Lingual Canal Research Articles

Vascular and neurosensory evaluation in relation to lingual canal anatomy after mandibular midline implant installation in edentulous patients

ObjectivesThe aim of this study is to investigate vascular and neurosensory complications in edentulous patients following the installation of mandibular midline single implants in relation to lingual canals.Materials and methodsAfter performing a cone beam computed tomography scan for the 50 recruited patients, the relationship between the potential implant site and the lingual canals was assessed, and all vascular and neurosensory complications were recorded.ResultsSix patients (12%) reported profuse bleeding during implant placement, and 13 (26%) reported transient neurosensory changes, which were resolved after 3 months. According to the virtual implant planning, 44 patients (88%) would have their implants touching the lingual canals, six of them reported vascular changes (14%), and 12 out of 44 patients reported neurosensory changes (27%). For the six patients who would have their implants not touching the lingual canals, one patient reported transient neurosensory changes.ConclusionsThe mandibular lingual canals are constant anatomic landmarks. Injury to the supra-spinosum lingual canals may occur during midline implant placement, depending on the implant length and the bone height.Clinical relevanceDespite that injury to the supra-spinosum lingual canals during implant insertion does not result in permanent vascular or neurosensory complications, caution is required to avoid the perforation of the lingual cortices.

PREVALENCE AND ANATOMICAL VARIATIONS IN THE MANDIBULAR LINGUAL CANAL IN A SAMPLE OF EGYPTIAN POPULATION USING CBCT: A CROSS-SECTIONAL STUDY

Aim: With the development of surgical procedures, as the mandibular anterior dental implants and chin surgeries, there has been an increase in complications associated with anatomical elements in this anterior area. One of the most dangerous complications is related to bleeding caused by injured vessels associated with the lingual foramen and canal, which can cause a compression of the airway. Methodology: Eighty-two CBCT scans for Egyptian individuals were collected from the data base available at the Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Cairo University. Scans were selected according to specific inclusion and exclusion criteria, they were interpreted by two oral radiologists and analyzed in the three planes axial, coronal and sagittal. The midline was drawn on the axial scan by a line passing through the convexity of the genial tubercle to the mental ridge. The procedure was then standardized by adjusting the slice thickness and the spacing between all cuts at 0.4mm. After determining the midline on the axial plane, from the sagittal plane five consecutive cuts were taken on each side of the midline, these cuts were used for the assessment of the prevalence and the number of lingual canals present.

Cone beam computed tomography for evaluation of mandibular lingual canal in an Egyptian subpopulation

BackgroundA sample of three hundred cone beam computed tomography (CBCT) scans was evaluated. Median lingual canals (MLC) were identified and classified according to their anatomical location. Evaluation of the canal diameter, length, thickness of the buccal cortical plate, and the remaining bone above and below the canal was performed. The results were assessed twice with 2 weeks interval and statistically analyzed. The study was designed to evaluate MLC in an Egyptian subpopulation by the use of CBCT.ResultsMost of the scans presented with one MLC, with a maximum number of four canals, the mean diameter was 1.68± 1.27 mm, with a statistically significant difference in the length from the canal opening to the alveolar crest between females and males.ConclusionsAs the study detected a high prevalence of the MLC with a vast majority of the canals supra-spinosum, a vigilant examination is required using CBCT to avoid subsequent bleeding and airway obstruction.

Worldwide Prevalence of a Lingual Canal in Mandibular Premolars: A Multicenter Cross-sectional Study with Meta-analysis

IntroductionThe presence of multiple root canals is an important morphologic aspect of mandibular premolars. This study aimed to perform a worldwide analysis on the prevalence of a lingual canal in mandibular premolars and to evaluate its influence on patients’ demographics in 23 countries using cone-beam computed tomographic images. MethodsObservers from 23 countries were instructed to evaluate cone-beam computed tomographic images of 300 first and 300 second premolars (13,800 teeth) regarding the presence of a lingual canal, canal configuration, and data related to patients’ ethnicity, age, and sex following a standardized screening methodology. Intra- and interrater evaluations were performed using the Cohen kappa test and intraclass correlation coefficient. Proportion and odds ratio forest plots were calculated in order to compare groups. Statistical significance was set at 5%. ResultsBoth kappa and intraclass correlation coefficient values were above 0.60, and the percentage of agreement was 94.9% (first premolar) and 97.8% (second premolar). A significant statistical difference was observed between the worldwide proportion of a lingual canal in mandibular first (23.8%; range, 12.0%–32.7%) and second (5.3%; range, 1.0%–15.3%) premolars (P < .05). Asians and patients over 60 years old were associated with the lowest proportions of a lingual canal (P < .05), whereas Africans and younger groups were associated with the highest proportions (P < .05). The prevalence of a lingual canal in males (27.9%) was higher than females (20.0%) for the first premolar only (P < .05). Males were associated with 1.533 and 1.597 higher odds of presenting a lingual root canal in the first and second premolars, respectively. ConclusionsThe worldwide proportion of a lingual root canal was 23.6% and 5.3% for the first and second premolars, respectively. Ethnicity, geographic region, age, and sex had an influence on the outcomes.

