Skip to main content
Top
Published in: International Journal of Implant Dentistry 1/2019

Open Access 01-12-2019 | Research

Vestibular bone thickness of the mandible in relation to the mandibular canal—a retrospective CBCT-based study

Authors: Silvio Valdec, Jan M. Borm, Stephanie Casparis, Georg Damerau, Michael Locher, Bernd Stadlinger

Published in: International Journal of Implant Dentistry | Issue 1/2019

Login to get access

Abstract

Background

The aim of this study was to assess vestibular bone thickness of the mandible in relation to the mandibular canal and position of the mental foramen in relation to the neighbouring teeth. Measurements were performed on radiographic cone-beam computed tomography (CBCT) images.

Methods

This retrospective study analysed 314 CBCTs, having been taken at the Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, Switzerland.

Results

CBCTs from 168 female and 146 male patients (median age 40.2 years) were analysed. Median bone thickness lateral to the nerve canal to the buccal mandibular cortical plate was ~ 4 mm immediately posterior to the mental foramen, increased to ≤ 6 mm over the next 30 mm, then decreased to ~ 3 mm at the level of the mandibular foramen. In two thirds of cases, both mental foramina were located near the second premolar (66.2% right, 67.7% left). Bone thickness and the position of the mental foramen showed marked intra- and interindividual variance.

