Sensory Testing of Inferior Alveolar Nerve Injuries: A Review of Methods Used in Prospective Studies

Poort, Lucas J.; Neck, Johan W. van; Wal, K.G.H. van der

doi:10.1016/j.joms.2008.06.076

Cited by 149 publications

(132 citation statements)

References 38 publications

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“…Mechanoceptive testing is further divided into static light touch (LT), brush directional stroke (BSD) and two-point discrimination (TPD). Nociceptive testing is done by pin prick (PR) and thermal discrirnination [2].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Neurosensory Disturbance Following Orthognathic Surgery: A Prospective Study

Degala

Shetty

Bhanumathi

2013

J. Maxillofac. Oral Surg.

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Aim and Objectives The prospective study was to evaluate the incidence, type of neurosensory disturbance (NSD), grade its severity and monitor its recovery occurring in the lower lip and chin due to damage to inferior alveolar nerve following orthognathic surgery involving mandible. Materials and Methods The study included 10 patients who have undergone sagittal split osteotomy, genioplasty, and anterior subapical osteotomy (ASO). All the patients examined preoperatively and post operatively 1 week, 1 and 6 months according to standardized test to clarify the subjective and objective neurosensory status of the injured nerve. Pin prick test, blunt test, two-point discrimator test, brush stoke direction, light touch test, warm and cold test were used bilaterally to lower lip and chin area. Results Seven patients underwent bilateral sagittal split osteotomy (BSSO) (70 %), one patient had BSSO with genioplasty (10 %), two patients had BSSO with ASO (20 %). During the operation none of the nerves were transectioned, in 60 % of patients nerve was not visible and in 40 % of patients nerve was seen in distal segment. 70 % of patients underwent setback, 30 % of patients underwent advancement. The subjective evaluation of the patients revealed the incidence of 90 % at 1 week, 30 % at 1 month, 20 % at 6 months and 10 % at 1 year post operatively. The altered sensation reported subjectively was hypoesthesia in 50 % of the patients, anaesthesia in 40 % of the patients.There was 100 % recovery in advancement cases and 93.5 % recovery in setback cases. Conclusion There is a high incidence of NSD of the lower lip and chin after BSSO related to advancement, setback, intraoperative nerve encounter and surgical skill. However, recovery of sensation occurs with increasing frequency during the follow-up period. The clinical neurosensory tests are effective guides to study the neurosensory deficit.

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Section: Introductionmentioning

confidence: 99%

Evaluation of Neurosensory Disturbance Following Orthognathic Surgery: A Prospective Study

Degala

Shetty

Bhanumathi

2013

J. Maxillofac. Oral Surg.

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“…This number might be even lower if the follow-up period of 12 months was extended, since neural regeneration is slow. The large diversity in the published recovery rates might be explained due to the different methods of assessing the IAN function, as suggested by Poort et al, 2009. Sharp/blunt and two point discrimination as well as patient reporting was the method routinely used to check for IAN function in this study, which is one of the publication's limitations.…”

Section: Discussionmentioning

confidence: 97%

“…Different methods of assessing the IAN function have been suggested in the literature, such as the sharp/ blunt discrimination, two point discrimination, temperature testing, and others (Poort et al, 2009). While the more elaborate tests are more accurate it can be difficult to incorporate them into a quick postoperative follow-up, which might explain why simple tests are used more routinely.…”

Section: Introductionmentioning

confidence: 99%

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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“…Examination of the affected area can be carried out using thermal, mechanical, electrical, or chemical tests that elicit subjective responses. 13 When complications are suspected from the patient's complaints, history, and clinical examinations, overextension of filling material should be confirmed via radiography. CT is a useful imaging modality because it can not only demonstrate the presence of overextension of filling material but also its exact location and amount.…”

Section: Discussionmentioning

confidence: 99%

Accidental overextension of endodontic filling material in patients with neurologic complications: a retrospective case series

Kim¹,

Cho²,

Yi³

et al. 2016

Dentomaxillofacial Radiology

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Sensory Testing of Inferior Alveolar Nerve Injuries: A Review of Methods Used in Prospective Studies

Cited by 149 publications

References 38 publications

Evaluation of Neurosensory Disturbance Following Orthognathic Surgery: A Prospective Study

Evaluation of Neurosensory Disturbance Following Orthognathic Surgery: A Prospective Study

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

Accidental overextension of endodontic filling material in patients with neurologic complications: a retrospective case series

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