scholarly journals RADIOGRAPHIC ASSESSMENT OF THE COURSE AND VISIBILITY OF THE MANDIBULAR CANAL BY PANORAMIC RADIOGRAPHY

Author(s):  
Nashwan Yahya A Al-Shamahi ◽  
Al-Kasem Mohammed Abbas ◽  
Hassan Abdulwahab Al-Shamahy ◽  
Ameen Abdullah Yahya Al-Akwa ◽  
Khaled M Al-Ghaffari ◽  
...  

Background and Objectives:  The mandibular canal is a canal inside the mandible that contains the inferior alveolar artery, the inferior alveolar nerve and the inferior alveolar vein. The anatomy and variations of the human mandible are very important for planning various surgical measures such as extraction of the third molar, dental implants and mandibular reconstruction. This study was conducted to determine the frequency of the different courses of the mandibular canal  and to investigate the visibility of the mandibular canal by panoramic radiography, among a sample of Yemeni adults. Subjects and Methods: A retrospective cross-sectional study was conducted in Sana'a city on a sample of Yemeni adults. The study consisted of panoramic radiographs of 928 patients; the number of males was 340 (36.6%) and 588 females (63.4%). The mandibular canal course, as shown in the panoramic radiographs, was classified into four types: elliptical, linear, turning curves and spoon-shaped. The visibility of this canal from the first to the third molar region was assessed through visual determination of whether the lower canal was clearly visible, possibly visible, or invisible. Results:   Elliptical curves were the most observed along the mandibular canal course at 62.2% of the total, followed by the linear curve (24.8%) while the lower rate curve spoon (7.9%) and the turning curve (5.2%). There were no statistically considerable differences between the distribution of the mandibular canal courses between males and females except in the spoon curve where the ratio was 10.8% in males versus 6.1% in females (p <0.05). The percentage of clearly visible mandibular canals was the highest among the spoon-shaped curves (49.9% in the first molar, 63% in the second, 78.1% in the third molar) and the lowest among the linear curves (10.9% in the first, 18.7% in the second and 33.5% in the third molar). On panoramic radiographs, the invisible mandibular canals are found in 198 (21.3%) of the examined sites in the first molar region, in 85 (11%) in the second molar region, and in only 6 (0.64%) in the third molar region. Conclusion:  It was observed that elliptical curves along the path of the mandibular canal were the most present, while a decrease in the ratio of the two types of spoon curve and turning curve was observed. It was found that spoon curve was significantly more common among males than females. It was also found that the visibility of  madibular canal is fewer in the first molar region than in the third molar region. Peer Review History: Received: 21 September 2020; Revised: 8 October; Accepted: 29 October, Available online: 15 November 2020 UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Dr. Sunita Singh, Baylor College of Medicine, Houston, Texas, USA, [email protected] Dr. Ali Abdullah A. Al-Mehdar, Thamar University, Yemen,  [email protected]   Comments of reviewer(s): Similar Articles: BIOFILM FORMATION AND ANTIBIOTIC SUSCEPTIBILITY OF UROPATHOGENS IN PATIENTS WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS IN IBB CITY -YEMEN

