Case Archive
 
Oral Surgery, Dentistry
Ref. # 06018

A 48 year old Arkansas woman underwent placement of mandibular right and left implants. Intra-op the attending oral surgeon elected to expose and reposition the right Inferior Alveolar Nerve secondary to inadequate bone width. During the post-surgical period, the patient developed a painful dysesthesia, which did not recede. Ten months later, abutments were added to the implants. Over another nine months, the patient continued to experience extreme pain and was prescribed Tegretol and several analgesics, which induced numerous disabling side effects. Eighteen months into the patient's treatment, the oral surgeon referred her to a neurologist who, along with other treating physicians, diagnosed a surgical insult to the mandibular nerve. The woman requires surgical nerve exploration with decompression and/or resection with grafting, with a guarded prognosis. A medQuest oral surgeon reported the patient was presented with generic documentation for Informed Consent, which failed to address the possibility of a nerve repositioning procedure and any resultant permanent sensory change. Furthermore, there was negligent management of the dysesthesia over an extended period of time (surgical exploration should have been considered after 3-6 months). With appropriate care, the woman's prognosis would have been vastly improved.




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