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Int. J. Oral Maxillofac. Surg. 2014; xxx: xxx–xxx http://dx.doi.org/10.1016/j.ijom.2014.07.010, available online at http://www.sciencedirect.com
Systematic Review Paper Dental Implants
Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review B. M. Vetromilla, L. B. Moura, C. L. Sonego, M. A. Torriani, O. L. Chagas Jr. : Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review. Int. J. Oral Maxillofac. Surg. 2014; xxx: xxx– xxx. # 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Abstract. Inferior alveolar nerve (IAN) repositioning has been used widely in recent years as an alternative approach for dental implant placement in the atrophic posterior mandible. The aim of this study was to answer the question: What are the complications associated with IAN repositioning? A systematic literature review performed in accordance with the PRISMA statement, using the PubMed (MEDLINE), Cochrane Library, and Scopus databases, identified a total of 116 articles related to this technique. Of those articles, 24 were included in the final review. Lateralization was the chosen technique in seven studies, transposition in 15 studies, and two studies reported both techniques. The longest follow-up period was 49.1 months and the shortest 6 months. Of the patients who underwent lateralization, 95.9% initially showed a neurosensory disturbance, and the condition remained at the end of the study for 3.4% of those patients. With regard to the patients who underwent transposition, neurosensory alterations were observed in 58.9% of patients initially, and the condition remained for 22.1% of those affected at the end of the study. Only one study found no neurosensory disturbance at any time. More data consolidation is necessary to determine scientifically if, which, and when the IAN repositioning technique can be recommended.
For the last two decades, dental implant placement has been a popular option for the treatment of the edentulous mandible.1 In such cases, where there is insufficient height for implant placement, there are a few options available for rehabilitation, including short implants, bone graft, and 0901-5027/000001+07
inferior alveolar nerve (IAN) repositioning. Repositioning is performed via one of two surgical techniques, lateralization or transposition, with lateralization yielding lower degrees of nerve deficiency. In lateralization, the IAN is exposed and retracted laterally, held in this position
B. M. Vetromilla1, L. B. Moura1, C. L. Sonego2,3, M. A. Torriani1, O. L. Chagas Jr.1 1
Bone Repair Research Group – Osseointegration, Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil; 2 Bone Repair Research Group – Rigid Internal Fixation, Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil; 3 Post Graduate Program in Dentistry, Master Degree, School of Dentistry, Universidade Luterana do Brasil, Canoas, RS, Brazil
Keywords: Inferior alveolar nerve; dental implantation; inferior alveolar nerve transposition; inferior alveolar nerve lateralization. Accepted for publication 17 July 2014
during implant placement, then released to rest against the implants.2 In the transposition technique, first described in 19773 and modified in 1987,4 the mental foramen is included in the osteotomy, to allow incisive branch excision, so that the IAN can be pulled into a new position,
# 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Please cite this article in press as: Vetromilla BM, et al. Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review, Int J Oral Maxillofac Surg (2014), http://dx.doi.org/10.1016/j.ijom.2014.07.010
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generally more posterior. Although both techniques have seen improvements since their introduction,5–8 reported data remain sparse. The aim of the present study was to answer the question: What are the complications associated with IAN repositioning? Materials and methods Search strategy and selection criteria
An initial bibliographic search in the PubMed (MEDLINE), Cochrane Library, and Scopus databases was performed using three lines of search elements from a brief reading of the subject of interest: (1) ‘inferior’, ‘alveolar’, ‘nerve’, ‘lateralization’; (2) ‘inferior’, ‘alveolar’, ‘nerve’, ‘transposition’; and (3) ‘inferior’, ‘alveolar’, ‘nerve’, ‘translocation’, without time delimitations. The last search was performed on March 19, 2013. For the initial selection, article titles and/or abstracts were analyzed by three independent reviewers (BMV, LBM, and OLCJr), and the following inclusion criteria were observed: studies published in English; no time delimitations; studies of human beings; specific studies using IAN repositioning for rehabilitation with osseointegrated implants; case report, case series, prospective and/or retrospective clinical study types. Following initial selection, the three examiners (BMV, LBM, and OLCJr) read the previously selected articles in full, applying the selection criteria (see Table 1) to determine final inclusion or exclusion from the study. Disagreements among reviewers were settled by additional discussions. The authors established all selection criteria prior to commencement of this study.
making. The classification of the risk of bias potential for each study was based on the criteria adopted by Clementini et al., 9 described as follows: random selection in (of) the population (sample), definition of inclusion/exclusion criteria, follow-up loss reports, validated measurements, statistical analysis. A study that included all the criteria mentioned above was classified as having a low risk of bias; a study that did not include one of these criteria was classified as having a moderate risk of bias; when two or more criteria were missing, the study was assigned a high risk of bias. Results
The last electronic database search was performed on March 19, 2013 and yielded 116 results. In the selection step, it was not possible to access the full text of one article.10 Thirty articles were identified as relevant after reading the title and/or abstract. The full text of these 30 papers was evaluated according to the selection criteria in Table 1. Of these 30 articles, six did not fulfil one or more selection criteria and were excluded. Twenty-four articles were included in the final review.2,6,8,11–31 A flowchart of the selection and evaluation process is given in Fig. 1. Of the articles included in the final review, 14 were case reports and case series, seven were prospective studies, and three were retrospective studies. Regarding the quality assessment, only one
study achieved a low risk of bias. Two studies were assigned a moderate risk and 21 studies were determined to have a high risk of bias (Tables 2 and 3). Lateralization was chosen in seven studies,8,11–16 transposition was chosen in 15 studies,2,17,19–31 and two studies reported both techniques.6,18 Regarding the device used for osteotomy, four studies used piezoelectric surgery11,18,19,21 and 10 used burs;8,12– 15,17,22,23,30,31 10 did not report the device used.2,6,16,20,24–29 Four articles described the use of a resorbable membrane.8,11,23,27 Sixteen studies reported using bone graft to fill the bone defect left by the osteotomy,2,8,11–13,15,17–20,22,24,27,29–31 while the other eight studies did not indicate whether bone graft was used. Among the studies, the longest mean follow-up time was 49.1 months;23 at the end of follow-up, 7% of the patients (1/15) still experienced neurosensory disturbances. The shortest mean follow-up time was 6 months, with full neurosensory recovery of the entire sample population.12,17 Overall, 125 patients were submitted to lateralization. Of these, 123 were evaluated regarding neurosensory function and 95.9% (118 of 123) showed a disturbance initially, while at the end of follow-up, only 3.4% (4 of 118) of the patients with an initial disturbance still displayed this condition. With regard to transposition, 150 patients were treated, of whom 146 underwent neurosensory evaluation. Neu-
Quality rating
A methodological quality rating was performed using the PRISMA statement criteria in order to verify the strength of scientific evidence in clinical decisionTable 1. Eligibility criteria. Eligibility criteria for inclusion in the final review
Studies published in English Without time delimitations Studies of human beings Specific studies that used IAN repositioning for rehabilitation with osseointegrated implants Study type: case report, case series, prospective and/or retrospective clinical study IAN, inferior alveolar nerve.
