• Imaging Science in Dentistry
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• v.51 no.1
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• pp.35-40
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• 2021

Purpose: This study was conducted to evaluate the accuracy of cone-beam computed tomography (CBCT) in detecting the posterior superior alveolar(PSA) artery canal in a sample of the Egyptian population. Materials and Methods: CBCT images of 600 maxillary sinuses of patients were examined for the presence or absence of the PSA artery along the lateral wall of the maxillary sinus, and for the diameter and type of the canal in relation to age and sex. The distances from the canal to the alveolar crest and sinus floor were also measured. Each canal was assessed to determine whether it was bifid. Results: The PSA artery canal could be detected in 92.0% of the sinuses. The mean distance from the inferior border of the PSA artery canal to the sinus floor was 8.2±2.2 mm (range, 3.2-13.6 mm) in males and 7.3±2.1 mm (range, 3.0-13.1 mm) in females. The mean distance from the inferior border of the PSA artery canal to the alveolar crest was 18.2±2.7 mm (range, 11.0-23.9 mm) in males and 17.4±2.3 mm (range, 10.8-23.5 mm) in females. The mean diameter of the PSA artery canal was larger in male subjects. The PSA artery canal was bifid in 8.7% of cases. The most frequently observed location of the PSA artery canal was intraosseous(82.2%). Conclusion: CBCT was confirmed to be a valuable tool for evaluation and localization of the PSA artery before maxillary sinus lift surgery to avoid intraoperative bleeding.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.25 no.4
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• pp.350-355
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• 1999

Purpose : The purpose of this study was 1) to find nerve damage after inferior alveolar nerve transposition and 2) to examine whether the soft tissue or bone changes around the nerve produce the compression to the nerve in the healing period. Materials and Method : Inferior alveolar nerve was exposed through the bony window and the scratch was made in the bone to be thought as the inferior alveolar canal. Suture was made after the nerve was repositioned. The nerve and surrounding tissues were examined with the light microscope and the fluorescent microscope before surgery and at 1 month, 3 months, and 5 months after surgery. Results : After surgery, the epineurium was damaged and the nerve was divided to several fascicles covered with the perineurium The newly formed fibrous connective tissue and vessels were seen around fascicles. There was new bone formation. However the nerve was not compressed by the connective tissue or the new bone. Conclusion : The results of this study suggest that neurosensory disturbances after inferior alveolar nerve transposition are resulted by the direct trauma in surgery rather than the compression to the nerve by the scar or new bone formation in the healing period.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.2
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• pp.66-73
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• 2015

Objectives: To assess the validity of the vertical tube-shift method using intraoral periapical radiography (IOPAR) for determining the relationship between the mandibular third molar roots and the inferior alveolar nerve (IAN) canal in comparison with cone-beam computed tomography (CBCT). Materials and Methods: Fifty impacted mandibular third molars were analyzed using the IOPAR vertical tube-shift method and CBCT. The relationship of the IAN canal to the impacted mandibular third molar was recorded as buccal, lingual or in line with the apex and was compared with CBCT findings. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the vertical tube-shift method in depicting the relationship (buccal/lingual/in line with the apex) of the IAN canal to the third molar root apex was calculated. Results: The sensitivity and specificity PPV and NPV of the IOPAR vertical tube-shift technique was found to be highest for a lingual relationship (100%) followed by buccal (94.4%, 92.3%, 97.1%, and 85.7%) and in line with the apex relationship (88.9%, 95.0%, 80.0%, and 97.4%) of the IAN canal with the third molar root apex, respectively. A statistically significant association was observed between the IOPAR vertical tube-shift method and the CBCT with a P-value <0.01. Conclusion: The vertical tube-shift method can be used as an effective diagnostic tool in assessing the relationship of the IAN canal to the third molar root apex with high sensitivity, specificity, PPV, and NPV.

