Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
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Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

  • de Brito, Ana Caroline Ramos (Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas) ;
  • Nejaim, Yuri (Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas) ;
  • de Freitas, Deborah Queiroz (Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas) ;
  • Santos, Christiano de Oliveira (Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo)
  • Received : 2015.11.26
  • Accepted : 2016.05.06
  • Published : 2016.09.30
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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.

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References

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