Bifid Mandibular Canals Research Articles

Investigation of bifid mandibular canal frequency with cone beam computed tomography in a Turkish population

Objectives : It is important to know anatomic location and variations of the mandibular canal (MC) for surgical treatment on mandible such as implant operations, impacted molar tooth extraction and sagittal split ramus osteotomy. The purpose of our study is to determine the configuration and incidence of bifid mandibular canal (BMC) using cone beam computed tomography (CBCT). Methods: CBCT scans of 2000 patients were retrospectively analysed. Age and gender of the patients who were included in this study were recorded. BMC was subdivided, frequency was determined. Measurements of mean lengths, superior and inferior angles were performed. The all measurements were performed by one observer in 3 times at intervals of one week to confirm intra-observer reliability. SPSS 21 (Statistical Package for Social Science 21) was used for statistical analysis. It was benefited from Chi-square test to investigate qualitative observation and from T test and one-way analysis of variance for investigation of quantative observation. Differences were considered significant at p<0.05. Results: 1122 of 2000 patients (56.1%) were females and 878 of 2000 patients (43.9%) were males. BMC was observed in 61 of 2000 patients (3.05%). Because location of MC is bilateral, 122 sides in 61 patients were studied. BMC was observed in 65 of 122 sides (53.3%). In 39 of 65 sides (60%), BMC was observed in males, in 26 of 65 (40%) sides, BMC was observed in females. Conclusion: CBCT provides important informations about MC imaging and evaluation of variations. Evaluation of MC variations frequency and informing to surgeon in surgical procedures on mandible provides advantages for successful operations.

A prevalence study of bifid mandibular canals using cone beam computed tomography

AbstractAimThis study aims to assess the prevalence of bifid mandibular canals in a UK population using cone beam computed tomography.Materials and MethodsThis is a prevalence study of 140 patients (280 sides) referred to a dental hospital in the UK for extraction of a third molar. Canals were classified from cone beam computed tomography images using a novel classification.ResultsAt least one bifid canal was seen in 30.00% (n = 42/140) of patients (95% CI: 26.13–33.87%) and in 18.93% (n = 53/280) of sides (95% CI: 16.59–21.27%). The retromolar canal was the most common variant observed.ConclusionsThe bifid mandibular canal appears to be a common anatomical variant, of which clinicians should be aware. These variants are relevant to surgery in the retromolar region, dental extraction and implant placement, where damage has the potential to cause bleeding and sensory disturbance.

Cone beam computed tomography evaluation of bifid mandibular canals in the adult population in Sichuan Province

To investigate the incidence of bifid mandibular canals (BMC), and analyze the types, courses, and anatomic features of the variant canals in the adult population in Sichuan Province. Five hundred patients (1 000 hemimandibles) underwent cone beam computed tomography (CBCT) were included in this study. The incidence, bifurcate types and courses of the BMC were evaluated. The incidence of BMC was 13.8% (69/500) in the study, 9.2% in terms of total hemimandibles. The most frequently type was retromolar canals, followed by the dental and buccolingual type, meanwhile the lowest was the forward type. The mean diameter of the accessory canals was 0.90 mm and the mean length was 9.39 mm. CBCT used in this study has shown that the incidence of BMC assessed by CBCT was significantly higher than panoramic radiography. Furthermore, CBCT can depict the position, course, size and the branches of the mandibular canals. .

Bifid Mandibular Canal: A Rare or Underestimated Entity?

One of the rare anatomical variations that can be of significant importance for the dentist is the bifid mandibular canal. Many complications can occur from this condition such as failure of anesthesia when performing inferior alveolar nerve block, difficulties during the surgical extraction of the third mandibular molar, and during implants placement. Therefore, good knowledge of this condition is essential. In this report, we describe the radiographic finding of a unilateral bifid mandibular canal.

Prevalence of bifid mandibular canals by cone beam computed tomography.

The aim of this study was to evaluate the prevalence of bifid mandibular canals (BMC) by cone beam computed tomography (CBCT). We examined CT scans from 300 patients both male and female, aged 25 to 87years. The subjects were divided into groups according to gender, male group (MG) and female group (FG) as well as subgroups according to the side, right (R) and left (L). Tomographic acquisitions were performed on the device I-Cat ® Classic. Image analysis was performed on the XoranCat ® software of the equipment itself, aided by image filters associated with transverse, oblique, and panoramic reconstruction cuts for analysis of the BMC. The results were displayed as descriptive analysis of the values and comparisons between factors were performed using ANOVA at a significance level of 95%. BMC was observed in 80 cases (26.67%), of which, 39 (48.75%) were in males and 41 (51.25%) in females; no difference was seen between genders, neither by affected side, although the right side was more frequently affected (66.67%) when both genders were combined. The prevalence of BMC is significant and should not be overlooked.