Conclusions

A preoperative CBCT is recommended for detailed planning of surgical interventions that may reach the mandibular canal (e.g. wisdom teeth removal, root resection, implant placement, bone block harvesting).
Literature
1.
go back to reference Ozturk A, Potluri A, Vieira AR. Position and course of the mandibular canal in skulls. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(4):453–8.CrossRef Ozturk A, Potluri A, Vieira AR. Position and course of the mandibular canal in skulls. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(4):453–8.CrossRef
2.
go back to reference Agbaje JO, de Casteele EV, Salem AS, Anumendem D, Lambrichts I, Politis C. Tracking of the inferior alveolar nerve: its implication in surgical planning. Clin Oral Investig. 2017;21(7):2213–20.CrossRef Agbaje JO, de Casteele EV, Salem AS, Anumendem D, Lambrichts I, Politis C. Tracking of the inferior alveolar nerve: its implication in surgical planning. Clin Oral Investig. 2017;21(7):2213–20.CrossRef
3.
go back to reference Zahedi S, Mostafavi M, Lotfirikan N. Anatomic study of mandibular posterior teeth using cone-beam computed tomography for endodontic surgery. J Endod. 2018;44(5):738–43.CrossRef Zahedi S, Mostafavi M, Lotfirikan N. Anatomic study of mandibular posterior teeth using cone-beam computed tomography for endodontic surgery. J Endod. 2018;44(5):738–43.CrossRef
4.
go back to reference Lundgren S, Nystrom E, Nilson H, Gunne J, Lindhagen O. Bone grafting to the maxillary sinuses, nasal floor and anterior maxilla in the atrophic edentulous maxilla. A two-stage technique. Int J Oral Maxillofac Surg. 1997;26(6):428–34.CrossRef Lundgren S, Nystrom E, Nilson H, Gunne J, Lindhagen O. Bone grafting to the maxillary sinuses, nasal floor and anterior maxilla in the atrophic edentulous maxilla. A two-stage technique. Int J Oral Maxillofac Surg. 1997;26(6):428–34.CrossRef
5.
go back to reference Misch CM. Comparison of intraoral donor sites for onlay grafting prior to implant placement. Int J Oral Maxillofac Implants. 1997;12(6):767–76.PubMed Misch CM. Comparison of intraoral donor sites for onlay grafting prior to implant placement. Int J Oral Maxillofac Implants. 1997;12(6):767–76.PubMed
6.
go back to reference Koole R, Bosker H, van der Dussen FN. Late secondary autogenous bone grafting in cleft patients comparing mandibular (ectomesenchymal) and iliac crest (mesenchymal) grafts. J Craniomaxillofac Surg. 1989;17(Suppl 1):28–30.CrossRef Koole R, Bosker H, van der Dussen FN. Late secondary autogenous bone grafting in cleft patients comparing mandibular (ectomesenchymal) and iliac crest (mesenchymal) grafts. J Craniomaxillofac Surg. 1989;17(Suppl 1):28–30.CrossRef
7.
go back to reference Jensen J, Sindet-Pedersen S. Autogenous mandibular bone grafts and osseointegrated implants for reconstruction of the severely atrophied maxilla: a preliminary report. J Craniomaxillofac Surg. 1991;49(12):1277–87.CrossRef Jensen J, Sindet-Pedersen S. Autogenous mandibular bone grafts and osseointegrated implants for reconstruction of the severely atrophied maxilla: a preliminary report. J Craniomaxillofac Surg. 1991;49(12):1277–87.CrossRef
8.
go back to reference Misch CM, Misch CE. The repair of localized severe ridge defects for implant placement using mandibular bone grafts. Implant Dent. 1995;4(4):261–7.CrossRef Misch CM, Misch CE. The repair of localized severe ridge defects for implant placement using mandibular bone grafts. Implant Dent. 1995;4(4):261–7.CrossRef
9.
go back to reference Cordaro L, Amade DS, Cordaro M. Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients prior to implant placement. Clin Oral Implants Res. 2002;13(1):103–11.CrossRef Cordaro L, Amade DS, Cordaro M. Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients prior to implant placement. Clin Oral Implants Res. 2002;13(1):103–11.CrossRef
10.
go back to reference Khoury F. Bone augmentation in oral implantology. London: Quintessence; 2007. 435 p. Khoury F. Bone augmentation in oral implantology. London: Quintessence; 2007. 435 p.
11.