Fig. 1. Flowchart of the systematic review process.
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Table 2. Quality assessment of the prospective and retrospective studies included.
Year 2013 2013 2010 2005 2002 1999 1997 1995 1994 1992
Author and references Ferna´ndez Dı´az and Naval Gı´as11 Lorean et al.18 Hashemi14 Ferrigno et al.23 Morrison et al.2 Nocini et al.27 Kan et al.28 Hirsch and Bra˚nemark6 Jensen et al.30 Friberg et al.31
Random selection in population
Defined inclusion/exclusion criteria
Report loss to follow-up
Validated measurements
Statistical analysis
Estimated potential risk of bias
Yes
Yes
No
Yes
Yes
Moderate
Yes Yes Yes Yes No No No
No No Yes Yes No No No
No No No Yes No No No
Yes Yes Yes Yes Yes Yes Yes
No Yes Yes Yes Yes Yes Yes
High High Moderate Low High High High
No No
No No
No No
Yes Yes
No No
High High
rosensory alterations were observed in 58.9% (86 of 146) of the evaluated patients, and at the end of the studies, 22.1% (19 of 86) of the patients with a disturbance still showed signs of this condition. Among the studies that found a disturbance after the follow-up period, 11% used a piezoelectric device for the osteotomy (1 of 9).11 All results are shown in Tables 4 and 5.
Discussion
Nerve mobilization procedures are precise methods that require clinical experience, knowledge of anatomy, and the ability to intervene in the event of potential accidents and/or complications.32 In the last few years, IAN repositioning has been used widely as an alternative to short implants or bone grafts for osseointegrated implant placement in the posterior mandible of patients who do not have sufficient bone height for conventional treatment. Thus, determining whether IAN reposi-
tioning is supported by clinical and scientific evidence is important. We investigated the amount of neurosensory disturbance associated with IAN repositioning techniques, in order to establish best practice in the case of an atrophic posterior mandible where dental implants are desired. Different rehabilitation options are described for these cases. One option is the use of short implants; this decreases costs, and a cumulative survival rate of 92.3% has been shown.33 Another option is the establishment of a bone graft prior to implant placement to obtain the necessary height for standard implants. However, the need for two surgical procedures increases costs and the procedure time, and there is the potential risk of morbidity at the donor site. Only a few studies on IAN repositioning that fulfilled the selection criteria established in our review were found. Furthermore, of the studies analyzed, many were case reports, with a high risk of bias. Among the advantages of IAN repositioning is the option to use standard
implants with bicortical anchorage, increasing primary stability, which is essential in the osseointegration process. Osseointegrated implants placed in combination with IAN repositioning present a lower risk of bone loss than short implants when both are placed in similar circumstances.34 For clinical situations with less than the minimum height for short implants (5 mm), IAN repositioning is the technique indicated.11 This procedure also increases the resistance to occlusal forces and promotes a good proportion between implant and prosthesis.35 Compared to the option of performing a graft to allow placement of standard implants, in addition to the lower cost, IAN repositioning can be performed under local anaesthetic, does not require a donor site, and has a lower morbidity rate.7,36 IAN repositioning also presents many disadvantages. The technique does not recover the alveolar ridge anatomy and temporarily weakens the mandible. Mandibular fractures associated with endosseous implants have been documented and
Table 3. Quality assessment of the cases reports and case series included.
Year 2012 2009 2009 2008 2008 2008 2006 2005 2003 2002 2001 1998 1997 1995
Author and references Suzuki et al.12 Chrcanovic and Custo´dio17 Felice et al.19 Luna et al.20 Sakkas et al.21 Vasconcelos et al.22 Hashemi13 Proussaefs24 Karlis et al.25 Peleg et al.8 Hori et al.26 Garg and Morales15 Kan et al.29 Rugge et al.16
Random selection in population
Defined inclusion/exclusion criteria
Report loss to follow-up
Validated measurements
Statistical analysis
Estimated potential risk of bias
No Yes
No No
No No
Yes Yes
No No
High High
No No No No No No No No No No No No
No No No No No No No No No No No No
No No No No No No No No No No No No
Yes Yes No No No No Yes Yes Yes Yes Yes No
No No No No No No No No No No No No
High High High High High High High High High High High High
Please cite this article in press as: Vetromilla BM, et al. Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review, Int J Oral Maxillofac Surg (2014), http://dx.doi.org/10.1016/j.ijom.2014.07.010
Study type
Procedure performed Lateralization (piezoelectric) + implants + bone window replaced with miniplate or particulate + resorbable collagen membrane Lateralization or transposition (piezoelectric) + implants + barrier of platelet-rich fibrin + bone removed repositioned or crushed and mixed with allograft or xenograft Lateralization (bur) + implants
2013
Ferna´ndez Dı´az and Naval Gı´as11
Prospective
2013
Lorean et al.18
Retrospective
2010
Hashemi14
Prospective
2005
Ferrigno et al.23
Prospective
2002
Morrison et al.2
Retrospective
1999
Nocini et al.27
Prospective
1997
Kan et al.28
Retrospective
1995
Hirsch and Bra˚nemark6
Prospective
1994
Jensen et al.30
Prospective
1992
Friberg et al.31
Prospective
Number of patients
Number of repositionings
Neurosensory disturbance (number of patients and duration)
Average follow-up (months)
15
19
15 Still present in 1 patient at the end of the study
24
57
79
4 Normal after 6 months
20.62
87
110
12
Transposition (bur) + implants + resorbable membrane
15
19
Transposition + implants + bone removed as graft Transposition + implants + autogenous and/or allogeneic bone graft + resorbable membrane Transposition including or not the mental foramen + implants Transposition or lateralization + implants
15
26
10
18
15
21
87 Still present in 2 patients at the end of the study 6 Still present in 1 patient at the end of the study 15 Normal after 1 month 10 Still present in 9 patients at the end of the study 9 at the exam date (10–67 months)
19
24
6
10
7
10
Transposition (bur) + implants + bone window replaced Transposition (bur) + implants + spongious bone graft if necessary
18 Still present in 3 patients at the end of the study 1 at the exam date (12 months) 7 Still present in 2 patients at the end of the study
49.1 16 18 41.3 36 23 10
Vetromilla et al.
Year
Author and references
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Table 4. Prospective and retrospective studies included in the final review.
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Table 5. Cases reports and case series included in the final review.
Year
Author and references 12
Study type
Procedure performed Lateralization (bur) + implants + particulate bone window Transposition (bur) + implants + excised bone replaced + low-level laser therapy Transposition (piezoelectric) + iliac graft + implants (4 months later) Transposition + implants + particulated autogenous cortical bone and Pro-Bone Transposition (piezoelectric) + implants (3 months later)
2012
Suzuki et al.
