Factors influencing outcomes of inferior alveolar nerve repair: a systematic review

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Functional sensory recovery (FSR) significantly affects patients’ quality of life, but the influence of age, sex, timing of repair, and surgical methods remains unclear. Addressing this knowledge gap is essential for improving clinical outcomes and optimizing surgical approaches. By examining these variables, this research seeks to provide evidence-based insights to guide patient care and enhance recovery strategies. This study aims to identify factors influencing FSR of the inferior alveolar nerve (IAN) after microsurgical repair. Methods: A systematic review adhering to PRISMA guidelines was conducted. Predictor variables included age, sex, time from injury to repair, and method of repair. Eligible studies reported preoperative Medical Research Council Scale (MRCS) scores of S2+ or lower and assessed FSR rates. Exclusions applied to reviews, animal studies, pre-2010 publications, and those lacking full-text availability. Electronic searches of PubMed, Scopus, and Cochrane Library databases were performed on February 15, 2024. Risk of bias was evaluated using the GRADE framework, and study quality was assessed via the Newcastle-Ottawa Scale (NOS). FSR outcomes, defined as achieving an MRCS score of S3, were analyzed using chi-squared tests or Pearson’s correlation coefficients. Results: Six studies (5 retrospective cohort studies, 1 case series) were included. Age negatively correlated with FSR, with recovery declining by 3% per year after age 51 years (P=0.02). Sex did not significantly influence FSR (χ2=2.77, P=0.09). Earlier repair showed better FSR rates (85.7% within 60 days vs. 44.4% after 60 days; P=0.07). While the method of repair lacked statistical significance (χ2=14.05, P=0.08), autografts reported the highest FSR rate (87.32%). Conclusions: Early surgical intervention is critical for optimizing FSR outcomes, especially in older patients. Age and delayed repair negatively impact recovery, while sex and surgical methods demonstrate limited influence. Further high-quality research is necessary to validate these findings and refine clinical guidelines.

Original languageAmerican English
Article number25
JournalFrontiers of Oral and Maxillofacial Medicine
Volume7
DOIs
StatePublished - Dec 10 2025

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology

Keywords

  • functional sensory recovery (FSR)
  • Inferior alveolar nerve (IAN)
  • Medical Research Council Scale (MRCS)

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