Retromolar Foramen Research Articles

A Morphometric Study of the Retromolar Fossa and the Incidence of the Retromolar Foramen in Dry Human Mandibles.

The mandible is the largest and strongest facial bone which plays a crucial role for various surgeries and diagnostic imaging. The retromolar fossa, located behind the third molar socket on each side, was observed for morphometry of anterior, medial, and posterior borders. The present study aimed to assess the retromolar fossa and the presence of retromolar foramen. This cross-sectional study was conducted on 30 dry mandibles of adult humans of unknown sex; morphometry of retromolar foramen was done using three parameters: anteriorly, laterally, and posteroinferiorly. Dimensions of the retromolar trigone were seen with notable differences between the right and left sides. Dimensions of the anterior border had a mean of 12.34±1.175 mm on the right side and 12.56±1.46 mm on the left side. The mean of the medial border of the trigone on the right side was 20.23±2.84 mm and on the left side was 21.48±2.57 mm. The lateral border had the mean value of 18.33±3.56 mm and 19.21±3.93 mm on the right and left sides respectively. The P-value of the medial border was found to be statistically significant (P=0.02). Retromolar foramen was observed in 60% of mandibles; six were unilateral and 12 were bilateral. These foramina were closer to the anterior border of the retromolar trigone as compared to the anterior border of the ramus and lingula of the mandibles. The awareness of these findings is crucial for the prevention of complications, such as neurovascular damage, during surgeries in this region. This knowledge is particularly relevant in addressing oral pathologies and extracting third molars, contributing to improved surgical outcomes and patient safety.

Bifurcation of the mandibular canal according to sex, age, and facial skeletal pattern: a morphological and morphometric study of cone beam computed tomography.

To assess the presence of mandibular canal bifurcation (BMC) and classify these variations by correlating findings with sex, age and facial skeletal pattern, measurements were made, including height, width, and distance from bifurcation to anatomical cortical bones. BMC was identified in cone beam CT exams of 301 patients and classified according to its origin, location, direction, configuration and ending. The height and width of the MC before and after the bifurcation; height and width of the BMC; and distance from BMC to alveolar (C1), buccal (C2), lingual (C3) and basal (C4) bone cortices were measured. All data were correlated with sex, age, and facial skeletal pattern (class I, II, III). The significance level was 5%. 67 BMC (22.26%) were identified in 55 patients (18.28%). Bifurcations were more prevalent in females (p = 0.57), aged 18-39 years (p = 0.40), class I (p = 0.77). Single bifurcations, located in the posterior region of the mandible, originating in the MC, with a superior direction and ending in the retromolar foramen were more prevalent (p > 0.05). Mean cortical measurements were higher in male individuals, with significant differences only at C1 (p = 0.03). The mean height and width of BMC were 2.24 (± 0.62) and 1.75 (± 0.45) mm. There was no association between BMC classification and the variables studied (p > 0.05). Approximately 1/5 of the population studied had BMC. There were no associations of BMC presence or characteristics with sex, age, and facial skeletal pattern. The distance from bifurcation to alveolar (superior) cortical bone is greater in male individuals.

Anatomic considerations during placement of mandibular retromolar miniplates for orthodontic anchorage – A study of the characteristics of retromolar fossa

Objectives: The mandibular retromolar area offers a novel site for orthodontic skeletal anchorage. It houses the retromolar foramen (RMF), and surgical interventions in this area can lead to undesirable outcomes. This study aims to assess the characteristics of the RMF and its relation to the occlusal plane (OP) using cone-beam computed tomography (CBCT) data. Material and Methods: This cross-sectional observational in vitro study involved the analysis of CBCT data from 136 samples (68 males and 68 females) within the age range of 18–40 years. The study focused on factors such as the presence or absence of the RMF, whether it was unilateral or bilateral, the number of foramina on each side, and the distance of the RMF from the OP. Data analysis was conducted using the Statistical Package for the Social Sciences software, with P < 0.05 deemed statistically significant at a 95% confidence level. Results: About 39% of the sample showed the presence of RMF. The prevalence of unilateral RMF was higher than that of bilateral RMF. The mean distance of RMF above the OP was 5.99 mm, and that below the OP was 3.82 mm. Conclusion: The high prevalence (39%) of RMF suggests that the retromolar fossa region should be evaluated before the placement of mini-plates. The prevalence of RMF above the OP was significantly higher than that below the OP.

