A Bioabsorbable Collagen Nerve Cuff (NeuraGen) for Repair of Lingual and Inferior Alveolar Nerve Injuries: A Case Series

Evaluation of Neurosensory Function Following Inferior Alveolar Nerve Lateralization for Implant Placement

Background

Adequate bone height and width is the most important parameter for success of implants. Prolonged edentulous area in mandibular posterior region is often associated with atrophy precluding the use of dental implants. Inferior alveolar nerve (IAN) lateralization is a challenging surgical procedure as it involves the exposure of the neurovascular bundle from its compact bony compartment and adequate retraction while immediate placement of implant.

Aim

Evaluation of neurosensory disturbances related to IAN lateralization for implant placement in the posterior atrophic edentulous mandible.

Materials and Methods

Ten patients above the age of 18 years with an edentulous span in mandibular posterior region showing distance from alveolar crest to IAN ≤ 8 mm (CBCT) were included in the study. The postoperative analysis of NDs was done using Semmes-Weinstein Monofilaments (SWM). Readings were made on the 1st and 7th postoperative day and every month thereafter until the neural sensations were restored.

Results

All patients reported neurosensory disturbance on post-op day 1. None of the patients responded to SWM lesser than 4.56 on first postoperative day, which indicated 100% incidence of neurosensory disturbances. The minimum time required for complete recovery was 2.0 months, and maximum was 4.0 months.

Conclusion

IAN lateralization is a useful method for managing the atrophic posterior mandible with dental implants. If done precisely with experienced personnel, it can provide a worthy option for surgical restoration of atrophic mandible with minimal temporary NDs.

Repairing injured peripheral nerves: Bridging the gap

Peripheral nerve injuries that induce gaps larger than 1-2 cm require bridging strategies for repair. Autologous nerve grafts are still the gold standard for such interventions, although alternative treatments, as well as treatments to improve the therapeutic efficacy of autologous nerve grafting are generating increasing interest. Investigations are still mostly experimental, although some clinical studies have been undertaken. In this review, we aim to describe the developments in bridging technology which aim to replace the autograft. A multi-disciplinary approach is of utmost importance to develop and optimise treatments of the most challenging peripheral nerve injuries.