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A Pilot Study for Thermal Threshold Test of Trigeminal Nerve Injuries

삼차신경손상의 온도역치검사에 대한 예비연구

  • Kim, Mee-Eun (Department of Oral Medicine, Dankook University School of Dentistry)
  • 김미은 (단국대학교 치과대학 구강내과학교실)
  • Received : 2012.11.20
  • Accepted : 2012.12.07
  • Published : 2012.12.30

Abstract

Trigeminal nerve injuries due to invasive dental procedures such as implant surgery and extraction is one of the most serious issues in dentistry and may provoke medico-legal problems. Thus, for objective and reliable assessment of nerve injury, a need of QST (quantitative sensory testing) is emphasized and thermal threshold test is an essential part of QST, reported to have acceptable reliability in the orofacial region. This pilot study aimed to evaluate thermal thresholds for limited cases of trigeminal nerve injures. The study investigated 18 clinical cases with trigeminal nerve injuries who visited Department of Oral Medicine, Dankook Univeristy Dental Hospital during the period from May 2011 to Oct 2012. Thermal thresholds was measured by Thermal Sensory Analyzer, TSA-II (Medoc, Israel). Their CDT(cold detection threshold) was significantly decreased in the affected sides compared to the unaffected sides. Other parameters such as WDT(warm detection threshold), CPT(cold pain threshold) and HPT(heat pain threshold) did not show statistical difference between the affected and unaffected sides. Further researches are required to compare thermal thresholds relative to types of nerve deficits such as thermal hyper- or hypoesthesia and hyper- or hypoalgesia for larger sample.

Keywords

Trigeminal nerve injury;QST (quantitative sensory testing);Thermal threshold

Acknowledgement

Supported by : 단국대학교

References

  1. Ellies LG, Hawker PB. The prevalence of altered sensation associated with implant surgery. Int J Oral Maxillofac Implants 1993;8:674-679.
  2. 최영찬, 권정승, 김성택, 안형준. 하악신경 손상 후 발생한 감각부전 환자들에 대한 분석. 대한구강내과학회지. 2009;34:379-385.
  3. Renton T and Yilmaz Z. Profiling of patients presenting with posttraumatic neuropathy of the trigeminal nerve. J Orofac Pain 2011;25:333-344.
  4. 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
  5. Pigg M, Baad-Hansen L, Svensson P, Drangsholt M, List T. Reliability of intraoral quantitative sensory testing (QST). Pain. 2010;148:220-226 https://doi.org/10.1016/j.pain.2009.10.024
  6. Pigg M, Svensson P, List T. orofacial thermal thresholds: time-dependent variability and influence of spatial summation and test site. J Orofacl Pain 2011;25:39-48
  7. Wasner GL, Brock JA. Determinants of thermal pain thresholds in normal subjects. Clin Neurophysiol. 2009;119:2389-2395
  8. 임현대, 이정현, 이유미. 치아임플란트 시술 후 삼차신경에서의 전류인지역치에 대한 연구. 대한구강내과학회지 2007;32:187-199.
  9. 박진형, 유지원, 안종모, 옥수민, 윤창륙. 치과 수술 후 뉴로미터를 이용한 전류인지역치의 변화의 분석. 대한구강내과학회지 2010;35:293-297.
  10. Rolke R, Magerl W, Campbell KW et al. Quantitative sensory testing: a comprehensive protocol for clinical trials. Eur J Pain 2006;10:77-88. https://doi.org/10.1016/j.ejpain.2005.02.003
  11. Rolke R, Baraon R, Maier C: Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values. Pain. 2006;123:231-243. https://doi.org/10.1016/j.pain.2006.01.041
  12. Matos R, Wang K, Jensen JD et al. Quantitative sensory testing in the trigeminal region: site and gender difference. J Orofac Pain 2011;25:161-169.
  13. Essick G, Guest S, Martinez E, Chen C, McGlone F. Site-dependent and subject-related variations in perioral thermal sensitivity. Somatosensory & motor research 2004;21:159-175. https://doi.org/10.1080/08990220400012414
  14. Magerl W, Krumova EK, Baron R, Tolle T, Treede RD, Maier C. Reference data for quantitative sensory testing (QST): refined stratification for age and a novel method for statistical comparison of group data. Pain 2010;151:598-605. https://doi.org/10.1016/j.pain.2010.07.026
  15. Meh D, Denislic M. Quantitative assessment of thermal and pain sensitivity. Journal of the neurological sciences 1994;127:164-169. https://doi.org/10.1016/0022-510X(94)90069-8
  16. Kim HK, Kim KS, Kim ME. Influence of test site and baseline temperature on orofacial thermal thresholds. (unpublished data)
  17. Bcser N, Sand T, Zwart JA. Reliability of cephalic thermal thresholds in healthy subjects. Cephalagia 1998;18:574-582. https://doi.org/10.1046/j.1468-2982.1998.1808574.x
  18. Green BG, Gelhard B. Perception of temperature of oral and facial skin. Somatosens Res. 1987;4:191-200. https://doi.org/10.3109/07367228709144606
  19. Renton T. Prevention of iatrogenic inferior alveolar nerve injuries in relatin to dental procedures. Dent Update 2010;37:350-363.
  20. Poort LJ, van Neck JW, van der Wal KGH. Sensory testing of inferior alveolar nerve injuries: a review of methods used in prospective studies. J Oral Maxillofac Surg 2009;67:292-300. https://doi.org/10.1016/j.joms.2008.06.076