Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지
DOI QR코드

DOI QR Code

Sensory change after implant surgery: related factors for recovery

  • Jung, Joon-Ho (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry) ;
  • Ko, Ji-Hoon (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry) ;
  • Ku, Jeong-Kui (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry) ;
  • Kim, Jae-Young (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry) ;
  • Huh, Jong-Ki (Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry)
  • Received : 2022.08.26
  • Accepted : 2022.10.03
  • Published : 2022.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This retrospective study aimed to analyze data on nerve damage in patients who complained of sensory changes after dental implant surgery, the clinical results according to proximity of the implant fixture to the inferior alveolar nerve (IAN) canal, and the factors affecting recovery of sensation. Materials and Methods: The electronic medical records of 64 patients who had experienced sensory change after implant surgery were reviewed. Patients were classified by sex, age, implant installation sites, recovery rate and the distance between the implant fixture and IAN canal on computed tomography (CT). The distance was classified into Group I (D>2 mm), Group II (2 mm≥D>0 mm), and Group III (D≤0 mm). Results: The 64 patients were included and the mean age was 57.3±7.3 years. Among the 36 patients who visited our clinic more than two times, 21 patients (58.3%) reported improvement in sensation, 13 patients (36.1%) had no change in sensation, and 2 patients (5.6%) reported worsening sensation. In Group II, symptom improvement was achieved in all patients regardless of the removal of the implant fixture. In Group III, 8 patients (40.0%) had reported symptom improvement with removal of the implant fixture, and 2 patients (33.3%) of recovered patients showed improvement without removal. Removal of the implant fixture in Group III did not result in any significant difference in recovery (P=0.337), although there was a higher possibility of improvement in sensation in removal cases. Conclusion: Clinicians first should consider removing the fixture when it directly invades the IAN canal. However, in cases of sensory change after dental implant surgery where the drill or implant fixture did not invade the IAN canal, other indirect factors such as flap elevation and damage due to anesthesia should be considered as causes of sensory change. Removal of the implant should be considered with caution in these situations.

Keywords

References

  1. Sarikov R, Juodzbalys G. Inferior alveolar nerve injury after mandibular third molar extraction: a literature review. J Oral Maxillofac Res 2014;5:e1. https://doi.org/10.5037/jomr.2014.5401
  2. Juodzbalys G, Wang HL, Sabalys G, Sidlauskas A, Galindo-Moreno P. Inferior alveolar nerve injury associated with implant surgery. Clin Oral Implants Res 2013;24:183-90. https://doi.org/10.1111/j.1600-0501.2011.02314.x
  3. Lopez-Lopez J, Estrugo-Devesa A, Jane-Salas E, Segura-Egea JJ. Inferior alveolar nerve injury resulting from overextension of an endodontic sealer: non-surgical management using the GABA analogue pregabalin. Int Endod J 2012;45:98-104. https://doi.org/10.1111/j.1365-2591.2011.01939.x
  4. Pogrel MA. Permanent nerve damage from inferior alveolar nerve blocks: a current update. J Calif Dent Assoc 2012;40:795-7. https://doi.org/10.1080/19424396.2012.12220955
  5. Phillips C, Essick G. Inferior alveolar nerve injury following orthognathic surgery: a review of assessment issues. J Oral Rehabil 2011;38:547-54. https://doi.org/10.1111/j.1365-2842.2010.02176.x
  6. Yekta SS, Koch F, Grosjean MB, Esteves-Oliveira M, Stein JM, Ghassemi A, et al. Analysis of trigeminal nerve disorders after oral and maxillofacial intervention. Head Face Med 2010;6:24. https://doi.org/10.1186/1746-160X-6-24
  7. Pigg M. Chronic intraoral pain--assessment of diagnostic methods and prognosis. Swed Dent J Suppl 2011;(220):7-91.
  8. Choi YC, Kwon JS, Kim ST, Ahn HJ. Analysis of patients with dysesthesia after mandibular nerve injury. J Oral Med Pain 2009;34:379-85.
  9. Leung YY, Fung PP, Cheung LK. Treatment modalities of neurosensory deficit after lower third molar surgery: a systematic review. J Oral Maxillofac Surg 2012;70:768-78. https://doi.org/10.1016/j.joms.2011.08.032
  10. Kim JW, Cha IH, Kim SJ, Kim MR. Which risk factors are associated with neurosensory deficits of inferior alveolar nerve after mandibular third molar extraction? J Oral Maxillofac Surg 2012;70:2508-14. https://doi.org/10.1016/j.joms.2012.06.004
  11. Kjolle GK, Bjornland T. Low risk of neurosensory dysfunction after mandibular third molar surgery in patients less than 30 years of age. A prospective study following removal of 1220 mandibular third molars. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;116:411-7. https://doi.org/10.1016/j.oooo.2013.06.024
  12. Burstein J, Mastin C, Le B. Avoiding injury to the inferior alveolar nerve by routine use of intraoperative radiographs during implant placement. J Oral Implantol 2008;34:34-8. https://doi.org/10.1563/1548-1336(2008)34[34:AITTIA]2.0.CO;2
  13. Steinberg MJ, Kelly PD. Implant-related nerve injuries. Dent Clin North Am 2015;59:357-73. https://doi.org/10.1016/j.cden.2014.10.003
  14. Greenstein G, Carpentieri JR, Cavallaro J. Nerve damage related to implant dentistry: incidence, diagnosis, and management. Compend Contin Educ Dent 2015;36:652-9; quiz 660.
  15. Velasco-Torres M, Padial-Molina M, Avila-Ortiz G, GarciaDelgado R, Catena A, Galindo-Moreno P. Inferior alveolar nerve trajectory, mental foramen location and incidence of mental nerve anterior loop. Med Oral Patol Oral Cir Bucal 2017;22:e630-5. https://doi.org/10.4317/medoral.21905
  16. Jang SI, Paeng JY. Non-surgical management of inferior alveolar nerve damage after implant installation. J Dent Implant Res 2018;37:18-22. https://doi.org/10.54527/jdir.2018.37.1.18
  17. Juodzbalys G, Wang HL, Sabalys G. Injury of the inferior alveolar nerve during implant placement: a literature review. J Oral Maxillofac Res 2011;2:e1. https://doi.org/10.5037/jomr.2011.2101
  18. Greenstein G, Tarnow D. The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review. J Periodontol 2006;77:1933-43. https://doi.org/10.1902/jop.2006.060197
  19. Voon YS, Patil PG. Safe zone in anterior mandible related to the genial tubercle for implant osteotomy in a Chinese-Malaysian population: a CBCT study. J Prosthet Dent 2018;119:568-73. https://doi.org/10.1016/j.prosdent.2017.05.011
  20. Helmi MF, Huang H, Goodson JM, Hasturk H, Tavares M, Natto ZS. Prevalence of periodontitis and alveolar bone loss in a patient population at Harvard School of Dental Medicine. BMC Oral Health 2019;19:254. https://doi.org/10.1186/s12903-019-0925-z
  21. Khawaja N, Renton T. Case studies on implant removal influencing the resolution of inferior alveolar nerve injury. Br Dent J 2009;206:365-70. https://doi.org/10.1038/sj.bdj.2009.258
  22. Du Toit J, Gluckman H, Gamil R, Renton T. Implant injury case series and review of the literature part 1: inferior alveolar nerve injury. J Oral Implantol 2015;41:e144-51. https://doi.org/10.1563/aaid-joi-D-14-00022