2023 Volume 36 Issue 4 Pages 233-247
In recent years, CT has been introduced into dental clinical practice, and guided surgery has become more widespread, leading to an increase in medical institutions that provide safer medical care. This has contributed to a decreasing trend in the number of nerve damage cases caused by dental implants. However, if nerve damage does occur due to an implant, the patientʼs life can be drastically affected, and they may experience difficulties with daily activities or even lose their job. Therefore, accurate diagnosis is crucial, and treatment options are chosen based on that diagnosis. The selection of various drugs for nerve damage depends on the type of peripheral nerve pathology (type of damage) and the subsequent response (whether nerve repair surgery is performed or not). Additionally, in cases of partial or complete neurotmesis, traumatic neuroma often forms over time, making the use of drugs based on accurate diagnosis of these conditions important.
Those who perform implant treatment must understand the treatment flow for nerve damage, the rationale for drug selection, and their proper use. Furthermore, nerve repair surgery is an extremely specialized surgery that requires the use of surgical microscopes, and it is considered that it must be learned before the age of 40. Therefore, one should not attempt such surgery lightly. It is important to have the patient seen by a specialized oral surgeon capable of performing specialized nerve tests and nerve repair surgery as early as possible, rather than relying solely on medication or observation. If the specialized medical institution (referral) is far away, collaboration is required to proceed with diagnosis and treatment, so even primary medical institutions must understand Seddonʼs three classifications (neurapraxia, axonotmesis, neurotmesis)and drug use for neuropathic pain caused by traumatic neuroma.