Effect of canal preparation with XP-endo Shaper and ProTaper Next on root canal geometry and dentin thickness of mandibular premolars with radicular grooves and two canals: a micro-CT study.

This study aimed to evaluate the effects of different shaping protocols on the root canal geometry and remaining dentin thickness of mandibular premolars with radicular grooves (RG) and two canals by means of micro-CT. Mandibular premolars with RG and two canals were matched based on their similar morphological dimensions and assigned to 2 experimental groups according to the canal preparation (n=8): XP-endo Shaper (XPS) and ProTaper Next (PTN) systems. Before and after preparation, morphometric measurements of the volume, surface area, structure model index, area, perimeter, roundness, major and minor diameters, as well as untouched canal walls, canal transportation, and dentin wall thickness were evaluated. Data were statistically compared within and between groups using the independent sample t test (α=5%). XPS revealed less changes in volume, surface area, area, perimeter, and major and minor diameters (P<0.05). There was no significant difference in structure model index (SMI), roundness, and percentage of untouched canal walls between groups (P>0.05). XPS resulted in less apical canal transportation and a higher remaining dentin thickness toward the RG compared to PTN in lingual canals (P<0.05). XPS revealed fewer changes in root canal geometry as well as lower transportation and a greater remaining dentin thickness in the lingual canals toward the RG compared to PTN. Internal and external anatomical characteristics of mandibular premolars might have an influence on biomechanical preparation. Considering the risk of perforation, the canal preparation using XPS appears to be more conservative compared to PTN.

Terminological and debatable issues of the intraosseous organization of the anterior part of the mandible

In the scientific literature, one can find conflicting assumptions about the presence of «proper mental bone» and «upper and lower lingual canals», which make up a separate ossified area in the chin of the mandible and the system of blood supply and innervation. However, calling these lesions «lingual canals» or «incisal canals», as is often found in various articles, is incorrect based on the position of International Anatomical Terminology. This is due to the lack of topographic reference in the term, which can equally be understood as the canal of the tongue, the neurovascular bundle of the same name, and the root canal system of the teeth of the lower jaw and can also be associated with the maxilla. We searched for information in English, without time limits, in the PubMed Central database, and searched on Google and analyzed the bibliography, relevant studies and reviews. The selection of publications was carried out by request «mental spine canals», 58 articles were found in PubMed, of which 21 were relevant. For the analysis, publications were selected that described in detail the anatomical, clinical and radiological features of the structure of the anterior part of the mandible. As a result of previous studies and the study of literature data, the intraosseous structures of the anterior part of the lower jaw were refined and classified, which solve not only terminological disputes, but also are important clinical guidelines for endodontic treatment, dental implantation and local anesthesia.

Can a panoramic radiograph predict the inferior alveolar nerve canal's position, or canal compression, near third molar root apices?

Background: Injury to the inferior alveolar nerve can occur during surgical removal of the mandibular third molars (M3Ms), resulting in numbness of the mandibular teeth, chin, and lower lip. This occurs when the roots of M3M compress the inferior alveolar canal (IAC) against the lingual cortical plate. Cone-beam computed tomography (CBCT) reveals the buccolingual relationship of the IAC and M3M, but the panoramic radiograph (PR) has not been evaluated to determine whether the plane film can reveal this relationship. Aims: The aim of the study is to determine whether PR could predict buccal or lingual IAC position or compression near M3M. Design: This retrospective study evaluated 200 M3M sites in 42 women and 67 men, aged 17–28 years. Ninety-one bilateral measurements were taken; 98 left and 102 right halves were analyzed. Methods: IAC position and degree of compression were interpreted from the CBCT. Utilizing imaging software, 13 different measurements were obtained. Statistical Analyses: Fisher's exact test, t-test, principal component analysis, and multivariate analysis were utilized. Results: Male and female canal positions significantly differed. Canal position was significantly different comparing partially erupted to erupted and fully bony impacted molars. Lingual canal position, versus buccal, was more frequently associated with moderate-to-severe IAC compression. “Anterior-posterior ramus at the occlusal plane” and “anterior ramus to anterior IAC at the occlusal plane” contributed most to the severity of IAC compression. Conclusion: The variables evaluated did not identify a significant relationship. A larger data set is needed to evaluate any role the dimension of the ramus has on IAC compression.

