Injury of the Inferior Alveolar Nerve during Implant Placement: a Literature Review

Abstract

ObjectivesThe purpose of present article was to review aetiological factors, mechanism, clinical symptoms, and diagnostic methods as well as to create treatment guidelines for the management of inferior alveolar nerve injury during dental implant placement.Material and MethodsLiterature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were inferior alveolar nerve injury, inferior alveolar nerve injuries, inferior alveolar nerve injury implant, inferior alveolar nerve damage, inferior alveolar nerve paresthesia and inferior alveolar nerve repair. The search was restricted to English language articles, published from 1972 to November 2010. Additionally, a manual search in the major anatomy, dental implant, periodontal and oral surgery journals and books were performed. The publications there selected by including clinical, human anatomy and physiology studies.ResultsIn total 136 literature sources were obtained and reviewed. Aetiological factors of inferior alveolar nerve injury, risk factors, mechanism, clinical sensory nerve examination methods, clinical symptoms and treatment were discussed. Guidelines were created to illustrate the methods used to prevent and manage inferior alveolar nerve injury before or after dental implant placement.ConclusionsThe damage of inferior alveolar nerve during the dental implant placement can be a serious complication. Clinician should recognise and exclude aetiological factors leading to nerve injury. Proper presurgery planning, timely diagnosis and treatment are the key to avoid nerve sensory disturbances management.

Descriptive study of mandibular canal visibility: morphometric and densitometric analysis for digital panoramic radiographs

“…IAN injury is a predominantly iatrogenic complication with reported incidence of up to 40%. 1 Furthermore, IAN is the most commonly injured peripheral branch of the trigeminal nerve (64.4%). 2 Intraoperative pain, bleeding and temporary or permanent post-operative anaesthesia, paraesthesia, hypaesthesia or dysaesthesia can follow such an injury.…”

The diagnosis and management of nerve injury during endodontic treatment

“…Nevertheless, when a nerve injury occurs during the treatment, early intervention is important (Rosen et al, 2016). Thus, following the treatment, the practitioner needs to be ready to detect any possible signs of altered sensation (Givol et al, 2011;Pogrel, 2007;Juodzbalys et al, 2011;Givol et al, 2010).…”

“…Mechanical nerve injuries during endodontic treatment may be classified, based on the time course and the potential sensory recovery into: Neuropraxia (cases in which there is a brief altered sensation); Axonotmesis (partial damage to the nerve fibers that may fully recover within 2-12 months); and Neurotmesis (a nerve that has been entirely cut, with poor prognosis for recovery) (Rosen, 2014;Juodzbalys et al, 2011;Seddon, 1942).…”

A Survey of the Opinion and Experience of UK Dentists

“…[49] Inadequate radiological imaging and/or violation of established protocols and good practice guidelines published by ITI [54] , AO [52] , ICOI [12] , ADI [56] , and European Association of Osseointegration (EAO) [65] , appear to be responsible for these complications . [10,22,31,53,64,68,69] …”

“…[1][2][3] TG injuries are characterized by neurosensory disturbances, such as pain, numbness or altered tingling-type sensations (paraesthesia), within the teeth, skin and the mucosa. [4][5][6][7] The inferior alveolar nerve (IAN) and mental nerve (MN) and the lingual nerve (LN) are the most commonly damaged nerves during dental implant treatment [6,[8][9][10][11][12] with some studies reporting an incidence rate of up to 40% of nerve damage following implant placement surgery in the mandible related to the depth and the width of the implant bed preparation. [8,11,[13][14][15][16][17][18][19][20] Local anesthetic injections also cause TG damage due to mechanical or chemical injury.…”