Implant Placement Anesthesia

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This topic contains 3 replies, has 2 voices, and was last updated by  Anthony Tisoncik Mon Oct 14, 2019 02:06 pm.

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    Anthony Tisoncik

    Jay-I posted this on CDocs this morning and was hoping this forum could benefit from your answer. Thank you.

    Especially for the surgeons out there, I’m looking for some help/feedback on this case. Placed #29 and #30 Biohorizon implants with a digital guide. The guide fit perfectly and with plenty of keratinized tissue I did the case with tissue punches. I always only infiltrate the area for these cases and in the past have not had a “numbing” issues. For both sites, right off the bat with the 2.0 drill he was feeling pain even when I was not down to full depth. I placed guide pins and took a pa radiograph to verify that I was indeed where I needed to be, which I was. On to the 2.5 drill…..same thing. Tough guy, he said that he wanted to get it done regardless of how he was feeling the osteotomy. Just to be sure, I placed my 2.5 drills to depth and took a CT scan which again confirmed that I was where I planned the case. And after the CT scan, I blocked him. He showed all signs of profound anesthesia but still was feeling the drills and placement of the implants. I used plenty of irrigation and a slow pumping motion so as not to overheat the sites(all standard procedure). This is the first time I have experienced this and was wondering if anyone could shed some light on it. Septocaine and Marcaine for the infiltration and Lidocaine for the block(what I always use). Thanks in advance.

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  • #4032

    Anthony Tisoncik

    I tried to post pictures but for some reason they are being rejected. Thanks


    Dr. Jay Reznick

    That is pretty crazy. I have almost never needed to give anything but mucosal infiltration for placing implants.The only thing I can think of is that he might have an aberrant sensory nerve that enters at the mental foramen and travels through the mandible. I have seen this with cervical sensory nerves, but it is extremely rare.
    As far as uploading the photos, we are in the process of moving all of our website on to a new server/host. The old host had our content on 3 different server systems. The new web developer is working hard to bring everything together in one place. I will let him know about this issue, and hopefully it, and the CE Certificate issue will soon be solved.


    Anthony Tisoncik

    OK, thanks Jay. It was just very confusing for me. I saw him today and he is doing fine. Minimal pain and no swelling.

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