Which nerve should be considered to avoid numbness when placing implants in the mandible?

Which nerve should be considered to avoid numbness when placing implants in the mandible?

• A. Inferior alveolar nerve
• B. Mental nerve
• C. Incisive nerve
• D. Buccal nerve

Answer: (A)

The key idea is that numbness after mandibular implants most often comes from injury to the nerve that travels inside the mandibular canal. The inferior alveolar nerve runs through that canal and provides sensation to the lower teeth; as it nears the mental foramen it gives off the mental nerve to supply the lower lip and chin. If an implant encroaches on or presses the nerve in the canal, or on branches like the mental nerve, numbness or paresthesia in the lip, chin, or lower teeth can occur. Therefore, careful planning with imaging to map the canal and choosing implant length and position to stay clear of the canal are essential to avoid numbness. The mental and incisive nerves are branches of this same nerve, so awareness of the canal’s course helps protect those distributions as well; the buccal nerve is more about sensation to the cheek area and is less commonly the source of numbness in the typical implant scenario.

The key idea is that numbness after mandibular implants most often comes from injury to the nerve that travels inside the mandibular canal. The inferior alveolar nerve runs through that canal and provides sensation to the lower teeth; as it nears the mental foramen it gives off the mental nerve to supply the lower lip and chin. If an implant encroaches on or presses the nerve in the canal, or on branches like the mental nerve, numbness or paresthesia in the lip, chin, or lower teeth can occur. Therefore, careful planning with imaging to map the canal and choosing implant length and position to stay clear of the canal are essential to avoid numbness. The mental and incisive nerves are branches of this same nerve, so awareness of the canal’s course helps protect those distributions as well; the buccal nerve is more about sensation to the cheek area and is less commonly the source of numbness in the typical implant scenario.