Factors Affecting Functional Sensory Recovery After Inferior Alveolar Nerve Repair Using the Nerve Sliding Technique

The nerve sliding technique (NST) was introduced for repairing inferior alveolar nerve (IAN) defect and overcoming the disadvantages of conventional surgical treatment methods such as nerve graft. This study was conducted to identify factors associated with functional sensory recovery (FSR) following inferior alveolar nerve repair using the NST.

This was a retrospective cohort study including all patients who underwent IAN repair using the NST at Seoul National University Dental Hospital, Department of Oral and Maxillofacial Surgery from February 2009 to March 2020. The damaged part of the IAN was excised, and the incisive branch was transected intentionally to perform direct anastomosis without tension. Cox proportional hazard analysis was utilized to determine the relationships between predictor variables (age, gender, chief complaints, preoperative sensory results, duration from injury to repair, length of nerve tissue resected during the procedure, and neuroma formation) and outcome variable (time to FSR).

The sample was composed of 16 patients with a mean age of 56.1 ± 10.1 years, 25% were males and 75% were females. The mean nerve gap deficit was 7.69 mm (3-15 mm). Ten patients (62.5%) achieved FSR with a median time from operative treatment to FSR of 84.5 days. Dental implant placement was found as the main cause for IAN injury (93.8%) and 56.2% of patients complained of hypoesthesia and dysesthesia. Factors associated with time to FSR at 1 year were age, chief complaint, and early repair. Younger patients (P = .041) and patients without dysesthesia (P = .019) were more likely to achieve FSR. Higher proportion of early repair group achieved FSR, although not statistically significant (P = .068).

The use of NST in repair of IAN defects up to 15 mm achieved 62.5% FSR. Younger age and absence of dysesthesia were associated with higher FSR.