Characteristics and Prevalence of Anterior Buccal Mandibular Depression Area in Cone Beam Computed Tomography Images

Summary Background/Aim: The purpose of this study was to assess the anterior buccal mandibular depressions (ABMD) prevalence and clinical characteristics at cone beam computed tomography images (CBCT). Material and Methods: 198 CBCT images with minimal depression between the mandibular molars were evaluated retrospectively. Presence and location of ABMD, its maximum depth, maximum width, cortical width, if any, alveolar crest width at maximum depth, the distance between maximum depth and alveolar crest apex and existing teeth in the relevant region were examined in cross-sectional views. Panoramic radiography of ABMD patients was evaluated for trabecular pattern and radiopacity to determine the area of interest. The possible lingual depression area on the maximum depth of ABMD slice was investigated and the same measurements for ABMD was performed. The presence of aperture / foramen in the ABMD area was also investigated. Results: The prevalence of ABMD was found as 43.43% where 82 cases were at bilateral side and 4 cases were only at left side. Lingual depression was observed in 20.7% right side and 30.2% left side of the ABMD cases. There was no statistically significant difference for maximum depth between different age groups. Most frequent location was observed in lateral and canine region (27.4%) followed by lateral-first premolar area (25.6%). Least frequent location was at canine-second premolar area (1.2%). Conclusions: ABMD is a lesser known area with a high prevalence observed on CBCT images. The detectability of the area on panoramic radiographs is limited. Clinicians should take into consideration ABMDs’ characteristics to avoid confusion with periapical pathologies. Failure to detect these areas before implant surgeries may cause complications. For this reason, it is important to be examined in detail for ABMD before surgery.