PubMed · 10468447
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M A Siegel. 1999. Osseointegration?. https://doi.org/10.1016/s1079-2104(99)70101-0
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Surgical guides for edentulous patients often lack the stability desired for accurate implant placement. The difficulty is emphasized in the edentulous mandible when implant-supported metal-ceramic restorations, which require precise placement of implants, are planned. A technique is presented for the fabrication of a surgical and radiographic template, supported by transitional implants, that guides the placement of conventional implants. This template can enhance placement accuracy in an efficient way to achieve predictable, esthetic results.
BACKGROUND: One option for successful placement of dental implants in an atrophic posterior mandible without injury to the inferior alveolar nerve (IAN) is to transpose or lateralize the nerve. This procedure carries the risk of numbness along the distribution of the nerve, the complication that the procedure is undertaken to avoid in the first place. The purpose of the present study was to assess mental nerve function after transposition of the IAN. METHOD: We determined the outcomes of 20 IAN transposition procedures in 12 consecutive patients at the Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia. The study included objective testing of sensory nerve function as well as subjective assessment by the participants. RESULTS: All subjects reported initial transient sensory disturbance. Objective testing after a minimum of 6 months revealed that, for each patient, affected sites had the same level of sensation as unoperated areas. Eighty percent of the patients said that the lower lip and chin felt normal. The others said that these structures did not feel exactly normal but that the difference was of no consequence. CLINICAL SIGNIFICANCE: It is concluded that IAN transposition can be safely and predictably performed with low risk to the mental nerve sensibility.