Mandibular Canal and Its Incisive Branch : A CBCT Study (original) (raw)
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Proximity of the Mandibular Canal to the Tooth Apex
2011
Introduction: Knowledge of the inferior alveolar nerve (IAN) position is important in avoiding nerve damage during invasive dental procedures. Because the exact position of the nerve bundle can vary in patients, this study evaluated the distance from the apices of mandibular premolar and molar teeth to the superior border of the mandibular canal. Methods: Cone-beam computed tomography (CBCT) scans from 139 patients were analyzed to evaluate the proximity of the mandibular canal to the root apices of 743 mandibular second premolar and first and second molar teeth. Subjects were subgrouped by age and sex. A random intercept model was used to account for multiple measurements within a patient. Results: In all groups, root apices of the mandibular second molars were closer to the mandibular canal than other teeth. The mesial root of the second molar was closer to the nerve in female patients compared with male patients. Root apices in younger patients (<18 years) were generally closer to the mandibular canal than in older patients. Conclusions: The CBCT scan is an accurate, noninvasive method to evaluate the position of the mandibular canal. The variable position of this structure between patients suggests the need for CBCT to determine the proximity of the nerve bundle before attempting invasive treatment in this area. Dental practitioners should consider potential differences of mandibular canal position as a result of age and gender when performing these procedures in this area. (J Endod 2011;37:311-315)
2021
Background and Aim: Iatrogenic injuries to inferior alveolar nerve (IAN) are a well known complication of implant placement, osteotomies and other surgical procedures. This study was at attempted to determine the most common position of the mental foramen and to estimate difference in position of mental foramen, occurrence of anterior loop and to evaluate the variation in the location of mandibular canal using cone-beam computed tomography (CBCT) radiographs. Materials & Methods: A total of 205 north Indian subjects were selected during a period of two years. Formerly exposed CBCT images of the selected subjects were studied by ‘iCAT Vision’ and ‘Anatomage’ Software. Measurements from the mandibular canal to the root apices of the first premolar, second premolar, first molar and second molar were obtained. Likewise the distance from the inferior alveolar canal to the buccal cortical plate (BCP) and lingual cortical plates (LCP) were also studied. The estimation of the horizontal and...
Surgical and Radiologic Anatomy, 2018
Purpose This study aimed at identifying the course of the mandibular canal, the presence of anterior loop and accessory mental foramen, as well as verifying the association between these variables through the analysis of cone beam computed tomography (CBCT) exams. Methods CBCT images were analyzed to identify the type of mandibular canal path, classified into three types: (I) catenary; (II) progressive descending; and (III) straight. In addition, the presence of anterior loop and accessory mental foramen was analyzed. The variables were summarized by measures of absolute frequency, relative, mean and standard deviation. The Chi square and Fisher's exact tests were used in the comparative analysis of the frequency distribution. The level of significance was 5%. Results The most frequent mandibular canal course was straight type (74.4%), followed by catenary (19.4%) and finally the progressive descending (6.2%). It was observed a prevalence of 10.2% for anterior loop and 7.9% for accessory mental foramen. There was no association between the presence of anterior loop (P = 0.798) and accessory mental foramen (P 0.480) with the mandibular canal course pattern, as well as no association between the anterior loop and the presence of the accessory mental foramen (P = 0.407). Conclusions The CBCT analysis is the best methodology for the investigation and localization of mandibular anatomical variations, which provides a good image quality of the bone tissue and details of the anatomical structures, reducing the risk of injury to the lower alveolar vascular-nervous bundle and, consequently, cause paralysis and hemorrhage in the anterior region of the mandible and adjacent structures.
Anatomic and radiologic course of the mandibular incisive canal
Surgical and Radiologic Anatomy, 2000
The purpose of this article was to define the anatomic and radiographic courses of the incisive mandibular canal and discuss its clinical significance. The study group comprised of 46 hemimandibles fixed in formalin. After radiographic examination, the buccal cortical plate of the mandible was removed leaving the bony frame of the incisive bundle intact. The morphology of the bony walls of the canal was evaluated, as having complete, partial, or no cortical walls. The course of the intraosseous pathway of the canal and its diameter in four different locations were recorded. An incisive bundle was anatomically found in all hemimandibles, travelling within a canal with complete (n = 10), partial (n = 27), or no (n = 9) bony cortical borders. The diameter of the canal ranged from 0.48 mm to 2.9 mm. Radiographically, the canal was either well defined (n = 11, 24%), poorly defined (n = 15, 32%), or undetectable (n = 20, 44%). A statistically significant correlation was found between the anatomic structure of the incisive canal bony borders and its radiographic detectability (p = 0.043). No correlation was found between the anatomic and radiological width of the incisive canal diameter. An incisive canal with a large diameter could have an important role in successful osteointegration and prevention of postoperative sensory disturbances. According to the present study, the ability to interpret the incisive canal from conventional radiographs is limited. Therefore, it is recommended to use conventional tomographs or computerised tomographic dental scans for better imaging of the intermental foraminal area.