Case report
2009
Chrcanovic and Custo´dio17
Case series
2009
Felice et al.19
Case report
2008
Luna et al.20
Case report
2008
Sakkas et al.21
Case report
2008
Vasconcelos et al.22
Case report
2006
Hashemi13
2005
Proussaefs24
Case report and description of the technique Case report
2003 2002
Karlis et al.25 Peleg et al.8
Case report Case series
2001
Hori et al.26
Case series
1998
Garg and Morales15
1997
Kan et al.29
Case report and description of the technique Case report
1995
Rugge et al.16
Case report
are generally related to high levels of resorption in edentulous mandibles. Also, nerve mobilization leads to many factors that can increase the occurrence of fractures.20,25,29 A large portion of the buccal cortex is removed, reducing the structural integrity of a region that is under constant stress during chewing.25 In addition to that, sites that have been prepared and subsequently abandoned due to bad angulation or insufficient initial stability are areas of bone fragility susceptible to fracture.20 Poor nutrition as a consequence of blood perfusion changes associated with this nerve mobilization can also be a cause of fracture.37 Another disadvantage of
Transposition (bur) + implants + bone removed was replaced particulate Lateralization (bur) + implants + bone chips as graft (1) Vertical autogenous bone graft (2) Transposition + implants + bone window particulated and replaced Transposition + implants Lateralization (bur) + implants + allograft + resorbable collagen membrane Transposition + implants
Lateralization (bur) + implants + bone window replaced Transposition + implants + Bio-Oss Lateralization + implants
Number of patients
Number of repositionings
Neurosensory disturbance (number of patients and duration)
Average follow-up (months)
1
1
15
18
1
1
1
1
1
1
1
1
1
1
1
1
1 Normal after 3 months
36
1 10
1 –
– 6 Normal after 1.5 months
– 29.8
6
8
48
1
1
6 Still present in 5 patients at the end of the study –
1
1
–
1
1
Did not occur
IAN repositioning is the risk of nerve damage. Among the studies evaluated in this review, different protocols were used to evaluate neurosensory function; neurosensory disturbance remained at the end of nine studies,6,11,14,23,26–28,30,31 while only one study showed no neurosensory disturbance at any time.16 The duration and degree of neurosensory disturbance has been related directly to the amount of compression and tension applied to the nerve during the procedure,38 or to chronic distension/compression of the nerve after the surgery.27 Hypoesthesia, paresthesia, and hyperesthesia are the most common disorders.39 Despite nerve damage, many
1 Normal after 1 month 15 Normal after 6 months 1 Normal after 1.25 months – 1 Normal after 2 months 1 Normal after 7 months –
6 6
24 – 8 7 –
– – 12
patients in the studies reported that the damage did not disturb their routine and, based on the benefits achieved, they would choose the procedure again.2,23 The success rate of the lateralization procedure, regarding the osseointegration process, varies from 93.8% to 100%, and thus both patients and surgeons believe this to be a safe procedure; however, a small percentage of patients will have nerve damage for the rest of their lives.6 Concerning the use of materials as barriers between the implant and nerve, there is divergence in the literature, because while some authors consider the use of resorbable membranes to be helpful,40
Please cite this article in press as: Vetromilla BM, et al. Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review, Int J Oral Maxillofac Surg (2014), http://dx.doi.org/10.1016/j.ijom.2014.07.010
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others have observed faster healing of the bone wound without barriers, followed by the restoration of the mandibular canal.41 One advance is the utilization of piezoelectric devices, which allow the surgeon to perform the osteotomy without damaging soft tissue, because piezoelectric devices only affect mineralized tissues. In vitro tests have shown a lower risk of injury when piezoelectric devices are used to conventional rotary compared devices.42 Due to the unavailability of randomized control trials in the literature addressing IAN repositioning, this research highlights the necessity of standardized clinical studies that follow strict criteria for validation, such as the CONSORT guidelines.43 The high level of bias associated with the literature included in this review and the increasing number of posterior mandible atrophy cases worldwide, show the necessity of greater data consolidation to determine scientifically if and when the IAN repositioning technique can be recommended, despite the fact that there is an increasing global trend in treatments involving manipulation of the IAN and the available literature considers neurosensory disorders a complication that the patient can live with. Funding
None. Competing interest
None declared. Ethical approval
Not required. References 1. Van Der Weijden GA, Van Bemmel KM, Renvert S. Implant therapy in partially edentulous periodontally compromised patients: a review. J Clin Periodontol 2005;32:506– 11. 2. Morrison A, Chiaro M, Kirby S. Mental nerve function after inferior alveolar nerve transposition for placement of dental implants. J Can Dent Assoc 2002;62:46–50. 3. Alling CC. Lateral repositioning of the inferior alveolar neurovascular bundle. J Oral Surg 1977;35:419. 4. Jensen O, Nock D. Inferior alveolar nerve reposition in conjunction with placement of osseointegrated implants. A case report. Oral Surg Oral Med Oral Pathol 1987;63:263–8.
5. Yoshimoto M, Allegrini Jr S, Oshiro M, Teixeira V. Inferior alveolar nerve repositioning in implantodontics: clinical report. JBC: J Bras Clin Estet Odontol 1999;3: 53–7. 6. Hirsch JM, Bra˚nemark PI. Fixture stability and nerve function after transposition and lateralization of the inferior alveolar nerve and fixture installation. Br J Oral Maxillofac Surg 1995;33:276–81. 7. Rosenquist B. Fixture placement posterior to the mental foramen with transpositioning of the inferior alveolar nerve. Int J Oral Maxillofac Implants 1992;7:45–50. 8. Peleg M, Mazor Z, Chaushu G, Garg AK. Lateralization of the inferior alveolar nerve with simultaneous implant placement: a modified technique. Int J Oral Maxillofac Implants 2002;17:101–6. 9. Clementini M, Morlupi A, Canullo L, Agrestini C, Barlattani A. Success rate of dental implants inserted in horizontal and vertical guided bone regenerated areas: a systematic review. Int J Oral Maxillofac Surg 2012;41: 847–52. 10. Louis P. Inferior alveolar nerve transposition for endosseous implant placement: a preliminary report. Oral Maxillofac Surg Clin North Am 2001;13:265–81. ´ ., Naval Gı´as L. Reha11. Ferna´ndez Dı´az J.O bilitation of edentulous posterior atrophic mandible: inferior alveolar nerve lateralization by piezotome and immediate implant placement. Int J Oral Maxillofac Surg 2013;42:521–6. 