Cone Beam Computed Tomographic Analysis of the Course and Position of Mandibular Canal
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Estimation of the relative position of infra alveolar nerve (IAN) canal and its relation to the mandibular anatomical landmarks can be clinically useful in minimizing the risk of surgery complications such as neurosensory disturbances that may occur after invasive mandibular surgical procedures. The purpose of the present study was to investigate the anatomic location and radiographic course of the mandibular canal compared to anatomic landmarks on CBCT and to discuss its clinical significance and also to determine the possible correlations between the mandibular position and the age of the patients.
This cross sectional study was conducted on 242 CBCT of patients (99 males and 143 females). The location of canal was evaluated in 4 different regions. The first section in trans-axial view after mental foramen, in which the loop of mandibular canal is formed, was selected as point 1 for measurement and intervals of 10 mm, respectively, points 2, 3, 4 were selected for measurement. On these sections, the shortest linear distances (mm) from the most buccal and lingual aspects of the canal to the corresponding cortical plates of the mandible and also the minimum linear distance between the inferior aspect of canal and inferior border of mandible in these regions were calculated.
There was statistically significant correlation between the anatomic course of the canal and the patients’ gender. The mean vertical position of the canal, as measured from the lower border of the IAN canal to the inferior border of the mandible, was 8.50 mm, ranging from 4.80 to 14.50 mm. On average, the mandibular canal was situated more lingually at all sites to the point it reached the mental foramen. However, at the mental foramen region (Point 1), it was located closer to the buccal cortical plate.
Assessment of the exact course of the IAN preoperatively along the body of the mandible by using CBCT might contribute to efficient and accurate surgical planning and therefore positively influence the surgical results. The results of this study confirm the necessity of using CBCT before invasive surgical procedures to determine the variations in the relative position and course of IAN canal.
KeywordsInfra alveolar nerve canal Cone beam computed tomography Position Mandible
The authors thank the Vice-Chancellery of Shiraz University of Medical Sciences for supporting this research. The authors also thank Dr. Vosoughi of the Dental Research Development Center, of the School of Dentistry for the statistical analysis and Dr. Amal Saleh for improving the use of English in the manuscript.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they had no conflict of interest.
Human and Animal Rights
This article does not contain any studies with human participants or animals performed by any of the authors.
- 2.Ylikontiola L, Moberg K, Huumonen S, Soikkonen K, Oikarinen K (2002) Comparison of three radiographic methods used to locate the mandibular canal in the buccolingual direction before bilateral sagittal split osteotomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 93:736–742CrossRefGoogle Scholar
- 5.Yoshioka I, Tanaka T, Khanal A, Habu M, Kito S, Kodama M et al (2010) Relationship between inferior alveolar nerve canal position at mandibular second molar in patients with prognathism and possible occurrence of neurosensory disturbance after sagittal split ramus osteotomy. J Oral Maxillofac Surg 68:3022–3027CrossRefPubMedGoogle Scholar
- 15.Gowgiel J (1991) The position and course of the mandibular canal. J Oral Implantol 18:383–385Google Scholar
- 17.Klinge B, Petersson A, Maly P (1988) Location of the mandibular canal: comparison of macroscopic findings, conventional radiography, and computed tomography. Int J Oral Maxillofac Implants 4:327–332Google Scholar
- 20.Ma J, Lu L, Song C (2008) The position and course of mandibular canal through mandibular ramus in patients with prognathism. Shanghai kou qiang yi xue = Shanghai J Stomatol 17:200–203Google Scholar
- 23.Wittwer G, Adeyemo W, Beinemann J, Juergens P (2012) Evaluation of risk of injury to the inferior alveolar nerve with classical sagittal split osteotomy technique and proposed alternative surgical techniques using computer-assisted surgery. Int J Oral Maxillofac Surg 41:79–86CrossRefPubMedGoogle Scholar
- 28.Aizenbud D, Ciceu C, Hazan-Molina H, Abu-El-Naaj I (2012) Relationship between inferior alveolar nerve imaging and neurosensory impairment following bilateral sagittal split osteotomy in skeletal class III cases with mandibular prognathism. Int J Oral Maxillofac Surg 41:461–468CrossRefPubMedGoogle Scholar