• Journal of Dental Rehabilitation and Applied Science
• /
• v.27 no.3
• /
• pp.317-326
• /
• 2011

The mental foramen and anterior loop of the mandibular canal are important landmarks for mandibular surgical procedures. The purpose of this study was to analyze the shape and position of the mental foramen and anterior loop of the mandibular canal on the computed tomography (CT) images, and apply the results clinically. CT images of 96 patients (33 male, 36 female, age range 17~43 years, mean $24.6{\pm}4.99$ years) were enrolled. The horizontal and vertical position of the mental foramen, as well as the distance from the root apices were measured. The distance of the anterior loop of the mandibular canal to the root apices, and the buccal angle were measured. The mental foramen was found mostly below the second premolar observed in 81 cases (46.0%), between the first and second premolars in 67 cases (38.0%), and between the second premolar and first molar in 19 cases (10.2%). The mean distance between the mental foramen and the lower border of the mandible was $12.20{\pm}1.77$ mm, the mean distance between the mental foramen and root apex was $5.16{\pm}0.98$ mm. The mean distance of the anterior loop of the mandibular canal was $5.80{\pm}2.00$ mm. The buccal angle measured at $47.7{\pm}9.07^{\circ}$. The distance between the root apex and mental foramen measured as $5.16{\pm}0.98$ mm on panoramic radiography, and $6.2{\pm}3.07$ mm on CT. The mean distance between the mental foramen and mandibular canal was $5.39{\pm}1.62$ mm. When performing surgical procedures such as installing dental implants, it is important to minimize surgical trauma, especially the risk of damage to the mental nerve. To optimize the surgical outcome, a careful assessment of the shape and position of the mental foramen and the anterior loop of the mandibular canal must be made. CT images are useful for finding such anatomic structures.

• Journal of Oral Medicine and Pain
• /
• v.39 no.4
• /
• pp.133-139
• /
• 2014

Purpose: There have been reports regarding the various factors associated with the level of discomfort and recovery from neurosensory symptoms in patients with trigeminal nerve injury. However, the contributing factors remain uncertain and poorly understood. The purpose of this paper was to investigate the possible association between various factors expected to affect neurosensory discomfort and recovery in patients with mandibular nerve injury after dental implant surgery. Methods: Eighty-nine post-dental implant surgery patients with mandibular nerve injury were enrolled in this retrospective analysis. A medical records review of the patients was done to determine if the patients' improvement was related to pain intensity, the length of time between the injury and removal of the implant or the depth of penetration of the implant into the mandibular canal as determined by cone-beam computed tomography. Results: There was no significant linear relationship between pain intensity and symptomatic improvement (p=0.319). There was no significant linear relationship between the level of mandibular canal penetration and either pain intensity (p=0.588) or symptomatic improvement (p=0.760). There was a statistically significant linear relationship between length of time before the injury was treated, both with pain intensity (p=0.004), and symptomatic improvement (p=0.024). Conclusions: Our findings indicate that the length of time between nerve injury and initiation of conservative treatment is more closely related to the pain intensity and symptomatic improvement than other factors, including the level of mandibular canal invasion. Additionally, increased pain intensity and decreased symptomatic improvement can be expected over time, because of this linear trend. Therefore, although direct injury to the nerve is the most important factor contributing to a neurosensory disturbances, early neurosensory assessment and initiation of conservative treatment should be done to optimize recovery.

• Restorative Dentistry and Endodontics
• /
• v.7 no.1
• /
• pp.25-31
• /
• 1981

One of the most important factors for successful endodontic therapy is an accurate length determination of physiological root apex. Some methods suggested for the measurement of root canal length, include digital-tactile sense and roentgenographic technique with measuring wire, scale and grid. But these methods do not derermine an accurate working length to physiological root apex. Recently electronic measuring devices are used to locate the physiological root apex in root canal length determination and these devices are accepted as an effective apparatus. The 89 patients (116 teeth, 144 canals) among the out-patients of Yonsei University Dental Infirmary, who had had an endodontic treatment in the Department of Operative Dentistry, were measured by the Root-Canal Meter$^{(R)}$ as an electronic device, and radiographs to determine the distribution and location of physiological root apex, then the following results were made: (1) Range of ${\pm}$1mm from the radiographic root apex were present in 88.88% (128 canals) of the subjects. (2) Physiological root apex and radiographic root apex were coincided in 31.94% (46 canals) of the subjects. (3) The actual length of the physiological root apex of the teeth were as follow; A : in the maxillary central incisor : 0.46mm B : in the maxillary lateral incisor : 0.44mm C : in the maxillary canine : 0.44mm D : in the maxillary 1st premolar : a) Buccal : 0.59mm b) Lingual : 0.34mm E : in the maxillary 2nd premolar : 0.54mm F : in the maxillary 1st molar : a) Mesio-buccal : 0.50mm b) Disto-buccal : 0.42mm c) Lingual : 0.56mm G : in the mandibular central incisor : 0.62mm H : in the mandibular lateral incisor : 0.45mm in the mandibular canine : 0.54mm J : in the mandibular 1st premolar : 0.47mm K : in the mandibular 2nd premolar : 0.34mm L : in the mandibular 1st molar : a) Mesio-buccal : 0.54mm b) Mesio-lingual : 0.31mm c) Distal : 0.37mm.