Position and course of the mandibular canal in skulls
Objective. The aim of this study was to examine and describe the topography of the mandibular canal (MC) in both vertical and occlusal dimensions. Study Design. Fifty-two adult skulls deposited in the University of Pittsburgh School of Dental Medicine skull collection were evaluated in this study. Cone-beam computerized tomographic scans of each skull were obtained. Results. The vertical course of MC was classified into 3 types: straight projection (12.2%), catenary-like configuration (51.1%), and progressive descent from posterior to anterior (36.7%). The evaluation of the buccolingual dimension showed that the mandibular canal was located either in contact with or close to the lingual cortical plate (2 mm) in the molar region of the majority of the cases. As it proceeds anteriorly it moves toward the buccal aspect of the mandible, where it finally emerges through the mental foramen. Three emerging patterns of mandibular canal were observed: sharp turn (53.2%), soft curved exit (28.8%), and straight path (17.4%). The examination of 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 16 mm (range 13.4-20.3 mm) above the inferior border of the mandible. We found a strong correlation between height of the mandible and location of the mental foramen (r 0.64; P .0001). Conclusions. The course of mandibular canal described in vertical and axial dimensions and variation in its path have been classified. In addition to variation in location of MC, it has different anatomic configurations which clinicians should be familiar with in any surgical procedures involving the posterior mandible. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:453-458)
Evaluation of Mandibular Incisive Canal with Mental Foramen: A Retrospective Study Using CBCT
Saudi Journal of Oral and Dental Research
Aim and objective: To evaluate the presence, width and the initial part of mandibular incisive canal (MIC) and its relationship with the mental foramen (MF) in 60 CBCT scans for pre-surgical implant planning. Material and methods: In this retrospective analysis, random samples of 60 mandibular CBCT scans were taken to examine the dimension of MIC and its relationship to MF. Result: The location and measurements of the MIC in a contiguous system is measured by 60 CBCT scans. MIC was identified in 71.67 percent of cases with a mean diameter of 2.56mm, i.e. 45% started before MF and 26% began extremely close to foramen. Conclusion: The results from this analysis indicates that the presurgical preparation of the MIC in CBCT should be performed in order to ensure a minimally invasive and optimum location of the implant.
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.
Journal of Babol University of Medical Sciences, 2017
BACKGROUND AND OBJECTIVE: Iatrogenic injury to the inferior alveolar nerve is one of the possible complications in surgical procedures such as implant placement. Considering the anatomic variety in nerve placement, the present study aims to assess the exact position of mandibular canal in the posterior mandibular body using cone beam computed tomography (CBCT). METHODS: CBCT mandible images of 150 patients with mean age of 45 years were used in this cross-sectional study. The cross-sectional profiles of each patient were measured at intervals of 5 mm, starting from 1 mm before mental foramen to the anterior border of the ramus in two age groups, below 50 and above 50. In each profile, the distances from the walls of the mandibular canal to the cranial nerve (CN), inferior nerve (IN), buccal nerve (BN) and lingual nerve (LN) were measured. FINDINGS: 70 men with mean age of 48.91±13.46 years and 80 women with mean age of 41.56±14.41 years participated in this study. The mean distances (mm) on the right and the left were respectively as follows: CN:
Morphometrical analysis of the human mandibular canal: a CT investigation
Surgical and Radiologic Anatomy, 2011
Purpose This study aimed to clarify the correct localization of the mandibular canal (MC) that is essential in order to avoid injuries to the inferior alveolar neurovascular bundle during oral surgical procedures. Methods We have analyzed the position of the MC using computed tomography data bank examinations of the oral region from 50 partially dentulous Brazilian patients aging from 25 to 75 years old (mean ± SD values = 51.70 ± 4.50; females = 27; males = 23) that were obtained with the purpose of dental restoration and without any gross pathology of the mandible. Axial images were 1-mm-thick slices using bone regular algorithm, without intravenous contrast. Results We have measured (mean ± SD) the orthogonal distances between the MC and the following selected regions of the mandible: (a) the buccal cortical plate (6.10 ± 1.52 mm); (b) the inferior border of the mandible (10.55 ± 2.28 mm); (c) the lingual cortical plate (3.98 ± 1.14 mm); and (d) the superior border of the alveolar process (16.98 ± 2.85 mm). Conclusions Our morphometric findings may help clarifying the detailed anatomy of the MC and its topographical relations for the planning of dental implantation.
Clinical implant dentistry and related research, 2018
Anterior loop of the mental nerve is a very important anatomic landmark in implant placement and anterior mandibular osteotomies. Two-dimensional imaging techniques are not competent enough to locate and measure the mental nerve loop in majority of the cases. Any injury to this loop results in pain/paresthesia/numbness in the region supplied by the mental nerve. The aim of this study is to analyze the prevalence and measure the length of the loop using cone beam computerized tomography (CBCT) and calculate the average length and prevalence so that a safe margin can be given while placing the implants or the osteotomy cuts in the premolar region. A cross-sectional study was done using CBCT images of 85 patients taken for impaction surgery. The length of the loop was measured in mm using standardized lines drawn along specific anatomic landmarks. In our study 11.76% of patients had anterior loop in their mental nerve. Mean length of the mental nerve loop was calculated and found to be...