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Ni FD, Xu ZN, Liu MQ, Zhang MJ, Li S, Bai HL, Ding P, Fu KY. Towards clinically applicable automated mandibular canal segmentation on CBCT. J Dent 2024; 144:104931. [PMID: 38458378 DOI: 10.1016/j.jdent.2024.104931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVES To develop a deep learning-based system for precise, robust, and fully automated segmentation of the mandibular canal on cone beam computed tomography (CBCT) images. METHODS The system was developed on 536 CBCT scans (training set: 376, validation set: 80, testing set: 80) from one center and validated on an external dataset of 89 CBCT scans from 3 centers. Each scan was annotated using a multi-stage annotation method and refined by oral and maxillofacial radiologists. We proposed a three-step strategy for the mandibular canal segmentation: extraction of the region of interest based on 2D U-Net, global segmentation of the mandibular canal, and segmentation refinement based on 3D U-Net. RESULTS The system consistently achieved accurate mandibular canal segmentation in the internal set (Dice similarity coefficient [DSC], 0.952; intersection over union [IoU], 0.912; average symmetric surface distance [ASSD], 0.046 mm; 95% Hausdorff distance [HD95], 0.325 mm) and the external set (DSC, 0.960; IoU, 0.924; ASSD, 0.040 mm; HD95, 0.288 mm). CONCLUSIONS These results demonstrated the potential clinical application of this AI system in facilitating clinical workflows related to mandibular canal localization. CLINICAL SIGNIFICANCE Accurate delineation of the mandibular canal on CBCT images is critical for implant placement, mandibular third molar extraction, and orthognathic surgery. This AI system enables accurate segmentation across different models, which could contribute to more efficient and precise dental automation systems.
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Affiliation(s)
- Fang-Duan Ni
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing 100081, China; National Center for Stomatology & National Clinical Research Center for Oral Diseases, Beijing 100081, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | | | - Mu-Qing Liu
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing 100081, China; National Center for Stomatology & National Clinical Research Center for Oral Diseases, Beijing 100081, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
| | - Min-Juan Zhang
- Second Dental Center, Peking University Hospital of Stomatology, Beijing 100101, China
| | - Shu Li
- Department of Stomatology, Beijing Hospital, Beijing 100005, China
| | | | | | - Kai-Yuan Fu
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing 100081, China; National Center for Stomatology & National Clinical Research Center for Oral Diseases, Beijing 100081, China; National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China; Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
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Huang H, Yan Y, Jiang D, Zhao X, Cao D, She D. Is 3T MR nerve-bone fusion imaging a viable alternative to MRI-CBCT to identify the relationship between the inferior alveolar nerve and mandibular third molar. Clin Oral Investig 2024; 28:256. [PMID: 38630324 DOI: 10.1007/s00784-024-05649-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/02/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES To investigate the feasibility of MRI nerve-bone fusion imaging in assessing the relationship between inferior alveolar nerve (IAN) / mandibular canal (MC) and mandibular third molar (MTM) compared with MRI-CBCT fusion. MATERIALS AND METHODS The MRI nerve-bone fusion and MRI-CBCT fusion imaging were performed in 20 subjects with 37 MTMs. The Hausdorff distance (HD) value and dice similarity coefficient (DSC) was calculated. The relationship between IAN/MC and MTM roots, inflammatory, and fusion patterns were compared between these two fused images. The reliability was assessed using a weighted κ statistic. RESULTS The mean HD and DSC ranged from 0.62 ~ 1.35 and 0.83 ~ 0.88 for MRI nerve-bone fusion, 0.98 ~ 1.50 and 0.76 ~ 0.83 for MRI-CBCT fusion. MR nerve-bone fusion had considerable reproducibility compared to MRI-CBCT fusion in relation classification (MR nerve-bone fusion κ = 0.694, MRI-CBCT fusion κ = 0.644), direct contact (MR nerve-bone fusion κ = 0.729, MRI-CBCT fusion κ = 0.720), and moderate to good agreement for inflammation detection (MR nerve-bone fusion κ = 0.603, MRI-CBCT fusion κ = 0.532, average). The MR nerve-bone fusion imaging showed a lower ratio of larger pattern compared to MR-CBCT fusion (16.2% VS 27.3% in the molar region, and 2.7% VS 5.4% in the retromolar region). And the average time spent on MR nerve-bone fusion and MRI-CBCT fusion was 1 min and 3 min, respectively. CONCLUSIONS Both MR nerve-bone fusion and MRI-CBCT fusion exhibited good consistency in evaluating the spatial relationship between IAN/MC and MTM, fusion effect, and inflammation detection. CLINICAL RELEVANCE MR nerve-bone fusion imaging can be a preoperative one-stop radiation-free examination for patients at high risk for MTM surgery.
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Affiliation(s)
- Hao Huang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
- Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, People's Republic of China
| | - Yalan Yan
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
- Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, People's Republic of China
| | - Dongmei Jiang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China
- Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, People's Republic of China
| | - Xiance Zhao
- Philips Healthcare, Shanghai, 200000, People's Republic of China
| | - Dairong Cao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China.
- Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, People's Republic of China.
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, 350005, People's Republic of China.
- Department of Radiology, Fujian Key Laboratory of Precision Medicine for Cancer, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, 350005, People's Republic of China.
| | - Dejun She
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Cha-Zhong Road, Fuzhou, Fujian, 350005, People's Republic of China.
- Department of Radiology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, People's Republic of China.
- Key Laboratory of Radiation Biology of Fujian Higher Education Institutions, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, 350005, People's Republic of China.
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Jiang J, Chen K, Wang E, Duan D, Xu X. Endoscopically-assisted extraction of broken roots or fragments within the mandibular canal: a retrospective case series study. BMC Oral Health 2024; 24:456. [PMID: 38622566 PMCID: PMC11020977 DOI: 10.1186/s12903-024-04216-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024] Open
Abstract
PURPOSE To assess the impact of endoscope-assisted fractured roots or fragments extraction within the mandibular canal, along with quantitative sensory testing (QST) alterations in the inferior alveolar nerve (IAN). METHODS Six patients with lower lip numbness following mandibular third molar extraction were selected. All patients had broken roots or fragments within the mandibular canal that were extracted under real-time endoscopic assistance. Follow-up assessments were conducted on postoperative days 1, 7, and 35, including a standardized QST of the lower lip skin. RESULTS The average surgical duration was 32.5 min, with the IAN exposed in all cases. Two of the patient exhibited complete recovery of lower lip numbness, three experienced symptom improvement, and one patient remained unaffected 35 days after the surgery. Preoperative QST results showed that the mechanical detection and pain thresholds on the affected side were significantly higher than those on the healthy side, but improved significantly by postoperative day 7 in five patients, and returned to baseline in two patients on day 35. There were no significant differences in the remaining QST parameters. CONCLUSIONS All endoscopic surgical procedures were successfully completed without any additional postoperative complications. There were no cases of deterioration of IAN injury, and lower lip numbness recovered in the majority of cases. Endoscopy allowed direct visualization and examination of the affected nerve, facilitating a comprehensive analysis of the IAN.
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Affiliation(s)
- Junqi Jiang
- Department of Oral and Maxillofacial Surgery, National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Kenan Chen
- Department of Oral and Maxillofacial Surgery, National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Enbo Wang
- Department of Oral and Maxillofacial Surgery, National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Denghui Duan
- Department of Oral and Maxillofacial Surgery, National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Xiangliang Xu
- Department of Oral and Maxillofacial Surgery, National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, No. 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
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Luo GM, Yao ZS, Huang WX, Zou LY, Yang Y. Two-stage extraction by partial grinding of impacted mandibular third molar in close proximity to the inferior alveolar nerve. World J Clin Cases 2024; 12:1728-1732. [PMID: 38660071 PMCID: PMC11036467 DOI: 10.12998/wjcc.v12.i10.1728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/15/2023] [Accepted: 03/12/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Extraction of impacted third molars often leads to severe complications caused by damage to the inferior alveolar nerve (IAN). AIM To proposes a method for the partial grinding of an impacted mandibular third molar (IMM3) near the IAN to prevent IAN injury during IMM3 extraction. METHODS Between January 1996 and March 2022, 25 patients with IMM3 roots near the IAN were enrolled. The first stage of the operation consisted of grinding a major part of the IMM3 crown with a high-speed turbine dental drill to achieve sufficient space between the mandibular second molar and IMM3. After 6 months, when the root tips were observed to be away from the IAN on X-ray examination, the remaining part of the IMM3 was completely removed. RESULTS All IMM3s were extracted easily without symptoms of IAN injury after extraction. CONCLUSION Partial IMM3 grinding may be a good alternative treatment option to avoid IAN injury in high-risk cases.
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Affiliation(s)
- Guang-Ming Luo
- Kunbaida Outpatient Department, Kunming Medical University School and Hospital of Stomatology, Kunming 650106, Yunnan Province, China
- Yunnan Key Laboratory of Stomatology, Kunming 650106, Yunnan Province, China
| | - Zhang-Shun Yao
- Kunbaida Outpatient Department, Kunming Medical University School and Hospital of Stomatology, Kunming 650106, Yunnan Province, China
- Yunnan Key Laboratory of Stomatology, Kunming 650106, Yunnan Province, China
| | - Wei-Xiang Huang
- Kunbaida Outpatient Department, Kunming Medical University School and Hospital of Stomatology, Kunming 650106, Yunnan Province, China
- Yunnan Key Laboratory of Stomatology, Kunming 650106, Yunnan Province, China
| | - Lei-Yan Zou
- Kunbaida Outpatient Department, Kunming Medical University School and Hospital of Stomatology, Kunming 650106, Yunnan Province, China
- Yunnan Key Laboratory of Stomatology, Kunming 650106, Yunnan Province, China
| | - Yan Yang
- Kunbaida Outpatient Department, Kunming Medical University School and Hospital of Stomatology, Kunming 650106, Yunnan Province, China
- Yunnan Key Laboratory of Stomatology, Kunming 650106, Yunnan Province, China
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Iwanaga J. The alveolar canals and foramina in the first edition of Terminologia Oroanatomica: a preview. Anat Sci Int 2024:10.1007/s12565-024-00764-8. [PMID: 38573584 DOI: 10.1007/s12565-024-00764-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 02/29/2024] [Indexed: 04/05/2024]
Abstract
Anatomy was initially developed out of necessity to decrease surgery complications. Over time, anatomists and surgeons have sometimes used different terms for the same anatomical structures, thus resulting in numerous discrepancies in terminology between anatomy and surgery. To avoid any confusion or misunderstanding and to better elucidate the oral anatomy terms, the Federative International Programme for Anatomical Terminology (FIPAT) organized a group of specialists on oral anatomy, Terminologia Oroanatomica (ToA) working group, composed of dentists, anatomy researchers, anatomy educators, oral and maxillofacial surgeons, and oral and maxillofacial radiologists. Within the ToA working group, major anatomical structures in the mandible, such as the mandibular canal, were focused and discussed to determine the most appropriate term, i.e., inferior alveolar canal. Although yet to be approved by the International Federation of Associations of Anatomists (IFAA), this article will preview some changes suggested by the ToA.
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Affiliation(s)
- Joe Iwanaga
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA.
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.
- Dental and Oral Medical Center, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan.
- Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, Japan.
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Apaydın BK, Icoz D, Uzun E, Orhan K. Investigation of the relationship between the mandibular third molar teeth and the inferior alveolar nerve using posteroanterior radiographs: a pilot study. BMC Oral Health 2024; 24:371. [PMID: 38519914 PMCID: PMC10958910 DOI: 10.1186/s12903-024-04123-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/07/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND The most severe complication that can occur after mandibular third molar (MM3) surgery is inferior alveolar nerve (IAN) damage. It is crucial to have a comprehensive radiographic evaluation to reduce the possibility of nerve damage. The objective of this study is to assess the diagnostic accuracy of panoramic radiographs (PR) and posteroanterior (PA) radiographs in identifying the association between impacted MM3 roots and IAN. METHODS This study included individuals who had PR, PA radiographs, and cone beam computed tomography (CBCT) and who had at least one impacted MM3. A total of 141 impacted MM3s were evaluated on CBCT images, and the findings were considered gold standard. The relationship between impacted MM3 roots and IAN was also evaluated on PR and PA radiographies. The data was analyzed using the McNemar and Chi-squared tests. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of PR and PA radiographies were determined. RESULTS Considering CBCT the gold standard, the relationship between MM3 roots and IAN was found to be statistically significant between PR and CBCT (p = 0.00). However, there was no statistically significant relationship between PA radiography and CBCT (0.227). The study revealed that the most prevalent limitation of the PR in assessing the relationship between MM3 roots and IAN was the identification of false-positive relationship. CONCLUSIONS PA radiography may be a good alternative in developing countries to find out if there is a contact between MM3 roots and IAN because it is easier to get to, cheaper, and uses less radiation.
