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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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    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.