Assessment of the configuration of the mandibular canal using cone beam computed tomography

During dental implants placement and bone augmentation procedures, it is important to determine the presence and location of mandibular canal anatomical variation in order to avoid injuries to inferior alveolar bundle. This study aimed to describe the prevalence and configuration of mandibular canal branching in the posterior region of the mandible using cone beam computed tomography (CBCT).

The interpretation of the images was conducted according to the presence, classification and location of the mandibular canal. Horizontal and vertical distances from mandibular canal in the ramus region to the molar region was recorded. CBCT images of 751 patients, 486 women (64.7%) and 265 men (35.3%), with a mean age of 54.57 (±13.23; 14-93) years, were interpreted by one calibrated examiner.

Out of 1502 hemi-mandibles images, mandibular canal variations were observed in 130 (8.6%). Sixty-four (49.2%) mandibular canal variations were identified on the right side and 66 (50.8%) on the left side. The mean distances between superior cortical of the mandibular canal and the base of mandible, buccal cortical of mandibular canal and buccal cortical bone, and superior cortical of mandibular canal and alveolar ridge were 12.16 mm (±2.68), 4.17 mm (±1.30), and 12.97mm (±4.01), respectively. Type I mandibular canal variation was the most frequent (68; 52.2%), followed by type III (34; 26.1%).

Prevalence of mandibular canal variations was 8.6%, type I was the most common and its direction showed proximity with lingual surface in the second molar region.