ABSTRACT
RESUMEN: El canal incisivo mandibular (MIC) es un canal neural que contiene una de las ramas inferiores del nervio alveolar inferior, llamado nervio incisivo mandibular, que puede resultar dañado durante intervenciones quirúrgicas y causar complicaciones postoperatorias. Estudio descriptivo de corte transversal. Se identificó el MIC en la imagen transversal del canino en 83 hemiarcadas. Se registró edad, sexo, hemiarcada, longitudes desde reborde alveolar vestibular de canino a MIC, cortical lingual y vestibular de canino a MIC, base mandibular de canino a MIC y ubicación del MIC (tercio lingual, medio, vestibular). Medidas se registraron en milímetros. Se aplicó test T-student para muestras independientes para variables de longitud y Chi-cuadrado para ubicación espacial del MIC, en relación con grupo etario y sexo. Se evaluó el MIC en todas las muestras (100 %). El MIC fue encontrado mayormente en el tercio medio mandibular (p <0,05). La media desde el MIC a la cortical lingual es de 5,25 mm ? 1,42 mm (derecho) y 5,24 mm ? 1,18 mm (izquierdo). La media desde el MIC a la cortical vestibular fue de 4,42 mm ? 1,29 mm (derecho) y 4,53 mm ? 1,24mm (izquierdo). La media entre centro del canal y reborde alveolar vestibular fue 18,89 mm ? 2,68mm (derecho) y 18,20 mm ? 3,06 mm (izquierdo), media desde centro del MIC al margen basal fue de 9,77 mm ? 1,93 (derecho) y 10,12 mm ? 1,92 mm (izquierdo). Se encontró mayor distribución del MIC en el tercio medio mandibular. Se identificó el MIC en el 100 % de las muestras a través de CBCT por lo que su uso como examen complementario debe ser considerado al planificar cirugías en el sector anterior mandibular.
SUMMARY: The objective of the study was to determine the morphology of the mandibular incisive canal (MIC) and its location using cone beam computed tomography (CBCT) in the population of Valdivia, Chile. Descriptive cross-sectional study. MIC was identified in the canine cross image in 83 quadrants. Age, gender, quadrants, length from buccal alveolar ridge of canine to MIC, lingual and buccal cortical of canine to MIC, mandibular base of canine to MIC, and location of MIC (lingual, middle and buccal third) were recorded. Measurements were recorded in millimeters. Independent sample Student-T test was performed to determine length variables and Chi-square test was performed to determine spatial location of MIC, in relation to age group and gender. MIC was evaluated in all samples (100 %). MIC was found mainly in the mandibular third quadrant (p < 0.05). The mean from the MIC to the lingual cortex is 5.25 mm ? 1.42 mm (right) and 5.24 mm ? 1.18 mm (left). The mean from the MIC to the buccal cortex was 4.42 ? 1.29 mm (right) and 4.53 mm ? 1.24 mm (left). The mean between the center of the canal and the buccal alveolar ridge was 18.89 mm ? 2.68mm (right) and 18.20 mm ? 3.06 mm (left), the mean from the center of the MIC to the basal edge was 9.77 mm ? 1.93 (right) and 10.12 mm ? 1.92 mm (left). A greater distribution of MIC was found in the mandibular third quadrant. MIC was identified in 100 % of the samples through CBCT, therefore, its use as a complementary examination should be considered when planning surgeries in the anterior mandibular area.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Cone-Beam Computed Tomography , Mandibular Canal/diagnostic imaging , Mandibular Nerve/diagnostic imaging , Chile , Cross-Sectional Studies , Mandibular Canal/innervation , Mandibular Nerve/anatomy & histologyABSTRACT
The mandibular incisive canal (MIC) is a continuation of the mandibular canal, anterior to the mental foramen, containing the neurovascular bundle of the teeth in anterior mandibular segment. The aim of this study was to calculate the prevalence and analyze the morphometric parameters of MIC in a Chilean population through digital panoramic radiographs. A cross-sectional study was performed using 500 digital panoramic radiographies of adult individuals. The prevalence of MIC was set in different sexes, age groups and proximity to teeth; in addition to the morphometric parameters of length, width (diameter) and distances of MIC to dental element and the mandibular base. General MIC prevalence was 53 % (265 cases), 49.9 % in women and 57 % in men. In the age groups, prevalence was higher in men, MIC was predominantly associated to first premolars (98.2 % - women; 90 % - men), however a relevant number (42.6 % women; 55.1 % - men) was close to the canines. The MIC length ranged from 2.6 to 18 mm (median - 5 to 8 mm), the width of 0.8 to 5.4 mm (median - 2 to 3 mm), the distance to other elements from 0.6 to 12 , 5 mm (medians - 5 to 7 mm) and the margin of the mandible from 4.1 to 16.7 mm (median - 8 to 10 mm). The length decreases in older age groups regardless of sex. Width and distance the mandibular base was larger in men compared to women.