Do Morphological Changes in the Anterior Mandibular Region Interfere with Standard Implant Placement? A Cone Beam Computed Tomographic Cross-Sectional Study.

Objective To determine the morphological features in the anterior mandibular region, the presence of lingual foramen and canal dimensions in Saudi subjects that would interfere with standard implant placement. Methods CBCT scans of patients seeking implant treatment were examined. Based on the dentition status, patients were categorized into edentulous (group I) and dentulous (group I). On the panoramic view, the distance between the two mental foramina was divided into vertical segments of 10 mm width. In each segment, vertical bone height and buccolingual thickness at three levels (alveolar crest, 5 mm, and 10 mm apical to the crest) were assessed. The lingual foramen prevalence and canal features were assessed as well. Comparisons between the two groups regarding the assessed parameters were performed using the t-test. The percentage of edentulous mandibles with thickness <6 mm corresponding to the standard implant diameter was also calculated. Results Following the inclusion and exclusion criteria, group I consisted of 45 subjects and group II comprised 26 subjects. Bone height and thickness at the crestal level were significantly less in edentulous (I) than dentate mandibles (II) (P < 0.0001). The lingual foramen was detected in 90% of patients. In both groups, males had significantly greater mandibular height than females (P=0.02 and 0.005). At the crestal level, the thickness was <6 mm in 50% of the anterior mandibular segments. Conclusion Half of the edentulous patients may receive normal size implants in the anterior interforaminal segments, while the other half will be limited to narrow implants (3.5 mm and less). The lingual foramen location, canal size, and position may represent another limitation for implant placement in that segment.

CBCT INVESTIGATION OF THE INTRABONY CANAL COMMUNICATIONS BETWEEN THE VESTIBULAR AND LINGUAL PLATES IN THE ANTERIOR MANDIBLE

Purpose: To assess the presence of the vestibulo - lingual intrabony canal communications (VLC) in the anterior mandible using cone beam computed tomography (CBCT). Materials and methods: Study material included 200 CBCT scans taken for preoperative planning of implant placement. The images were examined carefully by three observers concerning the presence of VLC. Interobserver agreement in identification of the canal communications was excellent (mean kappa value – 0.82). Results: Vestibulo - lingual communications were found in 27 % of cases. The communications appeared as a crossing of the lateral lingual canal with the mandibular incisive canal (type 1), as a connection between midline lingual canal (or canals) and a vestibular nutrient canal (type 2) or as a lateral lingual canal connected with the anterior loop of the mandibular canal (type 3). The main type of VLC is those between a lateral lingual canal and mandibular incisive canal – 85.2% from all of the VLCs. Conclusions: A considerable part (27%) of Bulgarian citizens has vestibulo - lingual communications in the anterior mandible. The type 1 communication prevails, and it is more frequently located on the right side. The knowledge about vestibulo - lingual communications could contribute a better understanding of bone tumor invasion but further studies are necessary.

Ultrasound &amp; CBCT analysis of blood flow &amp; dimensions of lingual vascular canal: A Case Control study

Ultrasound &amp; CBCT analysis of blood flow &amp; dimensions of lingual vascular canal: A Case Control study

A REVIEW ON VARIATIONS IN LINGUAL FORAMINA OF THE MANDIBLE MIDLINE

The sublingual, submental arteries or their anastomosis perforate the lingual cortical plate through the lingual foramen. Both the arteries are branch of facial and lingual arteries respectively which either arises independently from the external carotid artery or arises from a common lingual facial trunk. The anterior mandibular midline at which the lingual foramen is frequently present is subjected to various procedure like dental implants, genioplasty, tori removal, block graft harvesting, screwing with or without plating following trauma or osteotomy. There is a wide range of anatomical variations of lingual foramen among individuals. Cone-beam computed tomography (CBCT) has been shown to be superior to panoramic radiographs in displaying mandibular lingual foramen and its variations. Numerous studies have been carried out to examine the frequency, diameter, and other anatomical features of the lingual foramen and its canals. There is a paucity of the data which compares the different group of the population based on the position and the occurrence of the lingual canal and very few studies compared the gender and population. The main purpose of the review is to examine the anatomical variations of the lingual foramen.

