Lateralization of the Inferior Alveolar Nerve After Repositioning of the Bone Window Versus Sticky Bone Augmentation

Alexandria University

Status: Completed

Conditions: Inferior Alveolar Nerve; Posterior Atrophic Mandible; Nerve Lateralization

Treatments: Procedure: Guided inferior Alveolar Nerve lateralization

Study type: Interventional

Funder types: Other

Identifiers

NCT04590339

0010556-IORG 00088390

Details and patient eligibility

About

Rehabilitation of edentulous posterior mandibular regions with severe ridge atrophy using implants is subject to anatomical, surgical, and biological difficulties. In many cases, the bone is severely atrophied that sufficiently long fixtures cannot be placed without encroaching on the inferior alveolar nerve (IAN). IANL is defined as the lateralization of inferior alveolar neurovascular bundle posterior to the mental foramen, with preservation of the incisive nerve; exposure and traction are used to deflect the IAN laterally while the implants are placed.

Full description

This prospective randomized clinical trial will enroll 20 patients with posterior mandibular ridge atrophy. Ten of which will undergo computer guided nerve lateralization with subsequent implant placement and repositioning of the osteomotized bone window and ten patients will undergo computer guided nerve lateralization with subsequent implant placement and sticky bone grafting.

Enrollment: 20 patients

Sex: All

Ages: 25 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patients suffering from unilateral posterior mandibular edentulism and having < 8 mm of bone above the mandibular canal.
• The width of the ridge should be > 4mm.
• The patient should be psychologically accepting the implant and the involved procedures.
• The patients should have adequate oral hygiene and adequate bone quality.

Exclusion criteria

• Any absolute contraindication for implant surgery such as uncontrolled diabetes mellitus, blood and/or bleeding disorders, serious osseous defects...etc.
• Any relevant systemic disease directly affecting bone metabolism and healing.
• Any habits that might reduce the blood flow and retard healing such as heavy smoking and alcoholism.
• A history of any grafting procedure at the designated area.
• Patient with thick cortical bone buccally and a thin neurovascular bundle.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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20 participants in 2 patient groups

Repositioning the bone window

Active Comparator group

Description:

Computer guided inferior alveolar nerve lateralization and implant placement with subsequent repositioning of the osteotomized bone window.

Treatment:

Procedure: Guided inferior Alveolar Nerve lateralization

Augmentation using sticky bone

Active Comparator group

Description:

Computer guided inferior alveolar nerve lateralization and implant placement with grafting around the implant using sticky bone

Treatment:

Procedure: Guided inferior Alveolar Nerve lateralization