Specialized Nerve Repositioning at Valley Oral Surgery in Livermore and Dublin, CA

What Is Nerve Repositioning?

Nerve repositioning is a surgical technique used to safely move or protect the inferior alveolar nerve — a major sensory nerve in the lower jaw — during dental implant placement. This nerve provides feeling to the lower lip, chin, and lower teeth.

In some patients, the position of this nerve limits the placement of dental implants in the back of the lower jaw (posterior mandible). When bone height is insufficient above the nerve canal, placing an implant without intervention risks nerve injury.

To avoid this, our surgeons may recommend lateral nerve repositioning, also known as nerve lateralization, to temporarily move the nerve and safely place implants in anatomically challenging areas.

Why Nerve Repositioning May Be Necessary

Dental implants require a minimum amount of bone height to ensure stability and avoid damaging nearby structures. In the lower jaw, that space is often limited by:

• Long-term bone loss after tooth extraction
• Anatomical variations in nerve position
• Failed prior implants or bridgework
• Severe resorption of the posterior ridge

If there’s not enough bone above the nerve canal, traditional implant placement may put the inferior alveolar nerve at risk, which could lead to:

• Numbness or tingling in the lip or chin
• Persistent nerve pain (neuropathy)
• Implant failure due to poor positioning

Nerve repositioning allows patients who would otherwise be ineligible for implants to move forward with treatment confidently.

Who Is a Candidate?

Nerve repositioning is considered for patients who:

• Are missing molars or premolars in the lower jaw
• Have significant bone loss above the nerve canal
• Have been told they’re not a candidate for implants due to low bone height
• Prefer a fixed solution (like implants) over removable dentures

Candidates are typically evaluated using 3D imaging to assess nerve location, bone density, and anatomical limitations. Learn more about our 3D imaging technology.

How the Procedure Works

Nerve repositioning is a complex but well-planned procedure performed by an experienced oral surgeon under IV sedation or general anesthesia.

Steps may include:

• Preoperative Evaluation: High-resolution 3D imaging is used to identify the exact path of the nerve and determine the feasibility of the procedure.
• Access to the Nerve Canal: A small opening is made in the side of the lower jaw (mandible) to access the nerve canal.
• Nerve Mobilization: The inferior alveolar nerve is gently isolated and temporarily moved aside to allow for implant placement.
• Implant Placement: Once the implants are inserted, the nerve is repositioned over or around the implants, and the bone opening is closed.
• Healing and Follow-Up: The area is monitored closely during healing. In some cases, temporary numbness may occur and improve over time.

Due to the precision required, this procedure is typically only performed by board-certified oral and maxillofacial surgeons with extensive experience in nerve and implant surgery — like Anna Lu, DMD and Jimmy Tung Nguyen, DDS, MD.

Alternatives to Nerve Repositioning

Not every patient will need or qualify for nerve repositioning. In many cases, alternatives such as:

• Short (reduced-height) implants
• Angled implants placed away from the nerve canal
• Bone grafting to build vertical height

...may be recommended instead, depending on your unique anatomy. Visit our Bone Grafting & Jaw Preservation page to explore more.

Risks and Considerations

As with any surgical procedure, there are risks to consider:

• Temporary or (rarely) permanent numbness of the lower lip, chin, or teeth
• Swelling and bruising
• Delayed healing in some patients
• Nerve sensitivity or discomfort during recovery

Our surgeons will discuss these risks in detail and determine whether the benefits of the procedure outweigh the potential side effects in your specific case.

Recovery and Post-Op Expectations

Recovery from nerve repositioning typically involves:

• 1–2 weeks of soft diet and rest
• Prescription medication for discomfort and inflammation
• Follow-up imaging to confirm implant integration
• Gradual return of nerve sensation over several weeks or months (if affected)

Patients are monitored closely throughout healing to ensure optimal nerve function and implant success. You’ll receive customized post-surgical care instructions following your procedure.