A Comparison of Cone-Beam Computed Tomography and Direct Measurement in the Examination of the Mandibular Canal and Adjacent Structures (original) (raw)
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Measurements of mandibular canal region obtained by cone-beam computed tomography: a cadaveric study
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2009
Objective. The objective of this study was to assess the accuracy and reproducibility of cone-beam CT measurements of specific distances around the mandibular canal by comparing them to direct digital caliper measurements. Methods. Six formalin-fixed hemimandible specimens were examined using the ILUMA cone-beam CT system. Images were obtained at 120 kVp, 3.8 mA, and a voxel size of 0.2 mm, with an exposure time of 40 seconds. Specimens were cut into sections at 7 locations using a Lindemann burr, and a digital caliper was used to measure the following distances on both the anterior and posterior sides of each section: Mandibular Width (W); Mandibular Length (L); Upper Distance (UD); Lower Distance (LD); Buccal Distance (BD); and Lingual Distance (LID). The same distances were measured on the corresponding cross-sectional cone-beam CT images using the built-in measurement software. All caliper and cone-beam CT measurements were made by 2 independent trained observers and were repeated after an interval of 1 week. The Bland/Altman method was used to calculate intra-and inter-rater reliability. Intra-class correlation coefficients (ICCs) from 2-way random effects model were calculated. Agreements between cone-beam CT and direct digital caliper were calculated by ICC for 6 distances and 2 observers. Results. Intraobserver and interobserver measurements for all distances showed high agreement. ICCs for intraobserver agreement ranged from 0.86 to 0.97 for cone-beam CT measurements and from 0.98 to 0.99 for digital caliper measurements. ICCs between observers ranged from 0.84 to 0.97 for the cone-beam CT measurements and from 0.78 to 0.97 for the digital caliper measurements. ICCs for cone-beam CT and direct digital caliper ranged from 0.61 to 0.93 for the first observer and from 0.40 to 0.95 for the second observer. Conclusion. Accuracy of cone-beam CT measurements of various distances surrounding the mandibular canal was comparable to that of digital caliper measurements.
Measurements of the mandibular canal by multidetector computed tomography
2012
Aim: The aim of this study was to investigate the measurements of the mandibular canal in different patterns of reabsorbed alveolar ridges, using multidetector computed tomography in order to evaluate the relationship of the mandibular canal with the cortex of the mandible remains. Methods: Central cross-sectional slice of 30 edentulous alveolar ridges in the mandibular first molar region of otherwise healthy patients using multidetector computed tomography were analyzed. Horizontal and vertical lines were performed tangent to the corticals of the mandible and mandibular canal. Fisher’s exact test, Spearman test and linear regression were used for statistical analysis. Significance level for all statistical tests was 95%. Results: The height of the mandible and the distance of mandibular canal to superior cortical in males were significantly higher when compared with females (p<0.05). When the height of the mandibular bone was correlated to the classification of edentulous jaws, ...
PAFMJ, 2021
Objective: To determine the mean distance of mandibular incisive canal from the mental foramen in patients reporting to a tertiary care centre using Cone Beam Computerized Tomography for placement of dental implants in the anterior/interforaminal region. Study Design: Cross-sectional study. Place and Duration of Study: Department of Prosthodontics, Foundation University College of Dentistry Rawalpindi, Jun to Nov 2019. Methodology: A total of 70 patients participated between the age of 20-45 years. Cone Beam Computerized Tomography (the investigation was carried out and measurements of the mandibular incisive canal from mental foramen were recorded with the help of measuring tools in the software and noted down on the proforma. Data were analyzed using SPSS-20. Results: The number of patients selected for this study was 70. Out of these 70 patients, 33 (47.1%) were males and 37 (52.9%) were females. The mean age of patients in this study was 36.31 ± 6.38 years. The mean distance/ext...
Journal of Applied Oral …, 2007
OBJECTIVE: The purpose of this study was to evaluate the accuracy of relative measurements from the roof of the mandibular canal to the alveolar crest in multislice (multidetector) computed tomography (MDCT) and single-slice computed tomography (SSCT). MATERIAL AND METHODS: The sample consisted of 26 printed CT films (7 SSCT and 19 MDCT) from the files of the LABI-3D (3D Imaging Laboratory) of the School of Dentistry of the University of São Paulo (FOUSP), which had been acquired using different protocols. Two observers analyzed in a randomized and independent order a series of 22 oblique CT reconstructions of each patient. Each observer analyzed the CT scans twice. The length of the mandibular canal and the distance between the mandibular canal roof and the crest of the alveolar ridge were obtained. Dahlberg test was used for statistical analysis. RESULTS: The mean error found for the mandibular canal length measurements obtained from SSCT was 0.53 mm in the interobserver analysis, and 0.38 mm for both observers. On MDCT images, the mean error was 0.0 mm in the interobserver analysis, and 0.0 and 0.23 mm in the intraobserver analysis. Regarding the distance between the mandibular canal roof and the alveolar bone crest, the SSCT images showed a mean error of 1.16 mm in the interobserver analysis and 0.66 and 0.59 mm in the intraobserver analysis. In the MDCT images, the mean error was 0.72 mm in the interobserver analysis and 0.50 and 0.54 mm in the intraobserver analysis. CONCLUSION: Multislice CT was demonstrated a more accurate method and demonstrated high reproducibility in the analysis of important anatomical landmarks for planning of mandibular dental implants, namely the mandibular canal pathway and alveolar crest height.
