Surgery removal of implant tooth, Micro surgery



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Surgery removal of implant tooth,

Micro surgery
Trigeminal nerve injuries (patient info TNI website & EFIC)


Consultation dedicated nerve injury clinic + psychologist psychiatrist

Website

Previous questionnaire (TNI)

Psychometrics

Post traumatic neuropathy

Defn IHS

Consider Referral InPUT

Pain management



Medical management

1. Pregabalin

2. Nortriptyline

3. Oxcarbazepine,

4. versatis

5. GON

Vit B/ NSAIDs

Discharge to GP

GP to continue Drug Therapy



Managing pain/ coping

Severe pain not coping

Review

8 week OFP MDT Neurology

Imaging

DPT or CBCT if retained roots

? future local MRI



Poor Quality of Life

Pain +ve

TMS related

Known nerve injury

Implant

Endo

Patient group

Patient day

Psychiatry/ Psychology referral completed
Neurovascular orofacial pain Headaches

Red Flag signsc:\users\znzz5729\desktop\patient pathways\nhs england headache algorithm.jpg


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