implants

Implants at Tendler Dental

Fortunately, at Tendler Dental, when it comes to dental implants, you’re in good hands.

For patients with a broken or missing tooth, dental implants can be an absolute godsend. An implant is a metal post that attaches to the jaw bone to provide a strength and stability similar to your original tooth. This means you can eat and smile with confidence rather than hiding your smile due to your missing teeth.

However, while implants are a great benefit, it’s important to get them done right.

Research study indicates nerve injury from dental implants

Researchers at King’s College, London have shown that improperly placed dental implants can cause permanent nerve damage. The Association of Dental Implantology’s President, Professor Cemal Ucer, supports these findings. The research findings have been published for public viewing in the British Dental Journal.

Patients suffer complications in surgery

In spite of patient consent and information gathered prior to surgery, pre-operative planning, and appropriate post-operative referrals, patients have been found to suffer from the complications of nerve injuries associated with dental implant surgeries. The risks need to be addressed in a timely manner and codes have to be established to prevent further such cases. With the help of a proper treatment protocol, injuries can be prevented to a significant extent.

Rise in dental implants leads to Inferior Alveolar Nerve injury

The incidence of Inferior alveolar nerve injuries (IAN) are on the rise thanks to inefficient dental implant surgeries. Each year 10,000 mandibular procedures are carried out in the UK and 100 reported injuries result from these procedures. Dental implant is an invasive procedure and the importance of approaching a highly experienced and qualified implantologist cannot be stressed enough.

Effects of injuries

  • Severe Pain
  • Altered sensations in the face
  • Affecting daily routine activities such as brushing, speaking, eating, shaving
  • Impacting the patient’s quality of life
  • Lead to major illnesses such as depression and mental health issues
  • Pain and numbness

Patient observations

Researchers took the history of 30 patients who had been affected with injuries rising from dental implants. Here are the observations:

  • 11 out of 30 patients aware of signing consent forms
  • 8 out of 11 not warned explicitly about injury
  • No radiographic evidence available pre or post-surgery by the practitioner in 15% of cases
  • 70% of 30 patients referred to specialist nerve injury clinic more than 6 months after surgery, despite strong evidence that removal of the implant within 30 hours of surgery can dampen the risk of permanent damage
  • Only 3 patients treated immediately post-surgery

Professional advice

Professor Tara Renton who is the lead author from the King’s College London Dental Institute states that:

  • Patients need to comprehend the risks associated with dental implants
  • Clinicians need to improve their systems and procedures
  • Doctors need to be vigilant about nerve injuries and must take adequate precautions
  • Often drilling too deep, past the bone into the nerve results in damage; hence, accurate measurements must be done or use a drill guard to avoid over-penetration

Research findings indicate post-surgery complications

The review of 30 patients post-surgery indicated the following:

  • 70% of patients experienced problems during the procedure such as severe bleeding and pain
  • Post-surgery, more than 15 patients suffered from constant pain and persisting discomfort; 40% spoke of numbness
  • 54% revealed that there was lack of pleasure in kissing
  • Speech affected in 46%
  • 30% of the patients faced difficulty in brushing, eating, and drinking
  • 30% reported psychological problems
  • 4 patients diagnosed with depression; two of them significantly suicidal

Recommendations

It’s important to have the patient’s consent before carrying out such procedures. The following were some of the recommendations:

  • Extensive and adequate pre-operative radiographic planning needs to be carried out
  • Use shorter implants to minimize risk of damage to nerve
  • Tomography, computerized tomography, and surgical exposure and also be used
  • Proper localization of the nerve before the procedure is crucial
  • Standard neurosensory examinations , before and after, should be conducted
  • Doctors mustn’t delay if an injury has been detected, specialist nerve injury clinics must be informed immediately
  • Use an implant that can be removed or unscrewed a few threads after placement to relieve pressure on the nerve
  • Before administering the treatment, determine the cause; it could be the implant or excessive drilling

A few more recommendations

  • Improvement of post-operative follow-up is vital. The patient should undertake a home checkup for 12 hours after the surgery. So during this time in case the patient experiences any persisting pain, he can report it to the doctor, timely action may be taken, and the implant may be removed on time.
  • When the patient experiences severe, throbbing pain, it is an indication that nerve damage has occurred. Four to six hours after surgery, a phone call can be made to the patient to determine whether a referral is needed.
  • Within 30 hours implants need to be removed if any abnormalities or problems have been detected
  • Steroids and anti-inflammatory drugs should be prescribed if absolutely needed to control inflammatory reactions
  • Any injuries to the nervous system needs to be reported to the Care Quality Commission

Summary of Findings

The five-year clinical study of IANI has shown Professor Ucer that with more care and caution, any dental implant related nerve injury could be drastically reduced. Strict guidelines need to be established that will ensure proper radiological planning and code of conduct by clinicians. Additionally, the best pharmacological and surgical techniques can be implemented. The doctors need to undergo rigorous training.

Patients themselves, have to become more aware of their symptoms and the nature of the procedure. Well-informed patients can provide their consent to the surgery after understanding all aspects. On their part, doctors have to ensure post-operative follow up and monitor the patients closely to reduce the risks of nerve damage.

The risks are definitely preventable if done by an experienced implantologist who assesses all risks and puts proper protocols in place to prevent injury.