Search Results (17)

Background: Augmented-reality (AR) navigation is emerging as a means of turning pre-operative cone-beam CT data into intuitive, in situ guidance for difficult tooth removal, yet the scattered evidence has never been consolidated nor illustrated with a full clinical workflow. Aims: This study aims to narratively synthesise AR applications limited to dental extractions and to illustrate a full AR-guided clinical workflow. Methods: We performed a PRISMA-informed narrative search (PubMed + Cochrane, January 2015–June 2025) focused exclusively on AR applications in dental extractions and found nine eligible studies. Results: These pilot reports—covering impacted third molars, supernumerary incisors, canines, and cyst-associated teeth—all used marker-less registration on natural dental surfaces and achieved mean target-registration errors below 1 mm with headset set-up times under three minutes; the only translational series (six molars) recorded a mean surgical duration of 21 ± 6 min and a System Usability Scale score of 79. To translate these findings into practice, we describe a case of AR-guided mandibular third-molar extraction. A QR-referenced 3D-printed splint, intra-oral scan, and CBCT were fused to create a colour-coded hologram rendered on a Magic Leap 2 headset. The procedure took 19 min and required only a conservative osteotomy and accurate odontotomy that ended without neurosensory disturbance (VAS pain 2/10 at one week). Conclusions: Collectively, the literature synthesis and clinical demonstration suggest that current AR platforms deliver sub-millimetre accuracy, minimal workflow overhead, and high user acceptance in high-risk extractions while highlighting the need for larger, controlled trials to prove tangible patient benefit. Full article

Background: Rehabilitation of atrophic posterior mandibles using dental implants is often complicated by anatomical limitations, particularly the proximity of the inferior alveolar nerve (IAN). Techniques such as IAN lateralization and transposition enable implant placement but are associated with neurosensory disturbances (NSDs). This systematic review and meta-analysis aimed to assess the incidence, duration, and predictors of NSDs following IAN repositioning for implant placement and to evaluate the effectiveness of adjunctive methods like piezo-surgery and platelet-rich fibrin (PRF) in minimizing complications. Methods: Following PRISMA 2020 guidelines, a comprehensive search of electronic databases and gray literature identified 20 studies, including randomized controlled trials, prospective cohorts, and retrospective analyses published between 2009 and 2024. Outcomes analyzed included incidence of NSDs, recovery rates, implant stability quotient (ISQ), marginal bone loss, and implant success rates. Meta-analysis was performed using RevMan 5.3 software, with heterogeneity and publication bias assessed using standard Cochrane tools. Results: Transient NSDs occurred in 15–40% of cases, with higher rates observed in transposition techniques. Most patients experienced recovery within 6 months. Piezoelectric surgery significantly reduced the incidence and duration of NSDs compared to rotary instruments. Meta-analysis revealed no statistically significant differences between lateralization and transposition techniques in ISQ, marginal bone loss, success rate, or NSDs at 3 months (p > 0.05). PRF was associated with accelerated nerve recovery. IAN repositioning is effective for implant placement in atrophic mandibles with a risk of transient NSDs. Conclusions: Lateralization combined with piezo-surgery and PRF shows favorable outcomes in minimizing nerve injury and optimizing implant success. The PROSPERO registration code is as follows: CRD420251086835. Full article

Objective: To compare the effect of different bone augmentation procedures, namely, autogenous bone blocks (ABBs) versus guided bone regeneration (GBR), on patient-reported outcomes (PROMs). Methods: This systematic review was conducted according to the PRISMA guidelines. A MEDLINE, Embase, and Web of Science search was conducted by two independent reviewers in combination with a free-hand search in relevant journals until June 2025. Outcomes were PROMs to enhance our understanding of the evolution of these procedures. Results: The electronic search yielded 6291 articles. After title screening, 67 articles were further analyzed for abstract review, which resulted in 14 articles eligible for full-text reading. Six articles were finally included based on the exclusion and inclusion criteria with a total of 295 patients. The overall study quality was low, since only two RCTs could be included. One study demonstrated a high risk of bias. Different PROMs were examined and compared such as pain, edema, neurosensory disturbance, Patient-Reported Predominant Symptom, OHIP-14, postoperative analgesic usage, willingness to repeat, and likelihood to recommend. Meta-analysis was not achievable due to a lack of direct comparisons and heterogeneity in terms of PROMs. Evaluation points varied between pretreatment and up to nearly 10-years of follow-up. Conclusions: Despite significant heterogeneity and reporting, this systematic review concluded that ABB and GBR are well-tolerated procedures. Trends such as transient postoperative pain and swelling with a minor occurring of neurosensory disturbances were reported in a few studies. Overall, a good perception of postoperative recovery was reported for both treatment modalities. Good quality of life was noted related to GBR procedures. Patient-reported outcomes were only analyzed for patients who completed the entire follow-up period. This may introduce bias, as patients who dropped out and were more likely to experience complications were not represented, potentially resulting in a more favorable portrayal of the outcomes. Further well-conducted prospective studies with a long follow-up are needed for an evidence-based evaluation and comparison of PROMs for these procedures. Full article

