Treatment modalities and risk factors associated with refractory neurosensory disturbances of the inferior alveolar nerve following oral surgery: a multicentre retrospective study

Int J Oral Maxillofac Surg. 2018 Jun;47(6):794-801. doi: 10.1016/j.ijom.2017.10.020. Epub 2018 Jan 5.

Abstract

Little research has been conducted into hypoesthesia, and no studies have elucidated the risk factors for refractory hypoesthesia and compared treatment modalities. The purpose of this multicentre retrospective cohort study was to investigate the relationships between various risk factors, treatment modalities, and refractory hypoesthesia. Risk factors for refractory hypoesthesia after oral surgery were evaluated using univariate and multivariate analysis. To minimize the selection bias associated with a retrospective data analysis, a propensity score analysis was performed between the medication and non-medication groups (65 sites in each group). Moderate or severe hypoesthesia (odds ratio 13.42) and no or late administration of ATP/vitamin B12 (odds ratio 2.28) were significantly associated with refractory hypoesthesia. In the propensity score analysis, the incidence rate of refractory hypoesthesia in the medication group was lower than that in the non-medication group (P<0.001). This study demonstrated the multivariate relationships between various risk factors, treatment modalities, and refractory hypoesthesia. Moderate or severe hypoesthesia and no or late administration of ATP/vitamin B12 were significantly associated with refractory hypoesthesia. Therefore, clinicians should consider these risk factors and initiate early oral administration of ATP/vitamin B12 in cases of hypoesthesia.

Keywords: extraction; hypoesthesia; neurosensory deficit; treatment.

Publication types

  • Multicenter Study

MeSH terms

  • Adenosine Triphosphate / therapeutic use
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Hypesthesia / diagnostic imaging
  • Hypesthesia / drug therapy
  • Hypesthesia / etiology*
  • Male
  • Mandibular Nerve
  • Middle Aged
  • Oral Surgical Procedures*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology*
  • Propensity Score
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Trigeminal Nerve Injuries / diagnostic imaging
  • Trigeminal Nerve Injuries / drug therapy
  • Trigeminal Nerve Injuries / etiology*
  • Vitamin B 12 / therapeutic use

Substances

  • Adenosine Triphosphate
  • Vitamin B 12