NS-7 - Nerve Injury Considerations & Management

Sensory disturbances to the peripheral branches of the trigeminal nerve can be a debilitating disruption to patients leading to problems with speech, mastication, food and liquid incompetence and difficulty with activities of daily living. These injuries may arise from a number of causes in dentistry including local anesthesia administration, exodontia, endodontic procedures, implant placement, preprosthetic surgery and treatment of maxillofacial pathology.

Some of the etiological factors resulting in trigeminal nerve injury are unpreventable, however, more precise surgical techniques and better imaging modalities may help reduce the incidence of these injuries. It is important for practitioners to explain these risks to patients as part of the informed consent process and to recognize and document the presence of nerve injuries. Patients should be treated in a timely fashion or referred to practitioners skilled in microsurgical techniques for optimal sensory improvement. This presentation will review the etiologies of trigeminal nerve injury, neurosensory testing and documentation, classification schemes, indications for treatment and referral, microsurgical techniques and outcome assessments.