Therapeutic modalities for iatrogenic late paresthesia in oral tissues innervated by mandibular branch of trigeminal nerve: a systematic review.

IF 2 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Maxillofacial Plastic and Reconstructive Surgery Pub Date : 2024-07-15 DOI:10.1186/s40902-024-00438-5
Elham Keykha, Elahe Tahmasebi, Mahdi Hadilou
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Abstract

Background: The present systematic review intended to evaluate the current evidence on the modalities used for treating iatrogenic late paresthesia in the oral tissues innervated by the mandibular branch of the trigeminal nerve.

Main text: As a common side effect of dental procedures, paresthesia can exert a profound adverse effect on patients' quality of life. The inferior alveolar nerve (IAN) and lingual nerve (LN) have the highest chance of injury during several dental procedures, including mandibular orthognathic surgeries, implant placement, extraction of the third molar, anesthetic injections, flap elevation, and endodontic treatments. Moreover, several methods have been proposed for treating iatrogenic late paresthesia, including photobiomodulation (PBM), microsurgery, medication, and close observation until achieving spontaneous recovery of sensation. However, no gold standard treatment for iatrogenic paresthesia has been agreed upon up to now. The present study included a comprehensive search of the databases of PubMed, Embase, Scopus, and Web of Science up to December 04, 2023, resulting in a total of 3122 related studies. Then, the titles, abstracts, and full texts of the studies were evaluated. Ultimately, seven controlled randomized trials (RCTs) were included in the final analysis. Also, the risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Among all fields, randomization, allocation concealment, and data analysis were found to have the highest chance of bias in the included studies.

Conclusions: In conclusion, PBM, vitamin B12, and corticosteroids could accelerate the recovery of late paresthesia. However, considering the low sample size of the included studies and the high risk of methodological bias, it is recommended to perform further RCTs with robust study designs following Good Clinical Practice (GCP) guidelines to achieve more reliable results.

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三叉神经下颌支支配的口腔组织先天性晚期麻痹的治疗方法:系统综述。
背景:本系统综述旨在评估用于治疗三叉神经下颌支支配的口腔组织先天性晚期麻痹的现有证据:作为牙科治疗过程中常见的副作用,疼痛会对患者的生活质量产生深远的负面影响。下牙槽神经(IAN)和舌神经(LN)在多种牙科手术中受伤的几率最高,包括下颌正颌手术、种植体植入、第三磨牙拔除、麻醉注射、牙瓣提升和牙髓治疗。此外,治疗先天性晚期麻痹的方法也有多种,包括光生物调节(PBM)、显微外科手术、药物治疗和密切观察,直到感觉自发恢复为止。然而,迄今为止尚未就治疗先天性麻痹的金标准达成一致。本研究对截至 2023 年 12 月 4 日的 PubMed、Embase、Scopus 和 Web of Science 等数据库进行了全面检索,共检索到 3122 项相关研究。然后,对这些研究的标题、摘要和全文进行了评估。最终,七项对照随机试验(RCT)被纳入最终分析。此外,还使用乔安娜-布里格斯研究所(Joanna Briggs Institute,JBI)的关键评估清单对偏倚风险进行了评估。在所有领域中,随机化、分配隐藏和数据分析在纳入的研究中出现偏倚的几率最高:总之,PBM、维生素 B12 和皮质类固醇可加速晚期麻痹的恢复。然而,考虑到纳入研究的样本量较少以及方法学偏倚的高风险,建议按照良好临床实践(GCP)指南进一步开展研究设计稳健的 RCT,以获得更可靠的结果。
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来源期刊
Maxillofacial Plastic and Reconstructive Surgery
Maxillofacial Plastic and Reconstructive Surgery DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.30
自引率
13.00%
发文量
37
审稿时长
13 weeks
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