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Fig. 4. Cross-sectional images of areas 1–3 of a...

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 infe...

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 ...

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...

Fig. 1. Cross-sectional images in the range of 30 mm just distal to the mental foramen were used for evaluation. The range was divided into three areas, each of which was 10 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...

Table 3 Frequency of cases with visibility ratio o...

  Number of cases Mandibular canal wall Area 1 Area 2 Area 3 Superior wall ...

Table 2 Mean visibility ratio ± SD : Diagnost...

NoneTable 2 Mean visibility ratio ± SD

Table 1 κ-values for interobserver agreement : Di...

Mandibular canal wall Area 1 Area 2 Area 3 Superior wall 0.7795 ...

About this article : Diagnostic ability of limited...

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 Download citation Received: 20 December 2017 Accepted: 23 April 2018 Published: 26 July 2018 D...

Rights and permissions : Diagnostic ability of lim...

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...

Ethics declarations : Diagnostic ability of limite...

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...

Author information : Diagnostic ability of limited...

Correspondence to Akemi Tetsumura.

Author information : Diagnostic ability of limited...

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...

Availability of data and materials : Diagnostic ab...

The datasets during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References : Diagnostic ability of limited volume ...

Bertl K, Heimel P, Reich KM, Schwarze UY, Ulm C. A histomorphometric analysis of the nature of the mandibular canal in the anterior molar region. Clin Oral Investig. 2014;18:41–7. Starkie C, Stewart D. The intra-mandibular course of the inferior dental nerve. J Anat. 1931;65:319–23. Carter RB, Keen EN. The intramandibular course of the inferior alveolar nerve. J Anat. 1971;108:433–40. Nai...

References : Diagnostic ability of limited volume ...

Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–91. Kundel HL, Polansky M. Measurement of observer agreement. Radiology. 2003;228:303–8. Alhassani AA, AlGhamdi AS. Inferior alveolar nerve injury in implant dentistry: diagnosis, causes, prevention, and managem...

References : Diagnostic ability of limited volume ...

Tyndall DA, Price JB, Tetradis S, Ganz SD, Hildebolt C, Scarfe WC. Position statement of the American Academy of Oral and Maxillofacial Radiology on selection criteria for the use of radiology in dental implantology with emphasis on cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113:817–26. Weckx A, Agbaje JO, Sun Y, Jacobs R, Politis C. Visualization techniques...

Abbreviations : Diagnostic ability of limited volu...

Cone beam computed tomography Field of view

Conclusions : Diagnostic ability of limited volume...

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 30 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...

Discussion : Diagnostic ability of limited volume ...

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...

Discussion : Diagnostic ability of limited volume ...

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...

Discussion : Diagnostic ability of limited volume ...

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...

Discussion : Diagnostic ability of limited volume ...

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. ...

Results : Diagnostic ability of limited volume con...

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...

Methods : Diagnostic ability of limited volume con...

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 ...

Methods : Diagnostic ability of limited volume con...

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...

Background : Diagnostic ability of limited volume ...

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...

Abstract : Diagnostic ability of limited volume co...

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 0.08 mm were used for the evaluation. A 30-mm range of the mandible just distal to ...

Figure 4. Sublingual artery originating from an an...

  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

Figure 3. Submental artery as the source of the su...

  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  

Figure 2. Lingual artery as the origin of the subl...

  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 so...

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)

Discussion : Arterial blood supply variation in th...

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 40 % of the dissected cadavers, with no case where the two terminate as a single sublingual artery. We found three (8.9 %) cases of an anastomotic branch of the submental and lingual artery formi...

Discussion : Arterial blood supply variation in th...

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 : Arterial blood supply variation in the a...

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 : Arterial blood supply variation in the a...

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 : Arterial blood supply variation in th...

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...

Arterial blood supply variation in the anterior mi...

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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