Nerve Repositioning

The inferior alveolar nerve, which gives feeling to the lower lip and chin, sometimes needs to be moved to make room for dental implants in the lower jaw. This advanced technique, known as nerve repositioning, can help restore both the aesthetics and functionality of your smile, making dental implants an option even in challenging cases.

What is Nerve Repositioning?

Nerve repositioning is a specialized procedure designed to facilitate dental implant placement in the lower jaw when traditional methods are not viable due to the position of the inferior alveolar nerve. This procedure is limited to the lower jaw and may be indicated when teeth are missing in the two back molars or second premolars.

This procedure is considered a very aggressive approach since there is almost always some post-operative numbness of the lower lip and jaw area. Symptoms typically dissipate very slowly but may be permanent. Other, less aggressive options are usually considered first (placement of blade implants, etc.).

Nerve Repositioning Procedure

The nerve repositioning procedure involves removing an outer section of the cheek on the side of the lower jawbone to expose the nerve and vessel canal. The nerve and vessel bundle are isolated and gently pulled to the side, allowing space to place the dental implants. Once the implants are positioned, the bundle is carefully released and placed back over them. The surgical access is then refilled with a bone graft material of the surgeon’s choice, and the area is closed.

Bone Graft Sources and Techniques

Depending on the patient's condition, the nerve repositioning and bone graft procedures can be performed separately or together. Bone grafts can be sourced from several areas:

  • Maxillofacial Region: Bone can be taken from inside the mouth, such as the chin, third molar region, or upper jaw behind the last tooth.
  • Other Body Areas: In more extensive cases, larger quantities of bone can be obtained from the hip or the outer aspect of the tibia at the knee.

Using the patient's own bone often yields the best results for repairs or augmentations.

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Alternative Grafting Materials

  • Allograft Material: Bone prepared from cadavers is used to encourage the patient’s bone to grow into the repair site. This method is highly effective and safe.
  • Synthetic Materials: Synthetic options are also available to stimulate bone formation.
  • Blood-Derived Factors: Factors from the patient’s own blood may be used to accelerate and promote bone growth in graft areas.

Post-Operative Care and Recovery

These surgeries are performed in an outpatient surgical suite under IV sedation or general anesthesia. After the procedure, it is recommended to rest in bed for one day, followed by limited physical activity for one week to ensure proper healing.

Interested in Learning More About Nerve Repositioning?

If you’ve been told that dental implants aren't an option due to nerve positioning, we’re here to explore every possible avenue to make your dental restoration goals a reality. Contact us today to learn more about nerve repositioning and how it can work for you.

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American Association of Oral & Maxillofacial Surgeons
American Association of Oral & Maxillofacial Surgeons
American Association of Oral & Maxillofacial Surgeons
American Association of Oral & Maxillofacial Surgeons