Bifid mandibular canals and their cortex thicknesses: A comparison study on images obtained from cone-beam and multislice computed tomography

Background/purposeHigh prevalence of bifid mandibular canals has been visualized with various types of computerized tomography (CT). Along the canals, a various ranged corticalization was recently reported. The depiction of the fine anatomic structures on multislice and cone-beam CT images was compared. Material and methodsThe presence or absence of the bifid canal was assessed on 327 images obtained by multislice CT (MSCT; n = 173) or by cone-beam CT (CBCT; n = 154), according to the configuration. The cortex thickness and distribution were also assessed. ResultsThe prevalence of bifid canal detected by CBCT was significantly greater than that detected by MSCT (42.2% vs. 18.7% for hemi-mandibles and 58.4% vs. 30.6% for patients). Cortical thickness recorded by CBCT was significantly thinner than that recorded by MSCT (0.48 mm vs. 0.65 mm, P < 0.001); however, the distributions of corticalization detected by the two tomography methods were similar. There was a significant association of cortex thickness with CT type and corticalization degree (R2 = 0.530, P < 0.001). ConclusionThinner cortices, but greater prevalence of bifid canals recorded by CBCT, compared to MSCT, suggests that clinicians should be cautious when using CT to interpret this fine anatomic structure.

Anatomical and radiographical studies of the bifid mandibular canal

To review the recent progress about the anatomical and radiographical studies of bifid mandibular canal (BMC) in English literature recorded in PubMed from 2006 to 2015 to deepen our understanding of BMC. A BMC is an anatomical variation of the mandibular canal; its occurrence might be a result of the incomplete fusion of mandibular canal during prenatal development. The four types of BMC have been classified according to anatomical location and configuration. Characteristic radiographic features and identifying methods of BMC on panoramic radiography and cone beam computed tomography (CBCT) were described; the visibility of BMC on panoramic radiographs and CBCT images was compared. Clinical value of identifying the location as well as the configuration of BMC for surgical procedures that involve the mandible was discussed.

Haemorrhage following coronectomy of an impacted third molar associated with a bifid mandibular canal: a case report and review of the literature

AbstractA bifid mandibular canal is a rare anatomical variant believed to result from failure in fusion of multiple embryonic canals. Although the anatomical variations have been well described, clinical sequelae from this anatomical variant have, to our knowledge, never been described before. We describe a case in which a partially erupted third molar closely associated with a bifid mandibular canal was treated with a coronectomy. The patient subsequently attended as an emergency with haemorrhage necessitating exploration under general anaesthesia due to failure of local measures to arrest it. Should such an anatomical variant be suspected, we would recommend cross‐sectional imaging such as cone beam computed tomography be mandatory to adequately plan the third molar extraction. Extraction and not coronectomy may provide greater access to any potential source of bleeding such that direct pressure might be directly applied to the area.

Bifid mandibular canal: Report of 2 cases and review of literature

Bifid mandibular canal: Report of 2 cases and review of literature

Haemorrhage following coronectomy of an impacted third molar associated with a bifid mandibular canal

Haemorrhage following coronectomy of an impacted third molar associated with a bifid mandibular canal

Incidence and classification of bifid mandibular canals using cone beam computed tomography

Aim: To determine the prevalence and classification of bifid mandibular canals using cone beam computed tomography (CBCT). Methods: The sample comprised 300 CBCT scans obtained from the Radiology and Imaging Department database at Sao Leopoldo Mandic Dental School, Campinas, SP, Brazil. All images were performed on Classic I-Cat(r) CBCT scanner, with standardized voxel at 0.25 mm and 13 cm FOV (field of view). From an axial slice (0.25 mm) a guiding plane was drawn along the alveolar ridge in order to obtain a cross-section. Results: Among 300 patients, 188 (62.7%) were female and 112 (37.3%) were male, aged between 13 to 87 years. Changes in the mandibular canal were observed in 90 patients, 30.0% of the sample, 51 women (56.7%) and 39 men (43.3%). Regarding affected sides, 32.2% were on the right and 24.5% on the left, with 43.3% bilateral cases. Conclusions: According to the results obtained in this study, a prevalence of 30% of bifid mandibular canals was found, with the most prevalent types classified as B (mesial direction) and bilateral.

Anatomical variations of mandibular canal detected by panoramic radiography and CT: a systematic review and meta-analysis.

To investigate the anatomical variations of the mandibular canal through assessment in situ, panoramic radiography, CT or CBCT and assess their frequency. Articles were selected from databases (Cochrane Library, LILACS, ProQuest, PubMed, Scopus, Web of Science and Google Scholar), articles without limitations of language, in which the main objective was to evaluate the frequency of bifurcation of the mandibular canal through assessment in situ, panoramic radiography, CT or CBCT were selected. A meta-analysis of prevalence using random effects was performed. Using a selection process in two phases, 15 articles were identified, and a meta-analysis was conducted. The results from these meta-analyses showed that the overall prevalence of anatomical variations for in situ studies was 6.46%, and through assessment of panoramic radiography and CT or CBCT the overall prevalence shown was 4.20% and 16.25%, respectively. There are two types of variations of the mandibular canal: the retromolar canal and bifid mandibular canal. The frequency variations through assessing in situ, panoramic radiography and CT or CBCT were 6.46%, 4.20% and 16.25%, respectively.

Haemorrhage following coronectomy of an impacted third molar associated with a bifid mandibular canal

Haemorrhage following coronectomy of an impacted third molar associated with a bifid mandibular canal

Morphological variations of the mandibular canal in digital panoramic radiographs: a retrospective study in a Chilean population.

Morphological variations of the mandibular canal (MC) have been described in literature, so the clinician must be able to recognise them and adapt their treatment accordingly. The aim of this study was to determine the prevalence of morphological variations of the MC using digital panoramic radiographs (DPR) of Chilean patients. A retrospective study in which 1400 DPR were analysed to identify cases of bifid, trifid and retromolar MC. The radiographs were analysed independently by two examiners who had previously been trained by a specialist in oral and maxillofacial radiology. Inclusion and exclusion criteria were applied to reach a final sample. Nine hundred and twenty-five radiographs were included (599 female, 326 male; mean age 36.1 ± 15.54 years). The prevalence of bifid MC was 11% (n = 102), with no significant differences by sex (p = 0.069). Proportion of bifid MC was higher among younger patients (p = 0.038). Prevalence of morphologi- cal variations of type 1 bifid MC was 7.4% (n = 69), type 2 was 2.3% (n = 23), type 3 was 0% (n = 0) and type 4 was 1.1% (n = 10). Prevalence of retromolar canal was 0.9% (n = 8), with no significant differences by sex (p = 0.893) or age (p = 0.371); of these, 2 (0.2%) cases were forward type and 6 (0.6%) cases were retromolar type. No cases of trifid MC were found. Digital panoramic radiographs are useful for detecting morphological variations of the MC; we were able to identify three types of bifid MC as well as retromolar canals. Proper identification of these variations by an easily accessible examination is important for avoiding possible complications in clinical-surgical practice.

Bifid mandibular canal: An unusual presentation

Bifid mandibular canal could be an interesting variation in the mandible. This condition can pose complications during surgical procedures in the mandible, such as extraction of lower molars, placement of implants, and surgery. Therefore, identification of this variation is sometimes very crucial and can assist in minimizing postoperative complications. Hereby, we report the presence of bifid mandibular canal in the first molar region, an unusual presentation. The patient was evaluated for implant prosthesis using cone beam computed tomography (CBCT) that confirmed the bifid canal which was seen as an unusual radiolucency on intraoral periapical radiograph.

Bifid Mandibular Canals: Prevalence and Implications

Bifid mandibular canals (BMCs) are variations of the normal anatomy, with a reported prevalence ranging from 0.08 to 65%. Aberrations of the mandibular canal can have important clinical implications. We therefore sought to assess the prevalence of BMCs and discuss several surgical implications that may be associated with this variation. A retrospective chart study of available digital panoramic images from our file archives from 2011 to 2013 was performed to search for the prevalence of BMCs; to this end, 5,000 consecutive panoramic radiographs of patients aged 18 to 80 years were studied. Detection of BMCs was based on visualization of 2 radiolucent lines and at least 3 radiopaque borders on the monitor and confirmed by 2 oral and maxillofacial surgeons and 2 dentists. The types of bifidity also were assessed and recorded. Data analysis was performed using the χ(2) test. BMCs were observed in 61, or 1.2%, of 5,000 digital panoramic images. There were no statistically significant correlations found regarding age or gender. The most frequently encountered type of bifid canal was type 2 (82%). The prevalence of BMCs seen on panoramic images in this study was 1.2% and was not correlated with age or gender.

Configuration and corticalization of the mandibular bifid canal in a Taiwanese adult population: a computed tomography study.

The configuration and degree of corticalization of bifid mandibular canals were examined using medical computed tomography (CT) images from 170 hemimandibles obtained from 308 Taiwanese adults. The configurations of the bifid canals were assessed according to their anatomical position in relation to the ramus, molars, premolars, and mental foramen; their course (anterior/posterior or superior/inferior); the presence or absence of confluence with the main mandibular canal; and the presence or absence of penetration through the mandible to form an accessory foramen. The percentage of the canal length that was corticalized was measured. Two different classifications of bifid canals were also briefly summarized and compared. When bifid canals are present (41.2% of patients; 27.6% of hemimandibles), the bifid canals were primarily located in the ramus and retromolar regions (67.7%) running anteriorly (95.9%) and superiorly (95.9%) without confluence with the main mandibular canal (91.1%). Up to 16.5% of bifid canals form accessory foramina on the cortical surface of the mandible. Approximately 78% of the bifid canals have varied degrees of corticalization around the bifid canals. The configuration and course of 170 mandibular bifid canals were evaluated with CT images. The bifid canals were primarily located in the ramus and retromolar regions; however, 32.4% of the bifid canals were located in potential positions for dental implant placement. Most of the bifid canals ran anteriorly superior to the main mandibular canal, did not rejoin with the main mandibular canal, and diminished within the mandibular body. Approximately half of the bifid canals (45%) were completely corticated.

Prevalence of bifid mandibular canals in panoramic radiographs: a maxillofacial surgical scope.

The present study aims to estimate the prevalence of bifid mandibular canals in patients treated at the Dental Clinic of the Federal University of Paraná, Brazil. The sample consisted of 3,024 panoramic radiographs from male (n = 1,155) and female (n = 1,869) patients (mean age 30 years). An experienced radiologist analyzed the panoramic radiographs according to the study of Langlais et al. (J Am Dental Assoc 110:923-926, 1985), which classifies bifid mandibular canals into four different types. Sixty patients (1.98 %) presented bifid mandibular canals. Specifically, 50 patients revealed bifid mandibular canals type I, while 10 patients revealed bifid mandibular canals type II. All the variations were unilateral. In addition, statistically significant results were not observed for gender distribution. The present findings indicate a low prevalence of morphologic alterations of the mandibular canal in the studied population. However, the present outcome highlights the clinical relevance of investigating the radiologic morphology of the mandibular canal prior to surgical interventions.

The incidence and configuration of the bifid mandibular canal in Koreans by using cone-beam computed tomography

PurposeThis study was performed to investigate the incidence and configuration of the bifid mandibular canal in a Korean population by using cone-beam computed tomography (CBCT) imaging.Materials and MethodsCBCT images of 1933 patients (884 male and 1049 female) were evaluated using PSR-9000N and Alphard-Vega 3030 Dental CT units (Asahi Roentgen Ind. Co., Ltd, Kyoto, Japan). Image analysis was performed by using OnDemand3D software (CyberMed Inc., Seoul, Korea). The bifid mandibular canal was identified and classified into four types, namely, the forward canal, buccolingual canal, dental canal, and retromolar canal. Statistical analysis was performed by using the chi-squared test and one-way analysis of variance (ANOVA).ResultsBifid mandibular canals were observed in 198 (10.2%) of 1933 patients. The most frequently observed type of bifid mandibular canal was the retromolar canal (n=104, rate: 52.5%) without any significant difference among the incidence of each age and gender. The mean diameter of the accessory canal was 1.27 mm (range: 0.27-3.29 mm) without any significant difference among the mean diameter of each type of the bifid mandibular canal. The mean length of the bifid mandibular canals was 14.97mm(range: 2.17-38.8 mm) with only a significant difference between the dental canal and the other types.ConclusionThe bifid mandibular canal is not uncommon in Koreans and has a prevalence of 10.2% as indicated in the present study. It is suggested that a CBCT examination be recommended for detecting a bifid canal.

Bifid mandibular canal: Case report and review of literature

Bifid mandibular canals are often unrecognized. The detection of these anatomical variations is important because of its clinical implications. Special attention has to be paid in surgical procedures involving the lower jaw. Purpose of the present article is to provide an extensive review of literature of this anatomical variation and also we present one such case report.