of the patients [21/56 (37.5 %)] after 1-year followup. The least recovery is seen from oral surgery, implant placement, orthognathic surgery and tooth extraction. After 1 year 85 % (12/14) of neuropathic pain cases still have their symptoms as compared to 19 % (5/26) of patients with hypoesthesia. Conclusion This study shows a low incidence of nerve damage among the new patients presenting in oral and maxillofacial surgery clinic (\1 %); however, one-third of patients who sustain nerve damage never recover fully. Early diagnosis of the cause of neuropathy is essential. There is a need to objectively assess all patients with symptoms of trigeminal nerve damage before, during and after treatment.

Role of MR Neurography for the Diagnosis of Peripheral Trigeminal Nerve Injuries in Patients with Prior Molar Tooth Extraction

“…4 Persistent nerve damage results in disabling neuropathic pain and substantial oral dysfunction. 23 Early diagnosis and timely management are essential for both improved patient outcomes and prognosis. The postoperative outcomes have been shown to be negatively affected by older age, delayed treatment (Ͼ3-6 months after injury), and a larger nerve gap.…”

Ablation of TRPV1+ Afferent Terminals by Capsaicin Mediates Long-Lasting Analgesia for Trigeminal Neuropathic Pain

“…Trigeminal nerve damage due to accidents, orthognathic surgery, or dental procedures often causes trigeminal neuropathic pain (TNP), which becomes chronic, lasting more than a year, in one third of patients (Agbaje et al, 2016). Since TNP responds more poorly to conventional medications than does spinal traumatic neuropathic pain (McQuay et al, 1996;Haviv et al, 2014), development of novel methods to manage TNP is crucial.…”

A cone‐beam computed tomography study of the anatomical relationships between mandibular teeth and the mandibular canal, with a review of the current literature

“…The performance of dental procedures posterior to the mental foramen increases the risk of injury to the IAN as a result of the close relationship between the IAN and root apices of the posterior mandibular teeth. Dental procedures including endodontic treatments (López‐López, Estrugo‐Devesa, Jané‐Salas, & Segura‐Egea, ; Pogrel, ), implant placements (Agbaje et al, ; Kraut & Chahal, ), and mandibular third molar extractions (Pogrel, ) can cause injury to this nerve, with resulting neuropathic pain and partial or complete numbness in the chin area (Kovisto, Ahmad, & Bowles, ). The most frequent intraoperative complications after such surgeries are hemorrhagic accidents, but sensory disturbances associated with injury to the IAN are also encountered frequently.…”