Implant Patient Complains of Numbness but Objective Signs Show No Problems: Recommendations?

Last Updated: May 06, 2012

I installed an implant in the mandible 5 days prior without any apparent complications. Â The patient returned for a follow up visit after 5 days post-operative. Â Objective signs were within normal limits except for her subjective complaint of heaviness and numbness in her lower lip. Â Should I back out the implant 1mm and see if that relieves her symptoms? Â Could her symptoms be normal for this short time period following the surgical installation of the implant? Â Could normal post-operative swelling and inflammation be causing this numbness? Â Or should I just continue to watch this patient and put off intervention at this time? Â I have prescribed vitamin B complex to promote nerve regeneration. Â What do you recommend?

15 Comments on Implant Patient Complains of Numbness but Objective Signs Show No Problems: Recommendations?

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A Shahab

05/07/2012

The numbness might be related to the soft tissue trauma that has been occurred during the surgery. If every other thing looks normal just follow the patient.

Peter Fairbairn

05/07/2012

With no radiological evidence it is hard to assess , do you have a pre-op scan orpost-op PAs . Your description is vague , symptoms would be noticed in a few hours post treatment. Did you use and ID block or not ? , Articane ? Too many missing details Good luck Peter

JIM

05/08/2012

There can be no answers to your questions without more info like pre op and post op xrays, scans, intraoral pics, and medical history of patient. How about technique used.....did you raise a flap or did you perform the procedure flapless? Any bone grafting involved? Type and size of implant. Final torque values obtained? D1 bone or was it D4?

DrT

05/08/2012

Yes, it would be very helpful to see how you documented this case. Thank you. DrT

Dr O

05/08/2012

If the soft tissue in / around the mental foramen was manipulated, swelling of the soft tissue could cause numbness for two weeks or more. If you wish to protect yourself in a legal sense, remove the implant.

dr.A.k.Meena

05/08/2012

dear friend history of numbness is most probably due to injury of mental nerve if you placed implant aroud 44,45 or 34,35 region. nothing to worry if it could be a nerve damage that can be repair but it takes time. it is the matter of time if patients is getting exhausted then try to explain him bcz its a normal complication that can be happen not a serious problem.

dr. dan

05/08/2012

Hope you had written informed consent.

Dr. Rateb

05/10/2012

Hello doctor can you show us more about this case like the obj you know there is cases that the nerve has wide loop or curved back , thank you.

Dr.S.Lin

05/11/2012

Where is the implant placed in the mandible? molar area or premolar area?

Denis cunneen

05/13/2012

Without another clinical details given , it would be prudent to back out the implant 1 or 2 mm .Use only gingival surface anaesthesia .

Richard Hughes, DDS, FAAI

05/13/2012

All of the above made good points. You may want to read Block and Kent's book titled "Endosseous Implants for Maxillofacial Reconstruction" also H L Wang, et al wrote a great paper about injury to the IAN. As per this case, more information is needed.

naser

05/14/2012

when did the numbness started ?if its started the same day of surgery it could be due to nerve injury but if few days later , might be due to inflammation and or infection and edema compressing the nerve within the canal more follow up is needed

Luis

05/21/2012

How long is the implant placed? Can it be replaced with a shorter one the sooner you do it the better. Need to provide more info to better asses the situation. About 25 years ago I had a similar problem and opted to remove the implant , I did and thank God every thing was normal after that . Good luck.

Dr G. Subraya Bhat

05/23/2012

hello dennis cunnen, can you eloborate more on when to back out the implant 1 or 2 mm , i mean related to the implant placement day, after a week , after 2 weeks or after 2 months, and does ir affect the osseointegration please give your valuable opinion

DENIS CUNNEEN

05/23/2012

BACKING OUT IS REALLY ONLY POSSIBLE IN THE WOVEN BONE STAGE WITHOUT CAUSING SOME LOSS OFF INTEGRATION DUE TO BONY FRACTURE.I WOULD USE IT THEN WITHIN 3 WEEKS IF POSSIBLE.Object is too reduce pressure on a constricted inflamed nerve tissue.I would not use total anesthesia in case my moving of the implant impacted onto the healing nerve tissue itself.The loss of 1 to max 2mm of bony crest should not condemn the implant to failure but does allow further smart people to assess the position and the surgical process and if required simpler removal of the implant.Its not an area where definitive research has shown a clinically proven pathway

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