Relieving neuropathic pain of the mental nerve by vertical bone augmentation between the mental foramina: A novel technique in place of conventional inferior alveolar nerve transposition

ObjectiveNeuropathic pain of the mental nerve is associated with extensive bone resorption in the atrophic edentulous mandible. One of the treatment options is inferior alveolar nerve transposition, which repositions the nerve canal deeper in the alveolar bone, but it carries a high risk of nerve damage, especially in cases of severe alveolar resorption. Here, we report a novel technique for relief of neuropathic pain of the mental nerve in an elderly edentulous patient with severe alveolar resorption who became unable to wear a complete denture.MethodsThis procedure was performed under general anesthesia. Bone was harvested from both coronoid processes, and bone augmentation was performed between the mental foramina via the extraoral approach to preserve the surrounding periosteum on the lowered mandibular bodies and around the mental nerves. The grafted bone was trimmed and fixed with bioresorbable plates and screws after decortications of the residual cortical bone.ResultsThe procedure provided sufficient height between the foramina and the alveolar crests. Complete relief of neuropathic pain was achieved postoperatively and following adjustment of the patient's complete denture during oral rehabilitation.ConclusionsThis novel method enabled repositioning of the alveolar nerve canal and may be a feasible alternative to IAN transposition in patients with severe alveolar resorption.