Occurrence and remission of loss of sensitivity of inferior alveolar nerve in mandibular fractures

Pellegrini Rocha-Junior, Washington Geraldo; Pavan, Eduardo Pipino; Luz, João Gualberto Cerqueira

doi:10.1590/1982-0216/20212340221

Washington Geraldo Pellegrini Rocha-Junior

Hospital M. Dr. Arthur R. de Saboya, Serviço de Cirurgia e Traumatologia Bucomaxilofacial, São Paulo, São Paulo, Brasil.

http://orcid.org/0000-0003-3624-0105

Eduardo Pipino Pavan

Hospital M. Dr. Arthur R. de Saboya, Serviço de Cirurgia e Traumatologia Bucomaxilofacial, São Paulo, São Paulo, Brasil.

http://orcid.org/0000-0001-7095-8343

João Gualberto Cerqueira Luz

Hospital M. Dr. Arthur R. de Saboya, Serviço de Cirurgia e Traumatologia Bucomaxilofacial, São Paulo, São Paulo, Brasil.

Universidade de São Paulo - USP, Faculdade de Odontologia, Departamento de Cirurgia, Prótese e Traumatologia Maxilofaciais, São Paulo, São Paulo, Brasil.

http://orcid.org/0000-0002-7686-7829

Corresponding address: Prof. Dr. João Gualberto C. Luz, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Brazil, Av. Prof. Lineu Prestes, 2227 - Cidade Universitária, CEP: 02036-021, São Paulo, São Paulo, Brasil, E-mail: jgcluz@usp.br

Conflict of interests: Nonexistent

Figures (2)
Tables (5)

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Figure 1:
Method of carrying out tactile and thermal tests. a) Tactile test with a 30x7 needle. b) Thermal test with a cold cotton swab. c) Dry ice was used in the thermal test (cooling spray solution with temperature of -50^oC, Endo-Ice, Maquira Dental Products, Maringá, PR, Brazil). d) Front view of mental region with 18 points for testing.

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Figure 2:
Mean values of the sensory changes verified by the tactile and thermal sensitivity tests according to the observation period. Pre: preoperative period; POI: immediate postoperative; 7DPO: 7 days postoperatively; 1MPO: 1 month postoperatively; 3MPO: 3 months postoperatively; 6MPO: 6 months postoperatively. Tat: tactile test; Ter: thermal test.

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Table 1:
Mean values of the sensory changes verified by the tactile and thermal sensitivity tests according to the observation period as well as the etiology and significance of the Kruskal-Wallis test

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Table 2:
Mean values of the sensory changes verified by the tactile and thermal sensitivity tests according to the observation period as well as the fracture location and significance of the Kruskal-Wallis test

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Table 3:
Mean values of the sensory changes verified by the tactile and thermal sensitivity tests according to the observation period as well as the type of fracture and significance of the Kruskal-Wallis test

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Table 4:
Mean values of the sensory changes verified by the tactile and thermal sensitivity tests according to the observation period as well as the degree of displacement and significance of the Kruskal-Wallis test

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Table 5:
Mean values of the sensory changes verified by the tactile and thermal sensitivity tests according to the observation period and the type of surgical access as well as significance of the Kruskal-Wallis test

Variable	Etiology	N	Test
			Tactile		Thermal
			Mean	S.D.	Mean	D.D.
Preoperative	Aggression	18	3.44	3.50	3.67	3.50
	Automobile	2	2.00	2.83	1.50	2.12
	Sports	4	2.50	4.36	0.00	0.00
	Motorcycle	21	1.57	2.60	2.10	3.06
	Falls	16	2.00	3.35	1.63	3.05
	Total	61	2.31	3.20	2.28	3.17
	p value		0.555		0.104
Immediate postoperative	Aggression	17	5.00	3.97	4.71	3.98
	Automobile	2	6.50	0.71	8.50	0.71
	Sports	4	5.50	4.04	5.00	3.92
	Motorcycle	21	4.19	3.61	4.62	3.81
	Falls	16	4.25	3.53	4.56	3.44
	Total	60	4.60	3.61	4.78	3.68
	p value		0.784		0.660
7 days postoperatively	Aggression	17	4.53	3.78	4.59	4.03
	Automobile	2	6.50	0.71	8.50	0.71
	Sports	4	4.25	3.59	2.50	4.36
	Motorcycle	21	3.76	3.86	4.00	4.00
	Falls	15	4.00	3.40	3.47	3.42
	Total	59	4.17	3.58	4.08	3.85
	p value		0.883		0.398
1 month postoperatively	Aggression	14	3.29	3.75	2.36	3.10
	Automobile	1	1.00	0.00	2.00	0.00
	Sports	4	3.25	3.40	2.50	4.36
	Motorcycle	21	2.76	3.42	3.24	3.74
	Falls	14	2.50	2.59	2.43	2.90
	Total	54	2.83	3.21	2.72	3.31
	p value		0.985		0.991
3 months postoperatively	Aggression	8	2.25	4.17	1.88	3.56
	Automobile	1	1.00	0.00	1.00	0.00
	Sports	2	0.00	0.00	0.00	0.00
	Motorcycle	17	1.94	3.23	1.59	2.96
	Falls	10	1.20	2.70	0.90	2.23
	Total	38	1.68	3.15	1.37	2.77
	p value		0.681		0.675
6 months postoperatively	Aggression	6	3.00	4.65	2.33	3.83
	Automobile	1	0.00	0.00	0.00	0.00
	Sports	2	0.00	0.00	0.00	0.00
	Motorcycle	13	1.08	2.63	0.62	1.26
	Falls	10	1.00	2.31	0.60	1.58
	Total	32	1.31	2.91	0.88	2.06
	p value		0.796		0.788

