Measurement and analysis of the course of the mandibular canal based on cone-beam computed tomography

doi:10.3877/cma.j.issn.1674-1366.2024.04.004

Abstract

Abstract:

Objective

To analyze the course of the mandibular canal in the posterior mandibular region using cone-beam computed tomography (CBCT) .

Methods

The CBCT data of 77 cases in the Department of Stomatology at the People′s Hospital of Fengqing County, Lincang City, Yunnan Province, from February 2018 to June 2021, were used. After three-dimensional reconstruction of the CBCT data, coronal images of the roots of the second premolars, first molars, and second molars were measured. The measurements included the vertical distance from the center of the mandibular canal to the lower margin of the mandible, to the buccal and lingual walls on the same horizontal plane, and the vertical distance from the upper margin of the mandibular canal to the apex, using an independent two-sample t-test to compare the distances between the alveolar nerve canal and the mandibular bone walls in males and females.

Results

The distance between the mandibular canal and the lower margin of the mandible was greater in males than that in females. This distance at the right lower second premolar point was (11.2 ± 1.7) mm in males, and (10.2 ± 1.2) mm in females, which was statistically different between genders (t = 3.123, P = 0.003). The distance at right lower second molar distal root point was (10.8 ± 1.7) mm in males, and (10.1 ± 1.6) mm in females, which was statistically different between genders (t = 2.133, P = 0.036). The distance from the mandibular canal to the buccal wall of the mandible was significantly longer than that to the lingual wall at the first and second molars, with the exception of the second premolars. The distance at the buccal side of the distal root point of the lower right first molars in males was (6.6 ± 1.6) mm, and the distance at the lingual side was (3.6 ± 1.3) mm, which was statistically different between the two sides (t = 9.181, P<0.001). The distance at the buccal side in females was (6.4 ± 1.2) mm, and at the lingual side was (3.8 ± 1.0) mm, which was statistically different between the two sides (t = 9.950, P<0.001). The distance at the buccal side of distal root point of the lower right second molars in males was (8.3 ± 1.4) mm, and the distance at the lingual side was (3.4 ± 1.0) mm, which was statistically different between the two sides (t = 18.57, P<0.001). This distance at the buccal side in females was (7.8 ± 1.5) mm, and the distance at the lingual side was (3.7 ± 1.3) mm, which was statistically different between the two sides (t = 16.90, P<0.001). The distance from the mandibular canal to the apex was longer in males than that in females on the other observation points except for the distal roots of the right first molars (Zone Ⅲ), and the mesial roots of the right first molars (Zone Ⅳ) .

Conclusion

The course of the mandibular canal within the mandible exhibited a certain curve in the vertical direction, with a more regular pattern in the buccolingual direction.

Key words: Mandibular canal, Cone-beam computed tomography, Imaing, Three-dimensional

Shimei Wang, Chao Xue, Zhipeng Li, Weixin Cai. Measurement and analysis of the course of the mandibular canal based on cone-beam computed tomography[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2024, 18(04): 237-242.

