Dear Valued Patient of D&P Dentistry, 


We are happy to report that we are able to start the process of a soft reopening as of May 11th.  However, there will be many policy changes made within the office that will be utilized at least for the first several weeks of as we adapt to these uncertain times.  We will be seeing patients at half capacity in order to practice optimum infection control, social distancing and also to control the burn rate of our personal protective equipment as it will still not be readily available in the future. 


 If you have an upcoming appointment and plan to reschedule PLEASE call us asap! As we are continuing to work on the schedule and accommodate everyone. The following are important steps patients should be informed of...


1.  Please arrive promptly for you appointment, remain in your car and call the office at (352) 331-4626 when you arrive.  
2.  Please wear your face covering or mask in the office (pursuant to the state of Florida office of the governor executive order number 20-11 and Alachua County Commissioner. 
3. A staff member will meet you at your car where you will be screened. We will check your temperature and pulse ox and have you fill out a questionnaire.  
4. We will take you straight back to the treatment room for your procedure. 
5. We ask that anyone accompanying you remain in the car. 


  * Please bring a jacket or blanket if you normally get cold! The temperature will be down and we will be wearing added gear. 


While some things seem so different we hope you find comfort knowing that at we are taking all necessary steps to protect our patients and staff.  Under all the masks and face shields the same familiar faces you are used to seeing will be taking care of you! 
                           

Thank you for your support!

 D&P Dentistry Team
 

We will continue to provide updates as needed. 

Nerve Repositioning

In order to safely place dental implants, the structures surrounding the treatment area must be carefully evaluated. The inferior alveolar nerve, which runs along the lower jaw, controls sensation in the patient’s lower lip and chin. In rare cases, nerve repositioning, or nerve lateralization, is necessary to avoid serious complications. This includes patients who have inadequate bone or the space between the bone and nerve is too narrow. The purposes of this procedure are to protect the inferior alveolar nerve, avoid potential complications, and allow the patient to maintain feeling in the lower lip and chin.

Candidates for the Procedure

Before recommending a patient for dental implant surgery, an oral surgeon or dentist must evaluate whether there is adequate bone present to support the implant post. Once teeth are lost or extracted, the bone naturally resorbs into the body. This can significantly weaken the jaw. If socket preservation (a type of bone grafting) was performed at the time of extraction, the bone may have retained its integrity. However, insufficient bone quality or density will require grafting prior to implant placement.

Nerve repositioning can help implant patients avoid potential complications, as well as maintain proper sensation in the lower lip and chin.

If the patient requires an implant in the back of the lower jaw and bone grafting is not an option, the surgeon must determine if there is sufficient space surrounding the inferior alveolar nerve to proceed with treatment. If a dental implant comes into contact with the nerve, the patient may experience pain, numbness, or other serious issues. Nerve repositioning may be beneficial for patients who are found to lack sufficient space.

Illustration of projected implant placement with or without nerve repositioning surgery
Without nerve repositioning surgery, certain patients could experience complications during dental implant placement.

Nerve Repositioning Surgery

Computed tomography (CT) scans, an advanced type of 3-D imaging, will be used to evaluate the amount and quality of bone present, as well as the position of the inferior alveolar nerve. This information can also be combined with computer modeling techniques to create a precise surgical plan.

Traditional Surgery

Nerve repositioning surgery is typically performed as an outpatient procedure. Prior to beginning, the surgeon will administer local anesthesia to numb the area. Sedation may also be available to further ensure patients' comfort.

To begin, an incision will be made in the outer portion of the cheek to gain access to the underlying tissue. Next, the doctor will create a small window in the lower jawbone to reach the inferior alveolar nerve. The nerve bundle is then carefully pulled aside. The doctor will place the implant in the jaw while avoiding contact with the nerve bundle. Following placement of the implant, the nerve bundle can be moved back into place. The space that was created in the jawbone is then filled bone grafting material, and the incision is closed.

In most cases, nerve repositioning surgery can be performed in conjunction with dental implant surgery, but sometimes the procedures may need to take place separately. 

Piezosurgery

Although most nerve repositioning surgery is performed using traditional methods, some dentists and oral surgeons use a newer technique called piezosurgery. During surgery, a specialized instrument uses high-frequency vibrations to incise bone while sparing the surrounding soft tissues, including skin, gums, and nerves. Piezosurgery is often preferable to traditional nerve repositioning surgery because it causes less trauma, which results in reduced bleeding and expedited healing. The most notable drawbacks of piezosurgery are the higher treatment cost and the fact that the doctor must also have received special training in the technique.

Weighing Your Options

Any kind of surgery carries some degree of risk. Nerve repositioning typically results in at least some degree of numbness in the lower lip, cheeks, and jaw. This should be temporary, and the majority of patients will see improvement in a few weeks to a few months. For a small number of patients, nerve damage may be permanent, and numbness may persist indefinitely. Due to the potential for permanent damage, nerve repositioning surgery is usually recommended only as a last resort. Your dentist can help you decide whether the surgery is right for you or whether an alternative, such as a traditional bridge or denture, is advisable. 

D&P Dentistry

The team of dental professionals at D&P Dentistry provides exceptional dental work and patient education to help you and your family achieve your best smiles. Our doctors are affiliated with:

  • American Dental Association
  • Alachua County Dental Association

To schedule an appointment at our Gainesville, FL, office, please contact us online or call (352) 331-4626.

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Gainesville Office

7575 W University Ave
Ste P
Gainesville, FL 32607

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