Background: Sensory disturbances and acquired paresthesia constitute a significant proportion of complications following orthognathic surgery. This systematic review examines the application of photobiomodulation (PBM) in managing these complications and its efficacy in promoting sensory recovery. Methods: In November 2024, a comprehensive digital search was performed across reputable databases, including PubMed, Web of Science, and Scopus, using carefully selected search terms: “orthognathic surgery” AND (physiotherapy OR physical therapy OR laser OR LLLT OR PBM OR light OR LED OR acupuncture) AND (nerve OR neurosensory OR paresthesia). The search adhered to the PRISMA guidelines. Of the 424 articles initially identified, 14 met the inclusion criteria and were included in the review. Results: The review focused on diode laser therapy for treating inferior alveolar nerve injuries, with most studies targeting this nerve and exploring diverse wavelengths, protocols, and surgical contexts, including orthognathic surgeries. Significant improvements were observed in tactile sensitivity, pain perception, and mechanical responsiveness. Factors such as earlier initiation of therapy, younger patient age, and higher treatment frequency were associated with improved outcomes. Conclusions: Low-level laser therapy emerges as a safe and effective intervention for enhancing neurosensory recovery following orthognathic surgery. However, the development of standardized treatment protocols and the conduct of larger-scale clinical trials are essential to optimize their clinical application. Full article

Study design: Systematic review. Objective: This systematic review examines the existing literature concerning the objective and subjective evaluations of osseous genioplasty outcomes. Methods: A comprehensive search was conducted in databases including PubMed, Embase, and Web of Science, yielding 2563 references, which were screened by two independent reviewers. We included 105 articles originating from 25 different countries. Data were systematically extracted, categorized, and documented. Results: Genioplasty was performed in 5218 patients, either independently (3560 cases) or in combination with other orthognathic procedures (1696 cases), with a predominant focus on female patients (64%). Objective evaluation primarily focused on surgical accuracy, relapse, and neurosensory disturbance, while subjective assessments were largely related to aesthetics and patient satisfaction. Despite significant advancements in three-dimensional surgical planning and assessment, the review highlights a lack of standardized methods for evaluating isolated genioplasty outcomes. Conclusions: The findings emphasize the need for improved and validated instruments that specifically assess the functional and aesthetic results of genioplastic surgery. Future research should prioritize patient-centered prospective studies and the development of assessment tools to ensure more comprehensive and reliable outcome evaluations. Full article

Study Design: Randomized Clinical Trial. Objective: Mandibular body fractures may result in inferior alveolar nerve damage. This study examined the effectiveness of platelet-rich fibrin (PRF) application to the inferior alveolar nerve during open reduction and internal fixation (ORIF) of mandibular fractures. Methods: This was a double-blind, split-mouth randomized clinical trial. Patients with bilateral mandibular body fractures with minimal displacement (<5 mm) who underwent ORIF were assessed for enrollment. PRF was placed within the fracture site before reduction and fixation on the studied side. Fixation was performed on the contralateral side (control side) without PRF. The study and control groups were randomized using QuickCalcs software. Neurosensory disturbance (NSD) was assessed through two-point discrimination (TPD), self-reported NSD (SR-NSD), and brush directional stroke discrimination test (BDSD) at 6 and 12 months postoperatively. Results: Twenty-five subjects were enrolled. BDSB recovery was greater in the study group during all time intervals (p < 0.001). There were no differences between TPD and SR-NSD at the follow-up periods (p > 0.05). Conclusions: The results of this split-mouth randomized clinical trial indicate that PRF may enhance the recovery of a damaged inferior alveolar nerve in mandibular body fractures. Full article

Background: Neurosensory deficits are one of the major complications after impacted lower third molar extraction leading to an impaired patient’s quality of life. This study aimed to evaluate the incidence of neurosensory deficits after lower third molar extraction and compare it radiologically to the corresponding position of the inferior alveolar nerve. Methods: In a retrospective study, all patients who underwent impacted lower third molar extraction between January and December 2019 were compiled. Therefore, clinical data as well as preoperative radiological imaging were assessed. Results: In total, 418 patients who underwent lower third molar extractions (n = 555) were included in this study. Of these, 33 (5.9%) had short-term (i.e., within the initial 7 postoperative days) and 12 (1.3%) long-term (i.e., persisting after 12 months) neurosensory deficits documented. The inferior alveolar nerve position in relation to the tooth roots showed apical position in 27%, buccal position in 30.8%, lingual position in 35.4%, and interradicular position in 6.9%. Conclusions: A statistically significant increased incidence of neurosensory deficits occurs when the inferior alveolar nerve is directly positioned lingually to the tooth roots (p = 0.01). Full article

