Evaluation of the effect of platelet rich fibrin membrane on the neurosensory function following inferior alveolar nerve lateralization for implant placement “A Randomized controlled Trial”

Abstract

Currently, Osseointegrated dental implants are extensively used for rehabilitation of partially or completely edentulous patients. Sufficient bone volume is required to achieve the optimum treatment outcomes. Placement of dental implants in posterior mandible is complicated by the anatomy and the pattern of bone resorption of this region following teeth extraction. The presence of the mandibular canal containing the neurovascular bundle is considered as a limiting factor of the available bone for implant placement especially with excessive bone resorption. Proper preoperative diagnosis, radiographic study and proper surgical planning is necessary to avoid direct or indirect injury of the inferior alveolar nerve and leaving a safety zone between the canal and the implant. Many surgical techniques are used to overcome the problem of insufficient bone height above the mandibular canal such as placement of short implants, ridge augmentation, distraction osteogensis, sandwich osteotomy, guided tissue regeneration and inferior alveolar nerve reposition technique. Inferior alveolar nerve reposition techniques have been used for placement of dental implants in posterior atrophic mandible with excessive bone resorption leaving a minimal amount of bone above the mandibular canal, nerve reposition surgery provide a solution to avoid direct injury of the IAN and placement of standard length or long implants without the need for augmentation procedures. These techniques are considered to be a sensitive techniques and require good surgical skills but it is associated with a high success and survival rates of the dental implants and provide a good solution for rehabilitation with fixed prosthesis in the cases with excessive bone resorption in mandible posterior region.