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Affiliation(s)
- Burak Kerem Apaydın
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Pamukkale University, Denizli, 20160, Turkey.
| | - Derya Icoz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Selcuk University, Konya, 42100, Turkey
| | - Ezgi Uzun
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Pamukkale University, Denizli, 20160, Turkey
| | - Kaan Orhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, 06500, Turkey
- Medical Design Application and Research Center (MEDITAM), Ankara University, Ankara, 06500, Turkey
- Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
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Allavéna J, Nicot R, Majoufre C, Schlund M. Inferior alveolar nerve repositioning surgical techniques and outcomes - a systematic review. J Stomatol Oral Maxillofac Surg 2024; 125:101631. [PMID: 37689139 DOI: 10.1016/j.jormas.2023.101631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
Inferior alveolar nerve (IAN) lateralization (IANL) or transposition (IANT) are both techniques allowing for dental implant placement in posterior atrophic mandibles. The aim of this study was to systematically review the implant survival rate and the complications associated with IAN reposition techniques with simultaneous implant placement in atrophic posterior mandibles. This systematic review was conducted following PRISMA guidelines (Preferred Reporting Items for Systematic review and Meta-Analysis). The review was designed to answer the following PICO question: Is IAN repositioning (I) a safe and efficient technique (O) to treat patient looking for fixed dental rehabilitation of an atrophic posterior mandible (P). Thirty-three articles were reviewed, including a total of 899 patients, and approximately 950 IAN repositioning procedures. Dental implant survival rate ranged between 86.95% and 100% with a mean dental survival rate of 90.16%. Among the 269 patients who underwent IANT, there were 93% immediate neurosensory disturbance, and 15% persistent neurosensory disturbance. Among the 350 patients who underwent IANL, there were 93% immediate neurosensory disturbance, and 6% persistent neurosensory disturbance. IANT and IANL are reliable techniques allowing safe dental implant placement in atrophic posterior mandible with high patient satisfaction. IANL seems to cause less persistent neurosensory disturbances compared to IANT. The level of evidence is poor due to the high number of bias present in the included studies. IAN neurosensory disturbance assessment should be better homogenized in order to increase comparability.
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Affiliation(s)
- Julie Allavéna
- Univ. Bordeaux, CHU Bordeaux, Service de Chirurgie Maxillo-Faciale et Stomatologie, Bordeaux 33000, France.
| | - Romain Nicot
- Univ. Lille, CHU Lille, INSERM, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008 - Advanced Drug Delivery Systems, Lille 59000, France
| | - Claire Majoufre
- Univ. Bordeaux, CHU Bordeaux, Service de Chirurgie Maxillo-Faciale et Stomatologie, Bordeaux 33000, France
| | - Matthias Schlund
- Univ. Bordeaux, CHU Bordeaux, Service de Chirurgie Maxillo-Faciale et Stomatologie, Bordeaux 33000, France; Univ. Bordeaux, CHU Bordeaux, INSERM, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1026 - Bioengineering of Tissues, Bordeaux 33000, France
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Hamad SA, Khrwatany KAK, Mohammed MR, Tutmayi SH. Effect of betamethasone injection into the pterygomandibular space on the neurosensory disturbance after bilateral sagittal split ramus osteotomy: a pilot study. Eur J Med Res 2024; 29:96. [PMID: 38297403 PMCID: PMC10832094 DOI: 10.1186/s40001-023-01615-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/23/2023] [Indexed: 02/02/2024] Open
Abstract
AIM The aim of this study was to evaluate the effect of local betamethasone injection into the pterygomandibular space on postoperative neurosensory deficits. MATERIALS AND METHODS A prospective controlled clinical study was conducted on 16 patients (6 male, 10 female; mean age, 24.95 ± 9.22 years) who underwent bilateral sagittal ramus osteotomy for mandibular discrepancies. One side of each patient's mandible was randomly selected as the control side, and the opposite side as the experimental side. On the experimental side, a solution of betamethasone (6 mg/1 ml) was injected into the pterygomandibular space after the completion of wound closure. Neurosensory tests, including light touch, two-point discrimination, direction of movement, thermal sensitivity, and pin-prick discrimination, were performed. The follow-up period ranged between 6 and 12 months, according to the particular sensory test. The Fisher exact test was used to analyse the data. RESULTS The light touch sensation was abnormal in 75% of the control side and 31% of the study side, with the difference being significant (p = 0.03). However, at 6 months, all the study cases regained touch sensation, compared to 69% of the control side. No significant difference in direction movement discrimination was seen; however, at 3 months, the study side showed significantly less direction sensation (19%) compared to the control side (56%) (p = 0.02). There was no significant difference in the two-point discrimination; however, at 3 months, the study side had a significantly less abnormal two-point sensation (13%) than the control side (56%) (p = 0.02). In addition, no significant difference was noted in thermal sensitivity or pin-prick sensation. CONCLUSION Betamethasone injection into the pterygomandibular space reduces neurosensory disturbances after bilateral sagittal split ramus osteotomies nd leads to faster recovery of sensations.
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Affiliation(s)
| | | | - Mustafa Rasul Mohammed
- Department of Dental Assistant, Medical Institute, Erbil Polytechnic University, Erbil, Iraq
| | - Saeed Hameed Tutmayi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Hawler Medical University, Erbil, Iraq
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Tsakiris E, Kitagawa N, Fukino K, Shekhawat D, Iwanaga J, Tubbs RS. A rare case of the auriculotemporal and inferior alveolar nerves communication. Surg Radiol Anat 2024; 46:191-194. [PMID: 38151551 DOI: 10.1007/s00276-023-03283-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023]
Abstract
This case study describes anatomical variations in the branching pattern of the posterior division of the trigeminal nerve and its clinical implications for dental and craniofacial surgery. The study presents two uncommon variations observed in an elderly male cadaver. A communicating branch connecting one of three roots of the auriculotemporal nerve and inferior alveolar nerve just before entering the mandibular foramen on the right side, and three communicating branches between the IAN and lingual nerve on the left side. The presence of such variations may complicate anesthesia associated with oral surgery procedures.
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Affiliation(s)
- Eli Tsakiris
- Tulane University School of Medicine, New Orleans, LA, USA
| | - Norio Kitagawa
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiko Fukino
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Devendra Shekhawat
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA
| | - Joe Iwanaga
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA.
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Anatomical Sciences, St. George's University, St. George's, Grenada
- Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA
- University of Queensland, Brisbane, Australia
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Yépez FDG, Bobrowski ÂN, Pagnoncelli RM. Neurosensory recovery of inferior alveolar nerve gap reconstruction: a systematic review. Br J Oral Maxillofac Surg 2024; 62:15-22. [PMID: 38101969 DOI: 10.1016/j.bjoms.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/13/2023] [Accepted: 10/26/2023] [Indexed: 12/17/2023]
Abstract
Numerous procedures can potentially injure the inferior alveolar nerve during oral and maxillofacial surgery, eventually causing loss or alteration of local sensitivity. When its total rupture occurs, a conduit, such as an autogenous graft, can be used to join it. Due to the morbidity resulting from this technique, alternative forms of sensorineural repair have been investigated. This systematic review includes an electronic search of PubMed, Embase, LILACS, and Web of Science databases, in addition to a grey literature and manual search. Article selection was performed by two independent researchers following a predetermined inclusion criterion: human studies evaluating the regression of sensorineural disorders after any form of grafting (autogenous, allogeneic, and synthetic). Of the 789 studies, 648 were analysed. Only 11 articles met the eligibility criteria. After analysing the results, it was noted that regaining normal sensitivity was uncommon, but the majority of reconstructed nerves recovered their protective abilities. Allografts showed success rates similar to autogenous grafts, making them a viable alternative. However, clinical trials are still needed to provide solid evidence. Prognosis for sensory recovery was impacted by grafting time and patient age.
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Affiliation(s)
- Franklin David Gordillo Yépez
- Post-Graduate Program in Dentistry (Maxillofacial Surgery), School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
| | - Ângelo Niemczewski Bobrowski
- Post-Graduate Program in Dentistry (Maxillofacial Surgery), School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Rogério Miranda Pagnoncelli
- Post-Graduate Program in Dentistry (Maxillofacial Surgery), School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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11
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Liu H, Li Y, Shen Y. Persistent paresthesia of inferior alveolar nerve after accidental extrusion of calcium hydroxide paste containing iodoform into the mandibular canal. J Dent Sci 2024; 19:720-721. [PMID: 38303869 PMCID: PMC10829615 DOI: 10.1016/j.jds.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/16/2023] [Indexed: 02/03/2024] Open
Affiliation(s)
- He Liu
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Yao Li
- Tiejun Dental Clinic, Jining, China
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
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12
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Kuang S, Liu Y, Zhuang W, Li K, Yang W, Tian Y. The effect of root orientation on inferior alveolar nerve injury after extraction of impacted mandibular third molars based on propensity score-matched analysis: a retrospective cohort study. BMC Oral Health 2023; 23:929. [PMID: 38008723 PMCID: PMC10680265 DOI: 10.1186/s12903-023-03661-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/13/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND The injury of the inferior alveolar nerve (IAN) is one of the most serious complications of impacted mandibular third molars (IMTMs) extraction. The influence of the root orientation of IMTMs on IAN injury is still controversial. A deeper understanding of the risk factors of IAN injury conduces to better prevention of IAN injury. This study aims to explore whether root orientation is an independent risk factor of IAN injury during IMTMs extraction using the statistical strategy of propensity score matching (PSM). METHODS This retrospective cohort study included 379 patients with 539 cases of high-risk IMTMs screened by panoramic radiography and cone beam computed tomography. The IAN injury incidence after extraction of different groups of IMTMs was analyzed using the chi-square test or Fisher's exact test. The correlation between third molar root orientation and impaction depth/contact degree with IAN was evaluated by the Lambda coefficient. Based on PSM for balancing confounding factors including age, sex, impaction depth, and contact degree, the effect of root orientation on the incidence of IAN injury was further analyzed using Fisher's exact test. RESULTS There were significant group differences in IAN injury incidence in impaction depth, root orientation, and contact degree of root-IAC before PSM. Root orientation was correlated with impaction depth and contact degree of root-IAC. After PSM, there were 9 cases with IAN injury and 257 cases without IAN injury. There were significant group differences between the buccal and non-buccal groups after PSM, and the risk of IAN injury was higher when the root was located on the buccal side of IAC (OR = 8.448, RR = 8). CONCLUSIONS Root orientation is an independent risk factor of IAN injury, and the risk is higher when the root is located on the buccal side of IAC. These findings could help better evaluate the risk of inferior alveolar nerve injury before the extraction of IMTMs.
