ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title CBCT Is Effective in Locating the Mandibular Canal in the Presence of Two Types of Expansile Tumors
Clinical Question Can CBCT locate a displaced Inferior alveolar canal in patients diagnosed with tumors and cysts capable of expanding the mandibular bone?
Clinical Bottom Line CBCT was used effectively in a study to locate the mandibular canal in the presence of two types of expansile tumors; however, no studies have been done to evaluate the accuracy of CBCT in this clinical situation.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 27651881 Abdi/201613 patients with histopathologic ameloblastoma lesion and 13 patients with histopathologic odontogenic keratocystsClinical Study
Key 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 [keratocystic odontogenic tumor] lesions." A chi-squared test did not show any statistically significant differences (P=0.70). Therefore, the statistical analyses showed no relationship between these lesions and the inferior alveolar canal displacement.
Evidence Search tumors, CBCT, inferior alveolar canal
Comments on
The Evidence
Validity: Preventive measurements were used to reduce bias in order to increase validity; for example, the CBCT examiners were blinded to the biopsy results and to each other, and two examiners each gave their own CBCT reading; in the case of disagreement, a third examiner was used so that the recorded position was the result of agreement between two blinded examiners. Perspective: Due to small sample size of 26, larger sample sizes are recommended. In addition, it would make the argument more valid to study other common cysts and tumors and their effect on finding the exact location of mandibular canal.
Applicability CBCT is indicated prior to any type of surgery that can potentially damage critical anatomical features. If expansile lesion is suspected to affect the mandibular canal, CBCT diagnostic technique should be used to locate the lesion’s exact relation to the mandibular canal before resection. Use of CBCT enables surgeons to accurately locate the margins of expansile lesion in relation to mandibular canal and more precisely avoid damaging them.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (Oral Surgery)
Keywords Mandibular canal, inferior alveolar nerve, cone beam computed tomography, ameloblastoma, odotogenic keratocyst
ID# 3164
Date of submission: 04/13/2017spacer
E-mail Marashi@livemail.uthscsa.edu
Author Iman Marashi
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Marcel Noujeim, DDS, MS
Faculty mentor/Co-author e-mail Noujeim@uthscsa.edu
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