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Purpose: The aim of this retrospective study is to determine the radiological features of keratocystic odontogenic tumors (KCOT) using cone-beam computed tomography (CBCT).Materials and Methods: CBCT images of 28 patients who had histopathologically-confirmed KCOT were retrospectively reviewed from the archives of the Department of Dentomaxillofacial Radiology, Gazi University Faculty of Dentistry. The location and size of KCOT, cortical expansion, cortical perforation, relation with the impacted teeth, and the impact on the mandibular canal were evaluated. Results: The mean age of patients at initial diagnosis was 34.5 years. Patients with an impacted tooth were significantly younger than those without an impacted tooth (p

Background: The routine oral and maxillofacial procedure involving the surgical removal of impacted mandibular third molars comes with inherent risks to nearby anatomical structures. Proximity of mandibular third molar roots to the inferior alveolar nerve (IAN) poses a significant risk for injury, prompting the need for reliable assessment methods. Radiographic indicators, particularly those observed on intraoral periapical radiographs (IOPARs), offer a dependable means to evaluate proximity., Objectives: This study seeks to examine the closeness between the mandibular canal and the roots of mandibular third molars using IOPARs and to assess the incidence of postoperative neurosensory disorders., Methods: A cohort of 100 subjects aged 18 to 25, presenting for partially erupted/ impacted mandibular third molar removal, underwent IOPAR examinations. Data analysis employed IBM SPSS Statistics for Windows, Version 12 (Released 2004; IBM Corp., Armonk, New York, United States), calculating frequencies, percentages, means, standard deviations, and ranges. Radiographic signs of proximity were evaluated, and a standardized surgical procedure was performed under local anesthesia. Postoperative neurosensory disorders were assessed using various methods., Results: Of the evaluated subjects, darkening of the root (52%) was the most prevalent radiographic sign, followed by interruption of the white line of the canal (20%). The prevalence of radiographic signs varied, with none of the patients experiencing narrowing of the root. Postsurgical paraesthesia assessment revealed no nerve sensitivity alterations in any patient., Conclusion: Preoperative radiographic examination is imperative for determining the relationship between mandibular third molar roots and the inferior alveolar canal, aiding in preventing IAN damage during extraction. Contrary to radiographic signs, there was no observed association between impacted mandibular third molar radiographic signs and the occurrence of postoperative neurosensory disorders., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Nayak et al.)

Context: Relation of inferior alveolar nerve to the impacted mandibular third molars (IMTMs). Aims: The aim of this study was to assess the reliability of seven specific radiographic signs of mandibular third molar root that are observed on orthopantomography (OPG) and to predict the proximity and the absence of corticalization between the mandibular canal and IMTM root on cone-beam computed tomography (CBCT) images. Settings and Design: The present study was conducted in the Department of Oral and Maxillofacial Surgery, Raja Rajeswari Dental College and Hospital. Subjects and Methods: Data set of 30 panoramic images was retrieved between the year of 2015 and 2016 indicated for extraction of lower third molars. The sample consisted of 30 individuals, who underwent preoperative radiographic evaluation before the extraction of impacted mandibular third molars (IMTM). Patients aged above 18 years with any of the seven specific signs observed on the panoramic radiograph which includes darkening, deflection, narrowing of roots, bifid root apex, diversion, narrowing of canal and interruption in the white line of the canal were included in the study. If any of the above mentioned seven specific sign were present, the patient was subjected to CBCT. On the CBCT images, the canal was traced in three planes. The acquired images were assessed for the presence or absence of corticalization. Statistical Analysis Used: Descriptive and inferential statistical analyses were used. Proportions were compared using the Chi-square test and Student's t-test. Results: Among the 4 subjects, diagnosed with an absence of corticalization, patients with isolated darkening of root P = 0.001 and patients with isolated interruption in white line P = 0.69. Patients with darkening of root in association with interruption in white lines on OPG showed the absence of corticalization on CBCT findings P = 0.001, respectively. Conclusions: This study showed the poor reliability of radiographic signs seen on OPG on predicting the proximity of third mandibular root with mandibular canal related to CBCT finding. Four were diagnosed with the absence of corticalization in CBCT findings. [ABSTRACT FROM AUTHOR]

