Preservation of the Inferior Alveolar Nerve during Mandibulectomy with Dynamic Implant Navigation System

The inferior alveolar nerve (IAN) is often sacrificed during mandibulectomy. However, nerve injuries can affect the quality of life. A nerve-sparing approach may offer a better sensory function. Several guided designs to the mandibular canal were reported, which can reduce trauma and intraoperative time, but they could not present the depth of the IAN. Dissection of the neurovascular bundle is a meticulous and tedious work. We tried improving this problem by using a dynamic dental implant navigation system. A 71-year-old man revealed pain in the left mandibular side and lip numbness after the removal of the left inferior first molar. According to image survey, diagnosed as stage 2 medication-related osteonecrosis of the jaw, he underwent the sequestrectomy and mandibulectomy. IAN was marked and dissected with dynamic dental implant navigation system. The postoperative course was unremarkable, and the patient reported much improvement in chin sensation. This application could decrease neurosensory deficit about lateralization or IAN reposition under dental implant placement.