DOI:

10.37988/1811-153X_2025_1_152

The influence of periosteal osteosynthesis on the course of inferior alveolar nerve neuropathy in mandibular fractures

Downloads

Authors

  • Z.E. Gorodkov 1, 2, postgraduate at the Surgical Dentistry and Maxillofacial surgery Department; maxillofacial surgeon
    ORCID: 0000-0002-3361-5576
  • A.I. Pylkov 1, Doctor of Science in Medicine, full professor of the Oral and maxillofacial surgery Department
    ORCID: 0000-0002-1260-8449
  • P.I. Golavskii 3, assistant at the Therapeutic and surgical dentistry Department
    ORCID: 0000-0001-7173-6515
  • K.S. Kolobovnikov 2, radiologist
    ORCID: 0009-0007-3167-754X
  • 1 Kemerovo State Medical University, 650056, Kemerovo, Russia
  • 2 Kuzbass Clinical Hospital, 650099, Kemerovo, Russia
  • 3 Astana Medical University, 010000, Astana, Kazakhstan

Abstract

The aim of study — to investigate the impact of inferior alveolar canal (IAC) injury caused by a fixation screw during titanium plate osteosynthesis on the recovery of inferior alveolar nerve (IAN) function.
Materials and methods.
A prospective cohort study was conducted involving 142 patients from the maxillofacial surgery department with mandibular fractures treated with titanium plate osteosynthesis between 2019 and 2023. Neurosensory disturbances of the IAN were assessed using the DN4 questionnaire and skin electroexcitability parameters. The recovery of IAN function following mandibular osteosynthesis was analyzed using the Kaplan—Meier method and Cox proportional hazards regression analysis.
Results.
The median recovery time of IAN function was 3 months in the group without IAC injury and 12 months in the group with IAC injury. The probability of IAN function recovery was 3.6 times higher (95% CI: 2.2–5.8) in patients without IAC injury compared to those with IAC injury (p<0.001).
Conclusions.
Mandibular canal injury by screws during osteosynthesis significantly affects the time required for the recovery of inferior alveolar nerve function. Osteosynthesis for mandibular fractures is an additional risk factor for inferior alveolar nerve damage and requires improved precision in positioning the fixation elements to reduce the risk of postoperative complications.

Key words:

inferior alveolar nerve neuropathy, mandibular fractures, mandibular osteosynthesis, mandibular fracture complications, DN4 questionnaire, skin electrical excitability

For Citation

[1]
Gorodkov Z.E., Pylkov A.I., Golavskii P.I., Kolobovnikov K.S. The influence of periosteal osteosynthesis on the course of inferior alveolar nerve neuropathy in mandibular fractures. Clinical Dentistry (Russia).  2025; 28 (1): 152—156. DOI: 10.37988/1811-153X_2025_1_152

References

  1. Smith H., Peek-Asa C., Nesheim D., Nish A., Normandin P., Sahr S. Etiology, diagnosis, and characteristics of facial fracture at a midwestern level I trauma center. J Trauma Nurs. 2012; 19 (1): 57—65. PMID: 22415509
  2. Golavskiy P.I., Pylkov A.I., Gorodkov Zh.E., Shternis T.A., Malkov N.V. Clinical and statistical analysis of maxillofacial trauma in Kuzbass. Clinical Dentistry (Russia). 2021; 4: 114—121 (In Russian). eLIBRARY ID: 47475771
  3. Boffano P., et al. European Maxillofacial Trauma (EURMAT) project: a multicentre and prospective study. J Craniomaxillofac Surg. 2015; 43 (1): 62—70. PMID: 25457465
  4. Ellis E. 3rd, Moos K.F., el-Attar A. Ten years of mandibular fractures: an analysis of 2,137 cases. Oral Surg Oral Med Oral Pathol. 1985; 59 (2): 120—9. PMID: 3856795
  5. Jariod Ferrer Ú.M., Blanco Sanfrutos S., Gavin Clavero M.A., Simon Sanz M.V., Uson Bouthelier T., Nadal Cristobal B. Epidemiological study of the socioeconomic impact of mandible fractures in a Spanish tertiary hospital: Review of the literature. J Maxillofac Oral Surg. 2019; 18 (2): 217—223. PMID: 30996541
  6. Iizuka T., Lindqvist C. Sensory disturbances associated with rigid internal fixation of mandibular fractures. J Oral Maxillofac Surg. 1991; 49 (12): 1264—8. PMID: 1955918
  7. Halpern L.R., Kaban L.B., Dodson T.B. Perioperative neurosensory changes associated with treatment of mandibular fractures. J Oral Maxillofac Surg. 2004; 62 (5): 576—81. PMID: 15122563
  8. Schultze-Mosgau S., Erbe M., Rudolph D., Ott R., Neukam F.W. Prospective study on post-traumatic and postoperative sensory disturbances of the inferior alveolar nerve and infraorbital nerve in mandibular and midfacial fractures. J Craniomaxillofac Surg. 1999; 27 (2): 86—93. PMID: 10342144
  9. Pankratov A.S. The analysis of postoperative complications with the use of modern technologies of osteosynthesis of the lower plate of four-jaw position (to the 130th anniversary of the development Hausmann first plate for fixation of fragments of the lower jaw). Russian Journal of Dentistry. 2016; 5: 237—244 (In Russian). eLIBRARY ID: 27379978
  10. Song Q., Li S., Patil P.M. Inferior alveolar and mental nerve injuries associated with open reduction and internal fixation of mandibular fractures: a Seven Year retrospective study. J Craniomaxillofac Surg. 2014; 42 (7): 1378—81. PMID: 24787242
  11. Champy M., Loddé J.P., Schmitt R., Jaeger J.H., Muster D. Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg. 1978; 6 (1): 14—21. PMID: 274501
  12. Bouhassira D., et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005; 114 (1—2): 29—36. PMID: 15733628
  13. Mouraux A., Marot E., Legrain V. Short trains of intra-epidermal electrical stimulation to elicit reliable behavioral and electrophysiological responses to the selective activation of nociceptors in humans. Neurosci Lett. 2014; 561: 69—73. PMID: 24361132
  14. Kopetsky I., Eremin D., Polunina N., Polunin V., Buslaeva G., Khetagurova A. Rehabilitation of patients with inferior alveolar nerve injuries. Bulletin of Russian State Medical University. 2018; 1: 84—89 (In Russian). eLIBRARY ID: 35121846
  15. Tay A.B., Lai J.B., Lye K.W., Wong W.Y., Nadkarni N.V., Li W., Bautista D. Inferior alveolar nerve injury in trauma-induced mandible fractures. J Oral Maxillofac Surg. 2015; 73 (7): 1328—40. PMID: 25914133
  16. Sinha S.P., Duong T.D.H., Duy T.T., Ko E.W., Chen Y.R., Huang C.S. Penetration of inferior alveolar nerve canal increased by bicortical fixation after bilateral sagittal split osteotomy in mandibular prognathism. Int J Oral Maxillofac Surg. 2022; 51 (2): 200—205. PMID: 33985866

Downloads

Received

October 15, 2024

Accepted

March 7, 2025

Published on

April 7, 2025