Aims: To determine the real not radio graphical proximity of mandibular third molar tooth to the inferior dental canal (IDC) using panoramic radiograph. Materials and Methods: 144 mandibular third molars were evaluated by panoramic radiography. The teeth were grouped into erupted vs. un erupted further subdivided by tooth angulations. The real distance from the most inferior aspect of the mandibular third molar tooth to the superior border of the inferior alveolar canal (IAC) was calculated regarding to the reference object used. Descriptive statistics were performed as well as a t test was performed to compare erupted and unerupted teeth, and ANOVA was used to determine a significant difference where exists based upon tooth angulations. In addition, intra observer analysis was done to ensure the standardization of the radiologist interpretation. Results: The mean distance from erupted mandibular third molar teeth to the inferior alveolar canal was 0.23mm. This distance was significantly different from unerupted teeth (P = .000). The mean values for unerupted teeth were negative values which indicated that the apices of all teeth measured was below the superior border of the canal –1.26 mm and as follows: Mesioangular–1.32 mm, vertical – 1.34 mm and –1.04mm for horizontal impactions. Statistically there was no significant positional difference between the impaction groups (P = .835). In general there was a significant difference in third molar position between those age equal and less than 22 years old and those equal and over 23 years old. Conclusions: Unerupted mandibular third molar teeth (mostly vertical impaction) are closer to the inferior alveolar canal than erupted teeth and persons in general of an age equal or less than 23 years old have a closer lower third molar to mandibular canal than other ages and there is no significant relation between this age group and any of impaction types.

Introduction: The knowledge of the precise location of anatomical landmarks such as mandibular foramen, Inferior Alveolar Canal (IAC), mental foramen and the course of the inferior alveolar neurovascular bundle is mandatory to obtain the desired outcome of different mandibular surgical procedures and overcome various surgical complications. Aim: To document a clinically relevant position of the Inferior Alveolar Nerve (IAN) in completely dentate patients, to identify the linear relationship of the IAC to the buccal and lingual cortex (BCP/LCP) of the mandible and to the peri apex of the teeth as well as to assess the presence and course of the anterior loop in the mental foramen region according to the gender and side, using Cone Beam Computerised Tomography (CBCT). Materials and Methods: This cross-sectional study utilised 378 CBCT images from 232 patients (one patient may has images of both side of mandible which are counted as two separate images) to obtain quantifiable data to localise the IAC. Measurements to the IAC were made from the BCP and LCP and the root apices of the mandibular premolars and molars. Results: In 15 subjects, 18 Accessory Mental Foramina (AMF) were detected. Anterior loop in the mental region was detected in 91% of the scans. The IAC was noted to be closest to the buccal cortical plate in the region of premolars on both sides. The distance between the lingual outer cortex to outer surface of the IAC along lingual side, distance between buccal outer cortex to outer surface of the IAC along buccal side, distance between the peri apex to the superior surface of IAC were recorded to assess accurately the position of the IAN within the IAC. Conclusion: CBCT may be utilised to meet the increasing demand for accurate preoperative assessment and planning prior to surgeries of the maxillofacial region by obtaining information on the appearance, location and course of the IAC and its relation to other anatomical structures in the mandible.

Stafne bone defect is a bone depression containing salivary gland or fatty soft tissue on the lingual surface of the mandible. The most common location is within the submandibular gland fossa and often close to the inferior border of the mandible. This defect is asymptomatic and generally discovered only incidentally during radiographic examination of the area. Stafne bone defect appears as a well-defined, corticated, unilocular radiolucency below the mandibular canal. Although it is not uncommon for this defect to appear as a round or ovoid radiolucency, it is rarely seen as a multilocular radiolucency. This report presents a case of a developmental salivary gland defect with multilocular radiolucency above the inferior alveolar canal in a male patient

Background/purpose: Various imaging modalities have been used by clinicians in the preoperative assessment of the third molar position. The purpose of this study is to investigate the diagnostic accuracy of orthopantomography (OPG) markers in determining the anatomical relation between the mandibular third molar and the mandibular canal by comparison using cone beam computed tomography (CBCT). Materials and methods: Ninety patients' panoramic and CBCT images were chosen for the study. From these, 180 teeth were studied by four trained examiners. The frequency of angulation, Monaco classification, spatial relation, and cortical perforation were detected. The values were then compared using a Chi-square test for both of the imaging modalities. Results: On OPG, 17.9% superimposition, 22.4% narrowing, 18.4% increased radiolucency, 28.3% interruption, and 13% diversion/deviation were recorded. On CBCT images, 57.8% of the molars were in a direct relation with the inferior alveolar canal and 42.2% had no relation. The statistically significant predictive values of positive test results are narrowing of the canal (72%), and interruption of the radiopaque border with the ratio (77.7%). Of the third molars in a direct relation with the canal, narrowing was recorded in 72% and interruption was recorded in 77.8% of cases with statistical significance. Conclusion: The presence of narrowing of the canal and interruption of the radiopaque border as radiographic markers on OPG predict contact between the lower third molar and inferior alveolar canal. Detailed radiological examination on CBCT is recommended in such cases.

