Documentos de Académico
Documentos de Profesional
Documentos de Cultura
Parestesia PDF
Parestesia PDF
REsuMEn Approach to
possible
Introduccin: La parestesia del nervio den-
paresthesia of
tario inferior es una complicacin bien
conocida que puede aparecer tras la extrac- lower dental nerve
cin quirrgica de los terceros molares after surgical
inferiores. La bibliografa revisada sugiere
extraction of the
realizar un estudio radiogrfico previo para
Ruiz Senz, Pedro Lus descartar factores predictivos. lower third molar
Doctor en Odontologa. Mster en
Ciruga Bucal. uCM Objetivo: El objetivo de este artculo fue rea-
AbsTRACT
lizar una valoracin y revisin bibliogrfica
Martnez-Rodrguez, Natalia
Doctora en Odontologa. del protocolo de actuacin en estas situacio- Introduction: The paresthesia of the lower den-
Profesora del Mster de Ciruga nes.
Bucal e Implantologa. hospital
tal nerve is a well-known complication that can
Virgen de la Paloma. Madrid. appear after surgical extraction of the lower
Caso clnico: Se presenta el caso clnico de
third molars. The revised bibliography suggests
Corts-Bretn Brinkman, un varn de 28 aos de edad, sin antece-
Jorge performing a previous radiographic study to
dentes mdicos de inters, que acude a la
Profesor asociado. Facultad de rule out predictive factors.
Odontologa. universidad Rey consulta derivado por su odontlogo para
Juan Carlos. Madrid. proceder a la extraccin quirrgica del tercer Objective: The objective of this article was to
Barona Dorado, Cristina molar inferior derecho por haber presentado make an evaluation and bibliographical review
Profesora asociada de Ciruga pericoronaritis aguda serosa congestiva de of the protocol for actions in this situation.
Bucal. Facultad de Odontologa.
uCM. Subdirectora del Mster de repeticin, con dolores que se irradiaban
Ciruga Bucal e Implantologa. Clinical case: The clinical case is presented
hacia la faringe homolateral. La exploracin
hospital Virgen de la Paloma. of a male of 28 years of age, without prior
Madrid. radiolgica confirm una relacin ntima
medical history of interest, who went to the
entre el tercer molar y el conducto dentario
Martnez Gonzlez, Jos consultation referred by his dentist to proceed
Mara
inferior. Como complicacin esperada se
to the surgical extraction of the lower right
Profesor titular de Ciruga produjo la anestesia de la zona hemilabial
Maxilofacial. Facultad de third molar due to having presented recurrent
Odontologa. uCM. Director del
derecha, objetivada mediante mapeo de la
acute serosal congestive pericoronitis, with
Mster de Ciruga Bucal e zona. Se paut tratamiento mediante com-
Implantologa. hospital Virgen de pain that radiated towards the homolateral
la Paloma. Madrid.
plejo vitamnico B cada 8 horas durante 21
pharnyx. The radiological examination confir-
das y se realiz los controles pertinentes
Indexada en / Indexed in: med an intimate relation between the third
consiguindose la prcticamente total recu-
- IME molar and the lower dental conduct. As an
- IBECS peracin de la sensibilidad.
expected complication, the anaesthesia of the
- LATINDEX
- GOOGLE ACADMICO Discusin: Los factores que presentan una right hemilabial area was produced, objecti-
mayor incidencia de lesiones nerviosas en la fied by the mapping of the area. A treatment
Correspondencia: ciruga del cordal inferior han sido relaciona-
Jos M Martnez Gonzlez
was prescribed of vitamin "B" complex every
hospimar@hotmail.com dos con aspectos clnicos derivados de la 8 hours for 21 days and the pertinent chec-
Fac. Odontologa.Dpto. Medicina y
Ciruga Bucofacial.
dificultad quirrgica. El protocolo de actua- kups were performed, achieving practically
UCM.Pza. Ramn y Cajal s/n. cin tras una parestesia post extraccin the total recovery of sensation.
28040. Madrid.
consta de dos vas de abordaje, siendo el
Tel. 913 941 967. Discussion: The factors that present a grea-
Fax. 913 941 973 tratamiento no quirrgico la indicacin pri-
ter incidence of nerve injuries in surgery of
Fecha de recepcin: 11 de marzo de 2013. maria. Coincidimos con algunos autores al
Fecha de aceptacin para su publicacin: the lower cordal have been related to clinical
21 de mayo de 2013.
