Mandibular Unilateral Paresthesia Following Implant Placement and Clinical Management: Clinical Case Report

Dental implantology has been considered the mainstay in the rehabilitation of partial or complete edentulism. Nevertheless, complications and failures are occasionally encountered, and the most significant is the neurosensory disturbance. It not only causes persistent discomfort to the patient but frequently degrades the patient's oral health-related quality of life, even leading to a negative psychological impact. This paper presents a case report of a 65-year-old male patient who underwent the replacement of his missing tooth in the right mandibular region (46) with an implant-supported prosthesis two years ago. Since then, he has been experiencing numbness in the right side of the lip and occasional drooling of saliva from the right corner of the mouth. Clinical examination revealed the presence of a prosthetic crown supported by an implant in relation to 46 with inflamed and enlarged gingiva in the region with paresthesia of the right lower lip region. Radiological examination with orthopantomogram (OPG) and cone beam computed tomography (CBCT) revealed that the implant apex rested on the inferior alveolar nerve canal. Careful surgical retrieval of the well-osseointegrated implant was performed under local anesthesia in about seven days. The patient gradually experienced neurosensory improvement, and the paraesthesia was completely resolved in a six-week period. After complete recovery, as evaluated with an objective and subjective assessment, the edentulous site was successfully restored with a provisional fixed partial denture.