Inferior Alveolar Research Articles

Delayed Hemorrhage From a Pseudoaneurysm of the Inferior Alveolar Artery following Maxillomandibular Advancement: A Case Report

Maxillomandibular advancement is a common orthognathic surgical procedure in the treatment of obstructive sleep apnea. Although rare, pseudoaneurysms may form following orthognathic surgery, which includes maxillomandibular advancement. Iatrogenic pseudoaneurysms from orthognathic surgery typically occur in the branches of the maxillary artery (sphenopalatine and descending palatine branches) or the facial artery, but uncommonly affect the inferior alveolar artery. We present a unique case of a pseudoaneurysm hemorrhage of the inferior alveolar artery on postoperative day 10 following maxillomandibular advancement diagnosed by computed tomographic angiography and successfully treated with fluoroscopy-guided endovascular embolization. Pseudoaneurysm hemorrhages of the inferior alveolar artery following orthognathic surgery are rare, with only 1 known published case report which occurred with significant intraoperative pulsatile bleeding. This is the only known case of a delayed inferior alveolar artery pseudoaneurysm bleed in the absence of significant intraoperative hemorrhage.

Serum Cortisol and Blood Glucose Concentrations in Anesthetized Dogs Administered Levobupivacaine and Low-Dose Dexmedetomidine for Regional Anesthesia of the Oral Cavity.

The effects on the stress response, postanesthetic sedation, and altered behavior were evaluated following regional anesthesia and dental treatment in 40 dogs. Serum cortisol and blood glucose concentrations were measured following the administration of levobupivacaine (LBUP) 0.5% and dexmedetomidine (DEX) (0.5 µg/kg) or a placebo. The dogs were randomly assigned to 4 groups of 10 dogs each. All dogs received a regional nerve block using LBUP 0.5%. Group 1 (LBUP + DEX IV) also received DEX intravenously (IV); group 2 (LBUP + PLC IV) also received a placebo IV; group 3 (LBUP + DEX IO) also received DEX in one infraorbital (IO) block; and group 4 (LBUP + DEX IA) also received DEX in one inferior alveolar (IA) block. Serum cortisol and blood glucose concentrations were determined before the administration of oral blocks and at the end of the procedure. Sedation and behavior scores were assessed before premedication and hourly for 6 h after the end of anesthesia. Cortisol concentration did not change in any group at either evaluation time. The glucose concentration was higher (P < .05) only in the LBUP + DEX IA group at the end of the procedure. The sedation score was higher until the end of the observation period only in the LBUP + DEX IV and LBUP + PLC IV groups. No change in behavior score was observed in any of the groups. The reduction of perioperative stress response in all groups was due to the use of LBUP and not DEX.

Morphological Analysis of the Anatomical Mandibular Lingual Concavity Using Cone Beam Computed Tomography Scans in East Asian Population-A Retrospective Study.

The rising demand for dental implants necessitates addressing anatomical challenges, particularly the shape of the mandible. Incorrectly angling implants can cause lingual perforations, risking damage to the inferior alveolar artery and nerve. This study analyzed 96 cone-beam computed tomography images from individuals aged 20 to 70 (8 males and 8 females) to evaluate mandibular anatomy in four areas: left and right sides and the first and second molars. Mandibular shapes were classified into U, C, and P types. U-shaped mandibles, with a wider crest width, pose the highest risk of lingual perforation. Measurements for U-shaped types included concavity angle, length, and depth. Statistical analyses (T-tests and ANOVA) with a 95% confidence interval showed no significant differences between the left and right sides. However, significant differences based on gender, age, and tooth type were found. The study found U-shapes in 34.6% of cases, P-shapes in 28.9%, and C-shapes in 36.5%, with U-shapes more common in second molars. Understanding these variations enhances the safety and effectiveness of implant procedures and oral surgeries.

Arterial vascularization of the mandible and soft tissues. Anatomic study.

