Diş Hekimliğinde Cerrahi Operasyonlar Sonrası Parestezi Gelişen Adli Vakaların Geriye Dönük İncelenmesi

Year 2024, Volume: 38 Issue: 1, 15 - 26, 29.04.2024

İhsan Çağlar Çinar

https://doi.org/10.61970/adlitip.1383809

Abstract

Amaç: Diş hekimliğinde cerrahi müdahaleler çeşitli başarısızlıklar içermektedir, bunlardan en önemlilerinden biri de sinir hasarlarıdır. Sinire verilen hasarın derecesine göre değişen oranlarda paresteziler görülebilmektedir. Bu çalışmanın amacı parestezi görülen vakalarda uygulanan oral cerrahi uygulamaların karşılaştırılmasıdır.

Yöntem: Adli Tıp Kurumu 7. İhtisas Kurulu diş hekimliği bölümüne Nisan 2019- Mayıs 2023 arasında intikal etmiş oral, dental ve maksillofasiyel cerrahi operasyonları sonucu parestezi görülen vakalar retrospektif olarak incelenmiştir. Toplam 387 adet vaka gömük mandibular yirmi yaş cerrahisi, ortognatik cerrahi ve dental implant cerrahisi olarak 3 gruba ayrılmış, gruplar birbiriyle karşılaştırılmış aynı zamanda uygulanan teknik, hastaların demografik özellikleri ve lokal faktörler de incelenmiştir.

Bulgular: Vakaların %58,9’u kadın (229 vaka), %41,1’i erkek (159 vaka) ortalama yaş ise 35.99 ± 10.24 olarak gözlenmiştir (p<0.05). Başarısızlıkların %32,3’ü gömük mandibular yirmi yaş cerrahisi (125 vaka), %18,9’u ortognatik cerrahi (73 vaka) ve %48,8’i dental implant cerrahisidir (189 vaka) (p<0.05). Gömük mandibular yirmi yaş cerrahisinde dişin sürme miktarı, ortognatik cerrahide uygulanan tekniğin tipi, dental implant cerrahisinde ise rezidüel kemik yüksekliği/implantın boyu parestezi meydana gelmesinde istatistiksel olarak anlamlı fark yaratan parametrelerdir (p<0.05).

Sonuç: Bu çalışmanın sınırları içerisinde parestezi dental implant cerrahisi neticesinde ve kadın hastalarda daha fazla meydana gelmektedir. Tüm oral cerrahi işlemlerin parestezi meydana gelmesi noktasında risk içerdiği ve bu durumundan sakınmak için tüm tedbirlerin titizlikle alınması gerektiği akıldan çıkartılmamalıdır.

Keywords

dental implant, parestezi, ortognatik cerrahi, gömük mandibular yirmi yaş dişi

Supporting Institution

Adli Tıp Kurumu

Thanks

Bu çalışmada emeği bulunan Adli Tıp Kurumu Başkanı Dr. Öğr. Üyesi Hızır Aslıyüksek ve 7. İhtisas Kurulu Başkanı Uzm. Dr. Caner Beşkoç'a teşekkürlerimi sunarım.

Evaluation of Postoperative Paresthesia Following Oral Surgery in Documented cases at Forensic Medicine

Abstract

Objective: Surgical procedures applied in dentistry are open to different complications and one of the most important of these complications is nerve damage. Paresthesia occurs at varying rates according to the degree of damage to the affected nerve. The aim of this study is to compare the surgical procedures applied in cases where paresthesia has occurred.

Methods: The study was designed retrospectively on cases referred to the Department of Dentistry of the 7th Specialization Board of the Council of Forensic Medicine between April 2019 and May 2023, with complaints of paresthesia following oral, dental and maxillofacial surgery operations. A total of 387 surgical procedures were divided into 3 groups as impacted mandibular wisdom tooth surgery, orthognathic surgery and dental implant surgery and the groups were compared with each other. The groups were also evaluated in terms of the technique, patient age and gender, and local factor variables applied within themselves.

Results: Of the cases, 58.9% were female (229 people) and 41.1% (159 people) were male (p<0.05) and the mean age was 35.99 ± 10.24. In terms of complication distribution rates, 32.3% (125 people) underwent impacted mandibular wisdom tooth surgery, 18.9% (73 people) underwent orthognathic surgery and 48.8% (189 people) underwent dental implant surgery (p<0.05). The amount of tooth eruption in impacted mandibular wisdom tooth surgery, the type of technique applied in orthognathic surgery, and residual bone height/implant length in dental implant surgery were determined as parameters that made a significant difference in the formation of paresthesia (p<0.01).

Conclusion: Within the limits of this study, nerve damage and paresthesia most often occur after dental implant surgery and in women. However, it should not be forgotten that there is a risk of paresthesia in all oral surgical procedures, and all kinds of precautions should be taken meticulously in order to prevent this situation.

Keywords

paresthesia, dental implant, impacted mandibular wisdom tooth, orthognathic surgery

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