Anterior Loop of the Inferior Alveolar Canal: A Cone-Beam Computerized Tomography Study of 494 Cases.

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.

Diagnostic accuracy of cone-beam CT compared with panoramic images in predicting retromolar canal during extraction of impacted mandibular third molars.

OBJECTIVES: The clinical significance of the existence of a retromolar canal and of its neurovascular content is not yet clear.The aim of the present study was to assess the visibility, diameter and course of the mandibular retromolar canal (MRC) using cone beam computed tomography (CBCT) scan--had been taken for pre-operative radiographic evaluation of impacted mandibular third molars--compared to panoramic radiographs. STUDY DESIGN: Subjects eligible for study enrollment were those who underwent preoperative CBCT scan for the extraction of impacted mandibular third molars were determined to be extremely close to the mandibular canal on panoramic radiographs. Radiographs were screened for the presence and course of retromolar canals, and linear measurements. RESULTS: 947 hemimandibles in 632 patients were examined.A total of 253 MRCs (144 left, 109 right) were detected with CBCT images (26.7%). Only 29 of these canals were also seen on the corresponding panoramic radiographs. Most MRCs had a vertical course (type VI, 28.46%), followed by slightly curved (type I, 26.09%). The visibility of the MRC on the OPGs, according to the increase in the diameter, was not statistically significant for both sides (p >.05).Statistically difference were found for the width at the point of origin from the mandibular canal (p: .037), the mean distance from the MRC to the second molar (p: .042) and height of MRC when compared the gender. CONCLUSIONS: The findings suggest that the MRC isn't a rare anatomical structure. This study therefore clearly establishes the incidence and importance of the MRC. The detection of the presence of the MRC using CBCT may be crucial for extraction of mandibular third molars.

Cone beam computed tomographic analyses of the position and course of the mandibular canal: relevance to the sagittal split ramus osteotomy.

PURPOSE: The aim of this study was to document the position and course of the mandibular canal through the region of the mandibular angle and body in dental patients, using cone beam computed tomographic imaging. METHODS: The position and course of the mandibular canal from the region of the third molar to the first molar were measured at five specific locations in the same plane: at three different positions just between the first and second molars; between the second and third molars; and just distal to the third molar. RESULTS: The study sample was composed of 500 hemimandibles from 250 dental patients with a mean age of 26.32. Significant differences were found between genders, distances, and positions. B decreased significantly from the anterior positions to the posterior positions in both females and males. The mean values of S and CB increased significantly from the posterior positions to the anterior positions in both females and males. CONCLUSION: Because the sagittal split ramus osteotomy is a technically difficult procedure, we hope that the findings of the present study will help the surgeon in choosing the safest surgical technique for the treatment of mandibular deformities.

Lateral lingual vascular canals of the mandible: a CBCT study of 500 cases.

PURPOSE: The aim of the present study was to use cone-beam computed tomography (CBCT) images of patients to assess the localization, diameter, and course of the lateral lingual vascular canal (LLVC). METHODS: CBCT (Morita, Accuitomo 170) images from 500 patients were used in the present study. The CBCT images were examined by two oral radiologists. The diameter, localization, and course of the LLVCs were assessed using axial, cross-sectional, and multiplanar reformatted images. Statistical analysis was performed using SPSS(®) v. 15 (SPSS Inc., Chicago, IL, USA), and t tests were used for statistical analysis. RESULTS: Of the 500 patients examined, 163 LLVCs were detected in 124 (24.8 %) cases. The mean diameter of LLVCs on the right side and left side was 0.65 ± 0.18 and 0.64 ± 0.17 mm, respectively. The majority of the LLVCs (n = 106, 83 %) were observed in the premolar region. There was a statistically significant difference between the occurrence of LLVCs in the premolar region and the other areas (p < 0.01). CONCLUSIONS: All the LLVCs observed in this study had a connection with inferior alveolar canal structures. The detection of an LLVC on CBCT images should alert the radiologist and surgeons to the possible presence of collateral arterial and vascular structures.

Assessment of the visibility and characteristics of the mandibular incisive canal: cone beam computed tomography versus panoramic radiography.