Introduction: The inferior alveolar canal is described as a dark linear shadow with thin radiopaque superior and inferior borders cast by the lamella of bone. Conventionally, preoperative assessment is performed by orthopantomogram (OPG). Spiral computed tomography (CT), allows the clinician to localize and determine the relation of the impacted tooth and the inferior alveolar neurovascular canal (IANC) in three dimensions. Objectives: To describe the anatomical and morphologic variation of IANC as it appears in digital OPG and to correlate its relation with IANC on the CT. Materials and Methods: 100 patients were subjected to OPG and were studied for anatomic and morphologic variation. Eleven patients with mandibular impacted third molar in close proximity to the IANC were further subjected to CT examination. Results: Linear type was the commonest on the left side (39.5% in females and 41.9% in males) and elliptical type on the right side (52.6% in females and 45.2% in males). Morphologic variation showed bifid canal present in only 1 (1.6%) male on the left side. On the left side, narrowing of canal was seen in 4 (100%) teeth on OPG, in which 3 (75%) teeth showed 0 mm with cortical break in the CT. Three (100%) teeth showing interruption of white line (superior radiopaque border of IANC) on the OPG also showed 0 mm with cortical break in the CT. On the right side, 2 (100%) teeth showing narrowing of canal on the OPG correlated with 0 mm with cortical break in the CT and 1 (100%) tooth showed interruption of white line which correlated with 0 mm with cortical break in the CT. Conclusion: The comparison between the OPG patients and the CT patients (selected using the Roods criteria from the OPG patients) showed statistically significant value for narrowing of canal and interruption of white line with 0 mm loss of cortication in CT.

Objectives: The aim of the study was to evaluate the proximity of the mandibular third molar (M3) and the inferior alveolar canal (IAC) in a panoramic radiograph of 20-year-old subjects. The specific aim was to assess differences in this proximity over time.Materials and methods: Two similar samples of panoramic radiographs taken in a routine oral health examination with 20-year time interval were examined retrospectively and images with both mandibular M3s were included. The material consisted of 300 subjects (25% men, mean age 20.5 ± 0.6 years). The radiographic relationship between the mandibular M3 root and the IAC was assessed as follows: the M3 root was either apart from, tangential to, superimposed with, or inferior to the IAC. Differences between frequencies were tested using the chi-squared test.Results: In the combined samples, only 16% of the M3s located apart from the IAC, 15% located tangential to, 61% superimposed with, and 8% inferior to the IAC. The proportion of the intimate locations had increased during the 20-year time interval from 79 to 88% (P < 0.01) and especially in females (P < 0.05).Conclusion: The vast majority of the mandibular M3s situated very close to the mandibular canal.Clinical relevance: Our results suggest that in the cohort of 20-year-old non-extraction subjects, most of the M3s are possibly at risk for inferior alveolar nerve injury at removal, as judged from the panoramic radiograph, and also the number of such teeth has increased over the 20-year period. [ABSTRACT FROM AUTHOR]

Context: Choosing an imaging source, which provides minimum radiation exposure to the patient, to facilitate surgical removal of impacted mandibular third molars (MTMs), thereby avoiding unwanted neurological complications. Aim: The aim of the study was to assess the efficacy of digital volume tomography (DVT) in evaluating the position of inferior alveolar canal (IAC) in relation to impacted MTMs and comparing it with conventional radiography (CR) in a subset of the Indian population. Materials and Methods: Four experienced observers assessed two groups: 33 DVT and 33 CR images, for the position of root-tips of impacted MTM in the proximity to IAC, in both vertical and horizontal planes. The diagnostic information was compared in both the groups. Statistical Analysis: Chi-square test, Mann--Whitney U-test, and Kappa statistics were used. Results: Comparison between DVT and CR revealed no statistically significant variation in assessing relationship in the vertical plane. There was, however, a significant difference between the groups, while comparing the diagnostic information for the horizontal dimension, for both the mesial and the distal roots, with an advantage for DVT (P < 0.05 for both mesial and distal roots). Conclusion: DVT is highly accurate in predicting neurovascular bundle exposure. It is indispensable for preoperative evaluation of impacted MTM. [ABSTRACT FROM AUTHOR]

