Abstract
The regeneration of nerve injuries after oral surgery procedures is a quite often attempted procedure in dental medicine. Despite several proposed technical approaches, there is still a lack of consensus on which should be considered the gold standard procedure, even-though in the last decades, the use of collagen-based devices allowing a tension-free direct neurorrhaphy has been used. A systematic search of multiple electronic databases and hand searching was conducted to assess the level of evidence behind the use of type I collagen devices to treat nerve injuries after oral surgery procedures. After screening, four articles (one case series and three retrospective studies) including overall 65 patients suffering from inferior alveolar (IAN)/lingual nerve (LN) injury after mandibular wisdom tooth extraction, met the inclusion criteria and could be included. The Oxford Centre for evidence-based medicine (OCEBM) scaling system was used to evaluate the quality of the included studies. Positive clinical results in terms of sensorial improvements were recorded at least 3 months after surgery, even-though the overall level of evidence is low. The use of collagen membranes to enhance nerve regeneration in oral surgery results in promising results. Nevertheless, additional clinical comparative trials with larger sample sizes are needed.
Highlights
Mandibular wisdom tooth removal is one of the most frequent oral surgery procedures performed in the clinical practice [1,2]
A large retrospective university-setting clinical study on 1559 patients, reported sensorial disturbance in 42 cases (2.69%) with only five cases of persistent sensory disturbance (0.32%), and four of these five lesions were in the lingual nerve (0.25%) [7]
As summarized by Coulthard and coworkers in 2014 [8], the impaired sensation caused by lesions at the inferior alveolar nerve has been classified as:
Summary
Mandibular wisdom tooth removal is one of the most frequent oral surgery procedures performed in the clinical practice [1,2]. This intervention is not free from complications as widely reported in the literature [3,4,5]: in particular, trigeminal injuries might be caused mainly by nerve compression and/or stretching. The incidence is up to 5% for the inferior alveolar nerve (IAN) [3] and ranges from 0.6% to 2% for the lingual nerve (LN) [6]. Despite the overall low percentage of complications, oro-facial disturbances cause considerable patients’ morbidity in terms of social disabilities and physical pain negatively affecting the whole quality of life.
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