Three-dimensional assessment of the mandibular lingual foramina with implications for surgical and implant therapy: A multicentre cross-sectional study

Treatment planning for dental implants in the anterior mandible is often complicated by the presence of vascular structures. The aim of our study was to investigate the prevalence, location and morphology of the mandibular lingual foramen (LF) through cone beam computed tomography (CBCT) scans and contribute to its anatomical knowledge in an Indian population. A total of 400 mandibular anterior CBCT scans from 4 centers were included in this retrospective analysis. The vertical distance from alveolar crest (H_cre) and inferior border of mandible (H_inf) to the LF, horizontal distance from lingual canal to labial cortical plate (LC-CP), length of the lingual canal (LLC) and diameter of the LF were measured. Data was analysed using Wilcoxon signed rank test and compared between median and lateral LF. 14 (3.5%) scans were excluded due to non-visualization of LF. A lateral LF was detected in 149 scans (38.6%), predominantly in the canine region (61.7%). H_cre was significantly higher for median LF (16.35 ± 4.59 mm) than lateral LF (12.94 ± 3.92 mm) (p < 0.001), while H_inf did not show significant difference between median (11.38 ± 3.62 mm) and lateral (12.94 ± 3.92 mm) LF (p = 0.0032). The LC-CP, LLC and diameter of LF averaged at 5.05 ± 1.76 mm, 6.26 ± 1.82 mm and 0.88 ± 0.72 mm respectively. The LF can be visualized in CBCT scans with a prevalence of 96.5%. This study stresses on the need for a CBCT, prior to surgeries in anterior mandible to avoid excessive bleeding episodes.