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Avoid Nerve Injury at the Lower 2nd Molar (Part 2)
In order to bury the implant completely, the implant should be placed 2 mm below the pointed crest. With the short implant (6.4x8 mm), there is 2 mm bone above the nerve in the coronal section (Fig.3). It appears safe.
In the sagittal view, the implant is 0.7 mm from the bulging segment of the nerve (Fig.3' >)!
To avoid nerve injury, the implant should be 2 mm shorter or placed at the level of the original crest top (Fig.4,4'). There is 4 mm from the main nerve trunk (Fig.4) or 2.7 mm from the bulging segment of the nerve sagittally (Fig.4' <). The exposed buccal (B) and lingual top microthreads will be covered by autogenous bone graft, harvested during reamer osteotomy. If not enough, allograft is supplemented. The bone graft is then covered by collagen membrane, which is fixed between the implant and a healing abutment.
Xin Wei, DDS, PhD, MS 1st edition 01/26/2014, last revision 02/01/2014