Modified surgical technique for transposition of the inferior alveolar nerve followed by immediate placement of endosseous implants in mandibles with moderate to severe atrophy are presented. Five transpositions of the inferior alveolar nerve together with the installation of 10 implants were performed in four patients. The mean postoperative follow-up time was 17 months, with a range of 8 to 20 months. All implants with functioning pontics remained stable, with no mobility or symptoms of pain and infection during the follow-up period. Neurosensory evaluation was performed using the two-point discrimination test. Two patients had objective neurosensory dysfunction at postoperative, but all the nerve function were reported as normal by the patients 4 months postoperatively.