Cross-Sectional Study of Mandibular Canal Branching in Regions Affected by Dental Inflammation with Cone Beam Computed Tomography / Estudio Transversal de la Ramificación del Canal Mandibular en Regiones Afectadas por Inflamación Dental con Tomografía Computarizada de Haz Cónico

ABSTRACT: The present study aimed to investigate the occurrence of mandibular canal alterations in regions with dental inflammation by means of cone beam computed tomography (CBCT). A database of 2,484 CBCTs was reviewed for identifying dental inflammation in mandibular alveolar ridges. The final sample consisted of 150 CBCTs, including 91 females and 59 males, with ages ranging from 13 to 89 years (mean age of 47.06; ± SD=18.722). The presence and location of dental inflammation, gender, age, as well as presence and location of mandibular canal branching (MCB) were evaluated. The Kolmogorov-Smirnov, Chi-square, and T-test were applied to verify the statistical relationship of the data. There were 178 images of dental inflammation on 150 CBCTs, mainly located at molars' region (75 %). Apical lesions were the most common type of dental inflammation found (79 or 44.4 % of the sample), followed by pericoronitis (32; 18.0 %). This study identified 135 mandibular canal branches in the exams that presented dental inflammation. The MCB were also most commonly located at molars' region (74.07 %). No statistical difference was identified regarding the distribution of mandibular canal branching in relation to the sites with dental inflammation (p=0.370).The MCB found were mostly single (86 or 63.7 % of the total). Sex had no influence on mandibular canal branching occurrence (p=0.308), not did age (p=0.728). A high prevalence of mandibular canal branching was observed in the regions where dental inflammation were identified, most commonly found in the molar region.

RESUMEN: El presente estudio tuvo como objetivo investigar la ocurrencia de ramificación del canal mandibular (RCM) en regiones con inflamación dental mediante tomografía computarizada de haz cónico (TCHC). Se revisó una base de datos de 2.484 TCHC para identificar la inflamación dental en las crestas alveolares mandibulares. La muestra final consistió en 150 TCHC, incluidas 91 mujeres y 59 hombres, con edades comprendidas entre 13 y 89 años (edad media de 47,06 ± DE = 18,722). Se evaluaron el sexo, la edad, la presencia y la ubicación de la inflamación dental, así como la presencia y ubicación de RCM. KolmogorovSmirnov, Chi-cuadrado y prueba-T se aplicaron para verificar la relación estadística de los datos. Hubo 178 imágenes de inflamación dental en 150 TCHC, ubicados principalmente en la región de los molares (75 %). Las lesiones apicales fueron el tipo más común de inflamación dental encontrada (79 o 44,4 % de la muestra), seguidas por pericoronitis (32; 18,0 %). Este estudio identificó 135 ramas del canal mandibular en las regiones que presentaron inflamación dental. El RCM también se localizó con mayor frecuencia en la región de los molares (74,07 %). No se identificaron diferencias estadísticas con respecto a la distribución de la ramificación del canal mandibular en relación con los sitios con inflamación dental (p = 0,370). Las RCM encontrados fueron en su mayoría solteros (86 o 63,7 % del total). El sexo no tuvo influencia en la ocurrencia de la ramificación del canal mandibular (p = 0,308), no la edad (p = 0,728). Se observó una alta prevalencia de ramificación del canal mandibular en las regiones donde se identificó la inflamación dental, que se encuentra con mayor frecuencia en la región molar.

Case-control study of mandibular canal branching and tooth-related inflammatory lesions.

OBJECTIVES: Morphological variations of mandibular canals increase the risk of neurovascular damage and bleeding during surgical procedures by decreasing the predictability of the inferior alveolar neurovascular bundle location. To improve the predictability with such variations, the present study aimed to verify the possibility of a relationship between mandibular canal branches (MCBs) and tooth-related inflammatory lesions, using trough cone-beam computed tomography (CBCT) examinations. METHODS: The sample comprised 150 age and sex-matched examinations (50 cases and 100 controls) from two databases. The CBCT examinations were grouped by the presence of MCBs starting in the mandibular body regions as the outcome variable. Tooth-related inflammatory lesions and measurements of gray levels in the posterior region of the alveolar ridge were assessed in both groups. A multiple logistic regression analysis was applied to verify the relationships between MCBs and independent variables (p < 0.05). RESULTS: Occurrence of tooth-related inflammatory lesions increased the risk of MCBs in the mandibular body regions (p < 0.001; OR 11.640; 95% CI 4.327-31.311). High-contrast images had a weaker association with MCBs (p = 0.002; OR 1.002; 95% CI 1.002-1.003). The most frequent tooth-related inflammatory lesions in both groups were endodontic (34 lesions; 45.94% of the total lesions). Most of the tooth-related inflammatory lesions related to MCBs were endodontic (20 cases) and combined endodontic and periodontal inflammation (20 cases). CONCLUSIONS: An association was observed between MCBs in the mandibular body regions and tooth-related inflammatory lesions. Inflammatory lesions of endodontic origin are most often associated with MCBs.

Mandibular canal branching assessed with cone beam computed tomography.

PURPOSE: The mandibular canal must be considered in dental procedures to avoid injuries of the alveolar inferior nerve. The occurrence of anatomical variations of the mandibular canal increases the risk of neurovascular injuries. The purpose of this study was to identify and describe the prevalence of mandibular canal branching (MCB) using cone beam computer tomography (CBCT). METHODS: Seven hundred standardized CBCTs were selected. The images were evaluated for the presence of MCB and for the detection of pathologies that could affect the structure of the canals. The data were analyzed using descriptive statistics and the Chi-squared test. RESULTS: The prevalence of MCB was 41.1%. There was no statistical difference between genders with the presence of the branches (p > 0.005). The highest prevalence was in the premolar and retromolar regions. Pathologies found in the molar region were frequently connected with MCB (77.8%), and the most common pathology related to branches was periapical lesion. CONCLUSIONS: Mandibular canal branching presented a high prevalence in CBCT imagery, more frequently located in regions of the premolar and retromolar. An adequate diagnosis of the MCB is necessary to perform dental procedures and verify possible associated pathologies.