Özet:

Objective: The aim of this case series is to evaluate the treatment of patients who develop hypoesthesia without direct nerve damage after dental implant placement. Cases: Three systemically healthy patients were referred to our clinic with the complaint of altered sensation in the lower chin and lip area. Clinical and radiological examinations were performed on patients who learned that implants were placed in the mandibular premolar region within 48 hours. With the radiographs taken from different angles, it was evaluated that the implants were not in contact with the inferior alveolar nerve (IAN). In clinical evaluation, facial swelling and edema was detected in all patients. Mechanoceptive and nociceptive tests were applied by giving a score of 1/10 against the stimulus to determine the extent of sensory changes of the patients. The diagnosis of hypoesthesia was made in the evaluation performed with the patient's eyes closed, in a quiet environment, using the contralateral side as a control. Following IV corticosteroid administration (prednisolone, 40 mg), 6 days of oral prednisolone was prescribed (1 mg per kg, max 80 mg). In addition, the non-steroidal anti-inflammatory (NSAID) prescribed for pain control after surgery was continued (ibuprofen 400mg, 3 times a day). The patients were informed and called for follow-up controls. Results: After 2 weeks, 80-90% improvement was detected in the senses and no additional medication was administered. No difference was detected from the contralateral side at the 3 and 6 month controls. Conclusion: Determining the extent and etiology of IAN damage is important in the management of such cases. Early detection of symptoms and early steroid administration may be effective in improving hypoesthesia findings. According to the results of this case series, corticosteroid and anti-inflammatory drug applications may contribute to the improvement of symptoms in the absence of direct nerve contact damage after implant surgery.

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