Preparation of the lingual canal in mandibular first premolar with canal bifurcation.

The aim of this study was to establish an effective method of locating and negotiating the lingual canal in mandibular first premolars with two canals during root canal preparation. A total of 125 mandibular first premolars with radicular grooves were collected, and after micro-computed tomography scanning, 50 mandibular first premolars with a Vertucci V/III canal form were selected based on the inclusion criteria. Access cavities were prepared, and the lingual canals (LCs) were searched in four following steps: step 1 direct vision and a straight K-file; step 2 stereomicroscopy and a straight K-file; step 3 stereomicroscopy and a pre-curved K-file; and step 4 a long-neck bur. After localization, the LCs were instrumented. In most cases, access to the LCwas achieved by step 2 (19/50, 38%) or step 3 (22/50, 44%). In three cases (6%), step 1 alone was enough to achieve access to the orifice, and in six cases (12%), access to the lingual canal was not achieved until step 4. Overall, 43 of the 50 mandibular first premolars (86%) were successfully instrumented, and the remaining seven failed. Two cases failed in the process of negotiating the canal to full length and five cases failed due to procedural errors (ledge formation, canal perforation, vertical fracture, or instrument separation). The LC in mandibular first premolars is a major endodontic challenge. A stereomicroscope and a pre-curved K file are suggested to be valuable tools for detecting and accessing the extra LC.

Anatomical and radiological features of the bone organization of the anterior part of the mandible

BackgroundThe classical anatomical representation of the lingual relief of the mental region of the mandible reflects the presence of geniohyoid as well as genioglossus attachment areas, which are divided into two or single areas.The International Anatomical Terminology (contains references to the presence of upper and lower spinae mentales, but the terminology does not reflect the content of these structures. The aim of this study was to examine and classify the lingual canals of the mental region. Materials and methodsUsing a Sirona ORTHOPHOS XG 3D tomograph (isotropic voxel size 0.1 in high-resolution mode) and KaVo 3D eXam cone beam computed tomography, the mental region of the mandible was analyzed in 561 patients aged 18–75 years with regard to bone density and the occurrence of a canal opening on the lingual side of the mandible. In order to visualize the mental spine area, another 50 mandibles were analyzed, divided into two groups of 25 mandibels each: 25 native and 25 dry preparations. ResultsBy prevalence the following channel types were classified: in 33% type I (narrow); in 32% type II (double) and of these in 17.5% (convergent) and type IIb in 14.5% a type IIb subtype (non-convergent); in 14% type III (wide); in 12% type IV (hook-shaped) and in 9% type V (diverging channel), identifying three combined components: the system of channels of the superior and inferior mental spine, and the transversal intraosseous canal of the mental region of the mandible. ConclusionsOur anatomical and radiological approach allowed us to suggest a new classification of intraosseous organization of the anterior part of the human mandible. As a result of studying X-ray anatomical and anatomical-topographical, constitutional-based, structural features of the mandible, intraosseous structures of the anterior mandible were clarified and classified, which solve not only terminological disputes, but also are important clinical guidelines for bone surgery, prosthetics, traumatology, endodontic treatment, dental implantation and local anesthesia.

Micro-Computed Tomographic Evaluation of Canal Transportation and Centering Ability of 4 Heat-Treated Nickel-Titanium Systems

IntroductionThis study aimed to evaluate and compare canal transportation and centering ability of 4 different root canal preparation systems produced with thermal treatments by means of micro–computed tomographic imaging. MethodsEighty mesial canals of human extracted mandibular molars were selected based on similar morphologic parameters and were randomly assigned to 4 experimental groups (n = 20) according to the canal instrumentation technique: HyFlex CM (HCM [Coltène-Whaledent, Allstätten, Switzerland]), HyFlex EDM (HEDM [Coltène-Whaledent]), WaveOne Gold (WOG [Dentsply Sirona, Ballaigues, Switzerland]), and OneCurve (OC [Micro-Mega, Besancon, France]). The specimens were scanned before and after root canal preparation using X-ray micro-computed tomographic imaging at a resolution of 19.9 μm. Apical transportation and centering ability were then analyzed at 3 different levels: 3 mm, 5 mm, and 7 mm from the apex, representing the apical, midroot, and coronal thirds of the root, respectively. One-way analysis of variance and Kruskal-Wallis tests were used to statistically compare the groups. The significance level was set at 5%. ResultsHCM caused less canal transportation than WOG at the 3-mm level in both the buccal and lingual canals (P < .05). Also, HCM resulted in less canal transportation than WOG and OC at the 7-mm level regarding lingual canals. No statistically significant differences were recorded between the groups when the mean centering ratios were compared. ConclusionsThe 4 evaluated systems safely prepared root canals causing minimal canal transportation and producing relatively centered preparations. In terms of canal transportation, HCM performed better than WOG at the apical level and better than WOG and OC at the coronal level.

