During implantology procedures, one of the most serious complications is damage of the inferior alveolar nerve (IAN). The mandibular incisive nerve is described as a terminal branch of the IAN and provides innervation to the lower anterior teeth and canines. The incisive nerve and canal are located in the interforaminal area. Although numerous studies report IAN damage during implant placement, few reports in the literature describes sensory disturbances, such as neuropathic pain, related to mandibular incisive nerve damage. The purpose of this retrospective clinical study was to evaluate the risk of neuropathic pain caused by implant placement in the interforaminal region of the mandible. Panaromic radiographs of patients who were treated with dental implants in the Department of Maxillofacial Surgery, Faculty of Dentistry at Erciyes University, between 2007 and 2012, were examined. Fifty-five patients with suspected relationship between mandibular incisive canal and dental implant were included into this study. Computed tomography scans were obtained from 10 patients who have postoperative neuropathic pain. Relationship between dental implant and mandibular incisive nerve was evaluated using a three-dimensional software program. Mandibular incisive nerve perforation by at least 1 implant was observed in all 10 patients. Descriptive analyses were also provided. Neuropathic pain may occur after implant placement in the interforaminal region due to the perforation of the incisive canal and nerve. According to the results of this retrospective study, the incisive canal and nerve perforation should be considered as a complication of implant surgery in the mandibular anterior area.

The objective of this research was to evaluate the stress and damage occurring on the bone model of D2 quality during implant insertion procedure using a novel dynamic finite element analysis (FEA) modeling. Three-dimensional finite element method was used to simulate the implant placement into the mandible. The cross-sectional model of the implant was created in SolidWorks 2007 software. The implant model was created to resemble a commercially available fine thread bone level dental implant (Bilimplant®, Turkey). 3 D bone models created with and without cortical bone drilling were specified according to D2 bone (Misch's Bone Classification) with a 1.5 mm cortical bone thickness. The stress patterns in both cancellous and cortical crestal bone were examined during implant insertion by using a novel dynamic FEA in ABACUS/Explicit (ABAQUS/Explicit version 6.14). According to the results of the dynamic FEA, it was reduced stress and damage significantly on the crestal bone region using the cortical drill before the implantation. Also, implant placement time was shorter when the cortical drill was used. The present research is a pilot study using a novel dynamic FEM to model and simulate the dental implant insertion process. This study showed that the use of cortical drills decreased the stress in the bone, especially crestal region, and shortened the whole implant insertion time.

There is no agreement on using inferior alveolar nerve (IAN) block or supraperiosteal infiltration anesthesia during dental implant surgery in the posterior mandibular region. The aim of this study was to evaluate the effectiveness of supraperiosteal infiltration anesthesia on posterior mandibular region during dental implant surgery. In this study 52 implants were inserted under supraperiosteal infiltration anesthesia in 29 patients. After the surgery, patients were instructed to note their pain and/or painless dyscomfort on the visual analogue scale (VAS). Their pressure pain threshold (PPT) scores were evaluated by mechanical algometer. The distance between the apical end of the implants and IAN was measured by using calipers on postoperatif panoramic radiographs. 50 implants to 27 patients had been able to place without pain under supraperiosteal infiltration. Implants which were placed at the mandibular second premolar and first molar region had been able to place with free of pain with supraperiosteal infiltration. There was no relationship among the distance between the apical ends of the implants and IAN with intraoperative discomfort of the patients. VAS scores during implant placement at the second premolar region were relatively higher than at the first and second molar region. Supraperiosteal infiltration anesthesia is a safe and effective method for posterior mandibular implant surgery. However the length of the implant should be determined carefully to avoid possible damage to IAN during implant placement under supraperiosteal infiltration anesthesia.

During implantology procedures, one of the most serious complications is the damage of the inferior alveolar nerve, which may result in neurosensory disturbances (NSD). Panoramic radiographs have been considered for a primary evaluation to determine the bone height and implant-mandibular canal distance. One thousand five hundred ninety-seven panoramic radiographs of patients, who were treated with 3608 dental implants in Erciyes University, Oral and Maxillofacial Hospital between 2007 and 2012, were examined. Forty-eight implants were determined to be near the mandibular canal using a 2-dimensional software program. A total of 48 implants were closer than 2 mm to the mandibular canal. A range of 0 to 1.9 mm distance was detected between the mandibular canal and these implants. Fourteen implants (29.16%) placed in a distance less than 1 mm to the mandibular canal, and 34 (70.83%) between 1 and 2 mm. One patient had NSD. Determination of the dental implant length using panoramic radiography is a reliable technique to prevent neurosensory complications. However computed tomography or cone-beam computed tomography based planning of dental implants may be required for borderline cases.