INFERIOR ALVEOLAR NERVE INJURY DURING IMPLANT PROCEDURE

Inferior alveolar nerve(IAN) injury is one of the most serious complications in Implant Dentistry. Some reports show traumatic injury to IAN following implant procedure is found in 17.75% of cases.
Injury to IAN can cause alteration of sensation in varying degrees from mild numbness to loss of pain sensation to complete loss of perception of stimulation.

                                               
ETIOLOGY:
 Nerve Injury can occur during local anaesthesia, implant osteotomy and during implant placement.
For dental practitioners, thorough understanding of anatomy, surgical procedures and implant system along with proper planning of treatment is essential to reduce the complications.
.Methods to locate IAN during treatment planning includes conventional radiography and CT e  and frequent IOPA radiographs should be taken.

PREVENTION:
              Proper presurgical planning, timely diagnosis and treatment are the key to avoid nerve injury.

• Slippage of drill due to lower resistance of spongy bone.. Therefore use of drill guards to prevent over penetration of drills.
• 2mm safety zone should be made between apical part of implant and upper border of IAN canal.
• Using infiltation instead of IAN block, so the patient will feel pain if drill approaches the IAN canal and gives an indication to stop drilling.
• Frequent intra oral  peri apical radiographs with presence of drills in the osteotomy site should be taken.