Nerve Repositioning and Bone Grafts
A Patient’s Guide to Understanding Nerve Repositioning
Oftentimes, the inferior alveolar nerve must be repositioned to allow for dental implants. This nerve is located in the lower jaw and is the nerve that gives feeling to the chin and lower lip. This procedure is often necessary if the back two molars have been extracted. The procedure is considered to be an aggressive approach because it can cause numbness of the jaw and lower lip area. The numbness may dissipate over time; however, there is a risk that the numbness will be permanent.
Oftentimes, other less aggressive tactics are used, such as placing blade implants. A blade implant involves removing an outer section of the cheek to expose the nerve and vessel canal. The vessel bundle and the nerve are moved to the side and the blade implants are placed. Once the blade implant is placed, the nerve bundle is released and placed on top of the implants. Then, the area is filled with a bone grafting material before the area is closed up and stitched.
The procedure of the bone graft and blade implant can be performed together or separately, depending on the patient’s overall health. The bone used for the graft can be taken from several different areas. It can be taken from the third molar region, the upper jaw or other regions inside the mouth. If more bone is needed than can be taken from the mouth, a bone may be removed from the outer tibia near the knee or the hip area of the patient. Because of the risk of rejections, bone is taken from the patient to reduce this risk.
There are times when other methods must be used to gather sufficient bone for the bone graft. Oftentimes, bones from cadavers are used. This process is an effective method for replacing a lot of bone. Another option is synthetic materials. Synthetic materials can help stimulate bone growth and fill in areas where bone is missing. The patients factors from their blood are incorporated into the graft to help promote new bone formation in the graft areas.
Both of these types of surgeries are performed in a surgical center or hospital under general anesthesia or IV sedation. After the procedure, the patient is monitored and then discharged. Following the procedure, the patient must be under bed rest for one day and then must limit their activities for approximately one week.