Mandibular Canal Research Articles

Prevalence of C-shaped second mandibular molar canals in the population of central Serbia: A cone-beam computed tomography study

Background/Aim. C-shaped canals are a complex morphological variation of the tooth root canal system that, if present, could greatly affect the outcome of endodontic therapy. The prevalence of these canal configurations varies between the populations of different ethnic and geographical origins. Therefore, the goal of this study was to analyze the prevalence and morphology of mandibular second molar C-shaped canals in the population of Central Serbia. Methods. The study included a total of 1 99 mandibular second molars receiving a cone-beam computed tomography (CBCT) examination and determining the presence of C-shaped canal systems, their configuration, minimal wall thickness and its relative position on axial cross-sections at the coronal, middle, and apical level. Results. The prevalence of C-shaped mandibular second molars was 5.53%. C1 canal configuration was the most frequent at the coronal cross-section, while C2 configuration was the most frequent at middle and apical cross-sections. Minimal wall thickness decreased going apically, with the mean value of 1.01 mm at the coronal, 0.87 mm at the middle, and 0 .67 mm at the apical cross-sections. Minimal wall thickness was mostly directed lingually at all cross-sectional levels. Conclusion. C-shaped canals should be expected in mandibular second molars of the population of Central Serbia. CBCT was shown to be the most valuable technique to determine C-shaped canals and facilitate understanding of the C-shaped canal morphology; its implementation could improve the success of endodontic therapy, especially if the complex root canal configuration is present.

Cone-beam computed tomography evaluation of prevalence and location of mandibular incisive canal in patients attending King Saud University Dental Hospital.

OBJECTIVE:This study aims to facilitate a surgeon's preoperative assessment by detecting the prevalence, location, and course of the mandibular incisive canal (MIC) in our population.METHODOLOGY:A retrospective study was conducted at King Saud University, Riyadh, Saudi Arabia. A total of 93 cone-beam computed tomography (CBCT) scans of patients aged 18–50 years were taken. The images were reformatted from the sagittal sections to para-sagittal sections at premolars, canines, lateral incisors, and central incisors measured to the distance of MIC to the tooth apex, to the inferior border of the mandible, to the buccal cortex, and to the lingual cortex.RESULTS:MIC among the patients was found to be present in 96.8% of the total subjects. Prevalence between genders showed that it was present in 97.9% of the male patients and 95.5% of the female patients. The average distance from the buccal cortex is 4.88, the lingual cortex is 5.54, inferior border is 9.94, and root apices is 7.67. The age-wise and gender-wise comparison of a mean distance of MIC to the different surfaces in the different cross-sections showed that there is no correlation, and there is a significant correlation, respectively.CONCLUSION:The detection of the MIC presence and location using CBCT should be earnestly considered for surgical procedures that are intended to be done in the interforaminal region.

Three Dimensional mapping of the root apex: distances between apexes and anatomical structures and external cortical plates.

This study aimed to determine the mean distances between apexes of the maxillary posterior teeth and the maxillary sinus, between apexes of the mandibular posterior teeth and the mandibular canal, and between the root apexes of all teeth and the adjacent cortical plates. A total of 800 cone-beam computed tomography (CBCT) scans (400 maxillary and 400 mandibular) were obtained from patients indicated for several treatments. The proximity between apexes and anatomical structures, and the relationship between apexes and adjacent cortical plates were assessed together with the risk of over-instrumentation. Paired-sample comparisons were performed by using the paired t-test. The means were compared by ANOVA, Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests. a) Most of the apexes classified as A (high-risk proximity) were observed in maxillary first and second molars, in mandibular first and second molars, and in second premolars in relation to near anatomical structures. b) A predominance of class A (86.42%) was noticed in the first premolars, between apexes of maxillary teeth and adjacent cortical plates. c) The distance between apexes of mandibular teeth and buccal cortical plates showed a predominance of medium-risk proximity (B) in all the groups, except the first premolars, with the highest risk (82.22%), and the second molars, with low-risk proximity (C) to distal and mesiobuccal apexes (91.77% and 89.62%). CBCT images are important for endodontic diagnosis and treatment, since many teeth have high risk proximity to near anatomical structures and adjacent cortical plates.

