• The Journal of the Korean dental association
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• v.53 no.12
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• pp.967-974
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• 2015

Purpose: This study was performed to investigate the characteristics of mandibular incisive canal (MIC) in Korean population. Materials and methods: A total of 97 subjects (60 males and 37 females) who underwent cone-beam computed tomography were included in the study. The anatomic features of MIC was assessed according to gender. Length, diameter and distance to inferior, lingual and buccal border were measured at the origin and the terminal. Also the distribution of MIC at each tooth position was evaluated. Results: Of 97 patients included, 75(77.3%) presented bilateral MIC and 13(13.4%) presented unilateral MIC. Of 194 hamimandibles, MIC was detected in 102(85%) sites in male and 61(82.4%) sites in female. Gender and side showed no statistically significant differences in detectability. The length, diameter and distance to adjacent structures were bigger in male than in female except the distance to lingual border. MIC travelled anteriorly in a slightly downward and lingual direction and usually terminated between the first premolar and the canine. On cross-sectional view, MIC showed individually scattered distribution both buccolingually and superoinferiorly. Conclusion: MIC is well detected with cone-beam computed tomography. Considered that the length and the location of MIC has large variations between individuals, its localization using cone-beam CT is highly recommended before performing surgical procedures such as implant placement and bone harvesting.

• Restorative Dentistry and Endodontics
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• v.16 no.1
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• pp.74-86
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• 1991

The purpose of this study was to evaluate the resulting root canal angulation and shape change after using various enlarging instruments. The mesial canals (120) of extracted human mandibular 1st and 2nd molars were randomly divided into 6 groups; Control, K-type me, Heliapical me, Canal Master me, sonic and ultrasonic instrumentation group. Vertical angulation of each canal was determined by a straight line through the long axis of canal and another straight line through the apical foramen to intersect at the point where the canal began to leave the long axis of the tooth. By recording and comparing the measured angles of the each set of pre-and postinstrumentation. Then, the roots were sectioned horizontally in the apical, middle, coronal thirds and the canal shapes examined, as was the mesiodistal canal diameter as it relates to the external root surface. The results were as follows: 1. Instrumentation using K-type me group resulted in the highest mean change in angulation ($9.900^{\circ}$) (p < 0.005), while Sonic Air MM 3000 group resulted in the least degree of straightening canals ($8.250^{\circ}$) (p < 0.005). 2. Canal Master file group resulted in the best canal shape at the three levels (P < 0.005). 3. Measured minimal mesial root width produced Heliapical me group at the apical 1/3 level, Sonic Air MM 3000 group at the middle 1/3 level, Heliapical me group at the coronal 1/3 level (P < 0.005). 4. Measured minimal distal root width produced Sonic Air MM 3000 group at the apical 1/3 level (P < 0.05), Heliapical me group at the middle 1/3 level (P < 0.005), Canal Master me group at the coronal 1/3 level (P < 0.005). 5. HeIiapical me group produced more increased canal diameter than any other groups (P < 0.005).

• Imaging Science in Dentistry
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• v.33 no.1
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• pp.43-49
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• 2003

Purpose : To evaluate the differences in bone height, bone width, and visibility of posterior spiral tomographic images according to various exposure directions, image layer thickness, and inclination of the mandibular inferior border. Materials and Methods: Six partially and completely edentulous dry mandibles were radiographed using Scanora spiral tomography. Spiral tomography was performed at different exposure directions (dentotangential and maxillotangential projection), image layer thicknesses (2 mm, 4 mm and 8 mm), and at various inclinations to the mandibular border (+ 100, 00 and -10°). The bone height and width was measured using selected tomographic images. The visibility of mandibular canal, crestal bone, and buccal and lingual surfaces were graded as 0, 1, or 2. Results : The bone width at the maxillo-tangential projection was wider than at the dento-tangential projection (p < 0.05). The visibility of buccal and lingual surface at the maxillo-tangential projection was higher than at the dento-tangential projection (p<0.05). Thinner image layer thicknesses resulted in greater visibility of buccal and lingual surfaces (p < 0.05). Bone height was greatest in the -10° group, and at the same time the bone width of the same group was the narrowest (p < 0.05). The visibility of alveolar crest and buccal surface of the + 10° group was the highest, while the visibility of the mandibular canal was greatest in the 00 group. Conclusion: When spiral tomography is performed at the mandibular posterior portion for visualization prior to implant surgery, it is important that the inferior border of mandible be positioned as parallel as possible to the floor. A greater improvement of visibility can be achieved by maintaining a thin image layer thickness when performing spiral tomography.

