Case Report
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Dişsiz Mandibulada Rezidüel Kret Rezorpsiyonu İle İlişkili Uyuşuk Çene Sendromu: Bir Olgu Sunumu

Year 2022, Volume 6, Issue 1, 33 - 38, 22.06.2022
https://doi.org/10.29228/erd.24

Abstract

Kronik, progresif ve irreversibl bir seyir izleyen rezidüel kret rezorpsiyonu (RKR), diş kaybı sonrası birçok lokal ve sistemik faktörün kümülatif etkisi altındaki alveolar remodelinge bağlıdır. Mandibula yüksekliğinin azalması; mental foramenin rezidüel kretteki lokalizasyonunun değişmesine ve “uyuşuk çene sendromu” olarak bilinen mandibular protezlerin baskısı nedeniyle subjektif ağrı ve parestezi ortaya çıkmasına yol açar. Bu olgu sunumunda; mandibulada şiddetli RKR mevcut olan ve subjektif ağrı ve parestezi şikayeti ile başvuran hastanın klinik ve radyolojik bulguları sunulmaktadır. Sağ mandibular dişsiz alveoler krette hassasiyet ve ağrı şikayeti ile kliniğimize başvuran 61 yaşındaki kadın hastanın klinik ve radyolojik muayenesi gerçekleştirilmiştir. İntraoral muayenede, dişsiz mandibular alveol kretinde şiddetli rezorpsiyon saptanmıştır. Panoramik radyografide, sağ mental foramenin alveol kret tepesine çok yakın lokalize olduğu izlenmiştir. Konik ışınlı bilgisayarlı tomografi görüntülemesi mandibuladaki şiddetli atrofiyi ve her iki taraftaki mental foramenin kret tepesinde konumlandığını doğrulayarak hastanın hassasiyet ve ağrı şikayetinin nedeni açıkça ortaya koymuştur. Dişsiz mandibulada RRR, mental foramenin alveolar kret tepesine yakın konumlanmasından dolayı mental sinirin zarar görmesine yol açabilir. Mental sinirin kronik baskıya maruz kalması, mental sinirin dağılım bölgesinde ağrı ve alt dudakta uyuşukluk şikayetine neden olabilir. Özellikle RKR mevcut olan dişsiz ağızlarda, detaylı radyolojik inceleme kesinlikle tanı ve protetik tedavi planlamasının önemli bir bileşeni olarak düşünülmelidir.

