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VOLUME 11 , ISSUE 3 ( July-September, 2021 ) > List of Articles

REVIEW ARTICLE

Comparative Accuracy of Panoramic Radiograph and Cone-beam Computed Tomography Images in Identification and Measurement of the Anterior Loop of Mental Nerve: A Meta-analysis and Review of the Literature

Soumitra Ghosh, Sayan Majumdar, Samiran Das

Citation Information : Ghosh S, Majumdar S, Das S. Comparative Accuracy of Panoramic Radiograph and Cone-beam Computed Tomography Images in Identification and Measurement of the Anterior Loop of Mental Nerve: A Meta-analysis and Review of the Literature. Int J Prosthodont Restor Dent 2021; 11 (3):132-137.

DOI: 10.5005/jp-journals-10019-1322

License: CC BY-NC 4.0

Published Online: 01-09-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aim and objective: This study aimed to assess the relative accuracy of two-dimensional panoramic radiographs compared with three-dimensional computed tomography (CBCT) images for identification and measurement of the anterior loop of the mental nerve. Materials and methods: The study was about to determine the comparative diagnostic accuracy of panoramic radiograph and cone-beam computed tomography and the study protocol was set according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagnostic test accuracy guideline. The search was limited to English literature only and included an electronic search through PubMed and Google Scholar databases. The search was further complemented by extensive hand-searching. All studies published up to November 2019 were included (without any starting limit). Two independent investigators extracted the data and assessed the studies based on the inclusion and exclusion criteria. Results: Out of the initial 308 records, only 4 studies were included in this review for qualitative data synthesis. The quality assessment of included studies was done through QUADAS-2. Quantitative data synthesis was done to compare the relative accuracy of two-dimensional radiographs compared with three-dimensional scans from three out of the four selected articles. Statistical analysis was done with the help of Meta-DiSc version 1.4. The pooled sensitivity of panoramic radiography was 0.45 (CI 95%: 0.34–0.56) and pooled specificity was 0.75 (CI 95%: 0.69–0.80). In the symmetric summary receiver operating characteristic (SROC) plot, the area under the curve (AUC) was 0.8832, and Q* was 0.8137. Conclusion: Compared with cone-beam computed tomography (CBCT) images as the gold standard reference test, two-dimensional panoramic radiographs showed lower sensitivity and reasonable specificity. It is clear from the SROC curve that panoramic radiography can be used for the identification of the anterior loops. Still, it is better to avoid it as an alternative to three-dimensional scans to determine the presence and extension of the anterior loop of the mental nerve because of the tendency toward low sensitivity and over or under-estimation of the length.


