Journal of Oral Medicine and Pain

  • 제41권3호
  • /
  • Pages.118-125
  • /
  • 2016
  • /
  • 2288-9272(pISSN)
  • /
  • 2383-8493(eISSN)
대한안면통증구강내과학회 (Korean Academy of Orofacial Pain and Oral Medicine)
권호 표지
DOI QR코드

DOI QR Code

Clinical Predictors of Permanent Neuropathy in Patients with Peripheral Painful Traumatic Trigeminal Neuropathy

  • Ryu, Ji-Won (Department of Oral Medicine, School of Dentistry, Chosun University) ;
  • Ahn, Jong-Mo (Department of Oral Medicine, School of Dentistry, Chosun University) ;
  • Yoon, Chang-Lyuk (Department of Oral Medicine, School of Dentistry, Chosun University)
  • 투고 : 2016.08.18
  • 심사 : 2016.09.08
  • 발행 : 2016.09.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The aims of this study were to evaluate the clinical characteristics of patients with altered sensation and/or pain, and to determine outcome predictors affecting persistent neuropathy. Methods: Patients who complained an altered sensation or pain following trigeminal nerve trauma were involved in this study. To determine outcome predictors affecting persistent neuropathy, the patients were divided into two groups; transient vs. persistent, and the clinical phenotypes are compared between groups. Data were analyzed with t-tests, chi-square, and multiple regression analyses with 95% confidence interval and p<0.05 significance level. Results: A total of 111 patients were included: 23 with transient and 88 persistent groups. The panoramic result and pin-prick test score were statistically different between the groups. Radiating symptoms after blunt and pinprick stimuli were also significantly different between groups. The results revealed that the presence of a neurologic lesion in the panoramic view result, reduced sensation in the pinprick test, and radiation in the pinprick test could affect the persistent group. Conclusions: The presence of a neurologic lesion in panoramic view result and reduced sensation and radiating symptoms in the pin prick test would be defining features of one of the main clinical features of persistent neuropathy. These features could serve as outcome predictors diagnosing the permanent nerve injury in trigeminal nerve.

