• The Journal of the Korean dental association
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• v.36 no.8 s.351
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• pp.570-575
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• 1998

• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.379-385
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• 2009

The purpose of this study was to present basic data that is needed in comprehension of dysesthesia after mandibular nerve injury and grasp meaning. We analyzed medical records of 59 patients who were diagnosed as dysesthesia after mandibular nerve injury from January 2007 to July 2009. The results are summarized as follows. 1. The most frequent cause was implant surgery (59%) and the most frequent injured branch of mandibular nerve was inferior alveolar nerve(81%). 2. The period passed after nerve injury showed significant interrelationship with level of pain. Visual Analogue Scale(VAS) increased from 4.82 to 6.91 after 6 month. 3. The period passed after nerve injury did not show significant interrelationship with recovery of dysesthesia. But, when conservative treatment was offered at earlier stage, ratio of patients who showed recovery of symptom tended to increase. 4. In computed tomography, level of invasion into inferior alveolar nerve canal did not show significant interrelationship with level of pain and recovery of dysesthesia. Conclusively, in the patients with dysesthesia of mandibular nerve, inferior alveolar nerve injury by dental implant surgery dominated most significant problem. Although level of invasion into inferior alveolar nerve is the most important factor to initiation of dysesthesia, there are other various factors exert more influence on the level of pain or recovery of dysesthesia. Therefore, begining conservative therapy at earlier stage is encouraged. Also, because nerve injuries can occur without direct invasion into nerve canal, so leaving enough safe space from nerve canal is needed for prevention of indirect nerve injury.

• Journal of Oral Medicine and Pain
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• v.36 no.3
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• pp.199-205
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• 2011

During root canal treatment, overinstrumentation with hand or mechanically driven files can perforate the mandibular canal, allowing the extrusion of endodontic sealers, dressing agents, and irrigant solutions out of the tooth and into the canal. The patient may report symptoms such as pain, hyperesthesia, hypoesthesia, anesthesia, dysesthesia and paresthesia. Such problems must be resolved as quickly as possible to avoid irreversible sequelae caused by certain neurotoxic materials that form part of endodontic sealants. Although there have been no controlled trials of treatment protocols involving endodontically related injuries to the inferior alveolar nerve, the normal therapeutic sequence for this complication is the control of pain and inflammation and, whenever possible, the surgical elimination of the cause. However, total resolution of pain and reduction in or disappearance of paraesthesia after a non-surgical management have been reported. Antiepileptic drugs such as gabapentin or pregabalin have been used for the treatment of neuropathic pain. This article describes a case of inferior alveolar nerve(IAN) damage after endodontic treatment of a mandibular right second molar and the treatment with non-surgical approach using prednisone and gabapentin medication, monitoring the patient's condition with clinical neurosensory examination and current perception threshold test(Neurometer).

• Journal of Oral Medicine and Pain
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• v.32 no.2
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• pp.177-185
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• 2007

Iatrogenic injury following dental treatments and the use of local anesthetics may cause taste disorders. The aims of this study were to investigate quantitative and qualitative changes of taste due to unilateral inferior alveolar nerve block anesthesia and further to evaluate potential effects on taste function related to anesthesia or hypoesthesia of inferior alveolar nerve, possibly occurring after dental procedure. 30 healthy volunteers in their twenties participated in this study (male to female = 1:1, mean age of $24.0{\pm}1.8$ years). Each subject received inferior alveolar nerve block anesthesia on his or her right side with 2% lidocaine HCl containing 1:100,000 epinephrine. Before and after anesthesia, electrogustometric test and chemical localized test for salty, sweet, sour and bitter tastes were performed on the eight sites in the oral cavity; right and left anterior and lateral tongue and circumvallate papilla of the tongue and soft palate. Unilateral inferior alveolar nerve anesthesia produced elevation of electrical taste threshold and reduction of intensity ratings for all 4 tastes (salty, sweet, sour and bitter) over anterior and lateral tongue and circumvallate papilla on the ipsilateral side (p<0.05). Contralateral sides exhibited decreased intensity ratings for salty and sweet taste (p<0.05) on anterior and lateral tongue while there was no significant difference in electrogustometric testing. Based on the results of this study, it is assumed that unilateral local anesthesia on inferior alveolar nerve can affect chorda tympani and glossopharyngeal nerves on the same side, leading to taste deficits. Taste intensity on the contralateral side may, in part, be deteriorated as well.

