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Evaluation of the Inferior Alveolar Nerve with 3 Tesla Turbo Spin Echo Magnetic Resonance Imaging

Year 2022, Volume: 6 Issue: 2, 73 - 79, 31.12.2022
https://doi.org/10.29228/erd.29

Abstract

Introduction: The purpose of this study is to evaluate the inferior alveolar nerve’s position and nerve plexus within the mandibular canal (MC) with turbo spin echo (TSE) sequences of magnetic resonance imaging (MRI).

Materials and Methods: The IAN position was evaluated retrospectively in 220 patients as right and left mandibles (n=440). IAN was classified according to topographical features and branches. MRI images were evaluated as the sequences of T1-weighted, T2-weighted and Proton Density TSE images with standard scanning protocols. Additionally, location of the nerve plexus var recorded as anterior, premolar, molar and retromolar regions.

Results: Patient age was in the range of 7-81 years and the mean age was 37.23 ±16.38. Most common type was Type I (75.2%) which identifies a single major branch of IAN, followed by Type II (21.8%) that identifies inferiorly located and extended branching IAN, and Type III (3%) which represents IAN divides posteriorly into two major branches. Also, it was found that molar region nerve plexus (66.2%) was significantly higher than other regions.

Conclusions: MRI is a non-invasive soft tissue imaging method and is an alternative promising modality regarding in the evaluation of IAN. Preoperative MRI examination may help surgical planning of mandible molar region to avoid complications.

