Injury to the inferior alveolar nerve due to dental implant installation. Approach using a new biomaterial.

Abstract

Surgical complications involving dental implants in the inferior alveolar nerve (IAN), although infrequent, cause great inconvenience to the professional and especially to the patient. 90% of neurosensory disturbances caused by the installation of implants in the posterior mandible are reversible within 8 weeks. In the remaining 10%, the lack of sensory perception in the lip and chin for more than six months dramatically reduces the patient's likelihood of cure and is considered by most authors to be permanent damage. The possible therapeutic approaches for treating injuries to the NAI have variable or even unpredictable results. The aim of this study was to describe the approach of a patient who reported complete anesthesia of the right lip and chin, following the installation of an implant that had invaded the mandibular canal (MC) more than nine months previously. Despite the literature indicating a low probability of cure for these cases, the decision was made to use a biomaterial recently developed and launched on the market, associated with photodynamic therapy and removal of the implant. The results indicated a sensory return of 60% in the first 28 days, reaching 90% on the 60th day and remaining stable at this level for a further 3 months, when the patient was discharged. The combination of these types of treatment resulted in clinical improvement, leading the patient to considerable sensory recovery. However, it is necessary to carry out randomized, controlled studies with a larger number of patients.