title: The Management of Persistent Pain From a Branch of the Trifid Mandibular Canal due to Implant Impingement.
abstract: The mandibular canal is a conduit that allows the inferior alveolar neurovascular bundle to transverse the mandible to supply the dentition, jawbone, and soft tissue around the lower lip. It is now acknowledged that the mandibular canal is not a single canal but an anatomical structure with multiple branches and variations. Iatrogenic injury to branches of the mandibular canal that carry a neurovascular bundle has been reported to cause injury to the main canal as severe as if the main canal itself is traumatized. These injuries include bleeding, neurosensory disturbance, or the formation of traumatic neuroma, and so far, they have involved cases with the bifid mandibular canal. This current report presents a case of neurosensory disturbance that resulted from the impingement of a branch of a trifid mandibular canal during implant insertion. Its management included analgesics, reexamination, and reinserting a shorter implant.
authors.affiliation: 1   Department of Oral & Maxillofacial Surgery, Hospital Kuala Lumpur, Malaysia.
authors.forename: Sharifah
authors.initials: S
authors.lastname: Aljunid
authors.affiliation: 2   Department of Oro-Maxillofacial Surgical & Medical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Saif
authors.initials: S
authors.lastname: AlSiweedi
authors.affiliation: 2   Department of Oro-Maxillofacial Surgical & Medical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Phrabhakaran
authors.initials: P
authors.lastname: Nambiar
authors.affiliation: 3   Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Wen-Lin
authors.initials: WL
authors.lastname: Chai
authors.affiliation: 2   Department of Oro-Maxillofacial Surgical & Medical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Wei-Cheong
authors.initials: WC
authors.lastname: Ngeow
mesh_terms: D015921:Dental Implants; D006801:Humans; D008334:Mandible; D008340:Mandibular Nerve; D010146:Pain
chemical_list: D015921:Dental Implants
keywords: implant; mandibular canal; neurosensory disturbance; trifid canal