Anatomical landmarks of mandibular interforaminal region related to dental implant placement with 3D CBCT: comparison between edentulous and dental mandibles

• Published in: Surgical and radiologic anatomy (English ed.) 2018-06, Vol.40 (6), p.615-623
• Main Authors: Sener, Elif, Onem, Erinc, Akar, Gulcan Coskun, Govsa, Figen, Ozer, Mehmet Asim, Pinar, Yelda, Mert, Ali, Baksi Sen, B. Guniz
• Format: Article
• Language: English
• Subjects: Adult; Anatomic Landmarks; Anatomy; Bedding; Cadaver; Computed tomography; Cone-Beam Computed Tomography; Dental Implantation, Endosseous; Dental implants; Dental restorative materials; Humans; Imaging; Jaw, Edentulous - diagnostic imaging; Jaw, Edentulous - surgery; Mandible; Mandible - anatomy & histology; Mandible - diagnostic imaging; Mandible - surgery; Medicine; Medicine & Public Health; Original Article; Orthopedics; Patients; Radiology; Surgery
• ISSN: 0930-1038; 1279-8517
• DOI: 10.1007/s00276-017-1934-8

Background Anterior mandibular (interforaminal) region is important in implant applications as it serves a basis for neurovascular bedding and holds the prosthesis for patients. Treatment planning for dental implant patients is often complicated by the unknown extent of the anterior loop of the neurovascular bundle. Anatomical structures including mandibular incisive canal (MIC) and lingual foramen (LF) should also be examined as part of the detailed analysis for their neurovascular structures. This study aimed to detect the positions of LF and MIC as well as the prolongation of interforaminal region in Anatolian population to supply the reference data of the surgical safe zone in chin for the clinicians. Materials and methods Mandibles of 70 adult specimens (35 edentulous + 35 dentate) were retrieved from the Department of Anatomy, Ege University. Images of the dry mandibles were obtained using a cone beam computed tomography unit applying a standardized exposure protocol. Afterwards, mandibles were sawn into vertical sections according to the respective tomographic cross-sections. Images were evaluated for the absence/presence of the MIC, its dimensions and antero-posterior length for both edentulous and dentate groups. In addition; the presence, number, location, labial canal and LF diameter and height of the LF were determined for both groups. Results The MIC was observed in 80 and 68.6% of the dentate and edentulous groups, consecutively ( p  > 0.05). The MIC continued towards the incisor region in a slightly downward direction. The LF was observed in all dentate mandibles (100%), while it was present in 94.3% of the edentulous mandibles ( p  > 0.05). For the dentate group, 62.9% of the specimens had two foramens and 20% had three foramens in the mandibular midline. Mean length of the MIC in dentate groups and edentulous groups was measured as 2.55 ± 0.809 and 3.08 ± 1.745 mm, respectively. Well-defined MIC mean diameter in dentate groups and edentulous groups were measured as 2.44 ± 0.702 and 2.35 ± 0.652 mm, respectively. Significant difference was found between dentate and edentulous group in most of the parameters except for the LF and the diameter of the MIC ( p  > 0.05). The correlation between observers’ measurements ranged between 0.742 and 0.993 for all anatomical landmarks and mandible groups. Conclusion The MIC and LF are associated with neurovascular bundle variations in number, location and size. Therefore, clinicians should determine eac