***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE This prospect i ve study evaluated the neurosensory recovery pattern of the inferior alveolar nerve following the bilateral sagittal split osteotomy ( BSSO ) .  PATIENTS AND METHODS Forty-two consecutive patients undergoing BSSO  were studied using five neurosensory tests : 1 ) static light touch , 2 ) moving touch discrimination , 3 ) two-point discrimination , 4 ) nociception , and 5 ) thermoreception . Intraoperative assessment of inferior alveolar nerve damage was made ; other variables recorded included type of fixation , age , concomitant procedures , advancement vs setback , and magnitude of the movement . A subjective question naire was completed by the patient . RESULTS The variables that affected neurosensory function following BSSO were degree of nerve damage and the amount of time elapsed following surgery . Larger myelinated fibers ( A-alpha ) recovered slower and to a lesser degree at all time intervals up to 2 years when compared with small myelinated and unmyelinated nerve fibers . The magnitude of nerve damage directly correlated with early neurosensory deficit , but equalized over time . CONCLUSION The long term ( 6 months and greater ) chance for neurosensory recovery is good despite intraoperative nerve manipulation . Patients seem to adapt and report normal neurosensory function even though objective testing indicates continued neurosensory deficit Three hundred seventeen normal fingers and 612 fingers in 153 h and s with carpal tunnel syndrome were tested for sensibility using the Weinstein Enhanced Sensory Test ( WEST ) with calibrated monofilaments , by static two-point discrimination ( s2PD ) and moving two-point discrimination ( m2PD ) , using the Disk-Criminator , and by Strauch 's ten test . Equivalent Semmes-Weinstein monofilament ( SWM ) test values were also determined as a gold st and ard for comparison . With both the WEST and SWM test values , the norms for interpretation have an unacceptably wide latitude because of the use of an ordinal scale of increasingly unequal intervals . With the WEST and Disk-Criminator tests , some cases of early sensory loss were missed . The SWM test apparatus , although producing relatively reliable values , is not easily portable , and its use is time-consuming in a busy office ; the WEST device is prohibitively expensive . The ten test is rapid , simple , and sensitive in evaluation . It measures sensibility on a continuous analog scale , and allows for multiple points of testing in the h and , with good inter- and intra-examiner reliability . It is accurate in detecting very early loss of sensibility . In addition , the ten test requires no instrumentation Objectives Semmes-Weinstein monofilaments are too long for use in parts of the oral cavity . The present study used shortened Semmes-Weinstein monofilaments to evaluate reliability and spatial differences in the intraoral tactile detection threshold ( TDT ) and the filament-prick pain detection threshold ( FPT ) in healthy volunteers . Methods For practical purpose s , classic Semmes-Weinstein monofilaments with 20 different diameters were cut to half their length ( ie , 19 mm ) and the bending forces were measured . Eighteen men and 18 women ( age range , 20 to 33 y ) were recruited to evaluate the reliability and reproducibility of measurements using half-cut monofilaments . The TDT and the FPT were measured on the labial maxillary gingiva , on the palatal maxillary gingiva , and at the anterior tip of the tongue , using a double r and om staircase method . Results According to the forces needed to bend the half-cut filaments , they were renumbered from 2.55 to 6.86 . There were significant differences of bending force between the half-cut and original monofilaments ( P<0.001 ) , Using half-cut filaments , the following differences could be detected ; the labial maxillary gingiva had a significantly higher TDT threshold compared with the other test sites ( P<0.001 ) . By contrast , the palatal posterior maxillary gingiva had a significantly higher FPT threshold compared with the other test sites ( P<0.001 ) . Discussion s The present study illustrated that in healthy participants , half-cut Semmes-Weinstein monofilaments reliably and easily assess TDT and FPT intraorally . A combined examination of sensory and pain thresholds using these filaments contributes to the clinical examination for orofacial pain The aim of this study was to conduct a prospect i ve clinical trial comparing the neurosensory function of the inferior alveolar nerve ( IAN ) after m and ibular advancement surgery with either bilateral sagittal split osteotomies ( BSSO ) or m and ibular distraction ostoegenesis ( MDO ) .  23 Class II m and ibular hypoplasia patients requiring m and ibular advancement were r and omized into two groups for either BSSO or MDO .  