Surgical and Radiologic Anatomy

, Volume 37, Issue 6, pp 591–597 | Cite as

In vitro correlation of the level of inferior alveolar canal with CBCT imaging

  • Ashok BalasundaramEmail author
  • Gary M. Heir
  • Francisco Plaza Villegas
  • Maha Ahmad
  • Fatima Taher
Original Article



The aim was to correlate the level of the inferior alveolar canal on cadaver specimens and as evaluated with three-dimensional radiographic cone-beam computed tomography (CBCT) imaging.


Twenty-one skulls with intact mandibles (42 inferior alveolar canals) were imaged with an I-CAT Cone-Beam 3D Imaging System and multi-planar reformatted images obtained were scored to assess the level of the canal (Level I, Level II, and Level III). The mandibles were later dissected and level of the canal was directly visualized, scored, and further correlated with results from CBCT imaging.


There was no difference in the level of the inferior alveolar canal between the dissected cadaver specimen and CBCT images. Also, there was no statistically significant difference in the level of the canal among the gender assigned to the specimens and corresponding CBCT images. There were no statistical differences in the level of the canal (cadaver specimen vs. CBCT) between the left and right sides of the specimens, as studied individually.


Our study indicates that there is close correlation of the level of the inferior alveolar canal between cadaver specimens and CBCT images. Well-designed studies would be required to further validate the findings in this study.


Cone-beam computed tomography Inferior alveolar canal Conventional radiography Implant therapy 


Conflict of interest

No potential conflict of interest to report in preparation of this manuscript.


