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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/24390

Title: Tracking of the inferior alveolar nerve: its implication in surgical planning
Authors: Agbaje, Jimoh O.
Van de Casteele, Elke
Salem, Ahmed S.
Anumendem, Dickson
Lambrichts, Ivo
Politis, Constantinus
Issue Date: 2017
Citation: CLINICAL ORAL INVESTIGATIONS, 21(7), p. 2213-2220
Abstract: The objective of the study is to assess the correlation between the mandibular canal tracing done on cone beam CT (CBCT) data, with the size, shape, and position of the neurovascular bundle (NB) obtained by magnetic resonance imaging (MRI). Six human cadaver mandibles were scanned with a CBCT PromaxA (R) scanner (Planmeca, Helsinki, Finland) and with an IngeniaA (R) 3.0 T MR system (Philips, Amsterdam, The Netherlands). The NB was segmented from the MRI dataset, while the mandibular canal (MC) tracing was done on the CBCT images. Quantitative 3D analysis was made for the full-segmented nerves and for three defined regions of specific clinical interest, namely angle, body, and mental region. From the 3D MRI analysis, the nerve thickness (for the angle, body, and mental region) ranges from 0.8 to 5.2 mm, while the thickness of the mandibular canal tracing is approximately 2.00 mm on both sides as chosen in the tracing software. The mean volume of the NB on the left is 828.49 +/- 215.54 mm(3) and on the right 792.98 +/- 264.57 mm(3). For the nerve tracing, the mean value is 351.92 +/- 16.42 and 339.69 +/- 16.12 mm(3) on the left and right sides, respectively. Wilcoxon signed-rank test showed significant differences between NB and MC volume measurements (p = 0.0005). The Bland-Altman plots show an increasing slope for thickness and volume, indicating that the absolute differences between neurovascular bundle, estimated by MRI, and the mandibular canal, drawn on the CBCT images, increase with larger mean values. Surgeons should be aware of the shortcomings of nerve tracing in the different regions of the mandible. Tracing of the inferior alveolar nerve (IAN) underestimates shape and volume. Whenever nerve tracing instead of well-recognizable anatomical bony landmarks is used for surgical planning that need precision, a wider safe margin is recommended.
Notes: [Agbaje, Jimoh O.; Van de Casteele, Elke; Salem, Ahmed S.; Politis, Constantinus] Katholieke Univ Leuven, Dept Imaging & Pathol, OMFS IMPATH Res Grp, Fac Med, Kapucijnenvoer 33, B-3000 Leuven, Belgium. [Salem, Ahmed S.] Mansoura Univ, Oral & Maxillofacial Surg Dept, Fac Dent, Mansoura, Egypt. [Anumendem, Dickson] Katholieke Univ Leuven, Ctr Educ Effectiveness & Evaluat, Leuven, Belgium. [Lambrichts, Ivo; Politis, Constantinus] Hasselt Univ, Fac Med, Diepenbeek, Belgium.
URI: http://hdl.handle.net/1942/24390
DOI: 10.1007/s00784-016-2014-x
ISI #: 000407820000010
ISSN: 1432-6981
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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