Fig. 4. Cross-sectional images of areas 1–3 of a 39-year-old female. The visibility ratios for the superior wall in areas 1, 2, and 3 were 0.2, 0.9, and 0.9, respectively, whereas those of the inferior wall were 0.7, 0.9, and 1.0, respectively
Fig. 4. Cross-sectional images of areas 1–3 of a 39-year-old female. The visibility ratios for the superior wall in areas 1, 2, and 3 were 0.2, 0.9...
Fig. 3. Visibility ratios of the superior and inferior walls in three areas. The Friedman test and Scheffe’s test were used for the statistical analysis
Fig. 3. Visibility ratios of the superior and inferior walls in three areas. The Friedman test and Scheffe’s test were used for the statistical analysis
Fig. 2. Visibilities of the superior and inferior walls of the mandibular canal. a Both walls are visible. b Only the inferior wall is visible. c Neither of the walls is visible
Fig. 2. Visibilities of the superior and inferior walls of the mandibular canal. a Both walls are visible. b Only the inferior wall is visible. c Neither of the walls is visible
Fig. 1. Cross-sectional images in the range of 30Â mm just distal to the mental foramen were used for evaluation. The range was divided into three areas, each of which was 10Â mm in length, designated as area 1, area 2, and area 3, from anterior to posterior. (The mental foramen was identified on another section and was not visualized on this image)
Fig. 1. Cross-sectional images in the range...
Â
Number of cases
Mandibular canal wall
Area 1
Area 2
Area 3
Superior wall
...
NoneTable 2 Mean visibility ratio ± SD
Mandibular canal wall
Area 1
Area 2
Area 3
Superior wall
0.7795
...
Ishii, H., Tetsumura, A., Nomura, Y. et al. Diagnostic ability of limited volume cone beam computed tomography with small voxel size in identifying the superior and inferior walls of the mandibular canal.
Int J Implant Dent 4, 18 (2018). https://doi.org/10.1186/s40729-018-0133-7
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Received: 20 December 2017
Accepted: 23 April 2018
Published: 26 July 2018
D...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
All procedures followed were in accordance with the ethical standards of the responsible committees on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. The study was approved by an institutional review board of our university (approval No. D2016-061). The requirement for informed consent from each patient was waived in this retrospect...
Correspondence to
Akemi Tetsumura.
Department of Oral and Maxillofacial Radiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
Hiroko Ishii, Akemi Tetsumura, Yoshikazu Nomura, Shin Nakamura & Tohru Kurabayashi
URA, Research Administration Division, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
Masako Akiyama
Yo...
The datasets during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Weckx A, Agbaje JO, Sun Y, Jacobs R, Politis C. Visualization techniques...
Cone beam computed tomography
Field of view
In conclusion, we evaluated the visibility of the mandibular canal walls on limited volume CBCT images with a small voxel size. Evaluation was performed in the range of 30Â mm in length just posterior to the mental foramen, which was divided into three equal areas (areas 1, 2, and 3, from anterior to posterior). The superior wall was significantly more poorly visualized than the inferior wall in a...
Our study had some limitations that should be addressed. First, in our study, antero-posterior location of the mandibular canal was defined by the distance from the mental foramen. Tooth positions could not be used as a reference, because premolars and molars were totally or partially missing in considerable number of the cases. Although areas 1–3 were considered mostly to correspond to the area...
Jung and Cho [6] reported that the mandibular canal was clearly visible in 50% of CBCT images in the first molar and in 58% in the second molar region. Similarly, Oliveira-Santos et al. [5] reported that it was visible in 63, 66, and 67% of second premolar, first molar, and second molar regions, respectively. As described above, these studies did not discriminate between the superior and the infer...
In this study, we only used CBCT images of the mandible obtained with the smallest FOV, 40 × 40 mm. On those images, the range of 30 mm in length in the mandible just posterior to the mental foramen was divided into three equal areas, each of which was 10 mm in length. They were designated as areas 1, 2, and 3, from anterior to posterior. After that, the visibilities of the superior and in...
It is very important to know the location of the mandibular canal prior to dental implant surgery to avoid surgical complications including vascular trauma or nerve damage.
CBCT is widely accepted to be the imaging method of choice for obtaining this information [1, 2]. However, it is well known that the mandibular canal cannot usually be identified over its entire course even when CBCT is used. ...
Interobserver agreement was substantial or almost perfect agreement (Table 1).