• Biomaterials and Biomechanics in Bioengineering
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• v.3 no.1
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• pp.15-26
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• 2016

Based on a survey done recently in Japan, 30 percent of the serious accidents occurred in oral implant surgery were concerned with the mandibular canal and 3/4 of them were related to drilling. One of the reasons lies in the lack of the education system. To overcome this problem, a new educational system focusing on drilling the mandibular trabecular bone has been developed mainly for dental college students in the form of an oral implant surgery training simulator that enables student to sense the reaction force during drilling. On the other hand, the conventional system uses polymeric model. Based on these systems, two approaches were proposed; the evaluation by experienced clinicians using the simulator, and experimental works on the polymeric model. Focusing on the combination of the drilling force sensed and drilling speed obtained through both approaches, the results were compared. It was found that the polymeric models were much softer especially near the mandibular canal. In addition, the study gave us an insight of the understanding in bone quality through tactile sensation of the drilling force and speed. Furthermore, the clinicians positively reviewed the simulator as a valid tool.

• Archives of Craniofacial Surgery
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• v.23 no.3
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• pp.103-110
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• 2022

Background: The primary objectives of mandibular surgery are to achieve optimal occlusion, low sensory disturbance, and adequate fixation with early movement. In-depth knowledge of the mandibular structure is required to achieve these goals. This study used computed tomography (CT) to evaluate the mandibular cortical thickness and cancellous space according to age and sex. Methods: We enrolled 230 consecutive patients, aged 20 to 50 years, who underwent CT scanning. The cortex and cancellous space centered around the inferior alveolar nerve (IAN) canal were measured at two specific locations: the lingula and second molar region. Statistical analysis of differences according to increasing age and sex was performed. Results: The t-test revealed that the cancellous space and cortical thickness differed significantly with respect to the threshold of 35 years of age. Both cortical thickness and cancellous space in the molar region were negatively correlated with age. Meanwhile, both cortical thickness and cancellous space in the lingula region showed a positive correlation with age. With respect to sex, significant differences in the cancellous space at the molar region and the cortical thickness at the lingula were observed. However, no further statistically significant differences were observed in other variables with respect to sex. The sum of each measurement on the mandibular body reflected the safe distance from the surface of the outer cortex to the IAN canal. The safe distances also showed statistically significant differences between those above and below 35 years of age. Conclusion: Knowledge of the anatomical structure of the mandible and of changes in bone structure is crucial to ensure optimal surgical outcomes and avoid damage to the IAN. CT examination is useful to identify changes in the bone structure, and these should be taken into account in the planning of surgery for older patients.

• Imaging Science in Dentistry
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• v.46 no.2
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• pp.69-75
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• 2016

Purpose: Sufficient area in the interforaminal region is required for dental implant placement, and the anterior loop of the mandibular canal is located within the limits of this area. The aim of this study was to evaluate the prevalence and extent of the anterior loop in a Brazilian sample population using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images from 250 patients (500 hemimandibles) obtained for various clinical indications were randomly selected and evaluated to determine the presence and length of the anterior loop. The length of the anterior loop was then compared based on gender, age, and the side of the mandible. The data were analyzed using the Pearson chi-square test and linear regression analysis. Results: An anterior loop was identified in 41.6% of the cases, and its length ranged from 0.25 mm to 4.00 mm (mean, $1.1{\pm}0.8mm$). The loop had a greater mean length and was significantly more prevalent in males (p=0.014). No significant differences were found between the right and left sides regarding length (p=0.696) or prevalence (p=0.650). Conclusion: In this study, a high prevalence of the anterior loop of the mandibular canal was found, and although its length varied greatly, in most cases it was less than 1 mm long. Although this is a prevalent anatomical variation, safety limits for the placement of implants in this region cannot be established before an accurate evaluation using imaging techniques in order to identify and preserve the neurovascular bundles.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.30.1-30.7
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• 2015

Background: The inferior alveolar nerve (IAN) may be injured during extraction of the mandibular third molar, causing severe postoperative complications. Many methods have been described for evaluating the relative position between the mandibular third molar and the inferior alveolar canal (IAC) on panoramic radiography and computed tomography, but conventional radiography provides limited information on the proximity of these two structures. The present study assessed the benefits of three-dimensional computed tomography (3D-CT) prior to surgical extraction of the mandibular third molar, to prevent IAN damage. Methods: This retrospective study included 4917 extractions in 3555 patients who presented for extraction of the mandibular third molars. The cases were classified into three groups, according to anatomical relationship between the mandibular third molars and the IAC on panoramic radiography and whether 3D-CT was performed. Symptoms of IAN damage were assessed using the touch-recognition test. Data were compared using the chi-square test and Fisher's exact test. Results: Among the 32 cases of IAN damage, 6 cases were included in group I (0.35 %, n = 1735 cases), 23 cases in group II (1.1 %, n = 2063 cases), and 3 cases in group III (0.27 %, n = 1119 cases). The chi-square test showed a significant difference in the incidence of IAN damage between groups I and II. No significant difference was observed between groups I and III using Fisher's exact test. In the 6 cases of IAN damage in group I, the mandibular third molar roots were located lingual relative to the IAC in 3 cases and middle relative to the IAC in 3 cases. The overlap was ${\geq}2mm$ in 3 of 6 cases and 0-2 mm in the remaining 3 cases. The mean distance between the mandibular third molar and IAC was 2.2 mm, the maximum distance 12 mm, and the minimum distance 0.5 mm. Greater than 80 % recovery was observed in 15 of 32 (46.8 %) cases of IAN damage. Conclusions: 3D-CT may be a useful tool for assessing the three-dimensional anatomical relationship and proximity between the mandibular third molar and IAC in order to prevent IAN damage during extraction of mandibular third molars.