12. Suzuki D, Bassi AP, Lee HJ, Alcaˆntara PR, De Sartori IM, Luvizuto ER, et al. Inferior alveolar nerve lateralization and implant placement in atrophic posterior mandible. J Craniofac Surg 2012;23:347–9. 13. Hashemi HM. Retraction of the inferior alveolar nerve during implant insertion using the rubber piston of a dental anaesthetic cartridge. Asian J Oral Maxillofac Surg 2006;18:134–5. 14. Hashemi HM. Neurosensory function following mandibular nerve lateralization for placement of implants. Int J Oral Maxillofac Surg 2010;39:452–6. 15. Garg AK, Morales MJ. Lateralization of the inferior alveolar nerve with simultaneous implant placement: surgical techniques. Pract Periodontics Aesthet Dent 1998;10:1197– 204. 16. Rugge G, Lekholm U, Nevins M. Osseointegration and nerve transposition after mandibular resection to treat an ameloblastoma: a case report. Int J Periodontics Restorative Dent 1995;15:396–403. 17. Chrcanovic BR, Custo´dio AL. Inferior alveolar nerve lateral transposition. J Oral Maxillofac Surg 2009;13:213–9. 18. Lorean A, Kablan F, Mazor Z, Mijiritsky E, Russe P, Barbu H, et al. Inferior alveolar nerve transposition and reposition for dental implant placement in edentulous or partially edentulous mandibles: a multicenter retro-
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
spective study. Int J Oral Maxillofac Surg 2013;42:656–9. Felice P, Corinaldesi G, Lizio G, Piattelli A, Iezzi G. Implant prosthetic rehabilitation of posterior mandible after tumor ablation with inferior alveolar nerve mobilization and inlay bone grafting: a case report. J Oral Maxillofac Surg 2009;67:1104–12. Luna AH, Passeri LA, de Moraes M, Moreira RW. Endosseous implant placement in conjunction with inferior alveolar nerve transposition: a report of an unusual complication and surgical management. Int J Oral Maxillofac Implants 2008;23:133–6. Sakkas N, Otten J, Gutwald R, Schmelzeisen R. Transposition of the mental nerve by piezosurgery followed by postoperative neurosensory control: a case report. Br J Oral Maxillofac Surg 2008;46:270–1. Vasconcelos JA, Avila GB, Ribeiro JC, Dias SC, Pereira LJ. Inferior alveolar nerve transposition with involvement of the mental foramen for implant placement. Med Oral Patol Oral Cir Bucal 2008;13:722–5. Ferrigno N, Laureti M, Fanali S. Inferior alveolar nerve transposition in conjunction with implant placement. Int J Oral Maxillofac Implants 2005;20:610–20. Proussaefs P. Vertical alveolar ridge augmentation prior to inferior alveolar nerve repositioning: a patient report. Int J Oral Maxillofac Implants 2005;20:296–301. Karlis V, Bae RD, Glickman RS. Mandibular fracture as a complication of inferior alveolar nerve transposition and placement of endosseous implants: a case report. Implant Dent 2003;12:211–6. Hori M, Sato T, Kaneko K, Okaue M, Matsumoto M, Sato H, et al. Neurosensory function and implant survival rate following implant placement with nerve transpositioning: a case study. J Oral Sci 2001;43:139–44. Nocini PF, De Santis D, Fracasso E, Zanette G. Clinical and electrophysiological assessment of inferior alveolar nerve function after lateral nerve transposition. Clin Oral Implants Res 1999;10:120–30. Kan JY, Lozada JL, Goodacre CJ, Davis WH, Hanisch O. Endosseous implant placement in conjunction with inferior nerve transposition: an evaluation of neurosensory disturbance. Int J Oral Maxillofac Implants 1997;12:463–71. Kan JY, Lozada JL, Boyne PJ, Goodacre CJ, Rungcharassaeng K. Mandibular fracture after endosseous implant placement in conjunction with inferior alveolar nerve transposition: a patient treatment report. Int J Oral Maxillofac Implants 1997;12: 655–9. Jensen J, Reiche-Fischel O, Sindet-Pedersen S. Nerve transposition and implant placement in the atrophic posterior mandibular alveolar ridge. J Oral Maxillofac Surg 1994;52:662–8. Friberg B, Ivanoff CJ, Lekholm U. Inferior alveolar nerve transposition in combination
Please cite this article in press as: Vetromilla BM, et al. Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review, Int J Oral Maxillofac Surg (2014), http://dx.doi.org/10.1016/j.ijom.2014.07.010
YIJOM-2957; No of Pages 7
Complications associated with IAN repositioning
32.
33.
34.
35.
36.
with Bra˚nemark implant treatment. Int J Periodontics Restorative Dent 1992;12: 441–9. Babbush CA. Transpositioning and repositioning the inferior alveolar and mental nerves in conjunction with endosteal implant reconstruction. Periodontology 1998;17: 183–90. Annibali S, Cristalli MP, Dell’Aquila D, Bignozzi I, La Monaca G, Pilloni A. Short dental implants: a systematic review. J Dent Res 2012;91:25–32. Vasco MA, Hecke MB, Bezzon OL. Analysis of short implants and lateralization of the inferior alveolar nerve with 2-stage dental implants by finite element method. J Craniofac Surg 2011;22:2064–71. Sethi A. Inferior alveolar nerve repositioning in implant dentistry: a preliminary report. Int J Periodontics Restorative Dent 1995;15: 474–81. Dario LJ, English Jr R. Achieving implant reconstruction through bilateral mandibular nerve repositioning. J Am Dent Assoc 1994;125:305–9.
37. Bradley JC. The clinical significance of age changes in the vascular supply to the mandible. Int J Oral Surg 1981;10(Suppl. 1):71–6. 38. Robinson PP. Observations on the recovery of sensation following inferior alveolar nerve injuries. Br J Oral Maxillofac Surg 1988;26:177–89. 39. Sandstedt P, Sorensen S. Neurosensory disturbances of the trigeminal nerve: a longterm follow-up of traumatic injuries. J Oral Maxillofac Surg 1995;53:498–505. 40. Kahnberg KE, Henry PJ, Tan AE, Johansson CB, Albrektsson T. Tissue regeneration adjacent to titanium implants placed with simultaneous transposition of the inferior dental nerve: a study in dogs. Int J Oral Maxillofac Implants 2000;15:119–24. 41. Yoshimoto M, Watanabe IS, Martins MT, Salles MB, Ten Eyck GR, Coelho PG. Microstructural and ultrastructural assessment of inferior alveolar nerve damage following nerve lateralization and implant placement: an experimental study in rabbits. Int J Oral Maxillofac Implants 2009; 24:859–65.
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42. Metzger MC, Bormann KH, Schoen R, Gellrich NC, Schmelzeisen R. Inferior alveolar nerve transposition—an in vitro comparison between piezosurgery and conventional bur use. J Oral Implantol 2006;32:19–25. 43. Moher D, Jones A, Lepage L, CONSORT Group (Consolidated Standards for Reporting of Trials). Use of the CONSORT statement and quality of reports of randomized trials: a comparative before-and-after evaluation. JAMA 2001;285:1992–5.