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Affiliation(s)
- Shijun Kuang
- Hospital of Stomatology, Guangdong Provincial Clinical Research Center of Oral Diseases, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, No.56, Lingyuan West Road, Yuexiu District, Guangzhou City, Guangdong Province, 510030, China.
| | - Yuhao Liu
- Hospital of Stomatology, Guangdong Provincial Clinical Research Center of Oral Diseases, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, No.56, Lingyuan West Road, Yuexiu District, Guangzhou City, Guangdong Province, 510030, China
| | - Weijie Zhuang
- Hospital of Stomatology, Guangdong Provincial Clinical Research Center of Oral Diseases, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, No.56, Lingyuan West Road, Yuexiu District, Guangzhou City, Guangdong Province, 510030, China
| | - Kechen Li
- Hospital of Stomatology, Guangdong Provincial Clinical Research Center of Oral Diseases, Guangdong Provincial Key Laboratory of Stomatology, Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, No.56, Lingyuan West Road, Yuexiu District, Guangzhou City, Guangdong Province, 510030, China
| | - Wenbin Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No.14, Third Section of Ren Min Nan Road, Chengdu City, Sichuan Province, 610041, China
| | - Yihong Tian
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No.14, Third Section of Ren Min Nan Road, Chengdu City, Sichuan Province, 610041, China
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Jiang JQ, Kang YF, Chen KN, Cui NH, Yan ZY, Guo CB, Wang EB, Xu XL. Endoscopic visualization of the inferior alveolar nerve associated with somatosensory changes after impacted mandibular third molar extraction. Odontology 2023; 111:982-992. [PMID: 36773195 PMCID: PMC10492667 DOI: 10.1007/s10266-023-00788-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 01/29/2023] [Indexed: 02/12/2023]
Abstract
The aim of this study is to assess the relationship between somatosensory functional changes and inferior alveolar nerve (IAN) exposure after impacted mandibular third molars (M3M) removal. We recruited 35 patients who underwent impacted M3M extraction near the IAN. The M3Ms were extracted by combined endoscopy, piezosurgery, and contra-angle high-speed turbine handpiece. All IAN canal perforations and exposed regions were recorded and measured by endoscopy after extraction and on cone-beam computed tomography (CBCT) images before extraction. The patients were followed up 1, 7, and 35 days after surgery. A standardized quantitative sensory testing (QST) battery was performed on the lower lip skin. All of 35 cases had exposed IAN on CBCT images, 5 of which had no exposed IAN under endoscopy. For the other 30 cases, the endoscopy-measured IAN length and width were shorter than the CBCT measurements (P < 0.001). The warm and mechanical detection thresholds (MDT) on the operation side were significantly higher than the contralateral side after surgery (P < 0.05). Thermal sensory limen, MDT, and cold pain threshold were strongly correlated with the exposed IAN length and MDT also with the exposed IAN width one day after surgery. In conclusion, it was found that not all exposed IAN in CBCT images were real exposure after surgery. The intraoperative exposed IAN endoscopic measurements were smaller than by CBCT and strongly correlated with some QST parameters.
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Affiliation(s)
- Jun-Qi Jiang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, No.22 Zhongguancun South Avenue, Haidian District Beijing, 100081 People’s Republic of China
| | - Yan-Feng Kang
- Department of Prosthodontics Center for Oral Functional Diagnosis, Treatment and Research, Peking University School and Hospital of Stomatology, Beijing, China
| | - Ke-Nan Chen
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, No.22 Zhongguancun South Avenue, Haidian District Beijing, 100081 People’s Republic of China
| | - Nian-Hui Cui
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, No.22 Zhongguancun South Avenue, Haidian District Beijing, 100081 People’s Republic of China
| | - Zi-Yu Yan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, No.22 Zhongguancun South Avenue, Haidian District Beijing, 100081 People’s Republic of China
| | - Chuan-Bin Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, No.22 Zhongguancun South Avenue, Haidian District Beijing, 100081 People’s Republic of China
| | - En-Bo Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, No.22 Zhongguancun South Avenue, Haidian District Beijing, 100081 People’s Republic of China
| | - Xiang-Liang Xu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, No.22 Zhongguancun South Avenue, Haidian District Beijing, 100081 People’s Republic of China
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14
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Vasegh Z, Bakhshaei P, Jahanbani M, Mahmoudi Anzabi R. Evaluation of anatomical relationships in the mandibular third molar region based on its angulation and depth of impaction: a CBCT-based study. Oral Maxillofac Surg 2023:10.1007/s10006-023-01178-y. [PMID: 37620734 DOI: 10.1007/s10006-023-01178-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE The aim of this study is to evaluate the relationship between the inclination/impaction depth and root proximity to the inferior alveolar canal/lingual plate on a millimeter scale using CBCT scans. METHODS 340 CBCT scans of the mandibular third molar (M3) of 219 patients were evaluated for this cross-sectional study. After adjustment of the 3D orientation of the individual's jaws, the study variables including the angulation between M3 and second molar (M2)/occlusal plane (OP), and the distance of mesial (M)/distal (D) roots of M3 from the inferior alveolar canal (IAC) and lingual plate (LP) were measured. Winter's classification was used for the specification of teeth angulation. The vertical position of each M3 was then evaluated using the 3D view window (based on Pell & Gregory classification). The Spearman correlation coefficient was used for reporting the correlation between quantitative variables. The One-way ANOVA test and the Welch analysis were used for inter-group comparisons. Finally, a multivariant analysis of variances was performed. RESULTS Most third molars had a mesioangular inclination (52.1%), and vertical inclination (25.9%) was in second place. There was no significant correlation between angulation and age or the D/LP. A strong positive correlation between M3:M2 and M3:OP was observed (0.983). Furthermore, there was a weak negative correlation between M/IAC or M/LP and angulation (- 0.16 and - 0.13, respectively). Concerning Winter's classification, the relationship between D/IAC and angulation was statistically significant (P = 0.003). Furthermore, teeth in position A had lesser inclination compared to those with B or C positions. Multivariate analysis revealed that there was no statistically significant relationship between particular combinations of inclination-impaction depth and proximity of the M3 roots to the IAC or LP (P = 0.211). CONCLUSIONS The findings of the current study revealed that there is a strong correlation between M3:M2 and M3:OP. The D/IAC was the only variable that had a significant relationship with the angulation of these teeth. Moreover, the roots of horizontally inclined teeth with position A were the closest to the LP and the farthermost to the IAC.
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Affiliation(s)
- Zahra Vasegh
- Oral and Maxillofacial Radiology Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pedram Bakhshaei
- Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Jahanbani
- Orthodontics Department, School of Dentistry, Babol University of Medical Sciences, Babol, Iran.
| | - Reza Mahmoudi Anzabi
- Orthodontics Department, School of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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15
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Lin X, Xin W, Huang J, Jing Y, Liu P, Han J, Ji J. Accurate mandibular canal segmentation of dental CBCT using a two-stage 3D-UNet based segmentation framework. BMC Oral Health 2023; 23:551. [PMID: 37563606 PMCID: PMC10416403 DOI: 10.1186/s12903-023-03279-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 08/02/2023] [Indexed: 08/12/2023] Open
Abstract
OBJECTIVES The objective of this study is to develop a deep learning (DL) model for fast and accurate mandibular canal (MC) segmentation on cone beam computed tomography (CBCT). METHODS A total of 220 CBCT scans from dentate subjects needing oral surgery were used in this study. The segmentation ground truth is annotated and reviewed by two senior dentists. All patients were randomly splitted into a training dataset (n = 132), a validation dataset (n = 44) and a test dataset (n = 44). We proposed a two-stage 3D-UNet based segmentation framework for automated MC segmentation on CBCT. The Dice Similarity Coefficient (DSC) and 95% Hausdorff Distance (95% HD) were used as the evaluation metrics for the segmentation model. RESULTS The two-stage 3D-UNet model successfully segmented the MC on CBCT images. In the test dataset, the mean DSC was 0.875 ± 0.045 and the mean 95% HD was 0.442 ± 0.379. CONCLUSIONS This automatic DL method might aid in the detection of MC and assist dental practitioners to set up treatment plans for oral surgery evolved MC.
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Affiliation(s)
- Xi Lin
- Clinic of Stomatology of the Shantou University Medical College, No. 22, Xinling Road, Shantou, Guangdong China
| | - Weini Xin
- Clinic of Stomatology of the Shantou University Medical College, No. 22, Xinling Road, Shantou, Guangdong China
- Department of Stomatology of Shantou University Medical College, No. 22, Xinling Road, Shantou, Guangddong China
| | - Jingna Huang
- Clinic of Stomatology of the Shantou University Medical College, No. 22, Xinling Road, Shantou, Guangdong China
| | - Yang Jing
- Huiying Medical Technology Co., Ltd, Room A206, B2, Dongsheng Science and Technology Park, Haidian District, Beijing, China
| | - Pengfei Liu
- Huiying Medical Technology Co., Ltd, Room A206, B2, Dongsheng Science and Technology Park, Haidian District, Beijing, China
| | - Jingdan Han
- Huiying Medical Technology Co., Ltd, Room A206, B2, Dongsheng Science and Technology Park, Haidian District, Beijing, China
| | - Jie Ji
- Network and Information Center, Shantou University, No. 243, University Road, Shantou, Guangdong China
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Salles M, Horikawa F, Allegrini Jr S, Zangrando D, Yoshimoto M, Shinohara E. Clinical evaluation of the perception of post-trauma paresthesia in the mandible, using a biomimetic material: A preliminary study in humans. Heliyon 2023; 9:e18304. [PMID: 37520975 PMCID: PMC10382299 DOI: 10.1016/j.heliyon.2023.e18304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/03/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023] Open
Abstract
There is a great effort from numerous research groups in the development of materials and therapeutic strategies for the functional recovery of patients who have suffered peripheral nerve injuries (PNI). In an article in vivo, the formation of a nerve bridge was observed, reconnecting the distal and proximal stumps, in the sciatic nerve of rats, indicating the effective participation of the biomaterial in the recovery of peripheral nerve injuries. For the current pilot study, 15 cases of multiple fractures of the mandible, with involvement of the inferior alveolar nerve (IAN) were selected and studied: JC (control cases) n = 6 with conventional treatment, and JT (treated cases) n = 9, with the use of biomimetic biomaterial. The evaluation of the return to sensitivity was measured through a self-assessment, where the patients assigned scores from 0 to 10, where zero (0) represented the complete absence of sensitivity and ten (10) the normality of the perception of local sensitivity. Patients were evaluated from the preoperative period to the 360th day. The statistical results obtained by the t-Student, Shapiro-Wilk normality and non-parametric One-Way ANOVA tests indicated statistically significant differences (p < 0.005; 0.005 e 0.5 respectively), between the two treatments, which were reflected in the clinical results observed, we also calculate the size of the effect represented by ϵ2, calculated by Cohen's d. The results indicate a great difference between the treatments performed,ϵ2 = 1.00. In the 6 cases followed up in the JC group, four remained with a significant deficit until the end of the evaluations and two indicated the remission of the lack of sensitivity in this period. In the JT group, in 28 days, all cases indicated complete remission of the lack of sensitivity with healing concentration. In one of the cases where there was a complete rupture of the mental nerve, the (score-10) was observed in 60 days. The observed results indicate the existence of a statistical significance between the groups and an important relationship when using the biomimetic biomaterial during the recovery of the perception of sensitivity in polytraumatized patients, compatible with the results observed in laboratory animals, which may indicate its clinical feasibility in the reduction of sequelae in PNI.
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Affiliation(s)
| | - F.K. Horikawa
- Depart. Oral and Maxillofac. Surg. Hospital Regional de Osasco SUS, São Paulo, Brazil
| | - S. Allegrini Jr
- Program in Biodentistry, Ibirapuera University (UNIB), São Paulo, SP, 04661 100, Brazil
- Católica Portuguesa University (UCP), Viseu, Portugal
| | - D. Zangrando
- Depart. Oral and Maxillofac. Surg. Hospital Regional de Osasco SUS, São Paulo, Brazil
- Department of Surgery Stomatology Pathology and Radiology of the Faculty of Dentistry of Bauru, University of São Paulo (FOB-USP) Bauru, São Paulo, Brazil
| | | | - E.H. Shinohara
- Depart. Oral and Maxillofac. Surg. Hospital Regional de Osasco SUS, São Paulo, Brazil
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Öztürk K, Kuzu TE, Gürgan CA, Önder GÖ, Yay A. The effect of different treatment protocols with diode laser on regeneration in axonetmesis ınjuries of the ınferior alveolar nerve: an animal study. Lasers Med Sci 2023; 38:169. [PMID: 37515606 DOI: 10.1007/s10103-023-03834-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 07/19/2023] [Indexed: 07/31/2023]
Abstract
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.
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Affiliation(s)
- Kübra Öztürk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey.
| | - Turan Emre Kuzu
- Department of Periodontology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Cem A Gürgan
- Department of Periodontology, Faculty of Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey
| | - Gözde Özge Önder
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Arzu Yay
- Department of Histology and Embryology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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Alladi S, Dhasarathan P, O.R Muralidoss H, Murugesan K, Vivigdha V. Incidence neurosensory deficit in mandibular fractures. Bioinformation 2023; 19:725-728. [PMID: 37885783 PMCID: PMC10598366 DOI: 10.6026/97320630019725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 10/28/2023] Open
Abstract
Sensory disturbances in the inferior alveolar nerve (IAN) prior to treatment can be attributed to various factors, including the site, type of fracture, and fracture displacement. Therefore, it is of interest to assess the incidence of inferior alveolar nerve injuries associated with mandibular fractures before and after surgical treatment. Group A consisted of patients with inferior alveolar nerve paresthesia before treatment, while Group B consisted of patients with inferior alveolar nerve paresthesia after treatment. A significant difference was observed between the two groups, with a p-value of 0.031 (p <0.05) with the overall incidence of IAN deficit was 57.33% before treatment and 61.33% after treatment. These findings highlight the importance of promptly identifying and managing IAN injuries to minimize long-term consequences.