The literature has for too long described the arterial supply of the mandible as coming from a single artery, the inferior alveolar artery, and being of the terminal type. Rather, it appears to come from an extensive and complex arterial network dependent on the lingual, facial, and maxillary arteries and their collateral branches. Our study aims to confirm and demonstrate the arterial vascular richness of the mandible and to establish arterial mapping. The arterial vascularization of the mandible was revealed in six anatomic specimens after performing selective injections of the lingual, facial, and maxillary arteries with different dyes. A specimen was injected intra-arterially with colored latex at the level of the maxillary artery for a morphometric study. Eighteen selective arterial injections were performed on six anatomic specimens. The mucocutaneous, musculoperiosteal, and intramedullary vascularizations were analyzed. Each of the arteries has a defined and delimited cutaneo-mucous vascular territory. The facial and maxillary arteries supply the musculoperiosteal vascularization of the mandible from the condyle to the symphysis. The lingual artery supplies only the inner cortex of the parasymphyseal and symphyseal regions. The facial and maxillary arteries provide intramedullary vascularization from the angle of the mandible to the parasymphysis. The vascularization of the symphysis depends on the facial artery. No staining was found in the condyle region. Neoprene latex injection was performed on an anatomic specimen, revealing a permeable anastomosis between the inferior alveolar and facial arteries. The arterial vascularization of the mandible is dependent on the maxillary, facial, and lingual arteries. This is a network vasculature. This study makes it possible to establish an arterial map of the mandible. The presence of an anastomosis between the inferior alveolar artery and the facial artery confirms the existence of dynamic and borrowed vascularization. Knowledge of this arterial system makes it possible to adapt maxillofacial surgical care and to anticipate possible intraoperative complications.

Study of the Effect Age and Gender of the Bone Height on the Position of the Inferior Dental Canal Using Cone Beam Computed Tomography

Inferior alveolar canal considered as one from the most important vital structures exist in the mandible and any injury to the (IAC) during the surgical procedures should be avoided, knowing the exact position of the (IAC) can help in avoiding the injury of the (IAC). The sample was consist of 100 patients divided into 2 main groups 1st group consist of 50 males (25 males dentulous, 25 males edentulous), and the 2nd group consisted of 50 females (25 females before menopause &amp; 25 females after menopause). Two measurements were taken the 1st from the crest of alveolar ridge to the superior rim of the (IDC), and the 2nd from the inferior rim of (IDC) to the lower border of the mandible in both right and left sides of the mandible. Results: the stastical analysis of the distance from the crest of alveolar ridge to the superior rim of the (IDC) for both males &amp; females groups showed that there were highly significant difference between male (edentulous versus dentulous) the mean values less in edentulous groups ,and female ( before menopause versus after menopause) the mean values are greater in the ( before menopause ) groups, the stastical analysis of the distance from the inferior rim of (IDC) to the lower border of the mandible showed that the mean values in case of dentulous in males groups was less in edentulous group than dentulous group (right side) with non-significant difference while in the measurement of left side the mean value was higher in the edentulous group with non-significant difference and in females groups the mean values were greater in( before menopause) groups. Conclusion : it can be concluded that the position of the inferior dental canal heavy influenced by the due to the dental status ,due to the teeth loss , age and hormonal changes affect the bone height which is also affected by gender. the vertical distance from the crest of the alveolar ridge to superior rim of (IAC)., the vertical distance from the crest of the alveolar ridge to superior rim of (IAC) , and the distance from lower rim of (IAC) to the lower border of the mandible would be smaller due to the effect of bone height.

