Evaluation of Neurosensory Function Following Inferior Alveolar Nerve Lateralization for Implant Placement

Mukund Rathod, Rajesh Ashok Kshirsagar, Samir Joshi, Sudhir Pawar, Vishal Tapadiya, Suman Gupta, Vrushika Mahajan, Mukund Rathod, Rajesh Ashok Kshirsagar, Samir Joshi, Sudhir Pawar, Vishal Tapadiya, Suman Gupta, Vrushika Mahajan

Abstract

Background: Adequate bone height and width is the most important parameter for success of implants. Prolonged edentulous area in mandibular posterior region is often associated with atrophy precluding the use of dental implants. Inferior alveolar nerve (IAN) lateralization is a challenging surgical procedure as it involves the exposure of the neurovascular bundle from its compact bony compartment and adequate retraction while immediate placement of implant.

Aim: Evaluation of neurosensory disturbances related to IAN lateralization for implant placement in the posterior atrophic edentulous mandible.

Materials and methods: Ten patients above the age of 18 years with an edentulous span in mandibular posterior region showing distance from alveolar crest to IAN ≤ 8 mm (CBCT) were included in the study. The postoperative analysis of NDs was done using Semmes-Weinstein Monofilaments (SWM). Readings were made on the 1st and 7th postoperative day and every month thereafter until the neural sensations were restored.

Results: All patients reported neurosensory disturbance on post-op day 1. None of the patients responded to SWM lesser than 4.56 on first postoperative day, which indicated 100% incidence of neurosensory disturbances. The minimum time required for complete recovery was 2.0 months, and maximum was 4.0 months.

Conclusion: IAN lateralization is a useful method for managing the atrophic posterior mandible with dental implants. If done precisely with experienced personnel, it can provide a worthy option for surgical restoration of atrophic mandible with minimal temporary NDs.

Keywords: Inferior alveolar nerve (IAN) lateralization; Mandibular atropy; Neurosensory disturbances; Semmes–Weinstein monofilaments (SWM).

Figures

Fig. 1
Fig. 1
Semmes–Weinstein monofilament
Fig. 2
Fig. 2
Osteotomy
Fig. 3
Fig. 3
MSR lateralizer
Fig. 4
Fig. 4
Nerve lateralization
Fig. 5
Fig. 5
Nerve lateralization 1
Fig. 6
Fig. 6
Guiding stent

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