Address: Otacilio Luiz Chagas Jr. Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics School of Dentistry Federal University of Pelotas Rua Gonc¸alves Chaves 457 – 38 Andar Centro Pelotas RS 96015-560 Brazil Tel.: +55 5381115872 E-mail: [email protected]
Please cite this article in press as: Vetromilla BM, et al. Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review, Int J Oral Maxillofac Surg (2014), http://dx.doi.org/10.1016/j.ijom.2014.07.010
Int. J. Oral Maxillofac. Surg. 2014; xxx: xxx–xxx http://dx.doi.org/10.1016/j.ijom.2014.07.010, available online at http://www.sciencedirect.com
Systematic Review Paper Dental Implants
Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review B. M. Vetromilla, L. B. Moura, C. L. Sonego, M. A. Torriani, O. L. Chagas Jr. : Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review. Int. J. Oral Maxillofac. Surg. 2014; xxx: xxx– xxx. # 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Abstract. Inferior alveolar nerve (IAN) repositioning has been used widely in recent years as an alternative approach for dental implant placement in the atrophic posterior mandible. The aim of this study was to answer the question: What are the complications associated with IAN repositioning? A systematic literature review performed in accordance with the PRISMA statement, using the PubMed (MEDLINE), Cochrane Library, and Scopus databases, identified a total of 116 articles related to this technique. Of those articles, 24 were included in the final review. Lateralization was the chosen technique in seven studies, transposition in 15 studies, and two studies reported both techniques. The longest follow-up period was 49.1 months and the shortest 6 months. Of the patients who underwent lateralization, 95.9% initially showed a neurosensory disturbance, and the condition remained at the end of the study for 3.4% of those patients. With regard to the patients who underwent transposition, neurosensory alterations were observed in 58.9% of patients initially, and the condition remained for 22.1% of those affected at the end of the study. Only one study found no neurosensory disturbance at any time. More data consolidation is necessary to determine scientifically if, which, and when the IAN repositioning technique can be recommended.
For the last two decades, dental implant placement has been a popular option for the treatment of the edentulous mandible.1 In such cases, where there is insufficient height for implant placement, there are a few options available for rehabilitation, including short implants, bone graft, and 0901-5027/000001+07
inferior alveolar nerve (IAN) repositioning. Repositioning is performed via one of two surgical techniques, lateralization or transposition, with lateralization yielding lower degrees of nerve deficiency. In lateralization, the IAN is exposed and retracted laterally, held in this position
B. M. Vetromilla1, L. B. Moura1, C. L. Sonego2,3, M. A. Torriani1, O. L. Chagas Jr.1 1
Bone Repair Research Group – Osseointegration, Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil; 2 Bone Repair Research Group – Rigid Internal Fixation, Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil; 3 Post Graduate Program in Dentistry, Master Degree, School of Dentistry, Universidade Luterana do Brasil, Canoas, RS, Brazil
Keywords: Inferior alveolar nerve; dental implantation; inferior alveolar nerve transposition; inferior alveolar nerve lateralization. Accepted for publication 17 July 2014
during implant placement, then released to rest against the implants.2 In the transposition technique, first described in 19773 and modified in 1987,4 the mental foramen is included in the osteotomy, to allow incisive branch excision, so that the IAN can be pulled into a new position,
# 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Please cite this article in press as: Vetromilla BM, et al. Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review, Int J Oral Maxillofac Surg (2014), http://dx.doi.org/10.1016/j.ijom.2014.07.010
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generally more posterior. Although both techniques have seen improvements since their introduction,5–8 reported data remain sparse. The aim of the present study was to answer the question: What are the complications associated with IAN repositioning? Materials and methods Search strategy and selection criteria
An initial bibliographic search in the PubMed (MEDLINE), Cochrane Library, and Scopus databases was performed using three lines of search elements from a brief reading of the subject of interest: (1) ‘inferior’, ‘alveolar’, ‘nerve’, ‘lateralization’; (2) ‘inferior’, ‘alveolar’, ‘nerve’, ‘transposition’; and (3) ‘inferior’, ‘alveolar’, ‘nerve’, ‘translocation’, without time delimitations. The last search was performed on March 19, 2013. For the initial selection, article titles and/or abstracts were analyzed by three independent reviewers (BMV, LBM, and OLCJr), and the following inclusion criteria were observed: studies published in English; no time delimitations; studies of human beings; specific studies using IAN repositioning for rehabilitation with osseointegrated implants; case report, case series, prospective and/or retrospective clinical study types. Following initial selection, the three examiners (BMV, LBM, and OLCJr) read the previously selected articles in full, applying the selection criteria (see Table 1) to determine final inclusion or exclusion from the study. Disagreements among reviewers were settled by additional discussions. The authors established all selection criteria prior to commencement of this study.
making. The classification of the risk of bias potential for each study was based on the criteria adopted by Clementini et al., 9 described as follows: random selection in (of) the population (sample), definition of inclusion/exclusion criteria, follow-up loss reports, validated measurements, statistical analysis. A study that included all the criteria mentioned above was classified as having a low risk of bias; a study that did not include one of these criteria was classified as having a moderate risk of bias; when two or more criteria were missing, the study was assigned a high risk of bias. Results
The last electronic database search was performed on March 19, 2013 and yielded 116 results. In the selection step, it was not possible to access the full text of one article.10 Thirty articles were identified as relevant after reading the title and/or abstract. The full text of these 30 papers was evaluated according to the selection criteria in Table 1. Of these 30 articles, six did not fulfil one or more selection criteria and were excluded. Twenty-four articles were included in the final review.2,6,8,11–31 A flowchart of the selection and evaluation process is given in Fig. 1. Of the articles included in the final review, 14 were case reports and case series, seven were prospective studies, and three were retrospective studies. Regarding the quality assessment, only one
study achieved a low risk of bias. Two studies were assigned a moderate risk and 21 studies were determined to have a high risk of bias (Tables 2 and 3). Lateralization was chosen in seven studies,8,11–16 transposition was chosen in 15 studies,2,17,19–31 and two studies reported both techniques.6,18 Regarding the device used for osteotomy, four studies used piezoelectric surgery11,18,19,21 and 10 used burs;8,12– 15,17,22,23,30,31 10 did not report the device used.2,6,16,20,24–29 Four articles described the use of a resorbable membrane.8,11,23,27 Sixteen studies reported using bone graft to fill the bone defect left by the osteotomy,2,8,11–13,15,17–20,22,24,27,29–31 while the other eight studies did not indicate whether bone graft was used. Among the studies, the longest mean follow-up time was 49.1 months;23 at the end of follow-up, 7% of the patients (1/15) still experienced neurosensory disturbances. The shortest mean follow-up time was 6 months, with full neurosensory recovery of the entire sample population.12,17 Overall, 125 patients were submitted to lateralization. Of these, 123 were evaluated regarding neurosensory function and 95.9% (118 of 123) showed a disturbance initially, while at the end of follow-up, only 3.4% (4 of 118) of the patients with an initial disturbance still displayed this condition. With regard to transposition, 150 patients were treated, of whom 146 underwent neurosensory evaluation. Neu-
Quality rating
A methodological quality rating was performed using the PRISMA statement criteria in order to verify the strength of scientific evidence in clinical decisionTable 1. Eligibility criteria. Eligibility criteria for inclusion in the final review
Studies published in English Without time delimitations Studies of human beings Specific studies that used IAN repositioning for rehabilitation with osseointegrated implants Study type: case report, case series, prospective and/or retrospective clinical study IAN, inferior alveolar nerve.