855 Mirror-Image Large Complex Odontomes

Abstract Background This report outlines a nine-year follow-up of two 10-year-old patients who attended the paediatric dental department reporting an absent mandibular first permanent molar (FPM). Both reported no pain, no familial history of hypodontia and no altered sensation in the inferior dental (ID) nerve distribution. Clinical examination revealed mandibular expansion in the unerupted tooth area. Special Investigations Panoramic jaw radiographs revealed extensive radio-opaque masses in the mandibular FPM area in both children, in mirror-image sites. Subsequent cone beam CT identified extensive displacement of the FPM with an associated large mixed radiopaque/radiolucent lesion in the body of mandible. Interestingly, the mandibular second permanent molar (SPM) was present in one case and absent in the other. Diagnosis/Management The provisional diagnosis for both cases was a complex odontome however, heavily calcified ameloblastic fibro-odontoma could not be excluded. Management involved surgical removal of the odontogenic tumour with FPM maintenance. Histopathology confirmed the diagnosis of a complex odontoma in both cases. On long-term review in both cases the FPM failed to erupt. Cystic follicular enlargement of the FPM in one case prevented eruption, and a coronectomy was performed in the other on the FPM apices were too close to the ID nerve to be extracted. Discussion These cases highlight the importance of monitoring dental eruption patterns in childhood. Despite the mirror image diagnosis, multiple factors were considered when identifying treatment options for each individual patient. Aetiological questions regarding this particular odontogenic tumour type are raised by the presence or absence of the SPM.

Morphological integration in inferior alveolar canal and mandibular shapes.

During embryogenesis of mandible, the initial ossification centre begins at the bifurcation of the inferior alveolar (IA) and the mental nerves. Additionally, in congenital anomalies like craniofacial microsomia (CFM), the IA canal is completely absent on the microsomic side. These observations led us to hypothesise that there may be a morphological integration between these structures - the IA nerve and the mandibular shapes. Therefore, the primary objective of this study was to test for morphological integration between these structures and the secondary objective was to determine if there were shape variations in these structures among skeletal Classes I, II and III subjects. The sample size of the study is 80 full-head cone-beam computed tomography (CBCT) scans (age 16-56 years). We retrieved CBCT scans from our archived database using specific inclusion/exclusion criteria. In the de-identified CBCT scans, traditional coordinate landmarks and sliding semi-landmarks were placed on the mandible and the IA canal (proxy for IA nerve). Using geometric morphometric analyses, we tested integration between the IA canal and the mandibular shapes. We used Procrustes ANOVA to test for overall shape variations among the three skeletal classes (Classes I, II and III). The IA canal and posterior/inferior border of mandible showed strong integration (r-PLS = .845, P = .001). Similar strong integration was also observed between the IA canal and the overall shape of the mandible (r-PLS = .866, P = .001). Additionally, there was a statistically significant variation in overall shape between skeletal Class I and Class II (P = .008) and Class II and Class III (P = .001). The strong integration between two structures suggests that the IA nerve may play a role in establishing mandibular shape early in development. We posit this may be important in driving mandibular defects seen in CFM, which warrants further investigation.

Structural and CBCT analysis of mandibular canal microvessels expressing neurotransmitters in human cadavers.

This study focused on the detailed structure of microvessels of the neurotransmitter-positive vasa nervorum of the inferior alveolar nerve, vein, and artery in the mandibular canal (MC) to obtain information for improved safety in dental treatments. We also observed the detailed structure of the MC from the mental foramen to the mandibular foramen using cone-beam computed tomography (CBCT). In this study, mandibles from 45 sides of 23 human cadavers aged 76-104years were examined by microscopy, immunohistochemistry, and CBCT analysis. These data were further evaluated by principal component analysis (PCA). The microvessels of the vasa nervorum with calcitonin gene-related peptide- and neuropeptide Y-positive reactions were classified into 5 types: large (4.19%, 28/667); irregular large (7.35%, 49/667), numerous intermediate (29.23%, 195/667),irregular intermediate (29.23%, 195/667), and scattered fine (30.0%, 200/667) microvessels. The MC showed various structures from the 3rd molar to the premolars and was also classified into three types, including complete (57.0%, 228/400), partial (33.8%, 135/400), and unclear (9.2%, 37/400), from the mandibular foramen to the mental foramen. PCA results revealed that developed capillaries were mainly localized in the molar region. Fine microvessels of the vasa nervorum expressing neurotransmitters are present from the molar to premolar region, which is key information for mandibular dental treatments. The different microvessel structures also indicate differences in specific characteristics between dentulous and edentulous cadavers regarding oral surgical and implant treatments.

