MANDİBULAR İNTERFORAMİNAL BÖLGEDE DENTAL İMPLANT TEDAVİSİ İLE İLİŞKİLİ NÖROSENSÖRİYEL BOZUKLUKLARIN RETROSPEKTİF ANALİZİ

Yıl 2021, Cilt: 30 Sayı: 3, 251 - 255, 24.12.2021

Cihan Topan Ahmet Emin Demirbaş Nükhet Kütük Alper Alkan

https://doi.org/10.34108/eujhs.1040295

Öz

Bu çalışmanın amacı, dental implant cerrahisinde inferior alveoler sinirin ön loop bölgesinin hasarı kaynaklı nörosensoriyel bozukluk riskini panaromik radyografi ile değerlendirmektir. Dental implant tedavisi yapılmış 1614 hastanın panaromik radyografileri incelenmiş ve mental foramenlere 5 mm'den daha kısa bir mesafede bulunan implantları olan hastalar kayıt altına alınmıştır. Bu hastaların parestezi, anestezi, nöropatik ağrı durumları retrospektif olarak incelenmiştir. 405 hastada, dental implantların mental foramenlere 5 mm'den daha kısa bir mesafede yerleştirilmiş olduğu tespit edilmiştir. Mental foramenler ve dental implantlar arasında 0.6 mm ila 5 mm’lik mesafe olduğu ölçülmüştür. Hiçbir hastada çift taraflı parestezi şikâyeti görülmemiştir. 242 bölgenin beşinde (%2.06) hastaların tek taraflı olarak alt dudaklarında kalıcı parestezi olduğu tespit edilmiştir. Sonuç olarak panoramik radyografi, interforaminal bölgede dental implant planlaması için tamamen güvenilir bir görüntüleme yöntemi değildir. Tedavi öncesi nörosensoriyel bozukluk riskini değerlendirmek için daha ileri görüntüleme yöntemleri gereklidir.

Anahtar Kelimeler

Dental implant, ön loop, panaromik radyografi.

RETROSPECTIVE ANALYSIS OF NEUROSENSORY DISTURBANCES RELATED TO DENTAL IMPLANT PLACEMENT IN MANDIBULAR INTERFORAMINAL REGION

Öz

The aim of this study is to evaluate the risk of neurosensory disturbances resulting from the injury of the anterior loop of the inferior alveolar nerve (IAN) in dental implant surgery with panoramic radiography. Panoramic radiographs of 1614 consecutive patients treated with dental implants were examined, and patients with implants located at a distance less than 5 mm to the mental foramen were recorded. Paresthesia, anesthesia, neuropathic pain was investigated retrospectively. In 405 patients, the implants were located in a distance less than 5 mm to the mental foramen. A range of 0.6 mm to 5 mm distance was detected between the mental foramen and these dental implants. No patient complained of bilateral paresthesia. In five (2.06%) of the 242 regions, it was found that patients had permanent unilateral paresthesia in their lower lips. In conclusion, panoramic radiography is not an entirely reliable imaging method for dental implant planning in the interforaminal region. Methods that are more sophisticated may be required to assess the risk of neurosensory disorder before treatment.

Anahtar Kelimeler

Anterior loop, dental implant, inferior alveolar nerve.

