David Salomon, DDS

While most nerve injuries do recover on their own, it is important to establish care with an oral and maxillofacial surgeon who is experienced with trigeminal nerve injuries and repair. You should be seen soon, as timely evaluation and monitoring is critical in determining if recovery is appropriate, or if you may benefit from possible nerve repair surgery. 

Typically, pain and swelling should be starting to improve by day 5. At this point, it may be easier to leave the denture out since the gums are now swollen. You should see your dentist to possibly reline the denture and continue your home care including good hygiene and a soft diet.

If pain and swelling are worsening, you should see your surgeon ASAP. 

If an implant becomes loose, then it needs to be removed. The site can usually be gone grafted and after a healing period, a new implant can be placed. Depending on the specific situation, sometimes an implant may be able to be placed in an adjacent site at the same time the failed implant is removed. It depends on the available bone remaining, your anatomy, the type of denture, and the configuration of the remaining implants. 

If you have bone loss around an implant, but no pain or signs of infection, it may be possible for your dentist to follow closely. If the bone loss continues to progress, then likely the implant would need to be removed. However, if the bone loss stabilizes with appropriate treatment and adequate bone support remains, then the implant may be able to be maintained. 

It is often possible do procedures such as this in one surgical step (all-on-4, 5, 6, etc) and have a fixed denture the same day. However, it is not always possible and depends on a variety of patient-specific factors. Some practitioners have more experience in single stage procedures, but this involves a team of both a surgeon and a restorative dentist that work together to complete this. There are occasions when even if the plan is to place implants and place a fixed denture that day, it becomes necessary to not "load the denture" that day due to the stability of the implants. In these instances, it is more predictable to let the implants heal and wear a conventional denture which will be fixed to the implants at a later time. The surgeon should explain this is a possible outcome. When you have a number of teeth that need to be extracted, it can sometimes lessen the predictability of placing the implants with enough stability to fix the denture that day.