El canal incisivo mandibular (MIC) es una continuación del canal mandibular, anterior al agujero mentoniano, que contiene la rama neurovascular de los dientes en el segmento mandibular anterior. El objetivo de este estudio fue calcular la prevalencia y analizar los parámetros morfométricos del MIC en una población chilena mediante radiografías panorámicas digitales. Se realizó un estudio de corte transversal utilizando 500 radiografías panorámicas digitales de individuos adultos. La prevalencia de MIC se estableció en diferentes géneros, grupos de edades y proximidad a los dientes; Además de los parámetros morfométricos de longitud, ancho (diámetro) y distancias de MIC al diente y a la base mandibular. La prevalencia general de MIC fue de 53 % (265 casos), 49,9 % en mujeres y 57 % en hombres. En los grupos de edad, la prevalencia fue mayor en los hombres, el MIC se asoció predominantemente a los primeros premolares (98,2 % - mujeres, 90 % - hombres), sin embargo un número relevante (42,6 % mujeres y 55,1 % hombres) estaba cerca de los caninos. La longitud del MIC osciló entre 2,6 y 18 mm (medianas de 5 a 8 mm), el ancho de 0,8 a 5,4 mm (medianas de 2 a 3 mm), la distancia a otros elementos de 0,6 a 12,5 mm (medianas de 5 a 7 mm) y al borde de la mandíbula de 4,1 a 16,7 mm (medianas de 8 a 10 mm). El largo disminuye en los grupos de mayor edad independientemente del sexo. Ancho y distancia a la base mandibular fue mayor en hombres que en mujeres.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Incisor/anatomy & histology , Incisor/diagnostic imaging , Mandible/anatomy & histology , Mandible/diagnostic imaging , Age and Sex Distribution , Age Factors , Chile , Cross-Sectional Studies , Prevalence , Radiography, Panoramic , Sex CharacteristicsABSTRACT
Objective@#To find out the existence of Mandibular Incisive Canal (MIC) through CBCT scanning and measure its 3D relationship with the surrounding tissue, so as to provide protection for the operation in submental area. @*Methods@# CBCT images of 100 patients were measured and three dimensionally reconstructed. The measurement include following items, the existence of the MIC; vertical and horizontal diameter of MIC; vertical distance from MIC to the mandibular buccal and lingual wall; to the root apex, to the inferior border of mandible and alveolar crest in corresponding points (the mandibular first premolar, canine and incisor). @*Results @# the MIC was 100% visible in CBCT. The mean distance between MIC and buccal bone plate and lingual bone plate was 3.52 ± 0.54 mm and 5.37 ± 0.25 mm. The average distance from the inferior border of the mandible, the apex of the root and the crest of the alveolar bone was 10.44 ± 0.61 mm、10.57 ± 0.76 mm and 20.21 ± 0.83 mm relatively. The distance from MIC to the inferior border of the mandible in male was 10.70 ± 0.43 mm and 10.17 ± 0.63 mm in female, P<0.05. @*Conclusion @# The detection rate of MIC is high and there are many variations. It was suggested that the location and size of the MIC should be checked in CBCT in each patient before operation, which is helpful to avoid surgical complications in submental area.
ABSTRACT
Objective This study was conducted to measure the mandibular incisive canal (MIC) by cone beam computed tomography(CBCT)and to assess 3?dimensional structure, course and adjacent structure of the MIC , in order to ensure safe region for surgery of the mandibular interforaminal area. Methods A total of the CBCT images from 83 patients were studied and measured. The detection rates of MIC were calculated The diameter of the MIC and the distances from MIC to the labial and lingual cortices and the inferior border of the mandible and tooth tips were measured at canines and lateral incisors. Results MIC was found in 67.8%of the patients. In the position of canine, the diameter of MIC, the mean distance of the MIC to the tips of the teeth, to the buccal border of the mandible , to the lingual border of the mandible and the inferior border of the mandible were (1.3±0.4), (8.9±2.9), (4.3±0.9), (5.2±1.1) and (8.6± 1.5) mm, respectively. In the position of the incisor, the distance of MIC, the mean distance of the MIC to the tips of the teeth, to the buccal border of the mandible , to the lingual border of the mandible and the inferior border of the mandible were (1.0 ± 0.3), (13.3 ± 4.0), (4.2 ± 0.9), (5.9 ± 0.9) and (8.9 ± 1.8) mm, respectively. Conclusion CBCT clearly show three dimensional structure, course and adjacent structure of the MIC. Preoperative CBCT can provide vital information for surgery of the mandibular interforaminal area.
ABSTRACT
La región anterior de la mandíbula generalmente se considera un área quirúrgica segura, con pocos riesgos de daño a estructuras anatómicas importantes. Sin embargo, esta región contiene un canal intraóseo, el canal incisivo de la mandíbula (CIM), que es la continuación del canal mandibular mesial al foramen mental, donde se encuentra el nervio incisivo de la mandíbula acompañado de estructuras vasculares. Su presencia y el curso de la inervación mandibular anterior siguen siendo un tema de debate y algunos autores incluso niegan su existencia. Este reporte define el curso anatómico del CIM bilateralmente mediante tomografía computarizada, confirmando la presencia del nervio incisivo de la mandíbula mediante técnica microquirúrgica asistida por endoscopía. El conocimiento de la presencia, longitud y diámetro del CIM pueden jugar un rol importante en el éxito de la oseointegración de un implante y prevenir alteraciones sensoriales postoperatorias.
The anterior mandible region is generally considered a safe surgical area, involving few risks of damage to vital anatomic structures. However, this area has an intraosseous canal, the mandibular incisive canal (MIC), the continuation of the mandibular canal, mesial to the mental foramen where the mandibular incisive nerve along with vascular structures is located. The presence and course of the incisive nerve remains a matter of debate and some authors even neglect it. This case report defines the anatomic courses of the incisive mandibular canal bilaterally using cone-beam computed tomography and confirms the presence of the incisive nerve by endoscopically assisted surgical technique. The knowledge of the MIC presence, length and diameter may play an important role in successful implant osseointegration and prevention of postoperative sensory disturbances.