References

  • Kim ST, Hu KS, Song WC, Kang MK, Park HD, Kim HJ. Location of the mandibular canal and the topography of its neurovascular structures. J Craniofac Surg. 2009; 20:936–939.
  • Fukami K, Shiozaki K, Mishima A, Kuribayashi A, Hamada Y, Kobayashi K. Bifid mandibular canal: confirmation of limited cone beam CT findings by gross anatomical and histological investigations. Dentomaxillofac Radiol. 2012; 41:460- 465.
  • Weckx A, Agbaje JO, Sun Y, Jacobs R, Politis C. Visualization techniques of the inferior alveolar nerve (IAN): a narrative review. Surg Radiol Anat. 2016 Jan;38(1):55-63. doi: 10.1007/s00276-015-1510-z. Epub 2015 Jul 12. PMID: 26163825; PMCID: PMC4744261.
  • Juodzbalys G, Wang HL. Identification of the mandibular vital structures: practical clinical applications of anatomy and radiological examination methods. J Oral Maxillofac Res. 2010 Jul 1;1(2):e1. doi: 10.5037/jomr.2010.1201. PMID: 24421966; PMCID: PMC3886050.
  • Chau A. Comparison between the use of magnetic resonance imaging and cone beam computed tomography for mandibular nerve identification. Clin Oral Implants Res. 2012 Feb;23(2):253-256. doi: 10.1111/j.1600-0501.2011.02188.x. Epub 2011 Apr 13. PMID: 21488971.
  • de Oliveira-Santos C, Souza PH, de Azambuja Berti-Couto S, Stinkens L, Moyaert K, Rubira-Bullen IR, Jacobs R. Assessment of variations of the mandibular canal through cone beam computed tomography. Clin Oral Investig. 2012 Apr;16(2):387-93. doi: 10.1007/s00784-011-0544-9. Epub 2011 Mar 30. PMID: 21448636.
  • Ogawa A, Fukuta Y, Nakasato H, Nakasato S. Evaluation by dental cone-beam computed tomography of the incidence and sites of branches of the inferior dental canal that supply mandibular third molars. British Journal of Oral and Maxillofacial Surgery, 2016 54(10), 1116–1120. doi:10.1016/j.bjoms.2016.08.007
  • Imamura H, Sato H, Matsuura T, Ishikawa M, Zeze R. A comparative study of computed tomography and magnetic resonance imaging for the detection of mandibular canals and cross-sectional areas in diagnosis prior to dental implant treatment. Clin Implant Dent Relat Res. 2004;6(2):75-81. doi: 10.1111/j.1708-8208.2004.tb00029.x. PMID: 15669707.
  • Machtei EE, Zigdon H, Levin L, Peled M. Novel ultrasonic device to measure the distance from the bottom of the osteotome to various anatomic landmarks. J Periodontol. 2010 Jul;81(7):1051-5. doi: 10.1902/jop.2010.090621. PMID: 20214439.
  • Beltrán V, Fuentes R, Engelke W. Endoscopic visualization of anatomic structures as a support tool in oral surgery and implantology. J Oral Maxillofac Surg. 2012 Jan;70(1):e1-6. doi: 10.1016/j.joms.2011.09.011. PMID: 22182657.
  • Assaf AT, Zrnc TA, Remus CC, Schönfeld M, Habermann CR, Riecke B, Friedrich RE, Fiehler J, Heiland M, Sedlacik J. Evaluation of four different optimized magnetic-resonance-imaging sequences for visualization of dental and maxillo-mandibular structures at 3 T. J Craniomaxillofac Surg. 2014 Oct;42(7):1356-63. doi: 10.1016/j.jcms.2014.03.026. Epub 2014 Apr 13. PMID: 24837485.
  • Deepho C, Watanabe H, Kotaki S, Sakamoto J, Sumi Y, Kurabayashi T. Utility of fusion volumetric images from computed tomography and magnetic resonance imaging for localizing the mandibular canal. Dentomaxillofac Radiol. 2017 Mar;46(3):20160383. doi: 10.1259/dmfr.20160383. Epub 2017 Feb 17. PMID: 28045346; PMCID: PMC5606273.
  • Wamasing P, Deepho C, Watanabe H, Hayashi Y, Sakamoto J, Kurabayashi T. Imaging the bifid mandibular canal using high resolution MRI. Dentomaxillofac Radiol. 2019 Mar;48(3):20180305. doi: 10.1259/dmfr.20180305. Epub 2018 Nov 7. PMID: 30346803; PMCID: PMC6476361.
  • Deepho C, Watanabe H, Sakamoto J, Kurabayashi T. Mandibular canal visibility using a plain volumetric interpolated breath-hold examination sequence in MRI. Dentomaxillofac Radiol. 2018 Jan;47(1):20170245. doi: 10.1259/dmfr.20170245. Epub 2017 Oct 20. PMID: 28959898; PMCID: PMC5965732.