References

  • Al-Jabrah O, Al-Shumailan Y. Association of complete denture wearing with the rate of reduction of mandibular residual ridge using digital panoramic radiography. Int. J. Dent. Res. 2014;2(1):20-25.
  • Amorim MM, Prado FB, Borini CB, Bittar TO, Volpato MC, Groppo FC, Caria PHF. The mental foramen position in dentate and edentulous Brazilian’s mandible. Int. J. Morphol. 2008;26(4):981-987.
  • Arifin AZ, Asano A, Taguchi A, Nakamoto T, Ohtsuka M, Tsuda M, Kudo Y, Tanimoto K. Computer-aided system for measuring the mandibular cortical width on dental panoramic radiographs in identifying postmenopausal women with low bone mineral density. Osteoporos Int. 2006;17(5):753-759.
  • Bar-Ziv J, Slasky BS. CT imaging of mental nerve neuropathy: the numb chin syndrome. Am. J. Roentgenol. (AJR) 1997;168(2):371-376.
  • Baskaran RK, Krishnamoorthy, Smith M. Numb chin syndrome--a reflection of systemic malignancy. World. J. Surg. Oncol. 2006;4:52.
  • Bell C. The nervous system of the human body. London: Longman; 1830.
  • Burt RK, Sharfman WH, Karp BI, Wilson WH. Mental neuropathy (numb chin syndrome). A harbinger of tumor progression or relapse. Cancer. 1992;70(4):877-881.
  • Calverley JR, Mohnac AM. Syndrome of the numb chin. Arch. Intern. Med. 1963;112:819-821.
  • Čelebić A, Valentić-Peruzović M, Prpić G, Stipetić J. Alveolar ridge resorption as detected on panoramic radiographs. Acta. Stomatol. Croat. 1993;27(1):17-23.
  • Chapa NJ. Numb chin syndrome: a signal of underlying concern. J. Dent. Hyg. 2014;88(6):348-352.
  • Charalampakis A, Kourkoumelis G, Psari C, Antoniou V, Piagkou M, Demesticha T, Kotsiomitis E, Troupis T. The position of the mental foramen in dentate and edentulous mandibles: clinical and surgical relevance. Folia. Morphol. (Warsz). 2017;76(4):709-714.
  • Colella G, Giudice A, Siniscalchi G, Falcone U, Guastafierro S. Chin numbness: a symptom that should not be underestimated: a review of 12 cases. Am. J. Med. Sci. 2009;337(6):407-410.
  • Dekker H, Schulten EAJM, Ten Bruggenkate CM, Bloemena E, van Ruijven L, Bravenboer N. Resorption of the mandibular residual ridge: A micro-CT and histomorphometrical analysis. Gerodontology. 2018;35(3):221-228.
  • Divya KS, Moran NA, Atkin PA. Numb chin syndrome: a case series and discussion. Br. Dent. J. 2010;208(4):157-160.
  • Kadioglu MN, Senturk MF, Oncul AMT, Cambazoglu M. Repositioning of the mental nerve in case of severe mandibular atrophy: A case series. Int. J. Experiment. Dent. Sci. 2014;3(1):41-43.
  • Kale TP, Patel JN, Bhutani H. Mental nerve repositioning – A case report. Int. J. Dent. Clin. 2010:2(3):58-60.
  • Knezović-Ziatarić D, Celebić A. Mandibular bone mineral density changes in complete and removable partial denture wearers: a 6-month follow-up study. Int. J. Prosthodont. 2003;16(6):661-665.
  • Kovačić I, Knezović Zlatarić D, Celebić A. Residual ridge atrophy in complete denture wearers and relationship with densitometric values of a cervical spine: a hierarchical regression analysis. Gerodontology. 2012;29(2):e935-947.
  • Laurencet FM, Anchisi S, Tullen E, Dietrich PY. Mental neuropathy: report of five cases and review of the literature. Crit. Rev. Oncol. Hematol. 2000;34(1):71-79.
  • Murray D. Full dentures for the aging patient. Barnes IE, Walls A, editors. Gerodontology. Oxford: Wright; 1994, p.146-159.
  • Närhi TO, Ettinger RL, Lam EW. Radiographic findings, ridge resorption, and subjective complaints of complete denture patients. Int. J. Prosthodont. 1997;10(2):183-189.
  • Rimmele F, Maschke H, Großmann A, Jürgens TP. A case report: Numb Chin Syndrome due to thalamic infarction: a rare case. BMC Neurol. 2019;19(1):303.
  • Ryba F, Rice S, Hutchison IL. Numb chin syndrome: an ominous clinical sign. Br. Dent. J. 2010;208(7):283-285.
  • Smith JH, Cutrer FM. Numbness matters: a clinical review of trigeminal neuropathy. Cephalalgia. 2011;31(10):1131-1144.
  • Smith RM, Hassan A, Robertson CE. Numb Chin Syndrome. Curr. Pain. Headache. Rep. 2015;19(9):44.
  • Tallgren A. The continuing reduction of the residual alveolar ridges in complete denture wearers: a mixed-longitudinal study covering 25 years. J. Prosthet. Dent. 1972;27(2):120-132.
  • Vincent B. Sur un signe précoce de certaines ostéites du maxillaire inférieur se terminant par une nécrose. Rev. Trimestr. Suisse d’Odontol. 1896;6:148-163.
  • Watanabe PCA, Issa JPM, Oliveira TM, Monteiro SAC, Iyomasa MM, Regalo SCH, Siéssere S. Morphodigital study of the mandibular trabecular bone in panoramic radiographs. Int. J. Morphol. 2007;25(4):875-880.
  • Xie Q, Närhi TO, Nevalainen JM, Wolf J, Ainamo A. Oral status and prosthetic factors related to residual ridge resorption in elderly subjects. Acta. Odontol. Scand. 1997;55(5):306-313.
  • Yoshioka I, Shiiba S, Tanaka T, Nishikawa T, Sakamoto E, Kito S, Oda M, Wakasugi-Sato N, Matsumoto-Takeda S, Kagawa S, Nakanishi O, Tominaga K, Morimoto Y. The importance of clinical features and computed tomographic findings in numb chin syndrome: a report of two cases. J. Am. Dent. Assoc. 2009;140(5):550-554.
  • Zarb CA, Bolender CL, Hickey JC, Carlsson GE. Boucher's Prosthodontic Treatment for Edentulous Patients. St Louis: Mosby; 1990.

