Chronic idiopathic pain following implant placement in the anterior maxilla: a case series

Dental implants have progressively become more widely utilized in the rehabilitation of edentulous spans.¹ Some studies suggest that 100,000−300,000 implants are placed per year.¹ This progressive increase in use has been mirrored by an increasing awareness of the advantages, disadvantages and processes involved in placing and managing dental implants. An example of this includes the appropriate utilization of more advanced radiographic techniques to identify and avoid vital structures when planning and undertaking surgery. When correctly planned, placed and utilized, dental implants have the potential to improve oral health-related quality of life (OHR-QoL) significantly.

Common risks or complications of dental implant treatment include infection, failure of osseointegration, short-term post-surgical pain and the risks associated with trauma to vital structures (ie post-operative bleed or symptoms associated with nerve injury). Specific risks associated with placement in the mandible (risk to the inferior dental and lingual nerves) and posterior maxilla (risk to the maxillary sinus) are well covered in the literature.^{2, 3} Potential risks associated with implant placement in the anterior maxilla are, however, less well investigated. There is a dearth of literature reporting on chronic idiopathic pain following implant placement. This condition is characterized by patient-reported experience of long-term persistent and chronic pain within the region of implant placement which begins after implant placement and for which no anatomic pathology can be found. It can involve a small or large region and responds unpredictably to implant removal and to pharmacological treatments. It may present with a wide gamut of pain characters.^{4, 5}