Fig. 1. Flowchart of the systematic review process.
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Table 2. Quality assessment of the prospective and retrospective studies included.
Year 2013 2013 2010 2005 2002 1999 1997 1995 1994 1992
Author and references Ferna´ndez Dı´az and Naval Gı´as11 Lorean et al.18 Hashemi14 Ferrigno et al.23 Morrison et al.2 Nocini et al.27 Kan et al.28 Hirsch and Bra˚nemark6 Jensen et al.30 Friberg et al.31
Random selection in population
Defined inclusion/exclusion criteria
Report loss to follow-up
Validated measurements
Statistical analysis
Estimated potential risk of bias
Yes
Yes
No
Yes
Yes
Moderate
Yes Yes Yes Yes No No No
No No Yes Yes No No No
No No No Yes No No No
Yes Yes Yes Yes Yes Yes Yes
No Yes Yes Yes Yes Yes Yes
High High Moderate Low High High High
No No
No No
No No
Yes Yes
No No
High High
rosensory alterations were observed in 58.9% (86 of 146) of the evaluated patients, and at the end of the studies, 22.1% (19 of 86) of the patients with a disturbance still showed signs of this condition. Among the studies that found a disturbance after the follow-up period, 11% used a piezoelectric device for the osteotomy (1 of 9).11 All results are shown in Tables 4 and 5.
Discussion
Nerve mobilization procedures are precise methods that require clinical experience, knowledge of anatomy, and the ability to intervene in the event of potential accidents and/or complications.32 In the last few years, IAN repositioning has been used widely as an alternative to short implants or bone grafts for osseointegrated implant placement in the posterior mandible of patients who do not have sufficient bone height for conventional treatment. Thus, determining whether IAN reposi-
tioning is supported by clinical and scientific evidence is important. We investigated the amount of neurosensory disturbance associated with IAN repositioning techniques, in order to establish best practice in the case of an atrophic posterior mandible where dental implants are desired. Different rehabilitation options are described for these cases. One option is the use of short implants; this decreases costs, and a cumulative survival rate of 92.3% has been shown.33 Another option is the establishment of a bone graft prior to implant placement to obtain the necessary height for standard implants. However, the need for two surgical procedures increases costs and the procedure time, and there is the potential risk of morbidity at the donor site. Only a few studies on IAN repositioning that fulfilled the selection criteria established in our review were found. Furthermore, of the studies analyzed, many were case reports, with a high risk of bias. Among the advantages of IAN repositioning is the option to use standard
implants with bicortical anchorage, increasing primary stability, which is essential in the osseointegration process. Osseointegrated implants placed in combination with IAN repositioning present a lower risk of bone loss than short implants when both are placed in similar circumstances.34 For clinical situations with less than the minimum height for short implants (5 mm), IAN repositioning is the technique indicated.11 This procedure also increases the resistance to occlusal forces and promotes a good proportion between implant and prosthesis.35 Compared to the option of performing a graft to allow placement of standard implants, in addition to the lower cost, IAN repositioning can be performed under local anaesthetic, does not require a donor site, and has a lower morbidity rate.7,36 IAN repositioning also presents many disadvantages. The technique does not recover the alveolar ridge anatomy and temporarily weakens the mandible. Mandibular fractures associated with endosseous implants have been documented and
Table 3. Quality assessment of the cases reports and case series included.
Year 2012 2009 2009 2008 2008 2008 2006 2005 2003 2002 2001 1998 1997 1995
Author and references Suzuki et al.12 Chrcanovic and Custo´dio17 Felice et al.19 Luna et al.20 Sakkas et al.21 Vasconcelos et al.22 Hashemi13 Proussaefs24 Karlis et al.25 Peleg et al.8 Hori et al.26 Garg and Morales15 Kan et al.29 Rugge et al.16
Random selection in population
Defined inclusion/exclusion criteria
Report loss to follow-up
Validated measurements
Statistical analysis
Estimated potential risk of bias
No Yes
No No
No No
Yes Yes
No No
High High
No No No No No No No No No No No No
No No No No No No No No No No No No
No No No No No No No No No No No No
Yes Yes No No No No Yes Yes Yes Yes Yes No
No No No No No No No No No No No No
High High High High High High High High High High High High
Please cite this article in press as: Vetromilla BM, et al. Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review, Int J Oral Maxillofac Surg (2014), http://dx.doi.org/10.1016/j.ijom.2014.07.010
Study type
Procedure performed Lateralization (piezoelectric) + implants + bone window replaced with miniplate or particulate + resorbable collagen membrane Lateralization or transposition (piezoelectric) + implants + barrier of platelet-rich fibrin + bone removed repositioned or crushed and mixed with allograft or xenograft Lateralization (bur) + implants
2013
Ferna´ndez Dı´az and Naval Gı´as11
Prospective
2013
Lorean et al.18
Retrospective
2010
Hashemi14
Prospective
2005
Ferrigno et al.23
Prospective
2002
Morrison et al.2
Retrospective
1999
Nocini et al.27
Prospective
1997
Kan et al.28
Retrospective
1995
Hirsch and Bra˚nemark6
Prospective
1994
Jensen et al.30
Prospective
1992
Friberg et al.31
Prospective
Number of patients
Number of repositionings
Neurosensory disturbance (number of patients and duration)
Average follow-up (months)
15
19
15 Still present in 1 patient at the end of the study
24
57
79
4 Normal after 6 months
20.62
87
110
12
Transposition (bur) + implants + resorbable membrane
15
19
Transposition + implants + bone removed as graft Transposition + implants + autogenous and/or allogeneic bone graft + resorbable membrane Transposition including or not the mental foramen + implants Transposition or lateralization + implants
15
26
10
18
15
21
87 Still present in 2 patients at the end of the study 6 Still present in 1 patient at the end of the study 15 Normal after 1 month 10 Still present in 9 patients at the end of the study 9 at the exam date (10–67 months)
19
24
6
10
7
10
Transposition (bur) + implants + bone window replaced Transposition (bur) + implants + spongious bone graft if necessary
18 Still present in 3 patients at the end of the study 1 at the exam date (12 months) 7 Still present in 2 patients at the end of the study
49.1 16 18 41.3 36 23 10
Vetromilla et al.
Year
Author and references
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Table 4. Prospective and retrospective studies included in the final review.
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Table 5. Cases reports and case series included in the final review.
Year
Author and references 12
Study type
Procedure performed Lateralization (bur) + implants + particulate bone window Transposition (bur) + implants + excised bone replaced + low-level laser therapy Transposition (piezoelectric) + iliac graft + implants (4 months later) Transposition + implants + particulated autogenous cortical bone and Pro-Bone Transposition (piezoelectric) + implants (3 months later)
2012
Suzuki et al.