키워드

참고문헌

  1. Woda A. Painful posttraumatic trigeminal neuropathy: a recently recognized entity. J Orofac Pain 2013;27:97-98.
  2. Ryu JW, Kwon JS. Dysesthesia after tooth extraction and implant surgery reported by dentists. Korean J Oral Med 2007;32:263-272.
  3. Merrill RG. Prevention, treatment, and prognosis for nerve injury related to the difficult impaction. Dent Clin North Am 1979;23:471-488.
  4. Renton T. Prevention of iatrogenic inferior alveolar nerve injuries in relation to dental procedures. Dent Update 2010;37:350-362, 354-356, 358-360 passim. https://doi.org/10.12968/denu.2010.37.6.350
  5. Renton T, Yilmaz Z. Profiling of patients presenting with posttraumatic neuropathy of the trigeminal nerve. J Orofac Pain 2011;25:333-344.
  6. Benoliel R, Zadik Y, Eliav E, Sharav Y. Peripheral painful traumatic trigeminal neuropathy: clinical features in 91 cases and proposal of novel diagnostic criteria. J Orofac Pain 2012;26:49-58.
  7. Park JW, Choung PH, Kho HS, Kim YK, Chung JW. A comparison of neurosensory alteration and recovery pattern among different types of orthognathic surgeries using the current perception threshold. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:24-33. https://doi.org/10.1016/j.tripleo.2010.03.045
  8. Kraemer HC. Evaluating medical tests: objective and quantitative guidelines. Newbury Park (CA): Sage Publications; 1992.
  9. Hillerup S. Iatrogenic injury to the inferior alveolar nerve: etiology, signs and symptoms, and observations on recovery. Int J Oral Maxillofac Surg 2008;37:704-709. https://doi.org/10.1016/j.ijom.2008.04.002
  10. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet 2006;367:1618-1625. https://doi.org/10.1016/S0140-6736(06)68700-X
  11. Jerjes W, Swinson B, Moles DR, et al. Permanent sensory nerve impairment following third molar surgery: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:e1-e7. https://doi.org/10.1016/S1079-2104(06)00826-2
  12. Osborn TP, Frederickson G Jr, Small IA, Torgerson TS. A prospective study of complications related to mandibular third molar surgery. J Oral Maxillofac Surg 1985;43:767-769. https://doi.org/10.1016/0278-2391(85)90331-3
  13. Wofford DT, Miller RI. Prospective study of dysesthesia following odontectomy of impacted mandibular third molars. J Oral Maxillofac Surg 1987;45:15-19. https://doi.org/10.1016/0278-2391(87)90080-2
  14. Ziccardi VB, Steinberg MJ. Timing of trigeminal nerve microsurgery: a review of the literature. J Oral Maxillofac Surg 2007;65:1341-1345. https://doi.org/10.1016/j.joms.2005.11.090
  15. Benoliel R, Birenboim R, Regev E, Eliav E. Neurosensory changes in the infraorbital nerve following zygomatic fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;99:657-665. https://doi.org/10.1016/j.tripleo.2004.10.014
  16. Mason DA. Lingual nerve damage following lower third molar surgery. Int J Oral Maxillofac Surg 1988;17:290-294. https://doi.org/10.1016/S0901-5027(88)80005-5
  17. Wismeijer D, van Waas MA, Vermeeren JI, Kalk W. Patients' perception of sensory disturbances of the mental nerve before and after implant surgery: a prospective study of 110 patients. Br J Oral Maxillofac Surg 1997;35:254-259. https://doi.org/10.1016/S0266-4356(97)90043-7
  18. Kraut RA, Chahal O. Management of patients with trigeminal nerve injuries after mandibular implant placement. J Am Dent Assoc 2002;133:1351-1354. https://doi.org/10.14219/jada.archive.2002.0050
  19. Hillerup S, Jensen R. Nerve injury caused by mandibular block analgesia. Int J Oral Maxillofac Surg 2006;35:437-443. https://doi.org/10.1016/j.ijom.2005.10.004
  20. Grotz KA, Al-Nawas B, de Aguiar EG, Schulz A, Wagner W. Treatment of injuries to the inferior alveolar nerve after endodontic procedures. Clin Oral Investig 1998;2:73-76. https://doi.org/10.1007/s007840050048
  21. Jaaskelainen SK, Teerijoki-Oksa T, Virtanen A, Tenovuo O, Forssell H. Sensory regeneration following intraoperatively verified trigeminal nerve injury. Neurology 2004;62:1951-1957. https://doi.org/10.1212/01.WNL.0000129490.67954.C2
  22. Bataineh AB. Sensory nerve impairment following mandibular third molar surgery. J Oral Maxillofac Surg 2001;59:1012-1017. https://doi.org/10.1053/joms.2001.25827
  23. Hillerup S. Iatrogenic injury to oral branches of the trigeminal nerve: records of 449 cases. Clin Oral Investig 2007;11:133-142. https://doi.org/10.1007/s00784-006-0089-5
  24. Susarla SM, Lam NP, Donoff RB, Kaban LB, Dodson TB. A comparison of patient satisfaction and objective assessment of neurosensory function after trigeminal nerve repair. J Oral Maxillofac Surg 2005;63:1138-1144. https://doi.org/10.1016/j.joms.2005.04.021
  25. Khawaja N, Renton T. Case studies on implant removal influencing the resolution of inferior alveolar nerve injury. Br Dent J 2009;206:365-370. https://doi.org/10.1038/sj.bdj.2009.258
  26. Friedland B, Donoff B, Dodson TB. The use of 3-dimensional reconstructions to evaluate the anatomic relationship of the mandibular canal and impacted mandibular third molars. J Oral Maxillofac Surg 2008;66:1678-1685. https://doi.org/10.1016/j.joms.2007.08.032
  27. Tantanapornkul W, Okouchi K, Fujiwara Y, et al. A comparative study of cone-beam computed tomography and conventional panoramic radiography in assessing the topographic relationship between the mandibular canal and impacted third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:253-259. https://doi.org/10.1016/j.tripleo.2006.06.060
  28. Tantanapornkul W, Okochi K, Bhakdinaronk A, Ohbayashi N, Kurabayashi T. Correlation of darkening of impacted mandibular third molar root on digital panoramic images with cone beam computed tomography findings. Dentomaxillofac Radiol 2009;38:11-16. https://doi.org/10.1259/dmfr/83819416
  29. Pace NL, Eberhart LH, Kranke PR. Quantifying prognosis with risk predictions. Eur J Anaesthesiol 2012;29:7-16.
  30. Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Prev Vet Med 2000;45:23-41. https://doi.org/10.1016/S0167-5877(00)00115-X