Inferior Alveolar Nerve Lateralization Surgery for Implant Installation in Atrophic Posterior Mandible With Accessory Mental Foramen: A Challenge for the Usual Technique. The Journal of craniofacial surgery ABSTRACT:Implantology allows edentulous patients to smile and chew with confidence. However, the atrophy at posterior region of the mandible is still a challenge due the presence of the inferior alveolar nerve (iAN). The options of restoration with oral implants in this area with great atrophies are few and hazardous. The possibilities are: bone grafting, short implants, which are not always possible. So, the solution falls on the techniques of inferior alveolar nerve lateralization (IANL) or transposition. The knowledge of the anatomy and path of the IAN is decisive in this type of surgery. But anatomical variations may occur. Like the presence of an accessory mental foramen. This clinical study will present a relatively rare case of the occurrence of an accessory mental foramen that obliged to change the technique of iAN lateralization to contour this anatomical variance and install oral implants, maintaining the integrity of the iAN bundle. 10.1097/SCS.0000000000008039

Inferior alveolar nerve lateralization and transposition for dental implant placement. Part I: a systematic review of surgical techniques. Abayev Boris,Juodzbalys Gintaras Journal of oral & maxillofacial research OBJECTIVES:The purpose of this first part of a two-part series was to review the literature concerning the indications, contraindications, advantages, disadvantages and surgical techniques of the lateralization and transposition of the inferior alveolar nerve, followed by the placement of an implant in an edentulous atrophic posterior mandible. MATERIAL AND METHODS:A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed and PMC database, academic sites and books. The articles were searched from January 1997 to July 2014 and comprised English-language articles that included adult patients between 18 and 80 years old with minimal residual bone above the mandibular canal who had undergone inferior alveolar nerve (IAN) repositioning with a minimum 6 months of follow-up. RESULTS:A total of 16 studies were included in this review. Nine were related to IAN transposition, 4 to IAN lateralization and 3 to both transposition and lateralization. Implant treatment results and complications were presented. CONCLUSIONS:Inferior alveolar nerve lateralization and transposition in combination with the installation of dental implants is sometimes the only possible procedure to help patients to obtain a fixed prosthesis, in edentulous atrophic posterior mandibles. With careful pre-operative surgical and prosthetic planning, imaging, and extremely precise surgical technique, this procedure can be successfully used for implant placement in edentulous posterior mandibular segments. 10.5037/jomr.2014.6102

Inferior Alveolar Nerve Lateralization and Transposition for Dental Implant Placement. Part II: a Systematic Review of Neurosensory Complications. Abayev Boris,Juodzbalys Gintaras Journal of oral & maxillofacial research OBJECTIVES:This article, the second in a two-part series, continues the discussion of inferior alveolar nerve lateralization/transposition for dental implant placement. The aim of this article is to review the scientific literature and clinical reports in order to analyse the neurosensory complications, risks and disadvantages of lateralization/transposition of the inferior alveolar nerve followed by implant placement in an edentulous atrophic posterior mandible. MATERIAL AND METHODS:A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed and PMC databases, as well as academic sites and books. The articles were searched from January 1997 to July 2014. Articles in English language, which included adult patients between 18 - 80 years of age who had minimal residual bone above the mandibular canal and had undergone inferior alveolar nerve (IAN) repositioning, with minimum 6 months of follow-up, were included. RESULTS:A total of 21 studies were included in this review. Ten were related to IAN transposition, 7 to IAN lateralization and 4 to both transposition and lateralization. The IAN neurosensory disturbance function was present in most patients (99.47% [376/378]) for 1 to 6 months. In total, 0.53% (2/378) of procedures the disturbances were permanent. CONCLUSIONS:Inferior alveolar nerve repositioning is related to initial transient change in sensation in the majority of cases. The most popular causes of nerve damage are spatula-caused traction in the mucoperiosteal flap, pressure due to severe inflammation or retention of fluid around the nerve and subsequent development of transient ischemia, and mandibular body fracture. 10.5037/jomr.2014.6103