Variant anatomy of the mandibular canal topography

Abstract

This paper presents an analysis of 3D reconstruction models of the manifestation of variability of the mandible canal (canals) on both the left and right sides, their laying in the body of the mandible and the location, size and direction of the output canals. After all, the availability of minimally invasive techniques implemented in the research process helps to identify even minor anatomical variants or branches of the mandibular canal, which are quite common and do not allow the clinician to neglect them and require proper scientific evaluation. When planning reconstructive surgery on the mandible, the lack of high predictability to prevent functional complications, which are often irreversible (because the mandibular canal contains motor and sensory nerve fibers), forces us to reconsider the morphological fundamentality of its topography. Therefore, the aim of the work was to review computed tomography digital images, their analysis and identify possible anatomical variants of the canal (channels) of the mandible, as a basis for establishing its topographic features, on the left and right sides. After analyzing 426 digital CT scans of the mandible in males and females aged 25 to 75 years, 68 3D reconstruction models were reproduced using standardized X-ray diagnostic CT software Ez3D-I Original ver.5.1.9.0, used for visualizations of multimodal and multidimensional images, some of which are presented as the results of their own research. It is established that the entrance openings of the mandibular canals on both the left and right sides continue with one canal, however, in the projection of the second molar, the latter can be divided into two or three canals with high frequency. There is a difference in the diameters (Ø) of the canals and their opening – typical (in the projection of premolars on the right side) and atypical openings – in the projection of 3.6, 4.6 molars and central incisors, canines in the direction of the outlet and their location. There is no proper regular systematization of the number, topographic trajectory and size of the mandibular canals, their association or separation, as well as the direction of their exit, which requires additional vigilance not only during research but also in clinical dentistry or reconstructive surgery.