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cone beam – international magazine of cone beam dentistry

I literature review _ current publications _“Computed tomography findings of mandibular nutrient canals” by Y. Kawashima, K. Sekiya, Y. Sasaki, T. Tsukioka, T. Muramatsu, T. Kaneda (Implant Dent. 2015 Aug;24(4):458–63) Nutrient canals are small neurovascular bundles originating from the incisive branch of the inferior dentalcanal,inthemandibularanteriorregion.These canals travel upwards to the apices and interdental areas of the mandibular incisors. Identifying these canals is essential in obviating clinical morbidity, which may include a neurosensory disturbance and/ orhaemorrhage.Theirprevalenceontraditionalperi- apical films has been reported in the literature as anywherefrom5to40%.ThisstudyusedCTimages to assess canal prevalence, location, number, size, shape and Hounsfield units (HU) of the nutrient canals themselves. The study showed that the prevalence of nutrient canals in the mandible is 94.3%, with the majority of theseintheanteriorregion(92.7%),premolarregion toalesserextent(42%)andrarelyinthemolarregion (1%).Asfortheexactcanallocations,thepreponder- ance of these canals was found between mandibular central and lateral incisors, both left and right. This is true because these teeth are furthest from the infe- rior alveolar canal and therefore require alternate blood supply. While gender specific differences were notobserved,theprevalenceofnutrientcanalsinthe mandibular premolar region for males was greater than for females—a clinically significant difference. Additionally, there were no gender differences when comparing the HU of males and females. Age did im- pact the foramina size. The shapes of the foramina were generally ovoid and did not change shape with age.Lastly,thesizeofthesecanalsrangedfrom0.4to 2.0mm in diameter. This paper underscores the diag- nostic value of CT in visualising anatomy and reduc- ing surgical morbidity. _“Three-dimensional evaluation of alveolar bone and soft tissue dimensions of maxillary central incisors for immedi- ate implant placement: A CBCT assisted analysis” by M.G. Kheur, N.R. Kantharia, S.M Kheur, A. Acharya, B. Le, T. Sethi (Implant Dent. 2015 Aug;24(4):407–15) Proper diagnosis and treatment planning is criti- calwhenplacingimmediateimplantsinthemaxillary anterior region. In order to achieve optimum aes- thetic results detail must be paid to the soft tissues. The soft tissue around implants is affected by three major factors: the position of the implant within its receptorsite,labialbonethicknessandtissuebiotype. Studies show that a minimum of 2mm labial bone thicknessissufficienttoprovideadequatesofttissue thickness. Thicker soft tissue will result in less reces- sion and more stable interdental papillae. Addition- ally,thickertissuewillsufficientlymaskpotentialdis- coloration of the underlying abutment. CBCT provides a cost-effective, low dose method of assessing both cortical bone thickness as well as tissue thickness. In this study, cross-sectional images of maxillary centralincisorswheremeasuredforfacialandpalatal Figs. 1a–f_Axial view of foramina (white arrows) between mandibular central and lateral incisors (a). Panoramic view showing nutrient canals (black arrows) (b). Various sagittal views of nutrient canals proceeding to the lingual plate of cortical bone (c–f). “Computed tomography findings of mandibular nutrient canals” by Y. Kawashima, K. Sekiya, Y. Sasaki, T. Tsukioka, T. Muramatsu, T. Kaneda (ImplantDent.2015 Aug;24(4):458–63). Current and related literature abstracts Author_ Dr Barry A. Kaplan, USA 06 I cone beam4_2015 Fig. 1

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