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The objective of this study was to provide an updated review of the literature on the importance of the use of cone beam computed tomography (CBCT) in the recognition of the trajectory and variants of the mandibular canal (MCV).CBCT allows obtaining high quality images and visualization with an accuracy of approximately 94%, compared to 53% with periapical intraoral radiography (RIP) and 17% with panoramic extraoral radiography (REP), making CBCT an important diagnostic tool.The incidences of MCV in CBCT studies were between 1.3% and 69%, with differences between patients of different ethnic origins and within the same ethnic population, and in the types and configurations of MCV within each ethnic group. The studies available in the literature provide a histological description of the content of MCV. The presence of nerve and artery bundles of different calibers suggests that patients present clinical symptoms only if the neurovascular bundle reaches a certain size and number of fascicles. This review provides a description of the different classifications available and updated with CBCT.
ABSTRACT
PURPOSE: The mandibular canal must be considered in dental procedures to avoid injuries of the alveolar inferior nerve. The occurrence of anatomical variations of the mandibular canal increases the risk of neurovascular injuries. The purpose of this study was to identify and describe the prevalence of mandibular canal branching (MCB) using cone beam computer tomography (CBCT). METHODS: Seven hundred standardized CBCTs were selected. The images were evaluated for the presence of MCB and for the detection of pathologies that could affect the structure of the canals. The data were analyzed using descriptive statistics and the Chi-squared test. RESULTS: The prevalence of MCB was 41.1%. There was no statistical difference between genders with the presence of the branches (p > 0.005). The highest prevalence was in the premolar and retromolar regions. Pathologies found in the molar region were frequently connected with MCB (77.8%), and the most common pathology related to branches was periapical lesion. CONCLUSIONS: Mandibular canal branching presented a high prevalence in CBCT imagery, more frequently located in regions of the premolar and retromolar. An adequate diagnosis of the MCB is necessary to perform dental procedures and verify possible associated pathologies.
Subject(s)
Cone-Beam Computed Tomography/methods , Mandible/anatomy & histology , Mandible/diagnostic imaging , Adolescent , Anatomic Variation , Female , Humans , Male , Patient Care Planning , Young AdultABSTRACT
PURPOSE: The aim of this study was to evaluate the prevalence of bifid mandibular canals (BMC) by cone beam computed tomography (CBCT). MATERIALS AND METHODS: We examined CT scans from 300 patients both male and female, aged 25 to 87 years. The subjects were divided into groups according to gender, male group (MG) and female group (FG) as well as subgroups according to the side, right (R) and left (L). Tomographic acquisitions were performed on the device I-Cat ® Classic. Image analysis was performed on the XoranCat ® software of the equipment itself, aided by image filters associated with transverse, oblique, and panoramic reconstruction cuts for analysis of the BMC. The results were displayed as descriptive analysis of the values and comparisons between factors were performed using ANOVA at a significance level of 95 %. RESULTS: BMC was observed in 80 cases (26.67 %), of which, 39 (48.75 %) were in males and 41 (51.25 %) in females; no difference was seen between genders, neither by affected side, although the right side was more frequently affected (66.67 %) when both genders were combined. CONCLUSION: The prevalence of BMC is significant and should not be overlooked.
Subject(s)
Cone-Beam Computed Tomography , Image Interpretation, Computer-Assisted , Mandible/abnormalities , Mandible/diagnostic imaging , Radiography, Panoramic , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Sex FactorsABSTRACT
Objetivos: Evaluar las características tomográficas de la bifurcación del conducto dentario inferior (BCDI) mediante tomografía computarizada de haz cónico (TCHC). Material y Métodos: Se revisaron 1497 TCHC (527 hombres y 970 mujeres) del servicio de Radiología Oral y Maxilofacial de la Facultad de Estomatología de la Universidad Peruana Cayetano Heredia, periodo 2011 - 2014. El análisis de imágenes se realizó utilizando el software Galileos 1.7.2. El rango etario estuvo comprendido entre 10 a 89 años, con una media de 44.8 ± 14 años. Asimismo se utilizó la clasificación de Naitoh, Hiraiwa, Aimiya y Ariji. El análisis estadístico se realizó mediante el uso de la prueba chi-cuadrado. Resultados: La frecuencia de la BCDI fue del 10.75% (161 casos). Se encontró mayor frecuencia en la quinta década de vida para ambos sexos, no hubo diferencia estadísticamente significativa entre el sexo femenino y masculino (p=0.49). La distribución de la BCDI evidenció que el tipo Canal retromolar representó el 64% (103 casos), seguido del tipo Canal sin confluencia anterior con 21.1% (34 casos) y minoritariamente el Canal dental y Canal con confluencia anterior con un 9.9% (16 casos) y 5% (8 casos) respectivamente. Conclusiones: La BCDI tiene una prevalencia del 10.75% y la TCHC permite identificar oportunamente esta variante anatómica
Objectives: To evaluate the tomographic characteristics of the bifurcation of the mandibular canal (BCDI) using cone beam computed tomography (CBCT). Material and Methods: 1497 CBCT were reviewed (from 527 men and 970 women), of the Department of Oral and Maxillofacial Radiology, from Universidad Peruana Cayetano Heredia, period 2011 - 2014. Image analysis were made using the software 1.7.2 Galilee. Patients age was between 10 to 89 years old, averaging 44.8 ± 14 years. Naitoh classification, Hiraiwa, Aimiya and Ariji was also used. Statistical analysis was made by using the chi-square test. Results: The frequency of BCDI was 10.75% (161 cases). The highest frequency was found in the fifth decade of life for both sexes, there wasn't statistically significant difference between female and male sex (p=0.49). The distribution of the BCDI showed that the kind Canal retromolar represents 64% (103 cases), followed by the type Canal without previous confluence with 21.1% (34 cases) and minority was found the dental Canal and Canal above confluence with 9.9% (16 cases) and 5% (8 cases) respectively. Conclusions: The bifurcation of mandibular canal has a prevalence of 10.75% and CBCT allows timely identification of this anatomical variant.
