Salles M B, Horikawa F K, Allegrini S, Zangrando D, Yoshimoto M, Shinohara E H
Marcelo Yoshimoto Institute, Brazil.
Depart. Oral and Maxillofac. Surg. Hospital Regional de Osasco SUS, São Paulo, Brazil.
Heliyon. 2023 Jul 20;9(8):e18304. doi: 10.1016/j.heliyon.2023.e18304. eCollection 2023 Aug.
There is a great effort from numerous research groups in the development of materials and therapeutic strategies for the functional recovery of patients who have suffered peripheral nerve injuries (PNI). In an article , the formation of a nerve bridge was observed, reconnecting the distal and proximal stumps, in the sciatic nerve of rats, indicating the effective participation of the biomaterial in the recovery of peripheral nerve injuries. For the current pilot study, 15 cases of multiple fractures of the mandible, with involvement of the inferior alveolar nerve (IAN) were selected and studied: JC (control cases) n = 6 with conventional treatment, and JT (treated cases) n = 9, with the use of biomimetic biomaterial. The evaluation of the return to sensitivity was measured through a self-assessment, where the patients assigned scores from 0 to 10, where zero (0) represented the complete absence of sensitivity and ten (10) the normality of the perception of local sensitivity. Patients were evaluated from the preoperative period to the 360th day. The statistical results obtained by the t-Student, Shapiro-Wilk normality and non-parametric One-Way ANOVA tests indicated statistically significant differences ( < 0.005; 0.005 e 0.5 respectively), between the two treatments, which were reflected in the clinical results observed, we also calculate the size of the effect represented by , calculated by Cohen's . The results indicate a great difference between the treatments performed = 1.00. In the 6 cases followed up in the JC group, four remained with a significant deficit until the end of the evaluations and two indicated the remission of the lack of sensitivity in this period. In the JT group, in 28 days, all cases indicated complete remission of the lack of sensitivity with healing concentration. In one of the cases where there was a complete rupture of the mental nerve, the (score-10) was observed in 60 days. The observed results indicate the existence of a statistical significance between the groups and an important relationship when using the biomimetic biomaterial during the recovery of the perception of sensitivity in polytraumatized patients, compatible with the results observed in laboratory animals, which may indicate its clinical feasibility in the reduction of sequelae in PNI.
众多研究团队在为遭受周围神经损伤（PNI）的患者开发功能恢复材料和治疗策略方面付出了巨大努力。在一篇文章中，观察到在大鼠坐骨神经中形成了神经桥，重新连接了远端和近端残端，这表明生物材料在周围神经损伤恢复中发挥了有效作用。在当前的初步研究中，选择并研究了15例下颌骨多发骨折且累及下牙槽神经（IAN）的病例：JC（对照病例）n = 6，采用传统治疗；JT（治疗病例）n = 9，使用仿生生物材料。通过自我评估来测量感觉恢复情况，患者给出0到10分的评分，其中零（0）表示完全没有感觉，十（10）表示局部感觉正常。对患者从术前到第360天进行评估。通过t检验、夏皮罗-威尔克正态性检验和非参数单因素方差分析获得的统计结果表明，两种治疗方法之间存在统计学显著差异（分别为<0.005、0.005和0.5），这反映在观察到的临床结果中，我们还计算了由科恩效应量表示的效应大小。结果表明所进行的治疗之间存在很大差异=1.00。在JC组随访的6例病例中，4例在评估结束时仍有明显缺陷，2例在此期间表明感觉缺失缓解。在JT组中，28天时所有病例均表明感觉缺失随着愈合浓度完全缓解。在其中一例颏神经完全断裂的病例中，60天时观察到（评分-10）。观察到的结果表明两组之间存在统计学显著性，并且在多发伤患者感觉恢复过程中使用仿生生物材料时存在重要关系，这与在实验动物中观察到的结果相符，这可能表明其在减少PNI后遗症方面的临床可行性。