The Prevalence and Anatomical Variations of Bifid Mandibular Canal in a Sample of Egyptian Population Using CBCT. A Cross-Sectional Study

Aim: Detection of the prevalence of bifid mandibular canal and classification of its types in the Egyptian population. Methodology: Radiographic examination of 329 mandibular sides was done using Planmeca Promax 3D Mid CBCT machine. The scans varied depending on patients’ sizes (according to the manufacturer’s recommendations) using different FOVs with the same voxel size (0.4 mm (400 μm)). The bifid the mandibular canal was observed and classified according to Naitoh`s classification (retromolar, dental, forward, and buccolingual canals). In addition, the prevalence of location of accessory canal types and the mean distance to the alveolar ridge and teeth were reported. Results: In 329 hemimandibles, there were 101 bifid canals (30.7%) and 37 trifid canals (11.2%). The dental canal type was the most common (43.3%), followed by retromolar canal type (33.7%), forward canal type (17.2%), and buccolingual canal type (5.7%). The forward canals and the dental canals had statistically similar mean distances of 11.1 ±2.1 and 11.1±2.5 mm respectively. The accessory canals were at a significantly longer mean distance (12.1±1.6 mm) to the alveolar crest in the premolar area compared to distance in the molar area (10.9 ± 2.3 mm). Retromolar canals showed a significantly longer distance of 13.8± 4.4 mm. Conclusions: Examination of the mandibular canal is mandatory by surgeons to minimize the chance of missing any accessory branches, since its prevalence was more than 40% with 21.3 % presented with bilateral manifestation.

The occurrence of dental implant malpositioning and related factors: A cross-sectional cone-beam computed tomography survey.

PurposeDental implants are widely used for the rehabilitation of edentulous sites. This study investigated the occurrence of dental implant malpositioning as shown on post-implantation cone-beam computed tomography (CBCT) and to identify related factors.Materials and MethodsSamples with at least 1 malpositioned dental implant were collected from a central radiology clinic in Tehran, Iran from January 2017 to January 2019. Variables such as demographic characteristics, length and diameter of implants, type of implant, sites of implant insertion, different types of implant malpositioning problems (cortical plate perforation, interference with anatomical structures), angulation of the implant, and the severity of malpositioning were assessed. In addition, the incidence of implant fracture and over-drilling was evaluated. Data were statistically analyzed using the chi-square test, 1-sample t-test, and Spearman correlation coefficients.ResultsIn total, 252 patients referred for implant postoperative CBCT evaluations were assessed. The cases of implant malpositioning included perforation of the buccal cortical plate (19.4%), perforation of the lingual cortical plate (14.3%), implant proximity to an adjacent implant (19.0%), implant proximity to an adjacent tooth (3.2%), interference with anatomical structures (maxillary sinus: 18.3%, mandibular canal: 11.1%, nasal cavity: 6.3%, mental foramen: 5.6%, and incisive canal: 0.4%). Implant fracture and over-drilling were found in 1.6% and 0.8% of cases, respectively. Severity was categorized as mild (9.5%), moderate (35.7%), severe (37.7%), and extreme (17.1%), and 52.4% of implants had inappropriate angulation.ConclusionCBCT imaging is recommended for detecting dental implant malpositioning. The most common and severe type of malpositioning was buccal cortex perforation.

Tratamento de terceiros molares inclusos através da técnica coronectomia – aspectos clínicos

Nerve damage during third molars removal is an inherent risk of the procedure due to the anatomical proximity of these structures. Coronectomy is an effective technique that can reduce the risk of developing paresthesia caused by this injury. The present study aims to report a clinical case in which the coronectomy was performed describing its technique. The procedure was performed on a 25-year-old male patient, with third molars removal indication. The radiological exam suggested an intimate relationship between the lower right third molar roots and the mandibular canal. The coronectomy technique was performed under local anesthesia and the follow-up was performed after seven days, four months and four years. One week after surgery patient reported good recovery and does not showed radiographic signs or clinical symptoms of sensory or other pathological disorders. After four years, a new radiography was performed, where sign of peripheral bone formation and the absence of any pathological aspect or migration were observed. Considering the low complexity and morbidity of the technique, it becomes a good alternative to extraction, aiming to reduce the development of paresthesia in high-risk cases.