CBCT Based Evaluation of the Anatomical Variation of Retromolar Canal in A Sample of Egyptian Population. A Retrospective Study

The goal of this study is to estimate the prevalence of the retromolar in the Egyptian population and to enhance the allocation of the retromolar canals and foramina. Methodology: Using a Newtom Giano HR CBCT system, radiographic evaluation of 250 CBCT scans was performed. According to the manufacturer's guidelines, multiple FOVs were used with the same voxel size (0.3 mm) to produce distinct scans for different patient sizes. The presence of retromolar canal was checked for, using the CBCT scans. Linear measurements were made from the retromolar foramen to the mandibular foramen in an anteroposterior and a mediolateral directions, as well as to the lower second and third molars, and their courses was divided into three basic classes. Results: In this study, retromolar canal was absent in sides 207 (82.8%) while was presented in 43 (17%), absence of retromolar canal was significantly higher than its presence as P<0.0001. Regarding distribution, bilateral side (16.3%) was significantly lower than unilateral distribution (83.7%) as P<0.0001. In class distribution, class A (70%) was significantly the highest, while class C (6%) was significantly the lowest. Conclusion: The prevalence of retromolar canal in the Egyptian population is 17%. When evaluating the retromolar region to identify the presence of the retromolar canal and retromolar foramen to prevent problems after various dental surgical procedures, the use of CBCT is crucial.

Characterization of a retromolar foramen in a Chinese population: A radiographic study.

Retromolar canal (RMC) arises from the mandibular canal (MC) behind the second or third molar and travels anterosuperiorly to a retromolar foramen (RMF). RMCs and RMFs have generally been ignored in anatomical textbooks and have rarely been reviewed or studied in the anatomical and dental literature until the last decades. This study aimed to characterize RMF in a Chinese population concerning its incidence, origin, and classification via anatomical study and periapical radiography. 123 dry adult Chinese mandibles were collected to observe the incidence of RMFs. RMFs were determined using a steel wire 0.5mm in diameter. The passways or origins of the retromolar canal (RMC) were determined and classified via periapical radiography. For each RMF, two dentists independently measured the diameter and its distances to the lingual cortex, the buccal cortex, and the distal edge of the last tooth (or the alveolar fossa) using a vernier caliper. The incidence of RMFs was 31.71%. The average RMF diameter was 0.78 ± 0.27mm. From RMF, the distance was 4.27 ± 1.87mm to the lingual cortex, 8.61 ± 2.23mm to the buccal cortex, and 7.84 ± 3.87mm to the distal edge of the last tooth (or the alveolar fossa). RMCs were classified into MC type originating from the mandibular canal and AF type originating from the alveolar fossa. The diameters of MC ones were more significant than those of AF ones. There was no apparent correlation between the existence of the third molar and the presence of an RMF. The incidence of RMFs in Chinese may be about one-third, which is a potential factor in the onset of surgery accidents. RMCs can be classified into two types by their origins. One of them is MC, which originates from the mandibular canal, and the other is AF, which originates from the alveolar fossa.

Prevalence of retromolar foramen in nineteenth century Spanish population.

Among the non-metrical variants of the mandible that have been proven to be a key issue for dental practitioners, the retromolar foramen constitutes one of the most controversial details regarding its prevalence and associated variables. Thus, this study evaluated the prevalence of the retromolar foramen and the variables associated with its presence in a large Spanish collection of human dry mandibles from the nineteenth century. Six hundred Spanish human dry mandibles (1200 sides) belonging to an osteology collection were examined. The presence of teeth, the presence or absence of retromolar foramen, as well as its side, diameter, number, and location were evaluated. Descriptive analysis and analysis of the associations between the variables were performed. The retromolar foramen was observed in 184 mandibles (31%) and was predominantly present unilaterally (60.8%). Most mandibles (54.9%) had a single foramen. The most common location was the retromolar trigone region (84%). On analysis of the association of variables, it was observed a strong association (p < 0.001) between the presence or absence of the foramen and the presence of teeth. Moreover, a significant association was also found between sex vs. presence of teeth (p = 0.033), sex vs. presentation side of the foramen (p = 0.028), sex vs. number of foramina found (p = 0.004), and diameter vs. number of foramina found (p < 0.001). This study reveals that the retromolar foramen showed a high prevalence of 31% in nineteenth century Spaniards and was located primarily in the retromolar trigone, suggesting that dentists should be aware of and consider the relevant findings of this study.

Analysis of various accessory foramina in mandible

Introduction: The unnamed openings present in mandible are called accessory foramina. The distribution and importance of these foramina are variable, as they may serve as a conduct for nerve fibres or blood vessels. They may be important for dental surgeon and anaesthetists in performing complete nerve block and avoiding injury to the transverse get neurovascular structures. Materials &amp; Methods: In the present study a total of 50 dry human mandibles of unknown sex and without any gross abnormality were collected from the Department of Anatomy, Saveetha Dental College, Chennai for evaluation. With the help of Vernier Calliper and Ruler, the measurements like the length, breadth and diameter of sacral hiatus will be measured. The results obtained were analysed, tabulated and represented graphically. Results: The Accessory foramina on the internal surface of the mandible was examined.Frequency of accessory mandibular foramen in 0.5mm is 40% ,in 1.0mm is 18%, in 1.5mm is 9%. Frequency of accessory mental foramen and frequency of accessory retromolar foramen in 0.25mm is 20% and 9% respectively.Conclusion: The accessory foramina transmitting during nerve block.

Systematic review and meta-analysis of mandibular canal variations on cone beam computed tomography.

The purpose of this systematic review was to evaluate the mandibular canal (MC) variations and their anatomical incidences using cone-beam computed tomography (CBCT). Related articles on the anatomical variations of the MC using CBCT were searched through PubMed, Cochrane, and China National Knowledge Infrastructure (CNKI) to identify all relevant articles eligible for inclusion. Data extracted included incidences of the anatomical variations of the MC including the accessory mental foramen (AMF), retromolar foramen (RMF), mandibular lingual foramina (MLF), and the bifid mandibular canal (BMC). In total, 16 descriptive cross-sectional studies (one low quality and fifteen high quality) were included in the meta-analysis analyzing 8862 MC. The meta-analysis performed with a random-effects model showed that the incidence of AMF was 9.54% (95% CI 6.39-12.69%), the incidence of RMF was 23.64% (95% CI 14.44-32.84%). MLF was found in almost all adults studied, and the incidence of BMC was about 38.0%. The foramina and canals branched from the MC presented significant anatomical variations among individuals. CBCT-based study on the anatomical variations of the MC could provide guidance for clinical practice.

New Classification for Bifurcated Mandibular Neural Canal

Objectives To analyze the occurrence rate of bifurcated mandibular canal (BMC) by cone beam CT(CBCT) and summarise a new classification for further clinical work and academic communication. Method Randomly collected the CBCT images of 350 adult patients. Firstly, we analysed and summarized the BMCs into four types by the position of bifurcation point in the mandible. Second, we did statistics about occurrence. Then we have measured three kinds of distance of Type I and Type II. At last, we compared the advantages and disadvantages about different classifications. Results Among these 350 patients, we found 110 adult people with BMC which indicated the occurrence rate of BMC was 31.43%. The most common type was Type I, especially Type IB, and the least was Type III. Vertical distance between the apex of the second molar, the third molar and mandibular canal are 4.36±2.51 mm and 2.45±2.23 mm. Distance from the apex of two molars to the bifurcated spot are 15.87±6.82mm and 9.32±5.37mm. And the distance between the apex and retromolar foramen in Type I are 22.19±5.97mm and 15.82±4.68mm. Conclusion Comparing with former typing theory, we summarized a new classification which is simpler and more convenient, which should attach scholars’ attention to BMC during clinical work.

Retromolar canals and mandibular third molar position: Is there a possible connection?

Introduction: The retromolar canal (RMC) is an anatomical variation of the posterior part of the mandibular canal. It is thought that this variation is related to histological vestiges of the gubernacular canal and RMC presence may be associated with mandibular third molar (MTM) malposition. This study aims to investigate the relationship between MTM position and RMC existence. Material and Methods: Patients who had undergone cone-beam computed tomography examination for various purposes were included in the study. All of the patients had unilateral or bilateral MTM teeth. MTM impaction patterns were classified according to Winter and Pell-Gregory classifications. RMC existence, type, retromolar foramen (RMF) position, RMF dimensions, and distance from RMF to second and third molars were recorded. Results: Three hundred and forty-six retromolar areas with MTM of 244 patients were evaluated. RMCs were present in 11.5% of the patients. No statistically significant relationship between RMC and MTM impaction patterns was observed. A1-type RMC was found to be the most prevalent. The mean distance from RMF to the third molar was 6.09 ± 4.20 mm and was found to be higher in male patients. The mean distance from RMF to the second molar was 15.28 ± 4.73 mm. The average dimensions of the RMF were 1.4 ± 0.47 mm. Discussion and Conclusion: RMC is a relatively common anatomical variation of the mandibular canal. Although no correlation was observed between MTM impaction pattern and RMC existence, further research including more samples may be helpful to explain a possible correlation.

