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Rieder M, Remschmidt B, Schrempf V, Schwaiger M, Jakse N, Kirnbauer B. Neurosensory Deficits of the Mandibular Nerve Following Extraction of Impacted Lower Third Molars-A Retrospective Study. J Clin Med 2023; 12:7661. [PMID: 38137730 PMCID: PMC10743649 DOI: 10.3390/jcm12247661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/06/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Neurosensory deficits are one of the major complications after impacted lower third molar extraction leading to an impaired patient's quality of life. This study aimed to evaluate the incidence of neurosensory deficits after lower third molar extraction and compare it radiologically to the corresponding position of the inferior alveolar nerve. METHODS In a retrospective study, all patients who underwent impacted lower third molar extraction between January and December 2019 were compiled. Therefore, clinical data as well as preoperative radiological imaging were assessed. RESULTS In total, 418 patients who underwent lower third molar extractions (n = 555) were included in this study. Of these, 33 (5.9%) had short-term (i.e., within the initial 7 postoperative days) and 12 (1.3%) long-term (i.e., persisting after 12 months) neurosensory deficits documented. The inferior alveolar nerve position in relation to the tooth roots showed apical position in 27%, buccal position in 30.8%, lingual position in 35.4%, and interradicular position in 6.9%. CONCLUSIONS A statistically significant increased incidence of neurosensory deficits occurs when the inferior alveolar nerve is directly positioned lingually to the tooth roots (p = 0.01).
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Affiliation(s)
- Marcus Rieder
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria;
| | - Bernhard Remschmidt
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria;
| | - Vera Schrempf
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria (M.S.); (N.J.); (B.K.)
| | - Matthäus Schwaiger
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria (M.S.); (N.J.); (B.K.)
| | - Norbert Jakse
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria (M.S.); (N.J.); (B.K.)
| | - Barbara Kirnbauer
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria (M.S.); (N.J.); (B.K.)
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Marques DP, Chacur M, Martins DO. Photobiomodulation and vitamin B treatment alleviate both thermal and mechanical orofacial pain in rats. Photochem Photobiol Sci 2023; 22:2315-2327. [PMID: 37340216 DOI: 10.1007/s43630-023-00452-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/12/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE The present study investigates the efficacy of Photobiomodulation (PBM) and Vitamin B Complex (VBC) to relieve pain, both in separately and combined (PBM and VBC). METHODS Rats with chronic constriction injury of the right infraorbital nerve (CCI-IoN) or Sham surgery were used. PBM was administered at a wavelength of 904 nm and energy density of 6.23 J/cm2 and VBC (containing B1, B6 and B12) subcutaneously, both separately and combined. Behavioral tests were performed to assess mechanical and thermal hypersensitivity before and after CCI and after PBM, VBC, or PBM + VBC. The expression of inflammatory proteins in the trigeminal ganglion and the immunohistochemical alterations of Periaqueductal Gray (PAG) astrocytes and microglia were examined following CCI and treatments. RESULTS All testeds treatments reversed the painful behavior. The decrease in pain was accompanied by a decrease of Glial Fibrillary Acidic Protein (GFAP), a specific astrocytic marker, and Ionized calcium-binding adaptor molecule 1 (Iba-1), a marker of microglia, and decreased expression of Transient Receptor Potential Vanilloid 1 (TRPV1), Substance P, and Calcitonin Gene-Related Peptide (CGRP) induced by CCI-IoN in PAG and Trigeminal ganglion. Furthermore, both treatments showed a higher expression of Cannabinoid-type 1 (CB1) receptor in the trigeminal ganglion compared to CCI-IoN rats. Our results show that no difference was observed between groups. CONCLUSION We showed that PBM or VBC regulates neuroinflammation and reduces inflammatory protein expression. However, the combination of PBM and VBC did not enhance the effectiveness of both therapies alone.
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Affiliation(s)
- Daniel Pereira Marques
- Departamento de Anatomia, Laboratory of Functional Neuroanatomy of Pain, Universidade de São Paulo Instituto de Ciências Biomédicas, São Paulo, São Paulo, Brazil
| | - Marucia Chacur
- Departamento de Anatomia, Laboratory of Functional Neuroanatomy of Pain, Universidade de São Paulo Instituto de Ciências Biomédicas, São Paulo, São Paulo, Brazil
| | - Daniel Oliveira Martins
- Departamento de Anatomia, Laboratory of Functional Neuroanatomy of Pain, Universidade de São Paulo Instituto de Ciências Biomédicas, São Paulo, São Paulo, Brazil.
- Division of Neuroscience/Hospital Sírio-Libânes, Street Daher Cutait, 69, São Paulo, São Paulo, 01308-060, Brazil.
