A case report published in Frontiers in Oral Health describes three patients with inferior alveolar nerve injury who reported neurosensory recovery after a four-week multimodal protocol built around regenerative peptides. The authors are unusually blunt that this is not evidence the treatment worked.

The inferior alveolar nerve runs through the mandibular canal and supplies sensation to the lower lip and chin. Injuring it during implant placement, third molar surgery, bone grafting or orthognathic surgery can leave patients with numbness, altered sensation or pain, and the authors note that current management is mainly supportive: corticosteroids in the acute phase, sometimes microsurgery, pharmacologic neuroregulators or local anesthetics.

Three cases, one protocol

The patients were a 38-year-old woman and an 85-year-old patient, both with failed implants at site #30 and CBCT showing the surgical site around 2 mm from the nerve canal without direct penetration, plus a 48-year-old woman with persistent numbness after extraction and grafting. All three received weekly intraoral submucosal infiltrations over four weeks of ARA-290 (4 mg), TB-500 (10 mg) and BPC-157 (1 mg), alongside dexamethasone (8 mg) and bupivacaine 0.5% with epinephrine.

What the clinicians recorded

All three reported gradual improvement. The first case was left with roughly 3 mm of residual hypoesthesia below the vermilion border, the second with about 2 mm of diminished sensation at the chin, and the third reported numbness reduced by nearly 95%. No treatment-associated adverse events were documented, and at six months the hard tissue had healed well enough for implants.

Limitations

The authors list more caveats than findings. Three patients, no control group, no randomization, no blinding, and recovery assessed by routine clinical exam, patient report and photographs rather than quantitative sensory testing. Because every patient got the identical combination, there is no way to separate the peptides from the dexamethasone, the anesthetic, or the natural course of recovery. Spontaneous recovery after minor nerve injury is well established, and the paper names placebo effects, observer bias and regression to the mean as plausible alternative explanations.

The trials that would settle this

The authors call these hypothesis-generating observations and point to prospective controlled trials with standardized neurosensory measures as the next step. They also note that long-term safety, pharmacokinetics, dosing and regulatory status for many of these peptides remain poorly characterized.