Dentists typically treat edentulous patients via a complete implant-supported prosthetic with distal extension. The success of these procedures largely depend on the placement of the distal implants. The location of the inferior alveolar nerve determines the implant placement, but the length, prevalence, and symmetry between the left and right side of the anterior loop of the alveolar nerve are unknown.
Researchers recently measured the anterior loop of the inferior alveolar nerve, which determines the placement of distal implants, in a group of 55 subjects. The researchers expected to determine the average length, prevalence, and symmetry between the left and right side as well as any sex differences. These metrics could lead to safer prosthetic placement.
To differentiate the inferior alveolar nerve path, the researchers applied a new technique using Hounsfield unit (HU) thresholds. They hypothesized that they would find no significant differences between the left and right sides or between men and women for the anterior loop of the inferior alveolar nerve.
The researchers made 55 computed tomography (CT) scans (Somatom Sensation 16, Siemens Healthcare) that were visualized with InVesalius software. They measured the anterior loop on 3-D surfaces and used the t test to determine statistical differences between the left and right side and between the sexes. Also, they applied the interclass correlation coefficient test to verify the reliability of the measurements.
According to the results, 90% of participants showed the anterior loop of the inferior alveolar nerve. The length of the anterior loop ranged between 0.0 and 6.68 mm, with a mean of 2.19 mm. No significant differences were found between the right and left sides or between men and women.
Since the anterior loop shows a high degree of variability, the researchers recommend a CT scan for each patient to visualize a safety zone before placing implants close to the mental foramen.
The study, “Anterior Loop of the Inferior Alveolar Nerve: Averages and Prevalence Based on CT Scans,” was published by The Journal of Prosthetic Dentistry. It was written by Del Valle Lovato Juan, DDS, and Edgar Grageda, DDS, MS, of the National Autonomous University of Mexico; and Salvador Gómez Crespo, BSMIS, of Mexico City.
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