Evaluation of the effect of the lateralized inferior alveolar nerve isolation and bone grafting on the nerve function and implant stability. (Randomized Clinical Trial).

Abstract

The inferior alveolar nerve lateralization (IANL), although allows for an implant full-length mandibular height engagement, coincides with depleting the buccal bone support and sensory deficits. This study aims to assess whether interposing a bone graft coupled with securing a collagen membrane separation between the inferior alveolar nerve (IAN) and the underlying dental implants would preserve the nerve function, enhance the implant stability, and minimize the radiographic marginal bone loss. Eighteen patients with 30 atrophic mandibular edentulous ridges were subjected to IANL after being randomly assigned to two treatment modalities which consisted of 15 patients each. The (control group) utilized conventional IANL in direct contact with 20 implants. The (test group) implemented the IAN collagen-membrane wrapping and interposing bone graft to overlay 23 implants. The neural function, the radiographic marginal bone loss, and the implant stability quotient were assessed and compared 6 months postoperatively. All the patients regained their full neurosensory function after 6 months, with statistically nonsignificant differences between both groups throughout the follow-up period. The mean marginal bone loss in the test group was (0.42 ± 0.09) mm versus (0.38 ± 0.14) mm for the control group, which was statistically similar (P= 0.401). The 6-month postoperative mean implant stability quotient values of the test group recorded (74.73 ± 2.68) versus (74.73 ± 1.79) for the control group, which was statistically nonsignificant with a value of P= 0.626. The interposed bone graft, coupled with the collagen membrane isolation, neither subsided the neural disturbances nor enhanced the secondary implant stability and marginal bone loss.