Report of Neuropathic Pain After Dental Implant Placement: A Case Series

Purpose: To report on a cohort of patients referred to a tertiary center because of neuropathic pain after dental implant placement. Materials and Methods: This retrospective study of pain after dental implant placement involved a minimum follow-up of 12 months after the initial diagnosis of neuropathic pain or persistent, uncontrolled postoperative pain at the Department of Oral and Maxillofacial Surgery, Leuven University, Leuven, Belgium, from January 2013 to June 2014. Results: Following clinical and radiologic examination, the cause of pain was established in 17 of 26 patients, while the cause was unknown in 9 of 26 patients. Regular implants were placed in the mandibles of 18 patients; in the remaining 8 patients, 6 received regular implants and 2 received a zygoma implant in the maxilla. Surgical management alone brought relief to 2 patients, surgical and pharmacologic management did so for 12 patients, and pharmacologic management alone brought relief for 10 patients. Conclusions: Early removal of an at-risk implant seems justified, preferably within 48 hours after placement. No treatment, either surgical or medical, seems to cure neuropathic pain, but amitriptyline appears to be associated with consistent improvement in symptoms. Keywords: antidepressant, dental implant, inferior alveolar nerve, nerve pain, nerve regeneration, neuropathic pain