Alveolar Nerve Lateralization for Implants Placement in Posterior Atrophic Mandible

The rehabilitation of the posterior atrophic mandible has always been a challenge for surgeons, and many different techniques have been suggested for this treatment. In this video case, presented by Dr Vladimir GarcĂ­a Lozada, we show a step by step procedure of the alveolar nerve lateralization technique for placement of 2 implants in the right side of the mandible of a male patient 47 years old without any systemic disease. The treatment was performed with a crestal incision and a delicate flap opening to expose the mental nerve, then with a sterile pencil we designed the window. Osteotomies were done with piezosurgery and saw piece. Using chisels and hammer we release the buccal bone window and patiently with the diamond round bur of piezosurgery we eliminate the bone marrow. Once located the mandibular canal with the nerve, we used the sinus lift curettes, because they have different angulations and also do not have sharp edges, to lateralize it in a more secure way. We lateralized the nerve with a sterile dam and performed the osteotomies for implant placement. Once the implants are placed, particulate is filled between the nerve and implants and then finish with the buccal wall and covered with a collagen membrane. Closure with suture free tension is performed and then we waited 4 month for rehabilitation. As you can see, the alveolar nerve lateralization is one more potential successful, and evidence-based, treatment option for the posterior atrophic mandible. With the use of piezosurgery it can be performed in a safe way, avoiding complications.

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