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Affiliation(s)
- Sneha Alladi
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Pradeep Dhasarathan
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Hemavathy O.R Muralidoss
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Krishnan Murugesan
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Vedha Vivigdha
- Department of Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
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Wang B, Sun R, Li T, Sun Y, Zheng L, Zhao J. Does the "Root Removal First" strategy prevent postoperative complications in the surgical removal of impacted mandibular third molars in the Pell and Gregory class C and horizontal position? - a randomized clinical trial. BMC Oral Health 2023; 23:391. [PMID: 37316782 DOI: 10.1186/s12903-023-03086-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/28/2023] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE To evaluate the clinical outcomes of the "Root Removal First" strategy in the surgical removal of impacted mandibular third molar (IMTM) in the class C and horizontal position. MATERIALS AND METHODS A total of 274 cases were finally included in the statistics. The positions of IMTM in the horizontal position were confirmed by cone-beam computed tomography (CBCT). Cases were randomly divided into two groups: the "Root Removal First" strategy was applied in the new method (NM) group, and the conventional "Crown Removal First" strategy was executed in the traditional method (TM) group. The clinical information and relevant data upon follow-up were recorded. RESULTS The duration of the surgical removal and the incidence rates of lower lip paresthesia in the NM group were significantly lower than those in the TM group. The degree of mobility of the adjacent mandibular second molar (M2) in the NM group was significantly lower than that in the TM group at 30 days and 3 months post-operation. The distal and buccal probing depth of the M2, as well as the exposed root length of M2 in the NM group, were significantly lower than those in the TM group 3 months post-operation. CONCLUSIONS The "Root Removal First" strategy can reduce the incidence rate of inferior alveolar nerve injury and periodontal complications of the M2 in the surgical removal of IMTM in class C and horizontal position with high efficiency. TRIAL REGISTRATION ChiCTR2000040063.
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Affiliation(s)
- Bing Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
| | - Rui Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
- Department of Oral Surgery, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Tingting Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
| | - Yuqi Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
| | - Linwei Zheng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
| | - Jihong Zhao
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.
- Department of Oral Surgery, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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20
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Genc A, Isler SC, Keskin C, Oge AE, Matur Z. Effects of sagittal split osteotomy on brainstem reflexes. J Orofac Orthop 2023; 84:100-9. [PMID: 34570255 DOI: 10.1007/s00056-021-00350-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This prospective study was designed to assess whether patients with skeletal deformities show characteristic masseter inhibitory reflex (MIR) and blink reflex (BR) patterns. A secondary aim was to investigate whether these reflexes change following bilateral sagittal split osteotomy (BSSO). MATERIALS AND METHODS Fourteen consecutive patients who underwent single-jaw BSSO and 14 class I subjects who constituted the control group were enrolled into the study. MIR and BR, obtained by the stimulation of supraorbital (SBR) and mental nerves (MBR), were electrophysiologically recorded. Sensory impairment in the mental nerve distribution was clinically tested. Three evaluation periods were specified as immediately before (T0), 1 month (T1) and 6 months (T2) after surgery. RESULTS MIR early silent period duration was significantly shorter in the patients at T0 (p < 0.001). Sensory deficits developed on 23 sides after BSSO, of which, 17 recovered after 6 months. At T1, MBR was inelicitable bilaterally in 3 patients and unilaterally in 2 patients. These responses were still unrecordable bilaterally in 1 patient, and unilaterally in 4 patients at T2. MIR were unrecordable on 18 sides at T1 and recovered on 11 sides at T2. There were no parallels between the clinical sensory deficits and the abnormal results of the reflexes. CONCLUSIONS Shorter MIR in patients with dentofacial abnormalities may be a reflection of an adapted trigeminal reflex mechanism. Although MBR and MIR abnormalities do not develop parallel to the clinical sensory deficits, their course might provide insights into the disturbed trigeminal reflex pathways.
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21
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James O, Oyeneyin AO, Adeyemi MO, Erinoso OA, Adekunle AA, Adeyemo WL. Neurosensory Deficits of Inferior Alveolar Nerve Following Impacted Mandibular Third Molar Extraction: Comparison of One-Stage Complete Extraction with Two-Stage Partial Coronectomy Surgical Technique. J Maxillofac Oral Surg 2023; 22:178-186. [PMID: 36703659 PMCID: PMC9871121 DOI: 10.1007/s12663-021-01601-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/31/2021] [Indexed: 01/29/2023] Open
Abstract
Objectives Inferior alveolar nerve neurosensory deficit is a worrisome complication of surgical extraction of impacted mandibular third molars. A novel approach using two-stage partial coronectomy has been proposed as an alternative surgical procedure to reduce this complication. This study compared neurosensory deficits of inferior alveolar nerve following impacted mandibular third molar extraction using one-stage complete extraction with the two-stage partial coronectomy technique. Material and Methods Subjects with mesioangular or horizontal impacted mandibular third molar with an intimate relationship with inferior dental canal who met the inclusion criteria were recruited for the study. Subjects were divided into one-stage and two-stage partial coronectomy techniques. The subjects were evaluated for the presence of inferior alveolar neurosensory deficit, and the relationships of neurosensory nerve deficit with sex, age and type of impaction. Results Neurosensory deficit was observed in 5 subjects (7.8%), with all cases seen in the one-stage group. This difference was statistically significant (p = 0.03). The relationship between the incidence of neurosensory deficit and age, sex, type of impaction, surgical difficulty, operating time and root morphology was not statistically significant (p > 0.05). Conclusion Findings from this study suggest partial coronectomy compared to one-stage complete extraction reduces the incidence of Inferior alveolar nerve neurosensory deficit.
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Affiliation(s)
- Olutayo James
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Aliyu Ope Oyeneyin
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria
| | - Michael Olayinka Adeyemi
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Olufemi Akinwunmi Erinoso
- Department of Oral and Maxillofacial Surgery, Lagos State University Teaching Hospital Ikeja, Lagos, Nigeria
| | - Adeola Adegbayi Adekunle
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria
| | - Wasiu Lanre Adeyemo
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
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22
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Al-Haj Husain A, Stadlinger B, Winklhofer S, Piccirelli M, Valdec S. Magnetic resonance imaging for preoperative diagnosis in third molar surgery: a systematic review. Oral Radiol 2023; 39:1-17. [PMID: 35397042 DOI: 10.1007/s11282-022-00611-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/24/2022] [Indexed: 01/07/2023]
Abstract
In recent years, magnetic resonance imaging (MRI) has made great strides through various technical improvements and new sequences, which have made it one of the most promising and leading imaging techniques in the head and neck region. As modern imaging techniques in dentistry aim to reduce radiation exposure, this systematic review evaluated the possibilities, advantages, and disadvantages of advanced imaging diagnostics using dental MRI and its evidence for clinical indications and limitations relevant to mandibular third molar (MTM) surgery. Two reviewers performed multiple database searches (PubMed MEDLINE, EMBASE, Biosis, and Cochrane databases) following the PICOS search strategy using medical subject headings (MeSH) terms, keywords, and their combinations. Ten studies were included in this systematic review. By providing high spatial resolution and excellent soft tissue contrast, black bone MRI sequences such as 3D Double Echo Steady State (DESS) and 3D Short Tau Inversion Recovery (STIR) imaging protocols have the potential to become a valuable alternative to cone-beam computed tomography (CBCT) in future dental clinical routines. Overall, radiation-free MRI represents another step toward personalized dentistry and improved decision-making that avoids ineffectiveness and minimizes risks in oral surgery by taking into account additional patient-side factors such as comorbidity, anatomical norm variations, and imaging biomarkers.
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Affiliation(s)
- Adib Al-Haj Husain
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Sebastian Winklhofer
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marco Piccirelli
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
- Division of Periodontology, Department of Stomatology, Dental School, University of São Paulo, São Paulo, Brazil.
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Jena S, Panigrahi R, Pati AR, Hasan S. Prevalence, Patterns and Variations of Anterior Loop of Inferior Alveolar Nerve-A CBCT Based Retrospective Study. Indian J Otolaryngol Head Neck Surg 2022; 74:5424-5431. [PMID: 36742630 PMCID: PMC9895195 DOI: 10.1007/s12070-021-02691-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/13/2021] [Indexed: 02/07/2023] Open
Abstract
The fragment of inferior alveolar nerve (IAN) existing anterior to the mental foramen (MF), before dividing the canal, is known as the "Anterior Loop of the IAN". The presence of anterior loop (AL) is important when placing the implant in inter foraminal area of the mandible or during any other surgical procedure. It is imperative to precisely determine the position and dimensions of these anatomical variations on a cone-beam CT (CBCT) scan. To estimate the prevalence and pattern of anterior loop of IAN and establish any corelation between dimension of the MF with length and angulation of the AL of the IAN. Total 178 CBCT samples were collected fulfilling the inclusion criteria from a private diagnostic centre in Bhubaneswar, Odisha. The greatest diameter of the mental foramen was measured along with anterior loop length and angulation in the panoramic section of the CBCT scan. The angulation formed and the length was corelated with the greatest diameter of the mental foramen and analysed. Our study reveals that the AL was more frequently seen among males, predominantly on the left side of the mandible. The relationship between length of the anterior loop and diameter of the mental foramen demonstrated a mild negative corelation. There was no possible corelation present between angle formed by anterior loop with inferior alveolar canal and diameter of mental foramen. A small positive corelation was established between length of anterior loop and angle formed by the anterior loop with inferior alveolar canal. CBCT scans should be recommended for pre-surgical evaluation of anatomical variations in the mandibular region. Also, a safe margin of 3-4 mm anterior to mental foramen should be maintained while working in the premolar area. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-021-02691-w.
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Affiliation(s)
- Suvranita Jena
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar, Odisha India
| | - Rajat Panigrahi
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar, Odisha India
| | - Abhishek Ranjan Pati
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar, Odisha India
| | - Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
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Salari B, Nikparto N, Babaei A, Fekrazad R. Effect of delayed photobiomodulation therapy on neurosensory recovery in patients with mandibular nerve neurotmesis following traumatic mandibular fracture: A randomized triple-blinded clinical trial. J Photochem Photobiol B 2022; 232:112460. [PMID: 35551053 DOI: 10.1016/j.jphotobiol.2022.112460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/02/2022] [Accepted: 04/26/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION There is a possibility of neurotmesis of the inferior alveolar nerve (IAN) in mandibular fractures, which leads to neurosensory impairment. In this study, we aimed to investigate the efficacy of photobiomodulation therapy (PBMT) in patients with neurotmesis following trauma and mandibular fracture. MATERIALS AND METHODS This triple-blind randomized trial was carried out on patients who suffered neurotmesis of the IAN following mandibular angle and body fracture at least for 6 months. In the intervention group, laser irradiation was applied with a low-level GaAlAs diode laser (continuous wave of 810 nm wavelength, power of 200 mW, and energy density of 12-14 J/cm2). In the control group, the laser probe was turned off and placed on the affected area. LLLT was done for 12 sessions (2 times/week for 6 weeks). Light touch sensations, two-point discrimination, thermal discrimination (cold and warm stimulus), electric pulp test (EPT), and oral health impact profile (OHIP)-14 questionnaire were performed before the intervention, immediately after each PBMT session, and after 3, 6, 9 and 12 months. RESULTS In both groups, 3 and 23 patients were female and male, respectively. The results showed significantly improved light (cotton swab), light (wooden cotton swab), and sharp (dental needle) touch sensations, and two-point discrimination test in the PBMT group after the 10th, 11th, 10th, and 10th session, respectively. Two-way repeated measure ANOVA revealed that the trend of light touch sensation with cotton swab and two-point discrimination test was statistically significant (p-value = 0.002 and 0.001, respectively). The results of OHIP-14 test showed a significantly higher mean in the PBMT group 3 months after PBMT. There was no statistically significant difference in EPT and thermal discrimination tests regarding the patients' group. CONCLUSION PBMT could be an effective treatment for late post-traumatic nerve neurotmesis following a traumatic mandibular fracture.
