Lateralization of the Inferior Alveolar Nerve with Simultaneous Implant Placement: A Modified Technique

Purpose: Several nerve repositioning techniques have ben presented in the literature, each with limitations. This article presents a new technique involving the use of 2 osteotomies, with minimizes particularly the potential duration of sensory disruption and the risk of nerve paresthesia and inadvertent nerve transection or compression. Materials and Methods: Ten patients ranging in age from 47 to 67 years were selected for nerve lateralization utilizing the modified technique. A total of 23 cylindrical implants were placed. An average follow-up period was 29.8 months. Results: Of the 10 patients, 4 experienced total return of sensation within 3 to 4 weeks. One patient experienced complete recovery at 6 weeks. Discussion: Creating 2 osteotomies as described minimizes the chances for postoperative neuropraxia and nerve paresthesia or anesthesia. Conclusion: When there is moderate-to-severe bone resorption of the mandible posterior to the mental foramen, repositioning the inferior alveolar nerve using both an anterior and postetrior osteotomy allows for more bone to accomodate ideal placement and greater length of implant. Keywords: dental implants, inferior alveolar nerve, nerve repositioning, nerve transpositioning, neurosensory disturbance