When receiving dental implants in the lower jaw, in either of the two back molar or the second premolar positions, it may be necessary to reposition the inferior alveolar nerve. The inferior alveolar nerve allows feeling in the chin and lower lip. Dental implants require a titanium post to be placed into the jawbone. In these positions in the lower jaw, there is a very high risk that the titanium post would puncture the nerve, severing feeling in the chin and lower lip.
The repositioning of this nerve is considered to be a slightly risky procedure due to the fact that there is a higher than normal chance of post-operative numbness. Post-operative numbness usually goes away very slowly, but can last a lifetime.
The Procedure
Nerve repositioning is typically done in conjunction with the dental implant procedure. The first step is to access the nerve bundle which sits behind the bone, below the teeth in question. The bone on the cheek side of your jaw is carefully removed – this is known as a surgical access point. The nerve is located and moved out of the way of the implant post.
Once the nerve has been located and repositioned the implant will be set in place in your jaw. While the implant is being placed we will be tracking the location of the nerve very carefully to ensure its safety. When the implant has been set we will place the nerve appropriately and then pack the site with a bone graft. Once the graft is placed we will suture the site closed.
Recovery
After the procedure we typically recommend bed rest for a day or two. Limiting your physical activity is important following bed rest. People frequently believe that oral and maxillofacial surgery allows for a quicker return to physical activity, this is not the case. Overexertion can be a real issue during the post-operative phase of oral and maxillofacial surgery.
You will be given instructions on post-operative care as well as a prescription for pain management medication.
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