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Cone-beam computed tomography investigation of crucial mandibular canal variations in Thais

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Abstract

Objective

The physiology of the mandibular nerve is an important factor relevant to successful implant planning and surgical procedures in the mandible. Variability among ethnicities may influence the particular safety guidelines for each population. In this study, we retrospectively examined the incidences of canal orientations and variations in Thais using cone-beam computed tomography (CBCT) radiography.

Methods

CBCT images of 441 mandibular sides of 248 patients aged 20 to 82 years (mean age, 43.7 years) were examined. The incidences of canal courses and variations were assessed by two calibrated observers (Cohen's kappa coefficient >0.8). Descriptive and bivariate statistics were analysed for categorical findings. A p value of <0.05 was considered statistically significant.

Results

Two common canal courses were identified: linear curve (Type 1, 39.9%) and elliptic-arc curve (Type 3, 48.1%). In addition, one-fifth of the patients had bifid canals (20.6%). There was a short supplemental canal extending to the second or third molar (Type 2, 53.8%) and a supplemental canal arising in the retromolar pad region (Type 4, 46.2%). An anterior loop was identified in 74.2% of the cases and was frequently bilateral (78.3%).

Conclusions

Effective examination of the canal anatomy should be considered prior to surgical procedures because of the shallow curve of the mandibular canal with a high incidence of an anterior loop. In addition, the position of bifid canals was associated with an increased risk of neurovascular alteration in implant placement, sagittal split ramus osteotomy, and retromolar bone harvesting.

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Acknowledgements

This study was funded by the Faculty of Dental Medicine, Rangsit University. The authors are grateful to Dr. Watcharin Chongkonsatit, Ph.D., and Dr. Chalermrat Chantaradecha, Ph.D., who provided statistical advice. The authors also thank Asst. Prof. Dr. Kraisorn Sappayatosok, DDS, Ph.D., and Dr. Ozgur Erdogan, DDS, Ph.D., for their support.

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Authors and Affiliations

  1. Faculty of Dental Medicine, Rangsit University, 52/347 Muang-Ake Phaholyothin Road, Lak-Hok, Pathumthani, 12000, Thailand

    Piyanuch Karnasuta, Jananya Plianrungsi, Issarintip Denkongpon, Nantida Horsimasathaporn, Panthipa Chayutthanabun, Jariya Weerachartwattana, Pajaree Boonchalermchai, Sukanya Charoenwathana, Nattasit Narongrat, Kwanporn Jutipimarn & Natthawit Hongsatit

  2. Advanced Dental Technology Center, Thailand Centre of Excellence for Life Sciences (Public Organization), 111 Room 307-309, Third floor, Phaholyothin Road, Klongnueng, Klongluang, Pathumthani, 12120, Thailand

    Wichit Tharanon

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  1. Piyanuch Karnasuta
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Correspondence to Piyanuch Karnasuta.

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Conflict of interest

Piyanuch Karnasuta, Jananya Plianrungsi, Issarintip Denkongpon, Nantida Horsimasathaporn, Panthipa Chayutthanabun, Jariya Weerachartwattana, Pajaree Boonchalermchai, Sukanya Charoenwathana, Nattasit Narongrat, Kwanporn Jutipimarn, Natthawit Hongsatit, and Wichit Tharanon have no conflicts of interest.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional) and with the Helsinki Declaration of 1964 and later versions.

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This article does not contain any studies with animal subjects performed by any of the authors.

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Karnasuta, P., Plianrungsi, J., Denkongpon, I. et al. Cone-beam computed tomography investigation of crucial mandibular canal variations in Thais. Oral Radiol 33, 219–226 (2017). https://doi.org/10.1007/s11282-017-0270-3

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  • DOI: https://doi.org/10.1007/s11282-017-0270-3

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