Objectives: The objectives of this study were to assess the relationship between the third molar and the mandibular canal, to identify the radiographic markers most prevalent in predicting connectivity between these structures, and to associate these signs and proximity with the position of the third molar according to Bell, Gregory’s and Winter’s classifications. Subjects and methods: A retrospective cross-sectional study was conducted in the city of Sana’a on a sample of Yemeni patients in Ammar Dental Clinics who underwent panoramic radiography in the year 2019 until September 2020. The study consisted of panoramic radiographs of 597 patients with third molars with a total of 1017 third molars; the number of males was 216 (36.2%) and 381 females (63.8%). The panoramic radiographs were evaluated for proximity signs. Inclusion criteria were patients of both sexes who had at least a fully formed third molar of the mandible that was adjacent to the second molar. The radiographs were excluded if evidence of cystic, neoplastic, or extensive caries processes was detected. Seven radiological signs were used to determine if there was contact between the third molar and the mandibular canal. Results: A proximity to the mandibular canal was verified for 620 (61%) of 1017 third molars. The most frequent radiographic signs of proximity were darkened roots (315 teeth [31%]) and discontinuity of the mandibular canal (267 teeth [26.3%]). Third molar/mandibular canal proximity was found significantly more frequently in female patients and in patients aged 24 years and younger (P < 0.001). The tooth positions most frequently associated with proximity between the third molar and the mandibular canal were position C (highest point of the third molar located at or below the cervical margin of the second molar) and the mesioangular position (long axis of the third molar angled mesially toward the second molar). Conclusions: The frequency of third molar/ mandibular canal proximity was greater in female patients and patients aged 24 years or younger. The most frequently observed signs of proximity were darkening of the roots and discontinuity of the mandibular canal. The tooth positions most frequently associated with proximity of the third molar to the mandibular canal were position C and the mesioangular position.


Author(s):  
Josefine Cederhag ◽  
Nina Lundegren ◽  
Per Alstergren ◽  
Xie-Qi Shi ◽  
Kristina Hellén-Halme

Abstract Objectives The aim was to evaluate the characteristics of the mandibular third molars, especially in relation to the inferior alveolar nerve. Further aims were to investigate incidental findings in panoramic radiographs in an adult population, and to investigate image quality related to patient positioning. Materials and Methods From a previous study with 451 randomly selected adult participants who lived in Sweden, 442 panoramic radiographs from four dental public health clinics were used. The third molars’ characteristics and relation to inferior alveolar nerve were evaluated. Incidental findings and patient positioning were recorded. Statistical Analysis Frequency analysis was used to investigate the occurrence of all findings and their possible interconnections. Whether the patients’ age or gender had an impact or not was also analyzed. Results The third molars were erupted in vertical position among 73% regardless of age. When retained or semi-retained, they were most commonly in mesioangular positions. The inferior alveolar nerve was located inferior to the roots in 52%, whereas an overlapped position was most common if the third molar was retained (90%), semi-retained (83%) or the age was less than 30 years (66%). Common incidental findings were apical radiolucencies, idiopathic osteosclerosis, and tooth fragments. Suboptimal patient positioning was found in one-third of the radiographs. Conclusions Panoramic radiography is a useful method to evaluate third molar prior to surgical removal and may be the only image required. Most incidental findings on panoramic radiographs does not seem to require any further odontological management.


2014 ◽  
Vol 15 (6) ◽  
pp. 740-745
Author(s):  
Mojdeh Mehdizadeh ◽  
Navid Ahmadi ◽  
Mahsa Jamshidi

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.


2021 ◽  
Vol 10 (34) ◽  
pp. 2910-2914
Author(s):  
Abhishek Verma ◽  
Stuti Verma ◽  
Anushikha Dhankhar ◽  
Nitin Kumar Moral ◽  
Nidhi Nagar ◽  
...  

BACKGROUND A serious complication of surgical removal of impacted lower third molars is inferior alveolar nerve (IAN) injury. Evaluation of radiographic factors to predict IAN injury using CT and panoramic radiography includes root morphology assessment, follicular sac size, mandibular bone density, inferior alveolar nerve and vessels, condition of the overlying tissues, relation of the impacted tooth with the body and ramus of the mandible and the adjacent teeth. This study was done to evaluate the radiological features of the impacted lower mandibular teeth and their relationship with IAN through panoramic radiography and CT and to assess the most predictable radiological criteria for inferior alveolar nerve injury in impacted third molar surgery. METHODS All the patients indicated for lower third molar extraction were included in the study and pre-operative conventional panoramic radiographs (Planmeca Proline PM 2002 CC, Helsinki, Finland) and CBCT (Kodak CBCT) were taken. Any post-operative nerve injuries detected were followed up after 15 days or 1 month. Fisher’s exact test was done to find the association between the outcome variable and explanatory variables. RESULTS Only 11.4 % (N = 4) of all participants had IAN injury following surgical disimpaction. All the participants with IAN injury showed narrowing of the canal on their preoperative panoramic radiographs and presence of nerve approximation with the tooth in cone beam computed tomography (CBCT) reports (P < 0.05). CONCLUSIONS A statistically significant association exists between IAN injury and nerve exposure, radiographic signs of nerve involvement for panoramic radiograph, level of third molar impaction, and nerve approximation in CBCT. KEY WORDS Inferior Alveolar Nerve Injury, Lower Third Molar Impaction, Panoramic Radiography, CBCT


Author(s):  
Büyük Kaan Orhan ◽  
Dilek Yılmaz ◽  
Mehmet Ozgur Ozemre ◽  
Kıvanç Kamburoğlu ◽  
Orhan Gulen ◽  
...  

Objectives: To evaluate impacted mandibular third molar tooth region and obtain linear measurements using CBCT images and to assess the relationship between the impacted third molar and the mandibular canal. Methods: CBCT scans of 351 patients (208 females, 143 males) were assessed. Age, gender, and impaction site were recorded for each patient. The relationship of third molars with the vertical axis of second molars, 2nd molar resorption and the relationship between third molar apices and the mandibular canal were assessed. In addition, the distance between ramus and second molar, mesiodistal width of the third molar, the angle between third molar and second molar, and width of the third molar capsule were measured. Binary Logistic Regression, Chi-Square Test, and General Linear Model were used for statistical analysis. Results: The highest percentage of impaction was found for mesioangular followed by transversal and vertical. The transversal impacted third molars revealed a significant association with adjacent second molar root resorption (p<0.001). There was a statistical significance between the second molar resorption and distance between ramus and second molar (p<0.001). The mesioangular impacted third molars revealed significant relation with the mandibular canal (p<0.05). The most frequent variation found was the dental canal followed by the retromolar canal. In general, higher measurement values were obtained for men when compared to women (p<0.05). Conclusion: CBCT assessment of the third molar region provided useful information regarding impacted mandibular third molar surgery operations.


2017 ◽  
Vol 49 (2) ◽  
pp. 59
Author(s):  
David Buntoro Kamadjaja ◽  
Djodi Asmara ◽  
Gita Khairana

Background: Odontectomy of lower third molar has a potential risk for inferior alveolar nerve impairment. Paresthesia of inferior alveolar nerve has often been associated with close relationship between the apex of lower third molar and mandibular canal. Rood and Shehab’s category has been commonly used for radiological prediction of inferior alveolar nerve injury following third molar surgery. Purpose: This study aimed to determine whether there was correlation between Rood and Shehab’s radiographic features and the incidence of inferior alveolar nerve paraesthesia following odontectomy of lower third molar. Method: This was a retrospective cross-sectional study, using data obtained from the dental record of patients who had undergone odontectomy of lower third molars in Dental hospital of Universitas Airlangga during 2 years period. Samples were cases that, from presurgical radiograph, showed close relationship between lower third molar roots and mandibular canal. The case and non-case groups were assigned based on the presence of paraesthesia and non-paraesthesia of inferior alveolar nerves, respectively. Based on Rood and Shehab’s category, the samples collected were then classified into two groups which were those whose relationship matched and did not match with the category, respectively. Data were analyzed using Chi-square correlation test. Result: Of 975 odontectomy cases included in this study, 80 cases were taken as study samples consisting of 15 and 65 cases assigned, respectively, as case and non-case. The 32 cases matched with the criteria of Rood and Shehab's category while the remainder of 48 cases did not. Of 32 cases which met the criteria of Rood and Shehab’s relationship, only 5 cases showed paraesthesia, whereas out of 48 cases which did not met the criteria 10 cases showed paraesthesia. Statistical analysis showed significance value of 0.770 (p>0.05) indicating that there was no significant correlation between relations of third molar root and mandibular canal, based on Rood and Shehab’s category, and the incidence of inferior alveolar nerve paraesthesia. Conclusion: There was no correlation between Rood and Shehab’s radiographic features and the incidence of paraesthesia of inferior alveolar nerve following odontectomy of lower third molars.