Variations in Anatomical Landmarks of Mandible Using Cone Beam Computed Tomography - A Cross-Sectional Study

Background: Cone beam computed tomography (CBCT) is a diagnostic imaging modality for implant and surgical procedures in anterior and posterior mandibular area. It provides adequate information concerning maxillofacial regions, optimum image quality, excellent geometric accuracy, and low radiation dose. Aim: The aim of this study was to evaluate prevalence and anatomical variations in Mandible (Mandibular Incisive canal, Lingual Foramen, Mental Foramen, and Mandibular canal) in CBCT scans of the maxillofacial region. Methodology: All CBCT cross-sectional images of 40 study participants was analyzed for the presence of anatomical landmarks. All the anatomical parameters were compared with respect to age groups, dentition, gender, and right and left side and their respective distances from the inferior border of mandible and alveolar crest were measured using CS 3D imaging software (Kodak). Results: Lingual Foramen, Mental Foramen, and Mandibular Foramen were seen in all (100%) study samples, incisive foramen 83% and anterior loop in 25% of study samples. On statistical analysis, the difference of the mean distance of incisive foramen, mental foramen, anterior loop and mandibular foramen from lower border of mandible and alveolar crest was significant with relation to gender (P = 0.006) and with relation to dentate, partially dentate, and edentulous were found to be significantly different (P < 0.001). Conclusions: Careful assessment of the anatomical landmarks is essential to avoid neurosensory and bleeding complications using CBCT.

EVALUATION OF SHORT IMPLANTS’ SUCCESS FOR TEETH REPLACEMENT IN ATROPHIC POSTERIOR MANDIBULAR RIDGE (CLINICAL TRIAL)

Introduction: Atrophic mandibular jaws have been challenging to treat, using long implants. Techniques as jaw ridge augmentations, mandibular canal lateralization, and osseous distraction were proposed to allow the insertion of long Implants. However, complications as nerve injuries, tissue morbidity and prolonged healing have been inconvenient. Therefore, short implants with advanced surface treatments have been suggested. Objectives: Clinical and radiographic evaluation of splinted and single short implants, before and after loading, for teeth replacement in atrophic posterior mandibular alveolar ridges. Materials and Methods: A prospective study was done on 16 Patients with missing posterior teeth, with 6-8 mm of crestal height above the mandibular canal, and at least 7mm of bone width. Group A: 8 patients received 2 short implants loaded by splinted crowns. Group B: 8 patients received single short implants loaded by single crowns. Osstell and CBCts were used for implant stability and bone condition assessment. Results: Both groups maintained high implant stability with a mean of (68.79±4.61) for group A and (71.71±3.55) for group B, 6 months postoperative. Mean marginal bone loss for group A and group B was (0.11±0.04) and (0.16±0.10) respectively; however the difference is insignificant with P value 0.535. A remarkable increase in bone density for both groups among the follow up time with P value Conclusions: Short Implant is a useful solution for teeth replacement in atrophic posterior mandibular ridges, with an 87.5% of success recorded.

Neurosensory Disturbances After Apical Surgery of Mandibular Premolars and Molars: A Retrospective Analysis and Case-Control Study.

Objective:Apical surgery is an intervention to treat teeth with persistent or recurrent endodontic infection. The proximity of the mental foramen and mandibular canal may pose a risk of altered sensation when performing surgical interventions in the posterior mandible. The objective of this study was to determine the rate of neurosensory disturbances after apical surgery of mandibular premolars and molars. The secondary objective was to evaluate whether the occurrence of altered sensation correlated with the distances from the apex or the periapical lesion to the relevant anatomical structures.Methods:The charts of patients treated from September 1999 to December 2015 were retrospectively evaluated if an apical surgery had been performed in mandibular premolars or molars, and a minimum period of 1-year follow-up was documented. Patients with trauma or other surgical interventions in the same hemimandible were excluded. Cases with postsurgical altered sensation were defined as the test group. From the pool of unaffected cases, patients were selected to serve as controls. Two- or three-dimensional radiographs of test and control cases were assessed with regard to the shortest distances from the root apices/lesions to the mental foramen or mandibular canal.Results:The study population included 243 patients with 249 apical surgeries, of which 12.9% led to postoperative neurosensory disturbances. Sensation returned to normal within 22 days on average. The most frequent findings were hyperesthesia or paresthesia. With regard to the treated type of tooth, second premolars resulted more frequently (22.6%) in altered sensation than the other teeth (11.2 to 13.0%; p=0.310). There were no significant differences when comparing test and control cases regarding the measured distances in radiographs from the apex/lesion to the relevant anatomical structures.Conclusion:Altered sensation may typically occur following apical surgery in posterior mandibular teeth. However, in all cases of the present study, skin sensitivity in the lip/chin region returned to normal. The clinician must be particularly careful when performing apical surgery of second premolars due to the proximity of the mental foramen.

