On the need to develop a topographic classification of the mandibular canal in toothless patients for practical use by dentists

Abstract

Introduction. During the clinical analysis of topographic and anatomical features of the mandibular canal, practicing dentists often encounter specific difficulties, even if it is possible to use the CT method in their work. When teeth are lost, the neurovascular roots of the same name also undergo pathological changes with reflection on the central neurovascular bundle, which lies in the mandibular canal, which should provide nutrition and innervation of its toothless segments and is a frequent ethiopathogenic factor of irreversible bone atrophy. Under these conditions, it is pretty challenging to differentiate structural anatomical formations (artery, vein, nerve), and to identify the morphological structure of the neurovascular bundle through its degeneration due to tooth loss and "twisting" due to atrophic processes of bone tissue. At the same time, the use of Hounsfield units (Hu) or conventional international grayness units (CIGU) in the analysis of computer tomograms of the patient's lower jaw, despite the availability of these methods for determining the density of hard, soft, and connective tissues, does not remove the relevance of significant discussions among scientists regarding their evidence.