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Figures/Tables 5

References 31

[1]	Kim HJ，Jo YJ，Choi JS，et al. Anatomical risk factors of inferior alveolar nerve injury association with surgical extraction of mandibular third molar in korean population[J]. Appl Sci，2021，11（2）：816. DOI：10.3390/app11020816.
[2]	Kämmerer PW，Heimes D，Hartmann A，et al. Clinical insights into traumatic injury of the inferior alveolar and lingual nerves：A comprehensive approach from diagnosis to therapeutic interventions[J]. Clin Oral Investig，2024，28（4）：216. DOI：10.1007/s00784-024-05615-4.
[3]	Picoli FF，Fontenele RC，van der Cruyssen F，et al. Risk assessment of inferior alveolar nerve injury after wisdom tooth removal using 3D AI-driven models：A within-patient study[J]. J Dent，2023，139：104765. DOI：10.1016/j.jdent.2023.104765.
[4]	Kuang S，Liu Y，Zhuang W，et al. 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[J]. BMC Oral Health，2023，23（1）：929. DOI：10.1186/s12903-023-03661-0.
[5]	Bagourd T，Varazzani A，Dugast S，et al. Radiological evaluation of inferior alveolar nerve displacement after removal of impacted mandibular third molars prior to sagittal split osteotomy[J]. J Stomatol Oral Maxillofac Surg，2023，124（6S2）：101658. DOI：10.1016/j.jormas.2023.101658.
[6]	Ma YQ，Yang MM，Chen XD，et al. The effectiveness of photobiomodulation therapy on inferior alveolar nerve injury：A systematic review and META-analysis[J]. PLoS One，2023，18（8）：e0287833. DOI：10.1371/journal.pone.0287833.
[7]	Jung JH，Ko JH，Ku JK，et al. Sensory change after implant surgery：Related factors for recovery[J]. J Korean Assoc Oral Maxillofac Surg，2022，48（5）：297-302. DOI：10.5125/jkaoms.2022.48.5.297.
[8]	Aquilanti L，Mascitti M，Togni L，et al. A systematic review on nerve-related adverse effects following mandibular nerve block anesthesia[J]. Int J Environ Res Public Health，2022，19（3）：1627. DOI：10.3390/ijerph19031627.
[9]	Skrzat J，Ryniewicz W，Goncerz G，et al. Anatomical features of the mandibular canal and their clinical significance - review of literature[J]. Folia Med Cracov，2023，63（3）：157-170. DOI：10.24425/fmc.2023.147220.
[10]	Ni FD，Xu ZN，Liu MQ，et al. Towards clinically applicable automated mandibular canal segmentation on CBCT[J]. J Dent，2024，144：104931. DOI：10.1016/j.jdent.2024.104931.
[11]	Yang Y，Bao DY，Ni C，et al. Three-dimensional positional relationship between impacted mandibular third molars and the mandibular canal[J]. BMC Oral Health，2023，23（1）：831. DOI：10.1186/s12903-023-03548-0.
[12]	Patel PS，Shah JS，Dudhia BB，et al. Comparison of panoramic radiograph and cone beam computed tomography findings for impacted mandibular third molar root and inferior alveolar nerve canal relation[J]. Indian J Dent Res，2020，31（1）：91-102. DOI：10.4103/ijdr.IJDR_540_18.
[13]	Leung YY，Hung KF，Li DTS，et al. Application of cone beam computed tomography in risk assessment of lower third molar surgery[J]. Diagnostics（Basel），2023，13（5）：919. DOI：10.3390/diagnostics13050919.
[14]	Ahmed AA，Ahmed RM，Jamleh A，et al. Morphometric analysis of the mandibular canal，anterior loop，and mental foramen：A cone-beam computed tomography evaluation[J]. Int J Environ Res Public Health，2021，18（7）：3365. DOI：10.3390/ijerph18073365.
[15]	Kensara J，Jayam R，Almanea M，et al. Radiological assessment of the inferior alveolar canal and mental foramen using cone beam computed tomography for pre-operative evaluation of surgeries in the mandible：A single-center five-year retrospective study[J]. Saudi Dental Journal，2024，36（1）：91-98. DOI：10.1016/j.sdentj.2023.10.003.
[16]	Koç A，Öner Talmaç AG，Keskin S. Variation of mandibular canal branching related to anatomical regions in mandible：A radiographic study without contrast[J]. J Oral Maxillofac Surg，2022，80（12）：1966-1977. DOI：10.1016/j.joms.2022.08.005.
[17]	Alali Y，Mohammed WA，Alabulkarim M，et al. Assessment of bifid mandibular canals using cone beam computed tomography in general population：A retrospective evaluation[J]. Eur Rev Med Pharmacol Sci，2024，28（5）：1741-1750. DOI：10.26355/eurrev_202403_35587.
[18]	Arias A，Venegas C，Soto N，et al. Location and course of the mandibular canal in dentate patients：Morphometric study using cone-beam computed tomography[J]. Folia Morphol（Warsz），2020，79（3）：563-569. DOI：10.5603/FM.a2019.0103.
[19]	Yavuz E，Yardimci S. Comparison of periapical radiography，panoramic radiography，and CBCT in the evaluation of trabecular bone structure using fractal analysis[J]. Oral Radiol，2024. DOI：10.1007/s11282-024-00743-9.
[20]	Muttanahally KS，Sheppard S，Yadav S，et al. The utility of cone beam computed tomography scans in diagnosing and treating anterior lesions of the maxilla and mandible[J]. Cureus，2024，16（1）：e52804. DOI：10.7759/cureus.52804.
[21]	Sirin Y，Yildirimturk S，Horasan S，et al. Diagnostic potential of panoramic radiography and cbct in detecting implant-related ex vivo injuries of the inferior alveolar canal border[J]. J Oral Implantol，2020，46（3）：206-213. DOI：10.1563/aaid-joi-D-19-00005.
[22]	Chau A. Comparison between the use of magnetic resonance imaging and conebeam computed tomography for mandibular nerve identification[J]. Clin Oral Implants Res，2012，23（2）：253-256. DOI：10.1111/j.1600-0501.2011.02188.x.
[23]	Wyatt JJ，Pearson RA，Walker CP，et al. Cone beam computed tomography for dose calculation quality assurance for magnetic resonance-only radiotherapy[J]. Phys Imaging Radiat Oncol，2021，17：71-76. DOI：10.1016/j.phro.2021.01.005.
[24]	Al-Siweedi SY，Nambiar P，Shanmuhasuntharam P，et al. Gaining surgical access for repositioning the inferior alveolar neurovascular bundle[J]. Sci World J，2014：719243. DOI：10.1155/2014/719243.
[25]	Rath R，Sangamesh NC，Acharya RR，et al. Sexual dimorphism of inferior alveolar canal location：A record-based CBCT study in eastern India[J]. J Oral Maxillofac Pathol，2022，26（2）：277-282. DOI：10.4103/jomfp.jomfp_139_21.
[26]	Kalabalik F，Aytuğar E. Localization of the mandibular canal in a turkish population：A retrospective cone-beam computed tomography study[J]. J Oral Maxillofac Res，2019，10（2）：e2. DOI：10.5037/jomr.2019.10202.
[27]	Mousa A，El Dessouky S，El Beshlawy D. Sex determination by radiographic localization of the inferior alveolar canal using cone-beam computed tomography in an Egyptian population[J]. Imaging Sci Dent，2020，50（2）：117-124. DOI：10.5624/isd.2020.50.2.117.
[28]	戴慧颖.锥形束CT对下颌神经管走向的测量分析[D].合肥：安徽医科大学，2017. DOI：10.7666/d.D01241069.
[29]	Chua MKW，Koh WJ，Nimbalkar S，et al. CBCT evaluation of buccolingual orientation of inferior alveolar canal in mandibular posterior region for implant planning[J]. Int J Dent，2022：4682105. DOI：10.1155/2022/4682105.
[30]	Khorshidi H，Raoofi S，Ghapanchi J，et al. Cone beam computed tomographic analysis of the course and position of mandibular canal[J]. J Maxillofac Oral Surg，2016，16（3）：306-311. DOI：10.1007/s12663-016-0956-9.
[31]	Razumova S，Brago A，Howijieh A，et al. Evaluation the relationship between mandibular molar root apices and mandibular canal among residents of the moscow population using cone-beam computed tomography technique[J]. Contemp Clin Dent，2022，13（1）：3-8. DOI：10.4103/ccd.ccd_388_19.

