[Orthognathic surgery. Study of nerve injuries].
The correction of oral and maxillo-facial mal-formations causes lesions to sensitive nerves due to the invasive and traumatic surgery techniques required. Generally neuro-sensory and cutaneous-mucosal defects are reversible, with full recovery within 6-12 months. In a follow-up study (2 and 8 years) we found altered tactile and pain sensitivity in 43% of patients at subjective evaluation, with objective alteration in 17% of the group. Dental sensitivity evaluated by a pulp test showed an increase in for all teeth tested; values were higher for superior than for inferior teeth. Despite the increased pulp sensitivity threshold, due to the surgical damage, no signs of pulp disease were detected. Quality of life was not affected even by such a high subjective change in sensitivity. We therefore believe that patients undergoing orthognathic surgery must be fully informed; they must be made to understand the risks involved, and that damage may occur to sensitive nerves following surgery. All surgeons, including those with experience in the field, should continually seek to improve their skill and learn new techniques, in order to reduce complications to a minimum.
Nardi
P
P
U.O. di Chirurgia Maxillo-Facciale, Dipartimento di Odontostomatologia, Università degli Studi di Firenze, Firenze, Italy.
Guarducci
M
M
Cervino
M
M
D000293:Adolescent; D000328:Adult; D003791:Dental Pulp Test / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D019767:Maxillofacial Abnormalities / Q000601:surgery; D008875:Middle Aged; D009056:Mouth Abnormalities / Q000601:surgery; D010027:Osteotomy / Q000009:adverse effects* / Q000379:methods; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology*; D017060:Patient Satisfaction; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D061221:Trigeminal Nerve Injuries