Prevention and Treatment of IAN Injuries: A Literature Review

Abstract The inferior alveolar nerve (IAN) is one of the most important structures in dentistry. It is a terminal branch that originates from the mandibular root of the trigeminal nerve. This branch courses through the inner aspect of the mandible and innervates teeth and some muscles as the mylohyoid or digastric ones and the gums or lips by its mental branch. Although the main cause of IAN lesion occurs during third molars extractions, IAN can be injured during implant surgery, especially in cases with an atrophic posterior mandible. It is difficult to sever the nerve due to its large caliber. On the contrary, nerve compression or laceration constitute more common complications. Diverse preventive methods to avoid IAN injury have been reported such as using a precise diagnostic procedure as computerized tomography (CT), guided implant surgery, or placing short implants. We may classify nerve injury effects ranging from a light tingling (dysesthesia) to temporary or permanent loss of sensibility (hypoesthesia) or to increased sensibility. These cases require a careful management as these events may increase the patients' and dental practitioners' anxiety. When the IAN has not been totally interrupted, healing occurs in the next 3 to 6 month even spontaneously. Sometimes we can alleviate patients giving them some painkillers or vitamin complexes to minimize symptoms or to improve healing. The use and utility of this kind of treatment is controversial however we should not underestimate its placebo effects