Kaynakça

• Chen Z, Chen D, Tang L, et al. Relationship between the position of the mental foramen and the anterior loop of the inferior alveolar nerve as determined by cone beam computed tomography combined with mimics. J Comput Assist Tomogr 2015; 39:86-93.
• Prados-Frutos JC, Salinas-Goodier C, Manchón Á, et al. Anterior loop of the mental nerve, mental foramen and incisive nerve emergency: tridimensional assessment and surgical applications. Surg Radiol Anat 2017; 39:169-175.
• Jacobs R, Mraiwa N, VanSteenberghe D, et al. Appearance, location, course, and morphology of the mandibular incisive canal: An assessment on spiral CT scan. Dentomaxillofac Radiol 2002; 31:322-327.
• Scarano A, Sinjari B, Murmura G, et al. Neurosensory disturbance of the inferior alveolar nerve after 3025 implant placements. Implant Dent 2017; 26:735-743.
• Alhassani AA, AlGhamdi AST. Inferior alveolar nerve injury in implant dentistry: Diagnosis, causes, prevention, and management. J Oral Implantol 2010; 36:401-407.
• Juodzbalys G, Wang HL, Sabalys G. Injury of the inferior alveolar nerve during implant placement: A literature review. J Oral Maxillofac Res 2011; 2:1-20.
• Velasco-Torres M., Padial-Molina M, Avila-Ortiz G, et al. Inferior alveolar nerve trajectory, mental foramen location and incidence of mental nerve anterior loop. Med Oral Patol Oral Cir Bucal 2017; 22:630-635.
• Kim YK, Park JY, Kim SG, et al. Magnification rate of digital panoramic radiographs and its effectiveness for pre-operative assessment of dental implants. Dentomaxillofac Radiol 2011; 240:76-83.
• Tal H, Moses O. A comparison of panoramic radiography with computed tomography in the planning of implant surgery. Dentomaxillofac Radiol 1991; 20:40-42.
• Angelopoulos C, Thomas SL, Thomas S, et al. Comparison between digital panoramic radiography and cone-beam computed tomography for the identification of the mandibular canal as part of presurgical dental implant assessment. J Oral Maxillofac Surg 2008; 66:2130-2135.
• Loubele M, Jacobs R, Maes F, et al. Image quality vs radiation dose of four cone beam computed tomography scanners. Dentomaxillofacial Radiol 2008; 37:309-318.
• Juodzbalys G, Wang HL. Guidelines for the identification of the mandibular vital structures: practical clinical applications of anatomy and radiological examination methods. J Oral Maxillofac Res 2010; 1:1-15.
• Kuzmanovic DV, Payne AG, Kieser JA, et al. Anterior loop of the mental nerve: a morphological and radiographic study. Clin Oral Implants Res 2003; 14:464-471.
• Rodríguez-Lozano FJ, Sanchez-Pérez A, Moya-Villaescusa MJ, et al. Neuropathic orofacial pain after dental implant placement: review of the literature and case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109:8-12.
• Gümüşok M, Kayadüğün A, Özlem Ü. Anterior loop of the mental nerve and its radiologic imaging: a review. Marmara Dent J 2013; 1:81-83.
• Brito ACRD, Nejaim Y, Freitas DQD, et al. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal, Imag Sci Dent 2016; 46:159-165.
• Gómez-Román G, Lautner NV, Goldammer C, et al. Anterior loop of mandibular canal-a source of possible complication. Implant Dent 2015; 24:578-585.
• Parnia F, Moslehifard E, Hafezeqoran A, et al. Characteristics of anatomical landmarks in the mandibular interforaminal region: A cone-beam computed tomography study. Med Oral Patol Oral Cir Bucal 2012; 17:420-425.
• Vujanovic-Eskenazi A, Valero-James JM, Sánchez-Garcés MA, et al. A retrospective radiographic evaluation of the anterior loop of the mental nerve: comparison between panoramic radiography and cone beam computerized tomography. Med Oral Patol Oral Cir Bucal 2015; 20:2239-2245.
• Forni A, Sánchez-Garcés MA, Gay-Escoda C. Identification of the mental neurovascular bundle: A comparative study of panoramic radiography and computer tomography. Implant Dent 2012; 21:516-521.
• Bartling R, Freeman K, Kraut RA. The incidence of altered sensation of the mental nerve after mandibular implant placement. J Oral Maxillofac Surg 1995; 57:1408-1412.
• Wismeijer DV, Van Waas MAJ, Vermeeren JIJF, et al. Patients’ perception of sensory disturbances of the mental nerve before and after implant surgery: A prospective study of 110 patients. Br J Oral Maxillofac Surg 1997; 35:254-259.