The elusive retromolar foramen and retromolar canal: A CBCT study

This study aims to evaluate the presence of retromolar foramen (RMF) and retromolar canal (RMC) in the mandible using cone beam computed tomography (CBCT) in Chhattishgarh population and to correlate its possible clinical impact. 175 CBCT images were collected from which 100 bilateral CBCT images of patients were retrospectively selected from the Department of Oral Medicine and Radiology of the Chhattishgarh Dental College and Research Institute and evaluated bilaterally which were taken for diagnostic purposes from maxillofacial radiology clinic and data were statistically analyzed. This was an observational descriptive study and all the images were processed and analyzed on CS3D imaging software. The data was analyzed using chi square test. The prevalence of RMF and RMC was observed in 8.5%, of which 10 were in females and 7 in males. The RMCs traversed in different directions – horizontal, vertical and angular. Based on the subjective assessment, each of these canals was further subclassified into straight and curved canal. In the present study in 12 of the cases angular curved type was found and in 3 cases, vertical straight was noticed. The bifurcation of the inferior alveolar nerve (IAN) canal was observed in 15% of the scans and remaining 85% had single mandibular canal. The proximity of RMF from buccal and lingual cortical plates was found buccally in 16 cases and in single case was found to be lingually. Position of RMF might change with the presence and absence of third molar. The absence of third molar results in anteriorly located RMF. In majority of cases it was found that RMF was located more buccal than lingual. The parameters considered in the current study will guide the oral and maxillofacial surgeons while giving incisions in 3molar impacted cases, other pathologies and ease to preserve the retromolar foramen.

Evaluation of Retromolar Canals using Cone Beam Computer Tomography/ Avaliação do canal retromolar por meio de tomografia computadorizada de feixe cônico

The aim of this study was to evaluate the prevalence, location and clinical implications related to the presence of the retromolar canal (RMC) on cone beam computed tomography(CBCT). CBCT images of patients from Latin America Institute for Dental Research and Education - Curitiba,Pr,Brazil, was performed from June/2008 to February/2013. The interpretation was performed by a calibrated examiner, according to the criterias: presence, location and classification of the RMC variation, as well as, measurements of horizontal distances of the RMC in relation to the buccal bone cortical and diameter of these canals. A total of 751 CBCT images were interpreted: 486(64.7%) from females and 265 (35.3%) from male patients, with mean age of 54.57 (±13.23) years. The presence of RMC was observed in 58 (7.7%) patients, 23 men and 35 women. A total of 1502 hemi- mandibles were analyzed. The RMC was identified in 69(4.6%) hemi-mandibles, 44(63.8%) from females and 25(36.2%) from males. Thirty (42.8%) RMC were observed on the right side and 40 (57.2%) on the left one. The type B1 (n=33; 47.1%) was the most common, followed by the type A1 (n=18;25.7%). The mean diameter of RMC was 0.97mm (±0.44), and the mean distance between retromolar foramen and the buccal cortical of the mandible was 4.12mm (±1.35). There were no significant differences between the distances and genders, and distances and sides (p 0.05). The prevalence of RMC was 7.7% in the studied sample; they were predominantly unilateral and showed to be type B1.

Assessment of the Retromolar Canal in Taiwan Subpopulation: A Cross-Sectional Cone-Beam Computed Tomography Study in a Medical Center.

The retromolar canal is an anatomical variation that occurs in the mandibular bone. The retromolar canal typically originates in the mandibular canal on the distal side of the third molar and extends forward and upward to the retromolar foramen (RMF), which contains the neurovascular bundle. Accidentally damaging the neurovascular bundle in the retromolar canal during the extraction of the third molar, dental implant surgery, or maxillofacial orthognathic surgery may lead to subsequent complications such as incomplete local anesthesia, paresthesia, and bleeding during operation. The objective of this study was to investigate the prevalence of the RMF in the Taiwanese population in a medical center by using dental cone-beam computed tomography (CBCT) and to identify the position of the RMF in the mandibular bone. The dental CBCT images for the mandibular bone of 68 hemi-mandible were uploaded to the medical imaging software Mimics 15.1 to determine the prevalence of the RMF in the Taiwanese population and the three positional parameters of the RMF in the mandibular bone: (1) The diameter of the RMF, (2) the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the second molar, and (3) the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal. Seven RMFs were observed in the 68 hemi-mandibles. Thus, the RMF prevalence was 10.3%. In addition, the diameter of the RMF was 1.41 ± 0.30 mm (mean ± standard deviation), the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the the second molar was 12.93 ± 2.87 mm, and the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal below second molar was 13.62 ± 1.3487 mm. This study determined the prevalence of the RMF in the Taiwanese population in a medical center and its relative position in the mandibular bone. This information can provide clinicians with a reference for posterior mandible anesthesia and surgery to ensure medical safety.