Ruiz Senz P.L.; Martnez-Rodrguez n.; Corts-Bretn Brinkman J.; Barona dorado, C.; Martnez gonzlez J.M.
considerar que la microciruga est indicada a los 4-6 meses aspects derived from surgical difficulty. The protocol of action
de producirse la lesin, aunque no existe tasa de xito cono- after post-extraction parasthesia consists of two approach
cida para el nervio alveolar inferior, aunque s para el nervio channels, with the non-surgical treatment the primary appro-
lingual. ach. We agree with some authors by considering that
microsurgery is indicated at 4-6 months from the injury,
Conclusin: El mejor tratamiento para las lesiones neurosen-
although there is no known success rate for the lower alveolar
soriales del nervio dentario inferior es la prevencin mediante
nerve, although there is for the lingual nerve.
el estudio radiolgico previo y la realizacin de una correcta
tcnica quirrgica. Conclusion: The best treatment for the neurosensorial injuries
of the lower dental nerve is the prevention by means of the
prior radiological study and the performance of correct surgical
pALAbRAs CLAvE
technique.
CAsO CLnICO
actitud ante una posible parestesia del nervio dentario inferior tras la extraccin quirrgica del tercer molar inferior
Ruiz Senz P.L.; Martnez-Rodrguez n.; Corts-Bretn Brinkman J.; Barona dorado, C.; Martnez gonzlez J.M.
Fig. 9. impronta del conducto dentario. Fig. 11. Parestesia al mes de control.
actitud ante una posible parestesia del nervio dentario inferior tras la extraccin quirrgica del tercer molar inferior
Por otro lado, aunque mediante una radiografa panormica hiperestesia. Aumento de la sensibilidad a la estimulacin.
no se puede tener la certeza de que el diente mantiene una
Parestesia. Sensacin anormal, espontnea o evocada.
relacin directa con el conducto mandibular, no obstante hay
signos radiogrficos que sugieren la posible relacin, y que Sinestesia / Sensacin anormal desagradable, espontnea
interesan por su capacidad de predictibilidad. Segn el estudio Disestesia. o evocada.
de Rood y cols.14 se deben observar los signos referentes a
Anestesia. Prdida total de sensibilidad.
la raz del tercer molar como: oscurecimiento de la raz, cam-
Ruiz Senz P.L.; Martnez-Rodrguez n.; Corts-Bretn Brinkman J.; Barona dorado, C.; Martnez gonzlez J.M.
nervioso u otros.
actitud ante una posible parestesia del nervio dentario inferior tras la extraccin quirrgica del tercer molar inferior
bibliografa
1. Felez Gutirrez J, Roca Piqu L, Berini el nervio dentario inferior y el tercer mo- lationship of the mandibular canal and
Ayts L, Gay Escoda C. Las lesiones lar. Rev Esp Cir Oral Maxilofac. 1990; third molars: a survey of Australian oral
del nervio dentario inferior en el trata- 75(3): 261-4. and maxillofacial surgeons. Aust Dent J.
miento quirrgico del tercer molar inferior 9. Susarla AB, Dodson TB. Estimating third 2006; 51(1):64-8.
retenido: Aspectos radiolgicos, prons- molar extraction difficulty: A comparision 17. Palma-Carri C, Garca-Mira B, Larra-
ticos y preventivos. Arch Odontoestoma- of subjective and objective factors. J Oral zabal-Morn C, Pearrocha-Diago M.
tol. 1997; 13(2): 74-83. Maxillofac Surg 2005; 63: 427-34. Radiographic signs associated with in-
2. Park W, Choi JW, Kim Jy, Kim BC, Kim 10. Leung yy, Fung PP, Cheung LK. Treat- ferior alveolar nerve damage following
hJ, Lee Sh. Cortical integrity of the in- ment modalities of neurosensory deficit lower third molar extraction. Med Oral
ferior alveolar canal as a predictor of pa- after lower third molar surgery: a syste- Patol Oral Cir Bucal. 2010; 15(6): 886-
resthesia after third-molar extraction. J matic review. J Oral Maxillofac Surg. 90.
