MarcH comments:
Sorry I didn't visit this site lately to notice your post until now. I have seen this a number of times in patients that have been referred to me with pretty much the identical story. I totally agree with Dr. Patel's comments as to what likely occurred. I do not believe that you traumatized the IAN. Rather, infection secondary to osseo pressure necrosis caused by undersizing in the mandible is the culprit. The removal of the implant coupled with appropriate antibiotic therapy, as well as refraining from placing a new graft in the osteotomy site was absolutely the correct treatment. I would venture to guess that her V3 sensory deficit is likely already improved & will resolve over the next few weeks. Does she now report tingling or pins&needles at the areas innervated by the mental nerve distribution?