Case report
2009
Chrcanovic and Custo´dio17
Case series
2009
Felice et al.19
Case report
2008
Luna et al.20
Case report
2008
Sakkas et al.21
Case report
2008
Vasconcelos et al.22
Case report
2006
Hashemi13
2005
Proussaefs24
Case report and description of the technique Case report
2003 2002
Karlis et al.25 Peleg et al.8
Case report Case series
2001
Hori et al.26
Case series
1998
Garg and Morales15
1997
Kan et al.29
Case report and description of the technique Case report
1995
Rugge et al.16
Case report
are generally related to high levels of resorption in edentulous mandibles. Also, nerve mobilization leads to many factors that can increase the occurrence of fractures.20,25,29 A large portion of the buccal cortex is removed, reducing the structural integrity of a region that is under constant stress during chewing.25 In addition to that, sites that have been prepared and subsequently abandoned due to bad angulation or insufficient initial stability are areas of bone fragility susceptible to fracture.20 Poor nutrition as a consequence of blood perfusion changes associated with this nerve mobilization can also be a cause of fracture.37 Another disadvantage of
Transposition (bur) + implants + bone removed was replaced particulate Lateralization (bur) + implants + bone chips as graft (1) Vertical autogenous bone graft (2) Transposition + implants + bone window particulated and replaced Transposition + implants Lateralization (bur) + implants + allograft + resorbable collagen membrane Transposition + implants
Lateralization (bur) + implants + bone window replaced Transposition + implants + Bio-Oss Lateralization + implants
Number of patients
Number of repositionings
Neurosensory disturbance (number of patients and duration)
Average follow-up (months)
1
1
15
18
1
1
1
1
1
1
1
1
1
1
1
1
1 Normal after 3 months
36
1 10
1 –
– 6 Normal after 1.5 months
– 29.8
6
8
48
1
1
6 Still present in 5 patients at the end of the study –
1
1
–
1
1
Did not occur
IAN repositioning is the risk of nerve damage. Among the studies evaluated in this review, different protocols were used to evaluate neurosensory function; neurosensory disturbance remained at the end of nine studies,6,11,14,23,26–28,30,31 while only one study showed no neurosensory disturbance at any time.16 The duration and degree of neurosensory disturbance has been related directly to the amount of compression and tension applied to the nerve during the procedure,38 or to chronic distension/compression of the nerve after the surgery.27 Hypoesthesia, paresthesia, and hyperesthesia are the most common disorders.39 Despite nerve damage, many
1 Normal after 1 month 15 Normal after 6 months 1 Normal after 1.25 months – 1 Normal after 2 months 1 Normal after 7 months –
6 6
24 – 8 7 –
– – 12
patients in the studies reported that the damage did not disturb their routine and, based on the benefits achieved, they would choose the procedure again.2,23 The success rate of the lateralization procedure, regarding the osseointegration process, varies from 93.8% to 100%, and thus both patients and surgeons believe this to be a safe procedure; however, a small percentage of patients will have nerve damage for the rest of their lives.6 Concerning the use of materials as barriers between the implant and nerve, there is divergence in the literature, because while some authors consider the use of resorbable membranes to be helpful,40
Please cite this article in press as: Vetromilla BM, et al. Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review, Int J Oral Maxillofac Surg (2014), http://dx.doi.org/10.1016/j.ijom.2014.07.010
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others have observed faster healing of the bone wound without barriers, followed by the restoration of the mandibular canal.41 One advance is the utilization of piezoelectric devices, which allow the surgeon to perform the osteotomy without damaging soft tissue, because piezoelectric devices only affect mineralized tissues. In vitro tests have shown a lower risk of injury when piezoelectric devices are used to conventional rotary compared devices.42 Due to the unavailability of randomized control trials in the literature addressing IAN repositioning, this research highlights the necessity of standardized clinical studies that follow strict criteria for validation, such as the CONSORT guidelines.43 The high level of bias associated with the literature included in this review and the increasing number of posterior mandible atrophy cases worldwide, show the necessity of greater data consolidation to determine scientifically if and when the IAN repositioning technique can be recommended, despite the fact that there is an increasing global trend in treatments involving manipulation of the IAN and the available literature considers neurosensory disorders a complication that the patient can live with. Funding
None. Competing interest
None declared. Ethical approval
Not required. References 1. Van Der Weijden GA, Van Bemmel KM, Renvert S. Implant therapy in partially edentulous periodontally compromised patients: a review. J Clin Periodontol 2005;32:506– 11. 2. Morrison A, Chiaro M, Kirby S. Mental nerve function after inferior alveolar nerve transposition for placement of dental implants. J Can Dent Assoc 2002;62:46–50. 3. Alling CC. Lateral repositioning of the inferior alveolar neurovascular bundle. J Oral Surg 1977;35:419. 4. Jensen O, Nock D. Inferior alveolar nerve reposition in conjunction with placement of osseointegrated implants. A case report. Oral Surg Oral Med Oral Pathol 1987;63:263–8.
