| 2072 Neuropathic pain as an implantologic complication | ||
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O. GABBERT, B. KRESS, M. LECKEL, and M. SCHMITTER, University of Heidelberg, Germany Objectives: The aim of the present case report was to show the risk of development of neuropathic pain in consequence of setting an implant. Methods: A patient suffered from pain in the area of the nervus alveolaris for more than 18 months after setting two implants. The pain developed after one week, at the beginning moderate, afterwards with increasing intensity. Multiple endodontic treatments, root resections and finally the extraction of 2 previously symptom-free teeth mesial of the implants were performed in order to solve this problem. The pain persisted and a permanent opoid medication resulted. In this stage, the patient was sent to the department of prosthodontics for exclusion differential diagnosis of temporoman-dibular disorders. By CT and MRI diagnosis an implant perforating the roof of the mandibular canal was evaluated to be responsible for the compression of the neurovascular bundle within the canal. This mechanism is known as a trigger of neuropathic pain. The implants were removed and the pain abated within the following months. The persisting disorders could be controlled by the patient through the application of Capsaicin. Results: On the basis of this exemplary case, the necessity of a systematical clarification of chronic pain under abandonment of invasive interventions is shown. In particular the benefit of CT and MRT is discussed. Furthermore, an overview over the prevalence of neuropathic pain and paresthesia in the literature as a complication of the implantation is given. Conclusions: In case of long lasting pain after surgery, neuropathic pain should always be taken in consideration as one possible explanation. No invasive and irreversible treatment without a clearly diagnose should be done. Close coordinated teamwork between dentist, neurology, neurosurgery and neuroradiology at an early stage should be assured. Specific and inter-coordinated use of imaging processes should be made.
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| Seq #231 - Clinical Research 2:00 PM-4:00 PM, Friday, 11 March 2005 Baltimore Convention Center Exhibit Hall E-F | ||
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