Nerve Repositioning

The inferior alveolar nerve gives feeling to the lower lip and chin. It may need to be moved in order to make room for placement of dental implants in the lower jaw. This procedure is indicated when teeth are missing in the molar area of the lower jaw. It is considered to be an aggressive approach; some postoperative numbness of the lower lip and jaw area almost always occurs, and it typically dissipates only very slowly, if ever. Usually less aggressive options are considered first.

To reposition the nerve, an outer section of the cheek side of the lower jawbone is typically removed. Once the nerve and vessel canal are exposed, they can be pulled slightly to the side so that implants can be placed. Then the bundle is released and placed back over the implants. The surgical access is refilled with bone-graft material, and the area is closed.

The bone-graft material may be obtained from several areas of the body. Inside the mouth, it may be taken from the area of the chin or third molar region. For more extensive site, a greater quantity of bone can be attained from the hip or shinbone. Alternatively, allograft material (prepared from cadavers) or synthetic material may be used for dental bone grafting. The use of both is quite effective and safe. Using growth factors from the patient’s blood also can accelerate and promote bone formation in graft areas.

These surgeries are performed in the office surgical suite under IV sedation or general anesthesia. After discharge, bed rest is recommended for one day and limited physical activity for one week.