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  1. Bavitz JB, Harn SD, Hansen CA, et al. An anatomical study of mental neurovascular bundle-implant relationships. Int J Oral Maxillofac Implants 1993;8(5):563–567.
  2. Greenstein G, Tarnow D. The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review. J Periodontol 2006;77(12):1933–1943. DOI: 10.1902/jop.2006.060197.
  3. Yu SK, Kim S, Kang SG, et al. Morphological assessment of the anterior loop of the mandibular canal in Koreans. Anat Cell Biol 2015;48(1):75–80. DOI: 10.5115/acb.2015.48.1.75.
  4. Rosa MB, Sotto-Maior BS, Machado Vde C, et al. Retrospective study of the anterior loop of the inferior alveolar nerve and the incisive canal using cone beam computed tomography. Int J Oral Maxillofac Implants 2013;28(2):388–392. DOI: 10.11607/jomi.2648.
  5. Solar P, Ulm CH, Frey G, et al. A classification of the intra osseous paths of the mental nerve. Int J Oral Maxillofac Implants 1994;9:339–344.
  6. Apostolakis D, Brown JE. The anterior loop of the inferior alveolar nerve: prevalence, measurement of its length and a recommendation for interforaminal implant installation based on cone beam CT imaging. Clin Oral Implants Res 2012;23(9):1022–1030. DOI: 10.1111/j.1600-0501.2011.02261.x.
  7. Kaya Y, Sencimen M, Sahin S, et al. Retrospective radiographic evaluation of the anterior loop of the mental nerve: comparison between panoramic radiography and spiral computerized tomography. Int J Oral Maxillofac Implants 2008;23(5):919–925.
  8. McInnes MDF, Moher D, Thombs BD, et al. Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: the PRISMA-DTA statement. JAMA 2018;319(4):388–396. DOI: 10.1001/jama.2017.19163].
  9. Vujanovic-Eskenazi A, Valero-James JM, Sánchez-Garcés MA, et al. A retrospective radiographic evaluation of the anterior loop of the mental nerve: comparison between panoramic radiography and cone beam computerized tomography. Med Oral Patol Oral Cir Bucal 2015;20:e239–e245. DOI: 10.4317/medoral.20026.
  10. do Couto-Filho CE, de Moraes PH, Alonso MB, et al. Accuracy in the diagnosis of the mental nerve loop. A comparative study between panoramic radiography and cone beam computed tomography. Int J Morphol 2015;33(1):327–332. DOI: 10.4067/S0717-95022015000100051.
  11. de Brito ACR, Nejaim Y, de Freitas DQ, et al. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal. Imag Sci Dentis 2016;46(3):159–165. DOI: 10.5624/isd.2016.46.3.159.
  12. Kastala RK, David CM, Jayapal N. Momentousness of the mental loop: a comparative study. Contemp Clin Dent 2019;10(1):86–92. DOI: 10.4103/ccd.ccd_391_18.
  13. Whiting PF, Rutjes AWS, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 2011;155(8):529–536. DOI: 10.7326/0003-4819-155-8-201110180-00009.
  14. Zamora J, Abraira V, Muriel A, et al. Meta-DiSc: a software for meta-analysis of test accuracy data. BMC Med Res Methodol 2006;6(1):31. DOI: 10.1186/1471-2288-6-31.
  15. Zamora J, Muriel A, Abraira V, Meta-DiSc Statistical Methods. 2006 [ftp://ftp.hrc.es/pub/programas/metadisc/ MetaDisc_StatisticalMethods.pdf]..
  16. Wong SK, Patil PG. Measuring anterior loop length of the inferior alveolar nerve to estimate safe zone in implant planning: a CBCT study in a Malaysian population. J Prosthet Dent 2018;120(2):210–213. DOI: 10.1016/j.prosdent.2017.10.019.
  17. Neiva RF, Gapski R, Wang HL. Morphometric analysis of implant-related anatomy in Caucasian skulls. J Periodontol 2004;75(8):1061–1067. DOI: 10.1902/jop.2004.75.8.1061.
  18. Padmanabhan H, Kumar AV, Shivashankar K. Incidence of neurosensory disturbance in mandibular implant surgery – a meta-analysis. J Indian Prosthodont Soc 2020;20(1):17–26. DOI: 10.4103/jips.jips_373_19.
  19. Kheir MK, Sheikhi M. Assessment of the anterior loop of mental nerve in an Iranian population using cone beam computed tomography scan. Dent Res J 2017;14(6):418–422. DOI: 10.4103/1735-3327.218566.
  20. Bhargava A, Sehgal M, Gupta S, et al. Classification system on the selection of number of implants and superstructure design on the basis available vertical restorative space and interforaminal distance for implant supported mandibular overdenture. J Indian Prosthodont Soc 2016;16(2):131–135. DOI: 10.4103/0972-4052.176541.
  21. Pradeep Christopher J, Marimuthu T, Krithika C, et al. Prevalence and measurement of anterior loop of the mandibular canal using CBCT: a cross sectional study. Clin Implant Dent Relat Res 2018;20(4):531–534. DOI: 10.1111/cid.12609.
  22. Naitoh M, Nakahara K, Suenaga Y, et al. Comparison between cone beam and multislice computed tomography depicting mandibular neurovascular canal structures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109(1):e25–e31. DOI: 10.1016/j.tripleo.2009.08.027.
  23. Luangchana P, Pornprasertsuk-Damrongsri S, Kiattavorncharoen S, et al. Accuracy of linear measurements using cone beam computed tomography and panoramic radiography indental implant treatment planning. Int J Oral Maxillofac Implants 2015;30(6):1287–1294. DOI: 10.11607/jomi.4073.
  24. Santana RR, Lozada J, Kleinman A, et al. Accuracy of cone beam computerized tomography and a three-dimensional stereo lithographic model in identifying the anterior loop of the mental nerve: a study on cadavers. J Oral Implantol 2012;38(6):668–676. DOI: 10.1563/AAID-JOI-D-11-00130.
  25. Mardinger O, Chaushu G, Arensburg B, et al. Anterior loop of the mental canal: an anatomical-radiologic study. Implant Dent 2000;9(2):120–125. DOI: 10.1097/00008505-200009020-00003.
  26. Kuzmanovic DV, Payne AG, Kieser JA, et al. Anterior loop of the mental nerve: a morphological and radiographic study. Clin Oral Implants Res 2003;14(4):464–471. DOI: 10.1034/j.1600-0501.2003.00869.x.
  27. Honest H, Khan KS. Reporting of measures of accuracy in systematic reviews of diagnostic literature. BMC Health Serv Res 2002;2(1):4. DOI: 10.1186/1472-6963-2-4.
  28. Mishra SK, Nahar R, Gaddale R, et al. Identification of anterior loop in different populations to avoid nerve injury during surgical procedures-a systematic review and meta-analysis. Oral Maxillofac Surg 2021;25(2):159–174. DOI: 10.1007/s10006-020-00915-x.
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