Nervous system functioning disorders in patients with mandible fractures

Relevance. Fractures of the mandibular fracture are a stressor on the body and lead to changes in the functioning of the autonomic nervous system. At the same time, patients with mandibular fractures often experience local changes in the nervous system associated with the anatomical and physiological features of the location of the third branch of the trigeminal nerve and its damage. These changes affect the course of the post-traumatic period and may increase the likelihood of complications of mandibular fractures.

Purpose: to determine the significance of disturbances in the functioning of the nervous system during the post-traumatic period of fractures of the mandibular fracture.

Materials and methods. When examining 130 patients with fractures of the mandibular fracture, the state of the autonomic nervous system and local neurological changes were studied.

Results. In patients with mandibular fractures, dysfunction of the autonomic (autonomic) nervous system and local neurological changes were revealed.The severity of these changes is reflected in the development of complications of fractures. When studying the autonomic nervous system in patients with mandibular fractures, there was an increase in the activity of the sympathetic nervous system, which increased the likelihood of developing complications of mandibular fractures. A high incidence of injury to the inferior alveolar nerve was also found. The most pronounced deviations in autonomic balance indicators – pathological increased excitability of the autonomic nervous system – were diagnosed in patients with complicated fractures of the mandibular fractures. In most patients with complicated mandibular fractures, damage to the trigeminal nerve was detected, confirming the role of neurotrophic disorders in the development of complications.

Conclusion. With fractures of the mandible, there is an increase in the activity of the sympathetic nervous system, which increases the likelihood of complications. The most pronounced deviations in autonomic balance indicators were diagnosed in patients with complicated fractures of the mandible. In addition, in patients with mandibular fractures, a high incidence of damage to the inferior alveolar nerve was revealed; in complicated fractures, neuropathy is severe, which confirms the role of neurotrophic disorders in the development of complications. Thus, methods for preventing purulent-inflammatory complications in jaw fractures should include correction of neurological disorders.

1. Damage to the third branch of the trigeminal nerve during a fracture of the mandiblе / A. Yeshiev, N. Khasanshina, N. Azimbaev // Medicine and innovations. – 2022. – 1(4). – Р. 264–268.

2. Types of fractures of the mandiblе depending on anatomical features / G.R. Bakhteeva, S.S. Savelyeva, A.S. Bakhteeva, D.A. Grigorieva // Dental Forum. – 2020. – No. 4(79). – P. 7–8.

3. Lepilin A.V. The use of transcutaneous electrical neurostimulation in the complex treatment of patients with fractures of the mandiblе / A.V. Lepilin, G.R. Bakhteeva, N.L. Erokina // Dentistry. – 2007. – T. 86, No. 2. – P. 54–57.

4. Analysis of the reasons for the development of complications of fractures of the mandiblе / A.V. Lepilin, N.L. Erokina, S.B. Fishchev [et al.] // Periodonto- logy. – 2018. – T. 23, No. 2(87). – P. 62–65. – DOI: 10.25636/PMP.1.2018.2.11.

5. Bakhteeva G.R. Features of the course and treatment of fractures of the mandiblе, accompanied by damage to the third branch of the trigeminal nerve: specialty 01.14.14 «Dentistry»: dissertation for the degree of candidate of medical sciences / Bakhteeva Galiya Rifatovna. – Volgograd, 2010. – 106 p.

6. The state of the inferior alveolar and mental nerves during the healing of mandibular fractures under conditions of transosseous osteosynthesis / N.A. Shchudlo, I.V. Borisova, V.V. Krasnov, N.A. Dobychina // Dentistry. – 2012. – 91(3) – P. 4–6.

7. Damage to the trigeminal nerve. Four years of experience in one Argentine specialized center and review of the literature / M. Garcia-Blanco, A.F. Gualtieri, A.K. Lovaglio-Rivas, J.M. Ruffini, S.A. Puya // Acta Odontol Latinoam. – 2021. – 34(3). – Р. 263–270. DOI: 10.54589/aol.34/3/263.