Validation of different protocols of inferior alveolar canal tracing using cone beam computed tomography (CBCT)

The objective of this study was to evaluate, compare and validate different protocols of inferior alveolar canal tracing.

60 DICOM files with a total of 80 inferior alveolar canals were retrieved and imported to a third-party software where all proposed protocols can be performed. Initially, inferior alveolar canal was traced by two oral and maxillofacial radiologists together on cone beam CT cross-sectional images and considered as the baseline for future comparisons. Oral and maxillofacial surgeon performed the proposed different protocols. The protocols were color-coded differently by the surgeon before being compared with the baseline canal by the radiologists through a 5-point scale.

Results showed that no single protocol was successful in all cases, even the cross-sectional protocol. According to the present study, the hybrid protocol was the most accurate while the automatic protocol was the least accurate.

The hybrid protocol was reliable and showed the highest number of successful applications followed by the commonly used cross-sectional protocol. Dental practitioners should be aware of the application of multiple protocols and their pros and cons as no single protocol was successful in all the cases. Applying the same protocols on a larger sample size using different cone beam CT and multislice CT machines with different exposure parameters is recommended.