5. Yoshimoto M, Allegrini Jr S, Oshiro M, Teixeira V. Inferior alveolar nerve repositioning in implantodontics: clinical report. JBC: J Bras Clin Estet Odontol 1999;3: 53–7. 6. Hirsch JM, Bra˚nemark PI. Fixture stability and nerve function after transposition and lateralization of the inferior alveolar nerve and fixture installation. Br J Oral Maxillofac Surg 1995;33:276–81. 7. Rosenquist B. Fixture placement posterior to the mental foramen with transpositioning of the inferior alveolar nerve. Int J Oral Maxillofac Implants 1992;7:45–50. 8. Peleg M, Mazor Z, Chaushu G, Garg AK. Lateralization of the inferior alveolar nerve with simultaneous implant placement: a modified technique. Int J Oral Maxillofac Implants 2002;17:101–6. 9. Clementini M, Morlupi A, Canullo L, Agrestini C, Barlattani A. Success rate of dental implants inserted in horizontal and vertical guided bone regenerated areas: a systematic review. Int J Oral Maxillofac Surg 2012;41: 847–52. 10. Louis P. Inferior alveolar nerve transposition for endosseous implant placement: a preliminary report. Oral Maxillofac Surg Clin North Am 2001;13:265–81. ´ ., Naval Gı´as L. Reha11. Ferna´ndez Dı´az J.O bilitation of edentulous posterior atrophic mandible: inferior alveolar nerve lateralization by piezotome and immediate implant placement. Int J Oral Maxillofac Surg 2013;42:521–6. 12. Suzuki D, Bassi AP, Lee HJ, Alcaˆntara PR, De Sartori IM, Luvizuto ER, et al. Inferior alveolar nerve lateralization and implant placement in atrophic posterior mandible. J Craniofac Surg 2012;23:347–9. 13. Hashemi HM. Retraction of the inferior alveolar nerve during implant insertion using the rubber piston of a dental anaesthetic cartridge. Asian J Oral Maxillofac Surg 2006;18:134–5. 14. Hashemi HM. Neurosensory function following mandibular nerve lateralization for placement of implants. Int J Oral Maxillofac Surg 2010;39:452–6. 15. Garg AK, Morales MJ. Lateralization of the inferior alveolar nerve with simultaneous implant placement: surgical techniques. Pract Periodontics Aesthet Dent 1998;10:1197– 204. 16. Rugge G, Lekholm U, Nevins M. Osseointegration and nerve transposition after mandibular resection to treat an ameloblastoma: a case report. Int J Periodontics Restorative Dent 1995;15:396–403. 17. Chrcanovic BR, Custo´dio AL. Inferior alveolar nerve lateral transposition. J Oral Maxillofac Surg 2009;13:213–9. 18. Lorean A, Kablan F, Mazor Z, Mijiritsky E, Russe P, Barbu H, et al. Inferior alveolar nerve transposition and reposition for dental implant placement in edentulous or partially edentulous mandibles: a multicenter retro-
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
spective study. Int J Oral Maxillofac Surg 2013;42:656–9. Felice P, Corinaldesi G, Lizio G, Piattelli A, Iezzi G. Implant prosthetic rehabilitation of posterior mandible after tumor ablation with inferior alveolar nerve mobilization and inlay bone grafting: a case report. J Oral Maxillofac Surg 2009;67:1104–12. Luna AH, Passeri LA, de Moraes M, Moreira RW. Endosseous implant placement in conjunction with inferior alveolar nerve transposition: a report of an unusual complication and surgical management. Int J Oral Maxillofac Implants 2008;23:133–6. Sakkas N, Otten J, Gutwald R, Schmelzeisen R. Transposition of the mental nerve by piezosurgery followed by postoperative neurosensory control: a case report. Br J Oral Maxillofac Surg 2008;46:270–1. Vasconcelos JA, Avila GB, Ribeiro JC, Dias SC, Pereira LJ. Inferior alveolar nerve transposition with involvement of the mental foramen for implant placement. Med Oral Patol Oral Cir Bucal 2008;13:722–5. Ferrigno N, Laureti M, Fanali S. Inferior alveolar nerve transposition in conjunction with implant placement. Int J Oral Maxillofac Implants 2005;20:610–20. Proussaefs P. Vertical alveolar ridge augmentation prior to inferior alveolar nerve repositioning: a patient report. Int J Oral Maxillofac Implants 2005;20:296–301. Karlis V, Bae RD, Glickman RS. Mandibular fracture as a complication of inferior alveolar nerve transposition and placement of endosseous implants: a case report. Implant Dent 2003;12:211–6. Hori M, Sato T, Kaneko K, Okaue M, Matsumoto M, Sato H, et al. Neurosensory function and implant survival rate following implant placement with nerve transpositioning: a case study. J Oral Sci 2001;43:139–44. Nocini PF, De Santis D, Fracasso E, Zanette G. Clinical and electrophysiological assessment of inferior alveolar nerve function after lateral nerve transposition. Clin Oral Implants Res 1999;10:120–30. Kan JY, Lozada JL, Goodacre CJ, Davis WH, Hanisch O. Endosseous implant placement in conjunction with inferior nerve transposition: an evaluation of neurosensory disturbance. Int J Oral Maxillofac Implants 1997;12:463–71. Kan JY, Lozada JL, Boyne PJ, Goodacre CJ, Rungcharassaeng K. Mandibular fracture after endosseous implant placement in conjunction with inferior alveolar nerve transposition: a patient treatment report. Int J Oral Maxillofac Implants 1997;12: 655–9. Jensen J, Reiche-Fischel O, Sindet-Pedersen S. Nerve transposition and implant placement in the atrophic posterior mandibular alveolar ridge. J Oral Maxillofac Surg 1994;52:662–8. Friberg B, Ivanoff CJ, Lekholm U. Inferior alveolar nerve transposition in combination
Please cite this article in press as: Vetromilla BM, et al. Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review, Int J Oral Maxillofac Surg (2014), http://dx.doi.org/10.1016/j.ijom.2014.07.010
YIJOM-2957; No of Pages 7
Complications associated with IAN repositioning
32.
33.
34.
35.
36.
with Bra˚nemark implant treatment. Int J Periodontics Restorative Dent 1992;12: 441–9. Babbush CA. Transpositioning and repositioning the inferior alveolar and mental nerves in conjunction with endosteal implant reconstruction. Periodontology 1998;17: 183–90. Annibali S, Cristalli MP, Dell’Aquila D, Bignozzi I, La Monaca G, Pilloni A. Short dental implants: a systematic review. J Dent Res 2012;91:25–32. Vasco MA, Hecke MB, Bezzon OL. Analysis of short implants and lateralization of the inferior alveolar nerve with 2-stage dental implants by finite element method. J Craniofac Surg 2011;22:2064–71. Sethi A. Inferior alveolar nerve repositioning in implant dentistry: a preliminary report. Int J Periodontics Restorative Dent 1995;15: 474–81. Dario LJ, English Jr R. Achieving implant reconstruction through bilateral mandibular nerve repositioning. J Am Dent Assoc 1994;125:305–9.
37. Bradley JC. The clinical significance of age changes in the vascular supply to the mandible. Int J Oral Surg 1981;10(Suppl. 1):71–6. 38. Robinson PP. Observations on the recovery of sensation following inferior alveolar nerve injuries. Br J Oral Maxillofac Surg 1988;26:177–89. 39. Sandstedt P, Sorensen S. Neurosensory disturbances of the trigeminal nerve: a longterm follow-up of traumatic injuries. J Oral Maxillofac Surg 1995;53:498–505. 40. Kahnberg KE, Henry PJ, Tan AE, Johansson CB, Albrektsson T. Tissue regeneration adjacent to titanium implants placed with simultaneous transposition of the inferior dental nerve: a study in dogs. Int J Oral Maxillofac Implants 2000;15:119–24. 41. Yoshimoto M, Watanabe IS, Martins MT, Salles MB, Ten Eyck GR, Coelho PG. Microstructural and ultrastructural assessment of inferior alveolar nerve damage following nerve lateralization and implant placement: an experimental study in rabbits. Int J Oral Maxillofac Implants 2009; 24:859–65.
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42. Metzger MC, Bormann KH, Schoen R, Gellrich NC, Schmelzeisen R. Inferior alveolar nerve transposition—an in vitro comparison between piezosurgery and conventional bur use. J Oral Implantol 2006;32:19–25. 43. Moher D, Jones A, Lepage L, CONSORT Group (Consolidated Standards for Reporting of Trials). Use of the CONSORT statement and quality of reports of randomized trials: a comparative before-and-after evaluation. JAMA 2001;285:1992–5.
Address: Otacilio Luiz Chagas Jr. Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics School of Dentistry Federal University of Pelotas Rua Gonc¸alves Chaves 457 – 38 Andar Centro Pelotas RS 96015-560 Brazil Tel.: +55 5381115872 E-mail: [email protected]
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