Pain complications of oral implants: Is that an issue?

Abstract

The use of oral implants as a form of replacing missing teeth in partial or total edentulous patients is considered the gold standard in oral rehabilitation. Although considered a history of success in contemporary dentistry, surgical complications may occur, as excessive bleeding, damage to the adjacent teeth and mandibular fractures. Persistent pain and abnormal somatosensory responses after the surgery ordinary healing time are also potential problems and may lead to the development of a condition named posttraumatic trigeminal neuropathic pain (PTNP). Though relatively rare, PTNP has a profound impact on patient’s quality of life. Appropriated previous image techniques, effective anaesthetic procedures and caution during the surgical procedure and implant installation are recommended for the prevention of this condition. In case of the PTNP, different management modalities, including antidepressant and membrane stabilizer medications, as well as peripheral strategies, as the use of topical medication and the botulin toxin are presented and discussed.

Persistent, neuropathic-like trigeminal pain after dental implant loading

“…The success rate of DIT is overall high and the failures are mainly due to periimplantitis and treatment planning errors ( 1 , 2 ). Post-operative surgical pain usually resolve in a few days or weeks ( 3 ) but persistent pain can also occur, mainly as a result of nerve injury ( 4 - 6 ). Indeed DIT is suggested to be the second cause of trigeminal nerve injury and sensory disturbances, after third molar extraction ( 7 - 10 ).…”

“…Indeed DIT is suggested to be the second cause of trigeminal nerve injury and sensory disturbances, after third molar extraction ( 7 - 10 ). Its incidence ranges from 0.8% to 33% ( 6 , 9 ).…”

“…This type of neuropathic pain (NP) has a variable clinical phenotype, either in intensity, temporal pattern or quality, with patients experiencing mild to severe continuous or intermittent pain, reported frequently as burning, pricking or tingling sensations, electric shocks, paresthesia, and/or mechanical allodynia ( 7 , 12 , 13 ). The individual and societal impact of PTTN is nowadays recognized with impaired psychosocial functioning, affective behavior, food ingestion and communication, associated with decreased quality of life ( 6 , 9 , 14 ).…”

Somatosensory alterations and neuropathic pain symptoms after single-unit implant immediate loading: a 1-year follow-up study

“…Por isso, na dor de origem nociceptiva, os sintomas tendem a melhorar de acordo com o reparo tecidual. Porém, em casos de injúrias mais extensas a tecidos nervosos, esta condição pode progredir para uma condição de dor neuropática, com envolvimento de ambos mecanismos centrais e periféricos (CONTI et al, 2021;. Nestas situações, o nervo alveolar inferior costuma ser o mais afetado na região orofacial SELVIDO et al, 2021;VÁZQUEZ-DELGADO et al, 2018).…”

“…during the implant placement procedure, an inflammatory process is installed in the region, and if not well controlled, the patient may be exposed to unnecessary and excessive nociceptive stimuli [10][11][12] . This nociceptive type of pain tends to improve as healing of the injured tissue progresses, although neuropathic pain can develop in a few cases with involvement of both peripheral and central mechanisms 12,13 , where the inferior alveolar nerve is the most affected in the orofacial region 11,14,15 . This painful situation can compromise daily activities such as eating, drinking, talking and socializing, drastically reducing the affected subject's quality of life 16 .…”