ABSTRACT
Many articles have detailed local accidents and complications in dental implant treatment. Comparisons of the data they report are not always easy because different criteria have been followed in the various classifications and there is confusion between the terms accident and complication. The aim of this paper is to propose a classification that considers the timing of the events and makes a distinction between the two terms. Accidents are events that occur during surgery, and complications are any pathologic conditions that appear postoperatively. The proper diagnostic procedures and surgical techniques for their prevention and treatment are also described.
Subject(s)
Dental Implantation, Endosseous/adverse effects , Dental Implants/adverse effects , Intraoperative Complications/prevention & control , Postoperative Complications/prevention & control , Blood Loss, Surgical , Cranial Nerve Injuries/classification , Equipment Failure , Foreign Bodies/classification , Humans , Intraoperative Complications/classification , Intraoperative Complications/therapy , Maxillary Sinus/injuries , Nasal Cavity/injuries , Postoperative Complications/classification , Postoperative Complications/therapy , Soft Tissue Injuries/classification , Surgical Wound Dehiscence/classification , Terminology as Topic , Time Factors , Tooth Injuries/classificationABSTRACT
The surgical removal of lower third molars endangers both the lingual and inferior alveolar nerves. Patients sustaining an injury to either of these nerves must be managed correctly, and this requires a diagnosis of the injury type and regular monitoring of the recovery of sensation. Surgical intervention for a damaged inferior alveolar nerve is not usually indicated but may be undertaken: if the nerve is completely divided and the severed ends are misaligned; if a bony fragment has compressed the mandibular canal; or if the patient suffers from persistent neuropathic pain. In contrast, after injury to the lingual nerve, if sensory testing demonstrates no neural recovery within 3-4 months, exploration of the injury site and microsurgical repair of the damaged nerve is indicated.
Subject(s)
Cranial Nerve Injuries/prevention & control , Molar, Third/surgery , Postoperative Complications/prevention & control , Tooth Extraction/adverse effects , Trigeminal Nerve Injuries , Cranial Nerve Injuries/classification , Cranial Nerve Injuries/diagnosis , Cranial Nerve Injuries/etiology , Decision Trees , Humans , Lingual Nerve Injuries , Mandible , Postoperative Complications/diagnosis , Postoperative Complications/etiology , Recovery of FunctionABSTRACT
BACKGROUND AND PURPOSE: Electromyography is used in conjunction with clinical diagnosis to determine the presence and extent of craniofacial injuries; it is also an aid in prognosis of recovery. This article reviews the neural pathophysiology following trauma and the basic principles of electrodiagnostic testing; such understanding helps to determine indications for electrodiagnostic testing. METHODS AND MATERIALS: Electrodiagnostic techniques can detect and differentiate the degree of injury. There are three major categories of nerve injury--neurapraxia, axonotmesis, and neurotmesis. In neuropraxic injuries, stimulation distal to the lesion will continue to elicit a response indefinitely; in more severe injuries, axonal degeneration begins within 3 to 5 days postinjury. RESULTS AND/OR CONCLUSIONS: Electromyography may be used as a valuable adjunct to traditional forms of diagnosis and prognosis. The accuracy of electrodiagnostic data reported in the literature ranges from 50% to 67% in some studies and 77% to 90% in others. Studies with larger patient populations and longer follow-up periods are required.
