Evaluation of neuro-sensory disturbances of the inferior alveolar nerve after ORIF procedure in mandibular fracture: a systematic review

Introduction
Mandibular fracture can cause displacement of bones and affect the nerve that can lead to neuro-sensory disturbances of inferior alveolar nerve. Disturbances can vary among patients due to severity of the fracture and invasion of the procedure. It is important to evaluate these disturbances to inform patients and improve treatment results.

Objectives
To evaluate neuro-sensory disturbances of inferior alveolar nerves after open reduction internal fixation (ORIF) procedure in mandibular fracture.

Material and methods
This review used PubMed, Science Direct, SpringerLink, SCOPUS, Medline, and Cochrane databases as bibliographic resources. Studies with matching key words were analysed and screened with PRISMA recommendations.

Results
A total of 133 studies were reviewed, but only twelve were included in this evaluation. 44.4% of mandi­bular cases treated with ORIF suffered from neuro-sensory disturbances. Cases were mostly evaluated objectively by clinical neuro-sensory testing (CNST) with Zuniga-Essick algorithm, and subjectively with questioner with visual analogue scale (VAS) scoring system. Post-operative evaluation was performed in 75% in the first week, and 58% of patients were continued to be evaluated in the sixth month.

Conclusions
Neuro-sensory disturbance is the main risk of ORIF procedure in mandibular fracture management. Subjective and objective evaluation is important to obtain information about disturbances due to difficulties for patients to express their feeling. Periodic evaluation should be performed to monitor disturbances recovery.