Diagnosis and Treatment for Peripheral Nerve Disturbance Due to Oral Implant Surgery

Abstract

In the past, the focus within the head and neck region, including dentistry, was primarily on motor nerve paralysis, with very few reports concerning sensory nerves. Recently, with the increasing emphasis on quality of life（QOL）, there has been a rise in reports related to sensory nerve disturbance, particularly involving the inferior alveolar nerve, and the lingual nerve has been recognized as significantly impairing QOL. These issues have been increasingly addressed in dental care. Many of these reports highlighted mechanical injuries to the inferior alveolar nerve stemming from procedures like the extraction of lower third molars or implant surgery. Regarding implants in particular, the inferior alveolar nerve is commonly the main nerve injured, and although technologies such as CT scans and guided surgery are becoming more widespread as they enable safer procedures, there has not been a decreasing trend in nerve injuries. A major factor contributing to these injuries is that practitioners do not sufficiently understand the anatomical positioning of the inferior alveolar nerve and the lingual nerve, alongside often inadequate handling of surgical instruments. This paper discusses the essential knowledge that dental practitioners performing implant treatment should understand, particularly the anatomical characteristics of the inferior alveolar nerve, the diagnosis of the injury site and extent of damage, the classification and content of mechanical nerve injuries, the responses using these classifications, how to address nerve injuries when they occur, knowledge for preventing damage, surgical responses, and the use of pharmaceuticals.