Study the effect of neurectomy of nasopalatine nerve on the sensation of anterior palate in patients undergoing rehabilitation of anterior maxillary ridge with dental implant

Replacement of missing teeth in the anterior maxilla could be challenging if enlargement of the nasopalatine canal which is located in the midline of the palate posterior to the maxillary central incisors or ridge atrophy occur after tooth extraction. This could place the neurovascular content of the nasopaltine canal in the path of the dental implant which may lead to complications such as nasopalatine canal cyst, sensory dysfunction or implant failure. Technique to overcome this problem have evolved including neurectomy of the nasopalatine canal content and obliteration of canal with bone graft.

Loss of sensation in anterior palate following this procedure could be an annoying complication for patients. In recent studies regaining of sensation following such procedure have been reported, Confirmation of such results is essential to rule out the side effect of loss of sensation in the anterior palatal region

Inclusion Criteria:

• • Adult patients requiring dental implants placement in the anterior region of maxilla and has insufficient horizontal bone .

  • Patients should be free from any systemic conditions that may affect soft tissue healing.

Exclusion Criteria:

• • Patients with systematic disease that may complicate healing.

  • Uncontrolled diabetic patient.
  • Patients with advanced osteoporosis.
  • Patients under bisphosphonates treatment.
  • Patients with neurological disorders (neuralgias, Parkinson's disease).
  • Patients with horizontal ridge atrophy (if the horizontal dimension of the residual ridge <3mm as determined with ridge callipers).
  • Heavy smoker patients.