Implants too close to the inferior alveolar nerve?
I will have some dental implants placed in my lower jaw to replace my molars. The shortest implants(8 mm) will be placed at a distance of 0.5mm above my inferior alveolar nerve, since I do not have enough bone height. A CBCT scan will be done during the surgery. Is it safe to have implants placed so close to the IAN? I am afraid they may damage the nerve in the future because of the occlusal loads.
9 Comments on Implants too close to the inferior alveolar nerve?
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jdsmiledmd
10/26/2020
0.5 mm is close. I am not a very experienced surgeon. Anywhere near that close is way beyond my personal comfort zone. I would be certain that this is a skilled surgeon that is absolutely comfortable with that plan. My understanding is that you want to be certain that you are at least 1mm from IAN and must allow for some clinical error and imaging distortion.
Cold Ghost
10/26/2020
Thank you for your answer! Yes he is experienced but i am afraid that the nerve might get compressed because of the pressure from chewing on the implants,is that possible? Or maybe in case They will need to be removed some day maybe renoval will damage the nerve? Did anybody heard of something like that ?
Montana
10/26/2020
Remember that the "V" shaped drill will extend the osteotomy 1 to 1.5 mm past the length of the implant. If an implant is within 0.5 mm of the nerve, your drill will be into the nerve. I suggest using a 6 mm long implant; my preference for these is Astra EV 6.0 mm. Two mm shorter is better than nerve damage.
npdmd
1/6/2021
This is the key point! This is not a wise plan!
Mark
10/26/2020
Use a 6mm or 7.5mm short implant with at least 2mm above the IAN
Rosa
10/27/2020
Dear colleague,
Consider a 6 mm implant placed with guided surgery .The guided surgery will provide you safer, easier and stress free procedure.
Allowing proper and safe placement according to surgical and restorative ideal position
Matt Helm DDS
10/27/2020
0.5 mm fron the IAN is a no-no! Avoid it at all costs, regardless of how experienced your OS is. No OS that I know would risk it. 3 mm from the IAN is the minimum! use a short wide-body implant if there is sufficient bone width, or just a shorter implant (5mm) as wide as the bone width will allow. Next time attach your pre-op CBCT so that we, the professionals, can get a truer picture of your situation.
Cold Ghost
10/27/2020
Hello thank you for so much for your answers.I posted the question.I am not a practitioner, i am a patient that was going to have this kind of surgery. The surgeon is very experienced but i am still really scared of getting implants so close of the ian. I am afraid in case of future removal my ian will be permanently damaged. Or maybe there will be too much pressure from chewing once the implant is osseointegrated? Not even talking about the intra operative risk.
dr nisarg shah
10/29/2020
normally the nerve is situated medially to the width of the bone. please get a cbct done and confirm the progression of the nerve in that area. in case the nerve is place close to the lingual cortical plate then a 8 mm implant can be place lateral to the nerve leaving approximately 2-3 mm bone between the implant and the nerve.
in case possible get a surgical guide /stent prepared for a guided surgical procedure.
dr nisarg shah india
