Inferior alveolar neurosensory deficiency associated with placement of dental implants.
BACKGROUND
This study reports and analyzes a large series of patients with neurosensory deficiency related to the placement of dental implants (DIs) and resulting in liability claims (LCs).


METHODS
From 1998 to 2009, there were 92 LCs related to persistent altered sensation post DI placements in Israel. Patients' demographics, year and source of LCs, interval between the procedure that resulted in a neurosensory deficiency and the LC, qualifications of the surgeon, preoperative imaging modality, DI length, available alveolar bone for DI placement, placement site, timing of DI placement (immediately after tooth extraction or after socket healing), and treatment after the diagnosis of neurosensory deficiency were recorded and analyzed.


RESULTS
There were 21 cases during the first 5 years of the study (mean 4.2/year) and 63 cases (mean 12.6/year) over the following 5 years. Thirty LCs were issued during the second postoperative year and 15 LCs after >5 years. Most LCs (76%) involved procedures that were planned and performed according to radiographs and 24% after computed tomography. Sixty-five percent of the LCs were performed by general dental practitioners and 35% by specialists. More than one DI was performed during the surgical procedure that resulted in a neurosensory deficiency in 73 LCs (79.3%), and the DI was >10 mm in 55 (59.8%) cases.


CONCLUSIONS
LCs for DIs that result in a neurosensory deficiency pose a legal risk to the practitioner long after the injury has occurred.
Department of Oral and Maxillofacial Surgery, Sheba Medical Center, Tel-Hashomer, Israel.
Navot
N
Givol
Oren
O
Peleg
Noam
N
Yarom
Daniella
D
Blinder
Towy Sorel
TS
Lazarovici
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003758:Dental Implantation, Endosseous / Q000009:adverse effects* / Q000379:methods; D003815:Dentists / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006987:Hypesthesia / Q000209:etiology* / Q000628:therapy; D007557:Israel; D016365:Liability, Legal; D008297:Male; D008340:Mandibular Nerve / Q000000981:diagnostic imaging; D008875:Middle Aged; D010517:Periodontics / Q000706:statistics & numerical data; D011862:Radiography, Panoramic; D013515:Surgery, Oral / Q000706:statistics & numerical data; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D061221:Trigeminal Nerve Injuries / Q000000981:diagnostic imaging / Q000209:etiology*