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Características de lesões iatrogénicas do nervo alveolar inferior ocorridas na abordagem cirúrgica de terceiros molares mandibulares
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| 34.05 MB | Adobe PDF |
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Advisor(s)
Abstract(s)
A extração dos sisos, especialmente dos terceiros molares inclusos inferiores, são
um dos procedimentos mais comuns em cirurgia oral.
Com uma técnica cirúrgica adequada e atenta, as possíveis complicações que possam surgir são, principalmente, consequência da inflamação pelo trauma no osso e mucosas. No entanto, alguns danos neurológicos, embora pouco frequentes, mas complexos podem ocorrer para o doente, nomeadamente as lesões do nervo alveolar inferior (NAI).
Esta revisão bibliográfica tem como objetivo estudar as características de lesões
iatrogénicas do nervo alveolar inferior ocorridas na abordagem cirúrgica de terceiros
molares mandibulares.
Numa primeira parte será feita uma revisão anatómica do local a estudar.
A seguir, será realizada uma análise à fase inicial do plano de tratamento, que consiste em enquadrar um diagnóstico com a ajuda dos exames clínicos e complementares
de diagnósticos do doente. O objetivo desta abordagem é confirmar a indicação para o
tratamento, precaver possíveis complicações intra-operatórias e considerar as possíveis
complicações pós-operatórias, nomeadamente as lesões neurológicas. Para tal, iremos
recordar as diferentes classificações de acordo com a posição e o grau de inclinação do
terceiro molar.
Em terceiro lugar, estudaremos os passos cirúrgicos para esta extração.
Numa quarta fase e referente ao pós-operatório imediato, a prescrição medicamentosa e os cuidados pós-operatórios a ter, serão recordados.
Finalmente, os agentes responsáveis pelos danos causados ao NAI e serão
detalhados os passos cirúrgicos para a extração dos sisos inclusos mandibulares.
Wisdom teeth extraction, particularly impacted mandibular third molars, are one of the most common procedures performed in oral surgery. With an appropriate and careful surgical technique, the most predictable complications are mainly a consequence of inflammation caused by bone and soft tissues trauma, nevertheless, less frequently but more complex neurological damage to the patient may occur, in particular, inferior alveolar nerve (NAI) injuries. This literature review aims to study the characteristics of iatrogenic lesions of the inferior alveolar nerve occurred in the surgical approach of impacted mandibular third molars. In the first part, an anatomical review of the surgical site will be carried out. In a second part, an analysis of the initial phase of treatment planning will be made, which consists of framing a diagnosis with the help of clinical and radiographic data. The aim of this approach is to confirm the proper indication for the treatment, to prevent possible intraoperative complications and consider possible postoperative complications, namely neurological lesions. To this end, a recall of the most common classifications of third molar positions according to their position and degree of inclination will be carried out. In a third part, the surgical steps for these extractions will be reviewed. In a fourth part, regarding the immediate postoperative period, drug prescriptions and postoperative care will be presented. Finally, the responsible agents for the damage to NAI will be studied, existing treatment for the management of neurological iatrogenic lesions of the NAI will be reviewed.
Wisdom teeth extraction, particularly impacted mandibular third molars, are one of the most common procedures performed in oral surgery. With an appropriate and careful surgical technique, the most predictable complications are mainly a consequence of inflammation caused by bone and soft tissues trauma, nevertheless, less frequently but more complex neurological damage to the patient may occur, in particular, inferior alveolar nerve (NAI) injuries. This literature review aims to study the characteristics of iatrogenic lesions of the inferior alveolar nerve occurred in the surgical approach of impacted mandibular third molars. In the first part, an anatomical review of the surgical site will be carried out. In a second part, an analysis of the initial phase of treatment planning will be made, which consists of framing a diagnosis with the help of clinical and radiographic data. The aim of this approach is to confirm the proper indication for the treatment, to prevent possible intraoperative complications and consider possible postoperative complications, namely neurological lesions. To this end, a recall of the most common classifications of third molar positions according to their position and degree of inclination will be carried out. In a third part, the surgical steps for these extractions will be reviewed. In a fourth part, regarding the immediate postoperative period, drug prescriptions and postoperative care will be presented. Finally, the responsible agents for the damage to NAI will be studied, existing treatment for the management of neurological iatrogenic lesions of the NAI will be reviewed.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Terceiros molares mandibulares inclusos Nervo alveolar Lesões iatrogénicas