Reposicionamiento del nervio
The inferior alveolar nerve, which gives feeling to the lower lip and chin, may need to be moved in order to make room for the placement of dental implants in the lower jaw. La nerve repositioning procedure is limited to the lower jaw and may be indicated when teeth are missing in the area of the two back molars and/or second premolars. This procedure is considered a very aggressive approach since there is almost always some postoperative numbness of the lower lip and jaw area, which typically dissipates very slowly, but may be permanent. Usually other, less aggressive options are considered first (placement of blade implants, etc.).
Típicamente, we remove an outer section of the cheek on the side of the lower jaw bone in order to expose the nerve and vessel canal. We then isolate the nerve and vessel bundle in that area and slightly pull it out to the side. We then place the implants while tracking the neuro-vascular bundle. Then the bundle is released and placed back over the implants. The surgical access is refilled with material de injerto óseo of the surgeon’s choice and the area is closed.
These procedures may be performed separately or together depending upon the individual’s condition. Como se indica anteriormente, Hay varias áreas del cuerpo que son adecuadas para lograr injertos de hueso. In the maxillofacial region bone grafts can be taken from inside the mouth, en la zona de la barbilla o tercera región molar, o en la mandíbula superior detrás del último diente. In more extensive situations a greater quantity of bone can be attained from the hip or the outer aspect of the tibia at the knee. When we use the patient’s own bone for repairs or additions, generalmente obtenemos los mejores resultados.
En muchos casos, we can use allograft material to implement hueso que injertaba para implantes dentales. This bone is prepared from cadavers and is used to get the patient’s own bone to grow into the repair site. Es muy eficaz y muy seguro. Materiales sintéticos también pueden utilizarse para estimular la formación de hueso. We even use factors from your own blood to accelerate and promote bone formation in graft areas.
These surgeries are performed in the out-office surgical suite under IV sedation or general anesthesia. Después de la descarga, bed rest is recommended for one day, as well as limited physical activity for one week.