A retrospective cohort study was performed to assess the clinical usefulness of combination assessment using computed tomography (CT) images in patients undergoing third molar extraction. This study included 85 patients (124 extraction sites). The relationship between cortication status, buccolingual position, and shape of the inferior alveolar canal (IAC) on CT images and the incidence of inferior alveolar nerve (IAN) injury after third molar extraction was evaluated. IAN injury was observed at eight of the 124 sites (6.5%), and in five of 19 sites (26.3%) in which cortication was absent + the IAC had a lingual position + the IAC had a dumbbell shape. Significant relationships were found between IAN injury and the three IAC factors (cortication status, IAC position, and IAC shape; P = 0.0001). In patients with the three IAC factors, logistic regression analysis indicated a strong association between these factors and IAN injury ( P = 0.007). An absence of cortication, a lingually positioned IAC, and a dumbbell-shaped IAC are considered to indicate a high risk of IAN injury according to the logistic regression analysis ( P = 0.007). These results suggest that a combined assessment of these three IAC factors could be useful for the improved prediction of IAN injury. [ABSTRACT FROM AUTHOR]

Purpose The aim of this in vitro study was to investigate temperature increases in the inferior alveolar canal (IAC), when different bone preparation methods approximate and penetrate the IAC. Materials and methods In pig mandible, buccal bone removals were performed until the neurovascular bundle became visible. Temperatures were registered with thermocouple probes and with infrared thermometer. Preparations were performed with diamond drills (DD), tungsten carbide drills (TCD), piezoelectric diamond sphere (PT_D) and saw (PT_S) tips, and a combined preparation method was also performed whereby the superficial three-fourths of the bone was removed with TCD and the deepest one-fourth of the bone with PT_D (TCD + PT_D_7 °C) or PT_S (TCD + PT_S_7 °C), using cooled irrigation (7 °C). Results Preparations using room temperature irrigation caused significantly less heat on the bone surface than in the IAC. Piezosurgery in the IAC produced significantly higher temperatures (>13 °C) than the drills (<4 °C). Heat productions of the piezoelectric tips were reduced significantly by applying the combined bone removal methods. The speed of PT_S and TCD + PT_S_7 °C were comparable to the speed of TCD, whereas TCD + PT_D_7 °C was found to be significantly slower. Conclusion The speed of piezosurgery is comparable to that of the drills; however, it produces the highest, potentially nerve-harming temperatures. To eliminate the heat consequences during piezosurgery in the IAC, the use of cooled irrigation at 7 °C and predrilling is recommended. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the proximity and relation of impacted mandibular third molar and inferior alveolar canal on orthopantomogram and cone beam computed tomography (CBCT). Sixty impacted mandibular third molars having close proximity with the inferior alveolar canal were included. CBCT images were done to determine the exact location and relationship of impacted third molar tooth and inferior alveolar canal. We assessed the radiographic signs from orthopantomogram, the course of inferior alveolar canal and proximity to the third molar tooth in CBCT. The buccal course of inferior alveolar canal was most frequently detected (n=36) in CBCT findings. The impacted lower third molar roots were 55% contact with the inferior alveolar canal and 45% separate from the canal. On orthopantomogram, the following signs were strongly correlated with actual contact: Superimposed relationship between the third molar and the inferior alveolar canal. CBCT is useful as a presurgical planning in patients with impacted mandibular third molar showing close proximity to the inferior alveolar canal.

Mandibular canal is the most important anatomical landmark in the body of mandible which always must be considered for implant surgery in posterior mandibular region. Damage to vessels and inferior alveolar nerve that passes through the mandibular canal can cause problems such as hemorrhage and neurosensory disturbances. Damage to the mandibular canal can occur during implant surgery. Depending on the severity of injuries, it would result in temporary or permanent neurosensory disturbances. We have reported a case that mandibular canal narrowing occurred following implant surgery and resulted in anesthetic and hypoesthetic areas in the lower lip. Patient had a history of implant surgery in the region of teeth numbered 30 and numbered 31. The inserted implant failed after 6 years, and reimplantation was done in this area, but due to lower lip numbness in the right side, the second implant was removed, and another implant was inserted in the region of the tooth numbered 32. After 2 years, right lower lip numbness was reported again by the patient. Cone beam computed tomography images showed canal narrowing in the region of the tooth numbered 31 where the second implant was inserted. It seems that the main cause for anesthesia and hypoesthesia in this patient is canal narrowing due to damage during implant replacement and removal.

