Some patients have their mandibular nerve positioned very high in their jaw bone. The inter-arch vertical distance between the top of the crest of their mandibular jaw bone and their upper teeth is very limited. That inter-arch vertical distance is very necessary to allow room to put proper prosthetics on top of the implants, which will be placed in the mandible.
The inferior mandibular nerve usually exits the body of the mandible around the area of the lower bicuspids to provide a sensory supply to the lower lip. In inferior mandibular nerve lateralization surgery, the bone buccally (on the cheek-side) covering the inferior mandibular nerve will be removed. The nerve is then gently moved buccally out of its channel to instead make the nerve exit the body of the mandible at the wisdom tooth area. With the advancement in surgical techniques and instrumentation, ultrasound surgical instruments will be used to remove the bone covering the inferior mandibular nerve, without inflecting harm to the nerve tissue.
The pictures above demonstrate how we can place implants in deficient bone without grafting. In this situation, the nerve is displaced to the side to allow the implants to be placed without damaging it & then repositioned slightly lateral to its original position next to the implants.
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