Pharmacologic management of trigeminal nerve injury pain after dental implant surgery.
OBJECTIVE
Injuries to the trigeminal nerve are a common postoperative complication of dental implant surgery. Usually, the altered sensation and neuropathic pain caused by the nerve injury is temporary, but a permanent neurosensory disorder can sometimes occur. Surgery is commonly used to treat this condition, but the treatment is associated with some complications and a relatively low success rate. This study analyzed the characteristics of pharmacologic management of trigeminal nerve injury pain after dental implant surgery.


METHODS
Eighty-five patients who visited a temporomandibular joint and orofacial pain clinic with a history of trigeminal nerve injury pain after dental implant surgery were enrolled in this study. The pharmacologic management for trigeminal nerve injury pain was evaluated by prescribing a variety of medications for 12 weeks according to the prescription protocol of the study. The patients' pain characteristics, average percentage of pain reduction, and pain relieving factors were investigated prospectively.


RESULTS
Patients who took anticonvulsants and antidepressants for at least 12 weeks reported a mean reduction in pain of 24.8%. Interestingly, patients who experienced an altered sensation and neuropathic pain for more than 1 year also reported a reduction in pain and discomfort, with an average decrease of 17.1%. In addition, it was found that early treatment using medications had a significant effect on reducing the level of pain and discomfort.


CONCLUSIONS
These results suggest that pharmacologic management can be used for treating trigeminal nerve injury pain after dental implant surgery.
Park
Ju Hyun
JH
TMJ & Orofacial Pain Clinic, Department of Oral Medicine, School of Dentistry, Yonsei University, Seodaemun-gu, Seoul, Korea.
Lee
Seok Hyoung
SH
Kim
Seong Taek
ST
D000328:Adult; D000588:Amines / Q000627:therapeutic use; D000639:Amitriptyline / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D020209:Cranial Nerve Injuries / Q000188:drug therapy*; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D003511:Cyclohexanols / Q000627:therapeutic use; D015921:Dental Implants / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000627:therapeutic use; D010147:Pain Measurement; D011183:Postoperative Complications / Q000188:drug therapy*; D011446:Prospective Studies; D013997:Time Factors; D000077236:Topiramate; D014276:Trigeminal Nerve / Q000187:drug effects; D061221:Trigeminal Nerve Injuries; D014277:Trigeminal Neuralgia / Q000188:drug therapy*; D000069470:Venlafaxine Hydrochloride; D055815:Young Adult; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
D000588:Amines; D000700:Analgesics; D000927:Anticonvulsants; D000928:Antidepressive Agents; D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D003509:Cyclohexanecarboxylic Acids; D003511:Cyclohexanols; D015921:Dental Implants; D000077236:Topiramate; D000639:Amitriptyline; D005632:Fructose; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D000069470:Venlafaxine Hydrochloride; D009661:Nortriptyline