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Prevalence and morphology of lingual canals in mandibular incisors: a cone-beam computed tomography-based
Cicero Lucas Gomes Ramalho1, Eliane Maria Gonçalves Moreira de Vasconcelos1, Victor Archeti Vardiero2
1Dentistry, University Center of the Hermínio Ometto Foundation-FHO, Araras, São Paulo, Brazil.
Background:
Accurate identification of root canal anatomy is essential for endodontic success, particularly in mandibular incisors, where additional canals such as the lingual canal are frequently missed using conventional diagnostic methods. In this context, cone-beam computed tomography (CBCT) has emerged as a valuable tool for detecting complex anatomical variations. Therefore, this study evaluated the prevalence, distribution, and spatial characteristics of the lingual canal using CBCT, as well as its association with demographic factors.
Methods:
This observational, cross-sectional, retrospective study included CBCT scans from 342 patients (1,368 mandibular incisors). Images were acquired using standardized parameters (field of view: 10 × 5 cm; voxel size/slice thickness: 0.5 mm; interval: 1/1) and analyzed by a single previously trained examiner. Intra-rater reliability was assessed using test-retest analysis in 30% of the sample, demonstrating excellent agreement (ICC = 0.95). Associations between the presence of the lingual canal and demographic variables were evaluated using chi-square tests and odds ratios, while spatial characteristics were assessed using multivariate analysis of variance (MANOVA), adopting a significance level of p < 0.05.
Results:
The overall prevalence of the lingual canal was 8.84%. It was significantly more frequent in males than females (p < 0.05) and was associated with age, with higher occurrence in individuals aged 40-59 years (p < 0.01). A higher prevalence was observed on the right side, and the predominant canal configuration was straight. Multivariate analysis showed no significant effect of sex, canal position, or their interaction on the combined spatial variables (distance and angle) (p > 0.05). Therefore, the lingual canal is a relatively frequent anatomical variation, more prevalent in males, middle-aged individuals, and on the right side. These findings highlight the importance of careful anatomical assessment to improve endodontic outcomes.