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Kempers S, van Lierop P, Hsu TMH, Moin DA, Bergé S, Ghaeminia H, Xi T, Vinayahalingam S. Positional assessment of lower third molar and mandibular canal using explainable artificial intelligence. J Dent 2023; 133:104519. [PMID: 37061117 DOI: 10.1016/j.jdent.2023.104519] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 03/28/2023] [Accepted: 04/12/2023] [Indexed: 04/17/2023] Open
Abstract
OBJECTIVE The aim of this study is to automatically assess the positional relationship between lower third molars (M3i) and the mandibular canal (MC) based on the panoramic radiograph(s) (PR(s)). MATERIAL AND METHODS A total of 1444 M3s were manually annotated and labeled on 863 PRs as a reference. A deep-learning approach, based on MobileNet-V2 combination with a skeletonization algorithm and a signed distance method, was trained and validated on 733 PRs with 1227 M3s to classify the positional relationship between M3i and MC into three categories. Subsequently, the trained algorithm was applied to a test set consisting of 130 PRs (217 M3s). Accuracy, precision, sensitivity, specificity, negative predictive value, and F1-score were calculated. RESULTS The proposed method achieved a weighted accuracy of 0.951, precision of 0.943, sensitivity of 0.941, specificity of 0.800, negative predictive value of 0.865 and an F1-score of 0.938. CONCLUSION AI-enhanced assessment of PRs can objectively, accurately, and reproducibly determine the positional relationship between M3i and MC. CLINICAL SIGNIFICANCE The use of such an explainable AI system can assist clinicians in the intuitive positional assessment of lower third molars and mandibular canals. Further research is required to automatically assess the risk of alveolar nerve injury on panoramic radiographs.
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Affiliation(s)
- Steven Kempers
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Department of Artificial Intelligence, Radboud University, Nijmegen, the Netherlands
| | - Pieter van Lierop
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Tzu-Ming Harry Hsu
- MIT Computer Science & Artificial Intelligence Laboratory, 32 Vassar St, Cambridge, MA 02139, United States
| | | | - Stefaan Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Hossein Ghaeminia
- Department of Oral and Maxillofacial Surgery, Rijnstate Hospital, Arnhem, the Netherlands
| | - Tong Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Shankeeth Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; Department of Artificial Intelligence, Radboud University, Nijmegen, the Netherlands; Department of Oral and Maxillofacial Surgery, Universitätsklinikum Münster, Münster, Germany.
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Leung YY, Hung KF, Li DTS, Yeung AWK. Application of Cone Beam Computed Tomography in Risk Assessment of Lower Third Molar Surgery. Diagnostics (Basel) 2023; 13:diagnostics13050919. [PMID: 36900063 PMCID: PMC10001295 DOI: 10.3390/diagnostics13050919] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/22/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023] Open
Abstract
Risks of lower third molar surgery like the inferior alveolar nerve injury may result in permanent consequences. Risk assessment is important prior to the surgery and forms part of the informed consent process. Traditionally, plain radiographs like orthopantomogram have been used routinely for this purpose. Cone beam computed tomography (CBCT) has offered more information from the 3D images in the lower third molar surgery assessment. The proximity of the tooth root to the inferior alveolar canal, which harbours the inferior alveolar nerve, can be clearly identified on CBCT. It also allows the assessment of potential root resorption of the adjacent second molar as well as the bone loss at its distal aspect as a consequence of the third molar. This review summarized the application of CBCT in the risk assessment of lower third molar surgery and discussed how it could aid in the decision-making of high-risk cases to improve safety and treatment outcomes.
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Affiliation(s)
- Yiu Yan Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Correspondence:
| | - Kuo Feng Hung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Dion Tik Shun Li
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Rizzo G, Prado MC, Rigo L. Prevalence of dental implant positioning errors: A cross-sectional study. Imaging Sci Dent 2022; 52:343-350. [PMID: 36605853 PMCID: PMC9807798 DOI: 10.5624/isd.20220059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/11/2022] [Accepted: 06/14/2022] [Indexed: 01/09/2023] Open
Abstract
Purpose This study evaluated the prevalence of dental implant positioning errors and the most frequently affected oral regions. Materials and Methods A sample was obtained of CBCT images of 590 dental implants from 230 individuals who underwent diagnosis at a radiology center using cone-beam computed tomography from 2017 to 2020. The following variables were considered: thread exposure, violation of the minimum distance between 2 adjacent implants and between the implant and tooth, and implant contact with anatomical structures. Descriptive data analysis and the Pearson chi-square test (P<0.05) were performed to compare findings according to mouth regions. Results Most (74.4%) of the 590 implants were poorly positioned, with the posterior region of the maxilla being the region most frequently affected by errors. Among the variables analyzed, the most prevalent was thread exposure (54.7%), followed by implant contact with anatomical structures, violation of the recommended distance between 2 implants and violation of the recommended distance between the implant and teeth. Thread exposure was significantly associated with the anterior region of the mandible (P<0.05). The anterior region of the maxilla was associated with violation of the recommended tooth-implant distance (P<0.05) and the recommended distance between 2 adjacent implants (P<0.05). Implant contact with anatomical structures was significantly more likely to occur in the posterior region of the maxilla (P<0.05). Conclusion Many implants were poorly positioned in the posterior region of the maxilla. Thread exposure was particularly frequent and was significantly associated with the anterior region of the mandible.