Journal of Oral and Maxillofacial Surgery, 2010
Purpose: To investigate the reproducibility of 3 different tracing methods to determine a reliable method to define the proper anatomical position of the mandibular canal based on cone beam computed tomography (CBCT) data. Materials and Methods: Five dentate and 5 edentate patients were selected at random from the CBCT database. Two independent observers traced both the left and the right mandibular canal using 3-dimensional image-based planning software (Procera System NobelGuide; Nobel Biocare, Göteborg, Sweden). All mandibular canals were traced using 3 different methods. Method I was based on coronal views, also known as cross-sections. Panorama-like reconstructions were the starting point for method II. The third method combined methods I and II. Results: With respect to interobserver reliability, no significant difference (P ϭ .34) for the various methods was observed. The reproducibility was better in edentate than in dentate jaws (P ϭ .0015). The difference between 2 tracings was the lowest for the combined method: within a range of 1.3 mm in 95% of the course of the canal. The most obvious deviations were mainly seen in the anterior part of the canal. Conclusions: The best reproducible method for mandibular canal tracing is the combined method III. Between observers, still a mean 95th percentile deviation threshold of 1.3 mm (SD 0.384) is noted, indicating that a safety zone of 1.7 mm should be respected. When planning surgery on CBCT-based data, surgeons should be aware of the obvious deviations located in the region of the anterior loop of the canal.
Anatomy Cone bean computed tomography Bone graft of mandibular body a b s t r a c t Aim: The aim of this study was to determine the reliability of cone beam computed tomo-graphy to locate and take measurements of the mandibular canal, as well as the vestibular bone wall, in the planning of the bone graft surgery in the mandibular body. Material and methods: A total of 11 mandibles from fresh cadavers were studied (22 hemi-mandibles, half of them with teeth). A CBTC and a surgical procedure for the lateralization of the lower dental nerve were performed with the aim of measuring the thickness of the vestibular table and the mandibular canal (MC) or lower dental nerve at 5, 15, and 25 mm from the most posterior position of the mentonian hole. Results: The results obtained in the study indicate that CBTC, being the best diagnostic tool currently available, still appears to be unreliable when compared to actual results. This discrepancy is a mean of 1.15 mm as regards the thickness of the vestibular bone wall that covers the MC, and a mean of 0.3 mm in relation to the thickness of the lower dental nerve. Discussion: It is important to know and assess these discrepancies in view of the multitude of surgical procedures that can be performed in this area, and in the vicinity of the lower dental nerve.Padrós E, et al. Fiabilidad del uso de la tomografía computarizada de haz cónico en la localización y medida del conducto mandibular en la planificación de técnicas quirúrgicas en el cuerpo mandibular. Rev Esp Cir Oral Maxilofac. 2015;37:182-187.
Journal of Clinical and Experimental Dentistry, 2015
Background: This study aimed to assess the diagnostic accuracy of cone beam computed tomography (CBCT) and quantitatively evaluate the morphology of mandibular first molars using CBCT. Material and Methods: Twenty-four double-rooted mandibular first molars were evaluated by NewTom VGi CBCT. The distance from the furcation and apex to the cementoenamel junction (CEJ), diameter and thickness of canal walls, the buccolingual (BL) to mesiodistal (MD) ratio (ΔD), prevalence of oval canals at different sections and taper of the canals were all determined. In order to assess the diagnostic accuracy of CBCT, distance from the furcation and apex to the CEJ and thickness of canal walls at the CEJ and apex were compared with the gold standard values (caliper and stereomicroscope). Statistical analyses were carried out using intraclass correlation coefficient (ICC), paired t-test and repeated measures ANOVA. Results: A high correlation existed between the CBCT and gold standard measurements (P<0.001). In dimensional measurements, length of mesial root was higher than the distal root and lingual furcation was farther from the CEJ than the buccal furcation (P<0.001). An important finding of this study was the mesiodistal taper of the mesiobuccal (MB) and mesiolingual (ML) canals; which was equal to 0.02. Conclusions: CBCT has acceptable diagnostic accuracy for measurement of canal wall thickness. Cleaning and shaping of the canals should be performed based on the unique anatomy of the respective canal; which necessitates the use of advanced imaging techniques for thorough assessment of root canal anatomy in a clinical setting.
