Han Jisuk, Han Jeong Joon
Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, Republic of Korea.
Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
J Dent Sci. 2025 Jan;20(1):270-277. doi: 10.1016/j.jds.2024.07.025. Epub 2024 Aug 8.
BACKGROUND/PURPOSE: Inferior alveolar nerve (IAN) injury is the most serious complication associated with dental implant surgery, posing difficulties in treatment and potential for permanent disabilities. This study aimed to identify patient-related risk factors for IAN injury during implant placement and to investigate sensory disturbances depending on whether the implant was removed.
Twenty-eight patients with implant-related IAN injury were included. To determine risk factors, patient demographics and radiographic images were analyzed. Sensory functions were evaluated and compared based on whether the implant was removed.
IAN injury occurred more frequently in women (60.7%), with a mean age of 62.9 years. The distance from the alveolar crest to the IAN was 9.8 ± 3.0 mm, with 40.9% patients having a residual alveolar bone of 10 mm or more. The mean bone density was measured at 586.2 ± 392.5 HU, which is below the normal range for the mandible. Notably, 31.8% of the patients were found to have D4 bone. Compared to patients who did not have implants removed, those who did showed better sensory function, except pressure perception, although these differences were not statistically significant.
Older women with lower bone density were at an increased risk of IAN injury, and IAN injury occurred even in cases with sufficient alveolar ridge. The removal of implants related to the injury alone does not markedly influence the extent of sensory disturbances during follow-up period, suggesting that other aspects such as the timing of removal and severity of injury could be crucial.
背景/目的：下牙槽神经（IAN）损伤是牙种植手术最严重的并发症，给治疗带来困难并可能导致永久性残疾。本研究旨在确定种植体植入过程中与患者相关的IAN损伤风险因素，并根据种植体是否取出调查感觉障碍情况。
纳入28例与种植相关的IAN损伤患者。为确定风险因素，分析了患者的人口统计学数据和影像学图像。根据种植体是否取出评估并比较感觉功能。
IAN损伤在女性中更常见（60.7%），平均年龄为62.9岁。牙槽嵴到IAN的距离为9.8±3.0mm，40.9%的患者剩余牙槽骨为10mm或以上。平均骨密度测量值为586.2±392.5HU，低于下颌骨正常范围。值得注意的是，31.8%的患者为D4骨。与未取出种植体的患者相比，取出种植体的患者除压力觉外，感觉功能更好，尽管这些差异无统计学意义。
骨密度较低的老年女性IAN损伤风险增加，即使在牙槽嵴充足的情况下也会发生IAN损伤。仅取出与损伤相关的种植体对随访期间感觉障碍的程度没有明显影响，这表明取出时间和损伤严重程度等其他方面可能至关重要。
