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    Effects of Crest Morphology on Lingual Concavity in Mandibular Molar Region: an Observational Study
    (Uab Stilus Optimus, 2023) Cimen, Tansu; Asar, Neset Volkan; Goyushov, Samir; Duruel, Onurcem; Toezuem, Tolga Fikret
    Objectives: The aim of this radiological study is to evaluate the lingual concavity dimensions and possible implant length in each posterior tooth region according to posterior crest type classification by using cone-beam computed tomography. Material and Methods: According to inclusion criteria, 836 molar teeth regions from 209 cone-beam computed tomography images were evaluated. Posterior crest type (concave, parallel, or convex), possible implant length, lingual concavity angle, width, and depth were recorded. Results: In each posterior tooth region, concave (U-type) crest was detected most frequently while convex (C-type) was the lowest. Possible implant length values were higher in second molar regions than first molars. Lingual concavity width and depth were decreasing from second molars to first molars for both sides. Additionally, lingual concavity angle showed higher values in second molar sites than first molars. In all molar teeth regions, lingual concavity width values were the highest in concave (U-type) crest type while they were the lowest in convex (C-type) crest type (P < 0.05). Lingual concavity angle values were recorded as the highest in concave (U-type) and the lowest in convex (C-type) crest type at the left first molar and right molars (P < 0.05). Conclusions: The lingual concavity dimensions and possible implant length may vary according to crest type and edentulous tooth region. Due to this effect, the surgeons should examine crest type clinically and radiologically. All parameters in the present study are decreasing while moving from anterior to posterior as well as from concave (U-type) to convex (C-type) morphologies.
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    Evaluation of Cortical Thicknesses and Bone Density Values of Mandibular Canal Borders and Coronal Site of Alveolar Crest
    (Uab Stilus Optimus, 2023) Ataman-Duruel, Emel Tugba; Beycioglu, Zehra; Yilmaz, Dogukan; Goyushov, Samir; Cimen, Tansu; Duruel, Onurcem; Yilmaz, Hasan Guney
    Objectives: The objectives of this retrospective study are to measure the amount of the alveolar crest cortication and cortication around the mandibular canal, and to evaluate bone density values of alveolar crest, cortication around mandibular canal, and possible implant placement area for edentulous sites.Material and Methods: Six hundred forty-two cone-beam computed tomography scans from 642 subjects were evaluated in four centers. Cortical thicknesses of alveolar crest and mandibular canal cortical borders (buccal, lingual, apical, and coronal) in each mandibular posterior teeth region were measured. Bone density of alveolar crest and mandibular canal cortical borders (buccal, lingual, apical, and coronal) in each mandibular posterior teeth region were recorded. The correlations between numeric variables were investigated using Pearson's correlation test.Results: The largest cortical border of the canal was measured 1.1 (SD 0.71) mm at the left second molar area and in coronal side of the mandibular canal (MC). Left and right first premolar regions showed higher bone density values compared to the other sites in all bone density values evaluations. The buccal side of the canal at the right first premolar region showed the highest bone density values (832.32 [SD 350.01]) while the coronal side of the canal at the left second molar region showed the lowest (508.75 [SD 225.47]). The bone density of possible implant placement area at the both left (692.25 [SD 238.25]) and right (604.43 [SD 240.92]) edentulous first premolar showed the highest values. Positive correlations between the bone density values of alveolar crest and the coronal side of MC were found in molar and left second premolar regions (P < 0.05).Conclusions: Results may provide information about the amount of cortication and bone densities tooth by tooth for posterior mandible to surgeons for planning the treatment precisely.
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    Evaluation of symphysis donor site quantity by cone-beam computed tomography and its relation to anterior loop of mental foramen: an observational study
    (Bmc, 2025) Cimen, Tansu; Saka, Yunus Yigit; Ataman-Duruel, Emel Tugba; Duruel, Onurcem; Yilmaz, Hasan Guney; Tozum, Tolga Fikret
    ObjectiveFor severely atrophic alveolar ridges, block grafting procedures are usually decided to use for reliable results. Various intraoral donor sites for autogenous block graft are presented in the literature. However, vital anatomic structures can limit intraoral bone block graft surgeries, and they must be evaluated in detail. The aim of this study is to evaluate the dimensions and volume of the maximum potential symphysis block graft donor site and their relations to the anterior loop of mental foramen.Materials and methodsAccording to inclusion criteria, 408 cone beam computed tomography (CBCT) images were evaluated. Mental foramen diameter, anterior loop length, the maximum potential symphysis graft dimensions (height, width, and length) and volume were measured.ResultsPrevalence of anterior loop of mental foramen was calculated 30.15% (123 patients) for right and 29.66% (121 patients) for left sides. The length of anterior loop of mental foramen was measured for right and left side 4.470 +/- 1.355 and 5.223 +/- 1.599, respectively. The maximum potential symphysis graft height, width, length, and volume were 13.253 +/- 3.261 mm, 12.694 +/- 1.711 mm, 34.353 +/- 2.944 mm, and 3.102 +/- 1.013 cm 3, respectively. Presenting anterior loop has no significant effect on the maximum potential symphysis graft height (P = 0.560) and width (P = 0.242). However, the maximum potential symphysis block graft length (P = 0.017) and volume (P = 0.026) were decreased by increasing number of anterior loops of mental foramen.ConclusionThe mandibular symphysis bone block graft can be reliably selected as the donor site for a number of different augmentation procedures. However, there are restrictions owing to surrounding anatomical structures such as mental foramen and anterior loop. These vital structures should be considered using accurate CBCT evaluation. Presenting anterior loop of mental foramen is limiting symphysis bone block graft length and volume.
