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临床中对下颌和舌神经创伤损伤的深入了解:从诊断到治疗干预的全面方法。

Clinical insights into traumatic injury of the inferior alveolar and lingual nerves: a comprehensive approach from diagnosis to therapeutic interventions.

机构信息

Clinic of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 1, D-55131, Mainz, Germany.

Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glückstraße 11, 91054, Erlangen, Germany.

出版信息

Clin Oral Investig. 2024 Mar 15;28(4):216. doi: 10.1007/s00784-024-05615-4.

Abstract

OBJECTIVES

This scoping review explores the risk and management of traumatic injuries to the inferior alveolar and lingual nerves during mandibular dental procedures. Emphasizing the significance of diagnostic tools, the review amalgamates existing knowledge to offer a comprehensive overview.

MATERIALS AND METHODS

A literature search across PubMed, Embase, and Cochrane Library informed the analysis.

RESULTS

Traumatic injuries often lead to hypo-/anesthesia and neuropathic pain, impacting individuals psychologically and socially. Diagnosis involves thorough anamnesis, clinical-neurological evaluations, and radiographic imaging. Severity varies, allowing for conservative or surgical interventions. Immediate action is recommended for reversible causes, while surgical therapies like decompression, readaptation, or reconstruction yield favorable outcomes. Conservative management, utilizing topical anesthesia, capsaicin, and systemic medications (tricyclic antidepressants, antipsychotics, and serotonin-norepinephrine-reuptake-inhibitors), proves effective for neuropathic pain.

CONCLUSIONS

Traumatic nerve injuries, though common in dental surgery, often go unrecorded. Despite lacking a definitive diagnostic gold standard, a meticulous examination of the injury and subsequent impairments is crucial.

CLINICAL RELEVANCE

Tailoring treatment to each case's characteristics is essential, recognizing the absence of a universal solution. This approach aims to optimize outcomes, restore functionality, and improve the quality of life for affected individuals.

摘要

目的

本范围综述探讨了下颌牙科手术中下颌下神经和舌神经创伤损伤的风险和管理。强调诊断工具的重要性,综述综合了现有知识,提供了全面的概述。

材料与方法

文献检索涵盖了 PubMed、Embase 和 Cochrane Library。

结果

创伤性损伤常导致感觉减退/麻木和神经病理性疼痛,对个体的心理和社交产生影响。诊断包括详细的病史、临床神经评估和影像学检查。严重程度不一,可采用保守或手术干预。建议对可逆原因采取即时行动,而对于减压、重新适应或重建等手术疗法则可获得良好的效果。对于神经病理性疼痛,保守治疗,如局部麻醉、辣椒素和全身性药物(三环抗抑郁药、抗精神病药和 5-羟色胺去甲肾上腺素再摄取抑制剂)是有效的。

结论

尽管在牙科手术中很常见,但创伤性神经损伤往往未被记录。尽管缺乏明确的诊断金标准,但对损伤及其后续损伤进行细致的检查至关重要。

临床相关性

针对每个病例的特点定制治疗方案至关重要,因为不存在通用的解决方案。这种方法旨在优化结果,恢复功能,提高受影响个体的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/342a/10942925/ab5a9a8dfd5b/784_2024_5615_Fig1_HTML.jpg

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