  1. 1.
    Adiguzel O, Yigit-Ozer S, Kaya S, Akkus Z (2012) Patient-specific factors in the proximity of the inferior alveolar nerve to the tooth apex. Med Oral Patol Oral Cir Bucal 17:e1103–e1108. doi: 10.4317/medoral.18190 PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Angel JS, Mincer HH, Chaudhry J, Scarbecz M (2011) Cone-beam computed tomography for analyzing variations in inferior alveolar canal location in adults in relation to age and sex. J Forensic Sci 56:216–219. doi: 10.1111/j.1556-4029.2010.01508.x PubMedCrossRefGoogle Scholar
  3. 3.
    Basa O, Dilek OC (2011) Assessment of the risk of perforation of the mandibular canal by implant drill using density and thickness parameters. Gerodontology 28:213–220. doi: 10.1111/j.1741-2358.2009.00362.x PubMedCrossRefGoogle Scholar
  4. 4.
    Bornstein MM, Scarfe WC, Vaughn VM, Jacobs R (2014) Cone beam computed tomography in implant dentistry: a systematic review focusing on guidelines, indications, and radiation dose risks. Int J Oral Maxillofac Implants 29(Suppl):55–77. doi: 10.11607/jomi.2014suppl.g1.4 PubMedCrossRefGoogle Scholar
  5. 5.
    Carter RB, Keen EN (1971) The intramandibular course of the inferior alveolar nerve. J Anat 108:433–440PubMedCentralPubMedGoogle Scholar
  6. 6.
    Drikes S, Delcampe P, Sabin P, Lavis JF, Cordier G, Vacher C, Peron JM (2011) CT scan study of the mandibular nerve intra-mandibular path. Rev Stomatol Chir Maxillofac 112:e5–e10. doi: 10.1016/j.stomax.2011.02.001 PubMedCrossRefGoogle Scholar
  7. 7.
    Ellies LG, Hawker PB (1993) The prevalence of altered sensation associated with implant surgery. Int J Oral Maxillofac Implants 8:674–679PubMedGoogle Scholar
  8. 8.
    Garisto GA, Gaffen AS, Lawrence HP, Tenenbaum HC, Haas DA (2010) Occurrence of paresthesia after dental local anesthetic administration in the United States. J Am Dent Assoc 141:836–844. pii:141/7/836Google Scholar
  9. 9.
    Gazelle GS, Seltzer SE, Judy PF (2003) Assessment and validation of imaging methods and technologies. Acad Radiol 10:894–896PubMedCrossRefGoogle Scholar
  10. 10.
    Gerlach NL, Meijer GJ, Maal TJ, Mulder J, Rangel FA, Borstlap WA, Berge SJ (2010) Reproducibility of 3 different tracing methods based on cone beam computed tomography in determining the anatomical position of the mandibular canal. J Oral Maxillofac Surg 68:811–817. doi: 10.1016/j.joms.2009.09.059 PubMedCrossRefGoogle Scholar
  11. 11.
    Gowgiel JM (1992) The position and course of the mandibular canal. J Oral Implantol 18:383–385PubMedGoogle Scholar
  12. 12.
    Kilic C, Kamburoglu K, Ozen T, Balcioglu HA, Kurt B, Kutoglu T, Ozan H (2010) The position of the mandibular canal and histologic feature of the inferior alveolar nerve. Clin Anat 23:34–42. doi: 10.1002/ca.20889 PubMedGoogle Scholar
  13. 13.
    Kim KD, Jeong HG, Choi SH, Hwang EH, Park CS (2003) Effect of mandibular positioning on preimplant site measurement of the mandible in reformatted CT. Int J Periodontics Restorative Dent 23:177–183PubMedGoogle Scholar
  14. 14.
    Kim ST, Hu KS, Song WC, Kang MK, Park HD, Kim HJ (2009) Location of the mandibular canal and the topography of its neurovascular structures. J Craniofac Surg 20:936–939. doi: 10.1097/SCS.0b013e3181a14c79 PubMedCrossRefGoogle Scholar
  15. 15.
    Lautner N, McCoy M, Gaggl A, Krenkel C (2012) Intramandibular course of the mandibular nerve; clinical significance for distraction and implantology. Rev Stomatol Chir Maxillofac 113:161–168. doi: 10.1016/j.stomax.2012.02.002;10.1016/j.stomax.2012.02.002 PubMedCrossRefGoogle Scholar
  16. 16.
    Leite GM, Lana JP, de Carvalho Machado V, Manzi FR, Souza PE, Horta MC (2013) Anatomic variations and lesions of the mandibular canal detected by cone beam computed tomography. Surg Radiol Anat. doi: 10.1007/s00276-013-1247-5 Google Scholar
  17. 17.
    Levine MH, Goddard AL, Dodson TB (2007) Inferior alveolar nerve canal position: a clinical and radiographic study. J Oral Maxillofac Surg 65:470–474. pii:S0278-2391(06)01330-9Google Scholar
  18. 18.
    Lofthag-Hansen S, Grondahl K, Ekestubbe A (2009) Cone-beam CT for preoperative implant planning in the posterior mandible: visibility of anatomic landmarks. Clin Implant Dent Relat Res 11:246–255. doi: 10.1111/j.1708-8208.2008.00114.x PubMedCrossRefGoogle Scholar
  19. 19.
    Massey ND, Galil KA, Wilson TD (2013) Determining position of the inferior alveolar nerve via anatomical dissection and micro-computed tomography in preparation for dental implants. J Can Dent Assoc 79:d39PubMedGoogle Scholar
  20. 20.
    Mehra A, Pai KM (2012) Evaluation of dimensional accuracy of panoramic cross-sectional tomography, its ability to identify the inferior alveolar canal, and its impact on estimation of appropriate implant dimensions in the mandibular posterior region. Clin Implant Dent Relat Res 14:100–111. doi: 10.1111/j.1708-8208.2009.00226.x PubMedCrossRefGoogle Scholar
  21. 21.
    Morris CD, Rasmussen J, Throckmorton GS, Finn R (2010) The anatomic basis of lingual nerve trauma associated with inferior alveolar block injections. J Oral Maxillofac Surg 68:2833–2836. doi: 10.1016/j.joms.2010.06.193 PubMedCrossRefGoogle Scholar
  22. 22.
    Nakanishi O, Haas D, Ishikawa T, Kameyama S, Nishi M (1996) Efficacy of mandibular topical anesthesia varies with the site of administration. Anesth Prog 43:14–19PubMedCentralPubMedGoogle Scholar
  23. 23.
    Nortje CJ, Farman AG, Grotepass FW (1977) Variations in the normal anatomy of the inferior dental (mandibular) canal: a retrospective study of panoramic radiographs from 3,612 routine dental patients. Br J Oral Surg 15:55–63PubMedCrossRefGoogle Scholar
  24. 24.
    Oliveira-Santos C, Capelozza AL, Dezzoti MS, Fischer CM, Poleti ML, Rubira-Bullen IR (2011) Visibility of the mandibular canal on CBCT cross-sectional images. J Appl Oral Sci 19:240–243. doi: 10.1590/S1678-77572011000300011Google Scholar
  25. 25.
    Ozturk A, Potluri A, Vieira AR (2012) Position and course of the mandibular canal in skulls. Oral Surg Oral Med Oral Pathol Oral Radiol 113:453–458. doi: 10.1016/j.tripleo.2011.03.038 PubMedCrossRefGoogle Scholar
  26. 26.
    Simonton JD, Azevedo B, Schindler WG, Hargreaves KM (2009) Age- and gender-related differences in the position of the inferior alveolar nerve by using cone beam computed tomography. J Endod 35:944–949. doi: 10.1016/j.joen.2009.04.032 PubMedCrossRefGoogle Scholar
  27. 27.
    Sokhn S, Nasseh I, Noujeim M (2011) Using cone beam computed tomography to determine safe regions for implant placement. Gen Dent 59:e72–e77PubMedGoogle Scholar
  28. 28.
    Swasty D, Lee J, Huang JC, Maki K, Gansky SA, Hatcher D, Miller AJ (2011) Cross-sectional human mandibular morphology as assessed in vivo by cone-beam computed tomography in patients with different vertical facial dimensions. Am J Orthod Dentofacial Orthop 139:e377–e389. doi: 10.1016/j.ajodo.2009.10.039 PubMedCrossRefGoogle Scholar
  29. 29.
    Tal H, Moses O (1991) A comparison of panoramic radiography with computed tomography in the planning of implant surgery. Dentomaxillofac Radiol 20:40–42. doi: 10.1259/dmfr.20.1.1884852 PubMedCrossRefGoogle Scholar
  30. 30.
    Ueda M, Nakamori K, Shiratori K, Igarashi T, Sasaki T, Anbo N, Kaneko T, Suzuki N, Dehari H, Sonoda T, Hiratsuka H (2012) Clinical significance of computed tomographic assessment and anatomic features of the inferior alveolar canal as risk factors for injury of the inferior alveolar nerve at third molar surgery. J Oral Maxillofac Surg 70:514–520. doi: 10.1016/j.joms.2011.08.021 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag France 2014

Authors and Affiliations

  • Ashok Balasundaram
    • 1
    • 3
    Email author
  • Gary M. Heir
    • 2
  • Francisco Plaza Villegas
    • 1
  • Maha Ahmad
    • 1
  • Fatima Taher
    • 1
  1. 1.Department of Biomedical and Diagnostic SciencesUniversity of Detroit Mercy School of DentistryDetroitUSA
  2. 2.Division, Program and Clinical Director, Center for Temporomandibular Disorders and Orofacial PainRutgers University School of Dental MedicineNewarkUSA
  3. 3.NoviUSA

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