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    Evaluation of the Mental Foramen and Accessory Mental Foramen with Cone Beam Computed Tomography
    (Selcuk University, 2025) Çımen, Tansu; Saka, Yunus Yiğit; Kayacan Ünel, Helin; Duruel, Onurcem
    Background: Some anatomical variations, such as accessory mental foramen (AMF) should be considered to prevent clinical complications. This study aimed to assess the AMF via cone beam computed tomography (CBCT) and evaluate its relationship with the mental foramen (MF). Methods: Of 244 CBCT images, the AMF and MF diameter, AMF number, MF– crest distance, MF–mandibular basis distance, AMF–crest distance, and AMF– mandibular basis distance were measured. Results: The prevalence of AMF was 9.4% with a total of 46. The diameters of the first and second AMFs were 0.67 ± 0.28 mm and 0.56 ± 0.11 mm on the right, 0.68 ± 0.23 mm and 0.46 ± 0.11 mm on the left, respectively. MF diameters were 2.06 ± 1.37 mm (right side) and 1.91 ± 0.45 mm (left side). The AMF–crest distances for the first and second AMFs were 15.18 ± 2.77 mm and 13.5 ± 2.0 mm (right side), 13.90 ± 3.01 mm and 12.23 ± 0.9 mm (left side), respectively. Some patients had multiple foramina in the area surrounding the MF. First and second AMF–mandibular basis distances were 16.63 ± 2.64 mm and 14.13 ± 4.36 mm (right side), 13.14 ± 2.4 mm and 14.40 ± 3.21 mm (left side). Conclusion: Considering the presence of AMFs during surgical procedures and local anesthesia is critical. It may be damaged during surgical operations. CBCT is a useful method for determining the presence of AMFs to prevent possible complications. © 2025, Selcuk University. All rights reserved.
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    EXAMINATION OF MANDIBULAR LATERAL LINGUAL CANAL WITH CONE BEAM COMPUTED TOMOGRAPHY AND ITS RELATIONSHIP WITH ANATOMICAL STRUCTURES
    (2025) Çimen, Tansu; Saka, Yunus Yiğit; Sargın-Durakoğlu, Ayşe Gökçen; Duruel, Onurcem
    Background and Aim: The mandible contains many accessory foramina and canals, particularly on the lingual side. The aim of this study was to evaluate the presence of lateral lingual canal (LLC) and the number, diameter and position of lateral lingual foramen (LLF) using cone beam computed tomography (CBCT). Materials and Methods: CBCT images of 250 patients were retrospectively analyzed. The presence of LLC and the number, diameter and position of LLF were evaluated. The distance between LLF and top of alveolar crest and the distance between LLF and mandibular midline were measured. The effect of gender on numeric values was analyzed by Student’s t-test (p<0.05). Results: LLC was present 55.4% in patients, 53.2% were on the right side and 57.6% were on the left side. The mean diameters of LLF were 0.65±0.24 mm and 0.69±0.23 mm for the right and left sides, respectively. LLF was classified as mono 46.8% for the right side and 51.6% for the left side. LLF was observed more frequently in the second premolar region. The mean values of the distances from the LLF to the midline and to the alveolar crest were 14.30±3.73 mm and 21.07±4.13 mm for the right side and 14.61±3.50 mm and 20.65±4.92 mm for the left side, respectively. No effect of gender on numeric values except left LLF-crest distance was detected (p>0.05). The left LLF-crest distances were 20.59±3.61 mm in females and 20.70±5.86 mm in males (p=0.028). Conclusion: More than half of the participants had LLC in the present study. CBCT imaging can inform surgeons about the presence, number, dimensions and location of LLC and LLF, as well as the presence of possible arterial and vascular structures.
