Bifid canals: identification of three clinical cases using cone-beam computed tomography images

Paulo De Camargo Moraes,Daniela Prata Tacchelli,José Luiz Cintra Junqueira,Luciana Butini Oliveira,Rubens Gonçalves Teixeira

doi:10.1590/1981-8637201800030000113693

Paulo De Camargo Moraes, Daniela Prata Tacchelli + Show 3 more

Open Access

https://doi.org/10.1590/1981-8637201800030000113693

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Abstract

ABSTRACT Anatomical variations of mandibular canal have rarely been reported in the literature. The aim of this paper is to present three clinical cases of bifid mandibular canal diagnosed with cone-beam computed tomography (CBCT) as well as discuss its clinical implications. The first case is very interesting due to its anatomic variation verified in a panoramic radiograph during orthodontic planning, mimicking an odontogenic tumor. The second and the third cases were identified during tomographic evaluation for third molar exodontia. The diagnosis of bifid canals is extremely relevant in order to avoid complications during surgical procedures and implant placement as well as anesthesia failures which cause pain, paresthesia and bleeding. Furthermore, the shape of these anatomical variations can be confused with bone lesions.

Highlights

During the seven week of the uterine life the inferior alveolar nerve divides into mental and incisive branches that can show anatomic variant along its trajectory [1]
The present paper reports three cases of bifid canals using cone-beam computed tomography (CBCT)
A 21-year-old female was referred to the dental office for a routine dental appointment and orthodontic treatment and the dentist asked her for a panoramic radiography

Summary

INTRODUCTION

During the seven week of the uterine life the inferior alveolar nerve divides into mental and incisive branches that can show anatomic variant along its trajectory [1]. The authors described a case of unilateral mandibular canal with two mental foramina which was shown in a panoramic and lateral jaw radiographs. A previous report had shown a case of trifid mandibular canal diagnosed during a preimplant radiographic evaluation [4]. Bifid canals: identification of three clinical cases using cone-beam computed tomography images. The occurrence of bifid mandibular canal is extremely variated in the dental literature. 7 cases (0.35%) were found in radiographic images suggesting double mandibular canal, three of them were confirmed by computed tomography images. There are different classifications of the mandibular canal variations proposed by Carter & Keen [13], Nortje et al [11] and Langlais et al [10]. The present paper reports three cases of bifid canals using cone-beam computed tomography (CBCT)

CASE REPORTS

CONCLUSION

Findings

FINAL CONSIDERATIONS