  • Nasel C, Gahleitner A, Breitenseher M, Czerny C, Glaser C, Solar P, Imhof H. Localization of the mandibular neurovascular bundle using dental magnetic resonance imaging. Dentomaxillofac Radiol. 1998 Sep;27(5):305-7. doi: 10.1038/sj/dmfr/4600379. PMID: 9879221.
  • Eggers G, Rieker M, Fiebach J, Kress B, Dickhaus H, Hassfeld S. Geometric accuracy of magnetic resonance imaging of the mandibular nerve. Dentomaxillofac Radiol. 2005 Sep;34(5):285-91. doi: 10.1259/dmfr/89236515. PMID: 16120878.
  • Ferretti F, Malventi M, Malasoma R. Dental magnetic resonance imaging: study of impacted mandibular third molars. Dentomaxillofac Radiol. 2009 Sep;38(6):387-92. doi: 10.1259/dmfr/29929241. PMID: 19700532.
  • Kreutner J, Hopfgartner A, Weber D, Boldt J, Rottner K, Richter E, et al. High isotropic resolution magnetic resonance imaging of the mandibular canal at 1.5 T: a comparison of gradient and spin echo sequences. Dentomaxillofac Radiol 2017; 46: 20160268.
  • Beck F, Austermann S, Bertl K, Ulm C, Lettner S, Toelly A, Gahleitner A. Is MRI a viable alternative to CT/CBCT to identify the course of the inferior alveolar nerve in relation to the roots of the third molars? Clin Oral Investig. 2021 Jun;25(6):3861-3871. doi: 10.1007/s00784-020-03716-4. Epub 2020 Dec 7. PMID: 33289048; PMCID: PMC8137481.
  • Agbaje JO, de Casteele EV, Salem AS, Anumendem D, Lambrichts I, Politis C. Tracking of the inferior alveolar nerve: its implication in surgical planning. Clin Oral Investig. 2017 Sep;21(7):2213-2220. doi: 10.1007/s00784-016-2014-x. Epub 2016 Nov 22. PMID: 27878463.
  • Krasny A, Krasny N, Prescher A. Study of inferior dental canal and its contents using high-resolution magnetic resonance imaging. Surg Radiol Anat. 2012 Oct;34(8):687-93. doi: 10.1007/s00276-011-0910-y. Epub 2011 Dec 6. PMID: 22143348.
  • Cavalcanti MG, Ruprecht A, Johnson WT, Southard TE, Jakobsen J. Radiologic interpretation of bone striae: an experimental study in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Sep;88(3):353-7. doi: 10.1016/s1079-2104(99)70042-9. PMID: 10503868.
  • Couture RA, Whiting BR, Hildebolt CF, Dixon DA. Visibility of trabecular structures in oral radiographs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 Dec;96(6):764-71. doi: 10.1016/j.tripleo.2003.08.013. PMID: 14676770.
  • Olivier E. The inferior dental canal and its nerve in the adult. Br Dent J. 1928; 49:356 –358.
  • Polland KE, Munro S, Reford G, Lockhart A, Logan G, Brocklebank L, McDonald SW. The mandibular canal of the edentulous jaw. Clin Anat. 2001;14(6):445-52
  • Carter RB, Keen EN. The intramandibular course of the inferior alveolar nerve. J Anat. 1971; 108: 433-440.
  • Kieser J, Kieser D, Hauman T. The course and distribution of the inferior alveolar nerve in the edentulous mandible. J Craniofac Surg. 2005;16(1):6-9.
  • Nortjé CJ, Farman AG, Grotepass FW. Variations in the normal anatomy of the inferior dental (mandibular) canal: a retrospective study of panoramic radiographs from 3612 routine dental patients. Br J Oral Surg. 1977 Jul;15(1):55-63. doi: 10.1016/0007-117x(77)90008-7. PMID: 268217.
  • Kieser JA, Paulin M, Law B. Intrabony course of the inferior alveolar nerve in the edentulous mandible. Clin Anat. 2004 Mar;17(2):107-11. doi: 10.1002/ca.10196. PMID: 14974097.
  • Burian E, Probst FA, Weidlich D, Cornelius CP, Maier L, Robl T, Zimmer C, Karampinos DC, Ritschl LM, Probst M. MRI of the inferior alveolar nerve and lingual nerve-anatomical variation and morphometric benchmark values of nerve diameters in healthy subjects. Clin Oral Investig. 2020 Aug;24(8):2625-2634. doi: 10.1007/s00784-019-03120-7. Epub 2019 Nov 8. PMID: 31705309.
  • Murakami S, Maeda Y, Fuchihata H. The role of magnetic resonance imaging in preoperative examination for dental implant. J Jpn Soc Oral Implant 1996; 9:24–28.

