Effective end-to-end repair of inferior alveolar nerve defect by using nerve sliding technique

Objective: The aim of this study was to introduce a new inferior alveolar nerve (IAN) defect repair method that does not require a nerve graft.

Study design: The IAN was isolated after removal of a buccal cortical window. The scarred area or neuroma caused by the dental implant was excised with fresh cut ends and an epineural margin. If the excised gap was too wide for direct closure, the incisive nerve was intentionally transected 5 mm anterior to the mental foramen to obtain sufficient posterior mobilization of the distal stump of the IAN. The nerve ends were then approximated directly by sliding the distal nerve end to the proximal cut end. After completing the nerve repair by using four 10-0 nylon epineural sutures, the cortical window was repositioned with a microplate and screws.

Results: Using this technique, 3 nerve repairs without a nerve graft were successfully achieved for gaps ∼10 mm in size.

Conclusions: The great advantage of this technique is that a moderate nerve defect can be anastomosed without a nerve graft when direct closure of the nerve segment is impossible without tension.