Pre-Operative Assessment of Anatomical Position of Inferior Alveolar Nerve Using Cone Beam Computed Tomography During...

The aim of the study was to assess the pre-operative assessment of the anatomical position of the inferior alveolar nerve using computed tomography during bilateral sagittal split osteotomy surgery.

The inferior alveolar nerve was delineated on a pre-operative CBCT scan from the position of the lingual first visible to the mental foramen on both sides. The buccolingual and supero-inferior distances from the inferior alveolar nerve canal were measured bilaterally at four different locations. The location of the nerve during the partial and complete split was recorded based on the CT data.

There was a higher average distance in 47 and 37 locations, respectively, between the buccal cortex and the IAN canal. There were statistically significant differences in the mean distance between the lingual cortex and the IAN canal in 45 and 35 regions, respectively. Ten patients had no visible nerve on the right side after the partial split, whereas eight patients had no visible nerve on the left side. There was statistically no difference between the right and left sides. Only eight individuals on the left side had the nerve located in the distal section, compared to eleven on the right. There were statistically significant variations between the left and right sides.

The location and trajectory of the IAN canal can be ascertained with pre-operative CT imaging before BSSO surgery, which lowers the possibility of direct IAN bundle damage during the procedure.