Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Implant placement with inferior alveolar nerve repositioning in the posterior mandible

  • Doogyum Kim (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University) ;
  • Taeil Lim (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University) ;
  • Hyun-Woo Lee (Department of Oral and Maxillofacial Surgery, Uijeongbu Eulji Medical Center, Eulji University) ;
  • Baek-Soo Lee (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University) ;
  • Byung-Joon Choi (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University) ;
  • Joo Young Ohe (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University) ;
  • Junho Jung (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University)
  • Received : 2023.07.28
  • Accepted : 2023.09.03
  • Published : 2023.12.31
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Abstract

This case report presents inferior alveolar nerve (IAN) repositioning as a viable approach for implant placement in the mandibular molar region, where challenges of severe alveolar bone width and height deficiencies can exist. Two patients requiring implant placement in the right mandibular molar region underwent nerve transposition and lateralization. In both cases, inadequate alveolar bone height above the IAN precluded the use of short implants. The first patient exhibited an overall low alveolar ridge from the anterior to posterior regions, with a complex relationship with adjacent implant bone level and the mental nerve, complicating vertical augmentation. In the second case, although vertical bone resorption was not severe, the high positioning of the IAN within the alveolar bone due to orthognathic surgery raised concerns regarding adequate height of the implant prosthesis. Therefore, instead of onlay bone grafting, nerve transposition and lateralization were employed for implant placement. In both cases, the follow-up results demonstrated successful osseointegration of all implants and complete recovery of postoperative numbness in the lower lip and mentum area. IAN repositioning is a valuable surgical technique that allows implant placement in severely compromised posterior mandibular regions, promoting patient comfort and successful implant placement without permanent IAN damage.

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References

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