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) 22247929Renton/2011Patients with lingual nerve injuries (LNI) and iatrogenic inferior alveolar nerve injuries (IANI)Case-Control
Key resultsNeuropathy 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) 10596660Bartling/1999Patients who underwent the placement of mandibular implantsCase series
Key resultsFollowing 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: 03/19/2013spacer
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
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