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Affiliation(s)
- Behzad Salari
- Department of Orthodontics, Aja University of Medical Sciences, Tehran, Iran; Department of Orthodontics, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Nariman Nikparto
- Student Research Committee, Faculty of Dentistry, Aja University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Amirhossein Babaei
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, Aja University of Medical Sciences, Tehran, Iran; International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
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25
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Chen LW, Zhao XE, Yan Q, Xia HB, Sun Q. Dynamic navigation system-guided trans- inferior alveolar nerve implant placement in the atrophic posterior mandible: A case report. World J Clin Cases 2022; 10:3907-3915. [PMID: 35647174 PMCID: PMC9100722 DOI: 10.12998/wjcc.v10.i12.3907] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/23/2021] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In atrophic posterior mandibular areas, where the bone height superior to the inferior alveolar nerve (IAN) is less than 6 mm, short implants are not applicable. Conventional alternatives such as IAN transposition and various alveolar bone augmentation approaches are technically demanding and prone to complications.
CASE SUMMARY Computer-guided dynamic navigation implantation improves the accuracy, predictability, and safety of implant placement. This case report presents a dynamic navigation system-guided trans-IAN implant placement technique, which can successfully treat a posterior mandibular dentition defect when the bone height is only 4.5 mm. The implant was inserted into the buccal side of the IAN and was 1.7 mm away from the IAN. The implantation deviations were controlled within a satisfying range, and the long-term restoration outcome was stable.
CONCLUSION Dynamic navigation system-guided trans-IAN implant placement might be a recommended technique for patients with extremely insufficient residual bone height and sufficient bone width in the posterior mandibular area.
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Affiliation(s)
- Liang-Wen Chen
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
| | - Xiao-E Zhao
- Department of Special Care Clinic, Lanzhou Stomatological Hospital, Lanzhou 730000, Gansu Province, China
| | - Qi Yan
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
| | - Hai-Bin Xia
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
| | - Quan Sun
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
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Němec I, Smrčka V, Mihaljevič M, Hill M, Pokorný J, Páral V, Pračková I. Effect of Inferior Alveolar Nerve Transection on the Inorganic Component of Molars of Rat Mandible. Prague Med Rep 2022; 123:5-19. [PMID: 35248160 DOI: 10.14712/23362936.2022.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The objective of the study was to determine the effects of inferior alveolar nerve transection on inorganic components in mandibular molars of the rat. We used 26 male laboratory rats of the Wistar strain for the study, age 7-9 weeks. The rats were divided in three groups. The control group (intact) included 6 rats. The surgery was performed under general anesthesia. The experimental group included (group with the nerve transected on the left) included 12 rats. The sham group (group with the nerve prepared without transection) included 8 rats. The animals were sacrificed after 4 weeks. Molars from the left and right sides of the mandible were extracted. Element content levels were determined using inductively coupled plasma mass spectrometry. The following elements were determined in all samples: magnesium (Mg), sodium (Na), potassium (K), calcium (Ca), zinc (Zn), and strontium (Sr). The nerve transection caused: a reduction of the contents of Ca and Sr in the mandibular molars; an increase in the contents of Mg and Zn; a difference arrangement of both sides for Na. The surgery approach itself caused a decrease in the contents of Na and K in the experimental and sham groups; the difference in K in M3 between the left and right sides disappeared due to the surgery. Our results have confirmed the hypothesis of inferior alveolar nerve transection having an effect on inorganic components in mandibular molars in the rat.
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Affiliation(s)
- Ivo Němec
- Department of Otorhinolaryngology and Maxillofacial Surgery, Third Faculty of Medicine, Charles University and Military University Hospital Prague, Prague, Czech Republic.
| | - Václav Smrčka
- Institute for History of Medicine and Foreign Languages, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Martin Mihaljevič
- Institute of Geochemistry, Mineralogy and Mineral Resources, Faculty of Science, Charles University, Prague, Czech Republic
| | - Martin Hill
- Institute of Endocrinology, Prague, Czech Republic
| | - Jaroslav Pokorný
- Institute of Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Václav Páral
- Department of Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic
| | - Ivana Pračková
- Department of Anatomy, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic
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Deo SP, Ahmad MS, Singh A. Effectiveness of dexamethasone or adrenaline with lignocaine 2% for prolonging inferior alveolar nerve block: a randomized controlled trial. J Korean Assoc Oral Maxillofac Surg 2022; 48:21-32. [PMID: 35221304 PMCID: PMC8890966 DOI: 10.5125/jkaoms.2022.48.1.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/18/2021] [Accepted: 09/27/2021] [Indexed: 11/07/2022] Open
Abstract
Objectives Inferior alveolar nerve block (IANB) is commonly used for mandibular dentoalveolar surgery. The objective of this study was to evaluate and compare the effectiveness of coadministration of dexamethasone (4 mg/mL) or adrenaline (0.01 mg/mL) as an adjuvant with lignocaine 2% in IANB during third molar surgery (TMS). Patients and Methods This double-blind, randomized controlled trial was conducted between March and August 2020. The investigators screened patients needing elective TMS under local anesthesia. Based on strict inclusion and exclusion criteria, patients were enrolled in this study. These patients were assigned randomly into two study groups dexamethasone group (DXN) or adrenaline group (ADN). Outcome variables were postoperative edema, trismus, visual analogue scale (VAS), perioperative analgesia, onset time, and duration of IANB. Results Eighty-three patients were enrolled in this study, of whom 23 (27.7%) were eliminated or excluded during follow-up. This study thus included data from 60 samples. Mean age was 32.28±11.74 years, including 28 females (46.7%) in the ADN (16 patients, 57.1%) and DXN (12 patients, 42.9%) groups. The duration of action for DXN (mean±standard deviation [SD], 40207±03401 hours; standard error [SE], 00600 hours; log-rank P=0.001) and for ADN (mean±SD, 15834±02452 hours; SE, 00442 hours; log-rank P=0.001) were found. Similarly, time at which 1st analgesic consume and total number of nonsteroidal antiinflammatory drugs need to rescue postoperative analgesia was found statistically significant between study groups (t (58)=–11.95; confidence interval, –22541 to –14353; P=0.001). Early-hours VAS was also significantly different between the study groups. Conclusion A single injection of dexamethasone prolongs the duration of action of lignocaine 2% IANB. Additionally, it can be used in cases where adrenaline is contraindicated.
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Affiliation(s)
- Saroj Prasad Deo
- Department of Oral and Maxillofacial Surgery, National Medical College, Birgunj, Nepal
| | - Md Shakeel Ahmad
- Department of Dentistry, National Medical College, Birgunj, Nepal
| | - Abanish Singh
- Department of Community Dentistry, MB Kedia Dental College, Birgunj, Nepal
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Lamiae H, Samir MC, Marouane B, Bouchra T. Coronectomy of mandibular wisdom teeth: A case series. Int J Surg Case Rep 2021; 90:106673. [PMID: 34896774 PMCID: PMC8666538 DOI: 10.1016/j.ijscr.2021.106673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction and importance Coronectomy represents a common procedure performed in oral surgery, mostly involving the lower wisdom teeth when the extraction presents a risk of injury to the inferior alveolar nerve (NAI). The surgical approach can be described as a coronal separation of the tooth and leaving the roots intact in the socket. The result is impressive with the disappearance of the symptomatology at first and especially the root migration, which occurs most frequently in the first 6 months. Cases series presentation We present a series of clinical cases of coronectomy involving the lower wisdom tooth which was performed by respecting the preoperative, perioperative, and postoperative measures and whose indications were established correctly. Discussion and conclusion Besides the previously mentioned indication, this procedure can be associated with other clinical situations such as dentigerous cysts. However, there are several circumstances in which coronectomy is contraindicated. According to our study, we can conclude that coronectomy of mandibular wisdom teeth represents a reassuring alternative to the preservation of NAI. Complications may occur but follow-up remains a key point in visualizing the progression of the roots away from the mandibular canal. Coronectomy of mandibular wisdom teeth is one of the most common procedures performed in oral surgery. The indications must be established before the operation, while respecting the contra-indications. His success is dependent on the respect of the surgical measures Follow-up is very important in order to control the evolution of the roots in relation to the mandibular canal
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Affiliation(s)
- Hallab Lamiae
- Faculty of Dentistry-Rabat, University Mohammed V in Rabat, Morocco.
| | | | | | - Taleb Bouchra
- Faculty of Dentistry-Rabat, University Mohammed V in Rabat, Morocco
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29
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Lim HK, Jung SK, Kim SH, Cho Y, Song IS. Deep semi-supervised learning for automatic segmentation of inferior alveolar nerve using a convolutional neural network. BMC Oral Health 2021; 21:630. [PMID: 34876105 PMCID: PMC8650351 DOI: 10.1186/s12903-021-01983-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background The inferior alveolar nerve (IAN) innervates and regulates the sensation of the mandibular teeth and lower lip. The position of the IAN should be monitored prior to surgery. Therefore, a study using artificial intelligence (AI) was planned to image and track the position of the IAN automatically for a quicker and safer surgery. Methods A total of 138 cone-beam computed tomography datasets (Internal: 98, External: 40) collected from multiple centers (three hospitals) were used in the study. A customized 3D nnU-Net was used for image segmentation. Active learning, which consists of three steps, was carried out in iterations for 83 datasets with cumulative additions after each step. Subsequently, the accuracy of the model for IAN segmentation was evaluated using the 50 datasets. The accuracy by deriving the dice similarity coefficient (DSC) value and the segmentation time for each learning step were compared. In addition, visual scoring was considered to comparatively evaluate the manual and automatic segmentation. Results After learning, the DSC gradually increased to 0.48 ± 0.11 to 0.50 ± 0.11, and 0.58 ± 0.08. The DSC for the external dataset was 0.49 ± 0.12. The times required for segmentation were 124.8, 143.4, and 86.4 s, showing a large decrease at the final stage. In visual scoring, the accuracy of manual segmentation was found to be higher than that of automatic segmentation. Conclusions The deep active learning framework can serve as a fast, accurate, and robust clinical tool for demarcating IAN location.
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Affiliation(s)
- Ho-Kyung Lim
- Department of Oral and Maxillofacial Surgery, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Seok-Ki Jung
- Department of Orthodontics, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul, 08308, Republic of Korea
| | - Seung-Hyun Kim
- Department of Medical Humanities, Korea University College of Medicine, 46, Gaeunsa 2-gil, Seongbuk-gu, Seoul, 02842, Republic of Korea
| | - Yongwon Cho
- Department of Radiology and AI Center, Korea University College of Medicine, Korea University Anam Hospital, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
| | - In-Seok Song
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
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Lahoud P, Diels S, Niclaes L, Van Aelst S, Willems H, Van Gerven A, Quirynen M, Jacobs R. Development and validation of a novel artificial intelligence driven tool for accurate mandibular canal segmentation on CBCT. J Dent 2021; 116:103891. [PMID: 34780873 DOI: 10.1016/j.jdent.2021.103891] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/29/2021] [Accepted: 11/11/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES The objective of this study is the development and validation of a novel artificial intelligence driven tool for fast and accurate mandibular canal segmentation on cone beam computed tomography (CBCT). METHODS A total of 235 CBCT scans from dentate subjects needing oral surgery were used in this study, allowing for development, training and validation of a deep learning algorithm for automated mandibular canal (MC) segmentation on CBCT. Shape, diameter and direction of the MC were adjusted on all CBCT slices using a voxel-wise approach. Validation was then performed on a random set of 30 CBCTs - previously unseen by the algorithm - where voxel-level annotations allowed for assessment of all MC segmentations. RESULTS Primary results show successful implementation of the AI algorithm for segmentation of the MC with a mean IoU of 0.636 (± 0.081), a median IoU of 0.639 (± 0.081), a mean Dice Similarity Coefficient of 0.774 (± 0.062). Precision, recall and accuracy had mean values of 0.782 (± 0.121), 0.792 (± 0.108) and 0.99 (± 7.64×10-05) respectively. The total time for automated AI segmentation was 21.26 s (±2.79), which is 107 times faster than accurate manual segmentation. CONCLUSIONS This study demonstrates a novel, fast and accurate AI-driven module for MC segmentation on CBCT. CLINICAL SIGNIFICANCE Given the importance of adequate pre-operative mandibular canal assessment, Artificial Intelligence could help relieve practitioners from the delicate and time-consuming task of manually tracing and segmenting this structure, helping prevent per- and post-operative neurovascular complications.
