Assessment of Accessory Canals and Foramina in the Mandibular Arch Using Cone-Beam Computed Tomography and a New Classification for Mandibular Accessory Canals.

Sreekanth Kumar Mallineni,Xiao Lei Zhang,Sneha Choudhary,Lata Kale,Pooja Muley,Sami Aldhuwayhi,Amar Thakare

doi:10.1155/2022/5542030

Abstract

Objectives The objectives of the study include the following: (i) to assess the presence of accessory canals and foramina in the body of the mandible using cone-beam computed tomography (CBCT), (ii) to evaluate the location, number, diameter, and length of accessory canals in the body of the mandible, and (iii) to propose a new classification for mandibular accessory canals based on the location. Methods A total of 50 (25 males and 25 females) CBCT scans were analyzed in three anatomical planes and three-dimensional (3D) reconstructions for the exact number, location, diameter, and accessory length canals and accessory foramina in the body of the mandible. The statistical analysis used was an independent t-test. Results Out of 50 CBCT scans, a total of 243 accessory canals and 245 accessory foramina were found. About 53% of accessory canals and foramina were found in males, while 47% were observed in females; 89% were evident in the anterior region, and only 11% were in the posterior region. The majority (64%) of the medial lingual canals had a diameter greater than or equal to 1 mm, while only 32% of accessory canals had a diameter of less than 1 mm (p < 0.05). The mean length of median lingual canals in females was 1.2910 ± 0.2582 mm and 2.6438 ± 0.5288 mm in male subjects. Mandibular accessory canals are classified broadly into anterior and posterior accessory canals, which have further subdivisions. Conclusion CBCT plays a dynamic role in determining the mandible location of various neurovascular structures, including accessory canals and foramina. Female subjects were observed with more accessory canals and foramina and more common in the anterior region than in the posterior region.

Highlights

In the recent era, we are residing in an era of implants, and it becomes essential to have in-depth knowledge and understanding of the anatomy of neurovasculature and its variations [1,2,3,4]
Compared to conventional two-dimensional imaging, cone-beam computed tomography (CBCT), a three-dimensional imaging technique, has increased accuracy, a higher resolution, reduced scan time, reduced radiation dose, and reduced cost for the patient. It eliminates the superimposition of the surrounding structures, providing additional clinically relevant information [5], emerging as the most suitable technique to diagnose the presence of accessory canals
The present study was aimed at evaluating the presence and number of accessory canals and foramina radiographically in the mandible body using CBCT and assessing the location, length, and diameter of the accessory canals and foramina in the mandible

Summary

Introduction

We are residing in an era of implants, and it becomes essential to have in-depth knowledge and understanding of the anatomy of neurovasculature and its variations [1,2,3,4]. Accessory canals in the mandibular arch are attributed to the incomplete fusion nerve branches supplying the teeth [4] These anatomical structures were proposed as explanations for the failure of local anesthetic blocks [5]. Compared to conventional two-dimensional imaging, cone-beam computed tomography (CBCT), a three-dimensional imaging technique, has increased accuracy, a higher resolution, reduced scan time, reduced radiation dose, and reduced cost for the patient. It eliminates the superimposition of the surrounding structures, providing additional clinically relevant information [5], emerging as the most suitable technique to diagnose the presence of accessory canals. The present study was aimed at evaluating the presence and number of accessory canals and foramina radiographically in the mandible body using CBCT and assessing the location, length, and diameter of the accessory canals and foramina in the mandible

Objectives

Methods

Results

Conclusion