• 대한치주과학회:학술대회논문집
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• 2005.11a
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• pp.113-113
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• 2005

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.327-336
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• 2011

Reported causes of mandibular nerve injury in relation to neuropathic pain in dentistry include extraction, dental implant surgery, oral and maxillofacial surgery, periodontal treatment, and root-canal therapy. This study analyzed the characteristics of pharmacologic management of neuropathy after root-canal therapy. 32 patients who complain of abnormal sensation or pain after root-canal therapy and were referred to Department of Oral Medicine and the Temporomandibular Joint and Orofacial Pain Clinic at the Dental Hospital of Yonsei University, Seoul, Korea from 2004 to 2011 enrolled in this analysis and improvement of symptom was evaluated after pharmacologic management. Thirty-two patients who had hypoesthesia or dysesthesia at the initial visit were analyzed(9 men, 23 women; mean age: 44 years). The causes of neuropathy were local anesthesia(46.9%), chemical trauma from the sealant in root-canal(25%), endodontic surgery(15.6%), and unknown causes(12.5%). Medications such as steroids, anticonvulsants, antidepressants, and analgesics were took for improvement of symptoms and titrated for a variety of period from 1 week to 11 months. It was found that neuropathy of the inferior alveolar nerve and the lingual nerve was in 25 and 7 patients. The improvement of neurosensory disturbance and no improvement after pharmacotherapy was in 21(66%) and 11(34%) patients respectively. The hypoesthesia and dysesthesia was improved 67% and 65% respectively. These results suggest that symptomatic improvement by pharmacologic management can be possible in patients with neuropathy after root-canal therapy. But improvement of symptoms was influenced by the causes and degree of nerve injury, the periods of pharmacotherapy, and the choice of treatment methods. So, further investigation is needed by quantitative measurement of more variables in more individuals.

• Journal of Oral Medicine and Pain
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• v.38 no.3
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• pp.255-260
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• 2013

Bilateral sagittal split ramus osteotomy(BSSRO) of the mandible is an essential and commonly used procedure to correct dentofacial deformities and malocclusion. The possible complications associated with BSSRO include inferior alveolar nerve injury, bleeding, temporomandibular disorder, unfavorable fractures, and clinical relapse. The incidence of facial nerve palsy after orthognathic surgery recently reported is 0.1%. The probable etiologies have included facial nerve compression, complete or incomplete nerve transection, nerve traction, and nerve ischemia from anesthetic injection. Postoperative facial palsy is one of the most serious complications because it reduces the quality of life and significantly reduces social interaction. The case of a 24-year-old patient who underwent bilateral sagittal split ramus osteotomy is described. The medical records and postoperative photographs were reviewed in detail to collect information on the clinical course, treatment, and outcomes.

• The Journal of the Korean dental association
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• v.47 no.4
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• pp.211-224
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• 2009

