The spatial location of the mandibular canal in Chinese: a CT study

The inferior alveolar nerve (IAN) is vulnerable to injury from mandible fractures and surgical procedures so anatomical variations of IAN are important. Postoperative sensory alteration of the lip and chin region is high after mandibular orthognathic surgery. The incidence of IAN paresthesia following sagittal split ramus osteotomy (SSRO) ranges from 54% to 86% at 4-8 days, 41 to 75% at 1 month, 33 to 66% at 3 months, 17 to 58% at 6 months and 15 to 33% at 1 year postoperatively. This study determined the anatomical position of the mandibular canal in relation to cortical bone and molar teeth in Chinese using archived CT records. The mandibular canal was the farthest from the buccal cortex at the second molar region (mean 6.79mm; minimum distance 4.80mm). The anatomical location of the mandibular canal in local Chinese compares with studies on Asian cadavers. The mandible body was thickest in the region of the second molar (11.9mm). The vertical buccal cut for SSRO should be in the region of the mandibular second molar where the bone is thickest and the mandibular canal is furthest from the buccal cortex. The safe depth for the vertical buccal cut is 4.8mm (minimum horizontal distance).