Subjective and objective neurosensory evaluations were performed preoperatively and at the following postoperative times : 2 weeks ( TBD1 ) , 6 weeks ( TBD2 ) , 12 weeks ( TBD3 ) , 6 months ( TBD4 ) and 12 months ( TBD5 ) . Subjective evaluation included the use of a visual analogue scale ( VAS ) . Objective evaluation included the use of light touch ( LT ) , two-point discrimination ( 2PD ) and pain detection threshold ( PD ) tests . Intra-operative or postoperative complications were recorded . Using a mixed model , no significant differences were reported in subjective VAS scores and objective LT , 2PD and PD scores between the BSSO and MDO groups over 12 months ( p>0.05 ) . Common postoperative complications included localized wound infection ( BSSO=2 , MDO=6 ) and condylar resorption ( BSSO=1 , MDO=1 ) PURPOSE The purpose of this analysis was to compare the frequency and severity of nerve damage with rigid and wire fixation in patients participating in a prospect i ve , r and omized clinical trial . PATIENTS AND METHODS One hundred twenty-six patients who required a bilateral sagittal split osteotomy and m and ibular advancement were r and omly assigned to receive either rigid or wire fixation .  Tactile sensation in the mental nerve region bilaterally was determined presurgically and throughout the subsequent 2 years by using monofilament detection and brush stroke direction . Neurosensory levels were compared between the types of fixation over time . RESULTS Evaluation with monofilament detection showed no significant difference between types of fixation throughout the 2-year follow-up . However , brush stroke determination showed significantly greater hypesthesia with rigid compared with wire fixation from 8 weeks through 2 years postoperatively . CONCLUSION Rigid fixation result ed in more anesthesia in the mental nerve distribution than wire fixation when tested with brush stroke direction . However , increased anesthesia was not present when measured with monofilament determination PURPOSE This study investigated  neurosensory disturbances in patients after orthognathic surgery  in relation to differences in m and ibular splitting methods and degree of surgical skill . PATIENTS AND METHODS Forty-five patients who had undergone bilateral sagittal split ramus osteotomies ( SSRO ) , and 21 ( group L ) who had undergone intraoral inverted L ramus osteotomies ( ILRO )  , were examined for postsurgical neurosensory disturbances .  Twenty-two ( group S1 ) of the SSRO patients were treated by 11 surgeons who had little experience , and the others ( 23 patients ; group S2 ) were treated by 2 skilled surgeons who had considerable experience . One of the 2 skilled surgeons was the only surgeon carrying out the ILRO procedure . The neurosensory tests employed included light touching using a  Semmes-Weinstein monofilament tester ( SW tester ) , electrical stimulation , and a question naire to determine changes in subjective sensations , at the time of each sensory evaluation . Neurosensory examinations were carried out bilaterally ( 132 sides ) at 1 , 3 , 6 , and 12 months after surgery . RESULTS More patients showed abnormal thresholds for the 2 measurement techniques in the SSRO group than in the ILRO group , and furthermore there were more such patients in group S1 than in group S2 , at each measurement point . At 6 months after surgery , the number of patients with reduced sensitivity was significantly higher in group S1 than in group L ( P < .05 ) . In the SSRO group at each measurement point , the thresholds for the lower lip and chin were unrelated to the set-back ( or advance ) distance . By contrast , in group L only at the 1-month evaluation point , the thresholds for the lower lip and chin were significantly raised in patients whose setback distances were larger than average ( P < .05 ) . CONCLUSIONS Postsurgical neurosensory disturbances of the lower lip and chin occur more frequently in SSRO patients treated by surgeons having little experience than in those treated by skilled surgeons , although the difference is not significant . Long-term prognosis for resolution of postsurgical neurosensory disturbances is better in ILRO patients than in SSRO patients . Although the width of movement of the split bone fragments has an influence on postsurgical neurosensory disturbances immediately after ILRO , the relationship becomes less obvious with time The criteria and scoring method for a system to evaluate the quality of  r and omized control trials ( RCTs ) in dental research based on published reports is presented . This sytem is based on one devised for evaluation of RCTs in medicine . Items assessed in this system include r and omization and blinding procedures , subject selection criteria , treatment protocol s , and statistical analyses . Assessing the quality of RCTs can contribute to improved study design , implementation