ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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| Title |
Implant Placement May Lead to Post-Surgical Neuropathy |
| Clinical Question |
In adult patients, is post-surgical neuropathy more likely to occur following implant placement than following third molar extractions? |
| Clinical Bottom Line |
Following implant placement, neuropathy of trigeminal nerve remains an important consideration. Post-surgically, it seems to only affect a small percentage of people. Third molar surgery appears a more frequent cause of nerve damage as compared to implants. |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 22247929 | Renton/2011 | Patients with lingual nerve injuries (LNI) and iatrogenic inferior alveolar nerve injuries (IANI) | Case-Control | | Key results | Neuropathy of trigeminal nerve may occur following a number of dental procedures including implants, third molar surgery (TMS), endodontics, and local anesthesia. An evaluation of 90 cases of post-traumatic neuropathy showed that TMS related nerve damage was identified with a greater frequency (73%) than implants (18%). | | #2) 10596660 | Bartling/1999 | Patients who underwent the placement of mandibular implants | Case series | | Key results | Following placement of mandibular endosseous implants for 94 consecutive patients, altered sensation was identified in 8 patients (8.5%), with each of the patients with altered sensation reporting resolution of symptoms. | |
| Evidence Search |
("Paresthesia"[Mesh]) AND "Dental Implants"[Mesh |
Comments on
The Evidence |
Validity: Case control for Renton and case series for Bartling were conducted, to support and analyze neuropathy of trigeminal nerve following implant and other dental procedures. Patients were pre-selected who had nerve injuries to branches of trigeminal nerve and those that underwent implant procedures. The potential for biased results must be considered in both studies.
Perspective: The limited availability of strong evidence suggests post-surgical neuropathy remains an under appreciated morbidity of significance to patients. The greater frequency of occurrence following TMS may simply reflect a greater number of procedures done rather than relative risk of occurrence per procedure. |
| Applicability |
The acquired information is applicable to patients considering mandibular surgical and implant procedures and for those practitioners providing these procedures to understand the likelihood and consequences of neuropathy post-surgically. |
| Specialty/Discipline |
(General Dentistry) (Oral Surgery) (Periodontics) |
| Keywords |
Implant
|
| ID# |
2388 |
| Date of submission: |
03/19/2013 |
| E-mail |
ene@livemail.uthscsa.edu |
| Author |
Nicoleta Ene |
| Co-author(s) |
|
| Co-author(s) e-mail |
|
| Faculty mentor/Co-author |
Thomas Oates, DMD, PhD |
| Faculty mentor/Co-author e-mail |
oates@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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