Prevalence of lingual foramina in the anterior mandible: A cone-beam computed tomography study

Context: Serious hemorrhagic complications can result from arterial trauma associated with perforation of the lingual cortical plate or injury to the terminal branches of the sublingual and submental arteries that pierce the lingual cortex of the mandible in the anterior region. Aim: The aim of this study is to determine the prevalence of lingual foramina (LF) in the anterior mandible by cone-beam computed tomography (CBCT) and to determine the presence and number of foramina, lingual foramina canal length (LFC), distance from the base of the mandible to the entrance of the LFC, distance from the base of the mandible to the end of the LFC, distance from the end of the LFC to the buccal cortical plate, and diameter of the LFC, and to attempt to find a relation between the data obtained to age, sex, and dental condition. Settings and Design: This study design involves a retrospective cross-sectional study. Methods: A total of 303 CBCT images were evaluated of the anterior mandible with software and recorded the measurements into a spreadsheet, which was converted into graphs and tables. The CBCTs were assessed based on sex, age, and dental condition. Statistical Analysis Used: Fisher’s exact test and Student’s t-test. Results: We found a prevalence rate of 99.3%. The foramina were evident in 102 (99.0%) men and 199 (99.5%) women. The most prevalent number of canals was two (47.5%). The superior canal presented as greater length (7.25 ± 2.04 mm) and diameter (0.95 ± 0.58 mm). Conclusion: The prevalence of LF is high, and their presence is not related to sex, age, or dental condition.

Evaluation of the relationship between appearances of the lingual foramen on panoramic radiography and cone-beam computed tomography

The aim of this retrospective study is to determine the level of visibility of the lingual foramen in panoramic radiography using cone-beam computed tomography (CBCT) as a reference tool. A total of 200 patients (111 females and 89 males) were included in the study. Cross-sectional CBCT images of the mandible in the midline were used to locate and define the orifice and diameter of each lingual canal that was detected. The appearance of the lingual foramen in the anterior mandible in panoramic radiography was assessed using a five-point ordinal scale. Descriptive statistics including tables and graphs were used. The correlation between CBCT and panoramic radiography findings were analyzed using Chi-square tests. The lingual foramen was found to be located most frequently in the mandibular midline, above the genial tubercle (78.5%). A narrow-diameter type was found to occur most frequently (56.5%). A prominent genial tubercle was the most commonly found type (57.5%). The lingual foramen could be definitively identified in panoramic radiographs in only 8 cases (4%), while a high degree of probability was found in 25 cases (12.5%). The lingual foramen appears wider and therefore more distinctive in panoramic radiographs when the angulation of the lingual canal is less than 20° to the ground plane. Radiological evaluation with panoramic radiographs alone may lead to inadequate assessments prior to surgical procedures involving the anterior mandible. Clinicians may consider using three-dimensional imaging for procedures with a risk of hemorrhagic and neurosensory complications such as dental implant placement in the anterior mandible.

Evaluation of the Lingual Canals of Mandible in Cone Beam Computed Tomography

This study aims to assess the frequency of the lingual foramina and canals relative to their location on the mandibular cortical plate and also to closely inspect the course of the lingual canals inside the mandibular body using 3D reconstruction of the evaluated area. A retrospective study was conducted with 55 cone bean computed tomography (CBCT) scans in order to analyze the location, number, course and anastomosing pattern of the lingual canals. A total number of 165 lingual canals (LCs) were recorded from 55 patients, as follows: 94 median (MLC), 16 paramedian (PLC) and 55 lateral lingual canals (LLC). MLCs were a constant finding in all 55 patients (100% of the cases), PLCs were present in 15 patients (27.3% of the cases), and LLCs were identified in 35 patients (63.3% of the cases). The anastomosing pattern of the MLC, in which a supraspinous canal anastomosed with an infraspinous canal, was found in 10.9% of the cases (6 of 55 patients),. The LLCs were anastomosed with the mandibular incisive canal (MIC) in 56.3% of the cases (31 of 55 LLCs) and with the mandibular canal (MC) in 3.6% of the cases (2 of 55 LLCs). CBCT revealed itself to be a reliable tool for evaluating the intramandibular topography of the LCs. The anastomosing pattern of the lingual canals might raise the question whether the LCs could be responsible for incomplete anesthesia after conventional mandibular block by carrying sensory innervation from the mylohyoid nerve to the inferior alveolar nerve.