Evaluation of Mandibular Incisive Canal using Cone Beam Computed Tomography in Malaysians
Journal of Maxillofacial and Oral Surgery, 2018
Objectives The risk of damaging the mandibular incisive canal (MIC) during surgery in the anterior mandible should not be overlooked. Hence, preoperative radiographic assessment is essential to avoid complications. This study was aimed to estimate the length of the MIC in the interforaminal safe zone, to analyse its course in relation to the lingual and the buccal cortical plates of the mandible using cone beam computed tomography (CBCT) scans and to relate the above findings to age, gender, dental status and Malaysian races. Methods Retrospective analysis of 100 CBCT scans (n = 200) was performed on both sides of the mandible. Cross-sectional and panoramic images were reconstructed. The length of the MIC and the horizontal distances between the MIC and the buccal and the lingual cortical plates were measured at the three different points (starting, mid-, end points). Independent samples t-test and one-way ANOVA test were used to analyse the variation in the length and course of the MIC in gender, age, dental status and Malaysian races. Results The mean length of the MIC was 11.31 ± 2.65 mm, with the Malays having the longest MIC, followed by the Chinese and the Indians (p \ 0.05). The MIC deviated towards the lingual cortical plate, with significance seen in the Indian and the male patients (p \ 0.05). No significant difference was noticed with respect to patient age and dental status. Conclusions Assessment of the MIC should be performed using CBCT on a case-by-case basis as it provides essential information during preoperative planning of surgery in the anterior mandible.
Course and Topographic Relationships of Mandibular Canal: A Cone Beam Computed Tomography Study
The purpose of the present study was to determine the location and configuration of the mandibular canal and related vital structures as a pre-implant assessment using Cone Beam Computed Tomography. Materials and Methods: 141CBCT scans were undertaken by Kodak 9500 ® Cone Beam 3D Systems and the scanning parameters were 90 kV, 10 mA, voxel size 0.2 mm and medium field of view. Results: The course of the mandibular canal reported (61.17%) catenary-like, (28.19%) progressive descent and (10.64%) had a straight pattern. The buccolingual dimension showed that the mandibular canal was located close to the lingual cortical plate (almost 2-3 mm) in the molar region and as it proceeds anteriorly it moves toward the buccal aspect of the mandible to emerge finally through the mental foramen. The vertical dimension showed that the canal was located almost 1 cm above the inferior border of the mandible and then ascended to reach the mental foramen, which is located 15.72mm (range 13.82-18.25 mm) above the inferior border of the mandible. Conclusions: Anatomic variations and lesions affecting the mandibular canal were common findings in the CBCT images of the mandible produced for dental implant planning. An awareness of these alterations is important for dentistry because some of them might require treatment, change oral surgery planning and difficult inferior alveolar nerve anesthetic block.
Folia Morphologica, 2015
Background: The morphometric characteristics of the mandibular canal (MC) may vary according to the characteristics of the population studied. Correct location of the MC is fundamental for the indication and planning of different dental treatments, and it is therefore essential to have clinical parameters indicating its approximate location. The aim of this study was to describe the location and course of the MC by morphometric relations in the mandibular body, from the mental foramen to distal of the first molar, in dentate adult patients. Materials and methods: We analysed 55 cone-beam computed tomography (CBCT) of male and female patients, aged over 18 years and with fully dentate to the first molar. In each CBCT we selected five coronal sections (A-E) of the mandibular body at different levels using the teeth as references. We determined different morphometric measurements in each section to relate the MC with the corticals of the mandibular body (m1, m2, m3, m4), their orientation to lingual (F) and the thickness of the mandibular corticals (B1, B2 and B3). Results: The distance between the MC and the alveolar crests was greater in males than in females in all the sections. In general, in all the hemiarches, the MC courses away from the vestibular cortical of the mandible (and in some cases significantly towards the lingual cortical) from anterior to posterior in the mandibular body. In the left hemiarch of dentate females the MC describes a descent in the molar zone within the mandibular body. Any intervention in the mandible must be carried out with extreme caution to avoid damaging the vasculo-nervous bundle which passes through the MC. Conclusions: Cone-beam computed tomography is the best tool currently available for the planning and execution of surgical procedures, and is the only tool in clinical use which allows the precise course of the MC to be identified.