Guerra CO

Language: Spanish
References: 15
Page: 736-749
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ABSTRACT

Introduction: Neurosensory disorders are linked to the removal of retained lower third molars; its misdiagnosis and poor treatment can lead to their long persistence.
Objective: To characterize neurosensory disorders associated with the removal of retained lower third molars from the clinical and therapeutic point of view.
Material and Methods: A quasi-experimental study was conducted in 136 patients with specific inclusion criteria who underwent surgical removal of retained lower third molars in the Dental Faculty of the University of Havana, between 2016-2017. The patients were operated on and examined 3 and 10 days after surgery to identify the presence of neurosensory disorders. Three types of diagnostic tests were used to define the level of neurological function. VAS Scale was used to evaluate the sensitivity level in the patient, and the standardized interview was made to categorize the type of neurosensory disorders. Variables such as age, sex, kind of retention, modification of surgical techniques, and neurosensory findings were recorded.
Results: 3,5% of patients had neurosensory disorders, 2,1% were female. Class III, position C, mesioangular was the most linked retention (2,1%). The inferior dental nerve was the most involved (2,1%), and paresthesia was the most frequent finding (60%). The 60 % of disorders recovered their normal function after 180 days.
Conclusions: The appearance of neurosensory disorders linked to the removal of lower third molars presented a low frequency in the population studied, predominating in the inferior dental nerve, in class III retentions, Position B, mesioangular position; and they are more linked to the surgical techniques of ostectomies and odontosections. Dysesthesia is the most refractory to treatment.

REFERENCES

1. Gintaras J. Injury of the inferior alveolar nerve during implant placement: a literature review. J Oral Maxillofac Res. [Internet]. 2011 Mar [citado:8/01/2018]; 2(1): e1.Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PM C3886063/

2. Wei-Quang W, Chen M, Li Huang H, Jyh Fu, Ming-Tzu T, Jui-Ting H. New quantitative classification of the anatomical relationship between impacted third molars and the inferior alveolar nerve. BMC Med Imaging [Internet]. 2015 Dec [citado:8/01/2018];15:59.Disponible en: https://dx.doi.org/10.1186%2Fs12880-015- 0101-0

3. Deshpande P, Mahima V. G, Karthikeya P. Proximity of impacted mandibular third molars to the inferior alveolar canal and its radiographic predictors: A panoramic radiographic study. Journal Maxillof & Oral Surgery. [Internet]. 2013 Jun [citado:9/01/2018];12(2):145–151. Disponible en: https://dx.doi.org/10.1007%2Fs12663-012- 0409-z

4. Petersen L. Vaeth M, Wenzel A. Neurosensoric disturbances after surgical removal of the mandibular third molar based on either panoramic imaging or cone beam CT scanning: A randomized controlled trial (RCT). British Institute Radiology. Aarhus University, Aarhus, Denmark [Internet]. 2016 Feb [citado:8/01/2018];45(2). Disponible en: https://dx.doi.org/10.1259%2Fdmfr.20150224

5. Ozen T, Orhan, K, Ilker G, Efficacy of low level laser therapy on neurosensory recovery after injury to the inferior alveolar nerve. Head Face Med. [Internet].2006 Feb [citado:8/01/2018]; 2(1):3. Disponible en: https://dx.doi.org/10.1186%2F1746-160X-2-3

6. Sarikov R,Gintaras J. Inferior alveolar nerve injury after mandibular third molar extraction: a literature review. J Oral Maxillofacial Res. [Internet]. 2014 Oct [citado: 9/01/2018];5(4): e1. Disponible en: https://dx.doi.org/10.5037%2Fjomr.2014.5401

7. La Monaca G. Prevention of neurological injuries during mandibular third molar surgery: technical notes. Ann Stomatol(Roma). [Internet]. 2017 jun[citado:10/01/2018]; 8(2): 45–52. Disponible en: https://dx.doi.org/10.11138%2Fads%2F2017.8.2 .053

8. Charan Babu H., Praveen B. R, Rajesh Kumar B. P, Desai R. A. B. Shubha. Factors influencing lingual nerve paraesthesia following third molar surgery: A prospective clinical study. J Maxillofac Oral Surg. [Internet]. 2013 Jun [citado:10/01/2018];12(2):168–172. Disponible en: https://link.springer.com/article/10.1007%2Fs12 663-012-0391-5

9. Yadal S. Post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve in mandibular fracture: a prospective study. J Korean Assoc Maxillofac Surg. [Internet]. 2016 Oct[citado:11/01/2018];42(5):259–264. Disponible en: https://dx.doi.org/10.5125%2Fjkaoms.2016.42.5 .259

10. Akashi M. Hiraoka Y, Hasegawa T, Komori T. Temporal evaluation of neurosensory complications after mandibular third molar extraction: Current problems for diagnosis and treatment. Open Dent J. [Internet]. 2016 Dec[citado:10/01/2018];10:728-732.Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PM C5299585/

11. Gintaras J, Povilas D. Mandibular third molar impaction: Review of literature and a proposal of a classification. J Oral Maxillofac Res. [Internet].2013 Apr[citado:11/01/2018];4(2):e1.Disponible en: https://dx.doi.org/10.5037%2Fjomr.2013.4201

12. Ridaura-Ruiz L. Sensibility and taste alterations after impacted lower third molar extractions. A prospective cohort study. Med Oral Patol Oral Cir Bucal. [Internet].2012 Sep[citado:11/01/2018];17(5):e759- e764.Disponible en: https://dx.doi.org/10.4317%2Fmedoral.17890

13. Miloro M. An anatomic study of the lingual nerve in the third molar region. Journal of Oral and Maxillofacial Surgery. [Internet]. 2000 Jan[citado:16/01/2018];58(6), 652-653. Disponible en: https://uic.pure.elsevier.com/en/publications/a n-anatomic-study-of-the-lingual-nerve-in-thethird- molar-region

14. Mavrodi A. Influence of two different surgical techniques on the difficulty of impacted lower third molar extraction and their post-operative complications. Med Oral Patol Oral Cir Bucal. [Internet]. 2015 Sep. [citado: 16/01/2018]; 20(5):e640-e644. Disponible en: https://dx.doi.org/10.4317%2Fmedoral.20605

15. Raiesian SH, Khani M, Khiabani K, Hemmati E, Pouretezad M. Assessment of low-level laser therapy effects after extraction of impacted lower third molar surgery. J Laser Med Sci. [Internet]. 2017 Jan[citado: 18/01/2018]; 8(1):42-45. Disponible en: https://dx.doi.org/10.15171%2Fjlms.2017.08