Thesis (M.Sc.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Prosthodontics

Inferior alveolar nerve lateralization with simultaneous implant placement has been presented with different modifications in the literature to overcome or decrease the postoperative complications. The present study is a randomized clinical trial to evaluate the neurosensory disturbances, primary stability and marginal bone loss after IAN lateralization with and without isolation of the IAN by collagen membrane.A total of 30 sites with severely atrophied posterior mandibular ridge wereselected for IAN lateralization procedure; 15 sites received a collagen membrane as an isolation between the nerve and implant, while the other 15 sites had no isolationbetween the nerve and implant surface with a follow up period of up to 6 months.Neurosensory evaluation using the modified MRC scale was carried outpostoperatively after 2 weeks, 1month, 3 months and 6 months. Implant stability values were taken using Osstell device immediately after surgery and 6 months postoperative. Immediate CBCT sections to measure the level of the crestal bonerelative to implant platform, and 6 months postoperative measurements were recorded and calculated for marginal bone loss assessment. For group A, a grade of S3 and/or S3+ was achieved at 26.7%, 60% and 73.3% of the sites at time intervals of 2 weeks, 1 month and 3 months, respectively. While in group B, a grade of S3 and/or S3+ was achieved at 33.3%, 86.7% and 53.3% of the sites at time intervals of 2 weeks, 1 month and 3 months, respectively. For both groups, all patients reached a grade of S4 (which is considered to be a 2normal sensation3) after a period of 6 months. The marginal bone loss recorded was in between the mean range of 0.02 to 0.55 mm after 6 months of implant placement with no significant statistical difference between group A and group B. The primary stability of both groups immediately after the procedure ranged between ISQ values of 60-69, whereas 6 months postoperative assessment results ranged between ISQ values of 72-80

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