Nerve-Repositioning for Lower Dental Implants

Nerve-Repositioning for Lower Dental Implants

Nerve-Repositioning for Lower Dental Implants

Nerve-Repositioning or “Nerve Lateralization” is reserved for the rarest of cases, but is extremely useful in the right situation. This is a procedure that I perform.

It is only done to replace the lower back teeth with a very unique situation.  You may need this procedure if the bone is not “tall” enough to have an implant.  There also needs to be a lack of space from in-between you top and bottom teeth

Lower Back teeth with implants healing:


Here is a picture of a patient with a lot of space between the bottom and top teeth:


This space can be built back with bone with some difficulty.

This is a picture of a patient that has very little space:


It is more desirable to have less space, which means you have more bone.

A CT scan is required for this procedure.  Below are some example images.

The orange line in this image is where the nerve is. You don’t want the

implant to touch the nerve, but you need an implant that is not too short. The purple and green posts are the virtual implants placed by me when I do the surgery on the computer first.  In this case, there is plenty of room, so the nerve can be left alone.

Saldana ed x-ray

In this image below of one of my patients you can see how severe the situation is.  She has lost all the bone in the back, so the nerve is on top of the gums!  Anytime she bites, it hurts!  In her case, she did not want to have implants in the back, so four implants were placed in the front for an overdenture.

Karacuha hatice panoramic

This patient of mine wants back teeth, but there is not enough room from top to bottom for even the shortest of implants.  In addition, her bone is about as thick as a quarter standing on its edge!


The inferior alveolar nerve (orange line in the images), which gives feeling to the lower lip and chin, may need to be moved in order to make room for placement of dental implants to the lower jaw. This procedure is limited to the lower jaw and indicated when teeth are missing in the area of the two back molars and/or and 2nd premolar.

Nerve Reposition Ramsey Amin DDS

Many patients have come to me and said they were told they could not have implants.  This procedure can safely be done with a special instrument called a Piezo.  This highly specialized instrument cannot cut the nerve!

This procedure is traditionally done with a dental drill…yikes!  The risk of damaging the nerve is too high using a drill, for the bone removal closest to the nerve. At the surface, a drill is safe.

Even with the piezo, most of my patients experience a temporary numbness of the lip and chin for a few weeks.  That is considered normal healing. The worst risk possible, is permanent numbness of the lip, chin and teeth on that side.  Your ability to move your lip and chin remains normal should this occur.

In my experience, I have never had this occur, but it is a risk of course.  All other options such as blade or sub-periosteal implants should be considered also.

Nerve repositioning, in my opinion, is the most advanced surgical procedure in the realm of dental implants.  An extremely small percentage of dentists in the world perform this procedure.

Have you ever heard of this?


  1. Rita

    Sorry, I haven’t been in here in a long while. The dentist is in Maryland and his name is Dr. XXX. I asked him how many of these procedures he has done and he told me 2 or 3. That’s why I’ve been so reluctant to have him perform this type of surgery.

    September 9, 2020 at 11:08 am Reply
    1. Ramsey Amin

      I don’t know him. (Name removed)

      September 16, 2020 at 10:37 pm Reply
  2. carol Bissett Young

    I have both very back teeth, right side holding a bridge, that has given me problems, as it has fell out several times, on the left is one lonely tooth at the very back, then 2 caps, is it possible to put implants on the remaining back teeth, with bridges attached to replace the missing teeth,

    August 21, 2019 at 10:36 pm Reply
    1. carol Bissett Young

      I should mention I have implants to support a denture on the top, which is very comfortable with no problems

      August 21, 2019 at 10:39 pm Reply
    2. Ramsey Amin

      yes 😉

      August 22, 2019 at 12:57 am Reply
  3. Nuala Bonner

    I have two implants upper right 4 and 5 they are painful to hot and cold . I get pins and needles and numbness gum bleeding

    November 7, 2018 at 12:22 pm Reply
    1. RamseyAminDDS

      something else is wrong here. You’re probably getting sensitivity from teeth in the area rather than the implants. See a good dentist or endodontist and have your teeth tested for vitality

      November 8, 2018 at 2:49 am Reply
  4. Rita

    Yes. My dentist wants to perform this to add 2 implants 1 on each side of the jaw. I am terrified of getting this done.

    July 27, 2018 at 3:35 am Reply
    1. RamseyAminDDS

      who is the dentist?

