To Assess and Evaluate the Variation of Mandibular Anatomy Using Cone Beam Computed Tomography Before Planning an Implant Surgery: A Population-based Retrospective Study

Abstract

The accurate placement of implants in mandible requires consideration for angulations of the bone along with the vertical dimensions. The aim of this present study was to assess the variation of mandibular anatomy using computed tomography (CT) radiography and to evaluate the effect of presence and absence of teeth on the mandibular anatomy before planning an implant surgery. The present population-based retrospective study was conducted using 167 digital CT scan images those selected from departmental archives. The samples were sub-divided two groups: group 1included digital CT of edentulous mandible while group 2 included digital CT of edentulous mandible. The axial height, vertical height, and angulations were recorded separately for each group. The results of the present study showed a gradual increase in mandibular angle in both the groups with a statistically significant difference only in the canine-premolar area. The axial height showed a significant difference at canine and first premolar area and a second premolar and the first molar area. However, available height showed a significant difference in canine and first premolar area and distal to the second molar area. When both the sides were compared, no statistically significant difference was observed between right and left sides. It was concluded that due to the variability of the mandibular anatomy and because of the effects of various imperative factors, 3D imaging like CT scans should be recommended for safer and secure presurgical planning. In surgical osteotomies and implant placement especially in post-extraction sockets, two-dimensional (2D) image of panoramic radiographs should not be considered that reliable as these three-dimensional (3D) imaging radiographs. Therefore CT scans of various angulations and sections must be considered by the clinicians to rationally study the mandibular anatomy and their risk associated areas.