title: Mandibular nerve neurosensory impairment after dental implant surgery: management and protocol.
abstract: More than 70% of dentists have experienced patients with postoperative paresthesia/dysesthesia or anesthesia as a result of dental procedures. The most common nerve affected is the mandibular nerve, which may be injured during either implant surgery or bone grafting procedures. However, no organized protocol directed specifically for general dentists, or for the vast majority of specialists, has been published. The protocol presented in this article is divided into 5 periods: during surgery (1) nerve injury is suspected or (2) known nerve transection, post-operative period (3) 1 week and (4) 12 weeks. The appropriate treatment (pharmacology, monitoring, etc.) for each period is suggested, including the referral to a nerve specialist when appropriate.
authors.affiliation: Temple University, PA, USA. info@misch.com
authors.forename: Carl E
authors.initials: CE
authors.lastname: Misch
authors.forename: Randolph
authors.initials: R
authors.lastname: Resnik
mesh_terms: D000367:Age Factors; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D017679:Cryotherapy; D003758:Dental Implantation, Endosseous / Q000009:adverse effects*; D015921:Dental Implants / Q000009:adverse effects*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D007431:Intraoperative Complications; D008334:Mandible / Q000294:innervation; D008340:Mandibular Nerve / Q000033:anatomy & histology; D008465:Mechanoreceptors / Q000502:physiology; D009046:Motor Neurons / Q000648:ultrastructure; D009410:Nerve Degeneration / Q000209:etiology; D009412:Nerve Fibers / Q000648:ultrastructure; D009416:Nerve Regeneration / Q000502:physiology; D009431:Neural Conduction / Q000502:physiology; D009619:Nociceptors / Q000502:physiology; D010292:Paresthesia / Q000209:etiology; D011183:Postoperative Complications; D012017:Referral and Consultation; D011984:Sensory Receptor Cells / Q000648:ultrastructure; D012684:Sensory Thresholds / Q000502:physiology; D020886:Somatosensory Disorders / Q000209:etiology* / Q000628:therapy; D009435:Synaptic Transmission / Q000502:physiology; D061221:Trigeminal Nerve Injuries
chemical_list: D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D015921:Dental Implants; D005938:Glucocorticoids