Int J Stomatol

Int J Stomatol ›› 2023, Vol. 50 ›› Issue (6): 729-738.doi: 10.7518/gjkq.2023104

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Diagnosis and treatment of post-traumatic trigeminal neuropathic pain after dental implantation

Liao Honglin(),Fang Zhonghan,Zhang Yanyan,Liu Fei,Shen Jiefei.()   

  1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2023-03-31 Revised:2023-06-22 Online:2023-11-01 Published:2023-10-24
  • Contact: Jiefei. Shen E-mail:Honglinliao@126.com;shenjiefei@scu.edu.cn
  • Supported by:
    National Natural Science Foundation of China(81870800);the Department of Science and Technology of Sichuan Province Grant(2021JDRC0166)

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Abstract:

Dental implants are preferred in the restoration of missing teeth. With the explosive growth in the number of dental implants, the incidence of surgical complications has increased. Post-traumatic trigeminal neuropathic pain (PTNP) caused by implant surgery is a serious complication in the oral and maxillofacial regions and cannot be ignored in the application of implant prosthesis. The pathological mechanism of PTNP remains unclear, and no unified standard for clinical treatment is available. This article is a systematic review on the etiology, pathogenesis, clinical diagnosis, treatment, and prevention of PTNP, providing a reference for clinical management strategies for PTNP.

Key words: dental implant, trigeminal nerve, nerve injury, post-traumatic trigeminal neuropathic pain

CLC Number: 

  • R 783.4

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Tab 1

Seddon and Sunderland Classification for neural injury"

SunderlandSeddon病因组织学改变损伤表现恢复潜力
第1类神经机能麻痹神经压迫、水肿、血肿、热损伤、轻微拉伸神经束内水肿、传导阻滞神经炎、感觉异常一般1~7 d可完全恢复
节段性脱髓鞘一般4~8周可完全恢复
第2类轴索断伤神经压迫、牵拉、血肿、挤压、水肿、拉伸轴突撕裂，神经内膜、神经束膜和神经外膜完好感觉异常、发作性感觉障碍一般8~16周可完全恢复
第3类挤压、穿刺、严重血肿、拉伸神经内膜管切断，可能发生沃尔特变性感觉异常、感觉迟钝一般12周内可部分恢复
第4类完全粉碎、严重拉伸、直接化学创伤、严重热创伤只有神经外膜完整，整个神经束受损感觉丧失、感觉迟钝、神经瘤形成一般无恢复潜力
第5类神经断伤神经完全断裂、神经瘤形成神经连续性丧失麻醉、顽固性疼痛、神经瘤形成一般无恢复潜力
同一神经束内的不同轴突可表现为该列上述任意组织学改变的组合可表现为该列上述任意损伤表现的组合恢复潜力不可预测
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