TODENTJ-25-03-2019_TODENTJ-10-728 1553506899 Bentham Open doi@benthamopen.net Bentham Open The Open Dentistry Journal TODENTJ 1874-2106 12 30 2016 10 1 Masaya Akashi Yujiro Hiraoka Takumi Hasegawa Takahide Komori Objective: This retrospective study aimed to report the incidence of neurosensory complications after third molar extraction and also to identify current problems and discuss appropriate management of these complications. Method: Patients who underwent extraction of deeply impacted mandibular third molars under general anesthesia were included. The following epidemiological data were retrospectively gathered from medical charts: type of neurosensory complication, treatment for complication, and outcome. Results: A total 369 mandibular third molars were extracted in 210 patients under general anesthesia during this study period. Thirty-one of the 369 teeth (8.4%) in 31 patients had neurosensory complications during the first postoperative week resulting from inferior alveolar nerve damage. Neurosensory complications lasting from 1 to 3 months postoperatively included 17 cases of hypoesthesia and 8 of dysesthesia in 19 patients. Five cases of hypoesthesia and 4 of dysesthesia in 5 patients persisted over 1 year postoperatively. Sixteen of 369 teeth (4.3%) in 16 patients had persistent neurosensory complications after third molar extraction under general anesthesia. Stellate ganglion block was performed in 4 patients. Early initiation of stellate ganglion block (within 2 weeks postoperatively) produced better outcomes than late stellate ganglion block (over 6 months postoperatively). Conclusion: Refractory neurosensory complications after third molar extraction often combine both hypoesthesia and dysesthesia. Current problems in diagnosis and treatment included delayed detection of dysesthesia and the lack of uniform timing of stellate ganglion block. In the future, routinely inquiring about dysesthesia and promptly providing affected patients with information about stellate ganglion block might produce better outcomes. 12 30 2016 728 732 TODENTJ-10-728 1 10.2174/crossmark_policy opendentistryjournal.com benthamopen.com true Peer Reviewed Single blind Checked with iThenticate 2016-06-30 2016-11-07 2016-12-08 2016-12-30 https://creativecommons.org/licenses/by/4.0/legalcode 10.2174/1874210601610010728 1553506899 https://opendentistryjournal.com/VOLUME/10/PAGE/728/ https://opendentistryjournal.com/contents/volumes/V10/TODENTJ-10-728/TODENTJ-10-728.pdf https://opendentistryjournal.com/contents/volumes/V10/TODENTJ-10-728/TODENTJ-10-728.pdf https://opendentistryjournal.com/contents/volumes/V10/TODENTJ-10-728/TODENTJ-10-728.pdf https://opendentistryjournal.com/contents/volumes/V10/TODENTJ-10-728/TODENTJ-10-728.pdf https://opendentistryjournal.com/contents/volumes/V10/TODENTJ-10-728/TODENTJ-10-728.pdf https://opendentistryjournal.com/contents/volumes/V10/TODENTJ-10-728/TODENTJ-10-728.pdf https://opendentistryjournal.com/contents/volumes/V10/TODENTJ-10-728/TODENTJ-10-728.pdf https://opendentistryjournal.com/contents/volumes/V10/TODENTJ-10-728/TODENTJ-10-728.xml Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. Jerjes W. 102 e1 2006 10.1016/j.tripleo.2006.01.016 Jerjes W, Swinson B, Moles DR, et al. Permanent sensory nerve impairment following third molar surgery: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102 (4) : e1-7. J. Oral Maxillofac. Surg. Leung