PURPOSE: The aim of this study was to assess and compare the visibility, diameter, and course of the mandibular incisive canal (MIC) using cone beam computed tomography (CBCT) and panoramic radiography. MATERIALS AND METHODS: CBCT images and panoramic radiographs from 243 patients were used in this study. Standard exposure and patient positioning protocols were used for all the patients. Both types of images were assessed by two dentomaxillofacial radiologists. The diameter and the endpoint level of the MIC were measured using the CBCT images. Statistical analysis was performed using t tests in statistical software. RESULTS: Of the 486 hemimandibles examined, the MIC was visible in 249 (51.2%) radiographs and 459 (94.4%) CBCT images. The mean diameters of the MICs were 1.91±0.45 mm on the right side and 1.94±0.41 mm on the left side. The MICs on both the right and left sides of the mandible showed statistically significant differences in diameter in male versus female patients. The visibility of the MIC on the panoramic radiographs according to the increase in the diameter was not statistically significant for both sides. Twenty MICs reached to the midline of the mandible, and the majority of the MICs (n=114) terminated between the canine and the first premolar. CONCLUSION: The visibility of the MIC in CBCT is much better than that observed in conventional panoramic radiography. Even some large MICs could not be observed in panoramic radiographs. Detection of the MIC using CBCT may be crucial for surgical procedures involving the interforaminal region.

Infantile malignant osteopetrosis: report of 2 cases with osteomyelitis of the jaws.

Infantile malignant osteopetrosis (IMO) is an uncommon autosomal recessive disease characterized by dense, brittle, sclerotic, radiopaque bones, which generally results in neurological and hematological abnormalities. In general, IMO is fatal, as patients fail to grow and expire due to complications of the disease such as severe chronic anemia, bleeding, and/or infections. In children with IMO, the development of the dentition is seriously disturbed. Patients with infantile osteopetrosis have a variety of signs and symptoms, including osteomyelitis of the jaws, which frequently and generally resists treatment. Infections may eventually become lethal; hence, jaw infection control is an important aspect of the disease for dentists and oral surgeons to consider. The purpose of this case report was to present 2 rare cases of pediatric patients (one of them died due to respiratory failure at 10 years old) diagnosed with osteopetrosis complicated by osteomyelitis of the jaw.

Detection of bifid mandibular condyle using computed tomography.

OBJECTIVE: To determine the frequency and characteristics of bifid mandibular condyle (BMC) using computed tomography (CT) evaluation. STUDY DESIGN: A retrospective study was carried out using the CT records of 550 patients referred to the Medical School of Erciyes University (Kayseri, Turkey) between 2007 and 2010. T-tests were used to compare frequency of BMC between the left and right sides and between female and male patients. Statistical analysis was performed using SPSS software and a chi-squared test. RESULTS: Of the 550 Patients, 10 patients (1.82%) were found to have BMCs. Five patients were female (50%) and five were male (50%). Of these 10 patients, 7 (70%) had unilateral and 3 (30%) had bilateral BMCs. As a result, a total of 13 BMCs were found in 10 patients. No statistically significant differences were found between either the right- and left-sided BMCs or between female and male patients (p >.05). CONCLUSIONS: To our knowledge, this is the first retrospective study investigating the prevalence and characteristics of BMC using computed tomography. Although BMC is an uncommon anomaly, it may be a more frequent condition in the Turkish population. Further studies and research on the orientation of duplicated condylar heads should be carried out.

Prevalence of bifid mandibular condyle in a Turkish population.

The aim of this study was to determine the frequency of bifid mandibular condyle (BMC) using panoramic radiographs supported by different radiographic techniques. A retrospective study was carried out by evaluating panoramic radiographs of 18,798 patients referred to the Department of Dentomaxillofacial Radiology. T-tests were used to compare the frequency of BMC between left and right sides and between female and male patients. In this study, 98 patients (0.52%) were found to have BMC. Of these patients, 51 (52%) were females and 47 (48%) were males. Of the 98 patients, 71 (72.4%) had unilateral and 27 (27.6%) had bilateral BMC. A total of 125 BMCs were found in 98 patients. No statistically significant differences were found between the right and left BMCs or between female and male patients (P > 0.05). Because symptoms associated with BMC are either absent or minimal, it is usually discovered as an incidental finding during routine radiographic examination. Different appearances of BMC can be seen on panoramic radiographs. The exact orientation of the condyles can only be determined using 3D imaging techniques. BMC may be a more frequent condition in the Turkish population.