The variant relationship of the maxillary artery to the lateral pterygoid muscle: a cadaveric study

Study objective: To describe the variations and anatomical landmarks of the maxillary artery Study design and population: This was a descriptive cross-sectional cadaveric study, carried out in the department of human anatomy at the University of Nairobi. Study duration: This was conducted between November 2015 and May 2016. Material and methods: Ninety three (93) hemi-sections from 48 cadavers were used for the study. Dissection of the infratemporal fossa was done to expose the MA and its branches on both sides. The distance of the MA from the articular eminence, mandibular neck, mandibular notch and pterygoid fovea were recorded. The relationship of the MA with the LPM and its branching pattern noted. Results: Out of the 93 hemi-sections dissected 67% of the MA were within the parotid gland while 33% were medial. Thirty five of the MA had a medial relationship to the LPM while, 58 were lateral. Six (6.5%) hemi-sections had the middle meningeal artery (MMA) and the inferior alveolar artery (IAA) originating from a common trunk on the MA. The accessory meningeal artery (AMA) was absent in 3 (3.2%) hemi-sections on the right side and in 2 (2.2%) on the left. Amongst all distances measured of the MA to the bony prominences; mandibular notch, condylar neck, articular eminence, the Pterygoid fovea (14.61±7.07mm for the left and13.93±6.17 and the right side) was the most reliable. Conclusion: The relationship of the MA is more lateral than medial. The most reliable bony landmark is the pterygoid fovea. The branching pattern of the IAA and MMA off the MA is inconsistent in different studies. The MA is a very variable and tortuous artery, probably influenced by age, gender and ethnicity.

The Investigation of Mandibular Canal Variations in the Turkish Society Comparative with Cone Beam Computerized Tomography and Orthopantomography Methods

Mandibular canal and its neurovascular contents are highly important structures for dental clinicals. Accurate localization of the mandibular canal and determination of its variations are crucial aspects to achieve successful surgical results without complications. Inferior alveolar nerve, artery, and vein could be damaged during surgical interventions and serious complications may occur in post-operative period, such as permanent paraesthesia. Thus, the patients’ health and social life may be seriously affected. The aim of this study was to investigate the prevalence and features of mandibular canal variations in a group Turkish population using cone beam computed tomography (CBCT) and orthopantomography (OPG) techniques. This retrospective study was performed on CBCT and OPG images of 700 patients whose mandibular canal area was clearly observed and aged over 20 years old which were referred to our clinic between 2011-2016. Patients with congenital or acquired deformity affecting the mandible were excluded from the study. In order to make comparative analysis, various measurements were made on both types of imaging. In our study, mandibular canal variation rates were identified as 2.43% (17/700) and 8.57% (60/700) on OPG images and CBCT images, respectively. As a result of our study, it could be said that the mandibular canal variations are not rare cases for the Turkish population. Before risky surgical procedures and when there is a suspicious diagnosis due to inadequacy of OPG imaging method; the CBCT imaging method should be referred in order to prevent complications such as hemorrhage, paresthesia, and traumatic neuroma.

Choosing the optimal mandible position for inferior alveolar nerve block (IANB) using finite element analysis

