Repositioning the inferior alveolar nerve for placement of endosseous implants: technical note.

Placement of implants in the posterior mandible is limited by the height of bone between the alveolar crest and the inferior alveolar canal. This paper discusses a surgical technique to reposition and protect the neurovascular bundle so that endosseous implants may be placed. A rectangular window is cut in the cortical bone posterior to the mental foramen. The mental foramen is not violated and the mental nerve is not relieved peripherally into the soft tissue. Cancellous bone is removed from the window and the canal is uncovered. A vessel loop placed around the bundle repositions and protects the nerve laterally. After implant placement, the bundle is replaced within the cortical window and the mucoperiosteal flap is sutured. Avoiding manipulation of the terminal branches of the inferior alveolar nerve reduces the risk of permanent nerve damage.