Inferior Alveolar Sinirin 3 Tesla Turbo Spin Eko Manyetik Rezonans Görüntüleme Yöntemiyle Değerlendirilmesi

Year 2022, Volume: 6 Issue: 2, 73 - 79, 31.12.2022
https://doi.org/10.29228/erd.29

Abstract

Giriş: Bu çalışmanın amacı inferior alveolar sinirin konumunu ve mandibular kanalın içerisindeki sinir demetinin morfolojik sınıflamasını turbo spin eko manyetik rezonans görüntüleme (TSE MRG) ile değerlendirmektir.

Materyal ve Metot: Inferior alveolar sinirin konumu, 220 hastaya ait manyetik rezonans görüntülerinde sağ ve sol olarak (n=440) retrospektif olarak sagittal, koronal ve aksiyal kesitlerde değerlendirilmiştir. Inferior alveolar sinir topografik özelliklerine ve dallanmalarına göre sınıflandırılmıştır. Manyetik rezonans görüntüleri T1 ağırlıklı, T2 ağırlıklı, Proton Density olarak kaydedilmiştir. Sinir pleksusunun konumu anterior, premolar, molar, retromolar olarak kaydedilmiştir.

Bulgular: Yaş aralığı 7-81 ve yaş ortalaması 37.23±16.38 olmuştur. En sık görülen inferior alveolar sinir, tek bir sinir dalını ifade eden Tip I (75.2%) olmuştur. İkinci en sık görülen Tip II (%21.8) olup, mandibulanın inferiorundan geçen, uzamış sinir dallanmaları izlenen tipi olmuştur. Posteriorda iki ana dala ayrılan inferior alveolar sinir tipi Tip III olup, görülme sıklığı %3 olarak saptanmıştır. En sık görülen sinir demeti bölgesi molar bölge (%66.2) olarak bulunmuştur.

Sonuç: Manyetik rezonans görüntüleme (MRG), invaziv olmayan bir yumuşak doku görüntüleme yöntemi olup inferior alveolar siniri görüntülemede alternatif bir yardımcı yöntem olabilir. Preopertatif olarak MRG, mandibula molar bölgenin cerrahi planlamasında kullanılabilir.

