Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal
de Brito Ana Caroline Ramos, Nejaim Yuri, de Freitas Deborah Queiro, Santos Christiano de Oliveira,
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( de Brito Ana Caroline Ramos ) - University of Campinas Piracicaba Dental School Department of Oral Diagnosis
( Nejaim Yuri ) - University of Campinas Piracicaba Dental School Department of Oral Diagnosis
( de Freitas Deborah Queiro ) - University of Campinas Piracicaba Dental School Department of Oral Diagnosis
( Santos Christiano de Oliveira ) - University of Sao Paulo School of Dentistry of Ribeirao Preto Department of Stomatology Public Oral Health and Forensic Dentistry
Abstract
Purpose: The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images.
Materials and Methods: Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions.
Results: In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm.
Conclusion: CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region.
키워드
Radiography; Panoramic; Cone-Beam Computed Tomography; Mandible; Anatomic Variation
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