IM0310

I 19 report _ inferior alveolar nerve I implants3_2010 mandibulartootharea.Therearetwooperativeap- proaches cited in literature that suggest how to changetherouteofthenerve,andhowtomakeim- plantation possible. This article describes a tech- nique which minimizes risks thanks to exact plan- ning and by using Piezo surgery. _Surgical techniques In 1987, Jensen8 and Nock were the first to pub- lish this technique developed for the translocation of the mental foramen. Thetechniqueshowstheexitoftheinferioralve- olar nerve at the mental foramen. Being observed and taking care of the nerve, the foramen is ex- tended into distal direction, thus the nerve’s exit from the jaw is further distal and in the buccal di- rection. This allows implantation in position 5 and/or 6 withoutdamagingthenerve.Kan,PelgandFerrigno describe another surgical technique for the lateral- ization of the nerve, distal to the mental foramen. Withthistechniquetheinferioralveolarnervestays intact in the area of the mental foramen. The tech- nique is described in detail in this article. The fenes- tration of the compact bone was carried out distal to the foramen. The route of the nerve is visualized and the nerve lateralized. The optically controlled implant insertion is carried out leaving the nerve aside. After insertion the nerve will be put back into the bony window. _Risks and complications This technique carries the important risk of temporary or even permanent irritation of the nerve, which may lead to anesthesia, hypesthesia Fig. 4_Clinical initial situation. Figs. 5 & 6_Preparation of the buccal bony window with the cogged part of the Piezo device. Tab. 1_A variety of studies con- cerning the lateralization of nerves. Surgeries Technique Implants Sensoric disorders Survical rate Rosenquist12 1992 10 26 0% 12 M 96% Jensen7 1994 10 Displacement of the foramen 21 10% 12 M 50% 3 M 100% Kan6 1997 9 12 Displ.of foramen translocation 29 35 66,7% 10–67 M 33,3% 10–67 M 93,8% Peleg10 2002 10 Translocation 23 10% 6W nopermanent disorders 100% Ferrigno3 2005 19 Translocation 46 10% 12 M 96% Fig. 4 Fig. 5 Fig. 6