Injury to the inferior alveolar nerve during dental implant surgery

Injuries to the branches of the trigeminal nerve during surgical interventions in the maxillofacial region are rare but significant complications. Etiology: The branches of the trigeminal nerve can be affected during anesthesia, separation and elevation of the mucoperiosteal flap, jaw fractures, dental extractions, and predominantly during drilling in the creation of a neoalveolus in endosseous dental implant placement procedures and during lower third molar extractions. Histopathology: Trigeminal nerve injuries can result from compression, stretching, complete or partial damage to nerve fiber integrity, leading to neurosensory, temperature, and pain changes. Traumatic axonal injuries can have varying degrees of complexity, differentiated by the terms neuropraxia, axonotmesis, and neurotmesis. Evaluation of traumatic trigeminal nerve injuries: To identify and assess the extent of disorders, both objective and subjective diagnostic tests are used. These tests are conventionally categorized as mechanoreceptive (response to mechanical stimuli and compression) and the recognition of thermal stimuli, which are classified as nociceptive diagnostic procedures (sensation of pain). Treatment: Conservative treatment involves managing pain and inflammation through continuous monitoring of the patient to evaluate symptoms. Surgical treatment involves methods for nerve decompression in cases where nerve disorders result from compression by adjacent structures or removal of the causal factor in cases where the presence of foreign bodies is noted. Conclusions: Inferior alveolar nerve (IAN) injuries can occur for various reasons, including trauma, dental procedures, or surgical interventions in the maxillofacial region. The management of these injuries aims to restore nerve function and improve sensory deficits.