Journal of stomatology, oral and maxillofacial surgery · 2025
The impact of fracture fragment displacement on sensory function recovery of the inferior alveolar nerve in mandibular angle fractures.
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Huang Zhihui
Аннотация
OBJECTIVE: To investigate the correlation between the initial, three-dimensionally quantified displacement of mandibular angle fractures and the prognosis of inferior alveolar nerve (IAN) sensory function recovery following open reduction and internal fixation (ORIF).
METHODS: This retrospective cohort study included patients with unilateral mandibular angle fractures treated with ORIF between March 2022 and August 2025. Preoperative cone-beam computed tomography (CBCT) was used to measure the maximum 3-dimensional (3D) displacement of the fracture fragments. Patients were stratified into three groups based on displacement: mild (<2 mm), moderate (2-5 mm), and severe (>5 mm). IAN sensory function was systematically evaluated through objective tests (light touch, two-point discrimination, and pinprick) and subjective tests (Visual Analog Scale) at preoperative, 1 week, 1 month, 3 months, 6 months, and 12 months follow-ups. Multivariate logistic regression was used to identify independent predictors for complete sensory recovery.
RESULTS: A total of 128 patients were included: 45 in the mild, 52 in the moderate, and 31 in the severe displacement groups. The incidence of preoperative IAN sensory deficit was significantly higher in the severe group (67.7%) compared to the moderate (34.6%) and mild (11.1%) groups (p < 0.001). At the 12-month follow-up, the complete recovery rates were 91.1%, 63.5%, and 22.6% for the mild, moderate, and severe groups, respectively (P < 0.001). Multivariable logistic regression identified severe displacement (OR = 0.09, 95% CI: 0.03-0.29), moderate displacement (OR = 0.28, 95% CI: 0.11-0.71), and age>40 years (OR = 0.41, 95% CI: 0.18-0.93) as independent negative predictors for complete sensory recovery.
CONCLUSION: The initial 3D displacement of mandibular angle fractures is a significant predictor of IAN injury severity and postoperative sensory recovery. Preoperative quantitative assessment using CBCT may aid in personalized prognosis, patient counseling, and surgical planning.
METHODS: This retrospective cohort study included patients with unilateral mandibular angle fractures treated with ORIF between March 2022 and August 2025. Preoperative cone-beam computed tomography (CBCT) was used to measure the maximum 3-dimensional (3D) displacement of the fracture fragments. Patients were stratified into three groups based on displacement: mild (<2 mm), moderate (2-5 mm), and severe (>5 mm). IAN sensory function was systematically evaluated through objective tests (light touch, two-point discrimination, and pinprick) and subjective tests (Visual Analog Scale) at preoperative, 1 week, 1 month, 3 months, 6 months, and 12 months follow-ups. Multivariate logistic regression was used to identify independent predictors for complete sensory recovery.
RESULTS: A total of 128 patients were included: 45 in the mild, 52 in the moderate, and 31 in the severe displacement groups. The incidence of preoperative IAN sensory deficit was significantly higher in the severe group (67.7%) compared to the moderate (34.6%) and mild (11.1%) groups (p < 0.001). At the 12-month follow-up, the complete recovery rates were 91.1%, 63.5%, and 22.6% for the mild, moderate, and severe groups, respectively (P < 0.001). Multivariable logistic regression identified severe displacement (OR = 0.09, 95% CI: 0.03-0.29), moderate displacement (OR = 0.28, 95% CI: 0.11-0.71), and age>40 years (OR = 0.41, 95% CI: 0.18-0.93) as independent negative predictors for complete sensory recovery.
CONCLUSION: The initial 3D displacement of mandibular angle fractures is a significant predictor of IAN injury severity and postoperative sensory recovery. Preoperative quantitative assessment using CBCT may aid in personalized prognosis, patient counseling, and surgical planning.