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The Persistently Sensitive or Painful Osseointegrated Implant

Painful implant
Published:October 20, 2021DOI:https://doi.org/10.1016/j.oooo.2021.10.008

      Abstract

      Objective

      To determine why some implants can appear to be well osseointegrated with no signs of infection and yet can remain sensitive to percussion and painful and unable to tolerate the weight of a restoration.

      Study Design

      Five patients were identified who between them had 7 implants which met the criteria of being persistently painful and sensitive to percussion whilst appearing to be well integrated and otherwise disease free. High-definition cone-beam CT scans were obtained on all of these patients. All patients had failed medical treatments.

      Results

      The cone-beam CT scans showed radiolucent channels running from the nearest nerve trunk to the vicinity of the sensitive implants. These may represent neurovascular channels which originally supplied the teeth that were present at the site of the implants, and they may have terminal neuromas, and that these neuromas may be irritated by the implant. In all cases removal of the offending implant caused either substantial or complete relief of discomfort.

      Conclusion

      The presence of terminal neuromas within the jaws, may be responsible for persistent pain and sensitivity in an otherwise well integrated and disease free implant. Removal of the offending implant appears to be the only treatment.

      Keywords

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