Decision Criteria Proposed for the Treatment of Vertical Bone Atrophies in the Posterior Mandible.

In everyday practice, surgeons have to deal with bone atrophy. These rehabilitations are even more complex in the posterior mandible, and it is still unclear in the literature which fixed rehabilitation option is best. The purpose of this article was to help oral surgeons to choose the proper and updated treatment for their atrophic patients. Posterior mandible bone atrophies were divided into four main groups depending on the bone height measured above the inferior alveolar nerve: (1) ≤ 4 mm; (2) > 4 mm ≤ 5 mm; (3) > 5 mm ≤ 6 mm; (4) > 6 mm < 7 mm. Different approaches were proposed for each group, considering patient expectations. If ≤ 4 mm of bone height was available, guided bone regeneration was used as the adequate approach. For bone heights > 4 mm and ≤ 6 mm, the "sandwich" technique and/or short implants were used, depending on esthetics. In cases with > 6 mm and < 7 mm above the mandibular canal, short implants might be the proper option. The authors' clinical experience and the literature were considered in order to suggest a possible correct treatment decision based on the residual bone height in the posterior mandible.

Anatomical Analysis of Mandibular Posterior Teeth using CBCT: An Endo-Surgical Perspective.

Objective:This study sought to analyse the relationship between mandibular posterior teeth and the surrounding anatomical structures.Methods:A total of 170 CBCT images were examined to obtain measurements regarding the following: buccolingual (BL) and mesiodistal (MD) root thickness at the standard level of resection (3 mm from the apex), the thickness of the overlying buccal and lingual bone at the same level, the proximity of the mandibular canal (MC) to the apices of the mandibular posterior teeth, as well as the horizontal location of the mental foramen (MF).Results:The BL root width at 3 mm from the apex was the broadest at the mesial roots of the first molars with males: 5.33±0.99 mm and females: 5.16±0.88 mm (mean±SD). The root width was narrowest at the second premolars (males: 3.80±0.83 mm; females: 3.61±0.60 mm). At the same level; the buccal bone was thickest over the distal roots of the second molars (males: 6.92±1.85 mm; females: 6.95±1.95 mm) and thinnest over the first premolars (males: 1.73±0.93 mm; females: 1.49±1.01 mm), while the lingual bone was thickest over the distal roots of the first molars (males: 5.58±1.36 mm; females: 4.52±1.24 mm) and thinnest over the distal roots of the second molars (males: 3.13±1.50 mm; females: 2.60±1.46 mm). The nearest root apices to the MC were the distal roots of the second molars (male: 1.21±1.45 mm; female: 1.75±1.97 mm), while the furthest were the mesial roots of the first molars (male: 4.00±2.39 mm; female: 4.77±2.58 mm). The most common horizontal location of the MF was between the first and second premolars (51.8%). The lingual bone was significantly thinner over both roots of first molars in females (P<0.05).Conclusion:As the position of the teeth became more posterior, the buccal bone thickness increased, the lingual bone thickness decreased, and the distance to the MC became closer. CBCT analysis provides distortion- and superimposition-free images of the relevant anatomic structures.

