Gallesio Cesare, Berrone Mattia, Ruga Emanuele, Boffano Paolo
Division of Maxillofacial Surgery, Head and Neck Department, SanGiovanni Battista Hospital, University of Turin, Turin, Italy.
J Craniofac Surg. 2010 Nov;21(6):2003-7. doi: 10.1097/SCS.0b013e3181f535b8.
The objective of the study was to prospectively assess the intraoperative findings and the radiographic signs of a study population of patients with impacted third molars at risk of inferior alveolar nerve injury. One hundred thirty-four patients with impacted mandibular third molars at risk for nerve injury were included in the study. Radiographic signs of possible close relationship between the 2 structures and intraoperative exposition or damage of the inferior alveolar nerve were recorded. The follow-up controls comprised clinical examinations and assessment for the sensation of the lower lip and chin. In 24 patients, a real contiguity was encountered between the third molars and nerve. Among these, intraoperative neural exposition was observed in 19 patients. Four patients complained of postoperative temporary hypoesthesia. No deficit of sensibility was found in cases with no exposition of the nerve. The accidental exposition of the inferior alveolar nerve is associated with an increased risk for neural injuries. At panoramic radiograph, the presence of signs of bifid and radiolucent apex, superimposition, and radiolucent root band should be considered at high risk for neural damage.
本研究的目的是前瞻性评估有下牙槽神经损伤风险的阻生第三磨牙患者研究群体的术中发现和影像学征象。134例有神经损伤风险的下颌阻生第三磨牙患者纳入本研究。记录了这两个结构之间可能的密切关系的影像学征象以及下牙槽神经的术中暴露或损伤情况。随访对照包括临床检查和对下唇及颏部感觉的评估。24例患者的第三磨牙与神经实际相邻。其中，19例患者术中观察到神经暴露。4例患者术后主诉有暂时性感觉减退。未暴露神经的病例未发现感觉缺失。下牙槽神经的意外暴露与神经损伤风险增加相关。在全景X线片上，应将双叉和透射性根尖、重叠以及透射性根带等征象视为神经损伤的高风险因素。
