Greater-auricular-nerve grafting in a patient with dental-implant-induced inferior-alveolar-nerve damage

DOI Web Site 12 References
  • TAKASAKI Yoshito
    Oral & Maxillo-facial Surgery, Takasaki General Medical Center, National Hospital Organization Division of Oral and Maxillo-facial Surgery, Department of Clinical Oral Health Science，Tokyo Dental College
  • TAKANO Masayuki
    Division of Oral and Maxillo-facial Surgery, Department of Clinical Oral Health Science，Tokyo Dental College
  • YAMAMURA Tetsuo
    Division of Oral and Maxillo-facial Surgery, Department of Clinical Oral Health Science，Tokyo Dental College
  • TAGUCHI Tatsuo
    Division of Oral Implantology, Department of Clinical Oral Health Science，Tokyo Dental College
  • KASAHARA Masataka
    Department of Biochemistry and Integrative Medical Biology, School of Medicine, Keio University
  • HASHIMOTO Sadamitsu
    Department of Biology, Tokyo Dental College

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Other Title
  • インプラントによる下歯槽神経損傷に対し大耳介神経移植を行った1例
  • インプラント ニ ヨル シタ シソウ シンケイ ソンショウ ニ タイシ ダイジカイシンケイ イショク オ オコナッタ 1レイ

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Abstract

A 69-year-old man presented at our department with persistent severe hypoesthesia in the lower lip and mentum. The symptoms developed on the day after the placement of dental implants into the left mandibular molar region (36, 37) 7 months previously. Sensory testing of the inferior labial branch region revealed a Semmes-Weinstein (SW) test score of 4.08 (healthy side, 1.65) , an unmeasurable two-point discrimination (2PD) score (healthy side, 4 mm) , and inability to recognize heat, cold, or pain. Computed tomography revealed that the implant tip reached the inferior wall of the mandibular canal at 36 and 37. Implant removal and surgical exploration of neural damage were performed using a surgical microscope with the patient under general anesthesia. After resection of the damaged inferior alveolar nerve, a graft of the greater auricular nerve was applied to the defective region. Awareness of cold, pain, and heat returned in postoperative months 3, 6, and 10, respectively. Sensory testing demonstrated a postoperative SW score of 1.65 (healthy side, 1.65) at 10 months and a postoperative 2PD score of 6 mm (healthy side, 6 mm) at 18 months. Although symptoms of mild hypoesthesia were present from postoperative months 18 to 23, there was no dysesthesia or allodynia, and progress was satisfactory.

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