Prevalence of Retromolar Foramen in Dry Human Mandibles: A Cross-sectional Study

Introduction: Retromolar foramen present in the retromolar area is related with neurovascular contents, which can be manipulated in surgical procedures. So the knowledge of the presence of foramen is important. In this study, presence of retromolar foramen is identified on dry mandibles. Aim: The aim of the study is to determine the prevalence of the retromolar foramen, its size and shape and the distance of the retromolar foramen from the last socket and the anterior border of mandible and its clinical implications. Materials and Methods: This was a cross-sectional study conducted for a period of three months from September 2019 to November 2019. Forty mandibles were observed on both sides for the presence of the retromolar foramen and its size was measured with a divider and ruler to the nearest millimeters and its shape was observed. The distances of the foramen from last molar socket and also from the anterior border of the mandible were measured with a divider and ruler to the nearest millimeters. Results: Among the 80 sides, on 9 sides (11.25%) retromolar foramen was found: 5 (6.25%) on right side, 2 (2.5%) on left side and 1 (1.25%) bilaterally. Conclusion: According to the present study retromolar foramen can be sometimes observed in mandibles. For surgical and anaesthetical procedures in the retromolar area, retromolar foramen is considered as the neurovascular bundle passing through it.

A morphological study of retromolar foramen and retromolar canal of modern and medieval population.

Retromolar foramen (RMF) is small external orifice of the retromolar canal (RMC), located in the retromolar region of the mandible. Knowledge about the location of the retromolar foramen and the route of the retromolar canal within the mandible is significant for clinical practice due to a high risk of injury during oral and caniomaxillofacial surgery. In this study, the authors analysed 100 cone beam computed tomography (CBCT) scans of the modern people's retromolar region and 26 scans of samples from the medieval population. Additionally, 74 retromolar regions of the medieval people were examined macroscopically. The statistical analysis showed a correlation between the frequency of RMC occurrence and bone thickness on the medial surface of the retromolar canal. Also it was proven that the results of the RMF identification based on macroscopic examination of the bone may be falsely negative or positive and it is caused by destruction caused by resting in soil. Thus, CBCT is the best tool for RMF and RMC identification.

Incidence of retromolar canal in Egyptian population using CBCT: a retrospective study

BackgroundMany studies have been done to investigate the incidence and the course of the retromolar canal (RMC) in different populations either osseous studies using cadavers or dry mandibles, panoramic studies, or cone beam computed tomography (CBCT) studies. The location of the RMC is in the retromolar area distal to the third mandibular molar. The retromolar area is considered an imperative site where many dental surgeries are being held.The aim of this study is to determine the incidence of RMC in the Egyptian population using CBCT and measure the distance between the RMF and neighboring anatomical landmarks to better allocate the RMC and RMF and avoid the complications.Two hundred and fourteen CBCT scans were examined to detect the presence of RMC. Their course was classified to 3 main types A, B, and C, and linear measurements were done from the retromolar foramen (RMF) to the 2nd and 3rd molars in anteroposterior direction and from the RMF to the mandibular foramen (MF) in anteroposterior and mediolateral directions.ResultsThe RMC was present in 24 scans from the 214 with 11.2% incidence rate. The most common type was found to be type A, and type C was the rarest. The RMC has no significant difference between males and females, unilateral and bilateral distribution, and right and left sides. The linear measurements from the RMF to the 2nd and 3rd molars are 14.70 ± 5.07 mm and 4.26 ± 4.21 mm, respectively, and from the RMF to the MF in anteroposterior and mediolateral directions are 15.69 ± 3.43 mm and 2.62 ± 1.60 mm, respectively.ConclusionsThe incidence rate of RMC in Egyptian population represents 11.2%. The use of CBCT is quite important in the evaluation of the retromolar area to visualize the presence of the RMC or RMF and avoid the complications occurring due to different dental surgical procedures performed in the aforementioned site.

