Abstract

Along with the popularization of dental implant surgery, there has been considerable research on the lingual foramen using cone-beam computed tomography. Anatomical research has also revealed that the arteries entering the lingual foramina are branches of the submental and sublingual arteries. There have been no reports, however, of the submental or sublingual artery entering the mandible from the lingual foramen, perforating it, and then distributing to the inferior labial region. A 69-year-old man who donated his body to our department in 2015 was dissected. The mandible with overlying soft tissue of the mental region was resected and examined with microcomputed tomography, which showed that the canal perforated from the lingual foramen to the midline of the labial cortical plate. The canal was thus named the median perforating canal. To the best of our knowledge, there have been no other reports of a perforating artery of the mandible, so this case is thought to be rare. Hence, the existence of perforating arteries, such as in the present case, should be taken into consideration in preoperative diagnoses such as for dental implant surgery. Thus, the fusion of anatomical and radiological study is useful and necessary to understand surgical anatomy.

Highlights

  • The development of cone-beam computed tomography (CBCT) has contributed to finding many kinds of accessory foramina of the mandibular bone

  • Both the course of the artery before entering the mandible from the lingual foramen and the branches of the submental artery around the mental region have been studied in detail by gross anatomical dissection [1, 3]

  • median perforating artery (MPA) Vertical branch Other artery (a) that, in the frontal and posterior views, the labial and lingual accessory foramina were located near the inferior border of the mandible in the midline (Figures 1(c) and 1(d))

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Summary

Introduction

The development of cone-beam computed tomography (CBCT) has contributed to finding many kinds of accessory foramina of the mandibular bone. The course of the artery outside the mandible, cannot be visualized by CBCT, and thoughtless handling in the soft tissue near the foramina has a risk of damaging arteries. Both the course of the artery before entering the mandible from the lingual foramen and the branches of the submental artery around the mental region have been studied in detail by gross anatomical dissection [1, 3]. We report a case of a perforating canal of the mandible, with an artery passing through the canal and distributing to the inferior labial region, which we confirmed anatomically and radiologically. This study was performed in keeping with the requirements of the Declaration of Helsinki (64th World Medical Assembly, Fortaleza, Brazil, October 2013)

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