Assessment of the anterior loop of the inferior alveolar nerve via cone-beam computed tomography

OBJECTIVES: The aim of this study was to evaluate different anatomical variants of the anterior loop of the inferior alveolar nerve (IAN) via cone-beam computed tomography (CBCT). MATERIALS AND METHODS: CBCT images of 71 patients (36 males and 35 females) were evaluated. We used the classification described by Solar for IAN evaluation. In this classification, three different types of IAN loops were introduced prior to emerging from the mental foramen. We classified patients according to this system and introduced a new, fourth type. RESULTS: Type I was seen in 15 sites (10.6%), type II in 39 sites (27.5%), and type III in 50 sites (35.2%). We found a new type in 38 sites (26.8%) that constituted a fourth type. CONCLUSION: We found that type III was the most common variant. In the fourth type, the IAN was not detectable because the main nerve was adjacent to the cortical plate and the incisive branch was thinner than the main branch and alongside it. In this type, more care is needed for surgeries including inferior alveolar and mental nerve transposition.

Hemodynamic effect of 2% lidocaine with 1:80,000 epinephrine infiltration in maxillofacial surgeries under general anesthesia

Epinephrine-containing lidocaine is the most used anestheic drug in dentistry. The aim of this study was to investigate the hemodynamic changes following local infiltration of 2% lidocaine with 1:80,000 epinephrine in subjects undergoing orthognatic surgery under general anesthesia. Twenty five patients without any systemic disease participated. After general anesthesia, two cartridges of 2% lidocaine + 1:80,000 epinephrine were infiltrated around the surgery site. Systolic [SBP] and diastolic [DBP] blood pressure, mean arterial blood pressure [MAP], heart rate [HR], and blood sugar [BS] were measured in three stages: before the injection [M1], at the end of injection [M2], and 10 min after injection [M3]. No significant difference observed in SBP, DBP, and MAP at the end of injection and 10 min later. HR was increased significantly after injection and remained significantly higher than baseline after 10 min. BS increased slightly at the end of injection and continued to increase after 10 min. However, changes in BS were not significant. Using two cartridges of epinephrine-containing lidocaine have slight systemic changes in healthy subjects; as a result, this dosage could be used in patients with cardiovascular complications undergoing general anesthesia