Neurosensory Disturbances Following Inferior Alveolar Nerve Relocation and Implant Placement: A Systematic Review and
Raffaele Vinci1, Saverio Cosola1,2, Korath Varkey M3
1Post-Graduate School of Oral Surgery, Dental School, Vita-Salute and IRCCS San Raffaele University, 20132 Milan, Italy.
Journal of Clinical Medicine
|August 28, 2025
Summary
Dental implant placement in atrophic mandibles requires inferior alveolar nerve (IAN) repositioning. While effective, this can cause neurosensory disturbances (NSDs), though piezo-surgery and PRF may reduce risks.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Implantology
- Neurosensory Research
Background:
- Atrophic posterior mandibles pose challenges for dental implant placement due to the inferior alveolar nerve (IAN).
- IAN lateralization and transposition are techniques to facilitate implant placement but risk neurosensory disturbances (NSDs).
Purpose of the Study:
- To systematically review and meta-analyze the incidence, duration, and predictors of NSDs after IAN repositioning.
- To evaluate adjunctive methods like piezo-surgery and platelet-rich fibrin (PRF) for minimizing NSDs and optimizing implant success.
Main Methods:
- A PRISMA 2020-guided systematic review and meta-analysis of 20 studies (2009-2024).
- Analysis of outcomes including NSD incidence, recovery rates, implant stability quotient (ISQ), marginal bone loss, and implant success rates.
- Meta-analysis performed using RevMan 5.3, with heterogeneity and publication bias assessed.
Main Results:
- Transient NSDs occurred in 15-40% of cases, more frequently with transposition techniques; most recovered within 6 months.
- Piezoelectric surgery significantly reduced NSD incidence and duration compared to rotary instruments.
- No significant differences in ISQ, bone loss, or success rates between lateralization and transposition at 3 months; PRF correlated with faster nerve recovery.
Conclusions:
- IAN repositioning is effective for implant placement in atrophic mandibles, carrying a risk of transient NSDs.
- Combining IAN lateralization with piezo-surgery and PRF demonstrates favorable outcomes for reducing nerve injury and enhancing implant success.
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