A Modified Surgical Technique for Inferior Alveolar Nerve Repositioning on Severely Atrophic Mandibles: Case Series of 11 Consecutive Surgical Procedures
H.M. Barbu, L. Levin, M.B. Bucur, R.M. Comaneanu, A. LoreanOriginal article, no. 1, 2014
Background: To emphasize the characteristics and possiblepitfalls of nerve reposition in cases of severe bone resorptionin the posterior mandibular area, and to modify hard- andsoft-tissue manipulation accordingly.Methods: We analyzed retrospectively, 7 patients in which weperformed full arch lower jaw rehabilitation. The patientspresented for oral rehabilitation having a minimal residualbone above the mandibular canal and had undergone inferioralveolar nerve (IAN) displacement with modified surgicaltechnique for fixed prosthetic rehabilitation.Results: Eleven procedures of nerve repositioning were performed on severely atrophic mandibles. The average age ofthe patients was 43.29 years (12.37 SD). Residual bone abovethe mental foramen ranged between 0.5 mm and 1.5 mm, withan average of 0.93 mm (0.35 SD). In total, 32 dental implantswere inserted into the area simultaneously with nervedisplacement. The average follow-up time was 35.71 months(41.75 SD), ranging between 7 and 120 months.Conclusions: Severe atrophic cases require special attentiondue to the loss of keratinized tissue around the crestal area.The use of a modified surgical approach and specific surgicalinstruments provides a safer working environmentfor theoperator and ensures optimal results.
