Radiographic considerations for the regional anatomy in the posterior mandible

Natasha Yashar, Christopher G. Engeland, Alan L. Rosenfeld, Timothy P. Walsh, Joseph V. Califano

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Background: Previous studies of the inferior alveolar nerve have used cadaveric specimens in small patient groups. The purpose of this study was to describe the anatomy in the posterior mandible with respect to the inferior alveolar nerve (IAN) using computed tomography (CT) images in a large patient population. We hypothesize that CT scans are an important component of a thorough treatment plan for minimizing risk to the IAN and optimizing surgical outcomes. Methods: CT scans of 195 patients (62 males and 133 females; age range: 22 to 88 years) were evaluated retrospectively. With the aid of computer software, cross-sectional images were examined at 5-mmincrements distal to the mental foramen to the ascending ramus. Four measurements were made at each cross-sectional image. The distances from the IAN to the: 1) alveolar crest (CN); 2) buccal cortical plate (BN); 3) lingual cortical plate (LN); and 4) inferior border (IN) were measured. Results: Most measurements for males and females were significantly different. Mean values were as follows (males/females): CN, 13.85 ±0.43/11.98 ±0.40 mm (P <0.01); BN, 4.98 ±0.15/4.47 ±0.11 mm (P <0.01); LN, 2.93 ±0.12/ 3.19 ±0.10 mm (P <0.10); and IN, 7.76 -0.16/7.00 -0.15 mm (P <0.01). The 95% confidence intervals indicated that many patients had limited bone volume in the buccal shelf or ascending ramus. Conclusion: Given the high degree of variability in mandibular bone volume surrounding the IAN and the position of the IAN, the use of CT scans should be considered for surgical procedures in the posterior mandible when there is risk of injury to the IAN. J Periodontol 2012;83:36-42.

Original languageEnglish (US)
Pages (from-to)36-42
Number of pages7
JournalJournal of periodontology
Volume83
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

Keywords

  • Anatomy
  • Computed tomography
  • Mandibular nerve

ASJC Scopus subject areas

  • Periodontics

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