Post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve in mandibular fracture: a prospective study

Yadav, Sunil; Mittal, Hitesh Chander; Malik, Sunita; Dhupar, Vikas; Sachdeva, Akash; Malhotra, Vijaylaxmy; Gurdarshan, Singh

doi:10.5125/jkaoms.2016.42.5.259

Cited by 15 publications

(22 citation statements)

References 28 publications

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“…If only the inferior alveolar nerve-bearing area (body and angle fractures) is considered, the prevalence in our study was very high at 93.0%. This was similar to that given by Yadav et al 19 of 86.7%. According to the review by Thurmüller et al 4 , the post-traumatic, pre-treatment nerve injury considering only angle and body fractures ranged from 46% to 58.5%, but the same study reported overall postoperative IAND to be in the range of 0.4% to 91.3%, or between 76.1% and 91.3% when only nerve-bearing area were considered.…”

Section: Discussionsupporting

confidence: 93%

Inferior alveolar nerve dysfunction in mandibular fractures: a prospective cohort study

Shetty

et al. 2021

JKAOMS

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Objectives: To assess the prevalence and recovery of inferior alveolar nerve dysfunction (IAND) in mandibular fractures. Materials and Methods: This was a prospective cohort study. Clinical neurosensory testing was done preoperatively and the IAND was categorized as mild, moderate or severe. Postoperatively, neurosensory testing was repeated at 1 day, 1 week, 1 month, 3 months and every 3 months thereafter. Results: A total of 257 patients with 420 fractures were included in the study with a mean age of 31.7 years. Body fractures (95.9%) had the highest incidence of IAND, followed by the angle fractures (90.1%) and symphysis fractures (27.6%). The condyle and coronoid fractures did not have any IAND and hence were excluded from further study. After eliminating those cases, 232 patients remained in the study with 293 fractures. The overall prevalence of IAND in fractures occurring distal to the mandibular foramen was 56.3%. The changes until 1 week were minimal. From 1 month to 6 months, there was a significant reduction in the severity of IAND. A significant number of cases (60.0%) were lost to follow-up between 6 and 9 months. At 6 months, 23.9% of cases still had some form of IAND and 95.0% of the symphysis, 59.0% of the angle and 34.8% of the body fractures with IAND had become normal. Conclusion:This study documents the reduction in the degree of severity of IAND in the first six months and provides the basis for future studies with longer periods of follow-up.

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Section: Discussionsupporting

confidence: 93%

Inferior alveolar nerve dysfunction in mandibular fractures: a prospective cohort study

Shetty

et al. 2021

JKAOMS

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“…It is mainly associated with the inferior alveolar nerve, and it is more frequent in the mandibular ramus fractures than in the mandibular body fractures. Most nerve injuries are likely to recover if early appropriate treatment is applied but cannot be recovered if the damage by the fracture itself or by the wrong operation is irreversible [ 15 ]. An impacted third molar may cause nerve injury.…”

Section: Main Textmentioning

confidence: 99%

Postoperative malocclusion after maxillofacial fracture management: a retrospective case study

Kim

Choi

Kim

2018

Maxillofac Plast Reconstr Surg

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PurposeVarious complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture.Materials and methodsIn this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors’ department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery.ResultsOne patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration.ConclusionsConsidering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem.Electronic supplementary materialThe online version of this article (10.1186/s40902-018-0167-z) contains supplementary material, which is available to authorized users.

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“…Similarly, in a study of 583 patients, age was related to risk of complication [56]. Other studies also show that post-operative risks rise in frequency with increasing age [16,[57][58][59][60]. In a study in which germectomy was performed on 300 teeth in patients aged 12-19 years, no lingual nerve injury occurred [61].…”

Section: Discussionmentioning

confidence: 88%

The Evaluation of Further Complications after the Extraction of the Third Molar Germ: A Pilot Study in Paediatric Dentistry

et al. 2021

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Some authors suggest germectomy to prevent the impaction of mandibular third molars, which can cause anterior crowding. The aim of the study, conducted with 2 years of follow-up, was to clarify when the extraction of the germ of the third molar is optimal, together with possible post-operative complications. A new surgical approach was performed through the application of a combined suture, which can provide better wound healing. The study was performed on 25 patients with a mean age of 15.44 ± 2.06. Based on orthodontic and surgical indications, 46 germectomies were performed. Follow-ups were conducted after 1 week, 2 weeks, 4 weeks, 1 year and 2 years. All procedures were carried out by the same operator and were standardized. Data analysis was conducted using R-Software. Statistical evaluation used the chi-squared test and the Monte Carlo test. The level of significance was set as 0.05. Results showed that out of 46 germectomies, the prevalence of complications was 4.2% for two patients (8%). Both complications were observed in male patients. In the first case, the patient (at Nolla stage 7) showed delayed onset infections after four weeks; in the second case, the patient (at Nolla stage 6) showed bleeding immediately after surgery and suture. With reference to delayed onset infections, no statistically significant association was found among gender (χ2 = 0.719; p = 0.396), germ development stage (χ2 = 2.595; p = 0.658) or Winter’s classifications (χ2 = 0.046; p = 0.829); similarly, no significant associations were found among bleeding, gender (χ2 = 0.719; p = 0.396), germ development stage (χ2 = 2.595; p = 0.658) or Winter’s classification (χ2 = 0.046; p = 0.829). From our results, it is also possible to state that post-operative complications following germectomy of the mandibular third molar germ in adolescence occur in a significantly reduced percentage of patients, so this oral surgery treatment becomes a reliable surgical technique in adolescence.

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Post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve in mandibular fracture: a prospective study

Cited by 15 publications

References 28 publications

Inferior alveolar nerve dysfunction in mandibular fractures: a prospective cohort study

Inferior alveolar nerve dysfunction in mandibular fractures: a prospective cohort study

Postoperative malocclusion after maxillofacial fracture management: a retrospective case study

The Evaluation of Further Complications after the Extraction of the Third Molar Germ: A Pilot Study in Paediatric Dentistry

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