BackgroundOne of the most popular methods of local anesthesia in dentistry, inferior alveolar nerve block (IANB) involves the blockade of the inferior alveolar nerve (IAN) and lingual nerve (LN) in the pterygomandibular space. Despite the large number of works describing the contents of this space, the spatial displacements of the anatomical structures of this area at different positions of the mandible have not been sufficiently studied. The aim of our study was to study the spatial movements of the IAN and inferior alveolar artery (IAA) at various positions of the mandible using computer simulation and finite element analysis to find the safest way to conduct IANB. Materials and methodsReverse engineering was used to create a model of the cranial base and the mandible based on computed tomography (CT) data obtained from patient N (male, 24 years old), the arteries of the head and neck were designed from the data of multiphase angiography of patient M (female, 61 years old). Masticatory muscles, sphenomandibular ligament, temporomandibular joint and mandibular nerve were modeled in the SolidWorks software package based on an open database of anatomical structures. The finite element grid was generated in the Solidworks software.In the first series of experiments, the displacement of the mandible was modeled along the vertical axis down by 48 mm (maximum opening of the mouth), in the second series, the jaw was displaced vertically by 48 mm with a simultaneous transversal movement of 10 mm, in the third series, the jaw was displaced along the vertical axis down by 34 mm and transversally by 22 mm. ResultsThe largest distance between IAN and IAA was noted in the third series of experiments. The distance between the nerve and the vessel was minimal in the first series, with an open mouth without lateral displacements. ConclusionThe generated computer model opens new possibilities for studying the dynamic anatomy of the pterygomandibular space. The results of this study can be used for further experimental and clinical trials to find the safest approach to the implementation of IANB, as well as applied in the practice of the educational process.

Mandibulanın Anatomisi, Embriyolojisi ve Mandibular Foramen’in Klinik Önemi

Sagittal split ramus osteotomisi, mandibular travma, benign ve malign lezyonların çıkartılmaları, preprotetik cerrahi, nervus alveolaris inferior’un lokal anestezisinde sinir hasarı ve olası diğer komplikasyonları önlemek için mandibulanın anatomisi, mandibular foramen’in lokalizasyonu ve anatomik varyasyonlarının bilinmesi oldukça önemlidir. Bu derlemenin amacı mandibulanın anatomisi, embriyolojisi ve mandibular foramenin lokalizasyonun klinik önemini ortaya koyabilmektir.

Pulsatile hemorrhage posterior to the mandibular third molar due to abnormal branching of the inferior alveolar artery: A case report

AbstractBackgroundThe retromolar canal and foramen posterior to the mandibular third molar are rare anatomical variants through which branches of the inferior alveolar neurovascular bundle may pass.Case PresentationPulsatile hemorrhage occurred when the removal of a mandibular third molar and a surrounding cystic lesion was attempted in a 56‐year‐old woman. On imaging, well‐developed inferior alveolar artery branch was observed in the retromolar canal, and the facial artery could not be identified on the same side.ConclusionClinicians must be aware of this anatomical variant to avoid complications.

Fasiyal Asimetride Mandibular Sinir Total Eksplorasyonu

Depending on the affected craniofacial structures, facial asymmetry can be divided into skeletal, dental and functional asymetry. Some asymmetrical disorders can, besides being an aesthetic problem, negatively affect mouth-teeth and jaw functions. For the exact localization of the asymmetrical structures and to determine the cause and extent of the asymmetry, it is helpful to use other diagnostic aids such as study models, face bow transfer and various imaging procedures. The Nervus Alveolaris Inferior is of great importance for physicians, especially when performing operations in the posterior region of the lower jaw in orthodontic jaw surgery. For the exact localization of the asymmetrical structures and to determine the cause and extent of the asymmetry, it is helpful to use other diagnostic aids such as study models, face bow transfer and various imaging procedures.

21. An assessment of Inferior Dental (IDN) and Lingual Nerve (LN) injuries following third molar removal under LA, IVS, and GA – An audit and case-series

Neurosensory deficits following third molar removal affect the quality of life markedly. The purpose of this audit was to evaluate the incidence of IDN and LN damage and to compare departmental rates to an established standard.

Cardiopulmonary Effects and Pharmacokinetics of Dexmedetomidine Used as an Adjunctive Analgesic to Regional Anesthesia of the Oral Cavity with Levobupivacaine in Dogs.

