하악 임프란트 이식시 하치조신경에 대한 고려방안

The inferior alveolar nerve may be injuried during implant surgery on mandibular posterior regions. So, it is important for surgeon to evaluate the location and course of the inferior alveolar nerve by clinical and radiographic methods before implant surgery. This study presents the usefulness of panorama and conventional tomogram as diagnostic method, and the zone of safety in mandibular posterior region, and the methods of repositioning of the inferior alveolar nerve. We compared the predictability of the length of the fixture in 21 patients on panorama and conventional tomogram, and concluded that conventional tomogram was not more accurate than panorama. But, it was useful to evaluate three-dimensional anatomic relation. The zone of safety was measured in our 23 first-molar cases, and the average measurement on the center of mandibular first-molar was 12.78mm. So, we prudently concluded that this length might beguidance for selection of available length of the fixture. And, if the available length of the fixture is not sufficient for initial stability, it must be consider to reposition the inferior alveolar nerve. No matter how careful a surgeon may be, the possibility of iatrogenic damage of the nerve cannot be preclude. When the iatrogenic damage is occured, the nerve could be repaired by microsurgical reanastomosis, nerve graft, fibrin sealant, and the nerve coverage by Gore-tex tube etc. We present the considerations of the inferior alveolar nerve for implantation on mandible with literature review.