and reporting by investigators , and evaluation of reports by referees and editors of scientific journals Deficits in the neurosensory function ( NF ) of the inferior alveolar nerve ( IAN ) are often encountered after bilateral sagittal split osteotomy of the m and ible . A prospect i ve follow-up study was performed to examine the long-term effect of especially gentle h and ling of the soft tissues on the medial side of the ascending ramus . After the initial incision , the soft tissues of the ramus were either retracted extremely gently and minimally ( test side ) or , as was the earlier routine , more widely ( contralateral control side ) . NF was tested with 2-point discrimination ( 2-PD ) and vitality scanner tests ( VST ) preoperatively and four times postoperatively up to 1 year . Patients ' subjective sensations were also assessed . The results showed a difference between the sides , which was most distinct at the 6-month follow-up ( P=0.028 ) measured with VST , while 2-PD did not show any statistical differences . Our findings support the earlier intraoperative neurophysiologic reports that dissection trauma to the IAN around the m and ibular foramen may cause NF deficits in the IAN even before the actual splitting of the m and ible . Therefore , minimal distraction of the soft tissues in the ramus is indicated . Higher age is an evident risk factor , and subjective sensation correlates with 2-PD in the lower lip Sensory impairment after bilateral sagittal split osteotomy ( BSSO ) due to inferior alveolar nerve ( IAN ) lesions may be either temporary or permanent and either complete or partial . The aim of this prospect i ve study is to evaluate , by means of objective sensory testing , IAN sensory disturbances development in patients who underwent BSSO.IAN  sensory disturbances development at the first week , fourth week , sixth month , and twelfth month of follow-up review in a group of 60 patients who underwent BSSO from January 1 , 1998 , to July 31 , 1999 , at the Maxillofacial Surgery Department of the “ La Sapienza ” University of Rome . The 60 patients were examined in the presurgical period ; the IAN functionality regarding thermal sensibility , nociception , and two-point discrimination , was assessed at follow-up in 120 sides . In our study the highest rate of spontaneous recovery of the entire IAN functionality was observed at the sixth month . This finding witnesses how neuropraxia and axonotmesis give a spontaneous recovery that most frequently occurs within 6 months from surgery , independently from age and sex of the patient . The persistence of anesthesia over 12 months could be a sign of neurotmesis PURPOSE The aim of this prospect i ve study was to objective ly evaluate the inferior alveolar nerve ( IAN ) sensory disturbances in patients who underwent sagittal split ramus osteotomy ( SSRO )  and its spontaneous recovery and to define the incidence of sensibility loss , time , and area at which the recovery occurs . PATIENTS AND METHODS Clinical evaluation of the IAN sensory disturbance was undertaken preoperatively and at the first week , fourth week , 2 months , and 6 months postoperatively in 30 patients who underwent SSRO at the Oral and Maxillofacial Surgery Division of the Araraquara Dental School -- Unesp and at the Plastic Surgery Division of the Medical Sciences School -- Unicamp . The 30 patients were examined at all periods regarding the IAN functionality by Semmes-Weinstein testing . RESULTS The mean age of the patients included in this study was 29.36 years old . All patients showed sensibility loss at the 7-day evaluation time . The comparison between sides , gender , and age did not show any significant difference . In most of the examined zone , the data collected at 6 months were statistically similar to the data collected at the preoperative period . All zones presented significant recovery , starting from 30 days after surgery . Twenty patients had total spontaneous recovery at the final period , in all examined zones . CONCLUSIONS The SSRO presents the disadvantage of temporary paresthesia ; however , spontaneous nerve function recovery does occur . The Semmes-Weinstein test is a reliable , inexpensive , and easy-to-apply tool , which can be used for clinical evaluation on a daily basis at 
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Before surgery , the lowest detectable threshold corresponded to a mean of 0.07 to 0.16 g. At 1 month after surgery , the lowest detectable threshold averaged 6 g , and at 1 year after surgery , the mean value was 0.16 to 0.4 g. CONCLUSIONS After bilateral sagittal split osteotomy , at 1 month after surgery , the sensory threshold increases approximately 35- to 85-fold compared with the presurgery threshold .
Within 1 year , the threshold normally decreases almost to presurgery levels , representing 96 % to 98 % sensory recovery .