Nerve Repositioning

In certain cases, it may be necessary to move the inferior alveolar nerve, which provides sensation to the lower lip and chin, to accommodate the placement of dental implants in the lower jaw. This procedure is typically performed when teeth are missing in the area of the two back molars or the second premolar, and other less invasive options are not suitable. Since this is considered a complex procedure, there is often postoperative numbness in the lower lip and chin, which may take a long time to subside, if it does at all.

The process involves removing a section of the outer cheek side of the lower jawbone to access the nerve and vessel canal. The nerve and vessel bundle is then carefully isolated and moved to the side. Implants are placed while keeping track of the neurovascular bundle. After implant placement, the nerve and vessel bundle is returned to its original position over the implants. The surgical site is then filled with the surgeon’s choice of bone graft material and closed.

These procedures can be performed separately or together, depending on the individual’s condition. Bone grafts can be sourced from several areas of the body, such as the chin, third molar region, or upper jaw behind the last tooth. For larger grafts, bone may be taken from the hip or the outer part of the tibia at the knee. Using the patient’s own bone often yields the best results.

Allograft material, derived from cadavers, can be used to encourage the patient’s own bone to grow into the repair site. This approach is effective and safe. Synthetic materials can also be used to stimulate bone formation. Additionally, factors from the patient’s own blood may be utilized to accelerate and promote bone growth in the graft area.

These surgeries are typically performed in an outpatient surgical suite under IV sedation or general anesthesia. After the procedure, patients should rest for one day and avoid strenuous activities for one week.

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