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[Videoendoscopic study of mandibular bone defects involving the mandibular canal]
G V Remizov1, A P Vedyaeva1, A V Kuzin1
1Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia.
None:
Mandibular canal walls bone defects in the area of impacted teeth and follicular cysts can be a predisposing factor for inferior alveolar nerve injury during surgical intervention, followed paresthesia development. The aim of the study is to optimize surgical treatment of mandible bone defects involving mandibular canal to reduce the level of neurological complications.
Material And Methods:
The treatment of 49 patients with follicular cysts of the jaws in the area of the lower third molars was performed. The presence of a cyst cavity that projects onto or displaces the mandibular canal was the main criterion for inclusion in the study group. Based on CBCT and video endoscopy data, bone defects and mandibular canal structure of the within the boundaries of cavity formations of different volumes was determined.
Results:
Three types of bone defects in the mandibular canal were identified, which are important in choosing surgical treatment approaches. In 18.0% of cases (in 9 patients out of 49), according to CBCT, the mandibular canal did not have bone walls at the border of the cyst. The video-endoscopic examination allowed us to assess the completeness of the tooth extraction and cystectomy in each case. In particular, when examining the socket of the extracted tooth, we found fragments of roots and alveolar fragments, which were removed under the control of the endoscope. Flexible endoscope light was sufficient to examine the entire area of the jaw defect and take measurements. The actual size of bone defects measured under the control of an endoscope was 22.0% (p<0.01) smaller than the measurements based on CBCT data. The incidence of postoperative paresthesia was 25%.
Conclusion:
Video-endoscopic examination during cystectomy and tooth extraction allows for the assessment of bone defects in the mandibular canal and the integrity of the neurovascular bundle.
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