J Korean Assoc Oral Maxillofac Surg.  2011 Dec;37(6):464-469. 10.5125/jkaoms.2011.37.6.464.

Evaluation of the change of lower lip sensation after inferior alveolar nerve block by using the electric pulp tester

• Ku MS
• Kim JW
• Jeon YH
• Kwon TG
• Lee SH

• KMID: 2136982
• DOI: http://doi.org/10.5125/jkaoms.2011.37.6.464

Abstract

INTRODUCTION
As dental implant surgery is becoming increasingly popular, it has become one of the causes for the hypesthesia of the inferior alveolar nerve, along with other surgical procedures, such as a third molar extraction. In addition, it tends to cause legal problems between the operator and patient. Therefore, there must be a proper method that is reliable, objective and economical to assess the nerve impairment. For this reason, an attempt was made to use an Electric Pulp Tester to assess inferior alveolar nerve block anesthesia.
MATERIALS AND METHODS
Thirty patients were tested. Electric pulp testing of the lower jaw skin was performed at the three different times, before anesthesia, at the onset of sensory changes and after 15 minutes waiting from the onset, and on the 10 points of the chin, which produced 10 sections on the skin area.
RESULTS
Twenty seven patients (90%) could feel the electric stimulus on the chin at all 10 points before local anesthesia and the scores represent the statistical differences between the right and left points except R4 and L4. After anesthesia, the difference between the right and left points (L3-R3, L4-R4, L5-R5) increased significantly with time but two points (L2, R2) showed no significant difference. The scores on the left chin (L3, L4, L5) increased, whereas the other points (R1-R5, L1, L2) showed no significant differences.
CONCLUSION
This study highlights the potential clinical use of an electric pulp tester for an assessment of inferior alveolar nerve impairment.

Keyword

Pulp test; Hypesthesia; Inferior alveolar nerve

MeSH Terms

Anesthesia
Anesthesia, Local
Chin
Dental Implants
Humans
Hypesthesia
Jaw
Lip
Mandibular Nerve
Molar, Third
Sensation
Skin
Dental Implants

Figure

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  Fig. 1. Gentle-Pulse Pulp Vitality Tester D624MS (Parkell Inc., Edgewood, NY, USA). Myong-Suk Ku et al. Evaluation of the change of lower lip sensation after inferior alveolar nerve block by using the electric pulp tester. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 2. Schematic diagram of the evaluation landmarks for electric pulp tester included inferior alveolar nerves and photo of measuring patient. ① R1: a center of right mandible posterior 1/3, ② R2: a center of right mandible middle 1/3, ③ R3: the point 5 mm beneath right commissure of the lip (angular branch), ④ R4: one third of lower lip vermilion border: right (inferior labial branch), ⑤ R5: a center of perpendicular line from R4 to chin (mental branch), ⑥ L5: a center of perpendicular line from L4 to chin (mental branch), ⑦ L4: one third of lower lip vermilion border: left (inferior labial branch), ⑧ L3: the point 5 mm beneath left commissure of the lip (angular branch), ⑨ L2: a center of left mandible middle 1/3, ⑩ L1: a center of left mandible posterior 1/3. Myong-Suk Ku et al. Evaluation of the change of lower lip sensation after inferior alveolar nerve block by using the electric pulp tester. J Korean Assoc Oral Maxillofac Surg 2011

Reference

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