Computer Aided Bypass of the Inferior Alveolar Nerve for Implant Placement. A Case Report.

Zogakis Antonios D.D.S., Barlas Irodis D.D.S., Veis Alexander D.D.S.

This is a clinical case of a severely resorbed mandible in relation to vertical dimension, treated with implants using CBCT and dental implant planning software

 72 y.o, M Non-smoker No medical relevant history

Clinical exam severely reduced alveolar height at the posterior mandible

Methodology
Panoramic radiograph CBCT scan with radiographic template was taken Data analysis was carried out using SimPlant planning software Surgical template was used Three implants (3.4x9.5mm, 3.4x9.5mm and 3.0x11mm) were scheduled to be placed at positions #46m, #34 and #36 respectively

 Inadequate height at position #36 (7mm) and adequate crestal width at IANs Canal plane, resulted in planning implant insertion bypassing lingually the IAN. Implants were inserted utilizing Full thickness flap under Local Anesthesia 3 months later, prosthetic rehabilitation took place

Results
Three implants were successfully placed using surgical template. A second CBCT after implant placement revealed close proximity with IAN without any paresthesia or other postoperative complication. The patient was restored with One screw retained PFM crown at position #46 and Two cemented PFM bridge at position #34 and #36.

Conclusion
Guided surgery, with the use of Computer aided implant placement, CBCT scan and Dental implant planning software, allowed to treat a patient with edentulous posterior mandible and reduced height of alveolar ridge with implants and fixed prosthodontic restorations.