From freehand to precision: Dynamic navigation systems in transmandibular nerve canal implantation: A case series

This case series explores dynamic navigation systems (DNS) in transmandibular nerve canal implantation for patients with limited jaw space due to the proximity of the inferior alveolar nerve (IAN). The aim is to demonstrate how DNS improves implant placement precision and safety in cases where traditional methods face challenges.

The patients had limited bone height and proximity to the IAN, making traditional implant techniques challenging. Concerns included the risk of nerve damage and difficulties in achieving optimal implant placement due to anatomical constraints.

Both patients had severe bone resorption and insufficient bone height in the posterior mandible, with concerns about IAN positioning. The first patient had grade III mobility in tooth #46 with a periapical infection, while the second had bilateral posterior mandibular pain and grade III mobility in tooth #47.

Implants were placed using DNS, allowing precise planning and real-time guidance during surgery. Based on cone beam computed tomography, preoperative planning assessed bone height and IAN proximity. DNS ensured accurate implant placement, avoiding nerve interference, while bone grafts and growth factors were applied for healing.

Both cases showed successful implant placement without complications like nerve damage or implant misplacement. Follow-up cone beam computed tomography scans confirmed well-positioned implants, with minimal bone resorption in the first case over 2 years and stable conditions in the second case after 6 months.

This series highlights DNS's effectiveness in improving implant accuracy and reducing nerve injury risks, suggesting its value in complex dental implant surgeries.