Nerve damage after implant. Should I leave it in or have it removed? (Photo)

Question

Three weeks ago i had an implant placed in my mouth on tooth #30 on the right side of my lower jaw. Unfortunately my dentist drilled to far with the implant prep drill and nicked the inferior alveolar nerve. . I now have altered sensation and numbness on my lower lip, chin as well as gums and teeth. He informed me that this might be a permanent injury. A 3d cone beam scan confirmed that the implant is not violating the nerve. I cant decide whether to leave it in or have it removed. Any advice

Valentina Lyssova, DDS · Answer

Dear mike118, The numbness and altered
sensation in the lower lip can be caused not only by directly drilling through
the nerve, but also by the implant being placed in close proximity to the nerve
and putting pressure on the nerve. The implant should be backed out,and another
shorter implant could be placed in the future. Hopefully,your paresthesia is
transient. Good luck.

Nirav Patel, MDS, PhD · Answer

wait for  3-4 more weeks and observe, if u feel constant irritation or pain , just get it removed. and if u feel more comfortable day by day keep it . but remember do not wait for more than 2 months from date of implant placement, because once it will fuse with bone than its very hard to remove it.

Christian Yaste, DDS · Answer

Mike,While it might take up to 6 months before recovering the feeling in your jaw, your dentist is right in that you may never fully recover.  I generally would recommend removing the implant if numbness is not getting any better after the first month.  The implant can be backed out and the area grafted.  From another perspective you may want to consider a 3 unit bridge instead of an implant in that area as both teeth on either side of the space have already had considerate dental work and you could kill two birds with one stone by doing a bridge.  Also, there is little chance that the restoring dentist will ever be able to close the contact on the back of that implant with a crown because of how it is positioned.  That means you will probably have a food trap between the implant and your last tooth.  It is hard to judge without seeing your 3D scan, but ideally that implant would have been placed more towards the molar and not so close to the premolar.  It is a difficult position to put an implant in and a dentist really should be at the top of their game in order to place an implant at that particular site.All that being said.  Your best chance at this point for allowing the nerve to recover is to have the implant removed and grafting the site.  After 3-4 months you may be able to have another implant placed.  Have a consult with another dentist or surgeon who places at least 100-200 implants a year and has experience with several different implant systems as well as a CT or 3D scanner.  Best,Dr. Christian Yaste

Nerve damage after implant. Should I leave it in or have it removed? (Photo)

Answers (3)