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Affiliation(s)
- Pierre Lahoud
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; Department of Oral Health Sciences, Periodontology and Oral Microbiology, University Hospitals of Leuven, Belgium.
| | | | - Liselot Niclaes
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | - Stijn Van Aelst
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium
| | | | | | - Marc Quirynen
- Department of Oral Health Sciences, Periodontology and Oral Microbiology, University Hospitals of Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven & Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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Takatsuka D, Tachinami H, Tomihara K, Amirreza YJ, Ikeda A, Imaue S, Fujiwara K, Sonoda T, Nakamori K, Noguchi M. Novel strategy to predict high risk of inferior alveolar nerve injury during extraction of lower third molars based on assessment of computed tomographic images of multiple anatomical features. Br J Oral Maxillofac Surg 2021; 60:570-576. [PMID: 35422310 DOI: 10.1016/j.bjoms.2021.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/21/2021] [Indexed: 11/30/2022]
Abstract
Preoperative assessment is essential to prevent inferior alveolar nerve (IAN) injury during surgical extraction of the lower third molar (LM3). Here, we aimed to establish an assessment system to predict IAN injury during surgical extraction of the LM3. We conducted a retrospective cohort study on 115 patients diagnosed as 'high-risk' based on our previous risk assessment method involving three anatomical features of the inferior alveolar canal using computed tomographic (CT) images. We evaluated the occurrence of neurosensory impairment in these high-risk patients, and its association with novel anatomic features based on CT images. Neurosensory impairments were observed in 19 patients (16.5%). The inferior alveolar canal major diameter (p < 0.0001) and lingual bone thickness (p = 0.0039) were significantly associated with the occurrence of neurosensory impairment during LM3 extraction. Receiver operating characteristic curves were used to determine cut-off values of these quantitative factors to specifically predict IAN injury. Preoperative risk assessment with quantitative factors based on anatomical features observed on CT images may facilitate more appropriate surgical planning for patients at a high risk of IAN injury.
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Affiliation(s)
- Danki Takatsuka
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
| | - Hidetake Tachinami
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan.
| | - Kei Tomihara
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
| | - Younesi Jadidi Amirreza
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
| | - Atsushi Ikeda
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
| | - Shuichi Imaue
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
| | - Kumiko Fujiwara
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
| | - Tomoko Sonoda
- Department of Public Health, Sapporo Medical University School of Medicine, Japan
| | - Kenji Nakamori
- Department of Oral and Maxillofacial Surgery, Regional Independent Administrative Corporation Naha City Hospital, Japan
| | - Makoto Noguchi
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Toyama, Japan
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Hasani M, Razavi N, Haghnegahdar A, Zarifi M. Evaluating the presence of IAN injury in patients with juxta-apical radiolucency after third molar surgery: a retrospective cohort study. BMC Oral Health 2021; 21:428. [PMID: 34482829 PMCID: PMC8418743 DOI: 10.1186/s12903-021-01785-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 08/27/2021] [Indexed: 12/02/2022] Open
Abstract
Background Juxta-apical radiolucency (JAR) has been presented as a radiographic sign, suggestive of the IAN injury through third molar surgery. This study aimed to evaluate the relation of JAR with IAN injury in cone-beam computed tomography (CBCT) images and to determine whether the presence of JAR is related to tooth angulation, proximity to the mandibular canal, position to the IAN, and thinning of the cortical plates. Methods Of an initial sample of 545 mandibular third molars, a total of 75 JAR+ and 75 JAR− teeth were evaluated by CBCT. We assessed the relationship between the presence of JAR in cone-beam computed tomography (CBCT) images and the presence of IAN injury after mandibular third molar surgeries. Moreover, we investigated whether the presence of IAN injury is related to tooth angulation, proximity to the mandibular canal, position to the IAN, and thinning of the cortical plates. Descriptive statistics, Chi-square test, and Fisher’s exact test were performed for statistical analysis. Results A significant relationship was found between JAR and temporary IAN injury (P = 0.036). However, there was no case of permanent IAN injury. IAN injury showed no significant relationship with the tooth angulation, position to IAN and proximity to the mandibular canal, lingual cortical plate thinning, sex, and age. Conclusions JAR is generally in contact with the mandibular canal, and some degree of cortical thinning can be found in most cases. In this study, JAR was significantly related to temporary IAN injury. JAR may increase the risk of nerve injury during the surgical removal of third molars.
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Affiliation(s)
- Mahvash Hasani
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasim Razavi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdolaziz Haghnegahdar
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Motahhareh Zarifi
- School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Klatt JC, Sorowka T, Kluwe L, Smeets R, Gosau M, Hanken H. Does a preoperative cone beam CT reduce complication rates in the surgical removal of complex lower third molars? A retrospective study including 486 cases. Head Face Med 2021; 17:33. [PMID: 34389020 PMCID: PMC8364039 DOI: 10.1186/s13005-021-00271-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 05/24/2021] [Indexed: 12/17/2022] Open
Abstract
BACKROUND This study was designed to analyse the value of preoperative Cone Beam CTs (CBCT) prior to the surgical removal of complex lower third molars. Furthermore, the aim was to assess injuries to the inferior alveolar nerve (IAN) bundle and postoperative neurological disorders depending on the position of the lower third molar and the inferior alveolar nerve bundle. METHODS In this retrospective examination preoperative Cone Beam CTs and Orthopantomographs (OPT) of 324 patients were analysed concerning the location of the lower third molars in relation to the mandible and the inferior alveolar nerve bundle. Surgery protocols of all patients who underwent the surgical removal of at least one complex lower third molar were analysed concerning patient data, length of surgery, intraoperative haemorrhage, intraoperative exposure of the inferior alveolar nerve bundle, postoperative swelling and postoperative neurological disorders. The data was then compared to data from international studies. RESULTS In all 324 patients a permanent neurological damage was not found. Temporary neurological damage was recorded in 13 cases (2.6%). A caudal nerve position with no measurable distance to the root of the lower third molar was associated with the highest risk of a temporal neurological damage. A vestibular touching nerve route also correlated with postoperative sensitivity impairment. If a mesioangulation (Winter) or a Pell and Gregory Type IIIC appears in the OPT, risk of neurological damage is at its highest. CONCLUSIONS Three-dimensional radiographic imaging, in our patient group, does not significantly affect the risk for complications during the surgical removal of complex lower third molars. Therefore, it should only be utilized for risk assessment, especially in cases of symptom-free lower third molars. A preoperative orthopantomogram still can be accepted as standard for radiographic imaging. An intraoperative exposure of the IAN bundle does not necessarily predict simultaneous neurological damage. Exposure of the IAN bundle is no indication for a discontinuation of the surgery.
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Affiliation(s)
- Jan C Klatt
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Tony Sorowka
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Lan Kluwe
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Henning Hanken
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Vranckx M, Geerinckx H, Gaêta-Araujo H, Leite AF, Politis C, Jacobs R. Do anatomical variations of the mandibular canal pose an increased risk of inferior alveolar nerve injury after third molar removal? Clin Oral Investig 2021; 26:931-937. [PMID: 34279700 DOI: 10.1007/s00784-021-04076-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/08/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The present study aimed to assess whether anatomical variations of the mandibular canal are associated with neurosensory disturbances of the inferior alveolar nerve (IAN) following mandibular third molar removal. METHODS Two observers compared the detection of third molar root-nerve relations and bifurcations of the mandibular canal on panoramic radiographs and CBCT images of 201 patients undergoing removal of 357 mandibular third molars. Potential neurosensory disturbances of the IAN were surveyed ten days after surgery. Fisher's Exact was performed to correlate presence of canal variations to postoperative neurosensory disturbances. Positive and negative predictive values (PPV, NPV) and likelihood ratios (LR + , LR-) were calculated. RESULTS Thirteen patients reported postoperative altered sensation of the lower lip, with 2 of them having mandibular canal bifurcations on the ipsilateral side of the injury. Fisher's Exact showed that the studied mandibular canal variations were not related to postoperative neurosensory disturbances. CBCT was superior in visualization of anatomical variations of the mandibular canal. Prevalence of bifurcations was 14% on CBCT and 7% on panoramic radiographs. In both imaging modalities and for all parameters, PPVs were low (0.04 - 0.06) and NPVs were high (0.92 - 0.98), with LR ranging around 1. CONCLUSION In the present study, the assessed mandibular canal variations had limited predictive value for IAN neurosensory disturbances following third molar removal. CLINICAL RELEVANCE While a close relation between the third molar and the mandibular canal remains a high risk factor, mandibular canal variations did not pose an increased risk of postoperative IAN injury after third molar removal.
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Affiliation(s)
- Myrthel Vranckx
- OMFS-IMPATH Research Group, , Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7 blok a, 3000, Leuven, Belgium.
| | - Hannah Geerinckx
- OMFS-IMPATH Research Group, , Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7 blok a, 3000, Leuven, Belgium
| | - Hugo Gaêta-Araujo
- OMFS-IMPATH Research Group, , Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7 blok a, 3000, Leuven, Belgium
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Andre Ferreira Leite
- OMFS-IMPATH Research Group, , Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7 blok a, 3000, Leuven, Belgium
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
| | - Constantinus Politis
- OMFS-IMPATH Research Group, , Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7 blok a, 3000, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, , Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 7 blok a, 3000, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Elnadoury EA, Gaweesh YSE, Abu El Sadat SM, Anwar SK. Prevalence of bifid and trifid mandibular canals with unusual patterns of nerve branching using cone beam computed tomography. Odontology 2021. [PMID: 34263380 DOI: 10.1007/s10266-021-00638-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
Lack of knowledge concerning the inferior alveolar canal anatomical variations had proven to increase the incidence of surgical complications, so the study aimed to assess the configuration and prevalence of bifid and trifid mandibular canals using cone beam CT in Egyptian subpopulation. Cone beam CT scans of 278 patients (530 hemi-mandibles) were included in the study, in which bifid and trifid mandibular canals or any other branching patterns were recorded and evaluated. Bifid canals were categorized following Naitoh classification, and the diameter of the main mandibular and accessory canals was measured. Bifid canals were detected in 181 canals (34%) while trifid canals in 46 canals (8.7%). Upon classifying the bifid canals, 78 canals showed forward type, 40 retromolar type, 33 dental type, and 7 canals showed buccolingual type. Two special bifid canals subtypes were reported in 23 canals and nine distinct patterns of trifid canals were reported in our study. In addition, unusual patterns of canal branching were reported in 5 cases. The mean diameter of the accessory canals was 1.18 ± .54 mm and the main canal was 3.98 ± 1.31 mm. This study reported a high prevalence (54%) of canal branching, which reinforces the importance of cone beam CT in pre-surgical planning.
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Jain A, Sankhe S. Numb chin syndrome secondary to infiltration of inferior alveolar nerve as a presentation of relapse in treated testicular lymphoma-diagnosis on PET/CT and MR neurography. Indian J Cancer 2021; 58:437-440. [PMID: 34380845 DOI: 10.4103/ijc.ijc_364_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Numb chin syndrome (NCS) is a rare presentation of primary or recurrent malignant neoplasms among other non-neoplastic causes. The syndrome is characterized by altered sensations in the distribution of the mental nerve and presents with pain and paresthesias along the distribution of the inferior alveolar nerve and its branches. The primary diagnosis is indicated while following up patients through positron emission tomography/computed tomography (PET/CT) when a hypermetabolic focus is seen in the vicinity of the angle of the mandible. Further anatomical localization is performed using magnetic resonance (MR) neurography and postcontrast MR imaging, which demonstrates neural involvement. We hereby describe a case of a 56-year-old man, a treated case of DLBCL (diffuse large B-cell lymphoma), presenting with NCS and diagnosed with perineural invasion through PET/CT and further MR evaluation. To our knowledge, there are no other reports in the literature describing the MR neurography appearance of the inferior alveolar nerve in NCS. We hereby stress on the use of MR neurography followed by postcontrast 3D sequences with multiplanar reformatting for adequate lesion detection.
