Case–control study of mandibular canal branching and tooth-related inflammatory lesions
- 116 Downloads
Morphological variations of mandibular canals increase the risk of neurovascular damage and bleeding during surgical procedures by decreasing the predictability of the inferior alveolar neurovascular bundle location. To improve the predictability with such variations, the present study aimed to verify the possibility of a relationship between mandibular canal branches (MCBs) and tooth-related inflammatory lesions, using trough cone-beam computed tomography (CBCT) examinations.
The sample comprised 150 age and sex-matched examinations (50 cases and 100 controls) from two databases. The CBCT examinations were grouped by the presence of MCBs starting in the mandibular body regions as the outcome variable. Tooth-related inflammatory lesions and measurements of gray levels in the posterior region of the alveolar ridge were assessed in both groups. A multiple logistic regression analysis was applied to verify the relationships between MCBs and independent variables (p < 0.05).
Occurrence of tooth-related inflammatory lesions increased the risk of MCBs in the mandibular body regions (p < 0.001; OR 11.640; 95% CI 4.327–31.311). High-contrast images had a weaker association with MCBs (p = 0.002; OR 1.002; 95% CI 1.002–1.003). The most frequent tooth-related inflammatory lesions in both groups were endodontic (34 lesions; 45.94% of the total lesions). Most of the tooth-related inflammatory lesions related to MCBs were endodontic (20 cases) and combined endodontic and periodontal inflammation (20 cases).
An association was observed between MCBs in the mandibular body regions and tooth-related inflammatory lesions. Inflammatory lesions of endodontic origin are most often associated with MCBs.
KeywordsCone-beam computed tomography Mandibular canal Oral pathology
Compliance with ethical standards
Conflict of interest
Mauricio Augusto Aquino Castro, Manuel Oscar Lagravere Vich, Mauro Henrique Guimaraes Abreu, and Ricardo Alves Mesquita declare that they have no conflict of interest.
Human rights statements and informed consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study.
- 3.Monteiro MR, Groppo FC, Haiter-Neto F, Volpato MC, Almeida JF. 4% articaine buccal infiltration versus 2% lidocaine inferior alveolar nerve block for emergency root canal treatment in mandibular molars with irreversible pulpits: a randomized clinical study. Int Endod J. 2015;48:145–52.CrossRefPubMedGoogle Scholar
- 4.Li C, Yang X, Ma X, Li L, Shi Z. Preoperative oral nonsteroidal anti-inflammatory drugs for the success of the inferior alveolar nerve block in irreversible pulpitis treatment: a systematic review and meta-analysis based on randomized controlled trials. Quintessence Int. 2012;43:209–19.PubMedGoogle Scholar
- 38.Miller CS, Nummikoski PV, Barnett DA, Langlais RP. Cross-sectional tomography. A diagnostic technique for determining the buccolingual relationship of impacted mandibular third molars and the inferior alveolar neurovascular bundle. Oral Surg Oral Med Oral Pathol. 1990;70:791–7.CrossRefPubMedGoogle Scholar
- 39.Ritter L, Mischkowski RA, Neugebauer J, Dreiseidler T, Scheer M, Keeve E, et al. The influence of body mass index, age, implants, and dental restorations on image quality of cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:e108–e16.CrossRefPubMedGoogle Scholar
- 47.Hosmer DW, Lemeshow S. Logistic regression for matched case-control studies. In: Cressie NAC, Fisher NI, Johnstone IM, Kadane JB, Scott DW, Silverman BW et al, editors. Applied logistic regression. 2nd ed. New York: Wiley; 2004. pp. 223–52.Google Scholar
- 56.Graunaite I, Lodiene G, Maciulskiene V. Pathogenesis of apical periodontitis: a literature review. J Oral Maxillofac Res. 2011;2:e1.Google Scholar
- 57.Tyndall DA, Price JB, Tetradis S, Ganz SC, Hildebolt C, Scarfe WC, et al. Position statement of the american academy of oral and maxillofacial radiology on selection criteria for the use of radiology in dental implantology with emphasis on cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113:817–26.CrossRefPubMedGoogle Scholar