Assessment of the risk of perforation of the mandibular canal by implant drill using density and thickness parameters.
OBJECTIVE
The objective of this study was to investigate whether the resistance of the bone surrounding the mandibular canal had sufficient density and thickness to avoid perforation by drills when preparing the bed of the implant.


BACKGROUND
Damage to the inferior alveolar nerve (IAN) is more common than expected. This injury may lead to serious complications ranging from mild paresthesia to total anaesthesia of the lower jaw.


METHODS
The CT images of 99 patients, whose ages ranged between 20 and 79years, and who applied for an implant application to the posterior aspect of the mandible were included in this study.


RESULTS
The overall average bone thickness in the premolar and molar regions was 0.8717±0.1818 and 0.8556±0.1756mm, respectively, whereas the bone density in the premolar and molar regions was 649.18±241.42 and 584.44±222.73 Hounsfield Units (HU), respectively (p<0.001).


CONCLUSIONS
It was determined that the average density and thickness of the bone that surrounds the mandibular canal was not sufficient to resist the implant drill. It can be concluded that the risk of injury to the IAN may be minimised by accurately determining the bone mass on the canal prior to the implant procedure, and avoiding excessive force when approaching the canal.
Department of Oral Implantology, Yeditepe University, Faculty of Dentistry, Istanbul, Turkey.
Onur
O
Başa
Ozkan C
OC
Dilek
D000328:Adult; D000367:Age Factors; D000368:Aged; D001641:Bicuspid / Q000000981:diagnostic imaging; D015519:Bone Density / Q000502:physiology*; D054893:Cone-Beam Computed Tomography; D003724:Dental Arch / Q000000981:diagnostic imaging; D003758:Dental Implantation, Endosseous / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008334:Mandible / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery; D008338:Mandibular Injuries / Q000209:etiology* / Q000517:prevention & control; D008340:Mandibular Nerve / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D008875:Middle Aged; D008963:Molar / Q000000981:diagnostic imaging; D061330:Multidetector Computed Tomography; D010292:Paresthesia / Q000517:prevention & control; D018570:Risk Assessment; D012737:Sex Factors; D014057:Tomography, X-Ray Computed; D061221:Trigeminal Nerve Injuries / Q000209:etiology / Q000517:prevention & control; D055815:Young Adult