Refined Approach to Preservation of the Inferior Alveolar Nerve during Resection and Primary Reconstruction of the Mandible

Craniomaxillofacial Trauma & Reconstruction
Sergey Tereshchuk, Vladimir Sukharev

Abstract

Sacrifice of the inferior alveolar nerve (IAN) during resection of the mandible is taken as a rule. In 1987, Jensen and Nock described a technique that permitted placement of dental implants in the atrophied mandibular alveolar ridge that lacked sufficient vertical height superior to the mandibular canal. This technique was used by some authors to preserve continuity of the IAN during resection of the mandible in patients with benign tumors. The described techniques are traumatic, time-consuming, and not precise. We propose a new refined technique of preservation of IAN with use of a guide to approach mandibular canal, cutting guides with a slot for a relocated IAN, and a new approach to positioning of the fixating screws. We assessed the effectiveness of this new technique with use of an electro-odontometer. In 21 cases, we demonstrated a refined approach to preservation of the IAN. In 7 patients (33%), the IAN was preserved on one side and in 14 patients (67%), on both sides. Sensation in the lower lip was restored in 18 patients (86%). These patients generally recovered sensation within 22 days postoperatively. This proposed technique makes preservation of IAN easier, faster, less traumatic, and more predictable. In this art...Continue Reading

References

Apr 1, 1987·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·K E Kahnberg, A Ridell
Mar 1, 1987·Oral Surgery, Oral Medicine, and Oral Pathology·O Jensen, D Nock
Oct 10, 1998·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·J C De Vicente, J S López-Arranz
Jul 3, 2003·The Laryngoscope·M Abraham KuriakoseMark D DeLacure

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Citations

Jul 10, 2020·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Joe IwanagaR Shane Tubbs

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