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Variações anatómicas do nervo lingual face ao rebordo posterior da mandíbula
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Abstract(s)
A variação anatómica do nervo lingual em relação ao rebordo alveolar posterior da mandíbula é importante em procedimentos da medicina dentária, sendo o exemplo mais demarcado da sua importância as exodontias de terceiros molares inferiores. Em alguns casos, o nervo lingual pode se posicionar mais superior ou lateralmente em relação ao esperado, o que aumenta o risco de lesão durante a cirurgia. O nervo lingual é uma estrutura sensitiva que inerva a língua e a gengiva lingual, podendo apresentar variações anatómicas na sua trajetória em relação ao rebordo posterior da mandíbula. Em algumas pessoas, o nervo lingual pode estar posicionado mais superiormente do que o esperado, ou até mesmo lateralizado em relação ao trajeto comum. Essas variações podem aumentar o risco de lesão durante procedimentos cirúrgicos, como a extração de terceiros molares mandibulares. Por isso, é essencial que os profissionais de saúde estejam cientes dessas variações anatómicas e realizem o procedimento de modo a prevenir uma possível lesão, a fim de evitar danos ao nervo lingual e garantir a segurança do paciente durante o tratamento. Desta forma foi efetuada uma pesquisa bibliográfica com limite temporal a partir do ano 2013 nas bases de dados PubMed e B-On, seguindo as guidelines PRISMA. A pesquisa foi efetuada através das seguintes palavras-chave: "lingual nerve", "mandibular third region", "relation", "anatomical relationship", usando o operador boleano AND. Foram definidos os seguintes critérios de inclusão: revisões sistemáticas, casos clínicos, estudos clínicos, estudos observacionais, efetuados em humanos, artigos em inglês. Dos 120 artigos iniciais, foram incluídos 8 estudos que consideravam os objetivos propostos. Verificou-se que existem algumas variações anatómicas do nervo lingual, mas que estas observações devem ser analisadas com cautela devido à heterogeneidade dos estudos incluídos a nível de distribuição geográfica. Curiosamente, foram observadas distâncias horizontais e verticais médias semelhantes entre os vários estudos e pontos de medição. No entanto, o nervo lingual em posição supracrestal é mais frequente na região retromolar. Apesar das limitações, esta revisão oferece uma perspetiva clinicamente relevante sobre a anatomia do nervo lingual, fornecendo uma diretriz conservadora para os médicos dentistas.
The anatomical variation of the lingual nerve in relation to the posterior ridge of the mandible is important in dental procedures such as third molar extractions. In some cases, the lingual nerve may be positioned more inferiorly or laterally than expected, which increases the risk of injury during surgery. Thus, it is crucial to perform careful evaluation through imaging tests, such as panoramic x-rays or CT scans, to avoid nerve damage during dental procedures. The lingual nerve is a sensory structure that innervates the tongue and may present anatomical variations in its trajectory in relation to the posterior border of the mandible. In some people, the lingual nerve may be positioned lower than expected, or even lateralized relative to the common path. These variations can increase the risk of injury during surgical procedures, such as the extraction of mandibular third molars. Therefore, it is essential for healthcare professionals to be aware of these anatomical variations and to carry out a careful evaluation through imaging tests before any intervention in order to avoid damage to the lingual nerve and ensure patient safety during treatment. Thus, a bibliographic search was carried out with a time limit from the year 2013 in the PubMed and B-On databases, following the PRISMA guidelines. The search was performed using the following keywords: "lingual nerve", "mandibular third region", "relation", "anatomical relationship" using the Boolean operator AND. The following inclusion criteria were defined: systematic reviews, clinical cases, clinical studies, observational studies, human studies, articles in English and Portuguese. Of the initial 120 articles, 8 studies that considered the proposed objectives were included. It was found that there are some anatomical variations of the lingual nerve, but that these observations should be analyzed with caution due to the heterogeneity of the included studies in terms of geographical distribution. Interestingly, similar average horizontal and vertical distances were observed. However, the retromolar region was more frequent for lingual nerves with supracrestal positions, while the lingual nerve was more likely to come into contact with the lingual plate in the third molar region. Despite the limitations, this review offers a clinically relevant perspective on lingual nerve anatomy, providing a conservative guideline for dentists.
The anatomical variation of the lingual nerve in relation to the posterior ridge of the mandible is important in dental procedures such as third molar extractions. In some cases, the lingual nerve may be positioned more inferiorly or laterally than expected, which increases the risk of injury during surgery. Thus, it is crucial to perform careful evaluation through imaging tests, such as panoramic x-rays or CT scans, to avoid nerve damage during dental procedures. The lingual nerve is a sensory structure that innervates the tongue and may present anatomical variations in its trajectory in relation to the posterior border of the mandible. In some people, the lingual nerve may be positioned lower than expected, or even lateralized relative to the common path. These variations can increase the risk of injury during surgical procedures, such as the extraction of mandibular third molars. Therefore, it is essential for healthcare professionals to be aware of these anatomical variations and to carry out a careful evaluation through imaging tests before any intervention in order to avoid damage to the lingual nerve and ensure patient safety during treatment. Thus, a bibliographic search was carried out with a time limit from the year 2013 in the PubMed and B-On databases, following the PRISMA guidelines. The search was performed using the following keywords: "lingual nerve", "mandibular third region", "relation", "anatomical relationship" using the Boolean operator AND. The following inclusion criteria were defined: systematic reviews, clinical cases, clinical studies, observational studies, human studies, articles in English and Portuguese. Of the initial 120 articles, 8 studies that considered the proposed objectives were included. It was found that there are some anatomical variations of the lingual nerve, but that these observations should be analyzed with caution due to the heterogeneity of the included studies in terms of geographical distribution. Interestingly, similar average horizontal and vertical distances were observed. However, the retromolar region was more frequent for lingual nerves with supracrestal positions, while the lingual nerve was more likely to come into contact with the lingual plate in the third molar region. Despite the limitations, this review offers a clinically relevant perspective on lingual nerve anatomy, providing a conservative guideline for dentists.
Description
Keywords
Nervo lingual Região mandibular Relação anatómica Variações anatómicas Lingual nerve Mandibular third region Anatomical relationship Anatomical variations