Imaging Sci Dent.
2016 Sep;46(3):159-165. 10.5624/isd.2016.46.3.159.
Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal
- Affiliations
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- 1Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, São Paulo, Brazil. acarolinerb@hotmail.com
- 2Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
- KMID: 2408247
- DOI: http://doi.org/10.5624/isd.2016.46.3.159
Abstract
- PURPOSE
The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images.
MATERIALS AND METHODS
Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions.
RESULTS
In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm.
CONCLUSION
CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region.
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