title: Evaluation of the treatment modalities for neurosensory disturbances of the inferior alveolar nerve following retromolar bone harvesting for bone augmentation.
abstract: METHODS
  The purpose of this study was to evaluate the treatment modalities for neurosensory disturbances (NSDs) of the inferior alveolar nerve occurring after retromolar bone harvesting for bone augmentation procedures before implant placement.
  
  
  METHODS
  One hundred four patients, of which 49 and 55 exhibited vertical or horizontal alveolar ridge defects in the mandible and maxilla, respectively, were enrolled. Nineteen patients underwent block bone grafting, 38 underwent guided bone generation or autogenous bone grafting combined with titanium mesh reconstruction, and 47 underwent sinus floor augmentation. Using a visual analog scale, we examined subjective symptoms and discomfort related to sensory alteration within the area of the NSDs in these patients. NSDs were clinically investigated using a two-point discrimination test with blunt-tipped calipers. In addition, neurometry was used for evaluation of trigeminal nerve injury. We tested three treatment modalities for NSDs: follow-up observation (no treatment), medication, and stellate ganglion block (SGB).
  
  
  RESULTS
  A week after surgery, 26 patients (25.0%) experienced NSDs. Five patients received no treatment, 10 patients received medication, and 11 patients received SGB. Three months after surgery, patients in the medication and SGB group achieved complete recovery. Current perception threshold values recovered to near-baseline values at 3 months: recovery was much earlier in this group than in the other two groups. SGB can accelerate recovery from NSDs.
  
  
  CONCLUSIONS
  Our results justify SGB as a reasonable treatment modality for NSDs occurring after the harvesting of retromolar bone grafts.
authors.affiliation: Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, Miyagi, Japan.
authors.forename: Shinnosuke
authors.initials: S
authors.lastname: Nogami
authors.forename: Kensuke
authors.initials: K
authors.lastname: Yamauchi
authors.forename: Shunji
authors.initials: S
authors.lastname: Shiiba
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kataoka
authors.forename: Bunichi
authors.initials: B
authors.lastname: Hirayama
authors.forename: Tetsu
authors.initials: T
authors.lastname: Takahashi
mesh_terms: D000328:Adult; D000368:Aged; D000539:Alveolar Process / Q000002:abnormalities / Q000294:innervation* / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000009:adverse effects / Q000592:standards*; D016025:Bone Transplantation / Q000009:adverse effects / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008340:Mandibular Nerve / Q000473:pathology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000592:standards; D016037:Single-Blind Method; D055815:Young Adult
keywords: Inferior Alveolar Nerve; Neurosensory Disturbances; Stellate Ganglion Block