Could someone please review these images and let me know if it would be acceptable to perforate the Mandibular Incisive Canal (MIC) for an All-on-4 treatment plan or for an implant supported denture or hybrid? I have read some articles that state that perforation into the MIC can cause post-operative sensory disturbances, edema, hematoma and lack of osseointegration of implants as well as changes in pulp sensitivity. I have also seen videos of All-on-4 treatment that show 18mm implants inserted into a lower jaw and at the end of the treatment, the patient walks away with 4 lower implants and maybe a little bruising but no discussion of sensory disturbance, hematoma, edema or lack of osseointegration. Since this patient is missing teeth in anterior region, pulp sensitivity should not be a concern. Could someone please let me know if this treatment will work or will it harm the patient, assuming there is no perforation of the lingual plate? Thank you in advance and your help in this matter is greatly appreciated.
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