Protection of Inferior Alveolar Neurovascular Bundle in Alveolar Bone Operation

J Craniofac Surg. 2018 Mar;29(2):e155-e158. doi: 10.1097/SCS.0000000000004237.

Abstract

Purpose: The aim of this study was to investigate the protection of the inferior alveolar neurovascular bundle in alveolar bone operation in conditions such as chronic osteomyelitis and cementoma.

Patients and methods: The study enrolled 7 cases, 4 with chronic osteomyelitis and 3 with cementoma with pain. Computed tomography scan and 3-dimensional reconstruction were performed for the diseases. Data were processed by ProPlan CMF 1.3 software. The edge of lesion was defined and the inferior alveolar nerve was marked. Template was designed to guide the osteotomy line. Piezosurgery was used for osteotomy, with the avoidance of nerve canal. Current perception threshold (CPT) was performed to evaluate the nerve function after operation.

Results: The CPT difference of the affected side before and after operation showed no statistically significant differences compared with that of the unaffected side (P = 0.0556).

Conclusions: Digital template protects the inferior alveolar neurovascular bundle with the aid of piezosurgery during alveolar bone resection, which obtained satisfying clinical results. As powerful assistive tools of functional surgery, digital template and piezosurgery achieve both the purposes of treatment and function.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alveolar Process / blood supply
  • Alveolar Process / diagnostic imaging
  • Alveolar Process / innervation
  • Alveolar Process / surgery*
  • Blood Vessels / injuries
  • Cementoma / diagnostic imaging
  • Cementoma / surgery*
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Mandible / surgery
  • Mandibular Neoplasms / diagnostic imaging
  • Mandibular Neoplasms / surgery*
  • Mandibular Nerve
  • Middle Aged
  • Organ Sparing Treatments / methods
  • Osteomyelitis / diagnostic imaging
  • Osteomyelitis / surgery*
  • Osteotomy / adverse effects
  • Osteotomy / methods*
  • Piezosurgery
  • Tomography, X-Ray Computed
  • Trigeminal Nerve Injuries / prevention & control*
  • Vascular System Injuries / prevention & control