Assessment of open source software for CBCT in detecting additional mental foramina

The purpose of this study was to evaluate which post-processing imaging protocol would be better to analyze the additional mental foramen (AMF) in preoperative planning with cone-beam computed tomography (CBCT) exams, and to test reproducibility of measurements, using open source software (OsiriX). The software was used to detect the cases of AMF from among 58 exams for dental implant planning in edentulous mandible areas-three cases were found. The case images were submitted to qualitative analysis using 2D orthogonal MPR, 3D-MPR and 3D volume rendering protocols by two oral and maxillofacial radiologists. Quantitative analysis used the 3D-MPR protocol; the closed polygon tool measured the mental foramen (MF) and the AMF areas; the length tool measured the distance between foramina. The measurements were performed independently by the examiners, at two different times. Intra- and interexaminer agreement was assessed using the intraclass correlation coefficient. The panoramic view did not show the MF and the AMF clearly. The AMF could be detected in the parasagittal view. 2D Orthogonal MPR was effective to observe the AMF in some cases. The 3D-MPR and 3D view protocols were the most effective to locate and analyze the AMF. In conclusion, a 3D view improves visualization when anatomical points are not clearly visible. 3D-MPR was considered a more effective post-processing imaging protocol to observe foramina relationships. The high reproducibility of measurements for anatomical MF variations was established using specific tools featured in open source software for CBCT. OsiriX is realistic and recommended for preoperative planning.