• Imaging Science in Dentistry
• /
• v.54 no.1
• /
• pp.81-91
• /
• 2024

Purpose: The objective of this study was to propose a deep-learning model for the detection of the mandibular canal on dental panoramic radiographs. Materials and Methods: A total of 2,100 panoramic radiographs (PANs) were collected from 3 different machines: RAYSCAN Alpha (n=700, PAN A), OP-100 (n=700, PAN B), and CS8100 (n=700, PAN C). Initially, an oral and maxillofacial radiologist coarsely annotated the mandibular canals. For deep learning analysis, convolutional neural networks (CNNs) utilizing U-Net architecture were employed for automated canal segmentation. Seven independent networks were trained using training sets representing all possible combinations of the 3 groups. These networks were then assessed using a hold-out test dataset. Results: Among the 7 networks evaluated, the network trained with all 3 available groups achieved an average precision of 90.6%, a recall of 87.4%, and a Dice similarity coefficient (DSC) of 88.9%. The 3 networks trained using each of the 3 possible 2-group combinations also demonstrated reliable performance for mandibular canal segmentation, as follows: 1) PAN A and B exhibited a mean DSC of 87.9%, 2) PAN A and C displayed a mean DSC of 87.8%, and 3) PAN B and C demonstrated a mean DSC of 88.4%. Conclusion: This multi-device study indicated that the examined CNN-based deep learning approach can achieve excellent canal segmentation performance, with a DSC exceeding 88%. Furthermore, the study highlighted the importance of considering the characteristics of panoramic radiographs when developing a robust deep-learning network, rather than depending solely on the size of the dataset.

• Restorative Dentistry and Endodontics
• /
• v.36 no.1
• /
• pp.19-25
• /
• 2011

Objectives: The purpose of this retrospective study was to evaluate the success rate of intentionally replanted mandibular second molar with C-shaped canal configurations and to access the impact of preoperative periapical lesion on the success of intentional replantation procedure. Materials and Methods: This retrospective chart review study evaluated 52 intentionally replanted mandibular second molar teeth treated at Seoul National University Dental Hospital Department of Conservative Dentistry from January 2005 to December 2007. Seventeen teeth were lost for the follow-up, and another 6 teeth did not meet inclusion criteria of C-shaped root canal configurations. Healing outcome such as success, uncertain healing, and failure after follow-up was evaluated by clinical criteria and radiographs. Results: The overall success rate was 72.4% for the 29 intentionally replanted C-shaped mandibular second molars. The success rate of replanted teeth with preoperative periapical lesions was similar to that of replanted teeth which have no periapical lesions. Conclusions: Therefore, root canal treatment failure on C-shaped mandibular second molar can be predictably treated by intentional replantation regardless of the presence of periapical lesion.

• Restorative Dentistry and Endodontics
• /
• v.7 no.1
• /
• pp.59-63
• /
• 1981

Ninety four human mandibular third molars were chosen to study the anatomy of the root canal. The experimental teeth were injected with china ink, decalcified, cleared and used in study, in vitro, to determine the number of root, the number of root canals, canals per root, frequency and location of transverse anastomoses, frequency and location of lateral canals and frequency of the apical deltas. The results were as follows: 1. Most of the teeth showed two canals, but 17.0% of the teeth were found to have one canal, 17.0% of them three canals, 3.2% of them four canals and l.1% of them five canals. 2. In so far as observing one canal per root, 17.0% of the teeth were found to have one canal in single-rooted tooth, 48.9% of them in mesial root and 58.5% of them in distal root. 3. In roots with two or three canals, the separated apical foramen appeared in 55.6% in single-rooted tooth, 64.3% in mesial side and 80.0% in distal side, and the common apical foramen appeared in 44.4% in single-rooted tooth, 35.7% in mesial side and 20.0% in distal side. 4. Of the two root canals in one root, 19.1% of the canals were found to have transverse anastomoses and were usually located in the apical third of the root. 5. 63.8% of 94 teeth were found to have lateral canals, and ramifications were mainly located in the apical third of the root.

