Dental implants have become the preferred method of treatment in dental practice when the replacement of missing teeth is indicated. Injuries to the peripheral branches of the trigeminal nerve, especially its mandibular division (i.e., the inferior alveolar, mental, lingual nerves) are known and accepted risks of such procedures. Discussion of these risks is an essential component of the pretreatment consent process between the dentist and the patient.
Accurate preoperative planning, based upon clinical examination and appropriate imaging studies, and careful surgical technique during the implant procedure help to minimize the risk of nerve injury. If a nerve injury occurs, prompt evaluation of the patient’s sensory function and assessment of the position of the implant in relation to the inferior alveolar canal and/or mental foramen guide the clinician’s plan of treatment. Timely decisions regarding the fate of the implant and management of the nerve injury will maximize the patient’s likelihood of restoration of acceptable sensory function. In some patients, the nerve injury is managed by nonsurgical treatment, while in others surgical intervention for repositioning or replacement of the implant and exploration with microsurgical repair of the injured nerve are necessary to restore acceptable sensory function.
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