Implant Too Close To Nerve, Nerve Injury Protocol | Oral Surgery Techniques #6 with Dr. Gallagher

<p>Key Concepts:</p><p>1 – Debride before you decide: #31 had periapical radiolucencies, a bulbous root and furcation involvement, so after sectioning the bridge I spent about 5 minutes removing granulation tissue and irrigating before judging the site for an implant.</p><p><br></p><p>2 – Respect the inferior alveolar nerve: the canal sat about 13 mm below the crest, but infection can thin its roof, so you don&#39;t know how close you are until the site is clean and the osteotomy begins.</p><p><br></p><p>3 – If the CBCT shows the implant compressing or entering the canal, take it out. I grafted above the site (2 cc) without packing bone down toward the nerve; if the injury is obvious, consider not grafting at all.</p><p><br></p><p>4 – Place implants 1–2 mm below the crest to allow for the 0.5–1 mm of bone loss expected in the first 1–1.5 years. The #30 implant torqued to 45 Ncm and got a healing abutment the same day.</p><p><br></p><p>5 – Nerve injury protocol: a Medrol dose pack early (6-5-4-3-2-1 taper), plus vitamin B complex, acetyl-L-carnitine and alpha-lipoic acid for 1–2 months when paresthesia is present or anticipated.</p><p><br></p><p>Key Instruments/Materials:</p><p>• CBCT: checked the implant&#39;s relationship to the inferior alveolar canal after placement.</p><p>• Osteotomy burs: prepared the implant sites while staying clear of the nerve canal.</p><p>• Bone graft (2 cc) and membrane: filled the #31 site after the implant came out.</p><p>• 4-0 PTFE suture: figure-eight over the membrane plus a security stitch over its middle; it doesn&#39;t collect debris or smell like 4-0 Vicryl.</p><p>• 3-0 chromic gut suture: closed the #30 implant site.</p><p><br></p><p>Sponsors:</p><p>* Instrument Partner Of This Project – (Looking for a partner with instruments, I&#39;ll be talking about and showing the instruments I used in each case)</p><p>* Dental Implant Partner - (I place 3 different brands of implants and I&#39;m waiting for my favorite one to partner with me on this project so I can finally reveal it!)</p><p>* Bone Grafting Partner - (This could be you! You know who you are lol let me know)</p><p><br></p><p>Top 14 Viewers on this Episode on TikTok LIVE 131 Q&amp;A:</p><p>1st – JuliaJayBird1023, @crazycatperson2021</p><p>2nd – @emmac623</p><p>3rd – Diandler, @diandler143</p><p>4th – Ricky T, @daynightsigns</p><p>5th – @theorysmasher</p><p>6th – TitoRDH, @titordh6</p><p>7th – @user3939509162103</p><p>8th – User248, @jacob12456789</p><p>9th – Radian