Simple SummaryThe modern approach to multimodal analgesia is based on the use of various types of analgesics before, during, and after surgery, including local anesthetics, such as levobupivacaine. Dexmedetomidine is used as an adjunctive analgesic to enhance the efficacy and duration of local anesthetics, but its use may be associated with dose-related adverse effects, such as hypertension and bradycardia. The primary aim of the study was to investigate the cardiopulmonary effects of dexmedetomidine administered perineurally as an adjunctive analgesic to regional anesthesia of the upper and lower jaw with levobupivacaine in anesthetized dogs. The secondary aim of the study was to investigate the pharmacokinetics of dexmedetomidine to explain the changes in cardiopulmonary parameters due to dexmedetomidine administration. Infraorbital administration was associated with faster absorption of dexmedetomidine, while application into the submucosa near the inferior alveolar nerve resulted in better bioavailability and faster elimination. Perineural administration of dexmedetomidine was associated with lower plasma concentration compared to intravenous administration and may be preferable because it induces a less pronounced cardiovascular response in terms of hypertension and bradycardia.This study investigated the cardiopulmonary effects and pharmacokinetics of dexmedetomidine (DEX) used as an adjunctive analgesic for regional anesthesia of the oral cavity with levobupivacaine in anesthetized dogs. Forty dogs were randomly assigned to four groups of 10 dogs. All dogs received levobupivacaine (4 blocks) with DEX IO (infraorbital block, n = 10) or IA (inferior alveolar block, n = 10) or placebo (PLC; n = 10) or DEX (n = 10) was injected intravenously (IV) after administration of levobupivacaine. The dose of DEX was always 0.5 µg/kg. Cardiopulmonary parameters were recorded, and blood was drawn for the quantification of DEX in plasma using LC-MS/MS. Heart rate was lower in all LB + DEX groups, while mean arterial pressure (MAP) was higher in the LB + DEX IV and LB + DEX IA groups compared to the LB + PLC IV group. Compared to DEX IV, IO and IA administration resulted in lower MAP up to 2 min after application. Absorption of DEX was faster at IO administration (Cmax and Tmax were 0.47 ± 0.08 ng/mL and 7.22 ± 1.28 min and 0.76 ± 0.09 ng/mL and 7.50 ± 1.63 min for the IO and IA block, respectively). The IA administration resulted in better bioavailability and faster elimination (t1/2 was 63.44 ± 24.15 min and 23.78 ± 3.78 min for the IO and IA block, respectively). Perineural administration of DEX may be preferable because of the less pronounced cardiovascular response compared to IV administration.

Expect the unexpected: The course of the inferior alveolar artery – Preliminary results and clinical implications

IntroductionThe anatomical position of the inferior alveolar artery (IAA) within the mandibular canal and in relation to the substructures of the neurovascular mandibular bundle has been sparsely described to date. More detailed information on the exact IAA position would be beneficial for both dental and maxillofacial surgical procedures to minimize complications such as bleeding, nerve compression hematoma, and sensory deficiency. Material and methodsIn 31 Thiel-preserved and fresh-frozen cadaver hemimandibles the position of the IAA in relation to the structures of the inferior alveolar neurovascular bundle and the mandible borders was analyzed anatomically and histologically. ResultsIn 77.4% of the cases, rotation of the IAA around the mental nerve was apparent, resulting in a typical site-dependent IAA position. While the IAA was situated buccally within the pterygomandibular space, buccal-inferior in the mandibular foramen, superior in the molar region, and lingually in the premolar region. In 12.9% of the cases, a persistent lingual position of the IAA was observed for the entire mandibular canal. In one case, an additional mandibular canal and an accessory IAA were identified. DiscussionThis study provides new and encompassing information on the complete course and position of the IAA. This course is of practical use for oral implantology and various surgical procedures in dental- and maxillofacial surgery. Variations in the typical IAA course and site-dependent positional changes may be referred to as mandible growth and functional adaption to occlusion anomalies. This report helps enhance the morphological and functional understanding of IAA relationship during mandible development.

