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BİLATERAL SAGİTTAL SPLİT OSTEOTOMİ VE DİSTRAKSİYON OSTEOGENEZİ YÖNTEMLERİ İLE YAPILAN ALT ÇENENİN İLERLETİLMESİ GİRİŞİMLERİNDE OLUŞAN İNFERİOR ALVEOLAR SİNİR HASARLARININ İNCELENMESİ

Evaluation of the Inferior Alveolar Nerve Damages in Bilateral Sagittal Split Osteotomy and Distraction Osteogenesis Techniques Used For Mandibular Advancement

Journal Name:

  • İstanbul Üniversitesi Diş Hekimliği Fakültesi Dergisi

Publication Year:

  • 2012

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Bilateral sagittal split osteotomy (BSSO) and distraction osteogenesis (DO) are surgical techniques which are commonly used for mandibular advancement. During this procedure, the inferior alveolar nerve (IAN) which is the major innervations source of the mandibular bone and dentition, may be affected or injured at different level of severities. Such complications may lead to the paresthesia of the chin and lower lip regions or complaints of altered sensation that lasts longer than 12 months. Nerve damage is evaluated objectively by clinical methods or subjectively by self-reported questionnaires. However, large variations may appear when these methods are used simultaneously. Age, surgical technique, the amount of advancement and anatomical position of IAN have been reported as possible risk factors, particularly for BSSO. However, when used for similar purposes on randomly distributed patient groups, BSSO and DO did not differ significantly with respect to the percentage of long-lasting IAN disturbance. Comparative clinical studies that focus on the personal effects of sensory loss are needed in order to determine which technique should be preferred.
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Abstract (Original Language): 
Bilateral sagital split osteotomi (BSSO) ve distraksiyon osteogenezi (DO) alt çeneni n ilerletilmesini gerektiren olgularda sıklıkla kullanılan cerrahi tekniklerdir. Bu girişimler sırasında, alt çene kemiğinin ve dişlerin en önemli innervasyon kaynağı olan inferior alveolar sinir (IAS) etkilenebilir ve çeşitli derecelerde hasar görebilir. Bu komplikasyonlar, çene ucunda ve dudakta paresteziye ya da aynı bölgelerde hastaların 12 aydan uzun süren his değişikliklerinden yakınmalarına yol açabilir. Bunların değerlendirilmesi klinik duyu testleri gibi nesnel yöntemlerle ya da hastaların doldurduğu anketlerle öznel olarak yapılır. Ancak, bu iki yaklaşımla elde edilen bulgular arasında önemli farklıklar olabileceği göz önünde bulundurulmalıdır. Yaş, cerrahi teknik, ilerletme miktarı ve IAS'in konumu özellikle BSSO için değerlendirilmesi gereken olası risk etkenleridir. Ancak, kaynak bilgileri incelendiğinde BSSO ve DO benzer hasta gruplarında aynı amaçlarla kullanıldığında, iki yöntem arasında IAS hasarları bakımından bir farklılık bulunmamıştır. Hangi olguda hangi yaklaşımın daha uygun olduğunun belirlenmesi için, duyu kayıplarının hasta üzerindeki etkisini göz önünde bulundurarak tasarlanmış karşılaştırmalı klinik çalışmalara ihtiyaç vardır.
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