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Affiliation(s)
- Ayush Jain
- Department of Radiology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Shilpa Sankhe
- Department of Radiology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
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N CS, Shetty SK, Shetty SK, Shah AK. Inferior alveolar nerve dysfunction in mandibular fractures: a prospective cohort study. J Korean Assoc Oral Maxillofac Surg 2021; 47:183-189. [PMID: 34187958 PMCID: PMC8249188 DOI: 10.5125/jkaoms.2021.47.3.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/23/2021] [Accepted: 03/04/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives To assess the prevalence and recovery of inferior alveolar nerve dysfunction (IAND) in mandibular fractures. Materials and Methods This was a prospective cohort study. Clinical neurosensory testing was done preoperatively and the IAND was categorized as mild, moderate or severe. Postoperatively, neurosensory testing was repeated at 1 day, 1 week, 1 month, 3 months and every 3 months thereafter. Results A total of 257 patients with 420 fractures were included in the study with a mean age of 31.7 years. Body fractures (95.9%) had the highest incidence of IAND, followed by the angle fractures (90.1%) and symphysis fractures (27.6%). The condyle and coronoid fractures did not have any IAND and hence were excluded from further study. After eliminating those cases, 232 patients remained in the study with 293 fractures. The overall prevalence of IAND in fractures occurring distal to the mandibular foramen was 56.3%. The changes until 1 week were minimal. From 1 month to 6 months, there was a significant reduction in the severity of IAND. A significant number of cases (60.0%) were lost to follow-up between 6 and 9 months. At 6 months, 23.9% of cases still had some form of IAND and 95.0% of the symphysis, 59.0% of the angle and 34.8% of the body fractures with IAND had become normal. Conclusion This study documents the reduction in the degree of severity of IAND in the first six months and provides the basis for future studies with longer periods of follow-up.
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Affiliation(s)
- Chandan S N
- Department of Oral and Maxillofacial Surgery, JSS Dental College, JSS Academy of Higher Education and Research, Mysore, India
| | - Sujeeth Kumar Shetty
- Department of Oral and Maxillofacial Surgery, JSS Dental College, JSS Academy of Higher Education and Research, Mysore, India
| | - Sahith Kumar Shetty
- Department of Oral and Maxillofacial Surgery, JSS Dental College, JSS Academy of Higher Education and Research, Mysore, India
| | - Anjan Kumar Shah
- Department of Oral and Maxillofacial Surgery, Rajarajeshwari Dental College, Bangalore, India
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Janovics K, Soós B, Tóth Á, Szalma J. Is it possible to filter third molar cases with panoramic radiography in which roots surround the inferior alveolar canal? A comparison using cone-beam computed tomography. J Craniomaxillofac Surg 2021:S1010-5182(21)00137-2. [PMID: 34090736 DOI: 10.1016/j.jcms.2021.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/13/2021] [Accepted: 05/25/2021] [Indexed: 11/23/2022] Open
Abstract
Inferior alveolar nerve (IAN) entrapment in third molar (M3) roots bears a significant risk for nerve injury. The aim of this study was to identify specific panoramic radiographic (PR) signs that can reliably identify IAN entrapment (IANE) root conformations. In a retrospective case-control study, 10 IANE and 218 non-IANE third molar risk cases were examined by PR and CBCT. The collected data included "classic" specific high-risk panoramic signs, number of M3 roots, extent of inferior alveolar canal (IAC)-root tip overlap, rotated position of M3 and impaction pattern. After bivariate analysis, sensitivity, specificity, positive and negative predictive values, positive likelihood ratios (LR+) and accuracy (area under the curve [AUC]) were calculated for the most significant predictive variables. Interruption of both cortical lines (LR+: 43.6; AUC: 96.0%) and upward diversion of the IAC (LR+: 36.3; AUC: 96.5%) were the most accurate single signs indicating IANE. Upward diversion combined with root darkening and interruption of the IAC (AUC: 97.4%) and the combination of darkening with interruption and with a rotated M3 (LR+:130.8; AUC: 97.8%) were the most accurate combinations predicting IANE. IANE may be correctly filtered with PR when focusing on the signs of upward diversion, darkening, interruption and rotated M3 position, especially in cases involving their multiple (≥3) presence. CBCT evaluation is highly recommended in these cases before partial and total tooth removals.
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Ketabi AR, Zelka A, Lauer HC, Hassfeld S. The comparison of roof visibility of the mandibular canal between cone-beam computed tomography scans and panoramic radiograph images as dependent on the cortical bone thickness of the mandible. Int J Implant Dent 2021; 7:39. [PMID: 34002304 PMCID: PMC8128948 DOI: 10.1186/s40729-021-00324-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/17/2021] [Indexed: 12/05/2022] Open
Abstract
Background Accurate detection of the mandibular canal is a difficult process despite cutting-edge radiographic methods. The present study analyses whether mandibular canal roof visibility is comparable to panoramic radiography (PR) and cone-beam computed tomography (CBCT) and, further, examines whether the visibility in PR and CBCT is dependent on cortical bone thickness in the mandible. Methods This study was conducted on a group of 343 selected patients. It incorporated anonymised data on 343 patients in which a CBCT and PR were available. The first stage examines whether the mandibular canal roof visibility is comparable to PR and CBCT. In the second stage, measurements of cortical bone thickness showed buccal and lingual in the P2, M1, M2 and M3 teeth areas, both to the left and right of the mandible in CBCT images. Statistical analysis was supported by statistical software (IBM SPSS 25; Armonk, NY, USA). Results The mean age of the patients was 58.8 years with an almost equal gender distribution. When performing a McNemar test on the P2, M1, M2 and M3 on both the left and right jaws, the difference between the two image modalities, with regard to the visibility of the canal roof, was found to be significant (McNemar test, p < 0.001). Statistically (U test, p≥0.05), it follows that the thickness of the cortical bone of the mandible exerts no influence on the visibility of the roof of canalis mandibulae in PR and CBCT images. Conclusion We conclude that the visibility of the mandibular canal in PR and CBCT rays is not identical, and that the thickness of the cortical bone in the mandible does not represent a factor affecting the visibility of the roof of the mandibular canal.
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Affiliation(s)
- Ali-Reza Ketabi
- Private Practice, Epplestr. 29 A, 70597, Stuttgart, Germany.
| | | | - Hans-Christoph Lauer
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany
| | - Stefan Hassfeld
- Department of Oral and Maxillofacial Surgery, Dortmund Hospital gGmbH and Faculty of Health, Witten/Herdecke University, Münsterstr. 240, 44145, Dortmund, Germany
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Hakimiha N, Rokn AR, Younespour S, Moslemi N. Photobiomodulation Therapy for the Management of Patients With Inferior Alveolar Neurosensory Disturbance Associated With Oral Surgical Procedures: An Interventional Case Series Study. J Lasers Med Sci 2021; 11:S113-S118. [PMID: 33995979 DOI: 10.34172/jlms.2020.s18] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction: Inferior alveolar nerve (IAN) injury is a serious complication during intraoral surgeries. We aimed to evaluate the outcome of photobiomodulation (PBM) therapy in patients with IAN injury associated with third molar or implant procedures. Methods: Eight patients with an alteration of sensory function of the IAN after third molar or implant surgeries were enrolled in this case series study. The patients received 10 sessions of PBM therapy (810 nm diode laser, 200 mW, 10 J/cm2 per point, three times a week). Pinprick (PP) and visual analogue scale (VAS) neurosensory tests were recorded at each treatment session and 14 days after the last treatment. The association between explanatory variables and the outcome of interest was analyzed using generalized estimating equations. Results: The median percentage change of outcomes from the first to the last visit was as follows: VAS score: +125.00% (range: 50.00 to 166.67); PP score: +350% (range: 150 to 800). The duration of paresthesia was inversely correlated with changes in VAS and PP scores. No significant association was found between patients' gender or age and changes in VAS and PP scores. Conclusion: Considering the limitations of this study, PBM with the parameters used in this study presented positive effects on neurosensory recovery in patients suffering from IAN injury associated with routine intraoral procedures. Patients with shorter duration of paresthesia tended to respond more favorably to PBM therapy.
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Affiliation(s)
- Neda Hakimiha
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Rokn
- Dental Implant Research Center, Dentistry Research Institute, Department of Periodontology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Younespour
- Assistant Professor, PhD of Biostatistics, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Moslemi
- Department of Periodontology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Le Donne M, Jouan R, Bourlet J, Louvrier A, Ducret M, Sigaux N. Inferior alveolar nerve allogenic repair following mandibulectomy: A systematic review. J Stomatol Oral Maxillofac Surg 2021; 123:233-238. [PMID: 33933668 DOI: 10.1016/j.jormas.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/08/2021] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Processed nerve allografts (PNA) are an alternative to nerve autografts to reconstruct the inferior alveolar nerve (IAN) when it is damaged. The purpose of this study was to report the results of IAN reconstruction using PNA in the context of aggressive benign mandibular pathology. MATERIAL AND METHOD A systematic literature review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement through the MEDLINE (Pubmed) and SCOPUS (Elsevier) databases. Studies concerning reconstructive surgeries of IAN by PNA, performed at the same time as the surgical resection of the benign pathologies of the mandible were included. The following data were analyzed: gender and patient age, cause of mandibular resection, graft dimensions, sensory recovery at least 6 months after surgery according to the MRC scale, and adverse events related to the intervention. RESULTS The initial search yielded 290 studies and 5 were included in the final review. A total of 33 patients underwent 36 IAN reconstructions; 14 patients were female (42.4%) and mean age was 30 years old. The mean length of graft used was 64.0 ± 9.1 mm. The most common pathology that led to nerve resection was ameloblastoma (52%). Among the reconstructions for which follow-up data were available, functional sensory recovery occurred in 92.9% of cases. CONCLUSION PNA are a reliable, safe, and effective alternative to nerve autografts for the rehabilitation of the IAN with 92.9% of functional recovery according to the reported literature, avoiding any comorbidity associated with the use of a donor site.
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Affiliation(s)
- Mélanie Le Donne
- Private Practitioner, 3 Rue du Dr François Broussais 17100 Saintes, France, Faculté d'Odontologie, Université de Lyon, Université Claude Bernard Lyon 1, 11 rue Guillaume Paradin, 69008 Lyon, France.
| | - Robin Jouan
- Clinical Doctor, Chirurgie Maxillo-faciale, Hôpital Nord-Ouest, Plateau d'Ouilly 69400 Gleizé Villefranche sur Saône, France
| | - Jérôme Bourlet
- Clinical Doctor, Hospices Civils de Lyon, Chirurgie Maxillo-faciale et Stomatologie, Hôpital de la Croix Rousse, 103 Grande Rue de la Croix Rousse, 69004 Lyon, France
| | - Aurélien Louvrier
- Clinical Doctor, Service de chirurgie Maxillo-faciale et Stomatologie, Centre Hospitalier Régional Universitaire Jean Minjoz, 3 boulevard Alexandre Fleming, 25000 Besançon, France
| | - Maxime Ducret
- Associate Professor, Hospices Civils de Lyon, PAM Odontologie, Lyon, France, Faculté d'Odontologie, Université de Lyon, Université Claude Bernard Lyon 1, 11 rue Guillaume Paradin 69008 Lyon, France; Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500 Montreal QC H3A 1G1, Canada
| | - Nicolas Sigaux
- Clinical Doctor, Hospices Civils de Lyon, Chirurgie Maxillo-faciale et Plastique de la face, Hôpital Lyon Sud, 165 chemin du Grand Revoyet, 69310 Pierre-Bénite, France,; UFR de Médecine Lyon Sud, Université Claude Bernard Lyon 1, Université de Lyon, 165 Chemin du petit Revoyet, 69221 Oullins, France
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Scolozzi P. Buccal corticotomy using piezosurgery as a surgical approach for removal of deeply impacted mandibular teeth: An alternative procedure to avoid pitfalls associated with the conventional technique. J Stomatol Oral Maxillofac Surg 2021; 123:142-146. [PMID: 33930598 DOI: 10.1016/j.jormas.2021.04.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 04/23/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To describe and evaluate the use of buccal corticotomy (BC) using a piezosurgical approach for the removal of deeply impacted mandibular teeth. PATIENTS AND METHODS The charts of all patients who underwent BC for the removal of impacted mandibular teeth between 2011 and 2019 at the University Hospital of Geneva were reviewed. The primary outcome variables were (1) the indication for the removal of impacted mandibular teeth by BC, (2) complications. Other variables included age, gender, teeth involved, indication for tooth removal and radiological features. Follow-up was at 1, 3, 6 and 12 months, and we noted the status of healing and complications, if any. RESULTS Twenty-three mandibular-impacted teeth in 6 patients were extracted using BC (8 third molars, 6 second molars, 1 first molar, 4 second premolars and 4 first premolars). The indications for using the BC approach included (1) deeply impacted teeth closely related to the inferior alveolar nerve (IAN) that runs either lingually or inferior to the dental roots (4 patients); or (2) deeply impacted teeth closely related to the IAN and located anterior to the second molar region (2 patients). No complications were observed during the follow-up period. CONCLUSION The present study showed that the BC approach is a valuable method for removing deeply impacted teeth in close proximity to the mandibular canal and is associated with no complications and sound bone healing.
