Medicolegal aspects of altered sensation following implant placement in the mandible.
OBJECTIVE
Altered mandibular sensation following implant surgery may result in liability claims. Therefore the authors conducted a retrospective analysis of all liability claims related to persistent altered sensation following placement of mandibular implants reported to the Medical Consultants International (MCI) Company from 1992 to 1999.


METHODS
Reports related to persistent altered mandibular sensation in 16 patients (12 women and 4 men) who underwent implant surgery in Israel were examined. The MCI files were retrospectively evaluated according to a structured form. The parameters studied included patient age and gender, implant location and length, imaging modality, and the time between actual damage and filing of a claim (ie, letter of demand or lawsuit).


RESULTS
The time in months between actual damage and filing of claim ranged from 0 to 60 months (mean 21.5 months). No cases were found involving transient changes in sensation. The female/male ratio was 3:1. Implant length was equal to or longer than 13 mm in 6 of 7 implants placed in the molar region. In the premolar area, nerve injury was evident in 6 of 7 cases where implants shorter than 12 mm were used.


CONCLUSIONS
Transient nerve injury rarely results in legal action. Maximum effort should be devoted to accurately determining the appropriate implant length in the mandible.
Chaushu
Gavriel
G
Department of Oral and Maxillofacial Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Taicher
Shlomo
S
Halamish-Shani
Talia
T
Givol
Navot
N
D000328:Adult; D000367:Age Factors; D000368:Aged; D001641:Bicuspid; D015921:Dental Implants / Q000009:adverse effects*; D017267:Dental Prosthesis Design; D005260:Female; D006801:Humans; D007557:Israel; D016365:Liability, Legal; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D008963:Molar; D016300:Radiography, Bitewing; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000209:etiology*; D012737:Sex Factors; D013499:Surface Properties; D013997:Time Factors; D061221:Trigeminal Nerve Injuries
D015921:Dental Implants