Incidence of the retromolar foramen in dry mandibles and its significance for dental surgical procedures

O forame retromolar, assim como o canal retromolar, são variações anatômicas da mandíbula que se apresentam na região do trígono retromolar. Esse forame e canal contêm estruturas neurovasculares que fornecem inervação adicional aos molares inferiores e à área bucal. Objetivou-se verificar a incidência e ocorrência entre os sexos do forame retromolar em mandíbulas da Coleção de Ossos Contemporâneos da Universidade Federal de Pernambuco. Foram analisadas 61 mandíbulas secas, sendo 37 masculinas e 24 femininas. Das 61 mandíbulas, 18 apresentaram o forame retromolar (29,5%), sendo 12 mandíbulas apresentando o forame unilateralmente (19,67%). As mandíbulas masculinas apresentaram uma maior incidência comparada às femininas, tendo totalizado 12 (32,43%) mandíbulas com forame retromandibular. A população analisada mostra uma alta incidência do forame retromolar, especialmente para o lado direito. A identificação dessa variação anatômica auxilia no planejamento de cirurgias e durante os procedimentos anestésicos.

The clinical significance of the retromolar canal and foramen in dentistry.

The mandibular canal is nowadays acknowledged as a major trunk with multiple smaller branches running roughly parallel to it. Most of these accessory canals contain branches of the inferior alveolar neurovascular bundle that supplies the dentition, jawbone, and soft tissue around the gingiva and lower lip. This article reviews the prevalence, classification and morphometric measurements of the retromolar canal and its aperture. A retromolar canal is a bifid variation of the mandibular canal that divides from above this main canal, and travels anterosuperiorly within the bone to exit via a single foramen or multiple foramina into the retromolar fossa. This foramen, termed the retromolar foramen, allows accessory branches of the inferior alveolar neurovascular bundles to supply tissues at the retromolar trigone. Clinically, it is of the utmost importance to determine the exact location of the mandibular canal and to identify its retromolar accessory branches when surgery in the posterior mandible is to be performed.

Mandibular retromolar foramen and canal - A systematic review and meta-analysis

Introduction:The retromolar fossa is a small triangular area posterolateral to 3rd molar region in the mandible. The retromolar fossa often contains the retromolar foramen (RMF) as an anatomical variant. When the RMF is present, the foramen is connected with the mandibular canal (MC) through another canal known as the retromolar canal (RMC). RMC contains neurovascular bundle, which gives additional supply to the mandible. Although few studies have been conducted in past, a lacunae in comprehensive review is lacking. Although, these variations posed challenging situations for the practicing surgeons, they have been quite neglected and not well presented in textbooks. Hence, we made an attempt to provide a comprehensive and consolidated review regarding RMF and RMC.Materials and Methods:The relevant articles were selected by hand search and electronic media (Google scholar, PubMed, Science Direct, Medline, Embase and Cochrane) from 1987 to 2019. All the relevant articles were properly screened and findings were extracted from the articles.Results:There seems to be wide variations in morphology and morphometry of RMF and RMC.Discussion:Detailed knowledge of these anatomical variations is important in surgical procedure involving the retromolar area to protect the patient from complications such as unexpected bleeding, hematoma formation, and nerve damage. Furthermore, its knowledge makes us understand about the failed inferior alveolar nerve block, spread of infection, and metastasis in case of carcinoma. When there is any suspicious alteration in the MC, we suggest more accurate examination technique like CBCT.

Double retromolar foramen during an inferior third molar extraction: a rare case report

Objetivo: O objetivo do presente estudo foi relatar a ocorrência de um forame retromolar duplo durante a exodontia de um terceiro molar inferior. Relato de Caso: Um paciente de 20 anos do sexo masculino foi encaminhado à clínica odontológica da Universidade Federal de Alagoas para realizar extração dos terceiros molares do lado esquerdo, por motivos ortodônticos. Um forame retromolar duplo foi identificado perioperativamente durante o descolamento muco-periosteal na região do trígono retromolar, distalmente ao terceiro molar inferior esquerdo, onde houve hemorragia moderada, a qual foi controlada utilizando compressão local com gaze embebida em solução de anestésico local com vasoconstritor. A ocorrência dessa variação da normalidade foi registrada por fotografias. Antes da realização do procedimento, a radiografia panorâmica do paciente sugeria a presença dessa estrutura anatômica. Conclusões: O conhecimento acerca da ocorrência de um forame retromolar duplo apresenta importância clínica para exodontia de terceiros molares inferiores e pode auxiliar o dentista na prevenção e no manejo de acidentes e complicações durante esse procedimento cirúrgico