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Affiliation(s)
- Paolo Scolozzi
- Head, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland.
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Kim JY, Han MD, Jeon KJ, Huh JK, Park KH. Three-dimensional assessment of the anterior and inferior loop of the inferior alveolar nerve using computed tomography images in patients with and without mandibular asymmetry. BMC Oral Health 2021; 21:71. [PMID: 33593343 PMCID: PMC7885493 DOI: 10.1186/s12903-021-01424-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/04/2021] [Indexed: 11/15/2022] Open
Abstract
Background The purpose of this study was to investigate the differences in configuration and dimensions of the anterior loop of the inferior alveolar nerve (ALIAN) in patients with and without mandibular asymmetry. Method Preoperative computed tomography images of patients who had undergone orthognathic surgery from January 2016 to December 2018 at a single institution were analyzed. Subjects were classified into two groups as “Asymmetry group” and “Symmetry group”. The distance from the most anterior and most inferior points of the ALIAN (IANant and IANinf) to the vertical and horizontal reference planes were measured (dAnt and dInf). The distance from IANant and IANinf to the mental foramen were also calculated (dAnt_MF and dInf_MF). The length of the mandibular body and symphysis area were measured. All measurements were analyzed using 3D analysis software. Results There were 57 total eligible subjects. In the Asymmetry group, dAnt and dAnt_MF on the non-deviated side were significantly longer than the deviated side (p < 0.001). dInf_MF on the non-deviated side was also significantly longer than the deviated side (p = 0.001). Mandibular body length was significantly longer on the non-deviated side (p < 0.001). There was no significant difference in length in the symphysis area (p = 0.623). In the Symmetry group, there was no difference between the left and right sides for all variables. Conclusion In asymmetric patients, there is a difference tendency in the ALIAN between the deviated and non-deviated sides. In patients with mandibular asymmetry, this should be considered during surgery in the anterior mandible.
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Affiliation(s)
- Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Michael D Han
- Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago College of Dentistry, Chicago, IL, USA
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea
| | - Kwang-Ho Park
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, Korea.
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Maekawa S, Nagata M, Matsushita Y, Tubbs RS, Iwanaga J. An unusual anatomical variation of the inferior alveolar nerve. Anat Cell Biol 2020; 53:519-521. [PMID: 32814705 PMCID: PMC7769098 DOI: 10.5115/acb.20.145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/14/2020] [Accepted: 07/30/2020] [Indexed: 01/16/2023] Open
Abstract
A number of studies have previously shown variations of inferior alveolar, however, only a few reports focused on nearby the foramen ovale. In a formalin fixed cadaver, we identified three minor branches (anterior, middle, and posterior branches) arising from the main trunk of the mandibular nerve adjacent to the foramen ovale, passing lateral to the maxillary artery (MA), and joining the inferior alveolar nerve. The diameter of the branches was 0.68 mm, 1.43 mm, and 0.40 mm, respectively. The branches traveled inside the lateral pterygoid muscle (LPM) or between the LPM and tensor/levator veli palatini. Moreover, all of the branches were superficial to MA. Knowledge of such a variation might be helpful to dentists during, for example, anesthetic blockade and various oral surgeries.
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Affiliation(s)
- Shogo Maekawa
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Biointerfaces Institute, North Campus Research Complex, University of Michigan, Ann Arbor, MI, USA.,Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mizuki Nagata
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Yuki Matsushita
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA , USA
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Dental and Oral Medical Center, Kurume University School of Medicine, Fukuoka, Japan.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Fukuoka, Japan
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Firoozi P, Keyhan SO, Kim SG, Fallahi HR. Effectiveness of low-level laser therapy on recovery from neurosensory disturbance after sagittal split ramus osteotomy: a systematic review and meta-analysis. Maxillofac Plast Reconstr Surg 2020; 42:41. [PMID: 33331972 PMCID: PMC7746795 DOI: 10.1186/s40902-020-00285-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/26/2020] [Indexed: 11/15/2022] Open
Abstract
Background Orthognathic surgery such as bilateral sagittal split ramus osteotomy (BSSRO) for the treatment of mandibular deformities is one of the most common procedures in maxillofacial operations that may lead to neurosensory disturbance. In this study, we aimed to evaluate the effectiveness of low-level laser therapy (LLLT) on augmenting recovery of neurosensory disturbance of inferior alveolar nerve (IAN) in patients who underwent BSSRO surgery. Methods A comprehensive literature search was conducted by two independent authors in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, Embase, and Google Scholar electronic databases. Besides, a manual search of all textbooks and relevant articles were conducted. Searches took place in August 2020 and were limited to published and peer-reviewed articles from 2000 to 2020. All analysis was performed using the comprehensive meta-analysis (CMA) and the STATA MP (version:16) software. The weighted mean difference (WMD) using the inverse variance method and the standard mean difference (SMD) was considered for continuous variables. Results Seventy-four papers were retrieved after removing duplicate studies and finally, eight studies were assessed for qualitative synthesis and five for meta-analysis. Totally, 94 patients were included in the meta-analysis. Based on the meta-analysis, it was shown that LLLT was not effective in a short interval (0 to 48 h) after surgery, but in a period of more than 1 month after surgery, the positive results of treatment can be observed strikingly. Also, LLLT side/group showed no significant difference in some aspects of neurosensory recovery such as thermal sensation compared to the placebo side/group. Conclusions The meta-analysis of randomized controlled trials revealed that LLLT generally improves IAN sensory disturbance caused by BSSRO. Further high-quality clinical trials with longer follow-up periods and larger sample sizes are recommended.
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Affiliation(s)
- Parsa Firoozi
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran.
| | - Seied Omid Keyhan
- CMFRC, National Advance Center for Craniomaxillofacial Reconstruction, Tehran, Iran.,Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Founder and Director of Maxillofacial Surgery and Implantology Research Foundation, Tehran, Iran
| | - Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 28644, Republic of Korea
| | - Hamid Reza Fallahi
- Founder and Director of Maxillofacial Surgery and Implantology Research Foundation, Tehran, Iran.,Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Nishiyama A, Odaka K, Koyachi M, Sugahara K, Katakura A. Alternative technique to repair damaged inferior alveolar nerve using data fusion from computed tomographic and magnetic resonance imaging. Br J Oral Maxillofac Surg 2022; 60:207-8. [PMID: 34930645 DOI: 10.1016/j.bjoms.2020.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 09/04/2020] [Indexed: 11/20/2022]
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Iwanaga J, Shiromoto K, Kato T, Tanaka T, Ibaragi S, Tubbs RS. Anatomy of the mandibular canal and surrounding structures. Part II: Cancellous pattern of the mandible. Ann Anat 2020; 232:151583. [PMID: 32810613 DOI: 10.1016/j.aanat.2020.151583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/29/2020] [Accepted: 07/17/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE It is necessary to correlate cancellous bone patterns with cone beam computed tomography (CBCT) images, but this has not been done to date. The goal of this study was to establish how the superior wall of the mandibular canal (MC) on CBCT images correlates with the cancellous bone around the MC on gross anatomical findings. METHODS Twenty sides from 10 dry mandibles derived from six females and four males were used for this study. In order to observe the MC distally, the specimen was prepared by the method used in our previous study. The cancellous bone around the MC was observed and classified into three types: type I (trabecular pattern), type II (osteoporotic pattern), and type III (dense/irregular pattern). The mandibles were examined with CBCT and the superior wall of the MC on CBCT was scored as visible or non-visible. Finally, the scores (visible or non-visible) were compared to the type by gross observation. RESULTS For gross observation, a total of 80 areas were available for this study. The data were added to those from our previous study. As a result, 155 areas on 40 sides were analyzed. In dentulous sections, types I, II, and III were found in 55.8%, 20.9%, and 23.3%, respectively. In edentulous sections, the corresponding percentages were 25.0%, 41.1%, and 33.9%, respectively. The dentulous sections was more likely than edentulous to have a type I mandible in both sexes. More females than males had type II (osteoporotic) mandibles. When the superior wall of the MC was non-visible on CBCT, the cancellous bone was type II in 80%. CONCLUSIONS We believe the results can easily be applied to preoperative diagnosis with not only radiological but also anatomical evidence. This classification now necessitates clinical trials for further evidence.
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Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA; Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | | | - Tomotaka Kato
- Division of General Dentistry, Nippon Dental University Hospital, Tokyo, Japan
| | - Tsuyoshi Tanaka
- Department of Periodontology, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA; Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA; Department of Anatomical Sciences, St. George's University, St. George's, Grenada; Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
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Iwanaga J, Katafuchi M, Matsushita Y, Kato T, Horner K, Tubbs RS. Anatomy of the mandibular canal and surrounding structures: Part I: Morphology of the superior wall of the mandibular canal. Ann Anat 2020; 232:151580. [PMID: 32688018 DOI: 10.1016/j.aanat.2020.151580] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/11/2020] [Accepted: 06/25/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Previous studies of the mandibular canal (MC) have raised questions about the structure of its superior wall that have not been answered. The goal of this anatomical and radiological study was to investigate how CBCT imaging could predict the structure of the superior wall of the MC. METHODS Twenty sides from ten dry mandibles derived from six females and four males were used for this study. The mandibles were examined with CBCT. The specimens were then prepared by the methods of our previous study and observed inferiorly. The inferior views were classified into four groups by gross observation of the surface of the superior wall of the MC: class I (trabecular pattern), class II (osteoporotic pattern), class III (dense/irregular pattern), and class IV (smooth pattern). Coronal section CBCT images were classed according to whether the superior wall of the MC was visible. RESULTS Class I was most common in dentulous sections in both genders, and class IV was most common class in edentulous sections in both genders. The superior wall was visible in 59.1% in dentulous and 84.9% in edentulous sections, and non-visible in the remainder. CONCLUSION Tooth presence and sex are important factors influencing the superior wall of the MC. When the superior wall cannot be seen on CBCT, it is more likely to belong to class II (osteoporotic) than other classes.
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Rusu MC, Stoenescu MD. The mandibular incisive foramen, a false mental foramen. Morphologie 2020; 104:293-296. [PMID: 32620269 DOI: 10.1016/j.morpho.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND The mandibular incisive foramen (MIF) is an opening on the external surface of the dentate mandibular body, medial to, and facing the mental foramen (MF). There is actually scarce evidence of such MIF. CLINICAL PRESENTATION A retrospective Cone Beam CT (CBCT) study of the archived files of a 56 y.o. male patient was documented anatomically for dental medical purposes. In the 2nd premolar region of the left hemimandible were found two adjacent foramina facing one each other: the distal one was opened medially, while the medial one was oriented distally. On axial CBCT slices the mandibular canal was detected to open at the distal foramen in the outer cortical plate of the mandible. The medial foramen in that cortical plate served as entrance to the mandibular incisive canal, thus being a MIF. CONCLUSION CBCT accurately distinguishes the canals opening on the outer cortical plate of the mandible thus is of use to differentiate a MIF from a MF. Such adjacent foramina expose at risk not just the mental nerve, as in cases with true multiple MF, but also the IAN and the mandibular incisive nerve.
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Affiliation(s)
- M C Rusu
- Dr. Hab., Prof., Division of Anatomy, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, 8, Eroilor Sanitari Blvd., 050474 Bucharest, Romania.
| | - M D Stoenescu
- Division of Anatomy, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania; "Dr.Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania.
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Nayak U, Vadgaonkar R, Pai MM, Murlimanju BV. A case of inferior alveolar nerve encircling the arteria maxillaris. Anat Cell Biol 2020; 53:240-243. [PMID: 32647091 PMCID: PMC7343564 DOI: 10.5115/acb.19.194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/04/2019] [Accepted: 11/22/2019] [Indexed: 11/27/2022] Open
Abstract
Here we report a case of inferior alveolar nerve (IAN), which had variability in its formation. IAN was formed by dual roots, which were branching out from the posterior division of mandibular nerve. The observed roots were forming a loop around the pterygoid part of arteria maxillaris (MA). One of the roots was superficial to the MA and the other was deep to it. It is believed that this type of morphological variation in the formation of IAN can have clinial implications, which include compression by adjacent structures and nerve entrapment. The knowledge of this variation is important to anaesthesiologists and dentists, while administering local anaesthesia. This is also enlightening to the maxillofacial surgeons, neurologists and radiologists.
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Affiliation(s)
- Unnathi Nayak
- Third Semester MBBS Student, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rajanigandha Vadgaonkar
- Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Mangala M Pai
- Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - B V Murlimanju
- Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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