• Journal of The Korean Dental Society of Anesthesiology
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• v.9 no.1
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• pp.24-29
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• 2009

When performing the inferior alveolar nerve block anesthesia, surgeon often faced a difficulty of the surgical operation due to the incomplete anesthesia. One of the reason is the variety of mandibular canal anatomy. Up to now, there are some reports of index cases about bifid mandibular canal among mandibular canal anatomic variation, and some classification is applied according to anatomical location and configuration. When surgical operation is performed involving mandible such as dantal implant treatment, extraction of an impacted third molar, sagittal split ramus osteotomy, etc, the position of mandibular canal should be considered. Bifid mandibular canal clinically causes troublesome cases of anesthesia when inferior alvelor nerve block, especially is performed extraction of an impacted third molar. Therefore, It is important for clinicians to recognize the presence of bifid canals on radiographys. Nowadays, the position of mandibular canal can be measured precisely by using Dental CT. It is not found by panorama image but is found by Dental CT sometimes. Among the patients, which take panorama and Dental CT simultaneously, for tooth extraction of lower impacted third molar in our department, we report the case that did not identifying in panorama but identifying it in Dental CT.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.1
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• pp.89-93
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• 2005

Intraosseous neurilemmoma(Schwannoma) is an extremely rare benign neoplasm. The site most commonly involved is the mandible. This occurrence is understandable because of the length of the inferior alveolar canal through the mandible. No other bone contains a canal that transmits a neurovascular bundle of such size and length. We report on a peripheral and central neurilemmoma along pathway of inferior alveolar nerve of the lower lip and mandible in a 28-year old man. A panoramic radiograph of the mandible showed a well-defined bilocular lesion with a thin uniform sclerotic margin located in the ramus and body of the mandible. The CT scan confirmed a well-defined lesion with thinning of the cortex of the body of the left side of the mandible. Histologically, the lesion was a cellular neoplasm with distinct palisading and numerous Verocay bodies. Complete excision was achieved by removing the tumor with the inferior alveolar nerve.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.21 no.2
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• pp.307-316
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• 1991

The purpose of this study is to improve the availabilities of radiographic technics as diagnostic method related to mandibular canal in dental clinic. For this study 12 dry mandibles were used and 12 orthopantomograms were taken for measuring the gonial angle and the angle of mandibular canal to inferior border of mandible. 12 sites located between the 1st premolar to the 3rd molar region of 3dry mandibles were selected randomly, for measuring the vertical image magnification rates on three films; intraoral film, orthopantomogram, and computed tomogram, respectively and the thickness of cortical bone, and for observing bucco-lingually and supero-inferiorly location of the mandibular canal. The acquired results were as follows: 1. The means of the gonial angle and the angle of mandibular canal to inferior border of mandible were 123.9° and 143.5° And the two angles of dry mandible in alveolar crest stage were greater than in alveolar socket stage. 2. The vertical image length on intraoral film by paralleling technic was magnified by 3.07% on the average, the length on orthopantomogram by 18.49%, and the length on computed tomogram by 0.27%. 3. Observation of the bucco-lingually positional relationship of the mandibular canal was impossible by occlusal projection with the cross section technic and intraoral standard projection with the Clack's rule, however, possible by computed tomogram. 4. The thickness of the cortical bone of mandible was thickest in inferior border, and thicker by 6.59% at buccal side than at lingual side.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.29 no.1
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• pp.191-201
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• 1999

Purpose: To know whether there would be a difference among spiral tomograms of different slice thicknesses in the measurement of distances which are used for dental implant planning. Materials and Methods: 10 dry mandibules and 40 metal balls were used to take total 120 Scanorailll tomograms with the slice thickness of 2 mm, 4 mm and 8 mm. 3 oral radiologists interpreted each tomogram to measure the distances from the mandibular canal to the alveoalr crest and buccal. lingual and inferior borders of mandible. 3 observers recorded grades of 0, 1 or 2 to evaluate the perceptibility of alveolar crest and the superior border of mandibular canal. ANOVA with repeated measure. Chi-square tests and intrac!ass correlation coefficient(R₂, α) were used For statistical analysis. Results: There was not a statistically significant difference among spiral tomograms with different slice thicknesses in the measurement of the distances and in the perceptibility of alveolar crest and mandibular canal(p>0.05). All of them showed a good relationship in the reliability analysis. The perceptibility of alveolar crest and mandibular canal was almost similar and an excellent relationship was seen on all of them. Conclusions: There would be no significant difference. no matter which spiral tomogram of any slice thickness may be used in dental implant planning. considering the thickness of dental implant fixture.

