Inferior alveolar nerve repositioning.
Nerve repositioning is a viable alternative for patients with an atrophic edentulous posterior mandible. Patients, however, should be informed of the potential risks of neurosensory disturbance. Documentation of the patient's baseline neurosensory function should be performed with a two-point discrimination test or directional brush stroke test preoperatively and postoperatively. Recovery of nerve function should be expected in 3 to 6 months. The potential for mandibular fracture when combining nerve repositioning with implant placement also should be discussed with the patient. This can be avoided by minimizing the amount of buccal cortical plate removal during localization of the nerve and maintaining the integrity of the inferior cortex of the mandible. Additionally, avoid overseating the implant, thus avoiding stress along the inferior border of the mandible. The procedure does allow for the placement of longer implants, which should improve implant longevity. Patients undergoing this procedure have expressed overall satisfaction with the results. Nerve repositioning also can be used to preserve the inferior alveolar nerve during resection of benign tumors or cysts of the mandible. This procedure allows the surgeon to maintain nerve function in situations in which the nerve would otherwise have to be resected.
Louis
P J
PJ
Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA. patrick_louis@cs1.dental.uab.edu
D001284:Atrophy; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D007575:Jaw, Edentulous / Q000601:surgery; D008334:Mandible / Q000294:innervation / Q000473:pathology / Q000601:surgery*; D008336:Mandibular Diseases / Q000601:surgery; D008337:Mandibular Fractures / Q000517:prevention & control; D008339:Mandibular Neoplasms / Q000601:surgery; D008340:Mandibular Nerve / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D020127:Recovery of Function / Q000502:physiology; D012677:Sensation / Q000502:physiology; D012678:Sensation Disorders / Q000209:etiology
D015921:Dental Implants