Canal Localization in Dry Mandibles: Two-Dimensional versus Three-Dimensional Imaging

• Main Authors: Ajay Chandran, Puttaraj T Kattimani, S Nachiappan, Marbon A Joevitson, Sreetama Chatterjee, Aarti M Rajambigai, Maneesha Das, Abhishek Singh Nayyar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Journal of International Clinical Dental Research Organization
• Subjects: cone-beam computed tomography; digital orthopantomography; dry mandibles; localization; mandibular canal
• Online Access: http://www.jicdro.org/article.asp?issn=2231-0754;year=2020;volume=12;issue=2;spage=154;epage=165;aulast=Chandran

Context and Aim: Dental implants are widely used for the rehabilitation of edentulous arches. Yet, placement of oral implants in the mandible is associated with numerous complications, including hemorrhage and neurosensory disturbances. Enumerating precise information concerning the vital structures of the mandible, thus, becomes all the more important before the placement of implants. The aim of the present study was to determine the efficiency and accuracy of digital orthopantomography (OPG) and cone-beam computed tomography (CBCT) in determining the location of mandibular canal in preoperative assessment of the mandibles for implant placement. Materials and Methods: Ten dry edentulous mandibles of adult humans were selected for this study which comprised two phases, namely a radiographic phase and an in vitro phase. The radiographic phase was based on the obtaining digital orthopantomographs and cone-beam computed tomograms. During the in vitro phase, all the mandibles were sectioned at an angle of 90° to the inferior border of the mandible, and in vitro measurements were obtained. Statistical Analysis Used: Statistical analysis was done using IBM SPSS statistics 20 (Chicago, IL, USA). Paired and unpaired t-tests were used to do a comparative analysis of the two modalities used. P < 0.05 was considered to be statistically significant. Results: The results of the present study revealed that the measurements of both the vertical (D1 and D2) and the buccolingual distances of the mandible (D3 and D4) obtained by CBCT were in accordance with the ones obtained with the help of in vitro measurements, and there was no statistically significant difference in the studied variables (D1, D2, D3, and D4) between the two measurements. On the contrary, there was a significant statistical difference between the values obtained from digital OPG (D1 and D2) when compared to the values obtained by in vitro measurements. Conclusion: The findings of the present study implied that CBCT is the most efficient and accurate diagnostic tool available to locate the course of mandibular canal in the selection of potential implant sites. The accuracy of the CBCT was found to be superior to the digital panoramic images in the present study because of multiplanar three-dimensional reconstructions.