The consequence of an error in the interpretation of the radiological diagnosis prior to the preparation for oral implantology

Abstract

Introduction. X-ray studies are an important component in the examination of patients before, during and after implantation. The tasks of X-ray examination are to correctly assess the state and parameters of the proposed implantation site in order to avoid unforeseen situations during surgery and postoperative complications, as well as timely detection of changes in the position of the implant and the state of the surrounding parts of the dento-alveolar system when observed in dynamics. Case presentation. Patient E.F., 44 years old, non-smoker, with no chronic conditions, came in 6 months ago with complaints of chewing difficulties due to the absence of lateral teeth. After a clinical and paraclinical examination, including X-ray methods (OPG, CBCT), the established diagnosis was: secondary partial edentulism of the mandible, class II in the Kennedy classification, due to caries and its complications. Discussion. In order to help the patient, it was decided to insert two implants in the area of missing teeth 3.6 and 3.7, with a preliminary CBCT. The next day following implantation, the patient came in complaining about a lack of sensitivity in the area of the third quadrant. The immediate x-ray examination revealed the localization of the dental implant directly in the lumen of the mandibular canal. On the same day, the implant was removed from the lumen of the mandibular canal, a consultation and treatment with a neurologist was scheduled. 6 months after surgery, good dynamics are observed, the function of the damaged nerve is restored. Conclusion. After injury, complete regeneration of the nerve is possible in the absence of prolonged exposure to the traumatic agent. Therefore, it is imperative to diagnose the possible complications as quickly as possible, with the subsequent initiation of the corresponding treatment which is aimed at restoring the anatomical integrity and functional viability of the inferior alveolar nerve.