2017 ◽  
Vol 6 (3) ◽  
pp. 1052-1061
Author(s):  
Isaac Kipyator Bokindo ◽  
Fawzia Butt ◽  
Francis Macigo

The mandibular third molar poses a challenge to dental surgeons due to it’s unpredictable morphology which leads to increased difficulty during its extraction. The root morphology of the third molar is considered to be the most variable in the human dentition. The study aims to document these variations which will be useful while undertaking procedures on the third molar. Three hundred and fifty nine panoramic views of the mandible were obtained from the Radiology division for patients seeking treatment in the School of Dental Sciences since 2010. The prevalence of third molar impaction was found to be 27%, with mesioangular being the commonest at 21.9% using the Winter’s classification. Dilacerations of roots was recorded at 44%, with a ratio of normal to dilacerated of 1:1 seen in impacted teeth while, non impacted teeth had a ratio of 1.3:1. Most teeth had 2 roots (85.5%), with one root seen in 12.1%. Partially fused roots was also observed in 2.4% of cases with only one case showing three roots. The total mean distance from the tips of roots to the mandibular canal was -0.5mm. Higher negative means of -1.5mm was recorded in impacted teeth than in normal teeth (-0.2mm). Teeth with dilacerated roots also showed closer proximity to mandibular canal than straight rooted teeth. The left side of the jaw also showed higher negative means. Present findings suggest that careful considerations should be made on impacted teeth. In addition to the type of impaction, proximity to the inferior alveolar nerve (IAN), number of roots and shape of the roots should be assessed. Similar considerations should also be made to non impacted teeth due to the high unpredictability observed in root morphology.Keywords: Third molar, root morphology, impaction


Tomography ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. 219-227
Author(s):  
Yen-Wen Shen ◽  
Wan-Chun Chang ◽  
Heng-Li Huang ◽  
Ming-Tzu Tsai ◽  
Lih-Jyh Fuh ◽  
...  

The retromolar canal is an anatomical variation that occurs in the mandibular bone. The retromolar canal typically originates in the mandibular canal on the distal side of the third molar and extends forward and upward to the retromolar foramen (RMF), which contains the neurovascular bundle. Accidentally damaging the neurovascular bundle in the retromolar canal during the extraction of the third molar, dental implant surgery, or maxillofacial orthognathic surgery may lead to subsequent complications such as incomplete local anesthesia, paresthesia, and bleeding during operation. The objective of this study was to investigate the prevalence of the RMF in the Taiwanese population in a medical center by using dental cone-beam computed tomography (CBCT) and to identify the position of the RMF in the mandibular bone. The dental CBCT images for the mandibular bone of 68 hemi-mandible were uploaded to the medical imaging software Mimics 15.1 to determine the prevalence of the RMF in the Taiwanese population and the three positional parameters of the RMF in the mandibular bone: (1) The diameter of the RMF, (2) the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the second molar, and (3) the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal. Seven RMFs were observed in the 68 hemi-mandibles. Thus, the RMF prevalence was 10.3%. In addition, the diameter of the RMF was 1.41 ± 0.30 mm (mean ± standard deviation), the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the the second molar was 12.93 ± 2.87 mm, and the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal below second molar was 13.62 ± 1.3487 mm. This study determined the prevalence of the RMF in the Taiwanese population in a medical center and its relative position in the mandibular bone. This information can provide clinicians with a reference for posterior mandible anesthesia and surgery to ensure medical safety.


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