Connector-Assisted Repair of Transected Inferior Alveolar and Lingual Nerves Using Photochemical Tissue Bonding

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Science
• Regenerative Medicine

Background:

• Inferior alveolar nerve (IAN) and lingual nerve (LN) injuries are common complications following oral surgery and trauma.
• Microsurgical repair is often necessary for these nerve injuries.
• Photochemical tissue bonding (PTB) offers a novel light-activated approach to create molecular crosslinks for tissue repair.

Purpose of the Study:

• To compare the mechanical repair strength of suture repair versus PTB using a nerve connector.
• To evaluate the efficacy of PTB in sealing nerve connectors for IAN and LN repair.

Main Methods:

• An ex vivo study using Yorkshire pig IAN and LN.
• Nerves were transected and repaired using either 4 simple interrupted 10-0 polyamide sutures or a PTB-activated porcine small intestinal submucosa (SIS) nerve connector.
• Mechanical testing measured maximal load to failure and maximum stress at failure using an ADMET mechanical microtester.

Main Results:

• PTB repair with porcine SIS conduits exhibited significantly greater maximal load to failure (2.76 ± 1.01 N) compared to suture repair (0.39 ± 0.28 N) (P = .0006).
• Maximum stress at failure was also significantly higher for PTB repair (0.490 ± 0.319 N/mm²) versus suture repair (0.125 ± 0.181 N/mm²) (P = .0039).

Conclusions:

• Photosealed porcine SIS nerve connectors provide superior mechanical strength over suture repair for transected nerves.
• PTB technology holds significant potential for improving and simplifying nerve repair procedures in oral and maxillofacial surgery.