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AIM: To gather existing radiographic classifications of mandibular canals branching, considering the criteria on which these were based. METHODS: The search for studies on mandibular canals based on imaging exams included literature reviews, epidemiological studies of prevalence, descriptive studies, or case reports. An electronic search in the MEDLINE (OvidSP), PubMed, EMBASE (OvidSP), Web of Science (Thompson Reuters), and Scopus (Elsevier) databases was performed, as well as a manual evaluation of the references of the selected articles. Combinations of key words were placed in each database. No restrictions were imposed regarding the year of publication or language. References collected in duplicate were removed by the authors. A table was drawn up, containing the included studies and respective interest data. RESULTS: Six classifications of mandibular canals branching were selected for the present literature review. Four were based on two-dimensional radiographic exams, and two were performed based on three-dimensional tomographic exams. Three-dimensional classifications were determined based on the analysis found in the least number of exams, comparatively to two-dimensional studies. The prevalence of mandibular canal branching varied from 0% to 38.75% in the works based on two-dimensional exams, while those found in three-dimensional exams ranged from 15.6% to 65%. The studies were mostly referred to branches that began in the mandibular ramus. Just one classification considered the branches that began in the mandibular body region. CONCLUSION: Three-dimensional exams appear to be the best method to view mandibular canal branching. Further studies are warranted to determine its true prevalence and questions concerning to associations.
ABSTRACT
Introducción: el objetivo de este estudio fue investigar la presencia de la variable canal mandibular bífido (VCMB), por sujeto y por lado. Se distribuyó por tipo, según la clasificación de Naitoh, Hiraiwa, Aimiya y Ariji, agregándose el tipo canal triple. Se asoció con el género y se comparó la observación de la VCMB entre la vista panorámica y los cortes sagitales y coronales del sistema Cone Beam. Métodos: se analizó una muestra aleatoria de 84 sujetos (52 mujeres, 32 hombres), entre doce y ochenta años, conducido entre los años 2008 y 2009 en el Centro Sistemas Radiológicos Máxilo Faciales de Santiago de Chile. Se efectuaron adquisiciones volumétricas por medio de TC, sistema Cone Beam, utilizando un equipo Siemens Sirona, modelo Galileos Comfort. Se clasificaron los pacientes por edad y sexo. Se realizó un análisis cualitativo y cuantitativo marcando recorrido de ambos conductos dentarios inferiores. Se clasifica la VCMB de acuerdo con la propuesta de los autores, Naitoh, Hiraiwa, Aimiya y Ariji y canal triple. Se observó y comparó la presencia de la VCMB entre vista panorámica y cortes sagitales y coronales. Resultados: el 69% de la muestra considerada en el estudio presentó al menos una variación en el trayecto del conducto dentario inferior. La variable del recorrido del conducto dentario que presentó mayor frecuencia fue la clasificada como prolongación anterior con confluencia (39,28%) y en segundo lugar la variable clasificada como canal retromolar (23,80%). Se encontró una diferencia estadísticamente significativa al comparar los cortes sagitales y coronales del estudio volumétrico mediante tomografía de alta resolución con relación a la reconstrucción panorámica, lo que sugiere que las imágenes panorámicas son insuficientes para la investigación de variables en el recorrido del conducto dentario inferior.
Introduction: the purpose of this study was to evaluate the presence of a bifid mandibular canal variable (BMCV), by subject and by side. It was distributed by type, as classified by Naitoh, Hiraiwa, Aimiya and Ariji, adding the triple canal type. It was also associated with gender and the BMCV observation was compared with the panoramic view and the sagittal and coronal Cone Beam System. Methods: a random sample of 84 subjects (52 women, 32 men) between 12 and 80 years of age was analyzed; it was conducted between 2008 and 2009 at the Maxillo Facial Radiology Systems Center of Santiago de Chile. Volumetric acquisitions were made by CT, Cone Beam System, using Siemens Sirona equipment, model Galileos Comfort. Patients were classified by age and gender. We performed a qualitative and quantitative analysis both marking the path of the mandibular canal; BMCV was classified according to the classification of Naitoh, Hiraiwa, Aimiya and Ariji. The presence of BMCV was observed and compared between panoramic, and the sagittal and coronal slices. Results: 69% of the sample of the study showed at least one variation in the trajectory of the inferior dental canal. The variable of the trajectory of the dental canal which showed the highest frequency was the one classified as anterior elongation with confluence (39.28%) and, in second place the variable known as retromolar canal (23.80%). There was a statistical significant difference when the sagittal slices were compared with the coronal slices of the volumetric study through high resolution tomography in relation with the panoramic reconstruction, which suggests that the panoramic images are not sufficient to look for variables in the trajectory of the inferior dental canal. As it relates to gender, it was found that there was a statistically significant difference (p = 0.02) for the variable classified as lingual canal.