Y.Y. 70 768 2012 10.1016/j.joms.2011.08.032 Leung YY, Fung PP, Cheung LK. Treatment modalities of neurosensory deficit after lower third molar surgery: a systematic review. J Oral Maxillofac Surg 2012; 70 (4) : 768-78. Int. J. Oral Maxillofac. Surg. Hasegawa T. 42 843 2013 10.1016/j.ijom.2013.01.023 Hasegawa T, Ri S, Shigeta T, et al. Risk factors associated with inferior alveolar nerve injury after extraction of the mandibular third molara comparative study of preoperative images by panoramic radiography and computed tomography. Int J Oral Maxillofac Surg 2013; 42 (7) : 843-51. J. Ir. Dent. Assoc. Mahon N. 60 241 2014 Mahon N, Stassen LF. Post-extraction inferior alveolar nerve neurosensory disturbancesa guide to their evaluation and practical management. J Ir Dent Assoc 2014; 60 (5) : 241-50. J. Oral Maxillofac. Surg. Nogami K. 73 1267 2015 10.1016/j.joms.2015.01.012 Nogami K, Taniguchi S. Stellate ganglion block, compared with xenon light irradiation, is a more effective treatment of neurosensory deficits resulting from orthognathic surgery, as measured by current perception threshold. J Oral Maxillofac Surg 2015; 73 (7) : 1267-74. J. Oral Maxillofac. Surg. Poort L.J. 67 292 2009 10.1016/j.joms.2008.06.076 Poort LJ, van Neck JW, van der Wal KG. Sensory testing of inferior alveolar nerve injuries: a review of methods used in prospective studies. J Oral Maxillofac Surg 2009; 67 (2) : 292-300. J. Maxillofac. Oral Surg. Bhat P. 11 304 2012 10.1007/s12663-012-0335-0 Bhat P, Cariappa KM. Inferior alveolar nerve deficits and recovery following surgical removal of impacted mandibular third molars. J Maxillofac Oral Surg 2012; 11 (3) : 304-8. J. Oral Maxillofac. Res. Sarikov R. 5 e1 2014 10.5037/jomr.2014.5401 Sarikov R, Juodzbalys G. Inferior alveolar nerve injury after mandibular third molar extraction: a literature review. J Oral Maxillofac Res 2014; 5 (4) : e1. Int. J. Oral Maxillofac. Surg. Cheung L.K. 39 320 2010 10.1016/j.ijom.2009.11.010 Cheung LK, Leung YY, Chow LK, Wong MC, Chan EK, Fok YH. Incidence of neurosensory deficits and recovery after lower third molar surgery: a prospective clinical study of 4338 cases. Int J Oral Maxillofac Surg 2010; 39 (4) : 320-6. 10.1155/2012/209474 Fukuda K, Ichinohe T, Kaneko Y. Pain management for nerve injury following dental implant surgery at tokyo dental college hospital. Int J Dent 2012; 2012 : 9. J. Orofac. Pain Melis M. 16 93 2002 Melis M, Zawawi K, al-Badawi E, Lobo Lobo S, Mehta N. Complex regional pain syndrome in the head and neck: a review of the literature. J Orofac Pain 2002; 16 (2) : 93-104. Reg. Anesth. Pain Med. Terakawa Y. 34 553 2009 10.1097/AAP.0b013e3181b4c505 Terakawa Y, Ichinohe T, Kaneko Y. Redistribution of tissue blood flow after stellate ganglion block in the rabbit. Reg Anesth Pain Med 2009; 34 (6) : 553-6. Pain Med. Nogami S. 16 501 2015 10.1111/pme.12618 Nogami S, Yamauchi K, Shiiba S, Kataoka Y, Hirayama B, Takahashi T. Evaluation of the treatment modalities for neurosensory disturbances of the inferior alveolar nerve following retromolar bone harvesting for bone augmentation. Pain Med 2015; 16 (3) : 501-12. Kokubyo Gakkai Zasshi Ka L. 73 40 2006 10.5357/koubyou.73.40 Ka L, Hirata Y, Kobayashi A, Wake H, Kino K, Amagasa T. Treatment results of acupuncture in inferior alveolar and lingual nerves sensory paralysis after oral surgery. Kokubyo Gakkai Zasshi 2006; 73 (1) : 40-6.