      July 28, 2018 at 1:09 am Reply

Write a Comment

Monica D.
Monica D.
December 29, 2020.
There aren't enough words (and I have a lot of words) to tell you how grateful I am to have found Dr. Ramsey Amin and his wonderful staff. I had an enormous amount of bone loss and I was hopeless after being treated by a different doctor for two years. I had multiple procedures such as gum graft, extractions, and a sinus lift. After all of that, the doctor released me and told me he could not help me any longer. He sent me to a large teaching hospital - who also had no idea how to help me. I was terrified and embarrassed. I had been missing teeth due to those procedures since 2017. That sent me out on a journey of meeting with no less than five different dentist/oral surgeons. Most of them shamed me for the bone loss and wondered what I had done to cause this. In reality, I had done nothing. The bone loss is my body's immune system fighting me, as well as hereditary traits. In fact not only was I having difficulty being able to have implants, I also had so much bone loss that I was also not a candidate for dentures. I researched "what to do when you have bone loss and can't get implants" and I found Dr. Amin's website. Then I researched him, read his reviews, watched every one of his You Tube videos. I called and got an appointment, and kept going to consultations with other providers. I had long since stopped smiling and being social. Missing teeth and the shaming was affecting my life so adversely. When I met with Dr. Amin for my consultation he was ready. He had all of my records and had already reviewed my scans. But more than that, he genuinely wanted to get to know about my life. He was/is authentic, kind and extremely professional with so much success and experience in difficult cases like mine. He worked up a treatment plan & I came back two weeks later to discuss my options...and the journey began. I have had three procedures under IV sedation, no pain, no narcotics needed for aftercare. Dr. Amin is a consumate, experienced oral surgeon who cares about your health & understands your fears. He communicates every step of the way and will provide you with all the information you need to make a decision to improve your health. I am still working toward my end goal, and we had to zig from traditional implants and zag to zygomatic implants instead...which is the reason I chose him in the first place. If there was nothing else that could be done to get me healthy & smiling again, I knew he would have that option to help me. And of course 2020, the year of CV-19. Don't worry, Dr. Amin & his staff follow all health & safety protocols. This review is long, because it is important you know my journey, so you might understand how fortunate I feel to be healing. I'm torn, because this place is like a great restaurant, I want to shout from the rooftops how great it is, how great he is. And at the same time, I want to keep this all to myself. I come 75 miles each way to see him. I know people travel from all over the world for his expertise. Do yourself a favor, have a consultation. You won't regret it. Dr. Amin is amazing and so is his staff.
Jennifer B.
Jennifer B.
December 18, 2020.
I cannot speak highly enough of Dr. Amin and his professional staff. I have to start off and say that I am absolutely TERRIFIED of the dentist due to several past experiences. I found myself putting this off for YEARS until I was referred over to Dr. Amin. I was petrified on my first visit... but he along with his WONDERFUL staff made me feel so calm and at ease. I had quite a bit of work that needed to be done, but we found the perfect plan that worked out for me, and I couldn't be happier. Words cannot express my gratitude to each and every staff member that made me feel safe and comfortable. Dr. Amin was always so attentive in asking if I was ever in pain... and I never was. These are truly remarkable individuals, and I'm so lucky to have a dentist that I can trust. I ABSOLUTELY LOVE each and every one of you! Thank you,
D M.
D M.
December 17, 2020.
I cannot say enough positive things about Dr. Amin and his staff. I originally found them on Yelp about two years ago. I needed an implant, front tooth of all places, and was extremely nervous not only about surgery but about how it would turn out. Let me just say I just adore the staff. Everyone is crazy friendly and the whole office has a very positive vibe. The staff is adorable and always has me smiling by the time I leave. They are all thorough and on-point about what they do, and I truly appreciate it. They are quick to respond to my emails no matter the question, and their appointment reminders are great too. Dr. Amin is very thorough and reassuring, and answered any questions my husband or I had. My regular dentist had questions about the procedure and Dr. Amin's office even reached out to them at my request (my dentist said they never received a call, but Dr. Amin's staff had date, time and notes - love the thoroughness!). After surgery the Dr. called to leave me a message about how it went. Very minimal pain during healing, never any pain during any visits. It took a few tries to get everything just right for the permanent crown (color, etc), but the end result is beyond fantastic! At one point during healing I thought I was experiencing some looseness or wiggling but unfortunately couldn't make it to the office. When I was finally able to make it in the Dr. was so relieved, bless his heart. Luckily it was just a false alarm and everything checked out ok. They're a bit further out from me, but I wanted the best. I sure found it! I wish they were my regular dentist, and I'm looking forward to seeing them again for my check-up which was delayed due to COVID.