go back to reference Hoppenreijs TJ, Nijdam ES, Freihofer HP. The chin as a donor site in early secondary osteoplasty: a retrospective clinical and radiological evaluation. J Craniomaxillofac Surg. 1992;20(3):119–24.CrossRef Hoppenreijs TJ, Nijdam ES, Freihofer HP. The chin as a donor site in early secondary osteoplasty: a retrospective clinical and radiological evaluation. J Craniomaxillofac Surg. 1992;20(3):119–24.CrossRef
12.
go back to reference Nkenke E, Radespiel-Troger M, Wiltfang J, Schultze-Mosgau S, Winkler G, Neukam FW. Morbidity of harvesting of retromolar bone grafts: a prospective study. Clin Oral Implants Res. 2002;13(5):514–21.CrossRef Nkenke E, Radespiel-Troger M, Wiltfang J, Schultze-Mosgau S, Winkler G, Neukam FW. Morbidity of harvesting of retromolar bone grafts: a prospective study. Clin Oral Implants Res. 2002;13(5):514–21.CrossRef
13.
go back to reference von Arx T, Hafliger J, Chappuis V. Neurosensory disturbances following bone harvesting in the symphysis: a prospective clinical study. Clin Oral Implants Res. 2005;16(4):432–9.CrossRef von Arx T, Hafliger J, Chappuis V. Neurosensory disturbances following bone harvesting in the symphysis: a prospective clinical study. Clin Oral Implants Res. 2005;16(4):432–9.CrossRef
14.
go back to reference Benninger B, Miller D, Maharathi A, Carter W. Dental implant placement investigation: is the anterior loop of the mental nerve clinically relevant? J Craniomaxillofac Surg. 2011;69(1):182–5.CrossRef Benninger B, Miller D, Maharathi A, Carter W. Dental implant placement investigation: is the anterior loop of the mental nerve clinically relevant? J Craniomaxillofac Surg. 2011;69(1):182–5.CrossRef
15.
go back to reference Greenstein G, Tarnow D. The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review. J Periodontol. 2006;77(12):1933–43.CrossRef Greenstein G, Tarnow D. The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review. J Periodontol. 2006;77(12):1933–43.CrossRef
16.
go back to reference Kuribayashi A, Watanabe H, Imaizumi A, Tantanapornkul W, Katakami K, Kurabayashi T. Bifid mandibular canals: cone beam computed tomography evaluation. Dentomaxillofac Radiol. 2010;39(4):235–9.CrossRef Kuribayashi A, Watanabe H, Imaizumi A, Tantanapornkul W, Katakami K, Kurabayashi T. Bifid mandibular canals: cone beam computed tomography evaluation. Dentomaxillofac Radiol. 2010;39(4):235–9.CrossRef
17.
go back to reference Jacobs R, Mraiwa N, Van Steenberghe D, Sanderink G, Quirynen M. Appearance of the mandibular incisive canal on panoramic radiographs. Surg Radiol Anat. 2004;26(4):329–33.CrossRef Jacobs R, Mraiwa N, Van Steenberghe D, Sanderink G, Quirynen M. Appearance of the mandibular incisive canal on panoramic radiographs. Surg Radiol Anat. 2004;26(4):329–33.CrossRef
18.
go back to reference Bavitz JB, Harn SD, Hansen CA, Lang M. An anatomical study of mental neurovascular bundle-implant relationships. Int J Oral Maxillofac Implants. 1993;8(5):563–7.PubMed Bavitz JB, Harn SD, Hansen CA, Lang M. An anatomical study of mental neurovascular bundle-implant relationships. Int J Oral Maxillofac Implants. 1993;8(5):563–7.PubMed
19.
go back to reference Ellies LG, Hawker PB. The prevalence of altered sensation associated with implant surgery. Int J Oral Maxillofac Implants. 1993;8(6):674–9.PubMed Ellies LG, Hawker PB. The prevalence of altered sensation associated with implant surgery. Int J Oral Maxillofac Implants. 1993;8(6):674–9.PubMed
20.
go back to reference Uchida Y, Yamashita Y, Goto M, Hanihara T. Measurement of anterior loop length for the mandibular canal and diameter of the mandibular incisive canal to avoid nerve damage when installing endosseous implants in the interforaminal region. J Oral Maxillofac Surg. 2007;65(9):1772–9.CrossRef Uchida Y, Yamashita Y, Goto M, Hanihara T. Measurement of anterior loop length for the mandibular canal and diameter of the mandibular incisive canal to avoid nerve damage when installing endosseous implants in the interforaminal region. J Oral Maxillofac Surg. 2007;65(9):1772–9.CrossRef
21.
