Complicaciones neurosensoriales en implantología. A propósito de un caso en paciente geriátrico

Abstract

66 year-old patient asking for an implant treatment. Panoramic radiological planning and Dentascan ® were carried out. The clinician decided to proceed with the placement of three implants in the mandibular third quadrant. During the immediate postoperative period, the patient suffered paresthesia of the dental nerve of that side. The contact between the implants and the mandibular canal ceiling was confirmed by new radiographic. The clinician proceeded with the removal of the implant. Four months later, once the lip sensitivity was recovered, the treatment continued with the rehabilitation of the implants. As an estimation, there is an incidence between 0.6 to 39 % of neurosensory problems in surgical practice and almost exclusively referred to the dental nerve. Even imaging with high reliability such as a TC, in which there is no magnification, we should be careful with the implants placement/installation. There are cases when the nerve is damaged without physical invasion of the duct, which is the reason why a minimum distance of 2 mm from the apex of the implant and the roof duct is recommended to be left. In conclusion, an adequate preoperative planning, diagnosis and timely treatment are the key to prevent sensorineural pathology after dental implants placements.