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牙源性角化囊肿切除术后暂时性感觉神经麻痹:病例报告

The Temporary Mental Nerve Paresthesia as an Outcome of Dentigerous Cyst Removal during Preparation for Dental Implant Placement: A Case Report.

机构信息

Privat Practice of Maxillo-Facial Surgery and Maxillo-Facial Surgery Ward, EMC Hospital, Pilczycka 144, 54-144 Wrocław, Poland.

Academy of Applied Sciences, Health Department, Academy of Silesius in Wałbrzych, Zamkowa 4, 58-300 Wałbrzych, Poland.

出版信息

Medicina (Kaunas). 2023 Apr 5;59(4):711. doi: 10.3390/medicina59040711.

Abstract

The usage of xenograft material is widely used in almost all oral cavity bone defects for regenerative and reconstructive purposes. The presented xenograft usage in the following care report enabled good bone defect healing and enabled the preservation of affected premolars. It is quite common to use any possible variations of bone materials to ensure bone defect improved healing. In some cases, the scope of surgeries requires the removal of each cyst within close proximity to various nerves and vessels. The inferior alveolar, infraorbital, lingual, and mental nerves are those most commonly adjacent to most operating sites in jaw bones. The usage of some additional materials such as collagen sponges, bone substitutes, resorbable membranes, or other additional materials are useful in each bone defect reconstruction but should be handled with care, as described in the following case. Before planning their usage, it is important to perform each surgery with close cone beam computed tomography imaging, which is very helpful to establish the scope of each lesion and the proximity of vital structures. There are a lot of factors that might influence any possible nerve damage, especially the different nerve anatomical variations. Even factors including the subperiosteal preparation and compression of adjacent tissues might influence later nerve function. When the lesion is expanding through the buccal cortical plate and when soft tissue fluctuation is present, some special care is needed. Similar to the presented case, a limitation in crushing, blowing, or any irritation of nerve fibers improves later postoperative outcomes. When the wound and surrounding tissues are handled with care, a limited possibility of any damage or paresthesia can occur. When the nerve itself is damaged or cut, loss of function can be permanent. Immediately after or even prophylactic prescription 1-2 days before the surgery of Vitamin B with NSAIDs (Non-steroidal anti-inflammatory drugs) (or other additional supplementary medicaments can improve nerve function in time. Possible nerve damage can be divided into many etiological factors. A quite different situation arises when the nerve is pulled in by the cyst growth into the cyst wall. The presented case report describes the outcomes of a cyst removal from the mandibular basis and treatment modalities.

摘要

异种移植物材料的使用在几乎所有口腔骨缺损的再生和重建中都得到了广泛应用。在以下护理报告中,异种移植物的使用使骨缺损得到了良好的愈合,并使受影响的前磨牙得以保留。为了确保骨缺损愈合的改善,使用任何可能的骨材料变化是很常见的。在某些情况下,手术范围需要切除每个靠近各种神经和血管的囊肿。下颌骨中最常见的是与大多数手术部位相邻的下牙槽、眶下、舌侧和颏下神经。在每个骨缺损重建中,使用一些额外的材料,如胶原海绵、骨替代物、可吸收膜或其他额外的材料是有用的,但应小心处理,如下例所述。在计划使用这些材料之前,重要的是要进行密切的锥形束计算机断层扫描成像,这对确定每个病变的范围和重要结构的临近程度非常有帮助。有很多因素可能会影响任何可能的神经损伤,尤其是不同的神经解剖学变异。即使是包括骨膜下准备和相邻组织的压缩在内的因素也可能影响后期神经功能。当病变通过颊侧皮质板扩展并且存在软组织波动时,需要特别注意。类似于所呈现的病例,对神经纤维的挤压、吹气或任何刺激的限制可以改善术后结果。当伤口和周围组织得到小心处理时,发生任何损伤或感觉异常的可能性有限。当神经本身受损或切断时,功能丧失可能是永久性的。在手术前或甚至预防性服用维生素 B 和 NSAIDs(非甾体抗炎药)(或其他额外的补充药物)可以及时改善神经功能。神经损伤可能有许多病因。当囊肿生长将神经拉入囊肿壁时,会出现一种截然不同的情况。本病例报告描述了从下颌基底切除囊肿和治疗方式的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/944b/10141477/b3ef716c6d26/medicina-59-00711-g001.jpg

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