LATERALIZATION OR TRANSPOSITION OF THE INFERIOR ALVEOLAR NERVE IN CONJUNCTION WITH IMPLANT PLACEMENT IN THE ATROPHIC POSTERIOR MANDIBLE
Placement of dental implants in the severely atrophic posterior mandible may involve a risk of intraoperative injury of the inferior alveolar nerve due to a reduced distance between the top of the alveolar crest and the mandibular canal. Lateralization or transposition of the inferior alveolar nerve in conjunction with simultaneous placement of implants is therefore considered a treatment option when the height of the alveolar ridge does not allow prosthetic reconstruction with short implants or vertical bone augmentation with sandwich osteotomy and delayed implant placement. Systematic reviews have revealed high implant survival and limited peri-implant marginal bone loss following lateralization or transposition of the inferior alveolar nerve. However, this treatment is associated with risk of serious complications involving mandibular fracture, loss of sensitivity of the teeth anterior to the mental foramen as well as temporary or permanent neurosensory disturbances of the chin and lower lip. In the present review, the current knowledge on lateralization or transposition of the inferior alveolar nerve in conjunction with simultaneous placement of standard-length implants in the atrophic posterior mandible is presented and the surgical procedures are illustrated.