A research assistant told me that the mandibular anterior region is a safe region for implant placement despite the presence of mandibular incisive canal because of the nerve atrophies after the extraction of teeth in this region. But what if we put a single implant between some other anterior teeth or if we take a graft from anterior bone in the presence of the teeth?
I don't know the answer but with the increasing use of cbct then the radiologists will be able to comment based on personal experience, the specific pt if they are imaged or in a larger series. Sounds like a project if it's not been done already.
It'd be better to check it with the help of MRI while in CBCT there is no direct visualization of neural tissue. According to your question my best guess that there could be some neural atrophy.
Hİ,
Some studies suggest that neurosensory disturbances could be seen in interforaminal interventions
Morbidity of harvesting of chin grafts: a prospective study. E. Nkenke, S. Schultze-Mosgau, F. Kloss, F. W. Neukam, Martin Radespiel-Tröger. Volume 12, Issue 5, October 2001
Pages 495–502
Presence and course of the mandibular incisive canal and presence of the anterior loop in cone beam computed tomography images of an Iranian population. Zahra Dalili Kajan, Ashkan Salari. Oral Radiol (2012) 28:55–61
Neurosensory disturbances following bone harvesting in the symphysis: a prospective clinical study. von Arx T, Häfliger J, Chappuis V. Clin Oral Implants Res. 2005 Aug;16(4):432-9.
The mandibular incisive canal and its anatomical relationships: A cone beam computed tomography study. Patrícia Pereira-Maciel, Emerson Tavares-de-Sousa, Marcelo-Augusto Oliveira-Sales. Med Oral Patol Oral Cir Bucal. 2015 Nov 1;20 (6):e723-8.
Thank you very much. Do you have any information about the nerve atrophy after extraction of mandibular anterior teeth?
Dear Dr,
In the 17th National Anatomy Congress, in the dental anatomy section, a case was reported by maxillofacial surgeons. In that case single implant was implanted for incisive tooth and patient was complaining of hypoesthesia after implant. I think this indicates nerve injury due to intervention. If there was nerve atrophy hypoesthesia would have ended but patient was complaining of hypoesthesia for 1 year. I hope this will help you.
Best wishes
dear Dr Ulkem Aydin .
I dont think the nerve atrophies at all we have done studies on the distribution of the nerve in the anterior area in cadavers (MSc thesis) not published )and we found that the nerve never atrophies its there but not in a huge amount as when the teeth were there .the nerves are shortnedbut shortened . if your implant is long enough it will reach it and cause numbness.
sincerely Yours
Dr.K.A.Galil.Professor of Dentistry
DDS.,D.Oral & Maxillofacial Surgery,PH.D,FAGD.,FADI.,Cert.Periodontist(Royal College of dental surgeons )
,Developer of The patented first App in Oral Histology for i Pad,i Phone ,i Pod Touch
visit the web site
https://itunes.apple.com/us/app/dgohe+/id1015383607?mt=8
and down load a free demo ,look at the bottom of the page .
see Dr.Galil listed as #17 on 51 first researchers
http://www.uwo.ca/research/51_firsts/
https://www.uwo.ca/research/_img/about/Publications/51%20Firsts%20English.pdf
he presence, location, and dimensions of mandibular incisive canal are an additional required data needs to be elicited before planning oral and maxillofacial surgeries at the anterior region of mandibula and surgeons are responsible to prevent their patients from complications.
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