References

  • Kim ST, Hu KS, Song WC, Kang MK, Park HD, Kim HJ. Location of the mandibular canal and the topography of its neurovascular structures. J Craniofac Surg. 2009; 20:936–939.
  • Fukami K, Shiozaki K, Mishima A, Kuribayashi A, Hamada Y, Kobayashi K. Bifid mandibular canal: confirmation of limited cone beam CT findings by gross anatomical and histological investigations. Dentomaxillofac Radiol. 2012; 41:460- 465.
  • Weckx A, Agbaje JO, Sun Y, Jacobs R, Politis C. Visualization techniques of the inferior alveolar nerve (IAN): a narrative review. Surg Radiol Anat. 2016 Jan;38(1):55-63. doi: 10.1007/s00276-015-1510-z. Epub 2015 Jul 12. PMID: 26163825; PMCID: PMC4744261.
  • Juodzbalys G, Wang HL. Identification of the mandibular vital structures: practical clinical applications of anatomy and radiological examination methods. J Oral Maxillofac Res. 2010 Jul 1;1(2):e1. doi: 10.5037/jomr.2010.1201. PMID: 24421966; PMCID: PMC3886050.
  • Chau A. Comparison between the use of magnetic resonance imaging and cone beam computed tomography for mandibular nerve identification. Clin Oral Implants Res. 2012 Feb;23(2):253-256. doi: 10.1111/j.1600-0501.2011.02188.x. Epub 2011 Apr 13. PMID: 21488971.
  • de Oliveira-Santos C, Souza PH, de Azambuja Berti-Couto S, Stinkens L, Moyaert K, Rubira-Bullen IR, Jacobs R. Assessment of variations of the mandibular canal through cone beam computed tomography. Clin Oral Investig. 2012 Apr;16(2):387-93. doi: 10.1007/s00784-011-0544-9. Epub 2011 Mar 30. PMID: 21448636.
  • Ogawa A, Fukuta Y, Nakasato H, Nakasato S. Evaluation by dental cone-beam computed tomography of the incidence and sites of branches of the inferior dental canal that supply mandibular third molars. British Journal of Oral and Maxillofacial Surgery, 2016 54(10), 1116–1120. doi:10.1016/j.bjoms.2016.08.007
  • Imamura H, Sato H, Matsuura T, Ishikawa M, Zeze R. A comparative study of computed tomography and magnetic resonance imaging for the detection of mandibular canals and cross-sectional areas in diagnosis prior to dental implant treatment. Clin Implant Dent Relat Res. 2004;6(2):75-81. doi: 10.1111/j.1708-8208.2004.tb00029.x. PMID: 15669707.
  • Machtei EE, Zigdon H, Levin L, Peled M. Novel ultrasonic device to measure the distance from the bottom of the osteotome to various anatomic landmarks. J Periodontol. 2010 Jul;81(7):1051-5. doi: 10.1902/jop.2010.090621. PMID: 20214439.
  • Beltrán V, Fuentes R, Engelke W. Endoscopic visualization of anatomic structures as a support tool in oral surgery and implantology. J Oral Maxillofac Surg. 2012 Jan;70(1):e1-6. doi: 10.1016/j.joms.2011.09.011. PMID: 22182657.
  • Assaf AT, Zrnc TA, Remus CC, Schönfeld M, Habermann CR, Riecke B, Friedrich RE, Fiehler J, Heiland M, Sedlacik J. Evaluation of four different optimized magnetic-resonance-imaging sequences for visualization of dental and maxillo-mandibular structures at 3 T. J Craniomaxillofac Surg. 2014 Oct;42(7):1356-63. doi: 10.1016/j.jcms.2014.03.026. Epub 2014 Apr 13. PMID: 24837485.
  • Deepho C, Watanabe H, Kotaki S, Sakamoto J, Sumi Y, Kurabayashi T. Utility of fusion volumetric images from computed tomography and magnetic resonance imaging for localizing the mandibular canal. Dentomaxillofac Radiol. 2017 Mar;46(3):20160383. doi: 10.1259/dmfr.20160383. Epub 2017 Feb 17. PMID: 28045346; PMCID: PMC5606273.
  • Wamasing P, Deepho C, Watanabe H, Hayashi Y, Sakamoto J, Kurabayashi T. Imaging the bifid mandibular canal using high resolution MRI. Dentomaxillofac Radiol. 2019 Mar;48(3):20180305. doi: 10.1259/dmfr.20180305. Epub 2018 Nov 7. PMID: 30346803; PMCID: PMC6476361.
  • Deepho C, Watanabe H, Sakamoto J, Kurabayashi T. Mandibular canal visibility using a plain volumetric interpolated breath-hold examination sequence in MRI. Dentomaxillofac Radiol. 2018 Jan;47(1):20170245. doi: 10.1259/dmfr.20170245. Epub 2017 Oct 20. PMID: 28959898; PMCID: PMC5965732.
  • Nasel C, Gahleitner A, Breitenseher M, Czerny C, Glaser C, Solar P, Imhof H. Localization of the mandibular neurovascular bundle using dental magnetic resonance imaging. Dentomaxillofac Radiol. 1998 Sep;27(5):305-7. doi: 10.1038/sj/dmfr/4600379. PMID: 9879221.
