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[下颌管位置接近的阻生第三磨牙手术后下牙槽神经病变的回顾性评估]

[Retrospective evaluation of inferior alveolar nerve neuropathies after impacted third molar surgery with mandibular canal close position].

作者信息

Kuzin A V, Vedyaeva A P, Sogacheva V V, Remizov G V, Potapova A I

机构信息

Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia.

Polyclinic No. 1 of the Office of the President of the Russian Federation, Moscow, Russia.

出版信息

Stomatologiia (Mosk). 2025;104(2):37-40. doi: 10.17116/stomat202510402137.

Abstract

THE AIM OF THE STUDY

Was to reduce the risks of surgical trauma to the inferior alveolar nerve by considering individual topographic and anatomical features, improving diagnostic methods and techniques for removing impacted third molars with close location of the mandibular canal.

MATERIAL AND METHODS

An analysis of cases of postoperative paresthesia of the lower lip and teeth was conducted in patients with trauma to the inferior alveolar nerve after surgery to remove an impacted tooth in the long term.

RESULTS

The frequency of damage to the inferior alveolar nerve after removal of an impacted tooth with close location of the mandibular canal is 18.2%. After 3 months, restoration of the function of the damaged nerve is observed in 84%. Permanent paresthesia lasting a year or more was detected in 4 patients (1.4%).

CONCLUSION

The main causes of nerve trauma during surgery to remove an impacted tooth were identified. The longest periods of neuropathy of the inferior alveolar nerve were found in patients with nerve damage by a drill during root separation, with an interroot type of position of the mandibular canal; and with nerve damage by a sharp edge of a tooth with a combination of lingual location of the mandibular canal and a pronounced root anomaly in the form of hypercementosis and dilaceration.

摘要

研究目的

通过考虑个体的局部解剖特征、改进诊断方法和技术,以降低下颌管位置较近的阻生第三磨牙拔除术中对下牙槽神经的手术创伤风险。

材料与方法

对长期拔除阻生牙后下牙槽神经损伤患者术后下唇和牙齿感觉异常的病例进行分析。

结果

下颌管位置较近的阻生牙拔除术后下牙槽神经损伤的发生率为18.2%。3个月后,84%的受损神经功能得到恢复。4例患者(1.4%)出现持续一年或更长时间的永久性感觉异常。

结论

确定了拔除阻生牙手术中神经损伤的主要原因。在下颌管呈根间型位置且在牙根分离时神经被钻头损伤的患者中,以及在下颌管舌侧位置并伴有以牙骨质增生和牙根弯曲形式存在的明显牙根异常且神经被牙齿尖锐边缘损伤的患者中,发现下牙槽神经病变持续时间最长。

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