Post-operative parasthesia: recommendations?

Inform the patient of what happened. If this just happened, medrol pack. If it happened a week ago, take it out and don't graft. Either way, the parasthesia may remain. Tell the patient. If it doesn't bother them, then make sure you get their signature that it doesn't bother them. Unfortunately, though, these parasthesias can last. As far as xrays, did you get a ct scan? How would you know where your implant exactly is with just with a pan or pa?

What is the time frame to administer a dose pak? Obviously, the sooner the better but when is it not recommended to use a dose pak?...a week or a few days?

The dose pack less than 24 to 48 hrs. That's to reduce inflammation. I have a feeling that it won't help you in this situation.

Hi Dr G. I would say take a cone beam ct of the implant, if there is distance between the implant and the nerve canal thsi is probably just a hemathoma that is compressing the nerve, so you are in luck and will have to ride it out . Corticoid therapy with vitamin b complex will help and speed the process. If there is intrussion into the canal, remove the implant asap and start the treatment inmediately. Best of luck

If the implant was in the "maxillary right first molar" and you've got mandibular n paraesthesia, then you're in deep trouble. I presume that was a typo. The implant is placed and if it is not in direct contact with the mandibular nerve, then there is not much point in removing the implant-the damage has already been done. The nerve is usually fairly tough if touched by a drill and as long as you haven't severed it and there is no pressure from the implant on the nerve as you appear to indicate, there is a reasonable to good chance that it will recover from the trauma and the paraesthesia will finally disappear over a period of months. If this doesn't happen, then it wouldn't happen by removing the implant also and the patient will be left with paraesthesia and no implant. If the nerve doesn't recover, at least in the interim you've given the patient some hope and if the area is small , the patient more than likely will get used to it and not be overly concerned, particularly if they have a functioning implant.

Again, I suggest to view the paper by Wang et al, which addresses in some detail, injury to the IAN.

you have to unscrew the implant two turn anticlockwise.. adminstrate B12 vitamin one month for patien start with injection then tablets... i had a case like this and its fine now