Alveolar Nerve Unfolding Technique for Synoptic Analysis: Visualization and Quantification of Inferior Alveolar Nerve Tracings in Three-dimensional Cone-Beam Computed Tomography

Abstract

The aim of the technique presented here is to visualize the anatomical context of the inferior alveolar nerve (IAN) canal. For 2 cases, cone-beam computed tomography images of the mandible were obtained from patient files together with the manual preoperative IAN canal tracings. For both cases, similar to simulated panoramic images, a two-dimensional image is extracted from a three-dimensional cone-beam computed tomography image. Unlike panoramic images, the unfolding does not follow the general curvature of the mandible but follows the nerve tracing closely and places the traced nerve track on a horizontal central line. Because of the centering of the nerve tracing together with the nerve canal and its surroundings in a two-dimensional representation, the technique (ANUTSA [Alveolar Nerve Unfolding Technique for Synoptic Analysis]) allowed the first case to evidence the adjacency of root tips along the IAN, whereas in the second case the degree of penetration of the IAN by an implant is revealed. The global aspect of the representation through unfolding allowed for the detection of the anomalies and the IAN-penetrating lesion along the IAN canal at a glance.