Numb Chin Syndrome Associated With Residual Ridge Resorption In Edentulous Mandible: Report Of A Case

Year 2022, Volume 6, Issue 1, 33 - 38, 22.06.2022
https://doi.org/10.29228/erd.24

Abstract

Residual ridge resorption (RRR), which follows a chronic, progressive, and irreversible course, is due to alveolar remodeling under the influence of cumulative effect of many local and systemic factors after tooth extraction. Decreased height of the mandible leads to change in the location of the mental foramina at the crest of the residual ridge and also subjective pain and paresthesia under mandibular dentures due to the pressure caused by the denture, a phenomenon known as “numb chin syndrome”. In this article, a case with excessive mandibular RRR is presented along with clinical and radiological findings. Clinical and radiological examinations of a 61-year-old female patient who admitted to our clinic with tenderness and soreness complaints in the right mandibular edentulous alveolar ridge were performed. Intraoral examination revealed severe resorption of the edentulous mandibular alveolar ridge. The right mental foramen was observed to be close to the alveolar crest in panoramic radiograph. Cone beam computed tomography scan confirmed the severe mandibular atrophy and mental foramen exposure at the top of the alveolar crest, clearly revealing the cause of the patient’s tenderness and soreness complaints. In the edentulous mandible, RRR predisposes the mental nerve to injury because of the proximity of the mental foramina to the alveolar crest. Chronic pressure on the mental nerve may cause pain in the mental nerve distribution region and numbness in the lower lip. Radiographic examinations should definitely be considered as an indispensable component of diagnosis and prosthetic treatment planning, especially in edentulous patients with RRR.

