Bucawit, Princess R.

DMD-3BB

NERVE
HEALING
 Segmental
demyelination occurs
when the myelin sheath
is damaged and causes
a slowing of the
conduction velocity,
Segmental which may prevent the
Demyelination transmission of nerve
impulses.
 Segmental  Post-infectious
demyelination is encephalomyelitis
a cardinal feature  Multiple sclerosis
of
 Acute idiopathic
polyneuropathy (Guillain-Barre
Syndrome)
 SEGMENTAL
DEMYELINATION

 The myelin sheaths become continuous

 The myelin sheath fragments separated from

the axon

 The axon and myelin remnants occupied

opposite margins of Schwann cell

 Finally, the myelin break down products

appeared in isolated islands of Schwann cells.
Symptoms of
Segmental
Demyelination

Paresthesia Dysesthesia

Spontaneous Spontaneous
and subjective and subjective
altered altered
sensation that sensation that
a patient does a patient finds
not find uncomfortable
painful
Hyperesthesia

Excessive
sensitivity of a
nerve to
stimulation
Hypoesthesia

Decreased
sensitivity of a
nerve to
stimulation
REGENERATION

New myelin sheaths Re-growth of lost or Begins about 20 days

may be form as the destroyed part of after injury
axons increases in tissue
diameter.
REGENERATION
  If the continuity of the Schwann cell tube is disrupted, connective tissue
may enter the tube while it is partially vacant.

Problems can
occur during
regeneration
that prevent
normal nerve
healing  When the growth cone reaches the connective tissue obstruction, it may
find a way around it and continue on or it may form a mass of aimless
nerve fibers that constitutes a traumatic neuroma subject to pain
production when disturbed.
TWO BRANCHES OF
TRIGEMENAL NERVE
INJURED MOST
INFERIOR ALVEOLAR NERVE LINGUAL NERVE
1.Mandibular angle fracture
2.Pre-prosthetic surgical procedure
including implant placement
3.Sagittal split osteotomy surgery
4.Mandibular resection for neoplasm CAUSES
5.Removal of impacted lower third molar
6.Local anesthetic injection technique
Thank you!