Assessing nerve injuries in oral surgery: a survey-based study on prevention and management.

IF 2.1 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
N Agbulut
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Abstract

Background: Understanding and mitigating iatrogenic nerve injuries, specifically IAN and LN, is crucial in the field of oral and maxillofacial surgery. These injuries may lead to profound sensory deficits, pain syndromes, and impaired quality of life for patients. This study aims to assess the prevention and management practices for inferior alveolar nerve and lingual nerve injuries among dental professionals. By gathering data through a survey, the study seeks to evaluate current experiences, awareness, and protocols, ultimately contributing to improved guidelines for nerve injury management.

Material and methods: This cross-sectional study utilized an online survey distributed via Turkish Dental Association to registered dentists and specialists. The predictor variables were the procedure types associated with nerve injuries. The main outcome variables were preventive measures and patient management strategies. Demographic profiling including age, years in profession, specialty, and type of current workplace were determined as covariates.

Results: 1477 respondents provided complete answers, with questions addressing demographics, nerve injury incidents, preventive measures, and management strategies. The most reported IAN and LN injuries were linked to dental implant surgery (n=1067), mandibular third molar surgery (n=958), and local anesthesia applications (n=459). Interestingly, more than 30% of participants reported no experience with nerve injuries. For preventive measures in tooth extraction, 281 respondents performed coronectomies, and in implant surgery over 80% of the participants evaluated tomographic images in high-risk cases. Most common management strategies for paresthesia included vitamin B12 (n=1093) and NSAIDs (n=1051). The use of gabapentin, and non-medical treatments like biofeedback and alternative therapies were rarely employed.

Conclusions: The survey revealed a diverse range of practices regarding nerve injury prevention and management, emphasizing the need for evidence-based approaches and consensus guidelines. Understanding current practices for managing IAN and LN injuries can inform future guidelines, reduce complications, and improve patient outcomes in oral and maxillofacial surgery.

口腔外科神经损伤评估:基于调查的预防与处理研究。
背景:了解和减轻医源性神经损伤,特别是IAN和LN,在口腔颌面外科领域至关重要。这些损伤可能导致严重的感觉缺陷、疼痛综合征和患者生活质量受损。本研究旨在探讨牙科专业人员下牙槽神经及舌神经损伤的预防及处理方法。通过调查收集数据,本研究试图评估当前的经验、意识和协议,最终为神经损伤管理的改进指南做出贡献。材料和方法:本横断面研究利用了通过土耳其牙科协会向注册牙医和专家分发的在线调查。预测变量为与神经损伤相关的手术类型。主要结局变量为预防措施和患者管理策略。人口统计特征包括年龄、职业年限、专业和当前工作场所类型被确定为协变量。结果:1477名受访者提供了完整的答案,包括人口统计、神经损伤事件、预防措施和管理策略等问题。报道最多的IAN和LN损伤与种植牙手术(n=1067)、下颌第三磨牙手术(n=958)和局部麻醉应用(n=459)有关。有趣的是,超过30%的参与者报告没有神经损伤的经历。对于拔牙的预防措施,281名受访者进行了冠状切除术,在种植手术中,超过80%的参与者评估了高危病例的断层扫描图像。对于感觉异常最常见的治疗策略包括维生素B12 (n=1093)和非甾体抗炎药(n=1051)。很少使用加巴喷丁以及生物反馈和替代疗法等非医学治疗。结论:调查揭示了神经损伤预防和治疗的各种实践,强调了循证方法和共识指南的必要性。了解目前处理IAN和LN损伤的做法可以为未来的指导提供信息,减少并发症,并改善口腔颌面外科患者的预后。
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来源期刊
Medicina Oral Patologia Oral Y Cirugia Bucal
Medicina Oral Patologia Oral Y Cirugia Bucal DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.60
自引率
0.00%
发文量
52
审稿时长
3-8 weeks
期刊介绍: 1. Oral Medicine and Pathology: Clinicopathological as well as medical or surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, as well as orofacial neurological disorders, and systemic conditions with an impact on the oral cavity. 2. Oral Surgery: Surgical management aspects of diseases affecting oral mucosa, salivary glands, maxillary bones, teeth, implants, oral surgical procedures. Surgical management of diseases affecting head and neck areas. 3. Medically compromised patients in Dentistry: Articles discussing medical problems in Odontology will also be included, with a special focus on the clinico-odontological management of medically compromised patients, and considerations regarding high-risk or disabled patients. 4. Implantology 5. Periodontology
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