Presencia Bilateral del Canal Incisivo de la Mandíbula: Una Estructura Anatómica con Relevancia Clínica

Prevalence of anterior loop and other patterns of mental nerve in a sample population of an Indian city: A retrospective study

Introduction:

The final portion of the inferior alveolar nerve (IAN), the mental nerve (MN), is a general somatic afferent nerve that provides sensation to the lip, chin, and gingival tissue. Three patterns of MN have been observed – straight, perpendicular or vertical, and anterior loop (AL) of MN. The interforaminal region of the mandible possesses a MN with a path that creates an AL before entering the mental foramina. The aim of the study is to evaluate the presence of AL of MN using cone-beam computed tomography (CBCT) and to measure the length of the AL of MN, if present, also to evaluate the prevalence of other anatomical patterns of MN – straight and vertical patterns.

Materials and Methods:

Mandible CBCT of 400 patients with the age of 20 years onward was included in the study. The images obtained were assessed for the different patterns of MN – straight, vertical, and ALs. The statistical analysis was done using the Chi-square test, paired t-test, and sample t-test.

Results:

Out of 400 CBCT scans comprising 800 hemimandibles, straight pattern was observed in 67.1%, vertical pattern in 26%, and Anterior Loop in 6.9%. The prevalence of AL pattern was 6.9%. AL length was found to be in a range of 2.4–6.6 mm.

Discussion:

Surgical trauma or injury to the AL of MN is possible during implant surgery in the interforaminal area of the mandible if AL is not assessed preoperatively.

Endoscopic Removal of a Supernumerary Premolar in the Mandible during a Dental Implant Placement

The surgical removal of supernumerary teeth is necessary in some cases, especially before the commencement of any orthodontic or implant treatment procedure. In the mandibular supernumerary premolar, a more conservative approach is required because of the presence of complications associated with conventional surgery due to the close proximity of the said premolar to the alveolar inferior and mental nerves, and the need for bone conservation for implant placement. The endoscopic surgical approach has been used for the removal of the maxillary supernumerary tooth, impacted third molar, and implants. In this case report, we present an endoscopically assisted surgical technique for the removal of an unerupted supernumerary premolar in the mandible associated with a dental implant placement procedure.

Removal of impacted mandibular third molars using an inward fragmentation technique (IFT) - Method and first results

PURPOSE

Conventional surgical extraction of impacted mandibular third molars (M3M) requires a lateral flap reflection in conjunction with lateral bone removal for outward mobilization of the tooth. The aim of this report is to outline a novel inward fragmentation technique (IFT) in conjunction with an occlusal miniflap approach to reduce the amount of bone removal to a minimum.

PATIENTS AND METHODS

Seventeen consecutive patients (7 men and 10 women; mean age 24.4 years, range 18-36 years) required the extraction of 21-impacted M3M with a close relationship to the inferior alveolar nerve (IAN). Occlusal miniflaps were used and only occlusal bone removal was performed to expose the M3M under endoscopic vision. A central space-making cavity was created followed by inward fragmentation and mobilization of the crown and subsequent root removal through the space created.

RESULTS

20 of 21 sites healed uneventfully, one late infection was observed, no permanent neurosensory lesion occurred. The mean preoperative buccal bone height was 15.5 (11-18) mm and the postoperative buccal bone height 14.7 (11-17) mm. On the 2nd day, the mean swelling level was 1.38 (0-2) on a 4 point scale, the pain level was 2.30 (0-5) on a 10 cm VAS, mean pain duration was 2.04 days.

CONCLUSION

An inward fragmentation technique allows preservation of >90% of the buccal bone height adjacent to mandibular third molars and may reduce postoperative morbidity without raising the risk of IAN lesions.