Am Dent Assoc. 2010; 141(3): 271-8. 2012; 70(4): 768-78. 18. Su-Kyoung yu, Ji-un Lee, Kyoung-A
11. Benediktsdottir IS, Wenzel A, Petersen Kim, Kwang-Joon Koh. Positional rela-
3. Zhang QB, Zhang ZQ. Early extraction:
JK, hintze h. Mandibular third molar re- tionship between mandibular third molar
a silver bullet to avoid nerve injury in lo-
moval: Risk indicators for extended ope- and mandibular canal in cone beam
wer third molar removal? Int J Oral Ma-
ration time, postoperative pain, and com- computed tomographs. Kor Jl Oral Ma-
xillofac Surg. 2012 ; 41(10): 1280-3.
plications. Oral Surg Oral Med Oral xillofac Radiol 2007; 37 (2): 197-203.
4. Borgonovo A, Bianchi A, Marchetti A, Nakamori K, Fujiwara K, Miyazaki A, To-
Pathol Oral Radiol Endod 2004; 97: 438- 19.
Censi R, Maiorana C. An uncommon cli- mihara K, Tsuji M, Nakai M, et al. Clinical
46.
nical feature of IAN injury after third mo- assessment of the relationship between
12. Valmesada-Castellon E, Berini-Aytes L,
lar removal: a delayed paresthesia. Case the third molar and the inferior alveolar
Gy-Escoda C Inferior alveolar nerve da-
series and literature review. Quintes- canal using panoramic images and com-
mage after lower third molar surgical ex-
sence Int. 2012 ; 43(5): 353-9. puted tomography. J Oral Maxillofac
traction: a prospective study of 1117 sur-
5. Szalma J, Lempel E, Jeges S, Olasz L. gical extractions. Oral Surg Oral Med Surg. 2008; 66(11): 2308-13.
Digital versus conventional panoramic Oral Pathol Oral Radiol Endod. 2001. 92 20. Gen PR, Vasconcelos BC. Influence of
radiography in predicting inferior alveolar (4): 337-43. the tooth section technique in alveolar
nerve injury after mandibular third molar 13. Amin MM, Laskin DM. Prophylactic use nerve damage after surgery of impacted
removal. J Craniofac Surg. 2012; 23(2): of indomethacin for prevention of pos- lower third molars. Int J Oral Maxillofac
155-8. tsurgical complications after removal of Surg. 2008; 37(10): 923-8.
6. ueda M, Nakamori K, Shiratori K, Iga- impacted third molars. Oral Surg Oral 21. Loescher AR, Smith KG, Robinson PP.
rashi T, Sasaki T, Anbo N et al. Clinical Med Oral Pathol 1983; 55 (5):448-51. Nerve damage and third molar removal.
significance of computed tomographic 14. Rood JP, Shehab BA. The radiological Dent update. 2003; 30(7): 375-80.
assessment and anatomic features of prediction of inferior alveolar nerve injury 22. Sanz Alonso J, Lpez-Quiles MJ, Santos
the inferior alveolar canal as risk factors during third molar surgery. Br J Oral Ma- Marino J, Rubio Alonso LJ, Martnez-
for injury of the inferior alveolar nerve at xillofac Surg 1990; 28(1):20-5. Gonzlez JM. Posibilidades terapeticas
third molar surgery. J Oral Maxillofac 15. Smith AC, Barry SE, Chiong Ay, hadza- en las lesiones del nervio dentario infe-
Surg. 2012; 70(3): 514-20. kis D, Kha SL, Mok SC et al. Inferior al- rior (Edicin espaola). J Am Dent As-
7. Swaim SF. Peripheral nerve surgery in veolar nerve damage following removal soc. 2011; 6(6): 279-84.
the dog. J Am Vet Med Assoc. 1972. 15; of mandibular third molar teeth. A pros- 23. Sanz Alonso J, Barona Dorado C, C-
161(8):905-11. pective study using panoramic radio- ceres Madroo E, Fernndez Cliz F,
8. Daz Torres MJ, Guisado Moya BF, Vega graphy. Aust Dent J. 1997; 42(3):149- Martnez-Gonzlez JM. Medios diagns-
del Barrio JM, Calatayud Sierra J, Carri- 52. ticos en las lesiones del nervio dentario
llo Baracaldo JS. Factores clnicos y ra- 16. Koong B, Pharoah MJ, Bulsara M, Ten- inferior. J Am Dent Assoc (Edicin Es-
diolgicos de verdadera relacin entre nant M. Methods of determining the re- paola). 2011; 6(5): 232-6.