Assessment of Mandibular Canal Using Cone-Beam Computed Tomography (CBCT) and Its Relevance in Post-Operative Neurosensory Disturbances Following Bilateral Sagittal Split Osteotomy Setback

Aim: Damage to the inferior alveolar nerve (IAN) during bilateral sagittal split osteotomy (BSSO) causes neurosensory disturbances (NSD) of the lower lip and chin. The study aims to investigate the pre-operative position and course of the mandibular canal using cone-beam computed tomography (CBCT) and orthopantomogram (OPG) and compare if there is any difference in NSD following the BSSO setback procedure. Materials and methods: This is an observational study. This study was conducted in the Department of Oral and Maxillofacial Surgery, Mar Baselios Dental College, Kothamangalam, from November 2017 to October 2019. Thirty patients undergoing BSSO setbacks are selected based on the inclusion and exclusion criteria and randomly grouped into two groups - group A (15) and study group B (15). OPG was done for both groups as it was required during surgical orthodontic evaluation and preoperative assessment of the mandibular canal was done using CBCT in group B. Neurosensory assessment was done in all the patients and compared the results. Results: NSD were reported in all the patients on the first postoperative day. The correlation between subjective and objective evaluation showed absolute coincidence but nearly all the patients returned to their presurgical situation within six months in group B and one year in group A who had NSD problems. Conclusion: From the study, it can be concluded that a CBCT scan is a useful and reliable modality in the pre-operative evaluation of the mandibular canal in patients undergoing BSSO setback procedures, which helps to improve the patient’s post-operative care and quality of life.