References

  • Al-Jabrah O, Al-Shumailan Y. Association of complete denture wearing with the rate of reduction of mandibular residual ridge using digital panoramic radiography. Int. J. Dent. Res. 2014;2(1):20-25.
  • Amorim MM, Prado FB, Borini CB, Bittar TO, Volpato MC, Groppo FC, Caria PHF. The mental foramen position in dentate and edentulous Brazilian’s mandible. Int. J. Morphol. 2008;26(4):981-987.
  • Arifin AZ, Asano A, Taguchi A, Nakamoto T, Ohtsuka M, Tsuda M, Kudo Y, Tanimoto K. Computer-aided system for measuring the mandibular cortical width on dental panoramic radiographs in identifying postmenopausal women with low bone mineral density. Osteoporos Int. 2006;17(5):753-759.
  • Bar-Ziv J, Slasky BS. CT imaging of mental nerve neuropathy: the numb chin syndrome. Am. J. Roentgenol. (AJR) 1997;168(2):371-376.
  • Baskaran RK, Krishnamoorthy, Smith M. Numb chin syndrome--a reflection of systemic malignancy. World. J. Surg. Oncol. 2006;4:52.
  • Bell C. The nervous system of the human body. London: Longman; 1830.
  • Burt RK, Sharfman WH, Karp BI, Wilson WH. Mental neuropathy (numb chin syndrome). A harbinger of tumor progression or relapse. Cancer. 1992;70(4):877-881.
  • Calverley JR, Mohnac AM. Syndrome of the numb chin. Arch. Intern. Med. 1963;112:819-821.
  • Čelebić A, Valentić-Peruzović M, Prpić G, Stipetić J. Alveolar ridge resorption as detected on panoramic radiographs. Acta. Stomatol. Croat. 1993;27(1):17-23.
  • Chapa NJ. Numb chin syndrome: a signal of underlying concern. J. Dent. Hyg. 2014;88(6):348-352.
  • Charalampakis A, Kourkoumelis G, Psari C, Antoniou V, Piagkou M, Demesticha T, Kotsiomitis E, Troupis T. The position of the mental foramen in dentate and edentulous mandibles: clinical and surgical relevance. Folia. Morphol. (Warsz). 2017;76(4):709-714.
  • Colella G, Giudice A, Siniscalchi G, Falcone U, Guastafierro S. Chin numbness: a symptom that should not be underestimated: a review of 12 cases. Am. J. Med. Sci. 2009;337(6):407-410.
  • Dekker H, Schulten EAJM, Ten Bruggenkate CM, Bloemena E, van Ruijven L, Bravenboer N. Resorption of the mandibular residual ridge: A micro-CT and histomorphometrical analysis. Gerodontology. 2018;35(3):221-228.
  • Divya KS, Moran NA, Atkin PA. Numb chin syndrome: a case series and discussion. Br. Dent. J. 2010;208(4):157-160.
  • Kadioglu MN, Senturk MF, Oncul AMT, Cambazoglu M. Repositioning of the mental nerve in case of severe mandibular atrophy: A case series. Int. J. Experiment. Dent. Sci. 2014;3(1):41-43.
  • Kale TP, Patel JN, Bhutani H. Mental nerve repositioning – A case report. Int. J. Dent. Clin. 2010:2(3):58-60.
  • Knezović-Ziatarić D, Celebić A. Mandibular bone mineral density changes in complete and removable partial denture wearers: a 6-month follow-up study. Int. J. Prosthodont. 2003;16(6):661-665.
  • Kovačić I, Knezović Zlatarić D, Celebić A. Residual ridge atrophy in complete denture wearers and relationship with densitometric values of a cervical spine: a hierarchical regression analysis. Gerodontology. 2012;29(2):e935-947.
  • Laurencet FM, Anchisi S, Tullen E, Dietrich PY. Mental neuropathy: report of five cases and review of the literature. Crit. Rev. Oncol. Hematol. 2000;34(1):71-79.
  • Murray D. Full dentures for the aging patient. Barnes IE, Walls A, editors. Gerodontology. Oxford: Wright; 1994, p.146-159.
  • Närhi TO, Ettinger RL, Lam EW. Radiographic findings, ridge resorption, and subjective complaints of complete denture patients. Int. J. Prosthodont. 1997;10(2):183-189.
  • Rimmele F, Maschke H, Großmann A, Jürgens TP. A case report: Numb Chin Syndrome due to thalamic infarction: a rare case. BMC Neurol. 2019;19(1):303.
  • Ryba F, Rice S, Hutchison IL. Numb chin syndrome: an ominous clinical sign. Br. Dent. J. 2010;208(7):283-285.
  • Smith JH, Cutrer FM. Numbness matters: a clinical review of trigeminal neuropathy. Cephalalgia. 2011;31(10):1131-1144.
  • Smith RM, Hassan A, Robertson CE. Numb Chin Syndrome. Curr. Pain. Headache. Rep. 2015;19(9):44.
  • Tallgren A. The continuing reduction of the residual alveolar ridges in complete denture wearers: a mixed-longitudinal study covering 25 years. J. Prosthet. Dent. 1972;27(2):120-132.
  • Vincent B. Sur un signe précoce de certaines ostéites du maxillaire inférieur se terminant par une nécrose. Rev. Trimestr. Suisse d’Odontol. 1896;6:148-163.
  • Watanabe PCA, Issa JPM, Oliveira TM, Monteiro SAC, Iyomasa MM, Regalo SCH, Siéssere S. Morphodigital study of the mandibular trabecular bone in panoramic radiographs. Int. J. Morphol. 2007;25(4):875-880.
  • Xie Q, Närhi TO, Nevalainen JM, Wolf J, Ainamo A. Oral status and prosthetic factors related to residual ridge resorption in elderly subjects. Acta. Odontol. Scand. 1997;55(5):306-313.
  • Yoshioka I, Shiiba S, Tanaka T, Nishikawa T, Sakamoto E, Kito S, Oda M, Wakasugi-Sato N, Matsumoto-Takeda S, Kagawa S, Nakanishi O, Tominaga K, Morimoto Y. The importance of clinical features and computed tomographic findings in numb chin syndrome: a report of two cases. J. Am. Dent. Assoc. 2009;140(5):550-554.
  • Zarb CA, Bolender CL, Hickey JC, Carlsson GE. Boucher's Prosthodontic Treatment for Edentulous Patients. St Louis: Mosby; 1990.

Details

Primary Language English
Subjects Dental
Journal Section Case Reports
Authors

Melda Pelin AKKİTAP>
MARMARA UNIVERSITY, FACULTY OF DENTISTRY
0000-0001-7744-6615
Türkiye


Birsay GÜMRÜ> (Primary Author)
MARMARA UNIVERSITY, FACULTY OF DENTISTRY
0000-0002-7734-4755
Türkiye


Sevilay DEVECİ This is me
MARMARA UNIVERSITY, FACULTY OF DENTISTRY
0000-0002-4076-5257
Türkiye


Ender İDMAN>
MARMARA UNIVERSITY, FACULTY OF DENTISTRY
0000-0001-7967-841X
Türkiye

Publication Date June 22, 2022
Published in Issue Year 2022, Volume 6, Issue 1

Cite

APA Akkitap, M. P. , Gümrü, B. , Deveci, S. & İdman, E. (2022). Numb Chin Syndrome Associated With Residual Ridge Resorption In Edentulous Mandible: Report Of A Case . European Journal of Research in Dentistry , 6 (1) , 33-38 . DOI: 10.29228/erd.24