下歯槽神経損傷後の知覚異常に伴う歯の知覚過敏：症例報告と関連する神経生理学的考察

Tooth hypersensitivity associated with paresthesia after inferior alveolar nerve injury: case report and related neurophysiology.

• Tae Min You

抄録

下歯槽神経（IAN）損傷は、通常、神経血管構造の伸展や圧迫、歯科治療後の歯槽内血腫や浮腫によって引き起こされる。その結果，同側の顎，唇（朱色の縁，皮膚，粘膜），下顎前歯の唇側または頬側の歯槽粘膜に知覚障害が生じる。しかし，IAN損傷後に歯の感覚変化，特に歯の知覚過敏が生じたという報告はない。本稿では，IANに近接した第三大臼歯を抜去した後，下唇の知覚異常と下顎前歯の知覚過敏が同時に生じた症例を報告する。さらに、神経損傷後に歯と顎（皮膚）で感覚の変化が異なる理由を、神経生理学的な観点から考察しています。歯髄や歯周組織は下歯槽感覚ニューロンの支配を強く受けていることから，歯科治療中にIANを損傷した場合，歯の感覚の変化に注意を払う必要があると思われる。

Inferior alveolar nerve (IAN) injury is usually caused by stretching or crushing of the neurovascular structures and postoperative intra-alveolar hematoma or edema after dental procedures. This results in paresthesia in the ipsilateral chin, lip (vermilion border, skin, and mucosa), and labial or buccal alveolar mucosa of the mandibular anterior teeth. However, there are no reports of sensory alterations in the teeth, especially tooth hypersensitivity, after IAN injury. I report a case in which paresthesia of the lower lip and hypersensitivity of the lower anterior teeth occurred simultaneously after the removal of the third molar that was located close to the IAN. In addition, I discuss the reasons for the different sensory changes between the tooth and chin (skin) after nerve injury from a neurophysiological point of view. Since the dental pulp and periodontal apparatus are highly innervated by the inferior alveolar sensory neurons, it seems necessary to pay attention to the changes in tooth sensitivity if IAN injury occurs during dental procedures.

Copyright © 2021 Journal of Dental Anesthesia and Pain Medicine.