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Rate of Georgia Dental Nerve Injuries Tracks Increase in Implants

According to some sources, between 3 and 5 million dental implants are installed each year in the United States. As an Atlanta Dental Malpractice Attorney, I have noticed that the number of injuries to the facial nerves has increased due to the increase in the number of implants being installed.

In layman’s terms, implants are installed by extracting the bad tooth, drilling a pilot hole, installing a post in the pilot hole, allowing the tissue and bone of the jaw to grow around and solidify onto the post (this is known as osseointegration), placing an abutment over the top of the post, and then placing a crown over the abutment.

In many cases, dental malpractice causes injury to the nerves that run along the alveolar ridge (the most common being the inferior alveolar nerve and the lingual nerve). Most of these injuries are caused by the dentist not properly calculating the distance to the nerve from the post. In other words, many of these injures occur because the pilot hole for the post is drilled too deep and into the nerve or the implant is screwed too deeply into the jaw which results in the nerve being crushed.

The are a number of procedures that the dentist should employ if the risk of injury is known. If, during surgery, known or observed trauma (including traction or compression of the nerve trunk) has occurred, the topical application of Dexamethasone is suggested. One to two ml of the intravenous form of Dexamethasone (4mg/ml) may be topically applied. The direct application of steroids will reduce neural inflammation and reduce compression from swelling, which may enhance recovery from neurosensory deficits. No morbidity has been associated with topical steroid application at the nerve injury site, yet significant improvement in post surgery recovery has been observed. This should be followed by a six-day regimen of oral steroids (which many patients know as a steroid pack). If known nerve trunk transection is clinically observed during the surgery, immediate referral to a nerve repair specialist is highly recommended.

The most important physiologic therapy at the time of surgery includes removal or repositioning of any irritant (implant, bone screw) in close approximation to the neurovascular bundle. In other words, if the implant was not planned properly and it is invading a nerve canal, it should be removed immediately and re-position so that it does not interfere with the nerve. A radiograph or CT scan immediately after implant placement is warranted to insure the nerve is not violated. If a post operative radiograph indicates the implant may encroach upon the IAN, it may be removed, a steroid introduced into the osteotomy site and then a shorter length implant replaced in the same site in a more ideal location.32 No bone grafting materials should be placed in the osteotomy site, since it may invade the mandibular canal and interfere with nerve repair.

Extreme care should be used by anyone contemplating a dental implant procedure. One should make sure the dentist performing the implant is experienced and skilled — and that the equipment that the dentist is relying on to properly evaluate the distance to the nerve is state-of-the-art, properly calibrated and accurate.

If you have suffered a dental nerve injury and suspect it was due to dental malpractice, please call (404) 525-5150 for a consultation. Attorney Fleming has been handling wrongful death cases, automobile accident cases, personal injury cases, dental malpractice and medical malpractice lawsuits for individuals and families who have been harmed, injured or died as a result of the carelessness or negligence of another for more than 20 years in and around Atlanta, Georgia and its surrounding areas, including Alpharetta, Austell, Avondale Estates, Chamblee, College Park, Conyers, Duluth, Decatur, Doraville, Hapeville, Johns Creek, Jonesboro, Lawrenceville, Norcross, Peachtree City, Riverdale, Roswell, Sandy Springs, Stone Mountain, and Smyrna. If you have been seriously injured and would like quality legal representation, contact Robert J. Fleming directly on (404) 525-5150 or contact us online.

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