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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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Lateralization Technique and Inferior Alveolar Nerve Transposition.

Angélica Castro Pimentel1, Marco Antonio Sanches2, Gabriel Cardoso Ramalho2

  • 1Department of Post Graduation, Division of Implantology, School of Dentistry, University of Santo Amaro (UNISA), Sao Paulo, SP, Brazil.

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Summary

Posterior mandible bone resorption poses implant challenges. Successful implant placement relies on achieving long bicortical anchorage for enhanced stability and biomechanics, particularly when addressing the inferior alveolar nerve.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Dental Implantology
  • Regenerative Medicine

Background:

  • Posterior mandibular bone resorption diminishes bone height, complicating dental implant installation.
  • The presence of the inferior alveolar nerve within the mandibular canal presents a significant anatomical challenge for posterior mandibular implants.

Purpose of the Study:

  • To evaluate the success rates of dental implants using inferior alveolar nerve lateralization and transposition techniques.
  • To identify the most effective sensory tests for assessing outcomes after these nerve repositioning procedures.

Main Methods:

  • Review of treatment alternatives including short implants, guided bone regeneration, grafting, distraction osteogenesis, and nerve lateralization/transposition.
  • Analysis of implant success rates specifically for lateralization and transposition techniques.

Main Results:

  • The study highlights that successful implant outcomes are associated with the ability to achieve long bicortical anchorage.
  • This bicortical fixation is crucial for ensuring primary implant stability and favorable biomechanics in the posterior mandible.

Conclusions:

  • Implant success in the posterior mandible, especially with nerve proximity, is significantly influenced by achieving robust bicortical fixation.
  • This fixation method enhances primary stability and biomechanical load distribution, crucial for long-term implant survival.