Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons · 2026
Time to Functional Sensory Recovery Following Mental Nerve Skeletonization.
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Xavier Frijo, Raghani Manish J, Rao Santhosh
Аннотация
BACKGROUND: Mental nerve skeletonization is commonly required during intraoral open reduction and internal fixation (ORIF) of mandibular parasymphysis and body fractures, yet objective, time-based data on functional sensory recovery (FSR) remain limited.
PURPOSE: The purpose of the study was to measure the association between Mandibular Injury Severity Score (MISS) and the time to FSR.
STUDY DESIGN, SETTING, AND SAMPLE: This prospective cohort study was conducted at the Department of Dentistry, Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Raipur, India. Individuals aged ≥14 years undergoing intraoral ORIF for displaced or minimally displaced mandibular parasymphysis or anterior body fractures were included. Subjects with preoperative neurosensory deficits, pathological or infected fractures, prior mandibular surgery, or intraoperative mental nerve transection were excluded.
PREDICTOR VARIABLE: The predictor variable was mandibular fracture severity measured using the MISS.
MAIN OUTCOME VARIABLES: The primary outcome was time to FSR, defined as attainment of S3 or greater recovery according to the British Medical Council sensory grading system based on standardized objective neurosensory testing. Secondary outcomes included time to subjective sensory recovery, defined as a visual analog scale score of ≤1 on a 0 to 10 scale.
COVARIATES: Covariates included age, sex, and fracture site.
ANALYSES: Kaplan-Meier survival analysis was used to estimate time to recovery. Univariate Cox proportional hazards regression models were constructed. Statistical significance was set at P < .05.
RESULTS: The sample included 26 participants with a mean age of 33.0 ± 11.8 years; 22 (84.6%) were male. The median MISS was 8.5 (interquartile range: 6.0 to 13.0). All participants achieved FSR during follow-up. The median time to FSR was 6.0 weeks (interquartile range: 6.0 to 12.0), with 61.5% (n = 16) recovering by 6 weeks and 100% (n = 26) by 12 weeks. MISS was not statistically associated with time to FSR (hazard ratio: 0.90; 95% confidence interval [CI]: 0.80 to 1.02; P = .09).
CONCLUSIONS: In this cohort study, FSR after mental nerve skeletonization during mandibular ORIF occurred within 12 weeks. MISS did not correlate with recovery time, informing postoperative counseling.
PURPOSE: The purpose of the study was to measure the association between Mandibular Injury Severity Score (MISS) and the time to FSR.
STUDY DESIGN, SETTING, AND SAMPLE: This prospective cohort study was conducted at the Department of Dentistry, Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Raipur, India. Individuals aged ≥14 years undergoing intraoral ORIF for displaced or minimally displaced mandibular parasymphysis or anterior body fractures were included. Subjects with preoperative neurosensory deficits, pathological or infected fractures, prior mandibular surgery, or intraoperative mental nerve transection were excluded.
PREDICTOR VARIABLE: The predictor variable was mandibular fracture severity measured using the MISS.
MAIN OUTCOME VARIABLES: The primary outcome was time to FSR, defined as attainment of S3 or greater recovery according to the British Medical Council sensory grading system based on standardized objective neurosensory testing. Secondary outcomes included time to subjective sensory recovery, defined as a visual analog scale score of ≤1 on a 0 to 10 scale.
COVARIATES: Covariates included age, sex, and fracture site.
ANALYSES: Kaplan-Meier survival analysis was used to estimate time to recovery. Univariate Cox proportional hazards regression models were constructed. Statistical significance was set at P < .05.
RESULTS: The sample included 26 participants with a mean age of 33.0 ± 11.8 years; 22 (84.6%) were male. The median MISS was 8.5 (interquartile range: 6.0 to 13.0). All participants achieved FSR during follow-up. The median time to FSR was 6.0 weeks (interquartile range: 6.0 to 12.0), with 61.5% (n = 16) recovering by 6 weeks and 100% (n = 26) by 12 weeks. MISS was not statistically associated with time to FSR (hazard ratio: 0.90; 95% confidence interval [CI]: 0.80 to 1.02; P = .09).
CONCLUSIONS: In this cohort study, FSR after mental nerve skeletonization during mandibular ORIF occurred within 12 weeks. MISS did not correlate with recovery time, informing postoperative counseling.