Computed tomography for the assessment of the potential risk following implant placement in fresh extraction sites in the posterior mandible

2020 ◽  
Author(s):  
Bahaa Haj Yahya ◽  
Gavriel Chaushu ◽  
Yafit Hamzani
Keyword(s):  
Computed Tomography ◽  
High Risk ◽  
Survival Rates ◽  
Inferior Alveolar Nerve ◽  
Primary Stability ◽  
Mandibular Canal ◽  
Anatomical Structures ◽  
Background Factors ◽  
Second Molar ◽  
Immediate Implants

Background and purpose: Immediate implants placement (IIP) are considered a reliable procedure, with survival rates of 94.9% to 98.4%. Nevertheless, in the posterior mandible it poses high risk of damage to anatomical structures. The aim of this study was to determine the risk of anatomical structures injury associated with IIP in the posterior mandible based on apical primary stability, respecting a safe distance from inferior alveolar nerve (IAN) and lingual plate. Moreover, to evaluate the influence of different factors on those risks. Materials and methods: Pre-extraction cone beam computed tomography (CBCT) scans of 100 patients were retrospectively analyzed. Measurements were taken from tooth apices to lingual plate and to mandibular canal. Values of <4mm of the former and <6mm of the later categorized as considerable risk. Values of <2mm at both measurements considered as high risk. Two-sided p values <0.05 were considered statistically significant.  Results: Mean root-to-alveolar canal (RAC) distance was 7.6±2.7mm in the first molar, 6.5±3mm in second premolar and 5.4±3 mm in the second molar ( p <0.005). Mean distance to the outer lingual cortex (DLC) was 3.9±2.1mm in the first molar and 3.2±0.1mm in the second molar. Thus, second molars were at the higher risk of inferior alveolar nerve injury and lingual plate perforation during IIP. Background factors associated with higher IIP risk were female sex and age <40 years. Conclusions: In the mandible, the anatomic risk posed by IIP is greatest for second molars and lowest for first molars. Several background factors affect the distances between root apices and the mandibular canal.

scholarly journals Potential Circumferential Bone Engagement following Tooth Extraction in the Posterior Mandible: Computed Tomography Assessment

Medicina ◽  
2021 ◽  
Vol 57 (9) ◽  
pp. 874
Author(s):  
Yafit Hamzani ◽  
Emran Yassien ◽  
Liad Moskovich ◽  
Talia Becker ◽  
Gavriel Chaushu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Primary Stability ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Anatomical Structures ◽  
Second Molar ◽  
Implant Placement ◽  
Root Position ◽  
Immediate Implant ◽  
Mandibular Teeth

Background and Objectives: Immediate implant placement (IIP) is a popular surgical procedure with a 94.9–98.4% survival rate and 97.8–100% success rate. In the posterior mandible, it poses a risk of injury to adjacent anatomical structures if the implant engages apical bone. This study sought to assess the implant dimensions that allow for circumferential bone engagement at each position in the posterior mandible without additional apical drilling. Materials and Methods: An observational, cross-sectional study design was used. The pre-extraction cone beam computed tomography scans of 100 candidates for IIP were analyzed. Measurements of each root of the posterior mandibular second premolar, first molar, and second molar were taken from three aspects: buccolingual, mesiodistal, and vertical. Two-sided p values < 0.05 were considered statistically significant. Results: A total of 478 mandibular teeth and 781 roots were assessed. Based on Straumann® BLX/BLT implant-drilling protocols, predicted rates of radiological circumferential engagement (RCE) were 96% for implants 5 mm in diameter in the second premolar root position; 94% for implants 4.0–4.2 mm in diameter in the first molar root position; and 99% for implants 4.5–4.8 mm in diameter in the second molar root position. Corresponding rates of achieving an available implant length (AIL) of 10 mm were 99%, 90%, and 86%. Patients <40 years old were at higher risk of lower RCE and lower AIL (p < 0.005) than older patients for all roots measured. Conclusions: The high primary stability prediction rates based on the calculation of RCE and AIL support the use of IIPs without further apical drilling in the posterior mandible in most cases.

