More than 70% of dentists have experienced patients with postoperative paresthesia/dysesthesia or anesthesia as a result of dental procedures. The most common nerve affected is the mandibular nerve, which may be injured during either implant surgery or bone grafting procedures. However, no organized protocol directed specifically for general dentists, or for the vast majority of specialists, has been published. The protocol presented in this article is divided into 5 periods: during surgery (1) nerve injury is suspected or (2) known nerve transection, post-operative period (3) 1 week and (4) 12 weeks. The appropriate treatment (pharmacology, monitoring, etc.) for each period is suggested, including the referral to a nerve specialist when appropriate.

The literature supports the use of CBCT in dental implant treatment planning particularly in regards to linear measurements, three-dimensional evaluation of alveolar ridge topography, proximity to vital anatomical structures, and fabrication of surgical guides. Areas such as CBCT-derived bone density measurements, CBCT-aided surgical navigation, and postimplant CBCT artifacts need further research. ICOI RECOMMENDATIONS: All CBCT examinations, as all other radiographic examinations, must be justified on an individualized needs basis. The benefits to the patient for each CBCT scan must outweigh the potential risks. CBCT scans should not be taken without initially obtaining thorough medical and dental histories and performing a comprehensive clinical examination. CBCT should be considered as an imaging alternative in cases where the projected implant receptor or bone augmentation site(s) are suspect, and conventional radiography may not be able to assess the true regional three-dimensional anatomical presentation. The smallest possible field of view should be used, and the entire image volume should be interpreted.

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It is proposed that, based on the findings of this study, 45.1% patients would require further consultation before proceeding with maxillary sinus augmentation surgery.