go back to reference Raghoebar GM, Louwerse C, Kalk WW, Vissink A. Morbidity of chin bone harvesting. Clin Oral Implants Res. 2001;12(5):503–7.CrossRef Raghoebar GM, Louwerse C, Kalk WW, Vissink A. Morbidity of chin bone harvesting. Clin Oral Implants Res. 2001;12(5):503–7.CrossRef
22.
go back to reference Nkenke E, Schultze-Mosgau S, Radespiel-Troger M, Kloss F, Neukam FW. Morbidity of harvesting of chin grafts: a prospective study. Clin Oral Implants Res. 2001;12(5):495–502.CrossRef Nkenke E, Schultze-Mosgau S, Radespiel-Troger M, Kloss F, Neukam FW. Morbidity of harvesting of chin grafts: a prospective study. Clin Oral Implants Res. 2001;12(5):495–502.CrossRef
23.
go back to reference Clavero J, Lundgren S. Ramus or chin grafts for maxillary sinus inlay and local onlay augmentation: comparison of donor site morbidity and complications. Clin Implant Dent Relat Res. 2003;5(3):154–60.CrossRef Clavero J, Lundgren S. Ramus or chin grafts for maxillary sinus inlay and local onlay augmentation: comparison of donor site morbidity and complications. Clin Implant Dent Relat Res. 2003;5(3):154–60.CrossRef
24.
go back to reference Phillips DJ, Swenson DT, Johnson TM. Buccal bone thickness adjacent to virtual dental implants following guided bone regeneration. J Periodontol. 2019;90(6):595–607.CrossRef Phillips DJ, Swenson DT, Johnson TM. Buccal bone thickness adjacent to virtual dental implants following guided bone regeneration. J Periodontol. 2019;90(6):595–607.CrossRef
25.
go back to reference Menziletoglu D, Tassoker M, Kubilay-Isik B, Esen A. The assesment of relationship between the angulation of impacted mandibular third molar teeth and the thickness of lingual bone: a prospective clinical study. Med Oral Patol Oral Cir Bucal. 2019;24(1):e130–e5.PubMed Menziletoglu D, Tassoker M, Kubilay-Isik B, Esen A. The assesment of relationship between the angulation of impacted mandibular third molar teeth and the thickness of lingual bone: a prospective clinical study. Med Oral Patol Oral Cir Bucal. 2019;24(1):e130–e5.PubMed
26.
go back to reference Nucera R, Lo Giudice A, Bellocchio AM, Spinuzza P, Caprioglio A, Perillo L, et al. Bone and cortical bone thickness of mandibular buccal shelf for mini-screw insertion in adults. Angle Orthod. 2017;87(5):745–51.CrossRef Nucera R, Lo Giudice A, Bellocchio AM, Spinuzza P, Caprioglio A, Perillo L, et al. Bone and cortical bone thickness of mandibular buccal shelf for mini-screw insertion in adults. Angle Orthod. 2017;87(5):745–51.CrossRef
27.
go back to reference Scomparin L, Soares MQ, Rubira CM, Yaedu RY, Imada TS, Centurion BS, et al. CBCT location of the fusion between the buccal and lingual cortical in the mandibular ramus: importance to sagittal split osteotomy. Med Oral Patol Oral Cir Bucal. 2017;22(4):e500–e5.PubMedPubMedCentral Scomparin L, Soares MQ, Rubira CM, Yaedu RY, Imada TS, Centurion BS, et al. CBCT location of the fusion between the buccal and lingual cortical in the mandibular ramus: importance to sagittal split osteotomy. Med Oral Patol Oral Cir Bucal. 2017;22(4):e500–e5.PubMedPubMedCentral
28.
go back to reference Kilic C, Kamburoglu K, Ozen T, Balcioglu HA, Kurt B, Kutoglu T, et al. The position of the mandibular canal and histologic feature of the inferior alveolar nerve. Clin Anat. 2010;23(1):34–42.CrossRef Kilic C, Kamburoglu K, Ozen T, Balcioglu HA, Kurt B, Kutoglu T, et al. The position of the mandibular canal and histologic feature of the inferior alveolar nerve. Clin Anat. 2010;23(1):34–42.CrossRef
29.
go back to reference Hwang K, Lee WJ, Song YB, Chung IH. Vulnerability of the inferior alveolar nerve and mental nerve during genioplasty: an anatomic study. J Craniofac Surg. 2005;16(1):10–4 discussion 4.CrossRef Hwang K, Lee WJ, Song YB, Chung IH. Vulnerability of the inferior alveolar nerve and mental nerve during genioplasty: an anatomic study. J Craniofac Surg. 2005;16(1):10–4 discussion 4.CrossRef
30.
go back to reference Massey ND, Galil KA, Wilson TD. Determining position of the inferior alveolar nerve via anatomical dissection and micro-computed tomography in preparation for dental implants. J Can Dent Assoc. 2013;79:d39.PubMed Massey ND, Galil KA, Wilson TD. Determining position of the inferior alveolar nerve via anatomical dissection and micro-computed tomography in preparation for dental implants. J Can Dent Assoc. 2013;79:d39.PubMed
