Implant Related Nerve Damage and Peri-implantitis?

I went for two lower right jaw implants at the end of January 2016. Second molar and second premolar, I believe. I had persistent numbness after the surgery, lips, chin, cheek on that side. As the numbness reduced a bit, severe pain persisted for weeks throughout the area, running along the nerve, upper molars ache, lower jaw aches, teeth sensitive on that side. Jaw joint is swollen and throbbing. The numbness mainly in front of the premolar but still present now, lip and chin initially, tingling and half sensation now. I suffered with this pain for 1 month. It seemed to be reducing somewhat, so I was waiting it out. I finally went to the implant specialist and had them look at it again. (I had already had two follow ups in that month and a second xray, where nothing was found.) They did a cone beam xray and found nothing on it, but upon looking at the gums, found severe bleeding, pockets, deterioration etc ( Something like perimplantitis.) They immediately removed both implants. The premolar was completely loose and showed bone deterioration. The back molar was still set in place at least somewhat with bone deterioration.

They are not very informative or forth coming with information. It has been 1.5 weeks since the removal. The numbness is still there but more like half sensation and the pain has not gone away yet. It is slightly reduced but is similar to what I already described. My jaw joint is swollen and painful. I would like a second opinion as to what happened here. I know I have nerve damage, but am not sure why I have the gum deterioration. They plan on waiting a month then trying a bone graft and repeating the procedure. They suggested it could be an allergic reaction to metal. I really believe it was an implant impinging on the nerve. Am I correct? I believe the premolar is the main problem. Could it be the back molar? Which is more likely? Can you explain the pain, numbness and “Perimplantitis”?

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7 Comments on Implant Related Nerve Damage and Peri-implantitis?

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melissa

3/13/2016

All of this work was done at a dental school by a resident oral surgeon. Additional complications have surfaced. Pain continued after removal of the implants. Tooth sensitivity, swelling at jaw joint, aching, swelling under the tongue, exhaustion, difficulty opening my mouth. Went back to resident on March 8th, asked for additional course of clindamycin twice. She refused. Told her about pain. She said it was TMJ. Asked to see a periodontist and a faculty experienced oral surgeon. She refused said recession my teeth us the same as before. On March 11th it got worse. Jaw stiffness, difficulty swallowing. I contacted my general dentist(student), and told her the pain was worse. She told me to just be patient. I told her I was going to the emergency room. She encouraged me not to. I went anyway. My blood pressure was 172/90. My pulse was 108. They did a CT scan and found Osteomyelitis. They sent me to the hospital run by the same dental school for an oral surgeon. At around 12am I arrived at the hospital. By 3 am I finally saw another resident oral surgery student who contradicted the 1st hospital and said it was some necrotic bone fragments near the implant site that caused all my symptoms or maybe that middle tooth in the photo was infected. I guess because it now looks so terrible after the implant infection. He sent me home with antibiotics and pain killers. Planned a surgery on the 14th for removal of bone fragments. 1.5 days on antibiotics more pain, and swelling is the same lymph nodes still swollen. It's harder to swallow now, jaw joint still sore. I think I have osteomyelitis. Not sure what to do. Will go to emergency again if this surgery doesn't work. Beg for them not to send me back to the school affiliated hospital. Please Help!

melissa

3/14/2016

Please help! I know I'm commenting on my own question, but can't figure out how to add events. I decided to get up at 5 am today 3/14/16 and go to get a second opinion from an oral surgeon. It was a surprise 7 am visit but they took me and he was a godsend. He wrote a note to the dental school and told them to check for osteomyelitis. I had surgery planned for 10 am. I brought in his note, xrays, and he called two faculty. They treated me like a queen. Unfortunately, the infection was so large, I have lost a good portion of bone in my second lower right molar region. I will have to go on intravenous IV for weeks. They made the claim that a bone graft is unnecessary if I am not going to get implants. Not sure yet what I will do, but I wonder if they shouldn't have grafted some bone. I had bone cut out of my lingual area and my lower palate has a gum indention. No grafts were done just biopsy to verify osteomyelitis or just a localized bone infection. What's the difference anyway? Please help ease my mind. Tell me what you think about this whole ordeal. It would really help me. Thank you.

PASCAL PINTO

3/16/2016

Dear Melissa, It is really difficult to comment on the case without seeing the X Rays.Clinically it does seem to suggest an infection but a infection of such magnitude would tend to occur only in a situation of immunocompromise. I am sure you are now in good hands of experienced surgeons.

melissa

3/19/2016

This is another question to add to my thread. Is there ever any question that you have osteomyelitis once a surgeon has had to go in and remove a large portion of bone from your jaw, debridement? Especially if you have sequestrum and have to be put on strong antibiotics. I'm on a 6week IV plus oral. One of my doctors is questioning my diagnosis of osteo and it doesn't make sense to me. Also can peri implantitis or something like it occur before osteo integration? It sure seems like it did for me. Thanks!

Dr krishan

3/30/2016

Dear Melissa the worse is behind now.We often have to remove a portion of bone and debride the area following osteomyelitis or even after some localized bone infection leading to necrosis.Do not allow conflicting opinions confuse you.Follow the advice of the attending surgeon and you should be fine.

Con

2/13/2020

I had 2 dental implants put in over a year ago. I always felt something wasn’t right and now I feel numbness and soreness all around implants. I went back to oral surgeon who said the ct scan looks fine. I am afraid that I have nerve damage and I don’t know how to proceed from here. I would appreciate any help you could give me.

Melissa/Renaissanista

2/17/2020

Sorry to hear about your problems. I ended up going to Costa Rica to get implants from an amazing implantologist named Arnoldo Anglada of Cleo Dental. It has been 2 years and no significant problems. Implants should not be painful, barring the occasional sore gums around the crowns since they aren't real teeth. I have a small amount of numb tingling on the chin area near that one original problem tooth because the nerve was just close but it is very light. I usually don't notice it. I have no pain. If you have significant numbness, you should get a second opinion. Arnoldo can look at an xray or ct online through email. If you tell him Melissa Snyder sent you, he will remember me. I also have a video on my channels Costa Rican Dental Tourism and Renaissanista on Youtube with some pictures of my trip and commentary. Hope this helps.

Implant Related Nerve Damage and Peri-implantitis?

7 Comments on Implant Related Nerve Damage and Peri-implantitis?

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