DOI:

10.37988/1811-153X_2025_4_132

Restoration of inferior alveolar nerve function in the treatment of mandibular fracture with complete neurovascular bundle transection

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Authors

  • M.S. Malykh 1, maxillofacial surgeon
    ORCID: 0000-0003-3448-7243
  • V.V. Sadovskij 2, 3, PhD in Medical Sciences, director; associate professor of the Pain management in dentistry Department
    ORCID: 0000-0003-1793-7222
  • R.V. Mellin 1, 4, PhD in Medical Sciences, head of the maxillofacial and plastic surgery ward; assistant professor of the Clinical dentistry Department
    ORCID: 0000-0002-1587-0581
  • I.N. Usmanova 5, Doctor of Science in Medicine, professor of the Therapeutic dentistry Department
    ORCID: 0000-0002-1781-0291
  • I.A. Lakman 6, PhD in Engineering, assistant professor of the Biomedical engineering Department, head of the Scientific Lab for the study of socio-economic problems of regions
    ORCID: 0000-0001-9876-9202
  • A.P. Akopyan 5, PhD in Medical Sciences, associate professor of the Neurology and neurorehabilitation Department
    ORCID: 0000-0001-8436-5610
  • Yu.L. Vasil’ev 7, 8, Doctor of Science in Medicine, professor of the Operative surgery and topographic anatomy Department; senior researcher at the Antimicrobial Photodynamic Therapy Lab
    ORCID: 0000-0003-3541-6068
  • 1 Republican Clinical Hospital, 655012, Abakan, Russia
  • 2 “National Institute for Research and Adaptation of Marketing Strategies (NIIAMS)” JSC, 125047, Moscow, Russia
  • 3 Russian University of Medicine, 127006, Moscow, Russia
  • 4 Lobachevsky State University of Nizhny Novgorod, 603022, Nizhny Novgorod, Russia
  • 5 Bashkir State Medical University, 450000, Ufa, Russia
  • 6 Ufa University of Science and Technology, 450076, Ufa, Russia
  • 7 Sechenov University, 119048, Moscow, Russia
  • 8 MIREA — Russian Technological University, 119454, Moscow, Russia

Abstract

Numerous techniques and treatment approaches exist for the restoration of the mandibular nerve following traumatic injuries, particularly in the practice of oral and maxillofacial surgeons. One of these is the implantation of microparticles of a cross-linked collagen fraction. Objective. To evaluate the clinical efficacy of an extracellular matrix (ECM) biomimetic in the treatment of traumatic paresthesia following a total rupture of the inferior alveolar nerve.
Materials and methods.
An esthesiometer with a cone-shaped rigid tip (0.5—0.8 cm in diameter) was used to assess the restoration of sensation in the skin of the chin and lower lip. Graduated stimulation was applied along a line from the healthy side of the face to the injured side, in 1 mm increments; areas of numbness were marked with a marker. Measurements were taken before treatment and on days 7 and 15 after the procedure. A Hitachi Aloka Noblus ultrasound system (Hitachi, Japan) equipped with a high-density linear transducer with a frequency of 5—18 MHz was used to assess the nerve condition. The study was performed in spectral Doppler mode, evaluating the spectrum of arterial and venous blood flow to exclude vascular components.
Results.
The use of “SPHEROGel” significantly reduced pain intensity by 1.38 points by day 7 and 1.67 points by day 15 post-operation. Patients in the main group showed a 62.5% reduction in the area of hypoesthesia by day 15, markedly greater than the 37.1% reduction in the comparison group. Ultrasound assessment confirmed superior nerve recovery, with the cross-sectional area of the mental nerve decreasing to 1.2 mm2 versus 2.5 mm2 in the control group.
Conclusions.
Restoration of pain and tactile sensitivity demonstrates the effectiveness of the proposed combined vector technique with bolus administration of the composition of the heterogeneous gel Sphero®GEL LIGHT for total ruptures of the vascular-nerve bundle in maxillofacial trauma clinics, regardless of the injury duration, according to the following schedule: 1 ml of the drug, 0.5 ml on day 7, and 0.5 ml on day 15.

Key words:

bioimplant, extracellular matrix, SpheroGEL LIGHT, maxillofacial trauma, paresthesia, EPT, jaw fracture

For Citation

[1]
Malykh M.S., Sadovskij V.V., Mellin R.V., Usmanova I.N., Lakman I.A., Akopyan A.P., Vasil’ev Yu.L. Restoration of inferior alveolar nerve function in the treatment of mandibular fracture with complete neurovascular bundle transection. Clinical Dentistry (Russia).  2025; 28 (4): 132—141. DOI: 10.37988/1811-153X_2025_4_132

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Received

September 29, 2025

Accepted

November 29, 2025

Published on

December 18, 2025