Mandibular second molars' C-shaped canal frequency in the Pakistani subpopulation: A retrospective cone-beam computed tomography clinical study

Introduction: The adequate knowledge of the canal configuration can improve the quality and prognosis of endodontic treatment. The aim of the study was to determine the frequency of C-shaped root canal in the mandibular permanent second molars among a Pakistani subpopulation sample by utilizing cone-beam computed tomography images. Materials and Methods: Cone-beam computed tomographic images of 360 patients with 720 mandibular second molars were analyzed for the presence of C-shaped canal configuration. The root canal system was classified according to Fan's classification at three distinct levels. Unilateral or bilateral presence of C-shaped root canals and the location of the longitudinal groove were assessed. Moreover, the correlation of frequency of C-shaped canal with the gender was measured using the Chi-square test. The data were analyzed using SPSS version 23. Results: Of 720 mandibular second molars of 360 patients, 10% of teeth were found to have C-shaped canals in 48 patients. The most commonly noted C-shaped canal configurations in the coronal and middle third were C1 (41.7%) and C3 (37.5%), respectively, whereas C2 (33.3%) and C4 (33.3%) configurations were commonly found in the apical third. Twenty-four of 48 patients had bilateral C-shaped root canals. Overall, 37.5% of the teeth were right-sided teeth and 62.5% were left-sided teeth. The frequency of C-shaped canals was significantly higher in females as compared to males, 15.6% and 4.2%, respectively (P = 0.03). The longitudinal groove was most commonly located on the lingual surface (66.7%). Conclusions: The frequency of C-shaped canal configuration in the Pakistani subpopulation was 10% in the mandibular second molar teeth.

Evaluation of implant survival by analysing dental panoramic radiographs: 10-year retrospective study

Background/Aim: Panoramic radiographs have been used widely for pre-implant evaluation and the preparation of treatment protocols. Panoramic radiography is often the first choice method for the implant placements because it gives information on the overall shape of the jaws, the position of the maxillary sinus floor and the nasal cavity floor, and vertical position of the mandibular canal and the mental foramen in relation to dental implants. The specific aim of the present study was to evaluate 10-year survival rate of dental implants by analysis of dental panoramic radiographs. Material and Methods: This retrospective study was conducted on 507 panoramic radiographs of 156 implant patients. Initial oral health status, proceedings of Restorative/Endodontic treatments before implant placement, missing number of teeth and edentulism types, finalization of implant related prosthetic treatments during controls, implant quality scorings at baseline/ controls and implant fails were analyzed. Results: The study results reveal statistically significant difference between the performed R/E treatment rates, according to the need for R/E treatments (p= 0.008). During the initial radiograph 96.1% of the implants were successful and 3.9% had satisfactory survival. At last control 86% of the implants were successful, 10.3% had satisfactory survival, 1% had impairment in survival and 2.8% were unsuccessful. The change in the last control compared to the initial radiograph is statistically significant (p= 0.000) regarding satisfactory survival. Conclusions: Long-term implant survival is not significantly affected by gender, age, type of edentulism, the presence of periodontal disease, R/E treatment needs, implant location, prosthesis type, and the presence of multiple implants.

Можливості застосування латеральных (дискових) імплантатів у випадках атрофії дистальних відділів нижньої щелепи: результати власного клінічного досвіду

Summary. Distal mandibular aspects, especially in conditions of atrophy of the alveolar processes, are traditionally considered unfavorable for dental implantation, which is primarily due to unsatisfactory anatomical and topographic peculiarities (proximity of the inferior alveolar nerve, presence of the mandibular fossa) and require on the pre-implant preparation stage a row of additional surgical procedures aimed on increasing of bone volume or an employment of alternative implantation techniques. Aim – summarizing of own experience of placement of lateral (disc) implants in cases of severe distal mandibular atrophy. Materials and methods. 10 patients (men – 3, women– 7) with uni-, bilateral free-end defects or total mandibular adentia were examined and treated. 22 lateral (disc) implants BOI® (Ihde Dental AG, Switzerland) were installed in combination with 1-stage screwable compression implants KOS®, TPG® Uno (Ihde Dental AG, Switzerland) and loaded immediately within 3–4 days. Results. On the control clinical and roengenological inspections 6-9 mo post-op 20 (90.9 %) of 22 installed lateral (disc) were stable, painless at percussion, with absence of evident inflammation around them, demonstrating the signs of osteointegration. There was no one case of complications due to direct mechanical damage of mandibular canal walls by disc components of the implants. Conclusions. Placement of lateral (disc) implants in distal mandibular aspects creates a serious alternative to generally recognized techniques of pre-implant surgery, allows to provide a functional status of dento-maxillary system in shortest terms owing to realization of their immediate loading protocol. Key words: distal mandibular aspects, atrophy of the alveolar process, pre-prosthetic preparation, lateral (disc) implantation.