• The Journal of the Korean dental association
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• v.50 no.4
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• pp.203-210
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• 2012

Objective: The aim of this study was to investigate the incidence of the C-shaped canal of permanent mandibular second molar (PMSM) in Korean sub-population using Cone-Beam CT (CBCT) data and analyze the types of C-shaped canal. Materials & Methods: The protocol for this study was approved by the Institutional Review Board at the Pusan National University Hospital (E-2011039). Among the CBCT images taken of patients who visited the St. Bennedict Dental Hospital (Busan, Korea) from May 2008 to April 2011 for implant surgery and surgical removal of impacted teeth, high-quality CBCTs from 705 patients (361 male and 342 female) were screened and 607 PMSMs of 383 patients were evaluated retrospectively. All PMSMs were anatomically analyzed in detail by using image viewer software (EasyDent; Vatech). PMSMs were evaluated in the axial plane to investigate the shape of root and canals. The C-shaped canals were classified into five types. The total incidence, gender ratio, bilateral and unilateral appearance. and the correlation between right-side and left-side occurrences of C-shaped PMSMs were computed and compared statistically using the chi-square test. Results: Among the 607 PMSMs of 383 CBCTs of 187 females and 196 males, 198 PMSMs(32.6%) had C-shaped root and 158 PMSMs(26.0%) had C-shaped canals. The shape of C-shaped root canals at the furcalion level did not have significant change at the level of mid root (P<0.0001). Female had more prevalence of C-shaped root canals than male (P<0.0001). The prevalence of bilateral occurrence of C-shaped root canals was higher than unilateral occurrence. Conclusions: The occurrence of C-shaped PMSMs among a Korean population was 32.6% and was higher than other countries and ethnicities. Understanding the prevalence of PMSMs with a C-shaped root and/or canal in a Korean population may be useful for successful endodontic treatments.

• Imaging Science in Dentistry
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• v.52 no.2
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• pp.231-238
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• 2022

Intraosseous xanthoma of the mandible is a rare benign disorder. A 17-year-old male patient presented with a suspected abscess in the right mandibular third molar, detected on a panoramic radiograph. The patient had no history of systemic or lipid-related metabolic diseases and complained of no specific symptoms or pain. A radiographic examination revealed a heterogeneous radiolucency extending from the apical to the distal aspect of the right mandibular third molar tooth germ. The lesion measured 9 × 16 × 24 mm (antero-posterior × mediolateral × supero-inferior) and showed a relatively well-defined, multilocular, foamy appearance with hyperostotic borders spreading to the inferior alveolar nerve canal. After excisional biopsy, a diagnosis of central xanthoma was made. The lesion recurred, and intraoral vertical ramus osteotomy was done near the lesion. For the treatment of xanthoma of the mandible, extensive and delicate surgical treatment under general anesthesia should be considered.

• The Journal of the Korean dental association
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• v.45 no.6 s.457
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• pp.362-369
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• 2007

The aim of this study was to investigate the effect of the hybrid instrumentation method with ProTaper and ProFile on the change of root canal area and distance from the canal to the root surface after canal shaping. The mesial canals of twenty extracted mandibular first molars having $10-20^{\circ}\Delta$ curvature were scanned using X-ray microcomputed tomography (XMCT)-scanner before root canals were instrumented. They were divided into four groups (n=10 canals ter group). In Group 1, root canals were instrumented by the step-back technique with stainless steel K-Flexofile after coronal flaring. The remainders were instrumented by the crown-down technique with, ProTaper system (Group 2), ProFile (Group 3) or ProTaper (Group 4). All canals were prepared up to size 25 at the end-point of preparation and scanned again. Pre- and post-operative cross-sectional images of 1, 3, 5, and 7 mm from the apical foramen were compared. For each level, change of cross-sectional canal are and distance to the nearest external root surface was calculated using Adobe Photoshop 6.0 and image software program. In the change of cross-sectional area, Group 4 was less than Group 2 at 3 mm and 5 mm level (p<0.05). In the difference of the distance from the canal to the root surface after canal shaping, Group 4 was least among the other groups at 7 mm level (p<0.05). According to the results, the methods using ProFile or K file only and the hybrid instrumentation technique using ProTaper and ProFile are more appropriate methods of canal preparation than ProTaper system for narrow of curved canals.