The effect of ameloblastoma and keratocystic odontogenic tumor on the displacement pattern of inferior alveolar canal in CBCT examinations

Abstract

Background. The inferior alveolar canal should be examined as a significant anatomical landmark, particularly in the posterior body and ramus of the mandible, for dental and surgical procedures. In the present study, the effects of two pathological lesions, ameloblastoma and keratocystic odontogenic tumor, on canal displacement were investigated.Methods. This study had a single-blinded design. Twenty-six patients with lesions in the mandible referred to Imam Reza Hospital, Tabriz, Iran, were studied in two equal groups (13 patients with a histopathological diagnosis of ameloblastoma and 13 with a histopathological diagnosis of odontogenic keratocyst). After confirming the initial incisional biopsy and pathological report, cone beam computed tomography (CBCT) of lesions larger than 3 cm mesiodistaly and those involving the mandibular posterior body and ramus were included in the study. Two maxillofacial surgeons in association with an oral and maxillofacial radiologist examined three points on CBCT images to determine the mandibular canal position relative to the lesions from the lingual and buccal aspects.Results. The results of statistical analyses showed that in ameloblastoma, the inferior alveolar canal had been displaced more buccally in the ramus area (point A) (84.6%) but in the distal region (point C), the displacement was less buccal (41.6%). The canal was displaced buccally in 53.8% of cases at point A and in 46.2% of cases at point C in KOT lesions. Finally chi-squared test did not show any statistically significant differences between these two lesions.Conclusion. The results of this study showed no relationship between these lesions and the displacement of the mandibular canal.

Common conditions associated with displacement of the inferior alveolar nerve canal: A radiographic diagnostic aid

“…1012 Odontogenic keratocysts grow in the anterior-posterior direction in the jawbone and do not cause considerable expansion 10. According to Abdi et al,4 53.8% of odontogenic keratocysts caused buccal displacement, while 46.2% caused lingual displacement of the IANC. Moreover, Farman et al9 found that odontogenic keratocysts may cause slight downward displacement of the IANC.…”

“…Ameloblastoma can cause displacement of the adjacent teeth, root resorption, and/or extensive bone expansion 19. According to Abdi, 84.6% of ameloblastomas cause buccal displacement of the IANC, and 15.4% cause lingual displacement 4. According to Kolokythas et al,17 buccal displacement of the IANC caused by odontogenic tumors may be explained based on the relationship of the developing tooth bud with the IANC and its contents.…”

“…This distance varies from 0.57 mm to 5.8 mm in the ramus region and from 0.40 mm to 70 mm in the molar region. These variations in values reported in the literature may be attributed to differences in age and race, as well as anatomical variations 4. A comprehensive literature review identified 8 types of jaw lesions that may cause displacement of the IANC, including odontogenic cysts, pseudocyst, tumors, and hamartomatous lesions associated with displacement of the IANC.…”

Directions of mandibular canal displacement in ameloblastoma: A computed tomography mirrored-method analysis

“…Ameloblastomas cause buccal displacement of the inferior alveolar nerve (IAN) in 84.6% of cases and lingual displacement in 15.4%. 5 When treating patients with ameloblastoma, it is essential to know the pathway of the mandibular canal when determining the direction of biopsy access and the safety limits of surgical excision in order to prevent neurovascular injuries. 5 6 Precise localization of the IAN may be particularly crucial for posterior mandibular lesions, especially if preservation of the neurovascular bundle is included in the surgical planning.…”

Common conditions associated with mandibular canal widening: A literature review

“…At this location, the inferior alveolar nerve branches into the incisive and mental nerves. The distance between the mandibular canal and the buccal cortical plate in the molar region is greater than that in the ramus region, and may vary from 0.57 mm to 5.8 mm in the ramus region and from 0.40 mm to 70 mm in the molar region 12. The mandibular canal has several normal anatomical variations, such as a bifid canal, a trifid canal, or an enlarged canal 13.…”