Melissa E.
Melissa E.
December 9, 2020.
I found Dr. Amin a few years back after I hadn't been to a dentist in a decade. Many traumatic dental experiences in childhood have made me so phobic that even getting a cleaning was a knee-knocking, heart-pounding trial. But finally I couldn't put off some things any longer. During my first anesthesia session, Dr. Amin replaced five old metal fillings, and during the second he did three more plus a crown. I was completely comfortable, and never felt a thing. Because they were extra-long sessions, I did sleep for about 12 hours after, but the next day I felt just fine. This past week, my back top tooth cracked in half and fell out of my mouth, and a couple days later the crown on the remainder of the tooth fell out too! Despite being nervous about Covid 19, I had to get it taken care of, so I called and quizzed the staff about precautions, which turned out to be even above and beyond what I would have expected. So yesterday I went for the tooth extraction and plug. After they put on the blood pressure cuff and put in the IV, I gradually got a little tired and closed my eyes. I sat there for about 10 minutes and thought Gee, I wonder if they're going to get started any time soon, and a minute later Dr. Amin said "Wake up, you're all done!" That was a short session, and I didn't have the kind of fatigue I did my first time. I stayed up most of the evening. Today, everything is good! I'm taking my antibiotic and eating soft foods, and there is surprisingly little pain now that the numbness has worn off. The tooth site and my cheek are a little sore, and the corner of my mouth, and I have a very slight headache, but nothing to any great level--I'm not even taking the acetaminophen. I feel good, and wide awake. Thanks to everyone at the office for a comfortable and professional job! I really REALLY appreciate you for giving me painless dental experiences!
Tanya S.
Tanya S.
December 3, 2020.
What can I say about Dr. Amin he is the best! I'm so grateful for him. He has literally changed my life and given me the confidence to smile more. I had major restorative dental work done and everything went smoothly. Dr. Amin is very compassionate and he really cares about his patients he made me feel comfortable and cared for. He is very knowledgeable and has a great sense of humor. His office is very clean and they take the patients health and safety very serious. His staff is also amazing they made me feel very welcomed and important. I'm so happy I did my research and found Dr. Amin.  Thank you Dr. Amin and team.
Sheila S.
Sheila S.
November 6, 2020.
Two implants done! Finished all procedures and I couldn't be happier. It's the first time in years I looked forward to going to the dentist. Even during Covid life the staff and Dr. Amin took care of me. There is a possibility I may move to Long Beach but I would still travel to keep Dr. Amin as my dentist.
Allison S.
Allison S.
November 4, 2020.
I could not ask for a more caring, exceptionally knowledgeable dental care provider. He's not just a dentist, but someone who looks after your immediate dental needs and helps you plan and prepare for the future.
Julia R.
Julia R.
October 8, 2020.
I've been going to Dr. Amin since I turned 16 and have been going since. Before going to Dr. Amin's dental office, I had 4 crowns that I was not happy with and dealt with it until finally I asked Dr. Amin and because I  feel comfortable and because I trust him with his work I recently had my crowns fixed and worked on by  Dr. Amin and have never loved my smile the way I do now, I can actually enjoy my pictures, I can enjoy my smile from either angle and that really mattered to me. Thank you so much Dr. Amin still and will be in love with MY smile
Aaron D.
Aaron D.
October 6, 2020.
I've been coming to Dr. Ramsey for about five years and I have to say, he is by far the best dentist I've had - ever. The staff is professional and kind, the office is exceptionally well maintained, and Dr. Ramsey is careful and extremely knowledgeable about current developments and research in dentistry. I recently had a dental implant which was a long process but well worth it. I required a sinus lift as well as a bone graft. The surgery went off without a hitch, I was comfortable and the healing process was quick and without complication. Highly recommend!!
Flo O.
Flo O.
September 21, 2020.
This is my 1st review of Dr. Amin, and in my over 17 years of being with him, my experiences with Dr. Amin and his staff have always been positive.  I don't recall a bad experience with the several implant procedures i have had.  They run an efficient office.  I like that they are proactive and reach out to their patients to remind us of routine care needed.  Dr. Amin's bedside care is impeccable.  They are also technologically up to date in terms of sending out texts as reminders, ability to incorporate any appointment into your mobile phone.  That is certainly a plus.  Keep up the great care!!!