Explore Nerve Repositioning Technique in Implant Surgery

Dental implants are a modern solution for tooth restoration, but not everyone is a suitable candidate for the procedure. For patients with low mandibular bone density, the risk of inferior alveolar nerve injury is significantly higher. The nerve repositioning technique offers a solution to enhance the safety of implant placement while preserving both chewing function and aesthetics. In this article, we will provide you with a deeper understanding of this specialized technique. Join The East Rose Dental Clinic as we explore this innovative approach!

What is the nerve repositioning technique in dental implant placement?

The Inferior Alveolar Nerve Repositioning technique is a complex surgical procedure used when a patient has insufficient mandibular bone height, preventing safe implant placement.

The inferior alveolar nerve (IAN) is a branch of the trigeminal nerve that runs through the mandibular canal within the lower jawbone, providing sensation to the lower teeth, lower lip, and chin. Long-term tooth loss can lead to jawbone resorption, reducing the distance between the bone surface and the nerve. If an implant is placed in this area without adequate space, the nerve may be at risk of injury, potentially causing numbness, loss of sensation, or chronic pain.

The nerve repositioning technique mitigates this risk by temporarily relocating the inferior alveolar nerve to create sufficient space for the implant post. We carefully reposition and stabilise the nerve to restore normal function once we place the implant.

When is the nerve repositioning technique necessary?

Not all patients with missing lower teeth require the nerve repositioning technique. We recommend this procedure exclusively in the following cases:

• Severe mandibular bone resorption: According to Misch CE (2015), if the vertical height of the lower jawbone from the alveolar ridge to the inferior alveolar nerve canal is less than 10mm, the risk of nerve injury during implant placement is significantly high.
• Bone-to-nerve distance less than 5mm: Experts recommend a minimum safe distance of 5mm for implant placement without requiring nerve repositioning. If this distance is smaller, the risk of nerve compression increases substantially.
• Bone grafting is not an option: In some cases, bone grafting cannot be performed due to poor bone density or systemic conditions, such as osteoporosis or diabetes. In these situations, nerve repositioning becomes a viable alternative.
• Functional restoration requires implants longer than 10mm, as short implants (under 8mm) often fail to provide sufficient long-term stability. If a patient requires longer implants but lacks adequate bone height, this technique helps create optimal conditions for placement.

Important considerations for the inferior alveolar nerve repositioning technique

The inferior alveolar nerve repositioning technique in dental implant placement demands a high level of precision and strict adherence to surgical protocols. If not performed correctly, patients may face serious complications, including prolonged numbness or permanent nerve damage.
To ensure patient safety, the dentist must conduct a comprehensive evaluation of the jawbone and nerve condition before proceeding with the surgery. Below are essential considerations during the procedure.

Appropriate indications for inferior alveolar nerve repositioning

Not all cases of lower tooth loss require nerve repositioning. This technique should only be considered when the jawbone height is too low to allow implant placement without posing a risk of nerve damage. If alternative approaches such as bone grafting or the use of short implants are feasible, less invasive options should be prioritised.

Additionally, patients with underlying conditions such as uncontrolled diabetes, bleeding disorders, or osteoporosis require thorough evaluation due to an increased risk of post-surgical complications.

Pre-surgical imaging assessment

The dentist will ask for a panoramic X-ray (OPG) or cone beam CT scan before surgery to get a good idea of where the nerves are and how thick the jawbone is. With 3D imaging technology, the dentist can carefully plan implant placement to prevent nerve damage. Skipping this step or misinterpreting the imaging results significantly increases the risk of complications, potentially causing prolonged numbness or chronic pain after surgery.

Precision is required in the surgical procedure.

During nerve repositioning, the dentist carefully creates a small opening in the jawbone to access and relocate the nerve to a safer position. The dentist then places the implant and meticulously protects the nerve before closing the surgical site. This is a highly delicate procedure; improper execution may result in prolonged numbness in the lower lip or chin or even persistent pain. Therefore, a highly skilled and experienced specialist must perform the surgery.

Post-surgical care to minimise risks

Following surgery, adhering to your dentist’s instructions is crucial for proper healing and minimising complications. In the first few days, consume soft foods and avoid chewing near the implant site. Your dentist may prescribe pain relievers, anti-inflammatory drugs, and vitamins to aid nerve recovery. Most importantly, attend all follow-up appointments to ensure proper healing. If you experience persistent pain, prolonged numbness, or any signs of infection, seek immediate medical attention.

Choose a reputable dental clinic and an experienced dentist

Only a reputable dental clinic should perform this highly complex procedure. A well-established clinic will have experienced dentists and state-of-the-art equipment to ensure safety and success. When selecting a clinic, research the dentist’s qualifications, past successful implant cases, and the technology they use. Choosing the right clinic not only facilitates a smooth surgical procedure but also ensures long-term results and minimises potential risks.

Customer Mr. Dmitry Underwent Nerve Repositioning and Implant Placement at The East Rose Dental Clinic

The nerve repositioning technique is an advanced solution that allows patients with insufficient lower jawbone to safely undergo dental implant placement. However, this is a complex procedure that requires a high level of precision from the surgeon. If you are looking for a reputable clinic to perform this technique, contact The East Rose Dental Clinic today for a detailed consultation!  

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