open access

Ahead of Print
Case report
Published online: 2020-05-25
Submitted: 2020-05-07
Accepted: 2020-05-17
Get Citation

Unilateral triple mandibular canal with double mandibular foramen: cone beam computed tomography findings of an unexpected anatomical variant

A. Borghesi, M. P. Bondioni
DOI: 10.5603/FM.a2020.0057
·
Pubmed: 32459362

open access

Ahead of Print
CASE REPORTS
Published online: 2020-05-25
Submitted: 2020-05-07
Accepted: 2020-05-17

Abstract

The mandibular canal is a bony channel located within the spongiosa of the mandible. The main structure contained in the mandibular canal is the inferior alveolar nerve (IAN). The IAN is a very important structure that requires due consideration during dental or surgical procedures involving the mandible. Therefore, a detailed morphological analysis of the mandibular canal should be carried out before any surgical procedure in the mandibular region in order to avoid complications and to reduce the risk of inadequate local nerve blocking. The human mandible typically has a single mandibular canal on each side; however, accessory mandibular canals have been described previously in the literature. The most common variant of the mandibular canal is the bifid mandibular canal, which has a prevalence ranging from 10-66% on cone-beam computed tomography (CBCT) examinations. A rare variant of bifid mandibular canal is the trifid canal, accounting for less than 6% of all bifid canals. In some cases, the bifid and trifid mandibular canals are associated with a double mandibular foramen, which is a rare anatomical variant with a reported incidence of 1.35% on CBCT images. Herein, we present the interesting CBCT images of an unexpected anatomical variant characterized by unilateral triple mandibular canal with double mandibular foramen in a young Caucasian woman.

Abstract

The mandibular canal is a bony channel located within the spongiosa of the mandible. The main structure contained in the mandibular canal is the inferior alveolar nerve (IAN). The IAN is a very important structure that requires due consideration during dental or surgical procedures involving the mandible. Therefore, a detailed morphological analysis of the mandibular canal should be carried out before any surgical procedure in the mandibular region in order to avoid complications and to reduce the risk of inadequate local nerve blocking. The human mandible typically has a single mandibular canal on each side; however, accessory mandibular canals have been described previously in the literature. The most common variant of the mandibular canal is the bifid mandibular canal, which has a prevalence ranging from 10-66% on cone-beam computed tomography (CBCT) examinations. A rare variant of bifid mandibular canal is the trifid canal, accounting for less than 6% of all bifid canals. In some cases, the bifid and trifid mandibular canals are associated with a double mandibular foramen, which is a rare anatomical variant with a reported incidence of 1.35% on CBCT images. Herein, we present the interesting CBCT images of an unexpected anatomical variant characterized by unilateral triple mandibular canal with double mandibular foramen in a young Caucasian woman.

Get Citation

Keywords

mandibular canal, anatomic variation, accessory mandibular canal, accessory mandibular foramen, mandible, cone beam computed tomography

About this article
Title

Unilateral triple mandibular canal with double mandibular foramen: cone beam computed tomography findings of an unexpected anatomical variant

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Case report

Published online

2020-05-25

DOI

10.5603/FM.a2020.0057

Pubmed

32459362

Keywords

mandibular canal
anatomic variation
accessory mandibular canal
accessory mandibular foramen
mandible
cone beam computed tomography

Authors

A. Borghesi
M. P. Bondioni

References (15)
  1. Borghesi A, Pezzotti S, Nocivelli G, et al. Five mental foramina in the same mandible: CBCT findings of an unusual anatomical variant. Surg Radiol Anat. 2018; 40(6): 635–640.
  2. Castro MA, Lagravere-Vich MO, Amaral TM, et al. Classifications of mandibular canal branching: A review of literature. World J Radiol. 2015; 7(12): 531–537.
  3. 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.
  4. Choi YY, Han SS. Double mandibular foramen leading to the accessory canal on the mandibular ramus. Surg Radiol Anat. 2014; 36(9): 851–855.
  5. 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.
  6. Fuentes R, Arias A, Farfán C, et al. Morphological variations of the mandibular canal in digital panoramic radiographs: a retrospective study in a Chilean population. Folia Morphol. 2019; 78(1): 163–170.
  7. Kawai T, Sato I, Asaumi R, et al. Cone-beam computed tomography and anatomical observations of normal variants in the mandible: variant dentists should recognize. Oral Radiol. 2018; 34(3): 189–198.
  8. Kqiku L, Weiglein AH, Pertl C, et al. Histology and intramandibular course of the inferior alveolar nerve. Clin Oral Investig. 2011; 15(6): 1013–1016.
  9. 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.
  10. Muinelo-Lorenzo J, Suárez-Quintanilla JA, Fernández-Alonso A, et al. Descriptive study of the bifid mandibular canals and retromolar foramina: cone beam CT vs panoramic radiography. Dentomaxillofac Radiol. 2014; 43(5): 20140090.
  11. Ngeow WC, Chai WL, Ngeow WC, et al. The clinical anatomy of accessory mandibular canal in dentistry. Clin Anat. 2020; 33(8): 1214–1227.
  12. Rashsuren O, Choi JW, Han WJ, et al. Assessment of bifid and trifid mandibular canals using cone-beam computed tomography. Imaging Sci Dent. 2014; 44(3): 229–236.
  13. Rodella LF, Buffoli B, Labanca M, et al. A review of the mandibular and maxillary nerve supplies and their clinical relevance. Arch Oral Biol. 2012; 57(4): 323–334.
  14. Yang X, Lyu C, Zou D. Bifid mandibular canals incidence and anatomical variations in the population of Shanghai area by cone beam computed tomography. J Comput Assist Tomogr. 2017; 41(4): 535–540.
  15. Zhang YQ, Zhao YN, Liu DG, et al. Bifid variations of the mandibular canal: cone beam computed tomography evaluation of 1000 Northern Chinese patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018; 126(5): e271–e278.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By  "Via Medica sp. z o.o." sp.k., Świętokrzyska 73, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl