Prevalence and management of neuropathic injury caused by dental implant insertion in mandible: a systematic review

To synthesize scientific knowledge regarding the prevalence of neuropathies and nerve injuries caused by dental implant placement in mandible and the available management. Observational and interventional studies evaluating neuropathies occurrence in adults who underwent dental implant surgery were included. Any neuropathy diagnostic was accepted. The searches were conducted in six databases and grey literature. Methodological quality was screened using the Joanna Briggs Institute. The resulting synthesis was a narrative summary, and prevalence meta-analyses were performed in MetaXL 5.3. Among 98 full texts assessed, 38 studies were included. Neuropathies were diagnosed by questionnaires and/or clinical assessment. Eighteen studies presented high, sixteen moderate, and four low methodological quality. In implant surgeries without nerve lateralization, 12% and 5% of the patients may experience neuropathy during the first week and after three months, respectively. In implant surgeries with nerve lateralization, the prevalence was from 90% in the first week to 42% after three months. Proposed management included drugs, laser therapy and dental implant removal. In mandible, the prevalence of neuropathies in dental implant surgeries without lateralization is lower when compared with those with lateralization (eight times more in both follow-up times). The most frequent treatment was pharmacologic management.