Comparative analysis of mandibular anatomical variations between panoramic radiography and cone beam computed tomography.

PURPOSE: The objective of this study is to compare the ability of panoramic radiography and cone beam computed tomography (CBCT) in detecting anatomical variations of the mandibular canal and mental foramen. METHODS: One hundred twenty-seven preoperative panoramic and CBCT images were evaluated. Two oral and maxillofacial radiologists investigated the presence of bifid mandibular canals and/or additional mental foramina on the right, left, or both sides of the mandible. Intra- and interobserver reliability was determined using Cohen's kappa coefficient. McNemar's test compared the prevalence of mandibular anatomical variations between panoramic radiography and CBCT. The significance level was set at 0.05. RESULTS: Additional mental foramen and bifid mandibular canal were detected in 1.2 and 7.4 % of the panoramic radiographs and 7.4 and 9.8 % of the CBCT images, respectively. The incidence of anatomical variations on the mandibular canal was not significantly different between both imaging modalities (P > 0.05). CONCLUSIONS: Although CBCT provides better viewing of anatomical structures, including location, shape, and relationship with the surrounding area, panoramic radiography is a conventional imaging modality that can be used in the study of the bifid mandibular canals.