测量位点	性别		t值	P值
测量位点	男（n = 39）	女（n = 38）	t值	P值
Ⅰ区	11.2 ± 1.7	10.2 ± 1.2	3.128	0.003^a
Ⅱ区	10.2 ± 1.8	9.5 ± 1.6	2.054	0.043^a
Ⅲ区	10.1 ± 1.6	9.6 ± 1.6	2.073	0.042^a
Ⅳ区	10.8 ± 1.7	9.6 ± 1.6	3.154	0.002^a
Ⅴ区	10.8 ± 1.7	10.1 ± 1.6	2.133	0.036^a
Ⅵ区	11.4 ± 1.6	10.2 ± 1.4	3.727	<0.01^a
Ⅶ区	10.6 ± 1.4	9.3 ± 1.4	3.860	<0.01^a
Ⅷ区	10.5 ± 1.5	9.3 ± 1.4	3.552	<0.01^a
Ⅸ区	10.8 ± 1.6	9.7 ± 1.8	2.895	0.005^a
Ⅹ区	11.0 ± 1.8	10.1 ± 1.8	2.364	0.021^a

测量位点	性别		t值	P值
测量位点	男（n = 39）	女（n = 38）	t值	P值
Ⅰ区	11.2 ± 1.7	10.2 ± 1.2	3.128	0.003^a
Ⅱ区	10.2 ± 1.8	9.5 ± 1.6	2.054	0.043^a
Ⅲ区	10.1 ± 1.6	9.6 ± 1.6	2.073	0.042^a
Ⅳ区	10.8 ± 1.7	9.6 ± 1.6	3.154	0.002^a
Ⅴ区	10.8 ± 1.7	10.1 ± 1.6	2.133	0.036^a
Ⅵ区	11.4 ± 1.6	10.2 ± 1.4	3.727	<0.01^a
Ⅶ区	10.6 ± 1.4	9.3 ± 1.4	3.860	<0.01^a
Ⅷ区	10.5 ± 1.5	9.3 ± 1.4	3.552	<0.01^a
Ⅸ区	10.8 ± 1.6	9.7 ± 1.8	2.895	0.005^a
Ⅹ区	11.0 ± 1.8	10.1 ± 1.8	2.364	0.021^a

