Management of patients with trigeminal nerve injuries after mandibular implant placement.
BACKGROUND
Placement of mandibular endosseous implants can result in damage to the lingual nerve, the inferior alveolar nerve or both nerves. All dentists who place mandibular implants should be aware of the appropriate early management of these injuries, as well as the appropriate time to refer patients with these injuries to a microneurosurgeon.


BACKGROUND
The lingual nerve is less likely to undergo spontaneous regeneration than is the inferior alveolar nerve, which is protected within the inferior alveolar canal. Since the inferior alveolar canal can be seen on most panoramic radiographs and on all high-quality computed tomographic scans, it is easier to avoid damage to the inferior nerve than to the lingual nerve, which is not visualized on radiographs and whose relationship to the posterior portion of the mandible varies from person to person.


RESULTS
The authors reviewed one study that showed that lingual nerve repair helped 90 percent of patients. A second study found that patients who underwent lingual nerve repair reported a mean score of 7 on a scale from 0 to 10 in regard to the postoperative return of nerve function. Several other studies reported favorable patient responses to inferior alveolar nerve repair.


CONCLUSIONS
These results reinforce the need for early referral and intervention when inferior alveolar nerve injuries occur. Failure to refer patients with trigeminal nerve injury before distal nerve degeneration develops prevents minimization of the injury through microneurosurgical repair.
Kraut
Richard A
RA
Oral and Maxillofacial Surgery, Montefiore Medical Center, Department of Dentistry, Bronx, NY 10467, USA. rkraut@montefiore.org
Chahal
Omar
O
D003758:Dental Implantation, Endosseous / Q000009:adverse effects; D015921:Dental Implants; D006801:Humans; D007431:Intraoperative Complications; D008036:Lingual Nerve / Q000503:physiopathology / Q000601:surgery; D061222:Lingual Nerve Injuries; D008334:Mandible / Q000294:innervation / Q000601:surgery*; D008340:Mandibular Nerve / Q000503:physiopathology / Q000601:surgery; D008866:Microsurgery; D009410:Nerve Degeneration / Q000209:etiology / Q000503:physiopathology; D009416:Nerve Regeneration; D009493:Neurosurgery; D010347:Patient Care Planning; D011183:Postoperative Complications; D011862:Radiography, Panoramic; D012017:Referral and Consultation; D012678:Sensation Disorders; D014057:Tomography, X-Ray Computed; D014276:Trigeminal Nerve; D061221:Trigeminal Nerve Injuries
D015921:Dental Implants