INFLUENCE OF DAMAGE OF LOWER ALVEOLAR NERVE AFTER REMOVAL OF IMPACTED LOWER MOLARS TO LEVEL ON MARKERS OF SURGICAL STRESS

• Main Authors: Oleg Ja. Mokryk, Nadiіa I. Paterega, Vira V. Vynarchuk-Patereha, Vitaliy I. Rozhko
• Format: Article
• Language: English
• Published: Romanian Dental Association for Education 2019-09-01
• Series: Romanian Journal of Medical and Dental Education
• Subjects: anxiety; cortisol; impacted lower third molars; lower alveolar nerve; neuropathy
• Online Access: http://journal.adre.ro/influence-of-damage-of-lower-alveolar-nerve-after-removal-of-impacted-lower-molars-to-level-on-markers-of-surgical-stress/

Post-traumatic stress disorder, caused by inflammation and swelling of the facial soft tissues, pain syndrome, trismus, sensory violation of the functions of the lower alveolar nerve (LAN) and / or tongue nerves, may occur after the complex removal of deeply impacted lower third molars (ILTM) in patients. An important role in the appearance of anxiety and psychoemotional stress belongs to the subjective and objective symptoms of neuropathy. The study of the effect of clinical symptoms of neuropathy of the LAN on the appearance of anxiety and growth of cortisol, as a marker of the severity of the body’s stress response, in the oral fluid of patients after the removal of ILTM was conducted. The observation was conducted in 30 operated patients for ILTM. For the first postoperative day, 17 patients (56,7%) had a mild degree, and 10 (33,3%) had a moderate degree of neuropathy of the LAN. The level of anxiety according to the HADS scale was elevated in 6 patients (20,0 %) with a mild degree of neuropathy of the LAN (8,5 ± 0,8 points), and in 7 patients (23,3 %) with moderate degree of neuropathy revealed clinically expressed symptoms of anxiety (11,7 ± 0.8 points). During the 3rd postoperative day, the number of patients with elevated anxiety increased to 8 (26,7 %) in patients with a mild degree of neuropathy of the LAN and in all patients with a moderate degree of neuropathy of the nerve, χ2 = 12,34 (р < 0,01). On the 1st day of postoperative period, the level of cortisol increased in 5 (16,7%) patients with subclinical manifestations of anxiety and in 7 patients (23,3%) with clinical manifestations (χ2 = 26,53, р˂0,001). On the 3rd day cortisol was elevated in 7 people (23,3%) with subclinical manifestations of anxiety and in 10 patients (33,3%) – with clinical manifestations (χ2 = 26,44, р˂0,001). The appearance of clinical symptoms of neuropathy in the LAN causes the appearance of psychoemotional stress (anxiety) of varying degrees of severity in them, which affects the growth of cortisol levels in the oral liquid.