• Restorative Dentistry and Endodontics
• /
• v.30 no.6
• /
• pp.477-485
• /
• 2005

The aim of this study was to compare the length between the mesio-buccal and mesio-lingual canal of the mandibular molars before and after early coronal flaring at the different measuring time using several electronic apex locators. Fifty mandibular molars with complete apical formation and patent foramens were selected. After establishing the initial working length of the buccal and lingual canal of the mesial root using a surgical microscope (Carl Zeiss Co Germany) at 25X with #15 K-fle tip just visible at the foramen, radiographs were taken for the working length. After measuring the length of mesio-buccal and mesio-lingual canal (control group), the electronic lengths were measured at different times using several electronic apex locators (experimental groups; I-Root ZX, II-Bingo, III-Propex, IV-Diagnostic). After early coronal flaring using the $K^3$ file, the additional electronic lengths were measured using the same manner The results were as follows: One canal has a correct working length for the mesial root of the mandibular molar, it can be used effectively for measuring the electronic working length of another canal when the files are superimposed or encountered at the apex. In addition, the accuracy of the electronic apex locators was increased as the measurement was accomplished after the early coronal flaring of the root canal and the measuring time was repeated.

• Imaging Science in Dentistry
• /
• v.31 no.2
• /
• pp.101-107
• /
• 2001

Purpose: To evaluate the precision of measurements of distances and angle in the cross-sectional views of linear tomogram of panorama and to assess the technique for visualizing the mandibular canal. Methods: Ten dry mandibles were radiographically examined with 3 continuous cross-sectional views of linear tomogram of panorama and 4 continuous computed tomograms. The distance between the superior border of canal and alveolar crest and the bucco-lingual width of alveolar bone at the level of the superior border of canal and the angle between the two lines above were measured. Measurements were performed by radiologist and implantologist group and compared with measurements on computed radiograms of the same areas. Results: The measurements differences for the distance of alveolar bone height between in panorama and in CT showed 0.9 mm±0.6 mm by radiologists and 1.3mm±0.8mm by implantologists. There was no statistically significant difference between two groups' measurements. The differences in measurements for the distance of alveolar bone width between in panorama and in CT showed 0.5mm±0.8mm by radiologists and 2.5mm±1.4 mm by implantologists. There was significant difference (P<0.05) between two groups' measurements. The average bucco-lingual inclination of alveolar bone above mandibular canal was average 95.8° in CT. The difference of measurements between two groups was average 1±0.9°. Three cross-sectional views of panorama could show that the mandibular canal crosses antero-lingually and slopes inferiorly from the posterior segment of the mandible. Conclusions: The measurements in the linear tomogram of panorama by radiologists gave the accurate values of the distances and the angle compared with the values in computed tomograms.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.35 no.1
• /
• pp.46-54
• /
• 2019

When inflammatory products are found in both periodontal and pulpal tissues simultaneously, a periodontal-endodontic combined lesion is established. The treatment of periodontal-endodontic combined lesions includes root canal therapy and periodontal regenerative procedure for resolution of both the apical and marginal inflammatory lesions. The present study reports the treatment of periodontal-endodontic combined lesions in the mandibular anterior area with root canal therapy, followed by guided tissue regeneration therapy. Teeth with severe bone destruction in each case could be preserved, without extraction, over a 3-year period. Therefore, it appears that treatment of periodontal-endodontic combined lesions in the mandibular anterior area using guided tissue regeneration technique after root canal therapy may provide clinical advantages.

• Restorative Dentistry and Endodontics
• /
• v.4 no.1
• /
• pp.23-27
• /
• 1978

Fifty two mandibular permanent canines were chosen to study the anatomy of the root canal. The experimental teeth were injected with China ink, decalcified, cleared and observed to investigate the number of root canals, frequency and location of lateral canals, the location of apical foramens, the frequency of apical deltas, and the curvature of root canals. The results were as follows: 1) all of the experimental teeth demonstrated single canal. 2) of the 52 canals, 9.6% of the canals were found to have lateral canals and the locations of the lateral canals were in the apical third of the roots 3) Thirty three apical foramens were located laterally on the root apices and nineteen foramens were located on the centers of the root apices. 4) 37 canals showed straight curvature, 12 canals distal curvature. 3 canals labial curvature.