Early Photobiomodulation for Post-Traumatic Trigeminal Neuropathy After Posterior Mandibular Implant Retreatment: A Case Report

Background Implant dentistry has advanced steadily since the advent of osseointegration with endosseous implants in the latter half of the 20th century. Despite overall safety, surgical complications, such as injuries to adjacent tissues and neural structures, remain a concern. These complications are often attributable to the anatomy of the operative site and can lead to significant sensory disturbances and persistent neuropathic hyperalgesia, with consequent functional impairment and psychological distress for patients. Case Presentation A 63-year-old man developed severe neuropathic pain and sensory deficit in the mental region days after reimplantation with short implants. To enable a more precise phenotypic characterization, pain was assessed with the Neuropathic Pain Symptom Inventory (NPSI) and Numeric Rating Scale (NRS). A combined therapeutic approach was implemented, integrating pharmacotherapy with early photobiomodulation (PBM) to the mental region (660/808 nm diodes, contact mode, 6 J per point; three sessions). As a result, the report of global pain intensity, measured by the NRS, dropped from 8 (severe intensity) in the baseline NPSI to zero (no pain) after the first PBM session and remained thereafter, allowing early discontinuation of analgesics. The NPSI Score decreased from 63/100 to 2/100 (96.8% reduction) with no domain-level worsening. Conclusions This case illustrates the feasibility of early, focal PBM as an adjunct for painful post-traumatic trigeminal neuropathy following implant retreatment, with rapid symptom relief, functional recovery and a potential role in preventing the chronification of neurosensory symptoms related to mental nerve injury and supports further study to define optimal timing and dosimetry.