Yekta Sareh Said, Smeets Ralf, Stein Jamal M, Ellrich Jens
Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Aachen University, Aachen, Germany.
J Oral Maxillofac Surg. 2010 Oct;68(10):2437-51. doi: 10.1016/j.joms.2009.12.013. Epub 2010 Jul 3.
Orofacial sensory dysfunction plays an important role in oral and maxillofacial surgery. Quantitative sensory testing (QST) is a psychophysical approach to evaluate thermal and mechanical somatosensation.
The present human study 1) collected normative QST data in extraoral and intraoral regions, 2) analyzed effects of age, gender, and anatomical sites on QST, and 3) applied QST in 11 patients with iatrogenic inferior alveolar nerve lesions. Sixty (30 male and 30 female) healthy volunteers were tested bilaterally in the innervation areas of infraorbital, mental, and lingual nerves. Ten patients with sensory disturbances in innervation areas of the mental nerve were investigated at 1, 4, and 8 weeks after surgery. Another patient with a complete sensory loss after surgery was repetitively tested within 453 days after primary surgery (dental implant) and subsequent surgical reconstruction of the inferior alveolar nerve by autologous graft.
Older subjects were significantly less sensitive than younger subjects for thermal parameters. Thermal detection thresholds in infraorbital and mental regions showed higher sensitivity in women. Sensitivity to thermal stimulation was higher in the infraorbital region than in the mental and lingual regions. QST monitored somatosensory deficits and recovery of inferior alveolar nerve functions in all patients.
Age, gender, and anatomic region affect various QST parameters. QST might be useful in the diagnosis of inferior alveolar nerve disorders in patients. In dentistry, the monitoring of afferent nerve fiber functions by QST might support decisions on further interventions.
口面部感觉功能障碍在口腔颌面外科中起着重要作用。定量感觉测试(QST)是一种评估热觉和机械性躯体感觉的心理物理学方法。
本人体研究1)收集口外和口内区域的QST标准数据,2)分析年龄、性别和解剖部位对QST的影响,3)将QST应用于11例医源性下牙槽神经损伤患者。60名(30名男性和30名女性)健康志愿者在眶下神经、颏神经和舌神经的支配区域进行双侧测试。对10例颏神经支配区域感觉障碍的患者在术后1周、4周和8周进行调查。另一名术后完全感觉丧失的患者在初次手术(牙种植体)及随后自体移植修复下牙槽神经后的453天内进行重复测试。
年龄较大的受试者对热参数的敏感性明显低于较年轻的受试者。眶下和颏区域的热觉检测阈值在女性中表现出更高的敏感性。对热刺激的敏感性在眶下区域高于颏和舌区域。QST监测了所有患者的躯体感觉缺陷和下牙槽神经功能的恢复情况。
年龄、性别和解剖区域影响各种QST参数。QST可能有助于诊断患者的下牙槽神经疾病。在牙科领域,通过QST监测传入神经纤维功能可能有助于支持进一步干预的决策。