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Affiliation(s)
- Gabriel Rizzo
- Faculty of Odontology, Meridional Faculty, Passo Fundo, RS, Brazil
| | - Mayara Colpo Prado
- Graduate Program in Dentistry, Meridional Faculty, Passo Fundo, RS, Brazil
| | - Lilian Rigo
- Graduate Program in Dentistry, Meridional Faculty, Passo Fundo, RS, Brazil
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Association of the Inferior Alveolar Nerve Position and Nerve Injury: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10091782. [PMID: 36141394 PMCID: PMC9498832 DOI: 10.3390/healthcare10091782] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 12/02/2022] Open
Abstract
Background: We aimed to compare the relationship between the buccal and lingual positions of the inferior alveolar nerve canal (IAC) relative to the lower third molar (LM3) and the rate of the inferior alveolar nerve (IAN) injury. Methods: A systematic search was performed in the following databases: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Journals@Ovid. No language or publication status restrictions were set. The publication year was set from 2009 to 2021. The process of meta-analysis was performed by Review Manager software (Cochrane Collaboration). Results: A total of 1063 articles were initially searched and full texts of 53 articles were read, and 11 satisfactory articles were found. There was a statistical difference between the rate of IAN injury and the lingual position and buccal position of the IAC relative to the LM3 roots (OR, 4.96; 95% CI, 2.11 to 11.62; p = 0.0002), with high heterogeneity (p = 0.001, I2 = 65%). Conclusion: A statistical difference was found in the rate of IAN injury between cases where the IAC was positioned buccally and lingually of the LM3 roots. The IAC was at a relatively higher risk of damage in third molar extraction when it was located on the lingual position of the LM3 roots.
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Iwanaga J, Kunisada Y, Masui M, Obata K, Takeshita Y, Sato K, Kikuta S, Abe Y, Matsushita Y, Kusukawa J, Tubbs RS, Ibaragi S. Comprehensive review of lower third molar management: A guide for improved informed consent. Clin Anat 2020; 34:224-243. [DOI: 10.1002/ca.23693] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/30/2020] [Accepted: 10/08/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences Tulane University School of Medicine New Orleans Louisiana USA
- Department of Neurology, Tulane Center for Clinical Neurosciences Tulane University School of Medicine New Orleans Louisiana USA
- Dental and Oral Medical Center, Kurume University School of Medicine Fukuoka Japan
- Division of Gross and Clinical Anatomy, Department of Anatomy Kurume University School of Medicine Fukuoka Japan
| | - Yuki Kunisada
- Department of Oral and Maxillofacial Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Masanori Masui
- Department of Oral and Maxillofacial Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Kyoichi Obata
- Department of Oral and Maxillofacial Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Yohei Takeshita
- Department of Oral and Maxillofacial Radiology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Kotaro Sato
- Department of Oral and Maxillofacial Surgery Nagoya University Graduate School of Medicine Nagoya Japan
| | - Shogo Kikuta
- Dental and Oral Medical Center, Kurume University School of Medicine Fukuoka Japan
| | - Yushi Abe
- Dental and Oral Medical Center, Kurume University School of Medicine Fukuoka Japan
| | - Yuki Matsushita
- University of Michigan School of Dentistry Ann Arbor Michigan USA
- Department of Clinical Oral Oncology Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
| | - Jingo Kusukawa
- Dental and Oral Medical Center, Kurume University School of Medicine Fukuoka Japan
| | - R. Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences Tulane University School of Medicine New Orleans Louisiana USA
- Department of Neurology, Tulane Center for Clinical Neurosciences Tulane University School of Medicine New Orleans Louisiana USA
- Department of Structural & Cellular Biology Tulane University School of Medicine New Orleans Louisiana USA
- Department of Neurosurgery and Ochsner Neuroscience Institute Ochsner Health System New Orleans Louisiana USA
- Department of Anatomical Sciences St. George's University St. George's Grenada
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
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