Custom Focal Trough In Cone-Beam Computed Tomography Reformatted Panoramic Versus Digital Panoramic For Mental Foramen Position To Aid Implant Planning

Objectives: To compare the linear measurements from digital panoramic (DP) radiographs and cone-beam computed tomography (CBCT) volumes for the localization of the mental foramen (MF).Material and Methods: Thirty-one patients with panoramic and CBCT radiographs depicted on the same machine were analyzed. The vertical and horizontal positions of the MF were compared by the differences in distances measured from reference points to the boundaries (tangents) of the MF in digital panoramic (DP) and CBCT reformatted panoramic (CRP) views. The vertical position of MF was also analyzed on CBCT oblique coronal views (CORO) and compared with its corresponding distances on DP and CRP views.Results: Statistically significant differences (P < 0.05) were found in all compared measurements between CRP and DP views. In addition, the vertical distance (Y1) compared between DP, CRP, and CORO views also showed a statistically significant measurement discrepancy in the mean distance (P < 0.000) with the highest mean difference of 1.59 mm (P < 0.05) was attained from Y1 (DP-CORO). Inter- and intra-examiner analysis indicated a high level of agreement for all measurements.Conclusion: The mean values of discrepancies in measurements between DP and CRP views for horizontal and vertical linear measurements were clinically tolerable. Nevertheless, significant differences in the vertical MF position were detected between the panoramic views (DP, CRP) and the coronal views (CORO). This implies that the use of coronal view measurements during implant planning might reduce the risk of neurovascular injuries.