scholarly journals Evaluation of the Relationship between Mandibular Third Molar and Mandibular Canal by Different Algorithms of Cone-beam Computed Tomography

2014 ◽  
Vol 15 (6) ◽  
pp. 740-745
Author(s):  
Mojdeh Mehdizadeh ◽  
Navid Ahmadi ◽  
Mahsa Jamshidi
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cross Sectional Study ◽  
Cone Beam ◽  
Cross Sectional ◽  
Mandibular Third Molar ◽  
The Relationship

ABSTRACT Objectives Exact location of the inferior alveolar nerve (IAN) bundle is very important. The aim of this study is to evaluate the relationship between the mandibular third molar and the mandibular canal by cone-beam computed tomography. Study design This was a cross-sectional study with convenience sampling. 94 mandibular CBCTs performed with CSANEX 3D machine (Soredex, Finland) and 3D system chosen. Vertical and horizontal relationship between the mandibular canal and the third molar depicted by 3D, panoramic reformat view of CBCT and cross-sectional view. Cross-sectional view was our gold standard and other view evaluated by it. Results There were significant differences between the vertical and horizontal relation of nerve and tooth in all views (p < 0.001). Conclusion The results showed differences in the position of the inferior alveolar nerve with different views of CBCT, so CBCT images are not quite reliable and have possibility of error. How to cite this article Mehdizadeh M, Ahmadi N, Jamshidi M. Evaluation of the Relationship between Mandibular Third Molar and Mandibular Canal by Different Algorithms of Cone-beam Computed Tomography. J Contemp Dent Pract 2014;15(6):740-745.

scholarly journals Inferior alveolar nerve paraesthesia after overfilling into the mandibular canal, confirmed by cone-beam computed tomography: a case report

2021 ◽  
Vol 24 (2) ◽  
Author(s):  
Claudemir de Souza Júnior ◽  
Ricardo Machado ◽  
Renee Ashley Batts ◽  
Lucas da Fonseca Roberti Garcia
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Cone Beam Computed Tomography ◽  
Root Canal ◽  
Inferior Alveolar Nerve ◽  
Mandibular Canal ◽  
Cone Beam ◽  
Filling Material ◽  
Mandibular Molar ◽  
Patient Reported

The filling material should be restricted to the root canal, and not extend to the periradicular tissues. Overextension occurs when there is an overflow of gutta-percha and sealer, whereas overfilling refers to the overflow only of sealer beyond the apical foramen. Both may cause several negative clinical consequences. Nevertheless, an accurate diagnosis of where they occurred cannot always be performed by conventional radiographic examination, because of the two-dimensional aspect of the image. This paper describes a clinical case of labiomandibular paraesthesia after overfilling into the mandibular canal (MC), as diagnosed by cone-beam computed tomography (CBCT), later used to perform the treatment planning. A 34-year-old Caucasian female patient sought a private dental clinic complaining of pain in the right mandibular posterior region. After taking the anamnesis and performing clinical and radiographic exams, the patient was diagnosed with pulp necrosis in the second right mandibular molar, and underwent root canal treatment. The final radiography showed overextension or overfilling, probably into the MC. About 2 hours after the procedure, the patient reported paraesthesia of her lower right lip and chin. A CBCT confirmed a small overfilling into the MC. For this reason, vitamin B12 was prescribed as the first treatment option. After 7 days, the patient reported a significant decrease in paraesthesia, and was completely normal after 15 days. This case report shows that CBCT is an effective radiographic diagnostic tool that can be used as an alternative in clinical cases of labiomandibular paraesthesia caused by overextension or overfilling.   Keywords Endodontic treatment; Overfilling; Paraesthesia; Conebeam computed tomography.

scholarly journals Immediate Implant Placement by Interradicular Bone Drilling before Molar Extraction: Clinical Case Report with One-Year Follow-Up

