PAINFUL DYSESTHESIA FOLLOWED AFTER IMPLANT PLACEMENT IN POSTERIOR MANDIBLE AND THEIR PROGNOSIS.
- Author:
Myung Rae KIM
1
;
Won Ho LEE
;
Chang Woo CHOI
;
Hyun Ju CHUNG
Author Information
1. Department of Oral and Maxillofacial Surgery, Ewha Womans University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
nerve injuries;
dysesthesia;
epineurotomy & tubulization
- MeSH:
Anesthesia;
Decompression;
Dental Implants;
Discrimination (Psychology);
Gingiva;
Humans;
Lip;
Mandible*;
Neuroma;
Nociception;
Paresthesia*;
Prognosis*;
Sensation;
Visual Analog Scale
- From:Journal of the Korean Association of Oral and Maxillofacial Surgeons
1998;24(4):421-427
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study is to examine the painful dysesthesia of lip & gingiva followed after implant surgeries and to evaluate the prognosis of microsurgical epineurotomy & tubulization with e-PTFE tubes. METHOD: Three patients who had been suffered from painful anesthesia and dysesthesia following dental implant surgeries were examined periodically and followed for over 1 year after epineurotomy and e-PTFE tubulization. Neurosensory dysfunctions were examined by Static Light Touch Threshold, Moving Direction Discrimination. Two Point Discrimination, Pin-Prick Nociception. Visual Analog Scales and Tinel sign. The subjective symptoms were confirmed by SSEP and DITI prior to surgical exploration. RESULT: Two patients complained of continuous tearing and lancinating pain disclosed complete avulsion of IAN and degenerative changes with neuroma. One patient complained of mild painful dysesthesia revealed partial adhesion & fibrous epineural changes. Two patients whose IAN were explored after over 1 year resulted in only mild improvement in sensory recovery and moderate reduction of pain score. While the patient to whom decompression & epineural repair were given in 3 months after nerve injuries resulted in satisfactory improvement in sensory function and pain reduction. CONCLUSION: Painful dysesthesias occurred after implant placement were resulted from neurotmesis and disclosed degenerative neuropathy. Therefore, the micro-surgical explorations and repairs (epineurotomy, decompression neurolysis, and neurorrhaphy) can be recommended for known injuries as early as possible. For the delayed painful dysesthesia lasted over year, however, epineurotomy & tubulization could be an option to improve the painful discomfort but not satisfactory.
