Assessment and comparison of age-related three-dimensional variation in the anterior loop of the inferior alveolar nerve for pre-surgical planning

Aim

The aim of this study is to assess and compare age-related three-dimensional variation in the anterior loop of the inferior alveolar nerve for pre-surgical planning.

Objective

Ethical considerations

The study proposal was approved by “Institutional Ethics Committee” of DMIMSDU, Sawangi (meghe), Wardhawith Ref. No. DMIHER (DU)/IEC/2023/855 on 31/03/2023.

Materials

Patients will be selected as per the inclusions and exclusion criteria. This study will be done using Cone Beam Computed Tomography. The study will be conducted at Sharad Pawar Dental College, Sawangi (Meghe), Wardha, in the Dept. of Oral Medicine and Radiology.

Equipment

PLANMECA pro-Max C.B.C.T. machine with Romexis viewer.

Inclusion criteria

Exclusive criteria

Procedure

Patients reporting to the Department of Oral Medicine and Radiology will be approached to take part. Those who are willing to participate in the study and give written informed consent will be included in the study (see Extended data for the sample consent form⁹).

After satisfying the inclusion and exclusion criteria (via medical records), patients will be taken for C.B.C.T. imaging. The three-dimensional PLANMECA proMax C.B.C.T. equipment with an exposure period of 11.30 s, a tube voltage of 90 kV, a current in a tube of 5 mA, and a cylindrical F.O.V. measuring 17mm 13mm with a voxel size of 300 will be used to acquire the C.B.C.T. pictures. To standardize the image selection criterion, the F.O.V. will be the same throughout all scans. Each picture should be af 90μm, and a single 360-degree scan will be used. All the scans will be taken with the subject’s head in an upright position and the patient will be instructed to make molars to molars contact and to breathe from their nose.

Data analysis

The occlusal plane will be horizontally positioned to the scan plane. The cantered plane will be the midsagittal plane. The planes on the CBCT pictures’ three axes (X,Y,Z) will be analyzed in order. All of the images’ contrast and brightness will be kept constant for consistency during image analysis. All images will be evaluated under the best viewing conditions using picture viewing software PLANMECA pro-Max.Each volume’s axial slice will be rebuilt on the specified axial slice and parallel to the mandible’s lower edge. The most anterior section of the IAN and the MF most anterior segment will be marked & length will be measured using PLANMECA pro-Max software.

Sample size calculation

Cochian Formula for Sample Size:

Where;

Zαl2 is the level of significance at 5%, i.e. 95% .confidenece interval = 1.96

P = prevalence of inferior alveolar nerve anterior loop = 22% = 0.22

d = desired error of margin = 10% = 0.10

Study Reference:⁸

Dissemination

This study protocol will be published in a PubMed, Web of Science, and Scopus Indexed Journal.

Study status

Not Yet Started.

Key Result

There are positions of the MC laterally in women, especially at the level of the premolars, that have been discovered to be significantly and clinically relevant correlated as observed on CBCT.

Interpretation

In research by Baratollah Shaban et al. 2017² 71 patients’ CBCT scans were used. There are three main anatomical variations of the IAN anterior loop. Type I: The incisive branch thickness is comparable to that of the main branch, and the anatomy is Y-shaped.

Edudara Helena Leandro do Nascimento et al. 2016³ employed CBCT on 250 patients; it was possible to determine the frequency and severity of anterior loop in a Brazilian population. Gender, age, and mandibular side were taken into consideration while contrasting the anterior loop’s length.

Juan Muileno Lorenzo et al. 2015⁴ compared the MF and AMF visualization capabilities of CBCT and panoramic radiograph and used CBCT to examine the supplementary mental foramen’s existence and the anatomic characteristics of the MF. The sample for the study included CBCT and PAN tests were performed on 357 individuals. The average AMF area in the study was between 1.5 and 2 mm.

Fereidoumparnia et al. 2012⁵ determined that it is risky to suggest any particular medial distance from the mental foramen after conducting a study on 96 patients using CBCT to evaluate the Anatomical landmarks in the mandibular: their appearance, visibility, placement, and course inter-foraminal region. The diameter of the canal and foramen should be evaluated separately for each person in order to choose the appropriate location.