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Stuardo Valenzuela ◽  
José M. Olivares ◽  
Nicolás Weiss ◽  
Dafna Benadof
Keyword(s):  
Survival Rates ◽  
Three Dimensional ◽  
Primary Stability ◽  
Bone Drilling ◽  
Implant Placement ◽  
Immediate Implants ◽  
Immediate Implant ◽  
One Year ◽  
Molar Extraction

The placement of immediate implants in the posterior sector is a widespread procedure where the success and survival rates are similar to those of traditional protocols. It has several anatomical challenges, such as the presence of interradicular bone septa that hinder a correct three-dimensional positioning of the implant and may compromise primary stability and/or cause damage of neighboring structures. The aim of this article is to present the treatment and the one-year clinical follow-up of a patient who received immediate implant placement using an interradicular bone-drilling technique before the molar extraction.

scholarly journals Ultrasonic Navigation for the Treatment of Medication-Related Jaw Osteonecrosis Involving the Inferior Alveolar Nerve: A Case Report and Protocol Review

2020 ◽  
Vol 3 (4) ◽  
pp. 70
Author(s):  
Gerardo Pellegrino ◽  
Francesca Pavanelli ◽  
Agnese Ferri ◽  
Giuseppe Lizio ◽  
Roberto Parrulli ◽  
...  
Keyword(s):  
Inferior Alveolar Nerve ◽  
Mandibular Canal ◽  
Surgical Removal ◽  
Hard Tissue ◽  
Anatomical Structures ◽  
Osteonecrosis Of The Jaws ◽  
Dynamic Navigation ◽  
The Right ◽  
Ultrasonic Navigation ◽  
Protocol Review

Dynamic navigation (DN) is a computer-guided technique employed in different surgical fields and recently adopted in dental implantology to improve the accuracy of dental implant insertion. Medication-related osteonecrosis of the jaws (MRONJ) often requires the surgical removal of the impaired, hard tissue, trying at the same time to spare the healthy tissue and the noble anatomical structures. A case of extensive bilateral medication-related osteonecrosis, with the symptomatic involvement of the right mandibular canal, was successfully resolved with the use of ultrasonic surgery associated with a dynamic navigation, in order to limit the invasiveness of the surgical approach improving its reliability and accuracy. The usefulness of this technology in the management of MRONJ can be considered in future clinical trials to confirm the advantages and standardize the technique.

scholarly journals Neurovascular Content of the Mandibular Canal and Its Clinical Relevance: A Literature Review of the Related Anatomical and Radiological Studies

2014 ◽  
Vol 18 (3) ◽  
pp. 124-132
Author(s):  
Apostolos N. Eliades ◽  
Kalliopi H. Manta ◽  
Anastasios T. Tsirlis
Keyword(s):  
Case Reports ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Anatomical Variations ◽  
Mandibular Canal ◽  
Terminal Branch ◽  
Anatomical Structures ◽  
Mandibular Foramen ◽  
Anterior Trunk ◽  
Radiological Studies

SUMMARYIn literature, anatomical variations of the inferior alveolar nerve branches (infratemporal, extraosseous and intraosseous) are reported and their importance in clinical practice is discussed too. The spatial vessels’ position in relationship with the nerve in the mandibular canal was explored, which is of clinical significance in impacted third molar and implant surgery. It is believed that the neurovascular content of the main mandibular canal follows any variations of the mandibular canal i.e. bifid mandibular, retromolar and accessory mental canals. Retrospective studies and case reports reported the presence of multiple foramina on the medial surface of the ramus, near the main mandibular foramen. In some cases, one supplementary mandibular foramen was found to be connected with the lower third molar, which is called “temporal crest canal”. Others found an accessory mandibular foramen that led into a second mandibular canal which joined the main mandibular canal (double) anteriorly. The bony canals contained a terminal branch of the anterior trunk of the mandibular nerve or a branch of inferior alveolar nerve before it entered the mandibular foramen.The aim of the study was to describe and classify anatomical structures of the mandibular canal and posterior foramina of the mandible through an extensive review of the corresponding studies via the PubMed, Scopus and Google Scholar databases.