  • Eggers G, Rieker M, Fiebach J, Kress B, Dickhaus H, Hassfeld S. Geometric accuracy of magnetic resonance imaging of the mandibular nerve. Dentomaxillofac Radiol. 2005 Sep;34(5):285-91. doi: 10.1259/dmfr/89236515. PMID: 16120878.
  • Ferretti F, Malventi M, Malasoma R. Dental magnetic resonance imaging: study of impacted mandibular third molars. Dentomaxillofac Radiol. 2009 Sep;38(6):387-92. doi: 10.1259/dmfr/29929241. PMID: 19700532.
  • Kreutner J, Hopfgartner A, Weber D, Boldt J, Rottner K, Richter E, et al. High isotropic resolution magnetic resonance imaging of the mandibular canal at 1.5 T: a comparison of gradient and spin echo sequences. Dentomaxillofac Radiol 2017; 46: 20160268.
  • Beck F, Austermann S, Bertl K, Ulm C, Lettner S, Toelly A, Gahleitner A. Is MRI a viable alternative to CT/CBCT to identify the course of the inferior alveolar nerve in relation to the roots of the third molars? Clin Oral Investig. 2021 Jun;25(6):3861-3871. doi: 10.1007/s00784-020-03716-4. Epub 2020 Dec 7. PMID: 33289048; PMCID: PMC8137481.
  • Agbaje JO, de Casteele EV, Salem AS, Anumendem D, Lambrichts I, Politis C. Tracking of the inferior alveolar nerve: its implication in surgical planning. Clin Oral Investig. 2017 Sep;21(7):2213-2220. doi: 10.1007/s00784-016-2014-x. Epub 2016 Nov 22. PMID: 27878463.
  • Krasny A, Krasny N, Prescher A. Study of inferior dental canal and its contents using high-resolution magnetic resonance imaging. Surg Radiol Anat. 2012 Oct;34(8):687-93. doi: 10.1007/s00276-011-0910-y. Epub 2011 Dec 6. PMID: 22143348.
  • Cavalcanti MG, Ruprecht A, Johnson WT, Southard TE, Jakobsen J. Radiologic interpretation of bone striae: an experimental study in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Sep;88(3):353-7. doi: 10.1016/s1079-2104(99)70042-9. PMID: 10503868.
  • Couture RA, Whiting BR, Hildebolt CF, Dixon DA. Visibility of trabecular structures in oral radiographs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 Dec;96(6):764-71. doi: 10.1016/j.tripleo.2003.08.013. PMID: 14676770.
  • Olivier E. The inferior dental canal and its nerve in the adult. Br Dent J. 1928; 49:356 –358.
  • Polland KE, Munro S, Reford G, Lockhart A, Logan G, Brocklebank L, McDonald SW. The mandibular canal of the edentulous jaw. Clin Anat. 2001;14(6):445-52
  • Carter RB, Keen EN. The intramandibular course of the inferior alveolar nerve. J Anat. 1971; 108: 433-440.
  • Kieser J, Kieser D, Hauman T. The course and distribution of the inferior alveolar nerve in the edentulous mandible. J Craniofac Surg. 2005;16(1):6-9.
  • Nortjé CJ, Farman AG, Grotepass FW. Variations in the normal anatomy of the inferior dental (mandibular) canal: a retrospective study of panoramic radiographs from 3612 routine dental patients. Br J Oral Surg. 1977 Jul;15(1):55-63. doi: 10.1016/0007-117x(77)90008-7. PMID: 268217.
  • Kieser JA, Paulin M, Law B. Intrabony course of the inferior alveolar nerve in the edentulous mandible. Clin Anat. 2004 Mar;17(2):107-11. doi: 10.1002/ca.10196. PMID: 14974097.
  • Burian E, Probst FA, Weidlich D, Cornelius CP, Maier L, Robl T, Zimmer C, Karampinos DC, Ritschl LM, Probst M. MRI of the inferior alveolar nerve and lingual nerve-anatomical variation and morphometric benchmark values of nerve diameters in healthy subjects. Clin Oral Investig. 2020 Aug;24(8):2625-2634. doi: 10.1007/s00784-019-03120-7. Epub 2019 Nov 8. PMID: 31705309.
  • Murakami S, Maeda Y, Fuchihata H. The role of magnetic resonance imaging in preoperative examination for dental implant. J Jpn Soc Oral Implant 1996; 9:24–28.
There are 31 citations in total.

Details

Primary Language English
Subjects Dentistry
Journal Section Original Articles
Authors

Melisa Bozkurt 0000-0003-1609-610X

Mehmet Oğuz Borahan 0000-0003-4193-2368

Cagatay Çimşit 0000-0003-4735-4140

Early Pub Date October 18, 2022
Publication Date December 31, 2022
Published in Issue Year 2022 Volume: 6 Issue: 2

Cite

APA Bozkurt, M., Borahan, M. O., & Çimşit, C. (2022). Evaluation of the Inferior Alveolar Nerve with 3 Tesla Turbo Spin Echo Magnetic Resonance Imaging. European Journal of Research in Dentistry, 6(2), 73-79. https://doi.org/10.29228/erd.29