{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:34:12Z","timestamp":1791855252998,"version":"4.3.4"},"reference-count":46,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Background: Tooth loss significantly impacts the quality of life for adults. Inferior alveolar nerve (IAN) repositioning has garnered interest as a treatment for facilitating dental implant placement in the severely atrophic posterior mandible. However, there remains a need for standardization and classification of these techniques to improve outcomes. This study aims to propose a new clinical classification system for IAN repositioning procedures based on anatomical and procedural parameters. Methods: This study retrospectively analyzed preoperative radiographic records and surgical procedure documents over a 15-year period (2008\u20132023) for patients who underwent implant placement combined with IAN repositioning in the posterior atrophic mandible. Cases were classified into four categories according to bone availability, nerve location, and type of surgical intervention. Results: The study analyzed 142 edentulous posterior mandibles in 105 patients (77 women, 28 men; age range: 20\u201375). The cases were divided into four categories: Category 1 (58 patients, 78 sites), treated with one surgery; Category 2 (15 patients, 15 sites), treated in two stages; Category 3 (20 patients, 25 sites); and Category 4 (12 patients, 24 sites), with Categories 3 and 4 treated in a single surgery. Across all 132 sites, 411 dental implants were placed and restored with implant-supported fixed prostheses. Conclusions: This proposed classification provides a structured systematic framework for assessing and planning IAN repositioning procedures. It facilitates better diagnosis, treatment planning, and prediction of surgical stages in patients needing IAN repositioning for dental implant placement.<\/jats:p>","DOI":"10.3390\/dj13060267","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T05:28:33Z","timestamp":1750051713000},"page":"267","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A New Classification of Inferior Alveolar Nerve Repositioning Procedures for Dental Implant Placement"],"prefix":"10.3390","volume":"13","author":[{"given":"Fares","family":"Kablan","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel"},{"name":"The Azrieli Faculty of Medicine, Bar Ilan University, Safad 1311502, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/0030-4220(87)90187-3","article-title":"Inferior alveolar nerve reposition in conjunction with placement of osseointegrated implants: A case report","volume":"63","author":"Jensen","year":"1987","journal-title":"Oral Surg. Oral Med. Oral Pathol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1016\/j.ijom.2013.01.020","article-title":"Inferior alveolar nerve transposition and reposition for dental implant placement in edentulous or partially edentulous mandibles: A multicenter retrospective study","volume":"42","author":"Lorean","year":"2013","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_3","first-page":"111","article-title":"A modified surgical technique for inferior alveolar nerve repositioning on severely atrophic mandibles: Case series of 11 consecutive surgical procedures","volume":"109","author":"Barbu","year":"2014","journal-title":"Chirurgia"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1111\/clr.12184","article-title":"The extremely resorbed mandible, 10-year results of a randomized controlled trail on 3 treatment strategies","volume":"25","author":"Stellingsma","year":"2014","journal-title":"Clin. Oral Implants Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1016\/j.joms.2009.03.031","article-title":"All-on-4 treatment of highly atrophic mandible with mandibular V-4: Report of 2 cases","volume":"67","author":"Jensen","year":"2009","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/S1061-3315(18)30020-9","article-title":"Inferior alveolar nerve repositioning","volume":"9","author":"Louis","year":"2001","journal-title":"Atlas Oral Maxillofac. Surg. Clin. N. Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/S0901-5027(88)80047-X","article-title":"A classification of the edentulous jaws","volume":"17","author":"Cawood","year":"1988","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_8","first-page":"e2","article-title":"Inferior alveolar nerve lateralization and transposition for dental implant placement. Part I: A systematic review of surgical techniques","volume":"6","author":"Abayev","year":"2015","journal-title":"J. Oral Maxillofac. Res."},{"key":"ref_9","first-page":"E778","article-title":"Repositioning of the inferior alveolar nerve in cases of severe mandibular atrophy. A clinical case","volume":"13","year":"2008","journal-title":"Med. Oral Patol. Oral Cir. Bucal"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1016\/j.ijom.2014.07.010","article-title":"Complications associated with inferior alveolar nerve repositioning for dental implant placement: A systematic review","volume":"43","author":"Vetromilla","year":"2014","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_11","first-page":"e3","article-title":"Inferior Alveolar Nerve Lateralization and Transposition for Dental Implant Placement. Part II: A Systematic Review of Neurosensory Complications","volume":"6","author":"Abayev","year":"2015","journal-title":"J. Oral Maxillofac. