Panoramic radiography and cone beam computed tomography for planning of pre-mental foramen Implants

Abstract

The identification of neurovascular anatomical variations, such as the anterior loop of the mental nerve and the incisive canal, is extremely important by the time of planning dental implant placement in the interforaminal region of the mandible. Damage to nerves and/or blood vessels in this region may cause complications during or after surgery like bleeding and sensory damage. Panoramic radiography has been the most common single radiographic examination used in implant treatment planning, although there are major limitations in relation to the location of the neurovascular structures. Thus, this study aims to evaluate the presentation of neurovascular anatomical variations preceding the mental foramen on panoramic radiographs and cone-beam computed tomography. The sample will be composed by panoramic radiography and cone beam computed tomography taken of 120 patients, with a clear visualization of the anterior mandible between the mental foramens. The images are derived from a database of the Piracicaba Dental School/UNICAMP, and include patients who underwent imaging exams for implant treatment and surgical removal of third molars planning. Two dentists, specialized in dental radiology, will assess the panoramic radiographs and CBCT slices to identify the presence of anterior loop of the mental nerve and mandibular incisive canal, and to predict a safe distance between the mental foramens for implant placement. The interobserver and intraobserver will be calculated by the interclass correlation coefficient (ICC). The presence or absence of neurovascular anatomical variations, in both radiographic examinations performed, will be correlated by Mc Namer test. The paired t test will be applied to evaluate the discrepancy between panoramic radiography and cone beam computed tomography to estimate the distances between the mental foramens. (AU)