Integrating Median Nerve Sonography and Clinical Wrist Examinations for Dental Practitioners at Risk for Carpal Tunnel Syndrome

Abstract

Objective:

The goal of this study was to conduct a multimodal wrist examination among dental practitioners. The purposes were twofold: (1) to describe bilateral wrist function and sonographic measures, including exploratory intraneural blood flow measures, and (2) to identify if otherwise healthy dental practitioners present with early signs and symptoms of carpal tunnel syndrome (CTS).

Materials and Methods:

This exploratory cross-sectional study examined both wrists of dental practitioners without CTS. Measurements included symptoms, grip strength, wrist motion, median nerve cross-sectional area (CSA, cm²), anterior-to-posterior distance (mm), intraneural peak systolic velocity (PSV, cm/sec) and power Doppler intensity quantification (PDI-Q) ratio.

Results:

A cohort of 23 dental practitioners were examined (age: 50.4 ± 10.9 years). Dominant wrists exhibited stronger grip (p < .001, Cohen d = 0.79), more flexion (p = .014, Cohen d = 0.56), and less extension (p = .01, Cohen d = −0.59). Intraneural blood flow was detected in all dominant (100%, n = 23/23) and 91% of nondominant (n = 21/23) wrists. There were no side-to-side differences in median nerve CSA (p = .625–.88), anterior-to-posterior distance (p = .39), PSV (p = .24) or PDI-Q ratio (p = .61).

Conclusion:

This exploratory study of healthy dental practitioners may suggest early signs and symptoms of CTS, such as decreased grip strength, enlarged median nerve, and ischemic changes in intraneural blood flow, which warrants further study. Routine examination may lead to early detection of changes and risk reduction for injury.