Purpose: We determined actual bucco-lingual angulation values and morphological variations of residual bone in the mandibular posterior edentulous region using cone-beam computed tomography (CBCT) and panoramic radiography. A second aim was to investigate whether it was possible to predict bone morphology from panoramic radiographs.
Methods: Data were collected from 77 consecutive patients referred for both CBCT and panoramic radiography in our department. Two-dimensional and three-dimensional images of the probable implant placement region were investigated. The bucco-lingual angulation values and crest type were determined directly from the cross-sectional images of the posterior edentulous region. The edentulous region was divided into three groups: second premolar, first molar, or second molar region. The observations were evaluated by the computer software, SPSS 22.0 (SPSS Inc. Chicago, USA). The crest type was classified into three groups: type U, type C, or type P. Kappa statistics, Kolmogorov-Smirnov tests, ANOVA, and Kruskal-Wallis tests were used in statistical analyses. The significance level was set at p < 0.05.
Results: Type C was more frequent in the second premolar region and the crest type had changed to type U in the second molar region. The predictability of the type U was highest in the second molar region. Moderate agreement was found in the predictability of type U in the molars (κ = 0.602). The mean value of bucco-lingual angulation was highest in the second molar region, followed by the first molar region. There were statistically significant differences between the bucco-lingual angulation of the crest types in the second premolar and first molar regions (p < 0.05).
Conclusions: Bucco-lingual angulation values and morphology change through the posterior mandible. Type U was predicted at a higher rate in the second molar region from panoramic radiographs. These results demonstrate predicting high-risk areas in the posterior mandible for implant therapy from panoramic radiography.
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