Evaluation of the Mandibular Lingual Canal and Anterior Loop Length to Minimize Complications Associated With Anterior Mandibular Surgeries: A Cone-Beam Computed Tomography Study

Abstract

This retrospective study evaluated the localization, incidence, and dimensions of the mandibular lingual canal and the anterior loop in the Taiwanese population using the simulation and visual interpretation of cone-beam computed tomography to minimize complications during symphysis block surgical procedures. The sample population consisted of 215 patients (105 men and 110 women; mean age, 57yr). The median lingual canal, symphysis bone thickness, and anterior loop length were defined and calculated using cone-beam computed tomography and 3-dimensional reconstructed images. The correlation of all data for men and women was assessed and analyzed statistically using unpaired t tests. All patients exhibited at least 1 median lingual canal in the symphysis, and the diameter of the main branch ranged from 0.21 to 1.48mm (mean, 0.85mm), with relevant differences between genders (longer in men than in women). A harvesting depth of 4mm for the distance from the buccal bone to the terminal end of the median lingual canal resulted in a risk of neurovascular injury (13.0%); this risk was notably higher in women (19.1%) than in men (6.7%). The right and left anterior loop lengths ranged from 0 to 5.46mm (mean, 2.60mm) and from 0 to 5.57mm (mean, 2.61mm), respectively, with no relevant differences between genders or sides. The results suggest that routine cone-beam computed tomographic examinations before surgical interventions in the symphysis region are necessary because of the numerous complicated anatomic variations.