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jpor.2017.06.004","article-title":"A systematic review of studies comparing conventional complete denture and implant retained overdenture","volume":"62","author":"Kutkut","year":"2018","journal-title":"J. Prosthodont. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1563\/aaid-joi-D-17-00210","article-title":"Oral health-related outcomes in edentulous patients treated with mandibular implant-retained dentures versus complete dentures: Systematic review with meta-analyses","volume":"44","author":"Kroll","year":"2018","journal-title":"J. Oral Implantol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.adaj.2018.09.010","article-title":"Tooth loss among older adults according to poverty status in the United States from 1999 through 2004 and 2009 through 2014","volume":"150","author":"Dye","year":"2019","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.ijom.2016.01.005","article-title":"Implant survival and complications in cases of inferior alveolar nerve lateralization and atrophied mandibles with 5-year follow-up","volume":"45","year":"2016","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s40729-021-00334-x","article-title":"Dental implant placement with inferior alveolar nerve repositioning in severely resorbed mandibles: A retrospective multicenter study of implant success and survival rates, and lower lip sensory disturbances","volume":"7","author":"Deryabin","year":"2021","journal-title":"Int. J. Implant Dent."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.bjoms.2019.01.006","article-title":"Neurosensory issues after lateralization of the inferior alveolar nerve and simultaneous placement of osseointegrated implants","volume":"57","year":"2019","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1563\/1548-1336(2006)32[19:IANTIV]2.0.CO;2","article-title":"Inferior alveolar nerve transposition: An in vitro comparison between piezosurgery and conventional bur use","volume":"32","author":"Mertzger","year":"2006","journal-title":"J. Oral Implantol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.ijom.2012.10.015","article-title":"Rehabilitation of edentulous posterior atrophic mandible: Inferior alveolar nerve lateralization by piezotom and immediate implant placement","volume":"42","year":"2013","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/S0915-6992(06)80008-7","article-title":"Retraction of the inferior alveolar nerve during implant insertion using the rubber piston of a dental anaesthetic cartridge","volume":"18","author":"Hashemi","year":"2006","journal-title":"Asian J. Oral Maxillofac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/j.ijom.2016.06.003","article-title":"The effect of a platelet-rich fibrin conduit on neurosensory recovery following inferior alveolar nerve lateralization: A preliminary clinical study","volume":"45","author":"Khojasteh","year":"2016","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e113","DOI":"10.11607\/jomi.6938","article-title":"Inferior alveolar nerve medialization for dental implant placement: Case report with the introduction of a new technique","volume":"33","author":"Sharifi","year":"2018","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1563\/aaid-joi-D-20-00041","article-title":"In-Block Lateralization as a New Technique for Mobilization of the Inferior Alveolar Nerve: A Technique Case Series","volume":"47","author":"Tomazi","year":"2021","journal-title":"J. Oral Implantol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1563\/aaid-joi-D-20-00382","article-title":"Expanding The Surgeon\u2019s Armamentarium\u2014Use of the Tubing Technique to Preserve the Inferior Alveolar Nerve During Transposition Procedure","volume":"49","author":"Kablan","year":"2023","journal-title":"J. Oral Implantol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s00276-011-0859-x","article-title":"The extramandibular inferior alveolar nerve in cases with severely atrophic lower jaws","volume":"34","author":"Rusu","year":"2012","journal-title":"Surg. Radiol. Anat."},{"key":"ref_26","first-page":"32","article-title":"Implant rehabilitation of extremely atrophic mandibles (Cawood and Howell Class VI) with a fixed-removable solution supported by four implants: One-year results from a preliminary prospective case series study","volume":"3","author":"Tallarico","year":"2017","journal-title":"J. Oral Sci. Rehabil."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Donkiewicz, P., Benz, K., Kloss-Brandst\u00e4tter, A., and Jackowski, J. (2021). Survival Rates of Dental Implants in Autogenous and Allogeneic Bone Blocks: A Systematic Review. Medicina, 57.","DOI":"10.3390\/medicina57121388"},{"key":"ref_28","first-page":"296","article-title":"Vertical alveolar ridge augmentation prior to inferior alveolar nerve repositioning: A patient report","volume":"20","author":"Proussaefs","year":"2005","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s40729-021-00311-4","article-title":"Simultaneous implant placement with autogenous onlay bone grafts: A systematic review and meta-analysis","volume":"7","author":"Ma","year":"2021","journal-title":"Int. J. Implant Dent."