Introduction: In the field of implant dentistry, cone beam computed tomography can give clinicians valuable information regarding anatomic structures, bone quantity and quality. If the mandibular nerve is encroached during surgery, severe morbidity of the patient and medico-legal issues may result. Thus the importance of accurate determination of the position of mandibular canal cannot be overemphasized. Purpose: The aim of this study is to evaluate the difference in the position of the mandibular nerve determined, and marked by a radiology technician utilizing nerve marking tool and compared to the same measurement by a clinician not utilizing a nerve marking tool. Materials and Methods: With ninety six consecutive CT scans taken by CB MercuRay for dental implants, the location of the nerve canal was marked with a nerve marking tool by both an experienced and inexperienced radiology technician each using the Simplant program from Materialise. The marked coronal image was printed on paper along with unmarked axial image, the distance between the film frame reference line to the superior border of canal and between the film frame reference line to the inferior border of the mandible was measured in all marked and unmarked printed images and the distance between the superior border of the canal to the inferior border of the canal in unmarked prints was also measured by one experienced surgeon. Results: The distance from the inferior border of mandibular canal to the inferior border of the mandible is 7.1 ± 1.8 mm, for the ES, 8.0 ± 2.1 mm, for the ERT, and 8.0 ± 2.2 mm for the IRT. There were no significant differences between these means ± SD. The measurement of the distance from the superior border of mandibular canal to the inferior border of the mandible is 14.2 ± 2.1 mm for ES, 11.0 ± 2.1 mm for the ERT, and 11.0 ± 2.2 mm for the IRT. The comparison of ERT to IRT would prove insignificant; however, the contrast between the ES versus the ERT, as well as, ES versus the IRT would prove highly significant (p< 0.001). Conclusion: There are differences between the position of the superior border of the mandibular canal determined by an experienced surgeon without utilizing a nerve marking tool and by radiology technician who utilized a nerve marking tool. Implant surgeons should interpret with caution the determined position of the mandibular canal with nerve marking tool performed by a radiology technician, and should always consider anatomic variation of the nerve. Key Words: Cone beam Computed Tomography, Inferior Alveolar Canal, Inferior Nerve, Nerve Marking Tool, Axial view categories.

LLU Discipline





School of Dentistry

First Advisor

Henkin, Jeffrey

Second Advisor

Caruso, Joseph M.

Third Advisor

Gantes, Bernard

Fourth Advisor

Kim, Yoon Jeong

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded

January 2012

Date (Title Page)




Library of Congress/MESH Subject Headings


Subject - Local

Mandibular Nerve; Nerve Marking Tools; Cone beam Computed Tomography; Inferior Alveolar Canal; Inferior Nerve; Axial View Categories; Implant Dentistry



Page Count

28 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses & Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives