Vertical Alveolar Ridge Augmentation Prior to Inferior Alveolar Nerve Repositioning: A Patient Report

This report describes treatment of a patient using vertical alveolar ridge augmentation performed prior to transposition of the inferior alveolar nerve (IAN). A preoperative computerized tomographic (CT) scan revealed 2 to 3 mm of bone above the canal in the left mandibular molar region. An autogenous bone graft harvested from the chin area was utilized along with a titanium mesh for vertical alveolar ridge augmentation in this area. CT scan after bone grafting revealed 5 mm of vertical ridge augmentation. Bone height above the IAN was 7 to 8 mm after bone grafting procedure. For IAN transposition, an osteotomy was performed to obtain a lateral access window located 4 mm below the crestal bone along the lateral side of the mandible. Two cylindric hydroxyapatite-coated implants were placed. Autogenous bone from the lateral access window that had been removed en bloc was particulated and placed around the implants. Because vertical alveolar ridge augmentation had been performed, the coronal portion of the implant was not exposed after transposition of the IAN. It is suggested that vertical ridge augmentation may be considered prior to transposition of the IAN in situations where minimal bone height exists above the IAN canal. However, long-term clinical investigations are recommended.