},{"key":"ref_30","first-page":"e38988","article-title":"Guided Bone Regeneration Effects on Bone Quantity and Outcomes of Dental Implants in Patients with Insufficient Bone Support: A Single-Center Observational Study","volume":"15","author":"Isufi","year":"2023","journal-title":"Cureus"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/j.ijom.2017.01.003","article-title":"Inferior alveolar neurovascular bundle repositioning: A retrospective analysis","volume":"46","author":"Sethi","year":"2017","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"142","DOI":"10.4103\/ams.ams_236_19","article-title":"Superioralization of the Inferior Alveolar Nerve and Roofing for Extreme Atrophic Posterior Mandibular Ridges with Dental Implants","volume":"10","author":"Kablan","year":"2020","journal-title":"Ann. Maxillofac. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1111\/j.1600-0501.2011.02262.x","article-title":"Evaluation of peri-implant bone resorption around Straumann Bone Level implants placed in areas reconstructed with autogenous vertical onlay bone grafts","volume":"23","author":"Chiapasco","year":"2012","journal-title":"Int. Oral Implants Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1111\/j.1600-0501.2012.02463.x","article-title":"Early bone resorption after vertical bone augmentation\u2014A comparison of calvarial and iliac grafts","volume":"24","author":"Mertens","year":"2013","journal-title":"Clin. Oral Implants Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1111\/cid.12799","article-title":"Implant survival rate in calvarial bone grafts: A retrospective clinical study with 10 year follow-up","volume":"21","author":"Vinci","year":"2019","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e220","DOI":"10.11607\/jomi.te58","article-title":"The use of free fat tissue transfer from the buccal fat pad to obtain and maintain primary closure and to improve soft tissue thickness at bone-augmented sites: Technique presentation and report of case series","volume":"29","author":"Kablan","year":"2014","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"179","DOI":"10.4103\/2231-0746.175759","article-title":"The use of Buccal fat pad free graft in regenerative treatment of peri-implantitis: A new and predictable technique","volume":"5","author":"Kablan","year":"2015","journal-title":"Ann. Maxillofac. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e14","DOI":"10.1097\/SCS.0000000000001225","article-title":"Use of the buccal fat pad as free graft for closure of oronasal fistula in a cleft palate patient","volume":"26","year":"2015","journal-title":"J. Craniofacial Surg."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"241","DOI":"10.4103\/2231-0746.200326","article-title":"The use of buccal fat pad free graft in closure of soft-tissue defects and dehiscence in the hard palate","volume":"6","author":"Kablan","year":"2016","journal-title":"Ann. Maxillofac. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"40","DOI":"10.26502\/droh.0061","article-title":"The use of a buccal free fat tissue graft to enhance primary soft tissue closure during socket preservation and improve ridge contour at the extraction site: Presentation of the Technique, and Report of Case Series","volume":"6","author":"Kablan","year":"2023","journal-title":"Dent. Res. Oral Health"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.1016\/j.jds.2024.03.006","article-title":"Free buccal fat pad graft for the bone defect filling of medication-related osteonecrosis of the jaws: A novel surgical approach","volume":"19","author":"Cheng","year":"2024","journal-title":"J. Dent. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"101631","DOI":"10.1016\/j.jormas.2023.101631","article-title":"Inferior alveolar nerve repositioning surgical techniques and outcomes\u2014A systematic review","volume":"125","author":"Nicot","year":"2024","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"ref_43","first-page":"230","article-title":"Spontaneous mandibular fracture as a complication of inferior alveolar nerve transposition and placement of endosseous dental implants in the atrophic mandible: A review of the literature and a report of two cases and their nonsurgical conservative management","volume":"51","author":"Kablan","year":"2020","journal-title":"Quintessence Int."},{"key":"ref_44","first-page":"22","article-title":"Utilization of cone beam computed tomography to determine the prevalence and anatomical characteristics of bifurcated inferior alveolar nerves","volume":"66","author":"Yoon","year":"2018","journal-title":"Gen. Dent."},{"key":"ref_45","unstructured":"Br\u00e5nemark, P.I., Zarb, G.A., and Albrektsson, T. (1985). Patient selection and preparation. Tissue-Integrated Prostheses: Osseointegration in Clinical Dentistry, Quintessence Publishing Co., Inc."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Filipov, I., Chirila, L., Bolognesi, F., and Cristache, C.M. (2023). Buccally or Lingually Tilted Implants in the Lateral Atrophic Mandible: A Three-Year Follow-Up Study Focused on Neurosensory Impairment, Soft-Tissue-Related Impaction and Quality of Life Improvement. Medicina, 59.","DOI":"10.3390\/medicina59040697"}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/6\/267\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:52:36Z","timestamp":1760032356000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/6\/267"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,16]]},"references-count":46,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["dj13060267"],"URL":"https:\/\/doi.org\/10.3390\/dj13060267","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,16]]}}}