The mean values of the visibility ratio of the superior and inferior walls in each area are shown in Table 2 and Fig. 3. In all areas, the ratio of the superior wall was significantly lower than that of the inferior wall (p = 0.0000). As for variance among the three areas, the ratio was highest in the most poste...
The ratio ranged from 0 to 1.
Sample size was determined using the free software G* Power 3.1 [11]. We evaluated 30 patients, and the effect size was calculated from the mean, standard deviation, and correlation. Wilcoxon signed-rank sum test was chosen, and the significance level was set to 0.05. The result showed that a sample size of 26 to 75 patients would provide a power of at least 0.8 for ...
This study was approved by an institutional review board of our university (D2016-061).
Among the patients whose mandibles were examined by CBCT at our dental hospital between April 2012 and August 2016, 96 patients who fulfilled the following two conditions were selected.
On CBCT imaging:
The smallest field of view (FOV) of the device, 40 × 40 mm, was used.
The mental foramen and the ma...
The mandibular canal is an important anatomical structure that contains the neurovascular bundle, i.e., the inferior alveolar nerve and artery. The location of the mandibular canal must be correctly identified prior to dental implant surgery to avoid complications including intraoperative and postoperative hemorrhage and neurosensory loss. Cone beam computed tomography (CBCT) is considered the ima...
The aim of this study was to evaluate the visibility of the superior and inferior walls of the mandibular canal separately using limited volume cone beam computed tomography (CBCT) with small voxel size.
CBCT cross-sectional images of 86 patients obtained by 3D Accuitomo FPD and reconstructed with a voxel size of 0.08Â mm were used for the evaluation. A 30-mm range of the mandible just distal to ...
Â
Figure 4. Sublingual artery originating from an anastomotic branch of the lingual and submental arteries: h submental artery, i hypoglossal artery, j lingual artery, and k anastomosis of the lingual and submental arteries
Â
Figure 3. Submental artery as the source of the sublingual artery entering the MMLF: e submental artery, f inferior border of the mandible, and g facial artery
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Figure 2. Lingual artery as the origin of the sublingual artery entering the MMLF: a external carotid artery, b lingual artery, c hypoglossal nerve, d right and left sublingual arteries originating from the ipsilateral lingual arteries and e inferior border of the mandible
Figure 1. Distribution of cadavers according to source of artery entering the MMLF (n = 34)
Figure 1. Distribution of cadavers according to source of artery entering the MMLF (n = 34)
The sublingual and submental arteries normally anastomose through their muscular mylohyoid branches. Loukas et al. only identified anastomotic patterns between sublingual and submental arteries in 40Â % of the dissected cadavers, with no case where the two terminate as a single sublingual artery. We found three (8.9Â %) cases of an anastomotic branch of the submental and lingual artery formi...
The MMLF is a consistent structure through which the sublingual artery enters the mandible. Perforation of the lingual plate by an implant drill poses a high risk of trauma to this vessel especially when the sublingual fossa is very pronounced because this vessel courses closely to the gland and fossa. When this artery is of a significant size, it is possible for 420 mL of blood to escape in...
Results
A total of 34 human cadavers were dissected in this study of which 30 (88.2 %) were males and 4 (11.8 %) were females (male/female, 15:2) aged between 25 and 40 years. The linear distance between the MMLF and the inferior border of the mandible ranged from 11.03 to 19.62 mm (mean = 15.58 mm ± 2.12 SD). The mesio-buccal thickness of the mandible at the level of the MMLF ra...
Methods
This was a cadaveric dissection study involving 34 human adult cadavers of indigenous Kenyan descent carried out at the Department of Human Anatomy, University of Nairobi. Majority of these cadavers are unclaimed bodies in the city of Nairobi, whose demographics are hardly known. Approval to conduct the study was obtained from the Kenyatta National Hospital/University of Nairobi Ethics,...
Background
The inter-foraminal region of the human mandible is a common elective area for several dental surgery procedures due to its favourable anatomic conditions. Some of the procedures done in this region include insertion of endosseous dental implants, bone harvesting from the chin, genioplasty in orthognathic surgery and placement of screws during plating in management of facial fracture...
Abstract
Background
Inter-foraminal implant placement poses a risk to the sublingual artery as it enters the mandibular midline lingual foramen. Lack of consensus on the source of this artery poses a dilemma to surgeons during management of haemorrhagic episodes. Determination of the exact source of this artery is therefore pivotal.
Methods
This was a cross-sectional descriptive study involv...
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