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    • Inferior Alveolar Nerve (IAN) transposition and horizontal extensive regeneration on the posterior atrophic mandible

    • cover image
    • Initial panoramic X-Ray showing the mental foramen near the bone ridge
    • Initial clinical photographic intra oral situation
    • Bone Ridge exposed after full thickness raised flap and incision with 15c scalpel blade
    • Mental (main and accessory) nerves exposed and individualized
    • Mental Nerves retracted with yellow sterile rubber and designed window for exposing inferior alveolar and incisive nerves, with grey sterile pencil
    • After cutting the window to expose the IAN with piezotome, removing the cortical wall with the help of a chisel
    • Retrieving the IAN nerve from his canal after cutting the incisive part of the nerve 3 mm in front of mental nerve (IAN transposition)
    • Implant placed in front of new position of transposed IAN
    • Decortication of bone that needs to be regenerated horizontally, mesially to transposed IAN
    • mp3 mixed with autologous bone (plate from the window that was milled with bone mill) and I-PRF and curved soft cortical lamina from Osteobiol with I-PRF
    • Sticky bone with mp3, autologous grinded bone and I-PRF in place
    • Cortical lamina in place after placing some putty biomaterial between the sticky bone and the cortical lamina . The lamina was also stabilized by a metallic pin and with sutures
    • Non resorbable sutures supramid 4(0) to close the operatory wound
    • After 6 months of healing of the horizontal ridge augmentation
    • Placing of extra 3 implants on the regenerated ridge
    • Panoramic X- ray with all implants placed
    • Final Rehabilitation with metalo - ceramic crowns . Case with 7 years of follow up
    • Clinical indication: horizontal augmentation
    • Products : Lamina, Lamina, mp3®, Putty
    • Authors : Prof. Dr. Raquel Zita Gomes (surgery) and Dr. Hugo Moreira (prosthodontics )
    • Information about patient: Female, 43 years old
    • Credits : Prof. Dr. Raquel Zita Gomes and Dr. Hugo Moreira, private practices, Portugal
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