Sensory testing of inferior alveolar nerve injuries: a review of methods used in prospective studies.
OBJECTIVE
The inferior alveolar nerve (IAN) can be injured during trauma or surgery. So far there is no consensus for evaluating IAN injury. This study aimed to identify a testing method suitable for daily clinical practice which allows us to identify nerve injury, grade its severity, and monitor its recovery.


METHODS
Covering a 20-year period, prospective studies on sensory changes after mandibular procedures were reviewed regarding sensory testing methods; 75 studies on third molar removal, osteotomy, fracture, and implants were included.


RESULTS
These studies reported varying incidences. In third molar removal and implant studies, a limited number of sensory tests were used, whereas in osteotomy and fracture studies more detailed testing was performed, using reproducible tests like light touch test with Semmes-Weinstein monofilaments and 2-point discrimination.


CONCLUSIONS
Sensory function was not uniformly tested and presented, making a comparison of data impossible and highlighting the need for uniform testing methodology. Based on the results of this review, the light touch test with Semmes-Weinstein monofilaments for grading is recommended, using a grid and control site describing unilateral or bilateral nerve injury. Additionally, a visual analog scale-based questionnaire should be used to evaluate subjective sensibility. Using this method to test IAN injuries will allow comparison of future studies and provide valuable insight in the severity and prognosis of IAN injuries.
Poort
Lucas J
LJ
Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. l.poort@erasmusmc.nl
van Neck
Johan W
JW
van der Wal
Karel G H
KG
D020209:Cranial Nerve Injuries / Q000175:diagnosis* / Q000209:etiology; D003758:Dental Implantation, Endosseous / Q000009:adverse effects; D006801:Humans; D008337:Mandibular Fractures / Q000150:complications; D008465:Mechanoreceptors / Q000502:physiology; D008964:Molar, Third / Q000601:surgery; D009460:Neurologic Examination / Q000379:methods*; D009619:Nociceptors / Q000502:physiology; D010027:Osteotomy / Q000009:adverse effects; D011446:Prospective Studies; D020886:Somatosensory Disorders / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D013697:Thermosensing; D014081:Tooth Extraction / Q000009:adverse effects; D055698:Touch Perception; D061221:Trigeminal Nerve Injuries