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that has a high prevalence and a significant economic impact. Our knowledge regarding neurosensory disorders and co-occurring medical conditions in the ASD population is limited, particularly for autistic women. Most of the studies include male participants or do not make comparisons with their female counterparts. The objective of this systematic review article is to explore the quality of life as well as the prevalence of neurosensory disorders and co-occurring medical conditions in individuals on the spectrum, with a special focus on autistic females. The literature search was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. A protocol of this systematic review was designed a priori and was registered in the PROSPERO database (registration number: CRD42022330368). We concluded that numerous medical areas were of concern. Autistic females are more likely than their male counterparts with ASD to suffer from psychiatric conditions such as post-traumatic stress syndrome, depression, and eating disorders. They are also more likely to report GI-related disturbances and chronic pain. Further investigations are warranted to determine quality of life, as well as the prevalence and severity of neurosensory disorders in individuals with ASD, specifically studies comparing autistic females with their male counterparts. The information derived from these studies will help develop better support systems for individuals with autism, particularly females on the spectrum, in pursuit of improving their quality of life. Full article

Quantitative sensory testing (QST) is a standard procedure in medicine to describe sensory patterns in various pathologies. The aim of this prospective clinical study was to define reference values of the trigeminal nerve (V3), including taste qualities, to create a compatibility for sensory loss or gain in pathologies. Fifty-one patients were included, and a standardized testing battery with 11 QST parameters according to the German Research Network on Neuropathic Pain (DFNS) was applied complemented by quantitative gustatory assessments. Significant somatosensory differences were found between the test sites (MDT at the chin, WDT at the lower lip) but no effect was detected for gender, age, and between body types. Taste sensitivity was dependent on concentration, gender (females being more sensitive) and increasing age (for bitter and sour taste). We provide reference values for somatosensory and gustatory testing of the facial area. Our data facilitate the detection of neurosensory abnormalities in the orofacial region. This might also serve as a control setting for COVID-19. Full article

(1) Background: The purpose of this study was to evaluate stability and complications following mandibular setback using intraoral vertical ramus osteotomy (IVRO) and provide an assessment of IMF (Inter-maxillary Fixation) compliance. (2) Methods: This is a retrospective cohort study. It included a total of 39 patients who underwent 78 IVRO for the treatment of mandibular prognathism between 2005 and 2021 at Sheba Medical Center. Radiographic and clinical examinations were performed preoperatively (T0), 3 days post-surgery (T1) and 8 months post-surgery (T2). Measurements of dental and skeletal stability, as well as neurosensory disturbances and TMJ dysfunctions, were statistically analyzed. (3) Results: The mean mandibular setback was 5.6 mm. A relapse of less than 2 mm was observed at T2. A short-term neurological disturbance was reported in 38.46% of the 39 patients, and 17.94% of them showed full recovery by T2. In 21 patients who underwent IVRO without genioplasty, only 14.28% reported long-term sensory disturbance. In addition, when a vertical osteotomy was performed, neurological damage was 174% higher as compared to oblique osteotomy. The IMF compliance rate for the 6 weeks postoperatively was 100%. (4) Conclusions: IVRO is still a relevant and valid technique for the treatment of mandibular prognathism that provides stable results with minimal complications rate. Full article

Cutaneous neurosensory symptoms have become increasingly reported findings in COVID-19; however, these virus-related manifestations are largely overlooked, and their pathology is poorly understood. Moreover, alterations of skin sensibility currently recognize no clear histopathology substrate. The purpose of this study was to provide pathology evidence of neurosensory skin system involvement in COVID-19 patients complaining of subjective neurological symptoms affecting the skin. Out of 142 patients, six long COVID-19 cases complaining of cutaneous subjective neurological symptoms assessed on an NTSS-6 questionnaire underwent histopathological and immunohistochemical analyses of skin areas affected by paroxysmal diffuse burning and itching sensations. Two patients also performed electroneurography examination. The histology investigation showed hypertrophic glomus vascular bodies with hypertrophic S100+ perineural sheath cells and adjacent hypertrophy of the nerve branches associated with increased basophil polysaccharide matrix. Electroneurography revealed disturbances of A-delta and C dermal neuronal fibers. The main limitation of this study consisted of a limited number of skin biopsy samples, requiring further investigation. Histopathology findings are consistent with hypertrophy of nerve endings, suggesting a condition such as “dermal hyperneury”, a recently reported small nerve hypertrophy condition affecting sensory C fibers. Such a neuropathic basis could explain dysesthesia experienced by the patients, as previously described in postherpetic neuralgia. Full article

