Nerve transposition and implant placement in the atrophic posterior mandibular alveolar ridge

The results obtained with a modified surgical technique for transposition of the inferior alveolar nerve followed by immediate placement of endosseous implants in mandibles with moderate to severe atrophy are presented. Ten transpositions of the inferior alveolar nerve together with the installation of 21 implants were performed in six patients. The mean postoperative follow-up time was 23 months, with a range of 12 to 46 months. All implants with functioning pontics remained stable, with no mobility nor signs or symptoms of pain and infection during the follow-up period. Postoperative radiographic evaluation disclosed no pathologic bone loss around the implants. Neurosensory evaluation was performed using the two-point discrimination test. One patient with unilateral transposition had objective neurosensory dysfunction at 12 months postoperative, although all the nerve function were reported as normal by the patients. Strict patient selection criteria are necessary, with full awareness by the patient of the possibility of long-term or even permanent nerve paresthesia, when this procedure is contemplated.