This retrospective study was to analyze the inferior alveolar nerve and lingual nerve damage after the removal of mandibular third molars. In this questionnaire study, the subjects chosen for this study were 2472 dentists who answered the questionnaire about numbness after the extraction of lower third molars. The data collected by E-mail and web site included the incidence of removal of the lower third molars, the incidence and the experience of numbness of the inferior alveolar nerve and lingual nerve, rate and duration of recovery, the influence in day life after the long-term sensory loss, the period and amount of the indemnity in the case of medical dispute. The results are summarized as follows. 1. The experience rate and the incidence rate of the inferior alveolar nerve numbness by oral surgeons in the past year were19.9% and 0.14%. Those of the lingual nerve by oral surgeon were 7.7% and 0.05%.2. The experience rate and the incidence rate of the inferior alveolar nerve numbness by the dentists except oral surgeons in the past year were 9.7% and 0.19%. Those of the lingual nerve by the dentists except oral surgeons were 5.5% and 0.11%.3. The recovery rate of the inferior alveolar nerve after 1 year and 2 years were 85.6% and 91.3%. The recovery rate of the lingual nerve after 1 year and 2 years were 84.8% and 89.3%.In conclusion, most of numbness may be recovered within 2 years. However the possibility of long term and persistent numbness should not be neglected. Therefore practitioner must inform the possibility of nerve injury and include this possibility in the consent forms.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.3
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• pp.250-257
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• 2001

Sensory dysfunction following the injury of the inferior alveolar nerve requires objective examination to get a reproducible data and to provide necessary treatment. This study was designed to evaluate if the SEP(somatosensory evoked potentials) of the mental nerve can be used as an objective method for the diagnosis of nerve injury and sensory disturbances. The subjects were nineteen patients ($37.4{\pm}11.3$ years old) who had been suffered from sensory disturbance of the unilateral lower lip and mental region for over 6 months after the inferior alveolar nerve injuries confirmed by the microsurgical explorations. The clinical neurosensory tests as SLTD(static light touch discrimination), MDD(moving direction discrimination), 2PD(two point discrimination), PPN(pin prick nociception) and accompanied pain were preceded to electro-physiologic examinations as SEP. The score of sensory dysfunction (sum score of all sensory tests) ranged from 0 to 8 were compared to the latency differences of the mental nerve SEPs. The correlation between clinical sensory scores and SEPs were tested by Spearman nonparametric rank correlation analysis, the differences in SEP latency by Kruskal-Wallis test and the latency differences according to PPN and accompanied pain by Mann-Whitney U test. This study resulted that the difference of the latencies between normal side and affected side was $2.22{\pm}2.46$ msec and correlated significantly with the neurosensory dysfunction scores (p=0.0001). Conclusively, the somatosensory evoked potentials of the mental nerve can be a useful diagnostic method to evaluate the inferior alveolar nerve injuries and the change of sensory dysfunction to be reproduced as an objective assessment.

• Journal of Oral Medicine and Pain
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• v.31 no.1
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• pp.59-67
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• 2006

There exist patients complaining speech problem due to dysesthesia or anesthesia following dental surgical procedure accompanied by local anesthesia in clinical setting. However, it is not clear whether sensory problems in orofacial region may have an influence on motor speech abilities. The purpose of this study was to investigate whether transitory sensory impairment of mandibular nerve by local anesthesia may influence on the motor speech abilities and thus to evaluate possibility of distorted motor speech abilities due to dysesthesia of mandibular nerve. The subjects in this study consisted of 7 men and 3 women, whose right inferior alveolar nerve, lingual nerve and long buccal nerve was anesthetized by 1.8 mL lidocaine containing 1:100,000 epinephrine. All the subjects were instructed to self estimate degree of anesthesia on the affected region and speech discomfort with VAS before anesthesia, 30 seconds, 30, 60, 90, 120 and 150 minutes after anesthesia. In order to evaluate speech problems objectively, the words and sentences suggested to be read for testing speech speed, diadochokinetic rate, intonation, tremor and articulation were recorded according to the time and evaluated using a Computerized Speech $Lab^{(R)}$. Articulation was evaluated by a speech language clinician. The results of this study indicated that subjective discomfort of speech and depth of anesthesia was increased with time until 60 minutes after anesthesia and then decreased. Degree of subjective speech discomfort was correlated with depth of anesthesia self estimated by each subject. On the while, there was no significant difference in objective assessment item including speech speed, diadochokinetic rate, intonation and tremor. There was no change in articulation related with anesthesia. Based on the results of this study, it is not thought that sensory impairment of unilateral mandibular nerve deteriorates motor speech abilities in spite of individual's complaint of speech discomfort.