{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T22:32:43Z","timestamp":1788474763351,"version":"build-2803163510"},"reference-count":24,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Rehabilitation of the severely atrophic posterior mandible remains surgically challenging, and inferior alveolar nerve (IAN) repositioning is a well-established technique that enables implant placement in anatomically compromised cases. Although neurosensory outcomes following nerve relocation have been extensively investigated, the regenerative capacity of the mandibular canal itself has not been previously evaluated. This study presents the first computer-assisted, cone-beam computed tomography (CBCT)-based assessment of bony canal regeneration after IAN transposition. Methods: Twenty-two patients who underwent unilateral IAN transposition were evaluated using standardized CBCT one year postoperatively. A semi-manual segmentation workflow was performed using Mimics Core Medical software version 27.0 (Materialise), and regenerated canal walls were identified according to four strict criteria: (1) canal continuity across sequential CBCT sections, (2) defined canal walls demonstrating high-density bone (&gt;800 HU, or &gt;400 HU), (3) \u2265270\u00b0 circumferential bony enclosure, and (4) morphology consistent with the native mandibular canal. Regeneration was quantified as the proportion of the surgically disrupted canal segment exhibiting a fully, or near fully, reconstructed canal. Results: Mandibular canal regeneration was observed in all patients. The mean regeneration at one year was 72.7% \u00b1 13% when applying strict &gt;800 HU criteria, with 20 patients demonstrating substantial (&gt;70%) reformation and 2 patients showing partial regeneration (&lt;40%). When a lower density threshold (&gt;400 HU) was applied to include early or less mineralized bone, the mean regeneration increased to 78.1% \u00b1 11%, indicating the presence of maturing bone structures that did not yet meet full-density criteria. Conclusions: Computer-assisted CBCT analysis demonstrates that partial to extensive regeneration of the mandibular canal occurs within one year following IAN transposition. This study provides the first quantitative evidence of this phenomenon, highlighting the intrinsic regenerative potential of the mandibular canal and suggesting a possible association with postoperative neurosensory recovery.<\/jats:p>","DOI":"10.3390\/jcm15030985","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T09:21:40Z","timestamp":1769505700000},"page":"985","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Computer-Assisted CBCT Evaluation of Inferior Alveolar Nerve Canal Regeneration One Year Following Nerve Transposition"],"prefix":"10.3390","volume":"15","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, Safed 1311502, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shadi","family":"Daoud","sequence":"additional","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, Safed 1311502, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amjad","family":"Shhadeh","sequence":"additional","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, Safed 1311502, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samer","family":"Srouji","sequence":"additional","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, Safed 1311502, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1186\/1477-7525-8-126","article-title":"Tooth loss and oral health-related quality of life: A systematic review and meta-analysis","volume":"8","author":"Gerritsen","year":"2010","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"291","DOI":"10.11607\/jomi.4861","article-title":"Vertical Ridge Augmentation in the Atrophic Mandible: A Systematic Review and Meta-Analysis","volume":"32","author":"Elnayef","year":"2017","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_3","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 mandibles: A multicenter retrospective study","volume":"42","author":"Lorean","year":"2013","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.bjoms.2019.01.006","article-title":"Neurosensory issues after lateralisation of the inferior alveolar nerve and simultaneous placement of osseointegrated implants","volume":"57","year":"2019","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_5","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_6","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_7","doi-asserted-by":"crossref","unstructured":"Hwaiti, H.S., Al-Rubidi, Y.A., Al-Ashwal, A., Al-Hadi, Y., Al-Kibsi, T., and Al-Wesabi, M.A. (2025). Inferior alveolar nerve relocation and immediate dental implant placement in severely resorbed mandibles: A prospective clinical case series. BMC Oral Health, 26.","DOI":"10.1186\/s12903-025-07492-z"},{"key":"ref_8","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_9","doi-asserted-by":"crossref","first-page":"347","DOI":"10.5125\/jkaoms.2023.49.6.347","article-title":"Implant placement with inferior alveolar nerve repositioning in the posterior mandible","volume":"49","author":"Kim","year":"2023","journal-title":"J. Korean Assoc. Oral Maxillofac. Surg."},{"key":"ref_10","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_11","doi-asserted-by":"crossref","unstructured":"Vinci, A., Cosola, R., Varkey, M., Gunasekaran, S., and George, J. (2025). Neurosensory disturbances following inferior alveolar nerve relocation and implant placement: A systematic review and meta-analysis. J. Clin. Med., 14.","DOI":"10.3390\/jcm14165741"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.jormas.2019.12.010","article-title":"Complications associated with inferior alveolar nerve reposition technique for simultaneous implant-based rehabilitation of atrophic mandibles: A systematic literature review","volume":"121","year":"2020","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"ref_13","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_14","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_15","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1563\/aaid-joi-D-24-00232","article-title":"Preoperative simulation with 3D printed models for bilateral inferior alveolar nerve lateralization: A case report with 6.5 year follow up and literature review","volume":"51","author":"Li","year":"2025","journal-title":"J. Oral Implant."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/0030-4220(90)90204-6","article-title":"Apparent regeneration of the mandibular canal in a free bone graft","volume":"70","author":"Hopper","year":"1990","journal-title":"Oral Surg. Oral Med. Oral Pathol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.joms.2004.03.011","article-title":"Bone healing after the inferior alveolar nerve lateralization: A histologic study in rabbits (Oryctolagus cuniculus)","volume":"62","author":"Yoshimoto","year":"2004","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"813.e1","DOI":"10.1016\/j.joms.2020.11.027","article-title":"Contralateral Inferior Alveolar Nerve Transposition for Simultaneous Dental Implant Placement on a Unilateral Reconstructed Mandible: A Case Report With a 7-Year Follow-Up","volume":"79","author":"Nguyen","year":"2021","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_19","first-page":"15","article-title":"Neurosensory recovery of inferior alveolar nerve gap reconstruction: A systematic review","volume":"62","author":"Bobrowski","year":"2023","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s10006-021-01005-2","article-title":"The neurosensory deficit of inferior alveolar nerve following bilateral sagittal split osteotomy: A prospective study","volume":"26","author":"Hanfesh","year":"2022","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Kablan, F. (2025). A New Classification of Inferior Alveolar Nerve Repositioning Procedures for Dental Implant Placement. Dent. J., 13.","DOI":"10.3390\/dj13060267"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1563\/aaid-joi-D-23-00022","article-title":"The Mandibular Canal: A Study to Determine If Cortical Bone Exists as a Protective Roof for the Inferior Alveolar Nerve","volume":"49","author":"Piermatti","year":"2023","journal-title":"J. Oral Implantol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1002\/ksa.12213","article-title":"Open-wedge high tibial osteotomy with and without bone void filler: Allograft leads to faster bone union and weight bearing with comparable return to work and sports rates","volume":"32","author":"Resch","year":"2024","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.cxom.2023.04.009","article-title":"Neurosensory reconstruction of the mandible","volume":"31","author":"Miloro","year":"2023","journal-title":"Atlas Oral Maxillofac. Surg. Clin."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/985\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T09:42:00Z","timestamp":1769506920000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/985"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,26]]},"references-count":24,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["jcm15030985"],"URL":"https:\/\/doi.org\/10.3390\/jcm15030985","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,26]]}}}