31.
go back to reference Von Arx T, Lozanoff S. Distances from mandibular canal to bone surfaces. In: Von Arx T, Lozanoff S, editors. Clinical oral anatomy: a comprehensive review for dental practitioners and researchers. Switzerland: Springer; 2016. p. 337–9. Von Arx T, Lozanoff S. Distances from mandibular canal to bone surfaces. In: Von Arx T, Lozanoff S, editors. Clinical oral anatomy: a comprehensive review for dental practitioners and researchers. Switzerland: Springer; 2016. p. 337–9.
32.
go back to reference Chrcanovic BR, de Carvalho MV, Gjelvold B. A morphometric analysis of the mandibular canal by cone beam computed tomography and its relevance to the sagittal split ramus osteotomy. Oral Maxillofac Surg. 2016;20(2):183–90.CrossRef Chrcanovic BR, de Carvalho MV, Gjelvold B. A morphometric analysis of the mandibular canal by cone beam computed tomography and its relevance to the sagittal split ramus osteotomy. Oral Maxillofac Surg. 2016;20(2):183–90.CrossRef
33.
go back to reference Yoshida T, Nagamine T, Kobayashi T, Michimi N, Nakajima T, Sasakura H, et al. Impairment of the inferior alveolar nerve after sagittal split osteotomy. J Craniomaxillofac Surg. 1989;17(6):271–7.CrossRef Yoshida T, Nagamine T, Kobayashi T, Michimi N, Nakajima T, Sasakura H, et al. Impairment of the inferior alveolar nerve after sagittal split osteotomy. J Craniomaxillofac Surg. 1989;17(6):271–7.CrossRef
34.
go back to reference Bou Serhal C, van Steenberghe D, Quirynen M, Jacobs R. Localisation of the mandibular canal using conventional spiral tomography: a human cadaver study. Clin Oral Implants Res. 2001;12(3):230–6.CrossRef Bou Serhal C, van Steenberghe D, Quirynen M, Jacobs R. Localisation of the mandibular canal using conventional spiral tomography: a human cadaver study. Clin Oral Implants Res. 2001;12(3):230–6.CrossRef
35.
go back to reference Hanser T, Doliveux R. MicroSaw and Piezosurgery in harvesting mandibular bone blocks from the retromolar region: a randomized split-mouth prospective clinical trial. Int J Oral Maxillofac Implants. 2018;33(2):365–72.CrossRef Hanser T, Doliveux R. MicroSaw and Piezosurgery in harvesting mandibular bone blocks from the retromolar region: a randomized split-mouth prospective clinical trial. Int J Oral Maxillofac Implants. 2018;33(2):365–72.CrossRef
36.
go back to reference Namano S, Behrend DA, Harcourt JK, Wilson PR. Angular asymmetries of the human face. Int J Prosthodont. 2000;13(1):41–6.PubMed Namano S, Behrend DA, Harcourt JK, Wilson PR. Angular asymmetries of the human face. Int J Prosthodont. 2000;13(1):41–6.PubMed
37.
go back to reference Phillips JL, Weller RN, Kulild JC. The mental foramen: 2. Radiographic position in relation to the mandibular second premolar. J Endod. 1992;18(6):271–4.CrossRef Phillips JL, Weller RN, Kulild JC. The mental foramen: 2. Radiographic position in relation to the mandibular second premolar. J Endod. 1992;18(6):271–4.CrossRef
38.
go back to reference Pyun JH, Lim YJ, Kim MJ, Ahn SJ, Kim J. Position of the mental foramen on panoramic radiographs and its relation to the horizontal course of the mandibular canal: a computed tomographic analysis. Clin Oral Implants Res. 2013;24(8):890–5.CrossRef Pyun JH, Lim YJ, Kim MJ, Ahn SJ, Kim J. Position of the mental foramen on panoramic radiographs and its relation to the horizontal course of the mandibular canal: a computed tomographic analysis. Clin Oral Implants Res. 2013;24(8):890–5.CrossRef
Metadata
Title
Vestibular bone thickness of the mandible in relation to the mandibular canal—a retrospective CBCT-based study
Authors
Silvio Valdec
Jan M. Borm
Stephanie Casparis
Georg Damerau
Michael Locher
Bernd Stadlinger
Publication date
01-12-2019
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Implant Dentistry / Issue 1/2019
Electronic ISSN: 2198-4034
DOI
https://doi.org/10.1186/s40729-019-0189-z

Other articles of this Issue 1/2019

International Journal of Implant Dentistry 1/2019 Go to the issue