Inferior alveolar nerve damage related to dental implant placement. A systematic review and meta-analysis

A concern associated with implant placement is the potential occurrence of neurovascular lesions and subsequent development of sensory alterations in patients undergoing implant placements. The objective of this review is to evaluate the incidence of neurosensory alterations based on the proximity between the implant and the mandibular canal Material and Methods: A systematic review was conducted in MEDLINE, Web of Science, and Scopus. Studies with common variables were selected to conduct a meta-analysis. The patient classification was based on the mandibular canal-implant distance. Neurosensory alteration percentages were calculated for each study and group.

The findings indicate significant correlations between implant placement proximity and neurosensory risks. The incidence of neurosensory alterations in patients with implants placed at a distance ≥ 2 mm from the mandibular canal was 0%. Similarly, for distances between 1-2 mm from the mandibular canal, the incidence remained at 0%. However, for implants placed at a distance of 0-1 mm from the mandibular canal, the incidence of neurosensory alterations was 68%. Additionally, patients with implants that intruded into the canal had an incidence of 53% in the development of neurosensorial alterations.

A distance of 1 mm from the mandibular canal might be safe. Implants placed at a distance less than 1 mm from the mandibular canal exhibit neurosensory alterations. Clinicians should be aware of the potential risk of nerve injury and adopt appropriate precautions, including meticulous preoperative planning and three-dimensional radiographic images.