Biomedical subjects
Publications and source records attributed to M Guarducci.
The correction of oral and maxillofacial malformations need invasive and traumatic surgery techniques that may cause damages to nerves. Some lesions related symptoms have been described especially with regard to sensory nerves and, more rarely, also to motor nerves. A case personally observed is described.
A case of hyperostosis of the left hemimandible medial face in a young patient is reported. This in an interesting case both for the remarkable size and the location of the lesion and because it was unique and asymmetrical; as a matter of fact this pathology, frequent on the jaws, is usually symmetrical and bilateral. The most probable etiopathogenetic hypothesis for the case presented to our observation seems to be an unknown localized stimulation of osteoblastic cells. Considering its size, the lesion was removed.
The correction of oral and maxillo-facial mal-formations causes lesions to sensitive nerves due to the invasive and traumatic surgery techniques required. Generally neuro-sensory and cutaneous-mucosal defects are reversible, with full recovery within 6-12 months. In a follow-up study (2 and 8 years) we found altered tactile and pain sensitivity in 43% of patients at subjective evaluation, with objective alteration in 17% of the group. Dental sensitivity evaluated by a pulp test showed an increase in for all teeth tested; values were higher for superior than for inferior teeth. Despite the increased pulp sensitivity threshold, due to the surgical damage, no signs of pulp disease were detected. Quality of life was not affected even by such a high subjective change in sensitivity. We therefore believe that patients undergoing orthognathic surgery must be fully informed; they must be made to understand the risks involved, and that damage may occur to sensitive nerves following surgery. All surgeons, including those with experience in the field, should continually seek to improve their skill and learn new techniques, in order to reduce complications to a minimum.