Aim: A thorough understanding of root and canal anatomical variations is essential for achieving successful endodontic treatment. Literature continues to demonstrate complex root and canal anatomical variations in mandibular third molars which are sometimes in close approximation to the inferior alveolar canal. Methodology: A 26-year-old male patient was referred for endodontic treatment of a three-rooted mandibular third molar with a dilacerated distal root and close approximation to the inferior alveolar canal. A cone beam computed tomography was performed to assess the root and canal anatomical variations together with the inferior alveolar canal. Conventional endodontic treatment was performed using a rotary nickel-titanium file system, and the canals were then obturated using a cold lateral condensation technique. Results: The endodontic treatment procedures were performed successfully and in the follow-up visit, the tooth was asymptomatic. Conclusions: Despite limited accessibility and challenges during root canal treatment procedures, retaining every functional component of the dental arch, including mandibular third molars, is an essential goal of contemporary dental practice. [ABSTRACT FROM AUTHOR]

Objectives To determine the position of mental foramen (MF) and frequency of anterior loop (AL) using dental cone beam computed tomography (CBCT). Materials and methods The study involved the evaluation of 302 CBCT scans (196 males, 106 females). The position of MF was determined with respect to adjacent teeth, nearest root apex of adjacent teeth and mandibular borders. MF position was also assessed based on gender and age. In addition, prevalence of anterior loop was evaluated by categorizing the inferior alveolar canal (IAC) patterns into linear, perpendicular and anterior looping. Results The study revealed that the most common position of MF was below the apex of 2nd premolar accounting for a total of 52.8% of scans whereas, only 29.6% observed MF between 1st and 2nd premolar ( p > 0.05). 38.7% of MF were located at a distance of 1–3 mm from the nearest root apex (2nd premolar), followed by a distance of less than 1 mm in 17.05 of cases. 63.2% of foramen on left side of the mandible were observed below the apex of 2nd premolar in females ( p = 0.023). Statistically significant findings were observed with regards to position of MF in different age groups ( p < 0.05). The most common IAC pattern observed was linear in nature which accounted for 46.2% of cases followed by perpendicular pattern (38.6%). AL was found only in 15.2% of cases. Conclusions Our sample population most commonly exhibited MF below the apex of 2nd premolar with linear IAC pattern. AL was regarded as the least common pattern in Saudi population. [ABSTRACT FROM AUTHOR]

Context: Better understanding of the anatomical location and course of the mandibular canal is necessary to avoid damaging inferior alveolar nerve. Aims: The aim of this study was to investigate the buccolingual course of the inferior alveolar canal (IAC) in different mental foramen locations, using cone beam computed tomography. Materials and Methods: Three hundred and twelve hemimandibular images were evaluated in this study. The location of mental foramen in relation to the apices of mandibular premolar and molar teeth were recorded. Nine measurements (in millimeters) were taken at the level of the IAC and posterior mandibular premolar and molar root apices. Relative distances of IAC to buccal and lingual mandibular cortex were calculated for different mental foramen types. Statistical Analysis Used: Data were analyzed by one-way analysis of variance and P < 0.05 was considered to be statistically significant. Results: The distribution of subjects according to the type of mental foramen includes: Type 1 = 50.3% (at the level of second premolar apex), Type 2 = 33% (between the apices of first and second premolars), and Type 3 = 16.7% (between the apices of second premolars and first molars). The buccolingual ratio of the IAC position was statistically significant in different mental foramen types (P = 0.00). Conclusion: The position of IAC was affected by the location of the mental foramen. The direction of IAC gradually changed from lingual to buccal and from posterior to anterior. [ABSTRACT FROM AUTHOR]

Introducción: Las lesiones iatrogénicas del nervio dentario inferior son complicaciones documentadas de diversos procedimientos quirúrgicos en la mandíbula. Debido a ello se justifica una descripción más detallada con referencias morfométricas de dicho conducto, como así también una correlación con imágenes. Materiales y métodos: Se realizó un estudio descriptivo observacional con una muestra de 44 hemimandíbulas secas y 100 tomografías computadas de mandíbulas de pacientes al azar. Se realizaron mediciones del foramen mandibular y mentoniano con respecto a bordes mandibulares. Se hicieron cortes en la rama y el cuerpo con sus respectivas mediciones. Se utilizaron Tomografías Computadas Cone Beam 3D de 100 pacientes las cuales fueron procesadas por el programa Compudent Navigator 3D®. Utilizando este programa se pudieron realizar las mismas mediciones que en los preparados anatómicos, como así también la reconstrucción del conducto. En una segunda etapa se realizó una correlación entre los valores morfométricos del estudio anatómico y se comparó con los estudios por imágenes (TC con reconstrucción 3D Dental Scan). Resultados: Se expresaron en tablas con diversas variables. Discusión: Los textos clásicos de anatomía y los libros de cirugía de la especialidad describen en detalle el recorrido y las relaciones del CAI, y presentan datos morfométricos pero no lo hacen en poblaciones locales. Como conclusión podemos afirmar que, tomando como punto de partida la anatomía y correlacionándola con la imagenologia, podemos llegar a evitar lesiones del nervio alveolar inferior en el transcurso de diversos procedimientos realizados en la mandíbula. Introduction: Iatrogenic inferior alveolar nerve injuries are documented complications of different surgical procedures in the jaw. It should justify a more detailed description with morphometric references of the duct and a correlation with images. Materials and method: A descriptive observational study with a sample of 44 dry hemijaws and 100 CT scans of patients. Measur-ements of the mandibular foramen and mental foramen with respect to jaw edges were made. Cuts in the branch and body were made with their respective measurements. Cone Beam Computed Tomography 3D (CBCT 3D) of 100 patients were processed by the Compudent Navigator 3D® program. The use of this program permited the same measurements done in the cadaveric jaws and the reconstruction of the duct. In a second stage we performed a correlation between the anatomic morphometric values compared with imaging studies (CT Dental Scan with 3D reconstruction) Results: They were shown in tables with different variables. Discussion: The classic texts of Anatomy and surgery books describe in detail the pathway and relations of the duct, and present morphometric data but not in local population. We may conclude that it is possible to avoid injuries of the inferior alveolar nerve during jaw surgery by considering the anatomy and its correlation with images.

