Estimation of inferior alveolar nerve proximitytothe root api-ces : A CBVI analysis

  • Authors

    • Sandeep Pagare
    • Christine Roy
    • Sonal Vahanwala
    • Kapil Gavand
    • Mandavi Waghmare
    • Saurabh Goyal
    2018-01-29
    https://doi.org/10.14419/ijdr.v6i1.8863
  • Inferior Alveolar Nerve (IAN), Cone Beam Computed Tomography (CBCT), Mandibular Posteriors

  • Abstract

    A sound knowledge of the relative three dimensional (3D) approximations to the inferior alveolar nerve (IAN) to the root apices of the mandibular premolars and molars and their significance to gender and age is imperative for any dental procedure. Utilization of Cone Beam Computed Tomography (CBCT) has facilitated increased accuracy, higher resolution, and scan time and dose reduction. Literature reveals that various procedures in endodontics and oral surgery may lead to IAN injury, a rare but serious treatment complication. It can result from over instrumentation, periapical surgery and over filling by root canal obturation materials. Surgical endodontic procedures require a thorough knowledge of anatomic structures that might be traumatized. What better view than CBCT, where it gives a thorough knowledge about the 3D position of the IAN, allowing 3D reconstruction in true 1:1 anatomic representation. Majority of IAN injury cases reported were in relation to the mandibular second molars hence before undertaking procedures with potential damage to the IAN, it is essential to know the location of the IAN with respect to the surrounding structures to avoid injury or harm. A study was undertaken with an aim to assess the distance between the apical tips of the mesial roots of the first, second molars and second premolars to the superior border of the IAN. The findings of which could be used to prevent injuries to the inferior alveolar nerve.

  • References

    1. [1] Carter RB, Keen EN. The intramandibular course of the inferior alveolar nerve. J Anat 1971; 108:433–40.

      [2] Claeys V, Wackens G. Bifid mandibular canal: literature review and case report. DentomaxillofacRadiol 2005; 34:55–8. https://doi.org/10.1259/dmfr/23146121.

      [3] Tara Renton. Prevention of Iatrogenic Inferior Alveolar Nerve Injuries in Relation to Dental Procedures. Dent Update 2010; 37: 350–363 https://doi.org/10.12968/denu.2010.37.6.350.

      [4] Özkan Adigüzel, Senem Yiğit-Özer, Sadullah Kaya, Zeki Akkuş. Patient-specific factors in the proximity of the inferior alveolar nerve to the tooth apex Med Oral Patol Oral Cir Bucal. 2012 Nov 1; 17 (6):e1103-8. https://doi.org/10.4317/medoral.18190.

      [5] Grötz KA, Al‑Nawas B, de Aguiar EG, Schulz A, Wagner W. Treatment of injuries to the inferior alveolar nerve after endodontic procedures. Clin Oral Investig 1998; 2:73‑6. https://doi.org/10.1007/s007840050048.

      [6] Escoda‑Francoli J, Canalda‑Sahli C, Soler A, Figueiredo R, Gay‑Escoda C. Inferior alveolar nerve damage because of overextended endodontic material: A problem of sealer cement biocompatibility? J Endod2007; 33:1484‑9. https://doi.org/10.1016/j.joen.2007.09.003.

      [7] Yatsuhashi T, Nakagawa K, Matsumoto M, Kasahara M, Igarashi T, Ichinohe T, et al. Inferior alveolar nerve paresthesia relieved by microscopic endodontic treatment. Bull Tokyo Dent Coll2003; 44:209‑12. https://doi.org/10.2209/tdcpublication.44.209.

      [8] Denio D, Torabinejad M, Bakland LK. Anatomical relationship of the mandibular canal to its surrounding structures in mature mandibles. J Endod 1992; 18: 161–5. https://doi.org/10.1016/S0099-2399(06)81411-1.