Modified coronectomy procedure for mandibular third molar: association of platelet-rich fibrin

ABSTRACT The present case report describes a modified technique of coronectomy for mandibular third molar with association of Platelet-Rich Fibrin Graft (PRF). The panoramic radiograph showed proximity of the roots of the vertical positioned 48 tooth with the superior wall of the mandibular canal, since the erasure of the superior cortical of the mandibular canal was observed. Due to the risk of injury to the inferior alveolar nerve, the technique of coronectomy was chosen. After the realized the coronectomy, in order to promote the regeneration of soft and hard tissues and also to prevent pulp changes that could lead to pain, pulp necrosis and infection, the PRF graft was used to fill the surgical defect formed by removal of the crown. Good healing evolution was observed and after 12 months of clinical and radiographic follow-up there was complete bone formation in the area where the crown was removed and no complications were observed.

Short Implants in Posterior Mandible: Case Report

Numerous studies show that after the insertion and osseointegration of the implants, only the first 2-3 spires assure their functioning. As a consequence, the minimum length of the implants diminished, and therefore the use of short implants is more and more frequent. Together with the shortening of the length of the implants, the apex was also changed to increase the surface of the implants and as a result their stability, as well as to avoid the injuring of the critical anatomical structures (sinus membrane, inferior alveolar nerve). This paper presents a case report in which implants in the posterior mandible 5.5 mm long and 5 mm in diameter were used. Drilling in the proximity of the mandibular canal was made with front cutting drills and for the stimulation of the osseous apposition in the newly created orifice and on the surface of the implant Plasma Rich in Growth Factors (PRGF) was applied. The implants were prosthetized by applying for ceramic dental work on zircon fastened by cementation. The literature of the field shows that a 2:1 crown–implant proportion does not determine osseous resorption but a higher crown of 16 mm generates long term osseous resorption. As a conclusion, we can state that short implants are a very good alternative to more complex surgical techniques like the insertion of the implants next to the inferior alveolar nerve, the lateralization of the inferior alveolar nerve or the vertical osseous augmentation.

Vascular-nerve complications following oral surgery: hematoma and neuroma: A literature review

Introduction: Oral traumas and surgery frequently lead to injuries such as neuromas and hematomas.Materials and Methods: PubMed was searched up using the keywords: “oral traumatic neuroma”, “neuroma dental implant” and “oral hematoma”. Works about oral surgery were considered. Results: In some of the studies included in this review, traumatic neuroma was found following dental extraction; others following chin augmentation and sagittal osteotomy of the mandible. Implant surgery also appears to be linked to the development of traumatic neuromas. Bilateral bifid mandibular canal is a rare anatomic variation which, if present, can lead to the neuroma following surgery of the lower third molar and the placement of dental implants. The vast majority of cases of hematoma are consequent to oral surgery (rarely have spontaneous hematomas have been described in patients taking antiplatelets or anticoagulants).Conclusion: The literature shows a concrete risk of hematoma and traumatic neuroma following oral or maxillofacial surgery. Particular attention should be paid to patients with coagulation abnormalities.

Características orais atípicas de paciente com neurofibromatose tipo 1: relato de caso

ABSTRACT The purpose of this article is to assist dental clinicians to identify neurofibromatosis type 1 and its variants. We present a rare case of a 68-year-old man affected since his childhood by the presence of generalized nodules throughout the body, causing aesthetic deformations. Interestingly, the impact in the oral cavity was not significant, presenting nodes only in the gingiva, an unusual area of manifestation. Panoramic radiograph showed a discrete enlargement of the mandibular canal. After 1 year of follow-up, the patient died due to cardiovascular complications caused by the syndrome.

