INFERIOR ALVEOLAR NERVE TRANSPOSITION IN CONJUNCTION WITH DENTAL IMPLANT PLACEMENT

ABSTRACT Introduction: In the posterior mandible, dental implants are usually used to support fixed prostheses. In many cases, serious bone resorption occurs in this region following tooth extraction and it is difficult to place implants in appropriate sizes due to the limitation of vertical distance of the inferior alveolar nerve (IAN). There are regenerative or reconstructive procedures in the posterior mandible to provide rehabilitation with implants in cases of excessive vertical bone loss. Repositioning of IAN is one of the alternative methods in the literature. Case Report: Full-mouth fixed mandibular prosthetic rehabilitation with dental implants was planned to a 62-year-old male patient in another clinic. However in the left mandibular posterior region, placed implants were failed twice. In radiographic examinations approximately 5 mm vertical height was determined in the posterior region. According to current clinical conditions, all available treatment options were discussed with the patient and dental implant placement with nerve transposition technique was decided. Under local anesthesia IAN was repositioned by implementing piezosurgery and dental implants were placed successfully. After one year follow-up there was no complaint or sensory loss. Conclusion: At the right indications, IAN repositioning techniques are useful surgical procedures that can be used for the rehabilitation of the atrophic posterior mandible with dental implants. Keywords: dental implant, nerve reposition, nerve transposition, nerve lateralization, inferior alveolar nerve INFERIOR ALVEOLAR SİNİR TRANSPOZİSYONU İLE BİRLİKTE GERÇEKLEŞTİRİLEN DENTAL IMPLANT UYGULAMASI ÖZ Giriş: Posterior mandibulada, dental implant uygulamaları genellikle sabit protezleri desteklemek amacıyla uygulanmaktadır. Ancak birçok vakada bölgede yaşanan diş kayıpları sonrasında oluşan ciddi rezorpsiyonlar nedeniyle özellikle inferior alveolar sinirin (IAS) vertikal boyut kısıtlamaları da eklenince uygun boyutlarda implant uygulamaları yapabilmek oldukça zor hale gelmektedir. Literatürde bu tip aşırı kemik rezorpsiyonu bulunan durumlarda dental implant uygulanabilmesine olanak sağlayacak çeşitli rejeneratif veya rekonstrüktif teknikler önerilmiştir. IAS’ın yeniden konumlandırılması teknikleri de literatürde geçen alternatif tekniklerden biridir. Olgu Sunumu: 62 yaşında erkek hastaya dış merkezde implant destekli tüm çene mandibular sabit protetik rehabilitasyon planlanmıştır. Ancak sol mandibula bölgeye yerleştirilen implantlar 2 defa tekrarlanmış ancak başarısız olmuştur. Tarafımızdan yapılan radyolojik muayenede bölgede 5 mm kemik yüksekliği tespit edilmiştir. Mevcut şartlar dahilinde hastaya uygulanabilecek tedavi alternatifleri açıklanmış ve nihayetinde sinir transpozisyon tekniği ile birlikte dental implant uygulanması kararlaştırılmıştır. Lokal anestezi altında piezocerrahi yardımıyla sinir repozisyonu uygulanmış ve bölgeye implant uygulamaları başarıyla yapılmıştır. 1 yıllık takibin ardından hastada herhangi bir şikayet bulunmazken, duyusal bir kayıp tespit edilmemiştir. Sonuç: Doğru endikasyonlarda sinir rezpozisyon teknikleri, atrofik posterior mandibular bölgelerin dental implantlarla rehabilitasyonuna olanak sağlayan kullanışlı tedavi seçenekleridir. Anahtar Kelimeler: dental implant, sinir repozisyonu, sinir transpozisyonu, sinir lateralizasyonu, inferior alveolar sinir

Anahtar Kelimeler:

dental implant, nerve reposition, nerve transposition, nerve lateralization

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