Endodontic-related inferior alveolar nerve injuries: A review and a therapeutic flow chart

Reliability of the AI-Assisted Assessment of the Proximity of the Root Apices to Mandibular Canal

Background: This study evaluates the diagnostic accuracy of an AI-assisted tool in assessing the proximity of the mandibular canal (MC) to the root apices (RAs) of mandibular teeth using computed tomography (CT). Methods: This study involved 57 patients aged 18-30 whose CT scans were analyzed by both AI and human experts. The primary aim was to measure the closest distance between the MC and RAs and to assess the AI tool's diagnostic performance. The results indicated significant variability in RA-MC distances, with third molars showing the smallest mean distances and first molars the greatest. Diagnostic accuracy metrics for the AI tool were assessed at three thresholds (0 mm, 0.5 mm, and 1 mm). Results: The AI demonstrated high specificity but generally low diagnostic accuracy, with the highest metrics at the 0.5 mm threshold with 40.91% sensitivity and 97.06% specificity. Conclusions: This study underscores the limited potential of tested AI programs in reducing iatrogenic damage to the inferior alveolar nerve (IAN) during dental procedures. Significant differences in RA-MC distances between evaluated teeth were found.

Evaluation the relationship between mandibular molar root apices and mandibular canal among residents of the moscow population using cone-beam computed tomography technique

Background:

The relationship between the inferior alveolar nerve and the root apices of the mandibular molars and premolars is of clinical importance. The aim of this study was to determine the relationship between the mandibular canal (MC) and the mandibular molar root apices using cone-beam computed tomography (CBCT) scanning among residents of the Moscow population.

Materials and Methods:

Three hundred CBCT scans for patients aged 20–70 years were analyzed. Patients were divided into three age groups: young group (20–44 years), middle-age group (45–59 years), and elderly group (60–70). The distance from the MC and the mandibular molar root apices was measured in each group in the coronal view of CBCT scans. Statistical analysis was set on P < 0.05.

Results:

The mean distance from the mesial root apices of the first, second, and third molars to the MC was 4.92, 2.85, and 2.24 mm, respectively. The distal root showed to be the closest root to the MC in multirooted teeth. The young age group showed smaller distances to MC than other age groups (P < 0.05). Females showed smaller distances to MC in mandibular molars than males (P < 0.05).

Conclusions:

The distance between the root apices and the MC has to be taken into consideration when performing surgical or endodontic procedures.

Endodontic remnants are found more than other radiopacities in proposed implant sites

Background

Foreign bodies may be a cause of concern in dental implant failure.

Purpose

The aim of the present study was to assess the occurrence and to evaluate the types of radiopacities in dental extraction sites using cone beam computed tomography (CBCT).

Materials and methods

The incidence, location, and types of radiopacities were evaluated in 180 CBCT scans.

Results

Different radiopaque structures could be noted in 84 scans. Foreign bodies and remaining roots were frequently seen. Most of the radiopacities were attributed to remaining endodontic filling in upper and lower jaws in 25 scans in different locations. Remaining roots could be detected in 20 scans. Focal and diffuse radiopaque bony lesions were observed in 16 scans. Tissue response in the form of radiolucency could be seen more with endodontic foreign bodies. Tissue reactions to radiopaque filling remnants were seen in 6.11% of cases.

Conclusions

Foreign body remnants, mostly of endodontic fillings, were frequently seen in CBCT in upper and lower jaws. Evidence of tissue reactions to extraction remnants could be found. Endodontic filling remnants could be seen more in the upper jaw. Thorough examination of implant site for the presence of endodontic foreign body remnants should be stressed. Debridement of the extraction socket should be done carefully in endodontically treated teeth.

Rare Case of Dental Implantation in the Segment with Residual Filling Material in the Mandibular Canal

Dental implantation is the most popular method of restoring lost teeth. There are risk factors for dental implantation. These risk factors include the localization of residual filling material in the lumen of the mandibular canal in the selected jaw segment for implantation. A rare clinical case of dental implant placement with preservation of the safety zone relative to the residual siler in the mandibular canal is presented. A surgical guide was used for precise positioning. The treatment protocol was carried out without an immediate loading stage to monitor the possible development of symptoms.