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Nerve Lateralization – Procedure, Risks & Recovery

Nerve lateralization is a surgical procedure in which a nerve is repositioned sideways to allow safe placement of dental implants or to relieve pressure on the nerve.

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Things worth knowing about "Nerve lateralization"

Nerve lateralization is a surgical procedure in which a nerve is repositioned sideways to allow safe placement of dental implants or to relieve pressure on the nerve.

What is Nerve Lateralization?

Nerve lateralization (also referred to as nerve transposition or inferior alveolar nerve lateralization) is a specialized surgical technique primarily used in oral and maxillofacial surgery and implantology. The procedure involves carefully repositioning a nerve – most commonly the inferior alveolar nerve – laterally (to the side) to create sufficient space for the placement of dental implants or to relieve the nerve from areas of compression.

The inferior alveolar nerve runs through the mandible (lower jawbone) and is responsible for sensation in the lower teeth, gums, lower lip, and chin. When significant bone loss occurs in the lower jaw – for example, following tooth loss – the nerve canal may lie very close to the bone surface, making implant placement difficult or impossible without first moving the nerve.

Indications

Nerve lateralization is considered in the following clinical situations:

Severely resorbed lower jawbone with insufficient vertical bone height above the nerve canal
Planned implant-supported restoration in the posterior mandible
Relief of chronic nerve compression or pain caused by tumors or cysts
Reconstructive procedures following jaw trauma or tumor surgery

Surgical Procedure

The procedure is typically performed under local anesthesia or general anesthesia. The surgeon exposes the inferior alveolar nerve canal in the lower jaw, carefully moves the nerve to the side, places the dental implants, and then repositions the nerve into a protected location.

Variants of the Procedure

Lateralization: The nerve is temporarily displaced to the side while implants are placed, then returned to a nearby position.
Transposition: The nerve is permanently repositioned into a new location, and the original canal is closed.

Risks and Complications

As this is a technically demanding procedure performed in close proximity to sensitive nerve structures, the following complications may occur:

Numbness or tingling (paresthesia) in the lower lip, chin, or teeth – usually temporary, rarely permanent
Postoperative pain or swelling
Infection or inflammation
Bone loss or implant failure
In rare cases, permanent nerve damage

Most sensory disturbances resolve within weeks to months. Complete nerve recovery is expected in the majority of patients.

Aftercare and Recovery

Careful follow-up care is essential after nerve lateralization. This includes regular check-ups with the oral surgeon or dentist, taking prescribed medications (e.g., antibiotics, pain relievers), and maintaining gentle oral hygiene. The full healing process may take several months before the final dental restoration can be placed.

References

Chrcanovic B.R., Custodio A.L.: Inferior alveolar nerve lateralization and transposition for dental implant placement. In: Oral and Maxillofacial Surgery, 2009; 13(4): 213–219.
Juodzbalys G. et al.: Inferior alveolar nerve injury associated with implant surgery. In: Clinical Oral Implants Research, 2011; 22(9): 1039–1047.
Rowe N.L., Williams J.L. (Eds.): Maxillofacial Injuries. Churchill Livingstone, Edinburgh, 2nd edition.

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