Implant Placement Lateral or Lingual to the Mandibular Canal

Implants are strategically positioned buccal or lingual to the neurovascular bundle, secured within the cortical bone at the base of the mandible.

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About this video

In select cases, when mandibular anatomy allows, implants may be placed lateral or lingual to the mandibular canal, angulated to engage the cortical bone and align with the upper dentition. Bicortical fixation can be achieved; however, while lingual placement offers dual bicortical anchorage, it is a complex and high-risk procedure requiring advanced surgical expertise due to potential complications from penetrating the lingual cortex into the floor of the mouth. This procedure demands meticulous technique and must be digitally planned, as osteotomies are performed blindly. A surgical template is essential, with posterior fixation pins and anterior fixation (either pins or teeth), preferably using a fully guided surgical template.