Evaluation of the Lingual Canals of Mandible in Cone Beam Computed Tomography

This study aims to assess the frequency of the lingual foramina and canals relative to their location on the mandibular cortical plate and also to closely inspect the course of the lingual canals inside the mandibular body using 3D reconstruction of the evaluated area. A retrospective study was conducted with 55 cone bean computed tomography (CBCT) scans in order to analyze the location, number, course and anastomosing pattern of the lingual canals. A total number of 165 lingual canals (LCs) were recorded from 55 patients, as follows: 94 median (MLC), 16 paramedian (PLC) and 55 lateral lingual canals (LLC). MLCs were a constant finding in all 55 patients (100% of the cases), PLCs were present in 15 patients (27.3% of the cases), and LLCs were identified in 35 patients (63.3% of the cases). The anastomosing pattern of the MLC, in which a supraspinous canal anastomosed with an infraspinous canal, was found in 10.9% of the cases (6 of 55 patients),. The LLCs were anastomosed with the mandibular incisive canal (MIC) in 56.3% of the cases (31 of 55 LLCs) and with the mandibular canal (MC) in 3.6% of the cases (2 of 55 LLCs). CBCT revealed itself to be a reliable tool for evaluating the intramandibular topography of the LCs. The anastomosing pattern of the lingual canals might raise the question whether the LCs could be responsible for incomplete anesthesia after conventional mandibular block by carrying sensory innervation from the mylohyoid nerve to the inferior alveolar nerve. Keywords: mandible, lingual canal, intramandibular anastomosis, CBCT

Mandibular canines with additional roots: An ex vivo study of the external and internal morphology.

The aim of this study was to investigate the root and root canal morphologies of mandibular canines with additional roots using cone-beam computed tomography. Seventy-seven extracted two-rooted and one-three-rooted permanent human mandibular canines were selected. Aspects of the external morphology evaluated were crown length, root length, total length, root bifurcation distance from the cementoenamel junction, root size, and direction of the root curvature in the apical third. Features of internal morphology assessed were root canal number per root, root canal bifurcation distance from the cementoenamel junction, and the angle between the buccal or lingual canal and the main canal. The root size and length presented considerable diversity. Most of the roots bifurcated at the middle third and exhibited a buccal curvature. The main root canal bifurcated coronally in two root canals, a buccal and a lingual. The majority of the buccal and lingual root canal angles were blunt. The presence of a third root in a specimen was a novel finding of this study.

Topographical distribution of neurovascular canals and foramens in the mandible: avoiding complications resulting from their injury during oral surgical procedures

PurposeCertain oral surgical procedures can injure neurovascular canals and foramens in the mandible. Hence, before performing surgical procedures, it is important to assess the distribution of the bifid mandibular canal (BMC), accessory mental foramen (AMF), medial lingual canal (MLC), lateral lingual canal (LLC), buccal foramen (BF), and lingual alveolar canal (LAC). This study aimed to assess the distribution of different types of canals and foramens. Furthermore, we investigated the limitations associated with finding these structures in panoramic images. MethodsFifty-eight patients who had undergone panoramic radiography and computed tomography (CT) scans at our hospital were randomly selected for this study. Imaging data obtained from these patients were retrospectively reviewed. ResultsWe found that the occurrence of BMC was 60.3%, AMF was 6.9%, MLC was 98.2%, LLC was 75.9%, BF was 43.1%, and LAC was 98.3%. Edge-contrasted inverted panoramic images revealed BMCs in 21.7% and AMFs in 25%; however, most of these canals could not be detected. In the panoramic images, the average diameter of the BMC was significantly different between the detected group and not detected group. The number of canals and foramens in the anterior region to the molar region decreased on the buccal and lingual sides, and most BMCs were in the retromolar to the ramus region. ConclusionOur results indicated different distributions and occurrence rates of each type of neurovascular canal and foramens.