INTRODUCCIÓN: los procedimientos quirúrgicos que se realizan en la mandíbula requieren conocimiento detallado de la posición y trayectoria del conducto alveolar inferior (CAI) que contiene en su interior al nervio alveolar inferior (NAI).La tomografía volumétrica computarizada (TCCB) es un medio diagnóstico subutilizado en nuestro medio principalmente por los costos, sin embargo es un medio sensible y preciso para la evaluación del CAI por encima de otros medios diagnósticos. MÉTODOS: se evaluaron 50 tomografías volumétricas computarizadas de última generación con tecnología Cone Beam (TCCB) de las mandíbulas de pacientes mayores de dieciocho años, con premolares y molares mandibulares en boca, sin anomalías evidentes de los maxilares, patologías mandibulares y patologías que comprometieran la calidad ósea, se realizaron cortes transeccionales e imágenes panorámicas. RESULTADOS: el promedio de distancia del CAI a la cresta alveolar fue 17,9 mm en mujeres y 19,8 en hombres, hacia la tabla vestibular el promedio fue 3,8 mm para ambos sexos; hacia la tabla lingual de 3,2 mm en mujeres y en hombres de 2,8; el promedio del CAI al borde basilar fue 6,5 mm para mujeres y 6,2 en hombres y del borde anterior de rama al foramen mandibular el promedio fue 12,3 mm para mujeres y 13,2 en hombres. CONCLUSIONES: la TCCB es una ayuda diagnóstica altamente sensible para la ubicación de la posición y trayectoria del CAI, no hubo diferencias significativas en cuanto a edad y lados, de las medidas tomadas en los tres sectores del cuerpo mandibular.INTRODUCTION: surgical procedures involving the mandible require a deep understanding of the position and course of the inferior alveolar conduct (IAC) that encloses the inferior alveolar nerve. Computerized volumetric tomography (CVT) is an under used diagnostic tool in our context, mostly because of the costs it compels, nevertheless it´s a sensitive and precise method for the evaluation of IAC above other diagnostic current tools. METHODS: 50 last generation computerized volumetric tomographies, using Cone Beam technology, were evaluated in 18 years old patients or older, with premolars and molars present, without any evident maxillary anomalies, mandibular pathology or alteration that decrease bone quality. Panoramic and transectional cuts were performed. RESULTS: the average distance from IAC to alveolar crest was 17.9 mm for women and 19.8 mm for men. The average distance from IAC to the vestibular plate was 3.8 mm for both genders towards the lingual plate, the distances from IAC was 3,2mm for women and 2.8 mm for men. The average distance from basilar border to IAC was 6.5 mm for women and 6.2 mm for men. From the mandibular foramen to anterior border of mandibular ramus, the average distance for men was 13.2 mm and 12.3 mm for women. CONCLUSIONS: CVT is a highly sensitive diagnostic tool for the assessment of IAC position and course. There were no differences regarding age or between both sides of the mandible among the three measured points on the mandibular body.

