Analysis of neurosensory dysfunction after dental implant surgery

Abstract

Background: There have been some reports on the various factors that are associated with the level of discomfort and recovery of neurosensory discomfort in patients with trigeminal nerve injury, however their relation remains uncertain and poorly understood.Objective: The purpose of this analysis was to investigate the possible association between some of the factors thought to affect neurosensory dysfunction and recovery from it in patients with mandibular nerve injury after dental implant surgery.Methods: 89 patients with mandibular nerve injury after dental implant surgery from January 2007 to October 2010 enrolled in this analysis. Level of invasion into the mandibular canal as assessed by CT, retrieval of the affecting implant to decompress the injured nerve, and time elapsed since nerve injury were evaluated through medical record review.Results: 1. There was no significant linear relationship between pain intensity and symptomatic improvement (p=0.319).2. There was no significant linear relationship between the level of mandibular canal invasion and either pain intensity (p=0.588) or symptomatic improvement (p=0.760).3. There was no significant linear relationship between retrieval of the affecting implant fixture to decompress the injured nerve and either pain intensity (p=0.934) or symptomatic improvement (p=0.121).4. There was a statistically significant linear relationship between time elapsed since nerve damage and both pain intensity (p=0.004) and symptomatic improvement after conservative treatment (p=0.024).Conclusion: Obtained findings indicate that the lapsed time from nerve injury to initiation of conservative treatment is most closely related to the pain intensity and symptomatic improvement than other factors including level of mandibular canal invasion. And increased pain intensity and decreased symptomatic improvement can be expected as

time goes on, because of their linear trend. Therefore, although direct nerve injury is the most important factor in the initiation of neurosensory disturbance, if a nerve injury is suspected during implant surgery, early initiation of conservative treatment followed by neurosensory evaluation should be performed to reduce patient discomfort and improved the probability of nerve recovery.