Dental Tribune United Kingdom

August 1-7, 2011United Kingdom Edition Implantology starts at the time of extraction ” ” Luxator is a registered trademark owned by Directa AB. 3382-1101©DirectaAB Easier for the dentist and dramatically less traumatic for patients and their dentition Highly acclaimed, renowned and proven functions in traditional shapes and sizes The Luxator® Periotome with 10 mm shorter shaft Elevator with traditional ergonomic Luxator handle providing extra strength and maintained tactility Innovative dual purpose tip for probing and luxating page 13DTß into distal direction, thus the nerve’s exit from the jaw is fur- ther distal and in the buccal di- rection. This allows implantation in position 5 and/or 6 without dam- aging the nerve. Kan, Pelg and Ferrigno describe another sur- gical technique for the laterali- sation of the nerve, distal to the mental foramen. With this technique the infe- rior alveolar nerve stays intact in the area of the mental foramen. The technique is described in detail in this article. The fenes- tration of the compact bone was carried out distal to the foramen. The route of the nerve is visu- alised and the nerve lateralised. The optically controlled implant insertion is carried out leaving the nerve aside. After insertion the nerve will be put back into the bony window. Risks and complications This technique carries the important risk of temporary or even permanent irritation of the nerve, which may lead to anesthesia, hypesthesia or par- esthesia. Several studies have considered this risk. In his 1992 study Rosenquist12 demonstrated that 12 months lat- er sensory disorders could not be observed in all 10 patients (26 im- plantations). Peleg’s10 2002 study did not show any permanent dis- orders either. Jensen7 quoted 10 per cent sensory disorders after 12 months. In 2005 Ferrigno3 reached the same results, and he also agreed with the figure stated by Watzek 14 . The interesting ret- rospective study by Kan9 1997 is the only one that compares both surgical techniques, the “dis- placement of the foramen” and the “lateralization of the inferior alveolar nerve”. He analysed 21 surgeries (64 implantations) af- ter 10 to 67 months. He found out that sensory disorders occurred significantly more often in cases of displacement of the foramen (66.7 per cent) compared to the lateralisation of the nerve (33.3 per cent). These results show that in this regard, lateralisation is less risky. The implant survival rate stated in the above-mentioned studies is between 93.8 per cent and 100 per cent. Kan describes for example another probable complication, ie a fracture of the mandible at the operation site. The mandible is weakend by the removal of the buccal corticalis, and by the crestal implantation at the same time, and thus there ‘This technique car- ries the important risk of temporary or even permanent irritation of the nerve, which may lead to anesthesia, hypesthesia or par- esthesia’ Fig 1 Fig 2 Fig 3 Fig 4 Fig 5 Tab. 1_A variety of studies concerning the lateralization of nerves