Neurosensory issues after lateralisation of the inferior alveolar nerve and simultaneous placement of osseointegrated implants

Publication date: Available online 31 January 2019

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): J.M. Castellano-Navarro, J.J. Castellano-Reyes, M. Hirdina-Castilla, A. Suárez-Soto, S. Bocanegra-Pérez, M. Vicente-Barrero

Abstract

Our aim was to evaluate neurosensory symptoms after lateralisation of the inferior alveolar nerve (IAN). We studied a retrospective case series with one-year follow up that included 139 procedures in 123 patients. After the IAN had been located it was deflected from the mandibular body and the implant placed. Sensitivity was mapped 24 hours, one month, six months, and one year after the intervention by gently pressing the skin and lips with the tip of a probe. A total of 337 implants were placed in 123 patients aged between 44 and 68 years.

There were 33 men and 90 women and they all recovered. The IAN was mobilised by one of two procedures, one that involves the nerve directly (transposition) and one that does not (lateralisation). During lateralisation the nerve is deflected laterally through a mandibular osteotomy, while the mental nerve and mental foramen are not manipulated. The resulting hypoaesthetic area was drawn on a graph to assess its extension. Although different techniques are available for placing implants in atrophic jaws, mobilisation of the IAN is indicated in certain cases in which other techniques are not feasible or have a high risk of complications.

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