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Abstract The aim of this study was to use of cone beam computed tomography (CBCT) in analysis of mandibular posterior area before endodontic surgery. One hundred and seventy CBCT scans were used to evaluate the measurements. Bone and root thickness were measured at the preferred resection site (3 mm). Also, mandibular canal and mental foramen location, superior-inferior dimension and bucco-lingual dimension of mandibular canal, proximity of mandibular canal to teeth apices, and the possible differences between males and females were measured The results showed that; the buccal bone was thickest over the distal root of second molar with an average (6.94 mm) and it was the thinnest over the first premolar with an average (1.57). It also found that the largest root thickness was the mesial root of first molar with an average (5.23 mm) and second premolar was the smallest with an average (3.69 mm). When combining the buccal bone thickness and root thickness, it reflects the total area that should be removed during apicectomy and it was the largest related to the mesial and distal roots of second molar and the smallest in relation to first premolar. Lingual bone thickness was thinnest in relation to mesial and distal roots of second molar, while it was thickest over the first premolar. Summary and Conclusions 67 Mandibular canal was closely related to distal root of second molar and it was the farthest from the mesial root of first molar. Also it was directed buccal to roots of second molar then lingual to mesial and distal roots of first molar in the majority of cases and finally it moves toward the buccal aspect of the mandible, where it finally emerges through the mental foramen. Mental foramen was located between first and second premolars in most of cases followed by the location inferior to second premolar. Conclusions This study is to provide normative information to describe the anatomic dimensions and relations in the posterior mandible in an Egyptian population. This Knowledge is essential for planning surgical and non-surgical endodontic treatment. As the teeth become more posterior, the buccal bone thickness increased and the mandibular canal becomes closer to the root apices. This complicates the surgical access to mesial and distal roots of second molar and distal root of first molar. CBCT is credible and precise to provide information about the surgical site and help the operator in pre-operative treatment planning for endodontic surgery. Summary and Conclusions 68 Recommendations To minimize sequelae of excessive buccal bone removal in the mandibular second molar region, other surgical techniques such as intentional replantation or the bony lid technique should be considered. Future studies should assess the role of dynamic navigation in protecting neurovascular structures during endodontic micro-surgery in the posterior mandible. |