Facial Plastics/Reconstructive Surgery

Pulp necrosis during septorhinoplasty†

  1. Saeed Moradi MD1,
  2. Mehdi Poursadegh MD2,
  3. Mehdi Bakhshaee MD3,*,
  4. Reyhaneh Bonyadimanesh MD4,
  5. Vahid Poursadegh MD4

Article first published online: 4 MAR 2010

DOI: 10.1002/lary.20820

Issue

The Laryngoscope

The Laryngoscope

Volume 120, Issue 4, pages 673–675, April 2010

Additional Information

How to Cite

Moradi, S., Poursadegh, M., Bakhshaee, M., Bonyadimanesh, R. and Poursadegh, V. (2010), Pulp necrosis during septorhinoplasty. The Laryngoscope, 120: 673–675. doi: 10.1002/lary.20820

Author Information

  1. 1

    Dental Research Center, Faculty of Dentistry , Mashhad, Iran

  2. 2

    Otorhinolaryngology–Head and Neck Surgery Department, Imam Reza Educational Hospital , Mashhad, Iran

  3. 3

    Ear, Nose, Throat, Head and Neck Surgery and Related Sciences Research Center , Mashhad, Iran

  4. 4

    Mashhad University of Medical Sciences , Mashhad, Iran

*Otorhinolaryngology Department, Immam Reza Hospital, Bahar street, Mashhad, Iran

  1. †

    The authors have no funding, financial relationships, or conflicts of interest to disclose.

Publication History

  1. Issue published online: 22 MAR 2010
  2. Article first published online: 4 MAR 2010
  3. Manuscript Accepted: 10 NOV 2009

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Keywords:

  • Septorhinoplasty;
  • pulp necrosis;
  • complication;
  • pulpal test;
  • Level of Evidence: 1b.

Abstract

Objectives/Hypothesis:

Bony manipulation near the nasal spine or maxillary crest trimming can predispose teeth to injury during septorhinoplasty, especially when there is an aberrant vascular supply or a highly situated root apex in the premaxilla.

Study Design:

Prospective cross-sectional study.

Methods:

A prospective cross-sectional study was carried out on 438 teeth (maxillary incisors and canines) that were supposedly affected and 73 control teeth (mandibular lateral incisors) in 73 candidates of septorhinoplasty before and after surgery to determine the frequency of pulp necrosis using electrical, heat, and cold pulpal tests. Those with difficult intubation, history of root canals or orthodontic procedures, history of dental trauma, or a positive preoperative test were excluded from the study. Patients were followed up 2 weeks, 3 months, and 6 months postoperatively, and test results were compared before and at three intervals after the surgery.

Results:

Seventy-three consecutive patients, including 11 males and 62 females, met the study criteria. Septoplasty with anterior maxillary crest trimming and anterior nasal spine manipulation was performed in 63 and 52 cases, respectively. Only 10 cases underwent septoplasty without manipulation of the maxillary crest or the anterior nasal spine. Based on pulp testing, no case of pulp necrosis was seen during the 6-month follow-up.

Conclusions:

Considering there are very few reports of dental problems during septorhinoplasty, it is an unlikely cause of serious dental complications such as pulp necrosis. An abnormal anatomy might be a good explanation for rare cases. Laryngoscope, 2010

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