Background and Objectives: Neurological manifestations of Coronavirus Disease 2019 (COVID-19) such as olfactory and gustatory disturbance have been reported among convalescent COVID-19 patients. However, scientific data on the prevalence of smell and taste disturbance are lacking. Therefore, we present findings on the degree of smell and taste disturbances among the Armenian population. Methods: Study participants were randomly recruited and then categorized into two groups based on their course of the disease. A cross-sectional study was performed to assess participants’ sensitivity to smell triggered by the olfactory and the trigeminal nerves; their ability to differentiate between various odors; and to evaluate their gustatory perception. Results: The smell test revealed that the degree of olfactory nerve disturbance was different by 30.7% in those participants of the early group as compared to those of the late group, and the degree of trigeminal nerve disturbance was different by 71.3% in the early group as compared to the late group. A variation of the differentiating ability among the participants of the early and late groups was detected. Gustatory disturbances for all flavors were also found to be different in both the groups. A moderate positive correlation (0.51) was found between the overall sensitivity of smell and the ability to differentiate between various odors as cumulatively stimulated by both the olfactory and trigeminal nerves. Also, a moderate positive correlation (0.33) was found between headache and smell sensitivity through the olfactory nerve and a high negative correlation (−0.71) was found between headache and smell sensitivity through the trigeminal nerve. Conclusion: Pathological changes in the olfactory and trigeminal perceptive abilities caused disturbances in smell sensation, with the trigeminal nerve being more affected. The capacity to differentiate fragrances did not improve with time and the disturbance severity of bitter taste perception was higher among the study participants. Full article

Study Design: Retrospective study. Objective: To evaluate current trends in maxillofacial trauma, a retrospective study of mandibular fractures at Government Dental College and Hospital Shimla H.P was carried out. Methods: In this retrospective study, records of 910 patients with mandibular fractures were reviewed between 2007 and 2015 in the Department of Oral and Maxillofacial Surgery out of total 1656 facial fractures. These mandibular fractures were assessed according to age, sex, aetiology in addition to monthly and yearly distribution. Post-operative complications such as malocclusion, neurosensory disturbances and infection were recorded. Results: It was observed that mandibular fractures were most frequent in males (67.5%) and in the age group of 21–30 years; accidental fall was the most common etiological factor (43.8%) in the present study and in stark difference to already published reports. The most common fracture site was that of condylar region 239 (26.2%). Open reduction and internal fixation (ORIF) were done in 67.3% cases whereas 32.6% were managed by maxillomandibular fixation and circummandibular wiring. Miniplate osteosynthesis was the most favoured technique. The complication with ORIF was 16%. Conclusions: To treat mandibular fractures, currently there are many techniques. However, in minimizing complications and in achieving satisfactory functional and aesthetic results experienced surgical team plays an important role. Full article

One in four myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients are estimated to be severely affected by the disease, and these house-bound or bedbound patients are currently understudied. Here, we report a comprehensive examination of the symptoms and clinical laboratory tests of a cohort of severely ill patients and healthy controls. The greatly reduced quality of life of the patients was negatively correlated with clinical depression. The most troublesome symptoms included fatigue (85%), pain (65%), cognitive impairment (50%), orthostatic intolerance (45%), sleep disturbance (35%), post-exertional malaise (30%), and neurosensory disturbance (30%). Sleep profiles and cognitive tests revealed distinctive impairments. Lower morning cortisol level and alterations in its diurnal rhythm were observed in the patients, and antibody and antigen measurements showed no evidence for acute infections by common viral or bacterial pathogens. These results highlight the urgent need of developing molecular diagnostic tests for ME/CFS. In addition, there was a striking similarity in symptoms between long COVID and ME/CFS, suggesting that studies on the mechanism and treatment of ME/CFS may help prevent and treat long COVID and vice versa. Full article

Altered smell is one of the most prevalent symptoms in acute COVID-19 infection. Although most patients recover normal neurosensory function in a few weeks, approximately one-tenth of patients report long-term smell dysfunction, including anosmia, hyposmia, parosmia and phantosmia, with a particularly notable impact on quality of life. In this complex scenario, inflammation and cellular damage may play a key role in the pathogenesis of olfactory dysfunctions and may affect olfactory signaling from the peripheral to the central nervous system. Appropriate management of smell disturbances in COVID-19 patients must focus on the underlying mechanisms and the assessment of neurosensorial pathways. This article aims to review the aspects of olfactory impairment, including its pathophysiology, epidemiology, and clinical management in post-acute COVID-19 syndrome (PACS). Full article