Microsurgical repair of inferior alveolar nerve

Abstract

Introduction Inferior alveolar nerve damage is a well-known risk of dental and oral surgical procedures. A. B. G. Tay et al. (2007) reported that nerve can be damaged by odontectomy (52.1 pct.) (lower third molar), local anesthetics injection (12.3 pct.), orthognatic surgery (12,3 pct.), implant surgery (11,0 pct.), trauma (2,7 pct.), endodontic therapy (1,4 pct.) [1]. Aim The aim of this study is to evaluate microsurgical inferior alveolar nerve repair results. Objectives 1. Evaluate indications for microsurgical inferior alveolar nerve repair. 2. Evaluate factors which affect operation outcomes. 3. Evaluate long term complications after microsurgical inferior alveolar nerve repair. Methods A literature review of English articles was conducted by using MEDLINE (PubMed), ScienceDirect, SpringerLink databases restricted to 2002-2015 and constructed according PRISMA guidelines. Search terms included „Microsurgical inferior alveolar nerve repair”, „Inferior alveolar nerve repair”, „Inferior alveolar nerve neurorrhaphy”. Only studies where follow-up was at least 9 months after operation were included in review. Results B. Ziccardi et al. (2007) stated that absolute indication for microsurgical inferior alveolar nerve repair is a witnessed transection. If at any time there is worsening of the hypoesthesia or development of dysesthesia, then microsurgical intervention would be warranted [2, 3]. Most authors recommend microsurgical inferior alveolar nerve repair when patient feels hypoesthesia, hypoesthesia with pain or anesthesia over 2-4 months, lack of protective reflexes [2, 4-7]. The best guidelines are probably those that are individualized for each patient with respect to their presenting complaints and symptoms [2]. Therefore, it would seem logical to repair the nerve as early as possible once it was.[...].