Temporal changes in mental foramen blood flow following orthognathic surgery

This prospective study aimed to assess temporal changes in vascularization and neurosensory function in the mental foramen region using Doppler ultrasonography (USG) and clinical sensory tests in patients undergoing orthognathic surgery. Sixteen patients with skeletal Class II or III malocclusion were included. Evaluations were performed at four time points: preoperatively (T0) and postoperatively at 1 week (T1), 1 month (T2), and 3 months (T3). Sensory assessments included pinprick, pressure (VAS), neurosensory sensitivity (VAS), brush, and two-point discrimination tests. Blood flow and mental foramen diameter were evaluated using a Philips eL18-4 MHz linear probe via Color and Power Doppler USG. Statistical analysis was performed using repeated-measures ANOVA with Greenhouse-Geisser correction or the Friedman test as appropriate; Bonferroni-adjusted post-hoc tests were applied. Accessory mental foramen was detected in 9.4 % of patients. The foramen diameter was significantly greater in males (p = 0.025). A significant reduction in blood flow was observed at T3 versus earlier time points (p < 0.05). Sensory scores showed significant time-dependent changes (p < 0.0083), with greatest deficits at T1 and partial recovery by T3. These findings suggest that vascular and neurosensory alterations in the mental foramen region are dynamic postoperatively. The reduction in flow at 3 months may impact long-term recovery. Doppler USG, being non-invasive and practical, offers valuable insight for surgical planning and follow-up.