Said-Yekta Sareh, Smeets Ralf, Esteves-Oliveira Marcella, Stein Jamal M, Riediger Dieter, Lampert Friedrich
Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Aachen University, Aachen, Germany.
J Oral Maxillofac Surg. 2012 Feb;70(2):263-71. doi: 10.1016/j.joms.2011.03.065. Epub 2011 Jul 29.
The aim of this study was to apply a standardized Quantitative Sensory Testing (QST) approach in patients to investigate whether oral surgery can lead to sensory changes, even if the patients do not report any sensory disturbances. Furthermore, this study determines the degree and duration of possible neuronal hyperexcitability due to local inflammatory trauma after oral surgery.
Orofacial sensory functions were investigated by psychophysical means in 60 patients (30 male, 30 female) in innervation areas of infraorbital nerves, mental nerves and lingual nerves after different interventions in oral surgery. The patients were tested 1 week, 4 weeks, 7 weeks, and 10 weeks postoperatively. As controls for bilateral sensory changes after unilateral surgery, tests were additionally performed in 20 volunteers who did not have any dental restorations.
No differences were found between the control group and the control side of the patients. Although not 1 of the patients reported paresthesia or other sensory changes postoperatively, QST detected significant differences between the control and the test side in the mental and lingual regions. Test sides were significantly less sensitive for thermal parameters (cold, warm, and heat). No differences were found in the infraorbital region. Patients showed significantly decreased pain pressure thresholds on the operated side. QST monitored recovery over time in all patients.
The results show that oral surgery can lead to sensory deficits in the mental and lingual region, even if the patients do not notice any sensory disturbances. The applied QST battery is a useful tool to investigate trigeminal nerve function in the early postoperative period. In light of the increasing forensic implication, this tool can serve to objectify clinical findings.
本研究的目的是在患者中应用标准化的定量感觉测试（QST）方法，以调查口腔手术是否会导致感觉变化，即使患者未报告任何感觉障碍。此外，本研究还确定了口腔手术后局部炎症创伤导致的可能的神经元兴奋性过高的程度和持续时间。
通过心理物理学方法对60例患者（30例男性，30例女性）在口腔手术的不同干预后眶下神经、颏神经和舌神经支配区域的口腔面部感觉功能进行了研究。在术后1周、4周、7周和10周对患者进行测试。作为单侧手术后双侧感觉变化的对照，还对20名没有任何牙齿修复的志愿者进行了测试。
对照组与患者的对照侧之间未发现差异。虽然没有1例患者术后报告感觉异常或其他感觉变化，但QST检测到颏部和舌部区域的对照侧与测试侧之间存在显著差异。测试侧对热参数（冷、温、热）的敏感性明显较低。眶下区域未发现差异。患者手术侧的疼痛压力阈值显著降低。QST监测了所有患者随时间的恢复情况。
结果表明，即使患者未注意到任何感觉障碍，口腔手术也可导致颏部和舌部区域的感觉缺陷。所应用的QST电池组是术后早期研究三叉神经功能的有用工具。鉴于法医意义的增加，该工具可用于客观化临床发现。