Objectives: The position of the inferior alveolar canal (IAC) and its course in the mandible is crucial to prevent complications in oral surgical procedures. Therefore, the present study aims to predict the course of IAC using landmarks specific to the mandible and to correlate with cone-beam computed tomography images., Methods: On the included panoramic radiographs (n=529), the closest point of the IAC to the inferior border of the mandible (Q) was determined, and the distances of this point to the mental (Mef) and mandibular foramen (Maf) were measured in millimeters. To determine the buccolingual course of the IAC on CBCT images (n=529), the distances from the center of the canal to the buccal and lingual cortices and between the cortices were measured at the level of the root apices of the first and second premolars and molars. Also, the positions of the Mef to adjacent premolars and molars were classified., Results: The most common position of mental foramen was Type-3 (37.1%). On the coronal plane, it was also observed that as the Q point approaches the Mef, the IAC is located in the mandible's center at the second premolar level (p=0.008) and moves away from the midline at the level of the first molar (p=0.007)., Conclusion: Based on the results, a correlation was observed between the horizontal course of the IAC and its proximity to the inferior border of the mandible. Therefore, the curvature of the IAC and its proximity to the mental foramen should be considered in oral surgeries., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The aim of this study was to use cone-beam computerized tomography (CBCT) images of patients to assess the prevalence of different types, especially anterior loop, of the mental portion of the inferior alveolar canal and to evaluate the anterior loop lengths. CBCT images of 494 patients providing inclusion criteria were examined by 2 oral radiologists. Sagittal, axial, and multiplanar reformatted images were used to detect the type of mental portion of the inferior alveolar canal. The anterior loop length was measured in the respective sections of each CBCT image. Statistical analysis was performed using SPSS v. 15, and t tests were used for statistical analysis. Of the 494 patients, 217 anterior loops were detected in 141 (28.5%) patients. The mean anterior loop lengths for the right side and the left side were 2.19 ± 1 mm and 2.08 ± 0.89 mm, respectively. The difference between males and females in the mean anterior loop length was statistically significant for both sides (Right: P < .05; Left: P < .05). A presurgical CBCT image examination is necessary prior to implant insertion to reveal the presence of anterior loop and to detect actual anterior loop length. [ABSTRACT FROM AUTHOR]

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Introduction: Iatrogenic inferior alveolar nerve injuries are documented complications of different surgical procedures in the jaw. It should justify a more detailed description with morphometric references of the duct and a correlation with images. Materials and method: A descriptive observational study with a sample of 44 dry hemijaws and 100 CT scans of patients. Measur-ements of the mandibular foramen and mental foramen with respect to jaw edges were made. Cuts in the branch and body were made with their respective measurements. Cone Beam Computed Tomography 3D (CBCT 3D) of 100 patients were processed by the Compudent Navigator 3D® program. The use of this program permited the same measurements done in the cadaveric jaws and the reconstruction of the duct. In a second stage we performed a correlation between the anatomic morphometric values compared with imaging studies (CT Dental Scan with 3D reconstruction) Results: They were shown in tables with different variables. Discussion: The classic texts of Anatomy and surgery books describe in detail the pathway and relations of the duct, and present morphometric data but not in local population. We may conclude that it is possible to avoid injuries of the inferior alveolar nerve during jaw surgery by considering the anatomy and its correlation with images. [ABSTRACT FROM AUTHOR]

Stafne bone defect is a bone depression containing salivary gland or fatty soft tissue on the lingual surface of the mandible. The most common location is within the submandibular gland fossa and often close to the inferior border of the mandible. This defect is asymptomatic and generally discovered only incidentally during radiographic examination of the area. Stafne bone defect appears as a well-defined, corticated, unilocular radiolucency below the mandibular canal. Although it is not uncommon for this defect to appear as a round or ovoid radiolucency, it is rarely seen as a multilocular radiolucency. This report presents a case of a developmental salivary gland defect with multilocular radiolucency above the inferior alveolar canal in a male patient. [ABSTRACT FROM AUTHOR]

Purpose : The aim was to correlate the level of the inferior alveolar canal on cadaver specimens and as evaluated with three-dimensional radiographic cone-beam computed tomography (CBCT) imaging. Methods: Twenty-one skulls with intact mandibles (42 inferior alveolar canals) were imaged with an I-CAT Cone-Beam 3D Imaging System and multi-planar reformatted images obtained were scored to assess the level of the canal (Level I, Level II, and Level III). The mandibles were later dissected and level of the canal was directly visualized, scored, and further correlated with results from CBCT imaging. Results: There was no difference in the level of the inferior alveolar canal between the dissected cadaver specimen and CBCT images. Also, there was no statistically significant difference in the level of the canal among the gender assigned to the specimens and corresponding CBCT images. There were no statistical differences in the level of the canal (cadaver specimen vs. CBCT) between the left and right sides of the specimens, as studied individually. Conclusion: Our study indicates that there is close correlation of the level of the inferior alveolar canal between cadaver specimens and CBCT images. Well-designed studies would be required to further validate the findings in this study. [ABSTRACT FROM AUTHOR]

