Objectives To compare the difference in mandibular canal (MC) visibility using three different cone beam computed tomography (CBCT) acquisition protocols: high resolution (HR), standard resolution (ST) and Quick scan+ (QS+). Methods Twenty-five human dry mandibles were scanned by one CBCT machine; i-CAT FLX (Imaging Sciences International, Hatfield, PA, USA), using three different acquisition protocols: high-resolution (HR), standard (ST) and Quick scan+ (QS+). DICOM data were transferred to a third party software Ondemand 3D (Cybermed Co., Seoul, Korea). The fusion module was used to superimpose images derived from different acquisition protocols to standardize the areas to compare the MC visibility. Comparison was performed at nine selected cross sections extending from an area distal to the third molar posteriorly to the first premolar anteriorly. Two expert radiologists evaluated the degree of MC visibility using five-scale scoring system. Results There was a statistically significant difference between the three acquisition protocols (HR, ST, QS+) at all investigated areas regardless of dentition status (p value < 0.001-0.034) except at the MR1M area where there was no statistically significant difference (p value = 0.094). HR protocol showed the highest prevalence of fully and partially corticated MC at almost all investigated areas while QS+ protocol showed the highest prevalence of invisible MC and clear and unclear noncorticated MC at almost all investigated areas. Conclusions QS+ protocol of i-CAT FLX CBCT machine is a recommended low-dose CBCT acquisition protocol for MC visibility at dentulous posterior mandibular regions while ST protocol is recommended at edentulous areas.
Background: Many studies have been done to investigate the incidence and the course of the retromolar canal (RMC) in different populations either osseous studies using cadavers or dry mandibles, panoramic studies, or cone beam computed tomography (CBCT) studies. The location of the RMC is in the retromolar area distal to the third mandibular molar. The retromolar area is considered an imperative site where many dental surgeries are being held. The aim of this study is to determine the incidence of RMC in the Egyptian population using CBCT and measure the distance between the RMF and neighboring anatomical landmarks to better allocate the RMC and RMF and avoid the complications. Two hundred and fourteen CBCT scans were examined to detect the presence of RMC. Their course was classified to 3 main types A, B, and C, and linear measurements were done from the retromolar foramen (RMF) to the 2nd and 3rd molars in anteroposterior direction and from the RMF to the mandibular foramen (MF) in anteroposterior and mediolateral directions. Results: The RMC was present in 24 scans from the 214 with 11.2% incidence rate. The most common type was found to be type A, and type C was the rarest. The RMC has no significant difference between males and females, unilateral and bilateral distribution, and right and left sides. The linear measurements from the RMF to the 2nd and 3rd molars are 14.70 ± 5.07 mm and 4.26 ± 4.21 mm, respectively, and from the RMF to the MF in anteroposterior and mediolateral directions are 15.69 ± 3.43 mm and 2.62 ± 1.60 mm, respectively. Conclusions: The incidence rate of RMC in Egyptian population represents 11.2%. The use of CBCT is quite important in the evaluation of the retromolar area to visualize the presence of the RMC or RMF and avoid the complications occurring due to different dental surgical procedures performed in the aforementioned site.
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