ABSTRACT
The mandibular interforaminal region has been considered safe for surgical procedures; nevertheless, the risk of injury to neurovascular structures, such as the mental foramen (MF) and its related structures (anterior loop [AL] and lingual foramina [LF]) should not be overlooked. The study aimed to evaluate the relative risk of injury to these structures during surgical procedures in the anterior region of the mandible based on cone-beam computed tomography (CBCT) scans. A retrospective cross-sectional and observational study was performed on 250 CBCTs from adults (18-69 years) with dentate jaws. Linear measurements of the MF, AL, and LF were evaluated to estimate the risk of injury to these structures during chin-related surgical procedures. The most frequent distance between the base of the mandible (BM) and MF was 8 mm (30.2%). In addition, 20.4% of the CTs had 6 mm from the vestibular cortical bone to the LF. The commonly found measurement from LF to the apex of the nearest tooth was 7 mm (24.0%); 64.2% of the CTs showed a 2-mm distance between the most distal point of the dental implant site to the most anterior point of the AL. Safety distances for genioplasty techniques (MF to mandible base > 6 mm, 96.6% [CI 95%, 95.0%-98.2%]) were observed. Considering the 5-mm cut-off point between the lower limit of a hypothetical bone graft and the chin, 65.4% (CI 95%, 58.9%-71.9%) of CTs were within this distance. Regarding the safety margin of 8 mm, 85.6% (CI 95%, 80.8%-90.4%) were up to this value. This study found safety margins for genioplasty and chin bone grafting surgical techniques that adopt a 5-mm cut-off point. Further similar studies assessing other surgical methods and employing larger samples from different geographical origins may contribute to this field of investigation.
Subject(s)
Cone-Beam Computed Tomography , Mandible , Humans , Adult , Middle Aged , Mandible/diagnostic imaging , Mandible/surgery , Mandible/anatomy & histology , Cross-Sectional Studies , Adolescent , Aged , Retrospective Studies , Young Adult , Male , Female , Mental Foramen/diagnostic imaging , Mental Foramen/anatomy & histology , Risk Assessment , Chin/anatomy & histology , Chin/diagnostic imagingABSTRACT
BACKGROUND: This study evaluated the epidemiological and morphological features of the mandibular incisive canal (MIC) using cone beam computed tomography (CBCT) in a significant sample of subjects in Brazil. MATERIAL AND METHODS: This retrospective, multicenter study assessed 847 CBCT scans performed at four oral imaging centers. The sample comprised CBCT images acquired from dentate individuals who presented at least from tooth 35 to tooth 45 in the anterior mandible region. Data regarding patient sex and age, and MIC linear measurements (length and diameter in mm), anatomical distances (to the alveolar, buccal and lingual cortexes, inferior border of the mandible, and adjacent teeth apexes), and location were obtained. RESULTS: The MIC was more prevalent in women (76.3% [p < 0.001]) between the fourth and sixth decades of life (p < 0.001). It was present bilaterally (p < 0.001) and exhibited a mean length of 7.7 mm (standard deviation [SD]=3.7 mm). Spearman correlation and logistic regression analysis revealed collinearity between age and linear measurements (p < 0.05). The mean distances varied from the initial to the final portion of the MIC, respectively, in relation to the buccal cortex (mean = 2.6 mm, SD = 1.27; mean=3.96 mm; SD =1 .43), to lingual cortex (mean=5.13 mm; SD=1.7; mean = 4.61 mm, SD = 1.65), and to the inferior mandibular border (mean = 9.32 mm, SD = 1.92; mean=8.76 mm, SD = 2.07 mm). The difference in the proximity of the MIC to the apex of the inferior lateral incisor was statistically significant (p < 0.05). CONCLUSIONS: Results of this study revealed a high prevalence of MIC with a bilateral pattern in women who were between the fourth and sixth decades of life. Both the distance between the MIC and the lingual cortex of the mandibular alveolar bone, and the diameter of the MIC, decreased as its trajectory assumed a more anterior position
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Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Mandible/diagnostic imaging , Cone-Beam Computed Tomography/methods , Mandible/anatomy & histology , Retrospective Studies , Odontometry , Radiography, Panoramic , Statistics, Nonparametric , Analysis of Variance , Sex Factors , Age FactorsABSTRACT
A displasia óssea florida (DOFL) é uma lesão fibro-óssea relativamente incomum dos maxilares, que acomete, principalmente, mulheres melanodermas de meia idade e geralmente é diagnosticada em radiografias de rotina. O presente trabalho tem como objetivo relatar o caso de uma paciente de 50 anos de idade, melanoderma, encaminhada ao Curso de Odontologia da Universidade Federal do Ceará para avaliação imaginológica. Clinicamente, não foi observada nenhuma alteração de volume de estruturas faciais ou intraorais. A radiografia panorâmica evidenciou imagens radiopacas circunscritas por halos radiolúcidos, localizadas bilateralmente em região edêntula de corpo mandibular, sugestivas de DOFL. Na tomografia computadorizada de feixe cônico (TCFC), observaram se áreas hiperdensas em regiões mandibulares edêntulas, sem expansão de corticais ósseas vestibulares e linguais, e recobertas por fina espessura de tecido ósseo, típicos da displasia. Diante do diagnóstico clínico-imaginológico de DOFL, a paciente foi encaminhada para tratamento odontológico multidisciplinar. Por meio da TCFC, foi possível se estabelecer um plano de tratamento que consistiu em procedimentos minimamente intervencionistas, considerando os aspectos clínicos e imaginológicos das lesões observadas. Em sumário, o presente trabalho reforça a importância do exame clínico meticuloso aliado à avaliação por meio de TCFC, com fins de embasar um plano de tratamento adequado em casos de DOFL assintomáticos... (AU)
Florid osseous dysplasia (FOD) is a fibrous lesion relatively uncommon of maxillary bones, mainly affects middle-age black women and generally is diagnosed on routine radiographs. This paper aims to report a case of black woman, aged 50 years, referred to Dentistry Faculty of Federal University of Ceará for imaging evaluation. Clinically, there were no facial or intraoral structures alterations. Panoramic radiography showed radiopaque images circumscribed by radiolucent halos, located bilaterally in the edentulous mandibular body region suggestive of FOD. Cone beam computed tomography (CBCT) showed hyperdense areas in edentulous mandibular regions, with no expansion of buccal and lingual cortical bone, and covered by fine thickness of bone tissue, characteristic of FOD. After the clinical-imaging diagnosis of FOD, the patient was referred for multidisciplinary dental treatment. Through the CBCT, it was possible to establish a treatment plan that consisted of minimally interventional procedures considering the clinical and imaging limits of the observed lesions. In summary, the present case emphasizes a meticulous clinical examination along with an evaluation by means of CBCT allowing an adequate treatment plan for asymptomatic FOD... (AU)
