Neurosensory disturbances following bone harvesting in the symphysis: a prospective clinical study.
OBJECTIVE
To analyse the occurrence and resolution of neurosensory disturbances following bone harvesting from the symphysis.


METHODS
In 30 patients, skin sensitivity of the chin/lower lip area and pulp sensitivity of all mandibular anterior teeth were assessed preoperatively, at the time of suture removal, at 6 and 12 months postoperatively. In addition, bone defect dimensions of the donor site were measured intraoperatively, and distances from defect margins to adjacent anatomical structures, such as root apices, mental foramen and inferior border of mandible, were assessed postoperatively on a panoramic radiograph.


RESULTS
Pulp sensitivity changes were found in 18.6% of adjacent teeth at the time of suture removal. At the 6-month follow-up, 8.1% of teeth, and at the 12-month re-examination, 0.6% of teeth presented with altered sensitivity. This decrease over time of the number of affected teeth per patients with sensitivity changes was significant (P=2.35e-007). Lower lip hypaesthesia was only observed in one patient postoperatively, with complete resolution at the 6-month follow-up. Radiographic measurements of distances between donor defect and adjacent anatomical structures only reached significant difference for one parameter in patients with sensitivity changes compared with patients without sensitivity changes.


CONCLUSIONS
Patients must be informed about possible transient and long-term sensitivity changes of adjacent teeth and soft tissues following bone harvesting from the chin. However, by correctly placing mucoperiosteal incisions and bone cuts, the risk of sensitivity changes can be minimized.
von Arx
Thomas
T
Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Berne, Berne, Switzerland. thomas.vonarx@zmk.unibe.ch
Häfliger
Jörg
J
Chappuis
Vivianne
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D002680:Chin / Q000000981:diagnostic imaging / Q000294:innervation / Q000601:surgery*; D015331:Cohort Studies; D003782:Dental Pulp / Q000294:innervation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008046:Lip / Q000294:innervation; D008047:Lip Diseases / Q000209:etiology; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000294:innervation / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D011862:Radiography, Panoramic; D012678:Sensation Disorders / Q000209:etiology*; D012867:Skin / Q000294:innervation; D013536:Suture Techniques; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000379:methods; D019227:Tooth Apex / Q000000981:diagnostic imaging / Q000473:pathology