Frequency of Inferior Alveolar Nerve (IAN) Injury in Mandibular Fractures at Tertiary Care Hospital
DOI:
https://doi.org/10.61581/mjsp.v6i02.325Keywords:
Inferior alveolar nerve (IAN), Mandible fracture, Traffic accident, InjuryAbstract
Objective: To evaluate the frequency of inferior alveolar nerve injury in patients with mandibular fracture at tertiary care hospital.
Methodology: The study was conducted in the Department of Oral and Maxillofacial Surgery at Jinnah Postgraduate Medical Centre, Karachi, from January 2024 to June 2024. Baseline information, and etiology of trauma (road traffic accident, fall, or assault), was recorded. Inferior alveolar nerve (IAN) injury involves any sensory impairment of the nerve, which can be clinically assessed by the absence of response to light touch using a Semmes-Weinstein monofilament or a camel brush.
Results: The mean age was similar in both groups, 31.43±3.86 vs. 32.56±4.24, and no significant differences were found in gender distribution, with 76.6% males in the injury group vs. 80.0% in the non-injury group. Road traffic accidents (RTA) were the most common cause of IAN injury at 55.5% vs 42.0%, followed by falls 31.3% vs 32.0%, and assaults 13.3% vs 26.0%.
Conclusion: The frequency of IAN is 71.9% in mandibular fractures, and there is no significant link between IAN injury and patient demographics. RTAs were the most common cause of IAN injury. Systemic factors like diabetes, hypertension, and obesity had little impact on IAN injury.
Downloads
References
1. Amarista Rojas FJ, Bordoy Soto MA, Cachazo M, Dopazo JR, Vélez H. The epidemiology of mandibular fractures in Caracas, Venezuela: Incidence and its combination patterns. Dental Traumatol. 2017 Dec;33(6):427-32.
2. Samman M, Ahmed SW, Beshir H, Almohammadi T,Patil SR. Incidence and Pattern of Mandible Fractures in the Madinah Region: A Retrospective Study. J Nat SciBiol Med. 2018 Jan-Jun;9(1):59-64.
3. Thu PNA, Trang TNT, Florenly, Novelya. Correlations between mandibular third molars to inferior alveolar nerve locations in Vietnamese population. Biomed J Indones 2021; 7(2):408-14.
4. Hassan T, Chishty M, Gulzar M, Ghaffari N, Zahra R, Khan M. Frequency of injury to lingual nerve & inferior alveolar nerve in case of mandibular 3rd molar impaction. J Khyber Coll Dent 2020; 10(01):64-7.
5. Singh A, Lone PA. Evaluation of post traumatic neurosensory disturbances in the distribution of inferior alveolar nerve in case of mandibular fractures and their management. International Journal of Applied Dental Sciences 2021; 7(3): 314-21.
6. Shrinivas B, Naik VG, Kumar Rai K, Malik G. Evaluation of presurgical/postraumatic neurosensory changes in the management of mandibular fractures. South Asian Research Journal of Oral and Dental Sciences. 2020;2:49-55.
7. Israr M, Sattar N, Irfan M, Khan M, Rehman S. Inferior alveolar nerve deficit after removal of lower third molars- frequency and factors affecting nerve damage in pros-pective clinical study of 1,487 extractions in 1,185 patients. J Khyber Coll Dent 2021; 11(02):59-65.
8. Krishnan B. The role of a conservative minimal interventional management protocol in the fractures of the dentate portion of the adult mandible. Craniomaxillofacial Trauma & Reconstruction. 2016 Mar;9(1):020-8. https://doi.org/10.1055/s-0035-155605
9. Mundepi N, Dora H, Sharma M, et al. (January 29, 2024) Comparison of Neurosensory Recovery of the Inferior Alveolar Nerve After Open and Closed Reduction for Mandibular Fractures: A Prospective Study. Cureus 16(1): e53175. DOI 10.7759/cureus.53175
10. Tay AB, Lai JB, Lye KW, Wong WY, Nadkarni NV, Li W, Bautista D. Inferior alveolar nerve injury in trauma-induced mandible fractures. Journal of oral and maxillofacial surgery. 2015 Jul 1;73(7):1328-40. https://doi.org/10.1016/j.joms.2015.02.003
11. He H, Ruan N. Factors influencing inferior alveolar nerve injury after extraction of mandibular third molar. Med Oral Patol Oral Cir Bucal. 2024 Sep 1;29(5):e613-e619.
12. Jerjes W, Upile T, Shah P, Nhembe F, Gudka D, Kafas P. Risk factors associated with injury to the inferior alveolar and lingual nerves following third molar surgery-revisited. Oral Surg Oral Med Oral Pathol Oral RadiolEndod. 2010;109:335–45.
13. Kim HJ, Jo YJ, Choi JS, Kim HJ, Kim J, Moon SY. Anatomical Risk Factors of Inferior Alveolar Nerve Injury Association with Surgical Extraction of Mandibular Third Molar in Korean Population. Applied Sciences. 2021; 11(2):816.
14. Sarikov R, Juodzbalys G. Inferior alveolar nerve injury after mandibular third molar extraction: a literature review. J Oral Maxillofac Res. 2014;5(4):e1.
15. Chandan SN, Shetty SK, Shetty SK, Shah AK. Inferior alveolar nerve dysfunction in mandibular fractures: a prospective cohort study. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2021 Jun 30;47(3):183-9.
16. Yadav S, Mittal HC, Malik S, Dhupar V, Sachdeva A, Malhotra V, Singh G. Post-traumatic and postoperative neurosensory deficits of the inferior alveolar nerve in mandibular fracture: a prospective study. Journal of the Korean Association of Oral and Maxillofacial Surgeons. 2016 Oct;42(5):259.
17. Schenkel JS, Jacobsen C, Rostetter C, Grätz KW, Rücker M, Gander T. Inferior alveolar nerve function after open reduction and internal fixation of mandibular fractures. J Cranio-Maxillofacial Surg. 2016 Jun 1;44(6):743-8.
18. Sedaghatfar M, August MA, Dodson TB. Panoramic radiographic findings as predictors of inferior alveolar nerve exposure following third molar extraction. J Oral Maxillofac Surg. 2005 Jan;63(1):3-7.
19. Bagheri SC, Meyer RA, Khan HA, Steed MB. Microsurgical repair of peripheral trigeminal nerve injuries from maxillofacial trauma. J Oral Maxillofac Surg. 2009;67(8):1791-805.
20. Smith WP. The relative risk of neurosensory deficit following removal of mandibular third molar teeth: The influence of radiography and surgical technique. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115(1):18-24.
Published
Issue
Section
License
Copyright (c) 2025 Ayesha Yousuf, Jehan Alam, Ruqayyah Shah, Anum Mushtaq, Muzna Tahir, Saba Rizwan
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work’s authorship and initial publication in this journal.