scholarly journals Evaluation of the Lingual Canals of Mandible in Cone Beam Computed Tomography

2019 ◽  
Vol 70 (11) ◽  
pp. 4105-4111
Keyword(s):  
Computed Tomography ◽  
Inferior Alveolar Nerve ◽  
Mandibular Canal ◽  
Sensory Innervation ◽  
Cone Beam ◽  
Cortical Plate ◽  
Incisive Canal ◽  
Mandibular Body ◽  
Mylohyoid Nerve ◽  
Lingual Canal

This study aims to assess the frequency of the lingual foramina and canals relative to their location on the mandibular cortical plate and also to closely inspect the course of the lingual canals inside the mandibular body using 3D reconstruction of the evaluated area. A retrospective study was conducted with 55 cone bean computed tomography (CBCT) scans in order to analyze the location, number, course and anastomosing pattern of the lingual canals. A total number of 165 lingual canals (LCs) were recorded from 55 patients, as follows: 94 median (MLC), 16 paramedian (PLC) and 55 lateral lingual canals (LLC). MLCs were a constant finding in all 55 patients (100% of the cases), PLCs were present in 15 patients (27.3% of the cases), and LLCs were identified in 35 patients (63.3% of the cases). The anastomosing pattern of the MLC, in which a supraspinous canal anastomosed with an infraspinous canal, was found in 10.9% of the cases (6 of 55 patients),. The LLCs were anastomosed with the mandibular incisive canal (MIC) in 56.3% of the cases (31 of 55 LLCs) and with the mandibular canal (MC) in 3.6% of the cases (2 of 55 LLCs). CBCT revealed itself to be a reliable tool for evaluating the intramandibular topography of the LCs. The anastomosing pattern of the lingual canals might raise the question whether the LCs could be responsible for incomplete anesthesia after conventional mandibular block by carrying sensory innervation from the mylohyoid nerve to the inferior alveolar nerve. Keywords: mandible, lingual canal, intramandibular anastomosis, CBCT

scholarly journals Evaluation of the Lingual Canals of Mandible in Cone Beam Computed Tomography

2019 ◽  
Vol 70 (11) ◽  
pp. 4105-4111
Author(s):  
Andrei Leonid Chirita ◽  
Mugurel Constantin Rusu ◽  
Ruxandra Stanescu ◽  
Gabriela Tanase ◽  
Mihai Butucescu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Inferior Alveolar Nerve ◽  
Mandibular Canal ◽  
Sensory Innervation ◽  
Cone Beam ◽  
Cortical Plate ◽  
Incisive Canal ◽  
Mandibular Body ◽  
Mylohyoid Nerve

This study aims to assess the frequency of the lingual foramina and canals relative to their location on the mandibular cortical plate and also to closely inspect the course of the lingual canals inside the mandibular body using 3D reconstruction of the evaluated area. A retrospective study was conducted with 55 cone bean computed tomography (CBCT) scans in order to analyze the location, number, course and anastomosing pattern of the lingual canals. A total number of 165 lingual canals (LCs) were recorded from 55 patients, as follows: 94 median (MLC), 16 paramedian (PLC) and 55 lateral lingual canals (LLC). MLCs were a constant finding in all 55 patients (100% of the cases), PLCs were present in 15 patients (27.3% of the cases), and LLCs were identified in 35 patients (63.3% of the cases). The anastomosing pattern of the MLC, in which a supraspinous canal anastomosed with an infraspinous canal, was found in 10.9% of the cases (6 of 55 patients),. The LLCs were anastomosed with the mandibular incisive canal (MIC) in 56.3% of the cases (31 of 55 LLCs) and with the mandibular canal (MC) in 3.6% of the cases (2 of 55 LLCs). CBCT revealed itself to be a reliable tool for evaluating the intramandibular topography of the LCs. The anastomosing pattern of the lingual canals might raise the question whether the LCs could be responsible for incomplete anesthesia after conventional mandibular block by carrying sensory innervation from the mylohyoid nerve to the inferior alveolar nerve.

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