An anatomical study of the blood supply to the mylohyoid muscle: the so-called “mylohyoid branch” of the inferior alveolar artery is an arterial anastomosis

BackgroundThe aim of this study was to clarify the morphology of the mylohyoid branch of the inferior alveolar artery and the main blood supply to the mylohyoid muscle. Methods: The maxillary artery (MA) and inferior alveolar artery (IAA) within the infratemporal fossa, the facial and submental arteries within the submandibular triangle, and the nerve to the mylohyoid muscle and related artery were dissected in twelve sides from embalmed cadaveric heads. The main blood supply to the extraoral (inferior) surface of the mylohyoid muscle was recorded. Results: The mylohyoid branch of the inferior alveolar artery was an anastomosis of the descending branch of either the inferior alveolar or maxillary artery and the ascending branch of either the submental or facial artery. The anastomosis was classified into four types according to the origins of the arteries. The main blood supply to the extraoral surface of the mylohyoid muscle was the submental artery. Conclusions: The results of this study indicate that the mylohyoid branch of the IAA in human adults is an anastomosis of branches of the maxillary and facial arteries.

Transient Diplopia After Inferior Alveolar Nerve Block: A Case Report

Ocular disturbances, such as diplopia, blurred vision, retrobulbar pain etc. after mandibular inferior alveolar nerve block (IANB) have been reported on rare occasions. Transient diplopia after IANB is a temporary ocular presentation in which two images of a single object is perceived simultaneously.Various theories have been put forth, supporting the possible explanation of this phenomenon such as accidentalretro flow of local anesthetic agent through the inferior alveolar artery to the orbital region, or its inadvertent entry into the venous system thereby reaching the cavernous sinus through emissary veins affecting cranial nerves III, IV, and VI, or a local anesthetic misadventure initiating sympathetic impulse traveling to the ophthalmic artery. Fortunately, most observed symptoms are temporary and self – limited, but they can be rather distressing to both patients and surgeons. This case report describes a 44-year-old female patient who developed transient diplopia following IANB. Key Words: Diplopia, Inferior alveolar nerve block, Transient.

Vestibular bone thickness of the mandible in relation to the mandibular canal in a population from Bosnia and Herzegovina

Introduction: Dental implantology is the branch of dentistry that is gaining greater significance because a larger number of patients come with requests of implant placements. During dental implant placements, with patients with whom operation is carried out in the mandible, very frequently nervus alveolaris inferior can be injured. The nerve injury may occur during the implant placement, but the nerve may also be injured in case of harvesting of intraoral bone graft. During the bone graft harvesting, but also during any other procedure in the dentistry that entails working on vestibular side of corpus of the mandible, in order not to injure the nervus alveolaris inferior, it is important to familiarize oneself with the distance of the nerve from the outer vestibular cortex of the mandible. The objective of the study was to assess the vestibular bone thickness of the mandible in relation to the mandibular canal with the help of analysis of cone-beam computed tomography (CBCT) images.Methods: It was accessed the database of CBCT images taken at the School of Dental Medicine at the University of Sarajevo, where out of 700 reviewed CBCT images, an analysis of 322 CBCT images was conducted that satisfied inclusion criteria of the study. CBCT images were taken using of ORTHOPHOS SLX imaging unit. The measurement was conducted by Sidexis program on cross-section of CBCT image. The measurement of vestibular bone thickness was performed, by measuring the distance from the lateral wall of the mandibular canal to buccal mandibular compact bone, in the region of the second premolar, of the first and the second molar.Results: There were statistically significant differences in vestibular bone thickness between men and women on both sides in the region of the second premolar (p &lt; 0.001) and first molar (p = 0.016 right, p = 0.018 left). T-test demonstrated no statistically significant difference in the vestibular bone thickens between men and women on either side in the case of vestibular bone thickness of the center of the second molar (p = 0.397 right, p = 0.743 left).Conclusion: Values of vestibular thickness of the mandible are larger with men than with women in all measuring points; however, statistically more significant differences between genders have been detected in the second premolar and center of the first molar.