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Analysis of the structure of the mandibular bone around mental foramen using MDCT images
EAO Online Library. ASAUMI R. Oct 9, 2018; 232633; P-BR-81
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The age at which mandibular molar teeth tend to be lost is earlier than other types of teeth. Therefore, implant treatment in the mandibular molar region is frequently performed. This region is associated with important anatomical structures such as the mandibular canal and submandibular gland fossa. In addition, to maintain implants, there are two important points- alveolar bone resorption as a result of missing teeth, which can limit the implant position and direction+ and the bone quality. The purpose of this study is to analyze differences in mandibular bone morphology and structure around the molar region between dentate and edentulous Japanese patients using multi-detector CT(+MDCT)+images.**This study used implant patient MDCT images (Aquilion, CANON MEDICAL SYSTEMS CORPORATION, Tochigi, Japan). The standardized horizontal plane was the occlusal plane. We selected dentate mandibles that had the first molar plus all the first and second premolars, and edentulous mandibles that had neither the molar nor premolars. **Cross-sectional MDCT images of the posterior region of the mental foramen were reconstructed (Mimic Research, Materialise, Leuven, Belgium). The following items were measured- the vertical height and width of the mandibular bone+ angle to the occlusal plane+ the vertical and buccolingual position of the mandibular canal relative to the mandibular bone+ and the cortical bone thickness at the buccal and lingual side of the mandibular bone both at the mandibular canal level and 10 mm from the mandibular canal. The differences between the dentate and edentulous groups in the perimolar bone morphology and structure were analyzed statistically.****The vertical height and angle to the occlusal plane of the edentulous group were significantly smaller than in the dentate group. The vertical and buccolingual positions of the mandibular canal in the mandibular bone and cortical bone thickness at all points showed no significant differences between the dentate and edentulous groups. In many cases it was difficult to detect the mandibular canal on the perimolar cross-sectional image. **The height of the alveolar bone after bone resorption and the angle of inclination to the lingual side were significantly smaller in the edentulous group. Bone morphology thus changes after teeth have been lost.**Our results suggest that cortical bone thickness is associated with other factors such as osteoporosis and sex. Furthermore, not only bone morphology, but also bone structure such as cortical and cancellous bone must be considered in the preoperative diagnosis for implant treatment.****
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