• Restorative Dentistry and Endodontics
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• v.40 no.2
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• pp.155-160
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• 2015

Objectives: Achieving adequate anesthesia with inferior alveolar nerve blocks (IANB) is of great importance during dental procedures. The aim of the present study was to assess the success rate of two anesthetic agents (bupivacaine and lidocaine) for IANB when treating teeth with irreversible pulpitis. Materials and Methods: Sixty volunteer male and female patients who required root canal treatment of a mandibular molar due to caries participated in the present study. The inclusion criteria included prolonged pain to thermal stimulus but no spontaneous pain. The patients were randomly allocated to receive either 2% lidocaine with 1:80,000 epinephrine or 0.5% bupivacaine with 1:200,000 epinephrine as an IANB injection. The sensitivity of the teeth to a cold test as well as the amount of pain during access cavity preparation and root canal instrumentation were recorded. Results were statistically analyzed with the Chi-Square and Fischer's exact tests. Results: At the final step, fifty-nine patients were included in the study. The success rate for bupivacaine and lidocaine groups were 20.0% and 24.1%, respectively. There was no significant difference between the two groups at any stage of the treatment procedure. Conclusions: There was no difference in success rates of anesthesia when bupivacaine and lidocaine were used for IANB injections to treat mandibular molar teeth with irreversible pulpitis. Neither agent was able to completely anesthetize the teeth effectively. Therefore, practitioners should be prepared to administer supplemental anesthesia to overcome pain during root canal treatment.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.25 no.2
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• pp.535-544
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• 1995

The purpose of this study was comparision of conventional tomography with reformatted computed tomography for dental implant in locating the mandibular canal. Five dogs were used and after conventional tomographs and reformatted computed tomographs were taken, four dentist traced all films. Mandibles were sectioned with 2mm slice thickness and the sections were then radiographed(contact radiography). Each radiographic image was traced and linear measurements were made from mandibular canal to alveolar crest, buccal cortex, lingual cortex, and inferior border. Following results were acquired : 1. Reformatted computed tomographs were exacter than conventional tomography by alveolar crest to canal length of -0.6mm difference between real values and radiographs. 2. The average measurements of buccal cortex to mandibular canal width and lingual cortex to mandibular canal width of conventional tomographs were exacter than reformatted computed tomographs, but standard deviations were higher than reformatted computed tomographs. 3. Standard deviations of reformatted computed tomographs were lower than conventional tomographs at all comparing sites 4. At reformatted computed tomography 62.5％ of the measurements performed were within. : filmm of the true value, and at conventional tomography 24.1％ were. 5. Mandibular canal invisibiity was 0.8％ at reformatted computed tomography and 9.2％ at conventional tomography. Reformatted computed tomography has been shown to be more useful radiographic technique for assessment of the mandibular canal than conventional tomography.

• Journal of Oral Medicine and Pain
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• v.36 no.3
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• pp.199-205
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• 2011

During root canal treatment, overinstrumentation with hand or mechanically driven files can perforate the mandibular canal, allowing the extrusion of endodontic sealers, dressing agents, and irrigant solutions out of the tooth and into the canal. The patient may report symptoms such as pain, hyperesthesia, hypoesthesia, anesthesia, dysesthesia and paresthesia. Such problems must be resolved as quickly as possible to avoid irreversible sequelae caused by certain neurotoxic materials that form part of endodontic sealants. Although there have been no controlled trials of treatment protocols involving endodontically related injuries to the inferior alveolar nerve, the normal therapeutic sequence for this complication is the control of pain and inflammation and, whenever possible, the surgical elimination of the cause. However, total resolution of pain and reduction in or disappearance of paraesthesia after a non-surgical management have been reported. Antiepileptic drugs such as gabapentin or pregabalin have been used for the treatment of neuropathic pain. This article describes a case of inferior alveolar nerve(IAN) damage after endodontic treatment of a mandibular right second molar and the treatment with non-surgical approach using prednisone and gabapentin medication, monitoring the patient's condition with clinical neurosensory examination and current perception threshold test(Neurometer).