Notifications

Discussions
NASIR HANEEF

· started a discussion

· 1 Months ago

Sir, Can you please explain what is this radiolucency pointed by the marker, since Compression of the ASAN seems to be answer but as per the question pain is elicited while brushing or touching, nerve injury due to cortical fracture and direct force transmission elicits the pain could be the possibilty which is further supplemented by the radiolucency at the implant site.. ' CONFUSED"

Question:
A female patient complains of localized persistent pain, described as electric-shock-like exacerbated by touching or brushing in the upper right central incisor region. History of implant placement in the upper front region of the jaw, 15 days ago. On intraoral examination, there are no clinical signs of abnormality in and around the implant. CBCT reveals findings as given in the image below. What is the most probable diagnosis?


Options:
A) Nerve injury due to fracture at the implant site
B) Compression of anterior superior alveolar nerve
C) Infection due to peri-implantitis
D) Compression of nasopalatine nerve
Solution:
The image shows coronal section of CBCT. The structure marked by the arrow is the Canalis Sinuosus. It is a tortuous bone channel which originates from the posterior infraorbital foramen and courses in an anterolateral direction to the anterior wall of nasal antrum below the orbital margin. It contains the anterior superior alveolar nerve and the relative veins and arteries. An implant placed in canalis sinuosus zone can lead to various types of neurological lesions and evident signs of neuropathy due to the compression of anterior superior alveolar nerve.

NASIR HANEEF

· commented

· 1 Months ago

Thanks sir, Got the answer.