      [9] Sato I, Ueno R, Kawai T, Yosue T. Rare courses of the mandibular canal in the molar regions of the human mandible: a cadaveric study. Okajimas Folia Anat Jpn 2005; 85: 95–101. https://doi.org/10.2535/ofaj.82.95.

      [10] Simonton JD, Azevedo B, Schindler WG, Hargreaves KM. Age- and gender-related differences in the position of the inferior alveolar nerve by using cone beam computed tomography. J Endod. 2009; 35: 944-9. https://doi.org/10.1016/j.joen.2009.04.032.

      [11] Tyler Kovisto, Mansur Ahmad, and Walter R. Bowles. Proximity of the Mandibular Canal to the Tooth Apex. J Endod 2011; 37: 311–315. https://doi.org/10.1016/j.joen.2010.11.030.

      [12] Özkan Adigüzel, Senem Yiğit-Özer, Sadullah Kaya, Zeki Akkuş. Patient-specific factors in the proximity of the inferior alveolar nerve to the tooth apex. Med Oral Patol Oral Cir Bucal. 2012 Nov 1; 17 (6):e1103-8. https://doi.org/10.4317/medoral.18190.

      [13] Balaji SM, Krishnaswamy NR, and Kumar SM, Rooban T. Inferior alveolar nerve canal position among South Indians: A cone beam computed tomographic pilot study. Ann Maxillofac Surg 2012; 2:51‑5. https://doi.org/10.4103/2231-0746.95319.

      [14] Sebastian Burklein, Carolin Grund and Edgar Schafer. Relationship between Root Apices and the Mandibular Canal: A Cone-beam Computed Tomographic Analysis in a German Population.J.Joen.2015.06.016.

      [15] B. S. Chong, A. Quinn, R. R. Pawar, J. Makdissi & S. K. Sidhu. The anatomical relationship between the roots of mandibular second molars and the inferior alveolar nerve. International Endodontic Journal, 48, 549–555, 2015. https://doi.org/10.1111/iej.12348.

      [16] Hemalatha Hiremath, Rolly Agarwal, Vishwanath Hiremath, Tushar Phulambrikar. Evaluation of proximity of mandibular molars and second premolar to inferior alveolar nerve canal among central Indians: A cone‑beam computed tomographic retrospective study.

      [17] Scolozzi P, Lombardi T, Jaques B. Successful inferior alveolar nerve decompression for dysesthesia following endodontic treatment: Report of four cases treated with mandibular sagittal osteotomy. Oral SurgOral Med Oral Pathol Oral Radiol Endod 2004; 97:625‑31. https://doi.org/10.1016/j.tripleo.2004.01.002.

      [18] Yamaguchi K, Matsunaga T, Hayashi Y. Gross extrusion of endodontic obturation materials into the maxillary sinus: A case report. Oral SurgOral Med Oral Pathol Oral Radiol Endod 2007; 104:131‑4. https://doi.org/10.1016/j.tripleo.2006.11.021.

      [19] Renton T, Hankins M, Sproate C, McGurkM. A randomized controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and removal of mandibular third molars. Br J Oral Maxillofac Surg 2005 Feb; 43(1): 7–12. https://doi.org/10.1016/j.bjoms.2004.09.002.

      [20] Shah Tejas N, Pagare Sandeep S, Shetty Naveen, Vahanwal a Sonal. Digital radiography-A cutting edge in the dental practice: A survey. Indian Journal of Contemporary Dentistry2014, 2(1): 73- 75. https://doi.org/10.5958/j.2320-5962.2.1.015.

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  • How to Cite

    Pagare, S., Roy, C., Vahanwala, S., Gavand, K., Waghmare, M., & Goyal, S. (2018). Estimation of inferior alveolar nerve proximitytothe root api-ces : A CBVI analysis. International Journal of Dental Research, 6(1), 13-16. https://doi.org/10.14419/ijdr.v6i1.8863

    Received date: 2017-12-17

    Accepted date: 2018-01-22

    Published date: 2018-01-29