CBCT Evaluation of Buccolingual Orientation of Inferior Alveolar Canal in Mandibular Posterior Region for Implant Planning

Evaluation of the Linear Relationship of the Inferior Alveolar Nerve Canal to the Lateral Cortex and the Alveolar Crest in the Posterior Mandible: A Computed Tomographic Study

Background and Objective

A cross-sectional study was conducted to evaluate a clinically relevant position of the inferior alveolar nerve and canal with respect to the lateral cortex, alveolar crest, and first and second molar root apices in adult dentate patients.

Methods

The study was conducted in the patients who reported various oral and maxillofacial surgical procedures at the Department of Oral and Maxillofacial Surgery for whom preoperative computed tomography (CT) scan was taken for the required surgical procedures. CTs were selected based on the selection criteria, and a total of 50 CTs were evaluated. Predictor variables were gender and side. Outcome variables were the average linear buccal measurements from the lateral cortex to the outer cortical margin of the inferior alveolar canal from below the mandibular foramen till the mental foramen, linear vertical measurements from the alveolar crest to the superior crest of the inferior alveolar canal in the third, second and first molar regions, and linear vertical distance from the superior aspect of inferior alveolar canal till the apices of second and third molars. Descriptive statistics were analysed with t test and paired t test. P value < 0.05 was taken as significant.

Results

The study sample was composed of 27 male and 23 female patients with a mean age of 29 ± 4.6 years. The mean value of linear measurements of IAN to the right lateral cortex at the mandibular foramen was 4.96 ± 1.13, and for the left side, it was 4.79 ± 1.33. The mean values of linear measurements from the superior aspect of IAN canal to the alveolar crest at third, second and first molar regions obtained in this study were 18.5 ± 3.79, 19 + 3.83 and 19.5 + 3.48 for the right side and 17.8 + 3.86, 18.8 + 3.54 and 19.143.31 for the left side, respectively. The average linear measurements of IAN to the root apex of first molar were 10.8 3.89 for the right side and 10.868 + 3.85 for the left side; for second molars, they were 10.5 + 3.62 for the right side and 10.52 + 3.62 for the left side. Gender and side influenced the outcome with varying statistical significance.

Conclusion

The study has identified the average linear measurements of the buccal cortical bone along the path of IAN in the mandible, average height of alveolar bone above the IAN and average distance between the IAN with the first and second molar root apices. This will be useful guide while planning and performing various mandibular surgical procedures close to the IAN nerve and procedures that can disturb the IAN. The implications of these findings will influence the course of surgery.

The effect of different treatment protocols with diode laser on regeneration in axonetmesis ınjuries of the ınferior alveolar nerve: an animal study

The inferior alveolar nerve can be damaged during dental procedures, leading to symptoms, such as tingling, numbness, and reduced quality of life. Recovery depends on factors such as medications, surgery, and photobiomodulation therapy. Photobiomodulation therapy has shown the potential to improve nerve function and reduce regeneration time; however, there is no standard treatment protocol yet. This study aimed to examine the effect of diode lasers on nerve regeneration in patients with axonetmesis injuries. In this experiment on animals, Wistar rats' damaged sensory systems were treated with lasers to restore them. Animals were randomly divided into six groups: a sham group, a control group, and four laser treatment groups(1st group: performed every day, 10 sessions; 2nd group: performed every 2 days, 10 sessions; 3rd group: performed every day, 20 sessions; and 4th group: performed every 2 days, 20 sessions). Sensory function was determined using the Semmes-Weinstein monofilament test, which was repeated after the surgical procedure. The results showed that the 20-session group had the best improvement, most closely resembling the group without sensory test damage. The histomorphometric results showed that the number of axons was significantly lower in the group that received 10 daily sessions and in the control group than in the undamaged nerve. Axon diameter was lower in all groups than in the sham group. In conclusion, the remarkable aspect of this study is that consecutive-day 20-session laser treatment showed better improvement than the over-the-day 20-session treatment protocol.