Nazarian Y, Eliav E, Nahlieli O
Dept. of Oral and Maxillofacial Surgery, Barzilai Medical Center, Ashkelon.
Refuat Hapeh Vehashinayim (1993). 2003 Jul;20(3):44-50, 101.
Nerve injury is a well-known complication following oral and maxillofacial surgery. Direct trauma, inflammation and infection are postoperative neural disturbances main causes. The most inflicted nerves associated with endosseous implant placement are those innervating the mandible: the inferior alveolar nerve, the mental nerve and the lingual nerve. Evaluation of the nerve injury characteristics and severity as early as possible has always imposed a great challenge for clinicians. We demonstrate a reliable yet simple way of dealing with this kind of problem in conjunction with comparing preoperative and postoperative sensation of the chin, the tongue and the lower lip. On the other hand, it is considerably important to take preventive measures for such injuries by using appropriate radiographic images. If a nerve damage has occurred, best prognosis is to be expected by early and appropriate treatment. It is imperative to treat such injuries in four months following the injury, otherwise a permanent nerve damage may occur. Further investigation of nerve damage risks following implant placement should be performed in order to enable patient to decide whether having implants dependent rehabilitation or choosing an alternative.
神经损伤是口腔颌面外科手术后一种众所周知的并发症。直接创伤、炎症和感染是术后神经功能障碍的主要原因。与骨内种植体植入相关的最常受累神经是支配下颌骨的神经：下牙槽神经、颏神经和舌神经。尽早评估神经损伤的特征和严重程度一直是临床医生面临的巨大挑战。我们展示了一种可靠且简单的方法来处理这类问题，同时比较术前和术后下巴、舌头及下唇的感觉。另一方面，通过使用适当的影像学图像对此类损伤采取预防措施相当重要。如果发生了神经损伤，早期且恰当的治疗有望获得最佳预后。必须在损伤后四个月内治疗此类损伤，否则可能会发生永久性神经损伤。应进一步研究种植体植入后神经损伤的风险，以便让患者能够决定是进行依赖种植体的修复还是选择其他替代方案。
