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      Evaluation of mandibular lingula and foramen location using 3-dimensional mandible models reconstructed by cone-beam computed tomography

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          Abstract

          Background

          The positions of the mandibular lingula and foramen have been set as indexes for inferior alveolar nerve (IAN) block and ramus osteotomies in orthognathic surgery. This study aimed to evaluate the anatomical structures of mandibular ramus, especially the mandibular lingula and foramen, by analyzing the cone-beam computed tomography (CBCT) data of young adults.

          Methods

          We evaluated 121 sides of hemi-mandibular CBCT model of 106 patients (51 male and 55 female patients; 18 to 36 years old). All the measurements were performed using the 2- and 3-dimensional rulers of OnDemand3D® software.

          Results

          Statistical analysis of the data revealed that there was no significant difference in the mandibular angle between the genders. The mandibular lingula was found to be located at the center of ramus in males, but a little posterior in relation to the center in females. The mandibular lingula was rarely located below the occlusal plane; however, the position of the mandibular foramen was more variable (84.3% below, 12.4% above, and 3.3% at the level of the occlusal plane).

          Conclusions

          The results of this study provide a valuable guideline for IAN block anesthesia and orthognathic surgery. CBCT can be considered effective and accurate in evaluating the fine structures of the mandible.

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          Most cited references28

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          Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature.

          This study reviewed the literature on cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial (OMF) region. A PUBMED search (National Library of Medicine, NCBI; revised 1 December 2007) from 1998 to December 2007 was conducted. This search revealed 375 papers, which were screened in detail. 176 papers were clinically relevant and were analyzed in detail. CBCT is used in OMF surgery and orthodontics for numerous clinical applications, particularly for its low cost, easy accessibility and low radiation compared with multi-slice computerized tomography. The results of this systematic review show that there is a lack of evidence-based data on the radiation dose for CBCT imaging. Terminology and technical device properties and settings were not consistent in the literature. An attempt was made to provide a minimal set of CBCT device-related parameters for dedicated OMF scanners as a guideline for future studies.
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            Three-dimensional cone beam computerized tomography in orthodontics.

            There has been an escalating interest in three-dimensional imaging devices over the last decade. Orthodontists are beginning to appreciate the advantages that the third dimension gives to clinical diagnosis, treatment planning and patient education. This article focuses on the cutting edge technology of cone beam CT, which utilizes conventional X-ray technology and computerized volumetric reconstruction to reproduce a three-dimensional image. A variety of applications and range of issues associated with this technology will be discussed.
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              Accuracy of measuring the cortical bone thickness adjacent to dental implants using cone beam computed tomography.

              To assess the accuracy of measuring the cortical bone thickness adjacent to dental implants using two cone beam computed tomography (CBCT) systems. Ten 4 x 11 mm Astra Tech implants were placed at varying distances from the cortical bone in two prepared bovine ribs. Both ribs were scanned in a reproducible position using two different CBCT scanners. Ten examiners each carried out four measurements on all 10 implants using the two CBCT systems: vertical distance between the top of the implant and the alveolar crest (IT-AC), and thickness of the cortical bone from the outer surface of the implant threads at 3, 6 and 9 mm from the top of the implant. Ground sections were prepared and bone thickness was measured using a light microscope and a graticule to give a gold standard (GS) measurement. The examiner's measurements were significantly different between CBCT systems for the vertical and thickness dimensions (P<0.001) while measuring the cortical bone thickness between 0.3 and 3.7 mm. Within that range, i-CAT NG measurements were consistently underestimated in comparison with the GS. Accuitomo 3D60 FPD measurements closely approximated the GS, except when cortical bone thickness was <0.8 mm. The mean percentage errors from the GS at 3, 6 and 9 mm measurement levels were 68%, 28% and 18%, respectively, for i-CAT NG and 23%, 5% and 6%, respectively, for Accuitomo 3D60 FPD. Within the limitations of this study, it was concluded that i-CAT NG (voxel size 0.3) may not produce sufficient resolution of the thin cortical bone adjacent to dental implants and, therefore, the measurements may not be accurate; whereas, Accuitomo 3D60 FPD (voxel size 0.125) may produce better resolution and more accurate measurement of the thin bone.
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                Author and article information

                Contributors
                +15098776833 , zhoucong@sdu.edu.cn
                +82 2 920 5423 , zalkka@hanmail.net
                +82 2 920 6776 , Omfs.junsang@gmail.com
                Journal
                Maxillofac Plast Reconstr Surg
                Maxillofac Plast Reconstr Surg
                Maxillofacial Plastic and Reconstructive Surgery
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                2288-8101
                2288-8586
                25 October 2017
                25 October 2017
                December 2017
                : 39
                : 1
                : 30
                Affiliations
                [1 ]ISNI 0000 0004 0474 0479, GRID grid.411134.2, Division of Oral & Maxillofacial Surgery, Department of Dentistry, , Korea University Anam Hospital, ; 73, Inchon-ro, Seongbuk-gu, Seoul, 136-705 South Korea
                [2 ]School of Stomatology, Stomatological Hospital of Shandong University, #44-1, Lixia District, Wenhuaxi Road, Jinan City, Shandong Province China
                [3 ]Shandong Provincial Key Laboratory of Oral Tissue Regeneration, Jinan, China
                [4 ]ISNI 0000 0001 0840 2678, GRID grid.222754.4, Korea University, ; Seoul, South Korea
                Article
                128
                10.1186/s40902-017-0128-y
                5655404
                29109943
                1b0b41a6-d6db-4298-a9e5-fcdab05e5a57
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 18 July 2017
                : 5 September 2017
                Funding
                Funded by: Basic Science Research Program through the National Research Foundation funded by the Ministry of Education
                Award ID: NRF-2013R1A1A1065373
                Award Recipient :
                Funded by: Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea
                Award ID: HI15C3136
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                3d anatomy,mandibular ramus,lingula,foramen,cone-beam ct
                3d anatomy, mandibular ramus, lingula, foramen, cone-beam ct

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