Diagnostic value of routine dental radiographs for predicting the inferior alveolar nerve localization validated by CBCT measurements.

Abstract Purpose To test the hypothesis that routine dental radiographs can be used to draw conclusions regarding inferior alveolar nerve (IAN) localization. Methods A total of 108 radiographs (36 orthopantomograms [OPTs], 36 lateral cephalograms [LCs], and 36 cone-beam computed tomograms [CBCTs]) of 36 patients were analyzed. Cephalometric parameters obtained through OPTs and LCs were correlated with CBCT scans for predictability of IAN localization. Results The IAN ran along the lingual half (n = 24) twice as often as in the buccal half (n = 12) in population of the study. The position was always symmetrical contralaterally. No sex-specific correlations were observed (p = 0.34). Lingual nerve courses correlated with enlarged and buccal courses with reduced jaw angles (p = 0.003 / p = 0.010). An increased jaw angle was significantly correlated with a more cranial nerve position; a deep and distal bite position was significantly correlated with a caudal and buccal nerve position (p = 0.020). Moreover, an increase of 1 point in the Hasund score predicted an increased probability of a buccal nerve position by 18.6%. The jaw angle analyzed in OPT, and LC images were positively correlated (r = 0.89, p < 0.001). Conclusions Routine dental radiographs provide meaningful conclusions about IAN localization in the vertical and transverse dimension prior CBCT scans. This finding could be used during the initial consultation and treatment planning to weigh more invasive diagnostic methods further down the line.