Variable	Fracture location	N	Test
			Tactile		Thermal
			Mean	S.D.	Mean	S.D.
Preoperative	Angle	20	3.50	3.59	3.35	3.54
	Condyle	12	1.83	3.33	0.67	1.50
	Body	12	2.33	3.17	2.25	3.52
	Parasymphysis	14	1.07	2.43	2.14	3.39
	Ramus	3	2.00	1.73	2.33	0.58
	Total	61	2.31	3.20	2.28	3.17
	p value		0.236		0.234
Immediate postoperative	Angle	19	4.47	3.32	4.89	3.49
	Condyle	12	2.25	3.44	2.67	3.70
	Body	12	6.00	3.36	5.83	3.56
	Parasymphysis	14	5.36	3.88	5.57	3.72
	Ramus	3	5.67	3.06	4.67	4.04
	Total	60	4.60	3.61	4.78	3.68
	p value		0.102		0.252
7 days postoperatively	Angle	18	4.33	3.46	4.22	3.95
	Condyle	12	1.75	2.45	1.08	1.73
	Body	12	5.83	3.54	5.50	3.85
	Parasymphysis	14	4.79	3.93	5.36	3.92
	Ramus	3	3.33	3.51	3.67	4.73
	Total	59	4.17	3.58	4.08	3.85
	p value		0.044 *		0.053
1 month postoperatively	Angle	16	2.88	3.42	2.31	3.20
	Condyle	12	1.42	1.88	0.58	1.17
	Body	10	4.20	3.52	4.70	3.37
	Parasymphysis	14	3.43	3.48	4.00	3.68
	Ramus	2	0.00	0.00	0.00	0.00
	Total	54	2.88	3.42	2.72	3.31
	p value		0.166		0.018*
3 months postoperatively	Angle	12	1.75	3.36	1.68	3.15
	Condyle	7	0.00	0.00	1.50	3.12
	Body	6	3.00	4.29	0.00	0.00
	Parasymphysis	11	2.27	3.32	2.33	3.27
	Ramus	2	0.00	0.00	1.82	3.13
	Total	38	1.68	3.15	0.00	0.00
	p value		0.270		0.297
6 months postoperatively	Angle	12	1.73	3.26	1.36	2.94
	Condyle	7	0.00	0.00	0.29	0.76
	Body	6	2.60	3.98	1.80	2.49
	Parasymphysis	11	1.25	3.15	0.25	0.71
	Ramus	2	0.00	0.00	0.00	0.00
	Total	32	1.31	2.91	0.88	2.06
	p value		0.497		0.659

Variable	Fracture type	N	Test
			Tactile		Thermal
			Mean	S.D.	Mean	S.D.
Preoperative	Comminuted	2	4.50	6.36	4.50	6.36
	Multiple	5	2.80	3.70	2.80	3.70
	Simple	54	2.19	3.09	2.15	3.06
	Total	61	2.31	3.20	2.28	3.17
	p value		0.715		0.592
Immediate postoperative	Comminuted	2	8.00	1.41	8.50	0.71
	Multiple	5	5.60	3.29	5.20	4.38
	Simple	53	4.38	3.65	4.60	3.64
	Total	60	4.60	3.61	4.78	3.68
	p value		0.290		0.257
7 days postoperativel	Comminuted	2	8.00	1.41	8.50	0.71
	Multiple	5	4.40	3.85	5.00	4.64
	Simple	52	4.00	3.58	3.83	3.78
	Total	59	4.17	3.58	4.08	3.85
	p value		0.304		0.201
1 month postoperatively	Comminuted	2	6.00	1.41	8.50	0.71
	Multiple	4	3.00	4.24	3.75	4.50
	Simple	48	2.69	3.16	2.40	3.07
	Total	54	2.83	3.21	2.72	3.31
	p value		0.365		0.072
3 months postoperatively	Comminuted	2	5.50	0.71	7.50	2.12
	Multiple	4	2.25	4.50	2.25	4.50
	Simple	32	1.38	2.96	0.88	2.06
	Total	38	1.68	3.15	1.37	2.77
	p value		0.093		0.024 *
6 months postoperatively	Comminuted	1	1.00	0.00	2.00	0.00
	Multiple	4	2.25	4.50	2.25	4.50
	Simple	27	1.19	2.76	0.63	1.52
	Total	32	1.31	2.91	0.88	2.06
	p value		0.334		0.226

Variable	Degree of displacement	N	Test
			Tactile		Thermal
			Mean	S.D.	Mean	S.D.
Preoperative	No displacement	11	0.73	2.41	0.55	1.81
	Less than 5mm	31	2.16	2.99	2.42	3.35
	Greater than 5mm	19	3.47	3.60	3.05	3.24
	Total	61	2.31	3.20	2.28	3.17
	p value		0.715		0.592
Immediate postoperative	No displacement	11	3.27	4.03	3.18	4.26
	Less than 5mm	31	5.29	3.45	5.39	3.33
	Greater than 5mm	18	4.22	3.54	4.72	3.79
	Total	60	4.60	3.61	4.78	3.68
	p value		0.249		0.353
7 days postoperatively	No displacement	11	3.09	4.13	3.09	4.32
	Less than 5mm	30	4.90	3.46	4.93	3.79
	Greater than 5mm	18	3.61	3.36	3.28	3.55
	Total	59	4.17	3.58	4.08	3.85
	p value		0.246		0.211
1 month postoperatively	No displacement	10	1.70	3.34	1.10	2.03
	Less than 5mm	29	3.31	3.23	3.72	3.58
	Greater than 5mm	15	2.67	3.11	1.87	2.92
	Total	54	2.83	3.21	2.72	3.31
	p value		0.257		0.048
3 months postoperatively	No displacement	8	0.13	0.35	0.13	0.35
	Less than 5mm	20	2.15	3.54	1.75	3.02
	Greater than 5mm	10	2.00	3.37	1.60	3.20
	Total	38	1.68	3.15	1.37	2.77
	p value		0.499		0.512
6 months postoperatively	No displacement	7	0.00	0.00	0.00	0.00
	Less than 5mm	17	1.94	3.29	1.24	2.51
	Greater than 5mm	8	1.13	3.18	0.88	1.81
	Total	32	1.31	2.91	0.88	2.06
	p value		0.161		0.295

Variable	Surgical access	N	Test
			Tactile		Thermal
			Mean	S.D.	Mean	S.D.
Preoperative	Intra-oral	31	2.29	3.31	2.52	3.41
	Extra-oral	30	2.33	3.13	2.03	2.94
	Total	61	2.31	3.20	2.28	3.17
	p value		0.969		0.715
Immediate postoperative	Intra-oral	31	5.45	3.49	5.74	3.42
	Extra-oral	29	3.69	3.57	3.76	3.73
	Total	60	4.60	3.61	4.78	3.68
	p value		0.046 *		0.029 *
7 days postoperatively	Intra-oral	30	5.23	3.53	5.47	3.76
	Extra-oral	29	3.07	3.35	2.66	3.46
	Total	59	4.17	3.58	4.08	3.85
	p value		0.012 *		0.004 *
1 month postoperatively	Intra-oral	27	3.85	3.36	3.96	3.33
	Extra-oral	27	1.81	2.76	1.48	2.83
	Total	54	2.83	3.21	2.72	3.31
	p value		0.017 *		0.002 *
3 months postoperatively	Intra-oral	17	2.12	3.46	1.41	2.72
	Extra-oral	21	1.33	2.90	1.33	2.87
	Total	38	1.68	3.15	1.37	2.77
	p value		0.306		0.383
6 months postoperatively	Intra-oral	15	1.67	3.22	0.93	2.46
	Extra-oral	17	1.00	2.67	0.82	1.70
	Total	32	1.31	2.91	0.88	2.06
	p value		0.514		0.814

[1] Corresponding address: Prof. Dr. João Gualberto C. Luz, Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Brazil, Av. Prof. Lineu Prestes, 2227 - Cidade Universitária, CEP: 02036-021, São Paulo, São Paulo, Brasil, E-mail: jgcluz@usp.br

Brasil

Brasil

Occurrence and remission of loss of sensitivity of inferior alveolar nerve in mandibular fractures

ABSTRACT

Purpose:

Methods:

Results:

Conclusion: