Baskaran Shivakumar, Ramakrishnan Hariharan, Arumuganainar Deepavalli
Department of Periodontics, Ragas Dental College and Hospital, Chennai, IND.
Department of Prosthodontics and Implantology, Thai Moogambigai Dental College and Hospital, Dr MGR Educational and Research Institute, Chennai, IND.
Cureus. 2024 Jul 7;16(7):e64001. doi: 10.7759/cureus.64001. eCollection 2024 Jul.
Dental implantology has been considered the mainstay in the rehabilitation of partial or complete edentulism. Nevertheless, complications and failures are occasionally encountered, and the most significant is the neurosensory disturbance. It not only causes persistent discomfort to the patient but frequently degrades the patient's oral health-related quality of life, even leading to a negative psychological impact. This paper presents a case report of a 65-year-old male patient who underwent the replacement of his missing tooth in the right mandibular region (46) with an implant-supported prosthesis two years ago. Since then, he has been experiencing numbness in the right side of the lip and occasional drooling of saliva from the right corner of the mouth. Clinical examination revealed the presence of a prosthetic crown supported by an implant in relation to 46 with inflamed and enlarged gingiva in the region with paresthesia of the right lower lip region. Radiological examination with orthopantomogram (OPG) and cone beam computed tomography (CBCT) revealed that the implant apex rested on the inferior alveolar nerve canal. Careful surgical retrieval of the well-osseointegrated implant was performed under local anesthesia in about seven days. The patient gradually experienced neurosensory improvement, and the paraesthesia was completely resolved in a six-week period. After complete recovery, as evaluated with an objective and subjective assessment, the edentulous site was successfully restored with a provisional fixed partial denture.
牙种植学一直被视为部分或完全无牙颌修复的主要手段。然而,并发症和失败情况偶尔会出现,其中最严重的是神经感觉障碍。它不仅给患者带来持续不适,还常常降低患者与口腔健康相关的生活质量,甚至造成负面心理影响。本文报告一例65岁男性患者的病例,该患者两年前在下颌右侧区域(46)用种植体支持的假体替换了缺失牙。从那时起,他右侧嘴唇一直麻木,且偶尔从右嘴角流口水。临床检查发现,46号牙位有一个由种植体支持的修复冠,该区域牙龈发炎肿大,右下唇区域感觉异常。通过曲面体层摄影(OPG)和锥形束计算机断层扫描(CBCT)进行的影像学检查显示,种植体根尖位于下牙槽神经管上。大约七天后,在局部麻醉下小心地手术取出了骨结合良好的种植体。患者的神经感觉逐渐改善,六周内感觉异常完全消失。完全恢复后,通过客观和主观评估,用临时固定局部义齿成功修复了无牙部位。