Anatomical configuration of the inferior alveolar neurovascular bundle: a histomorphometric analysis.

Abstract

The inferior alveolar neurovascular bundle (NVB) is important in implant placement and many other surgeries in dentistry because it is a major supplier of sensation and blood to the mandible via the mandibular canal. The purposes of the present study were to determine the areas and diameters of the NVB, the inferior alveolar nerve (IAN), and the inferior alveolar artery (IAA), and to verify the buccolingual location of the mandibular canal. The anatomical configuration of the NVB was examined by histomorphometrically analyzing 20 embalmed dentulous hemimandibles. The areas and maximum horizontal and vertical diameters of the NVB, IAN, and IAA were measured according to tooth region. The distances from the internal border of the mandibular canal to the outer surface of the buccal and lingual cortical plates were also measured. The areas of the vertically oval-shaped NVB and IAN appeared to be constant between the molar and premolar regions, which contain the mental branch, and decreased sharply in the lateral incisor after branching off of the mental branch via the mental canal. The mandibular canal was located close to the lingual cortical plate in the posterior tooth region before passing through the mental canal, immediately after which it was situated quite close to the buccal cortical plate, and then closer to the middle toward the anterior tooth region. The findings of this study provide useful anatomical information that should help to minimize the risk of injury to the NVB during surgical procedures in the mandibular region.