Saratov JOURNAL of Medical and Scientific Research

Effect of neurological symptoms on the course and the healing of fractures of the mandible

Year: 2012, volume 8 Issue: №2 Pages: 399-403
Heading: Neurology Article type: Original article
Authors: Bahteeva G.R., Lepilin A.V., Soyher M.G., Bulkin V.A., Muhina N.M.
Organization: Saratov State Medical University, Center for Interdisciplinary Dentistry and Neurology, Moscow
Summary:

Purpose: to study the dental status and neurological symptoms in patients with fractures of the mandible for improving diagnosis, predicting the course of reparative processes and the application of preventive measures of infam-matory complications. Material. We observed 132 patients with mandibular fractures of different location, the hospital received no later than 3 days after injury and comparison group, consisting of 15 healthy people. Dental status of patients included clinical examination: identifying reasons for injuries, complaints external examination of maxillofacial area. Assessment of pain that was observed in patients in the area of innervation of the trigeminal nerve, was carried out using a scale for measuring the intensity of pain and need for analgesics (Lantsev EA, AA Smirnov, 1990). Zone of hypesthesia and hyperesthesia were detected in patients in the study of the surface (pain, temperature and tactile) and the deep sensitivity of the skin. State of the motor portion of the third branch of the trigeminal nerve was assessed by palpation of masticatory and temporal muscles, according to electromyographic, in the late periods of the presence of atrophy of the masticatory muscles on the affected side and disturbance trajectory of the mandible. In addition, elec-trophysiological examination included registration of trigeminal somatosensory evoked potentials. The study of pain sensitivity of the teeth was carried out using a digital tester to determine the viability of the pulp «Digitest». This study was conducted on the day of admission and on the 10th day of treatment. Results. Clinical and instrumental evaluation of patients with uncomplicated fractures of the mandibular nerve fber damage detected in 100 % of cases. In complicated fractures clinically identifed sensory disorders paresteticheskih signs of interest in the trigeminal nerve were found in 51.8 % of cases. In patients with no sensory disorders paresteticheskih using electrophysiological methods trigeminal interest in fractures of the lower jaw found in 26.9 % of all cases. Thus, the overall damage to the trigeminal nerve in complicated fractures of the mandible comprise 77.8 % of cases. Conclusion. The results of our study, often leaving by the wayside, neurological symptoms affect the course and the healing of fractures of the mandible. Sensory disturbances in the form paresteticheskie hyperesthesia after the therapy offset, or pass into a more pronounced form — gipesteticheskie violation. Uncomplicated fractures of the lower jaw, accompanied by gipesteticheskimi sensory symptoms, in most cases are complicated. In our study, sensory disorders paresteticheskie in complicated fractures were found — in 77.8 % of patients. Undoubted interest of the trigeminal nerve in the development of complications of fractures, which was confrmed in our work. Thus, this study will enable the practitioner without additional methods reliably suggest a possible neurological symptoms, the recovery rate of trigeminal nerve and to adjust therapy in patients with mandibular fractures.

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