Implant Apex Extending into Inferior Alveolar Canal

A 37-year-old female with a history of pain in the left ramus area after a traumatic event was referred for evaluation of possible fractures or other causes. The radiologist identified the implant apex at site 18 extending into the superior half of the inferior alveolar canal with associated canal narrowing, despite normal crestal peri-implant bone levels. Implant extension into the inferior alveolar canal carries an increased incidence of neurosensory disturbance, including paresthesia, dysesthesia, or chronic neuropathic pain. Neurosensory assessment was recommended, along with counseling the patient regarding the elevated risk of developing symptoms and the need for close monitoring.