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    EXAMINATION OF THE MANDIBULAR LATERAL LINGUAL CANAL WITH CONE BEAM COMPUTED TOMOGRAPHY AND ITS RELATIONSHIP WITH ANATOMICAL STRUCTURES
    (Hacettepe Üniversitesi, 2025) Çimen, Tansu; Saka, Yunus Yiğit; Durakoğlu, Ayşe Gökçen Sargın; Duruel, Onurcem
    Background and Aim: The mandible contains many accessory foramina and canals, particularly on the lingual side. There are two main categories of accessory foramina on the lingual side: medial and lateral lingual foramina. The canal structures of these foramina have been labelled "vascular canals" due to their arterial content. The aim of this study to evaluate the presence of lateral lingual canal, diameter, number and position of the lateral lingual foramen using cone beam computed tomography (CBCT). Materials and Methods: In this study, CBCT images of 250 patients who met our inclusion criteria were retrospectively analysed. Results: Lateral lingual canal (LLC) was detected on the right in 53.2% of the patients and on the left in 57.6%. The mean diameter of the lateral lingual foramina (LLF) on the right and left sides was 0.65 ± 0.24 mm and 0.69 ± 0.23 mm, respectively and the number of canals was mono in 88.6% of the right and 92.1% of the left. LLF was observed more frequently in the second premolar region. The mean values of the distance of the right LLF to the midline of the mandible and the alveolar crest top were 14.30 ± 3.73 mm and 21.07 ± 4.13 mm, respectively. The mean values of the distance of the left LLF to the midline of the mandible and the top of the alveolar crest were 14.61 ± 3.50 mm and 20.65 ± 4.92 mm, respectively. Conclusion: CBCT is recommended for preoperative imaging to determine the location and size of LLF to avoid any possible surgical complications. These vital structures must be assessed using precise CBCT evaluation.
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    Inferior alveolar nerve topography and its bifurcation features: a cone beam computed tomography evaluation
    (Edizioni Minerva Medica, 2022) Asar, Neset, V; Cimen, Tansu; Duruel, Onurcem; Goyushov, Samir; Karabulut, Erdem; Tozum, Tolga F.
    BACKGROUND: Mandibular canal (MC) is the most important vital structure in mandible to prevent from complications such as bleeding and paresthesia. The aims of the present study were to inform the features (diameter, distances to the mandibular borders, and distance to tooth apex) of the MC for each posterior tooth region, and to present the bifurcation features of the MC. METHODS: Four-hundreds-eighteen MC images of 209 patients were evaluated. The parameters were recorded from right and left hemi-mandibles for each posterior teeth region: 1) MC diameter; 2) MC and mandibular basis distance; 3) MC and crest distance; 4) MC and tooth apex distance; 5) MC and buccal plate distance; 6) MC and lingual plate distance; and 7) possible implant length (the distance between 2 mm coronal of the MC and 1 mm apical of the crest). Additionally, MC bifurcation type and bifid mandibular canal length were noted for right and left sides. RESULTS: While higher MC diameter values were recorded at molars, MC diameter in first premolars bilaterally were the lowest. In premolars, MC and mandibular basis distance showed higher values than molars. There was a trend of decrease in MC and crest distance from molars to premolars. The highest MC and tooth apex distance was measured in second molar; however, the lowest was in the first premolar. Additionally, MC and buccal plate distances were higher in molars, while MC and lingual plate distances were higher in premolars. Possible implant length in first premolar was the lowest, when it was the highest in second molars. CONCLUSIONS: For simulating overall MC topography, it extended bucco-coronally from molars to premolars. Due to this topography, possible implant length increased from premolars to molars.
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    The Radiological Evaluation of Mandibular Canal Related Variables in Mandibular Third Molar Region: a Retrospective Multicenter Study
    (Uab Stilus Optimus, 2022) Yilmaz, Dogukan; Ataman-Duruel, Emel Tugba; Beycioglu, Zehra; Goyushov, Samir; Cimen, Tansu; Duruel, Onurcem; Tozum, Tolga Fikret
    Objectives: The aim of this retrospective study was to investigate anatomical structure of mandibular canal and the factors those increase the possibility of inferior alveolar nerve damage in mandibular third molar region of Turkish population. Material and Methods: Overall 320 participants with 436 mandibular third molars were included from four different study centers. Following variables were measured: type and depth of third molar impaction, position of mandibular canal in relation to third molars, morphology of mandibular canal, cortication status of mandibular canal, possible contact between the third molars and mandibular canal, thickness and density of superior, buccal, and lingual mandibular canal wall, bucco-lingual and apico-coronal mandibular canal diameters on cone-beam computed tomography scans. Results: Lingual mandibular canal wall density and thickness were decreased significantly as the impaction depth of mandibular third molar was increased (P = 0.045, P = 0.001 respectively). Highest buccal mandibular canal wall density and thickness were observed in lingual position of mandibular canal in relation to mandibular third molar (P = 0.021, P = 0.034 respectively). Mandibular canal with oval/round morphology had higher apico-coronal diameter in comparison to tear drop and dumbbell morphologies (P = 0.018). Additionally, mandibular canals with observed cortication border and no contact with mandibular third molar had denser and thicker lingual mandibular canal wall (P = 0.003, P = 0.001 respectively). Conclusions: Buccal and lingual mandibular canal wall density, thickness and mandibular canal diameter may be related with high-risk indicators of inferior alveolar nerve injury.