Relation Between Dysesthesia of the Inferior Alveolar Nerve After Mandibular Third Molar Extraction and Imaging Findings on Cone-beam Computed Tomography / 日本農村医学会雑誌

The mandibular third molars are usually located near the inferior alveolar nerve, and surgical extraction may damage this nerve causing dysesthesia. Recently, cone-beam computed tomography (CBCT) has become more widespread, facilitating the diagnosis of various diseases of the oral maxillofacial region. This study investigated dysesthesia of the inferior alveolar nerve following mandibular third molar extraction and the relationship between this complication and preoperative imaging findings. A total of 401 mandibular third molars were extracted from 345 patients with a mean age 33.9 ± 14.6 years (range, 16-81 years). All patients were evaluated by panoramic radiography, and 89 mandibular third molars were evaluated by CBCT. We classified the shape of the mandibular canal into 4 types based on its shape at the point closest to the mandibular third molars. The rate of dysesthesia after mandibular third molar extraction was 5.7% among patients considered to be at high risk who underwent CBCT, and 0.64% among patients considered to be at low risk. The mandibular third molars were not in contact with the inferior alveolar nerve in 51 of the patients who underwent CBCT. These results suggest that deformation of the mandibular canal may lead to dysesthesia following mandibular third molar extraction and that CBCT was useful for predicting the risk of this complication.

Group Medical Examination Upper Gastrointestinal Endoscopy Performed Early in the Morning at a Rural Clinic / 日本農村医学会雑誌

Koumimachi Clinic attached to Saku Central Hospital is located in an underpopulated rural area. We have annually performed a close medical examination by upper gastrointestinal endoscopy since 1982. Since 1986, it has been done early in the morning. In 1995, a total of 1, 513 radiographic examinations were performed and 555 cases were examined by upper gastrointestinal endoscopy. Two cases of gastric cancer-one being early stage and the other, advanced stage-were detected. Despite the busy season all the farmers who had been advised to have the endoscopic examination attended because it was performed early in the morning. The early morning examination was performed in cooperation with Saku Central Hospital, Naganoken Kouseiren Health Screening Center, and public health nurses of local governments. Without such cooporation, any health care project could not be carried out a rural area.