Background/purpose: Various imaging modalities have been used by clinicians in the preoperative assessment of the third molar position. The purpose of this study is to investigate the diagnostic accuracy of orthopantomography (OPG) markers in determining the anatomical relation between the mandibular third molar and the mandibular canal by comparison using cone beam computed tomography (CBCT). Materials and methods: Ninety patients' panoramic and CBCT images were chosen for the study. From these, 180 teeth were studied by four trained examiners. The frequency of angulation, Monaco classification, spatial relation, and cortical perforation were detected. The values were then compared using a Chi-square test for both of the imaging modalities. Results: On OPG, 17.9% superimposition, 22.4% narrowing, 18.4% increased radiolucency, 28.3% interruption, and 13% diversion/deviation were recorded. On CBCT images, 57.8% of the molars were in a direct relation with the inferior alveolar canal and 42.2% had no relation. The statistically significant predictive values of positive test results are narrowing of the canal (72%), and interruption of the radiopaque border with the ratio (77.7%). Of the third molars in a direct relation with the canal, narrowing was recorded in 72% and interruption was recorded in 77.8% of cases with statistical significance. Conclusion: The presence of narrowing of the canal and interruption of the radiopaque border as radiographic markers on OPG predict contact between the lower third molar and inferior alveolar canal. Detailed radiological examination on CBCT is recommended in such cases. [ABSTRACT FROM AUTHOR]

Background and Objective: Cone beam computed tomography (CBCT) has made considerable improvements in maxillofacial imaging. Estimating canal location is one of its applications. The aim of this study is to evaluate whether differences in patient gender or age are predictive of differences in the relative location of the inferior alveolar canal. Subjects and Methods: Existing CBCT images، acquired by the Promax 3D (Planmeca Finland)، taken from the maxillofacial region from 120 dentate patients (46.7% male،53.3% female ، mean age 42.1%)( who visited a private clinic in Ahvaz were selected and processed by Romexis viewer software. Sixteen measurements (in mm) were taken at the level of the IAN and mesial and distal root apices. Anatomic measurements were made by 2 observers. Data were analyzed by Pearson correlation and t-test. Results: The distance from the most lingual aspect of the root to the lingual cortical plate 3 mm coronal to the apex، were less in females in mesial and distal roots of second molar ( P<0.05). None of the other variables were associated with sex or age. Conclusions: Collectively، these data indicate that relative positions of IAN changes are not dependent on gender or age. Application of CBCT imaging in presurgical planning is recommended. [ABSTRACT FROM AUTHOR]

The purpose of this study was to review the current literature for the relationship between the preoperative position of the mandibular canal on three-dimensional (3D) radiographic imaging and postoperative neurosensory disturbance (NSD) following a sagittal split ramus osteotomy (SSRO). A literature search was conducted using PubMed, EMBASE, and the Cochrane Database for articles published from 1 January 2000 through 31 December 2013. Studies that included preoperative 3D imaging and assessment of NSD after surgery were reviewed. Study sample characteristics and results were extracted. Of the 69 articles identified, seven met the inclusion and exclusion criteria. There was no standardization for measuring the canal position or for evaluating NSD. General consensus was that the less space between the mandibular canal and the outer border of the buccal cortex the more frequent the occurrence of NSD. Increased bone density also appeared to contribute to a higher incidence of NSD. Utilization of 3D images to locate and measure the position of the mandibular canal is not standardized. Advances in 3D imaging and evaluation tools allow for new methodologies to be developed. Early attempts are informative, but additional studies are needed to verify the relationship between the location of the nerve and NSD following surgery. [ABSTRACT FROM AUTHOR]

Purpose: Assessment of location of vital anatomic structures is required while enterprising quality dental care. In this study, an assessment of the location of inferior alveolar canal (IAC) and mental foramen (MF) in the mandible was done by using computed tomography (CT). An attempt was done to compare the variation in the location in various age groups. Materials and Methods: The mean location of the IAC and MF from the alveolar crest was done on 30 patients by using cross-sectional CT. A comparison of the mean distance in the three age groups was done by using ANOVA. Results: The mean distance of the superior border of the IAC upto the alveolar crest of the mandibular second premolar was at 12.56 on the right side and 12.65 on the left side. The mean distance of mandibular first molar was up to about 12.29 mm on the right side and 12.71 on the left side. Mandibular second molar showed the mean distance of 11.97 mm on the right side and 11.94 mm on the left side. The mean distance of the superior border of the MF upto the alveolar crest was at 11.99 mm on the right side and 12.20 mm on the left side. A comparison between the three age groups showed a statistical difference (P < 0.05). Conclusion: Assessment of vital anatomic structures for its presence and distribution is important in the preoperative planning of dental implants so as to avoid bleeding due to damage of vessels within the jaw. The mean distance of the IAC with respect to the alveolar crest was decreasing as it was moving posteriorly. [ABSTRACT FROM AUTHOR]