Federico Biglioli1, Otilija Kutanovaite2, Luca Autelitano1, Alessandro Lozza3, Laura Moneghini4, Gaetano Bulfamante4, Fabiana Allevi5. 1. Maxillofacial Surgical Unit, San Paolo Hospital, Department of Health Sciences, University of Milan, Via di Rudini' 8, 20142, Milan, Italy. 2. Maxillofacial Surgery Department, Vilnius University Hospital Zalgiris Clinics, Vilnius, Lithuania. 3. Neurophysiopathology Service, C. Mondino National Neurological Institute, Pavia, Italy. 4. Unit of Pathology, Department of Health Sciences, San Paolo Hospital, Scienze della Salute Department, University of Milan, Milan, Italy. 5. Maxillofacial Surgical Unit, San Paolo Hospital, Department of Health Sciences, University of Milan, Via di Rudini' 8, 20142, Milan, Italy. fabiana.allevi@gmail.com.
Abstract
PURPOSE: Injuries of the inferior alveolar nerve (IAN) related to endodontic treatment are being increasingly reported. However, consensus on the preferred intervention and the timing of and indications for surgical treatment is lacking. Here, we describe our experience with painful IAN injuries arising from endodontic treatment and requiring prompt microsurgical treatment. METHODS: Seven consecutive patients with painful IAN injuries were referred to the Maxillofacial Surgery Unit of San Paolo Hospital in Milan. All patients had undergone root canals endodontic treatment in the mandibular molar or premolar between 2007 and 2014. The time elapsed between injury and referral for surgical treatment ranged from 10 days to 20 months. Each patient was treated by one of several different microsurgical procedures, described herein. RESULTS: Overall, neurosensory status and IAN-related pain improved in all seven patients. The best results were obtained by IAN replacement with a sural nerve graft. However, complete sensory recovery was not achieved in any of the patients. CONCLUSIONS: Although our sample includes only seven patients, early surgical treatment with an interpositional sural nerve graft seems to allow neurosensory recovery. Less satisfactory results are achieved in patients with IAN injuries of > 12 months duration.
PURPOSE: Injuries of the inferior alveolar nerve (IAN) related to endodontic treatment are being increasingly reported. However, consensus on the preferred intervention and the timing of and indications for surgical treatment is lacking. Here, we describe our experience with painful IAN injuries arising from endodontic treatment and requiring prompt microsurgical treatment. METHODS: Seven consecutive patients with painful IAN injuries were referred to the Maxillofacial Surgery Unit of San Paolo Hospital in Milan. All patients had undergone root canals endodontic treatment in the mandibular molar or premolar between 2007 and 2014. The time elapsed between injury and referral for surgical treatment ranged from 10 days to 20 months. Each patient was treated by one of several different microsurgical procedures, described herein. RESULTS: Overall, neurosensory status and IAN-related pain improved in all seven patients. The best results were obtained by IAN replacement with a sural nerve graft. However, complete sensory recovery was not achieved in any of the patients. CONCLUSIONS: Although our sample includes only seven patients, early surgical treatment with an interpositional sural nerve graft seems to allow neurosensory recovery. Less satisfactory results are achieved in patients with IAN injuries of > 12 months duration.
Authors: Paul Coulthard; Evgeny Kushnerev; Julian M Yates; Tanya Walsh; Neil Patel; Edmund Bailey; Tara F Renton Journal: Cochrane Database Syst Rev Date: 2014-04-16
Authors: Shahrokh C Bagheri; Roger A Meyer; Husain Ali Khan; Amy Kuhmichel; Martin B Steed Journal: J Oral Maxillofac Surg Date: 2009-12-29 Impact factor: 1.895