Avoiding Injury to the Inferior Alveolar Nerve by Routine Use of Intraoperative Radiographs During Implant Placement
Injury to the inferior alveolar nerve during implant placement in the posterior atrophic mandible is a rare but serious complication. Although a preoperative computerized tomography scan can help determine the distance from the alveolar ridge to the nerve canal, variables such as magnification errors, ridge anatomy, and operator technique can increase the chance for complications. The routine use of intraoperative periapical radiographs during the drilling sequence is an inexpensive and reliable tool, allowing the operator to confidently adjust the direction and depth of the implant during placement. Most important, it helps avoid the risk of injury to the inferior alveolar nerve in cases in which there is limited vertical alveolar bone. Using this technique for 21 implants placed in the posterior atrophic mandible, with less than 10 mm of vertical bone to the inferior alveolar nerve canal, the authors observed no incidents of postoperative paresthesia.Abstract
Contributor Notes
Jeffrey Burstein, DDS, MD, is the former chief resident, Chris Mastin, DMD, is the current chief resident, and Bach Le, DDS, MD, is an assistant professor at the Department of Oral & Maxillofacial Surgery, USC School of Dentistry, Los Angeles, California. Address correspondence to Dr Burstein at USC Department of Oral Surgery, Room 146, 925 West 34th Street, Los Angeles, CA 90089-0641. (docburstein@yahoo.com)