测量位点	颊舌侧	性别		t值	P值
测量位点	颊舌侧	男（n = 39）	女（n = 38）	t值	P值
Ⅰ区	颊侧	5.3 ± 1.2	4.6 ± 0.9	2.629	0.010^a
	舌侧	4.7 ± 1.3	5.0 ± 1.0	-1.176	0.243
Ⅱ区	颊侧	6.6 ± 1.5	6.4 ± 1.2	0.620	0.537
	舌侧	3.6 ± 1.3	3.8 ± 1.0	-0.604	0.547
Ⅲ区	颊侧	7.3 ± 1.6	6.9 ± 1.2	1.293	0.200
	舌侧	3.4 ± 1.1	3.6 ± 1.0	-0.642	0.523
Ⅳ区	颊侧	8.3 ± 1.4	7.8 ± 1.5	1.824	0.072
	舌侧	3.4 ± 1.0	3.7 ± 1.3	-1.089	0.280
Ⅴ区	颊侧	8.4 ± 1.4	8.1 ± 1.4	1.007	0.123
	舌侧	3.4 ± 1.0	3.6 ± 1.0	-0.899	0.371
Ⅵ区	颊侧	5.0 ± 1.1	4.4 ± 1.1	2.574	0.012^a
	舌侧	5.0 ± 1.6	5.0 ± 1.3	-0.133	0.894
Ⅶ区	颊侧	6.6 ± 1.5	5.9 ± 1.1	2.128	0.037^a
	舌侧	3.8 ± 1.3	3.9 ± 1.1	-0.351	0.727
Ⅷ区	颊侧	7.3 ± 1.4	6.6 ± 1.2	2.087	0.040^a
	舌侧	3.6 ± 1.1	3.7 ± 1.1	-0.722	0.472
Ⅸ区	颊侧	8.1 ± 1.4	7.6 ± 1.4	1.451	0.151
	舌侧	3.6 ± 1.1	3.7 ± 0.9	-0.672	0.504
Ⅹ区	颊侧	8.1 ± 1.6	8.0 ± 1.5	0.278	0.782
	舌侧	3.9 ± 1.6	3.7 ± 1.0	0.531	0.597

测量位点	颊舌侧	性别		t值	P值
测量位点	颊舌侧	男（n = 39）	女（n = 38）	t值	P值
Ⅰ区	颊侧	5.3 ± 1.2	4.6 ± 0.9	2.629	0.010^a
	舌侧	4.7 ± 1.3	5.0 ± 1.0	-1.176	0.243
Ⅱ区	颊侧	6.6 ± 1.5	6.4 ± 1.2	0.620	0.537
	舌侧	3.6 ± 1.3	3.8 ± 1.0	-0.604	0.547
Ⅲ区	颊侧	7.3 ± 1.6	6.9 ± 1.2	1.293	0.200
	舌侧	3.4 ± 1.1	3.6 ± 1.0	-0.642	0.523
Ⅳ区	颊侧	8.3 ± 1.4	7.8 ± 1.5	1.824	0.072
	舌侧	3.4 ± 1.0	3.7 ± 1.3	-1.089	0.280
Ⅴ区	颊侧	8.4 ± 1.4	8.1 ± 1.4	1.007	0.123
	舌侧	3.4 ± 1.0	3.6 ± 1.0	-0.899	0.371
Ⅵ区	颊侧	5.0 ± 1.1	4.4 ± 1.1	2.574	0.012^a
	舌侧	5.0 ± 1.6	5.0 ± 1.3	-0.133	0.894
Ⅶ区	颊侧	6.6 ± 1.5	5.9 ± 1.1	2.128	0.037^a
	舌侧	3.8 ± 1.3	3.9 ± 1.1	-0.351	0.727
Ⅷ区	颊侧	7.3 ± 1.4	6.6 ± 1.2	2.087	0.040^a
	舌侧	3.6 ± 1.1	3.7 ± 1.1	-0.722	0.472
Ⅸ区	颊侧	8.1 ± 1.4	7.6 ± 1.4	1.451	0.151
	舌侧	3.6 ± 1.1	3.7 ± 0.9	-0.672	0.504
Ⅹ区	颊侧	8.1 ± 1.6	8.0 ± 1.5	0.278	0.782
	舌侧	3.9 ± 1.6	3.7 ± 1.0	0.531	0.597

测量位点	性别		t值	P值
测量位点	男（n = 39）	女（n = 38）	t值	P值
Ⅰ区	4.7 ± 2.7	3.6 ± 2.1	2.075	0.041^a
Ⅱ区	6.4 ± 3.0	4.9 ± 2.9	2.135	0.036^a
Ⅲ区	5.8 ± 2.9	5.1 ± 2.4	1.184	0.240
Ⅳ区	4.8 ± 2.8	3.9 ± 2.5	1.523	0.132
Ⅴ区	4.5 ± 3.1	3.0 ± 2.4	2.406	0.019^a
Ⅵ区	4.8 ± 2.3	3.5 ± 2.0	2.687	0.009^a
Ⅶ区	5.9 ± 2.2	4.9 ± 2.3	1.152	0.035^a
Ⅷ区	5.8 ± 2.6	4.7 ± 2.4	2.016	0.047^a
Ⅸ区	4.7 ± 2.2	3.7 ± 2.1	2.066	0.042^a
Ⅹ区	4.3 ± 2.6	2.9 ± 2.3	2.610	0.011^a

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