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      Prevalence of bifid mandibular canal according to gender, type and side

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          Abstract

          Background/purpose

          An awareness of mandibular canal variations may help prevent complications due to nerve damage that can occur during surgery. The aim of this study is to evaluate the variations of mandibular canal distribution and frequency via cone beam computed tomography (CBCT), retrospectively, in a Turkish population.

          Materials and methods

          The study population comprises 500 (250 female, 250 male) randomly selected participants between the ages of 14 and 79 years. The study was conducted in Marmara University, Faculty of Dentistry, in the Department of Dentomaxillofacial Radiology. The distribution and frequency of mandibular canal variations were evaluated using the Naitoh classification, which includes retromolar canal, forward canal, dental canal, and buccolingual canal. The trifid canal was also included in this study. The data were analysed using IBM SPSS statistics 20.0. The data were then compared based on age group and gender.

          Results

          Bifid mandibular canals (BMCs) were found in 200 (40%) of the 500 subjects, and in 248 of the 1000 sides (24.8%). Mandibular canal variations were observed in 71.5% of patients on the right side, 52.5% on left side and 24% bilaterally. The forward canal was the most common type (48.8%), followed by the retromolar canal (26.2%), the dental canal (12.9%), the buccolingual canal (9.7%), and the trifid canal (2.4%).

          Conclusion

          BMCs were detected at a high rate in the Turkish subpopulation. Moreover, CBCT appears to be an appropriate method to assess the entity and shape of BMCs.

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          Most cited references34

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          What is cone-beam CT and how does it work?

          William C Scarfe, Allan G Farman (2008)
          This article on x-ray cone-beam CT (CBCT) acquisition provides an overview of the fundamental principles of operation of this technology and the influence of geometric and software parameters on image quality and patient radiation dose. Advantages of the CBCT system and a summary of the uses and limitations of the images produced are discussed. All current generations of CBCT systems provide useful diagnostic images. Future enhancements most likely will be directed toward reducing scan time; providing multimodal imaging; improving image fidelity, including soft tissue contrast; and incorporating task-specific protocols to minimize patient dose.
          Article 0 comments Cited 206 times – based on 0 reviews     Review now
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            Assessment of variations of the mandibular canal through cone beam computed tomography.

            Christiano de Oliveira Santos, Paulo Souza, Soraya de Azambuja Berti-Couto … (2012)
            The neurovascular bundle may be vulnerable during surgical procedures involving the mandible, especially when anatomical variations are present. Increased demand of implant surgeries, wider availability of three-dimensional exams, and lack of clear definitions in the literature indicate that features of anatomical variations should be revisited. The objective of the study was to evaluate features of anatomical variations related to mandibular canal (MC), such as bifid canals, anterior loop of mental nerve, and corticalization of MC. Additionally, bone trabeculation at the submandibular gland fossa region (SGF) was assessed and related to visibility of MC. Cone beam computed tomography exams from 100 patients (200 hemimandibles) were analyzed and the following parameters were registered: diameter and corticalization of MC; trabeculation in SGF region; presence of bifid MC, position of bifurcations, diameter, and direction of bifid canals; and measurement of anterior loops by two methods. Corticalization of the MC was observed in 59% of hemimandibles. In 23%, MC could be identified despite absence of corticalization. Diameter of MC was between 2.1 and 4 mm for nearly three quarters of the sample. In 80% of the sample trabeculation at the SGF was either decreased or not visible, and such cases showed correlation with absence of MC corticalization. Bifid MC affected 19% of the patients, mostly associated with additional mental foramina. Clinically significant anterior loop (>2 mm of anterior extension) was observed in 22-28%, depending on the method. Our findings, together with previously reported limitations of conventional exams, draw attention to the unpredictability related to anatomical variations in neurovascularization, showing the contribution of individual assessment through different views of three-dimensional imaging prior to surgical procedures in the mandible.
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              Augmentation of the sinus floor with mandibular bone block and simultaneous implantation: a 6-year clinical investigation.

              F. Khoury (1999)
              Between 1991 and 1995, 216 sinus-lift procedures were accomplished as part of a clinical study. The study involved placing 467 implants in the atrophic posterior maxillae of 142 female and 74 male patients. The initial bone height at the implant site was between 1 and 5 mm. The implants were supported subantrally with bone block grafts harvested from the retromolar or symphysis areas of the mandible. Perforations of the maxillary sinus membrane were observed in 51 patients; these were repaired with fibrin adhesive. The spaces remaining above the bone graft were filled with various materials. A total of 28 implants failed. All the remaining implants were deemed successfully osseointegrated, based on radiographic and clinical (including periodontal health) criteria. No patients experienced maxillary sinus complications. Clinically and radiographically, the best bone regeneration was observed in those patients in whom the surgically created space was completely grafted with autogenous bone that included a high percentage of resorption-resistant cortical bone. In those patients having bone grafts harvested from the mandibular symphysis, none of their facial profiles were adversely affected; however, some patients experienced neurosensory deficits involving the mandibular anterior incisors and adjacent alveolar mucosa. Occasionally, these symptoms persisted for up to 1 year following the procedure.
              Article 0 comments Cited 33 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Asım Dumlu
                Journal
                Journal ID (nlm-ta): J Dent Sci
                Journal ID (iso-abbrev): J Dent Sci
                Title: Journal of Dental Sciences
                Publisher: Association for Dental Sciences of the Republic of China
                ISSN (Print): 1991-7902
                ISSN (Electronic): 2213-8862
                Publication date PMC-release: 11 April 2019
                Publication date (Print): June 2019
                Publication date (Electronic): 11 April 2019
                Volume: 14
                Issue: 2
                Pages: 126-133
                Affiliations
                [a ]Department of Dentomaxillofacial Radiology, Altınbas University, Faculty of Dentistry, Istanbul, Turkey
                [b ]Department of Dentomaxillofacial Radiology, Marmara University, Faculty of Dentistry, Istanbul, Turkey
                Author notes
                [∗ ]Corresponding author. Marmara University, Faculty of Dentistry, Department of Oral and Dentomaxillofacial Radiology, Marmara Üniversitesi Başıbüyük Sağlık Yerleşkesi, Başıbüyük Yolu 9/3, Maltepe, Istanbul, 34854, Turkey. Fax: +90 216 421 02 91. asimdumlu@ 123456gmail.com
                Article
                Publisher ID: S1991-7902(19)30234-X
                DOI: 10.1016/j.jds.2019.03.009
                PMC ID: 6562102
                PubMed ID: 31210887
                SO-VID: 5a2ffc12-1bcc-43b7-8e0d-5c18f3ee3591
                Copyright © © 2019 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 7 March 2019
                Date revision received : 14 March 2019
                Categories
                Subject: Original Article

                Keywords: anatomical variation,bifid canal,cone beam computed tomography,mandibular canal,trifid canal
                Data availability:
                Keywords: anatomical variation, bifid canal, cone beam computed tomography, mandibular canal, trifid canal

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