Inferior Alveolar Nerve Transposition in Conjunction with Implant Placement
Nicola Ferrigno, DDS/Mauro Laureti, MD, DDS/Stefano Fanali, MD, DDS
Purpose: The aim of this prospective study was to determine the incidence of neurosensory disturbance and the cumulative survival and success rates of ITI solid-screw implants placed in conjunction with an inferior alveolar nerve (IAN) transposition technique. Materials and Methods: 46 ITI implants were placed in 15 patients following transposition of the IAN. In 4 patients nerve transpositioning was performed bilaterally, so a total of 19 IAN mobilization surgeries were performed. Neurosensory dysfunction was objectively evaluated by using light touch (LT), pain (PT), and 2-point discrimination (2-DT) tests. In addition, patients were asked to answer a short questionnaire to investigate individual feelings of discomfort and advantages related to this surgical technique. The mean follow-up period was 49.1 months (range, 12 to 78 months). Results: The cumulative implant survival and success rates were 95.7% and 90.5%, respectively. Only 2 implants were lost. Neurosensory disturbance (ie, disturbance registered by the LT, PT, and 2-DT tests) was experienced in 4 of 19 cases. However, at the time of data analysis (12 to 78 months after surgery), all patients indicated that they would go through the surgery again. Discussion: The IAN transposition technique, when used in the severely atrophied posterior mandible, allowed placement of implants with adequate length and good initial stabilization. All patients felt that they had received significant benefits from their new prostheses. Conclusion: Based on the results of the present study, it can be concluded that lateral nerve transposition can be used as a surgical procedure to enable ITI implant placement in the severely resorbed posterior mandible.
(More than 50 references.) Int J Oral Maxillofac Implants 2005;20:610–620
Key words: dental implants, inferior alveolar nerve, nerve transpositioning