Stafne bone cavity: Report of two case series of Posterior variant with unusual presentation

Stafne bone cavity (SBC) is an unusual bony defect of the mandible, first described by Edward C.Stafne in 1942. SBC is described as an unusual, asymptomatic, unilateral, well-defined radiolucent area with corticated border on the lingual cortex of the mandible between the inferior border of mandibular canal and the lower body of the mandible. The most accepted concept of etiology is due to the entrapment or constant strain of the deranged salivary gland on the lingual cortex of the mandible. In this case series we have described the innocuous nature of SBC found incidentally on panaromic radiograph, and further evaluation done by clinical and Cone Beam Computed Tomography. Both the cases were asymptomatic with no signs of swelling or other clinically significant features. Hence, surgical intervention was not indicated, due to squelch nature of SBC, hence patients were advised for periodic follow up once in 1 year.

ASSOCIATION BETWEEN MANDIBULAR CANAL COURSE AND INTERFORAMINAL AREA IN PANORAMIC RADIOGRAPHS FOR IMPLANT PLACEMENT

ABSTRACT Objective: The aim of this study was to evaluate the relationship of mandibular canal course with mental foramen localization on edentulous patients’ for implant placement. Material and Methods: This retrospective study was carried out on the panoramic radiographs of 788 edentulous patients. Horizontal measurements L (left mental foramen to the left mandibular ramus), R (right mental foramens to the right mandibular ramus), M (between the mental foramens) and vertical measurements D1 (mental foramen’s inferior border to the mandibular basis), D2 (mental foramen’s superior border to the alveolar crest) were digitally evaluated. Mandibular canals were classified into two types as linear and elliptic. Analysis of demographic data and correlations between canal course and linear measurements were carried out. Kolmogorov-Smirnov and Shapiro Wilks tests, Kruskal Wallis test, and Chi-squared test was used to compare the qualitative data (p &amp;lt;0.05). Results: There was a statistically significant difference between the D1/D2 mean values and the canal course according to the age groups. The rate of the elliptic canal course in the men (41.6%) was significantly higher than that in the women (26.6%). There was no statistically significant difference between the mean D1/D2, (R + L)/M and L/M values according to the canal course. Conclusions: Both elliptical and linear canal courses do not affect the interforaminal distances, resulting ineffective in the anteroposterior spread of implants in cases of interforaminal implant placement. Key Words: Mandibular canal, canal course, interforaminal area, canal anatomy, implant. ÖZET Amaç: Bu çalışmanın amacı dişsiz hastalarda implant uygulaması için mandibular kanal seyri ve mental foramen konumunun ilişkisinin değerlendirilmesidir. Gereç ve Yöntemler: Bu retrospektif çalışma 788 dişsiz hastanın panoramik radyografileri ile yürütülmüştür. Ölçümler horizontal ve vertikal şeklinde dijital olarak yapılmıştır. L (sol mental foramen ile sol ramus arası mesafe), R (sağ mental foramen ile sağ ramus arası mesafe), M (mental foramenler arası mesafe) horizontal ölçümler; D1 (mental foramenin alt sınırı ile basis mandibular arası mesafe) ve D2 (mental foramenin üst sınırı ile alveol kret tepesi arası mesafe) ise vertikal ölçümlerdir. Mandibular kanal seyri doğrusal ve eliptik olarak iki sınıfta incelenmiştir. Demografik veriler, kanal seyri ve dijital ölçümler arası ilişki değerlendirilmiştir. Kolmogorov-Smirnov ve Shapiro Wilks testleri, Kruskal Wallis testi, ve Ki-Kare testi niteliksel verilerin karşılaştırılmasında kullanılmıştır (p &amp;lt;0,05). Bulgular: Yaş grupları arasında D1/D2 oranları ve kanal seyri açısından istatsitiksel olarak anlamlı farklılık tespit edilmiştir. Kanal seyrinin eliptik görülme oranı erkeklerde (%41,6) kadınlardan (%26,6) anlamlı derecede yüksek bulunmuştur. Kanal seyrine gore D1/D2, (R+L)/M ve L/M ortalamaları açısından istatistiksel olarak anlamlı farklılık yoktur. Sonuç: Eliptik ve doğrusal kanal seyrinin interforaminal mesafeye herhangi bir etkisi yoktur, bu durum antero-posterior yönde interforaminal aralığa implant yerleştirilmesini etkilememktedir. Anahtar Kelimeler: Mandibular kanal, kanal seyri, interforaminal bölge, kanal anatomisi, implant.