Prediction of recovery from neurosensory deficit after bilateral sagittal split osteotomy.
OBJECTIVE
To observe the suitability of different combinations of readily available tests to predict recovery from a neurosensory deficit after bilateral sagittal split osteotomy (BSSO).


METHODS
Thirty patients scheduled for BSSO were examined before surgery and 4 days, 3 weeks, 3 months, 6 months, and 1 year after surgery. At each follow-up, the patients self-evaluated the subjective neurosensory deficit of the lower lip and chin of both sides. Neurosensory function was also measured by tests consisting of light touch, 2-point discrimination, pin tactile discrimination, thermal discrimination, and sensibility testing of the mandibular molars. The positive predictive values (PPV) of each test for recovery from the neurosensory deficit were calculated. Furthermore, different tests were combined, and the PPVs for recovery from the neurosensory deficit of these combinations were analyzed.


RESULTS
A positive response to sensibility testing of the mandibular first and second molars 4 days and 3 weeks after surgery was related to a PPV of 100% and 87%, respectively, for full recovery from sensation loss at 1 year. However, none of the tests alone could reliably predict recovery from the neurosensory deficit after BSSO. When 3 different tests were combined, the best results were achieved by the combinations of a light test or a 2-point discrimination test and a pin tactile test with the sensibility testing of mandibular molars.


CONCLUSIONS
Sensibility testing of mandibular molars can be used to predict recovery from the neurosensory deficit after BSSO. The best positive predictive ability can be achieved by combining a mechanoceptive test, a nociceptive test, and sensibility testing of mandibular molars.
Ylikontiola
L
L
Institute of Dentistry, University of Oulu, Finland. leena.ylikontiola@oulu.fi
Kinnunen
J
J
Laukkanen
P
P
Oikarinen
K
K
D000293:Adolescent; D000328:Adult; D002680:Chin / Q000294:innervation; D004056:Differential Threshold; D005260:Female; D006801:Humans; D008046:Lip / Q000294:innervation; D008297:Male; D008334:Mandible / Q000601:surgery*; D008340:Mandibular Nerve / Q000503:physiopathology; D008875:Middle Aged; D008963:Molar / Q000294:innervation; D009460:Neurologic Examination / Q000379:methods*; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D010027:Osteotomy / Q000009:adverse effects; D011237:Predictive Value of Tests; D011379:Prognosis; D020886:Somatosensory Disorders / Q000175:diagnosis*; D061221:Trigeminal Nerve Injuries