Vol 78, No 1 (2019)
Original article
Published online: 2018-07-03

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Morphological variations of the mandibular canal in digital panoramic radiographs: a retrospective study in a Chilean population

R. Fuentes12, A. Arias123, C. Farfán4, N. Astete4, I. Garay1, P. Navarro2, F. J. Dias12
Pubmed: 30009366
Folia Morphol 2019;78(1):163-170.

Abstract

Background: Morphological variations of the mandibular canal (MC) have been described in literature, so the clinician must be able to recognise them and adapt their treatment accordingly. The aim of this study was to determine the prevalence of morphological variations of the MC using digital panoramic radiographs (DPR) of Chilean patients. 

Materials and methods: A retrospective study in which 1400 DPR were analysed to identify cases of bifid, trifid and retromolar MC. The radiographs were analysed independently by two examiners who had previously been trained by a specialist in oral and maxillofacial radiology. Inclusion and exclusion criteria were applied to reach a final sample. 

Results: Nine hundred and twenty-five radiographs were included (599 female, 326 male; mean age 36.1 ± 15.54 years). The prevalence of bifid MC was 11% (n = 102), with no significant differences by sex (p = 0.069). Proportion of bifid MC was higher among younger patients (p = 0.038). Prevalence of morphologi- cal variations of type 1 bifid MC was 7.4% (n = 69), type 2 was 2.3% (n = 23), type 3 was 0% (n = 0) and type 4 was 1.1% (n = 10). Prevalence of retromolar canal was 0.9% (n = 8), with no significant differences by sex (p = 0.893) or age (p = 0.371); of these, 2 (0.2%) cases were forward type and 6 (0.6%) cases were retromolar type. No cases of trifid MC were found. 

Conclusions: Digital panoramic radiographs are useful for detecting morphological variations of the MC; we were able to identify three types of bifid MC as well as retromolar canals. Proper identification of these variations by an easily accessible examination is important for avoiding possible complications in clinical-surgical practice. 

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References

  1. Aps JKM. Number of accessory or nutrient canals in the human mandible. Clin Oral Investig. 2014; 18(2): 671–676.
  2. Auluck A, Pai KM, Mupparapu M. Multiple mandibular nerve canals: radiographic observations and clinical relevance. Report of 6 cases. Quintessence Int. 2007; 38(9): 781–787.
  3. Capote TS, Gonçalves Md, Campos JÁ. Retromolar canal associated with age, side, sex, bifid mandibular canal, and accessory mental foramen in panoramic radiographs of Brazilians. Anat Res Int. 2015; 2015: 434083.
  4. Chávez-Lomeli ME, Mansilla Lory J, Pompa JA, et al. The human mandibular canal arises from three separate canals innervating different tooth groups. J Dent Res. 1996; 75(8): 1540–1544.
  5. Choi YY, Han SS. Double mandibular foramen leading to the accessory canal on the mandibular ramus. Surg Radiol Anat. 2014; 36(9): 851–855.
  6. de Souza Tolentino E, Silva PA, Pagin O, et al. Uncommon trajectory variations of the mandibular canal and of the mandibular incisive canal: case report. Surg Radiol Anat. 2013; 35(9): 857–861.
  7. Figún M, Garino R. Anatomía Odontológica Funcional y Aplicada. 2a ed. El Ateneo, Buenos Aires. 2001.
  8. Haas LF, Dutra K, Porporatti AL, et al. Anatomical variations of mandibular canal detected by panoramic radiography and CT: a systematic review and meta-analysis. Dentomaxillofac Radiol. 2016; 45(2): 20150310.
  9. Kalantar Motamedi MH, Navi F, Sarabi N. Bifid mandibular canals: prevalence and implications. J Oral Maxillofac Surg. 2015; 73(3): 387–390.
  10. Karamifar K, Shahidi S, Tondari A. Bilateral bifid mandibular canal: report of two cases. Indian J Dent Res. 2009; 20(2): 235–237.
  11. Kim MS, Yoon SJ, Park HW, et al. A false presence of bifid mandibular canals in panoramic radiographs. Dentomaxillofac Radiol. 2011; 40(7): 434–438.
  12. Kuczynski A, Kucharski W, Franco A, et al. Prevalence of bifid mandibular canals in panoramic radiographs: a maxillofacial surgical scope. Surg Radiol Anat. 2014; 36(9): 847–850.
  13. Miloglu O, Yilmaz AB, Caglayan F. Bilateral bifid mandibular canal: a case report. Med Oral Patol Oral Cir Bucal. 2009; 14(5): E244–E246.
  14. Mizbah K, Gerlach N, Maal TJ, et al. The clinical relevance of bifid and trifid mandibular canals. Oral Maxillofac Surg. 2012; 16(1): 147–151.
  15. Neves FS, Nascimento MC, Oliveira ML, et al. Comparative analysis of mandibular anatomical variations between panoramic radiography and cone beam computed tomography. Oral Maxillofac Surg. 2014; 18(4): 419–424.
  16. Nortjé CJ, Farman AG, Grotepass FW. Variations in the normal anatomy of the inferior dental (mandibular) canal: A retrospective study of panoramic radiographs from 3612 routine dental patients. Br J Oral Surg. 1977; 15(1): 55–63.
  17. Langlais RP, Broadus R, Glass BJ. Bifid mandibular canals in panoramic radiographs. J Am Dent Assoc. 1985; 110(6): 923–926.
  18. Latarjet M, Ruiz-Liard A. Anatomía Humana. 2a ed. Médica Panamericana, Buenos Aires. 2004.
  19. Leite GM, Lana JP, de Carvalho Machado V, et al. Anatomic variations and lesions of the mandibular canal detected by cone beam computed tomography. Surg Radiol Anat. 2014; 36(8): 795–804.
  20. Orhan K, Aksoy S, Bilecenoglu B, et al. Evaluation of bifid mandibular canals with cone-beam computed tomography in a Turkish adult population: a retrospective study. Surg Radiol Anat. 2011; 33(6): 501–507.
  21. Roa I, Arriagada O. Variaciones del Canal Mandibular con Importancia Clínica: Reporte de Caso. International Journal of Morphology. 2015; 33(3): 971–974.
  22. Sanchis JM, Peñarrocha M, Soler F. Bifid mandibular canal. J Oral Maxillofac Surg. 2003; 61(4): 422–424.
  23. Galdames IS, Matamala DZ, López MC. Canal mandibular accesorio: análisis de su prevalencia y aspecto imagenológico. Av Odontoestomatol. 2011; 27(2): 85–90.
  24. Wadhwani P, Mathur RM, Kohli M, et al. Mandibular canal variant: a case report. J Oral Pathol Med. 2008; 37(2): 122–124.