Skip to main content

Advertisement

Log in

Analysis of the frequency of visualization of morphological variations in anatomical bone features in the mandibular interforaminal region through cone-beam computed tomography

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to analyze the frequency of visualization of anatomical bone features and their possible variations in the mandibular interforaminal region through cone-beam computed tomography (CBCT).

Methods

This is a cross-sectional study that evaluated CBCT scans of the mandible of 141 women and 61 men, obtained by imaging archives from two private clinics of dental radiology. The study analyzed the frequency of visualization of: lingual symphyseal foramen (LSF), additional mental foramen (AdMF), absence of mental foramen (AbMF), mandibular incisive canal (MIC), and anterior loop (AL). Length measurements for MIC and AL were determined at first and following that the respective distances towards vestibular and lingual cortical walls were also individually verified. Statistical analyses included: Student’s t test, Chi-square test, and ANOVA for the evaluation of the anatomical features observed through panoramic and parasagittal images’ reconstructions.

Results

LSF presence was found in 97%, MIC in 75.9%, AL in 24%, AdMF in 4.7%, and AbMF in 2.5%. Chi-square tests demonstrated value results of p < 0.05 only for the presence of left AL in women when compared to men. Mean values for length measures of MIC and AL were of 10.1 and 2.12 mm, respectively. Mean distance from AL towards vestibular and lingual cortical walls was of 2.53 and 4.05 mm, respectively.

Conclusion

Anatomical variability concerning the mandibular interforaminal region emphasizes the importance of performing CBCT in pre-operative assessment of the mandible for surgical procedures with oral implants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12

Similar content being viewed by others

References

  1. Andrade E, Otomo-Corgel J, Pucher J, Ranganath KA, St George N Jr (2001) The intraosseous course of the mandibular incisive nerve in the mandibular symphysis. Int J Periodontics Rest Dent 21:591–597

    Google Scholar 

  2. Apostolakis D, Brown JE (2012) The anterior loop of the inferior alveolar nerve: prevalence, measurement of its length and a recommendation for interforaminal implant installation based on cone beam CT imaging. Clin Oral Impl Res 23:1022–1030. https://doi.org/10.1111/j.1600-0501.2011.02261.x

    Article  Google Scholar 

  3. Babiuc I, Tarlungeanu I, Pauna M (2011) Cone beam computed tomography observations of the lingual foramina and their bony canals in the median region of the mandible. Romanian J Morphol Embryol = Revue roumaine de morphologie et embryologie 52:827–829

    Google Scholar 

  4. Bernardi S, Rastelli C, Leuter C, Gatto R, Continenza MA (2014) Anterior mandibular lingual foramina: an in vivo investigation. Anat Res Int 25: 1–6.https://doi.org/10.1155/2014/906348

    Article  Google Scholar 

  5. Brito ACR, Nejaim Y, Freitas DQ, Santos CO (2016) Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal. Imaging Sci Dent 46:159–65. https://doi.org/10.5624/isd.2016.46.3

    Article  PubMed  PubMed Central  Google Scholar 

  6. Dechow PC, Wang Q, Peterson J (2010) Edentulation alters material properties of cortical boné in the human craniofacial skeleton: functional implications for craniofacial structure in primate evolution. Anat Rec (Hoboken) 293:618–629. https://doi.org/10.1002/ar.21124

    Article  Google Scholar 

  7. Gerlach NL, Meijer GJ, Maal TJ et al (2010) Reproducibility of 3 different tracing methods based on cone beam computed tomography in determining the anatomical position of the mandibular canal. J Oral Maxillofac Surg 68:811–817. https://doi.org/10.1016/j.joms.2009.09.059

    Article  PubMed  Google Scholar 

  8. Greenstein G, Tarnow D (2006) The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review. J Periodontol 77:1933–1943. https://doi.org/10.1902/jop.2006.060197

    Article  PubMed  Google Scholar 

  9. Haktanir A, Ilgaz K, Turhan-Haktanir N (2010) Evaluation of mental foramina in adult living crania with MDCT. Surgical Rad Anat 32:351–356.https://doi.org/10.1007/s00276-009-0572-1

    Article  Google Scholar 

  10. Hanihara T, Ishida H (2001) Frequency variations of discrete cranial traits in major human populations. IV. Vessel and nerve related variations. J Anat 199:273–287. https://doi.org/10.1046/j.1469-7580.2001.19930273.x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. He P, Truong MK, Adeeb N, Tubbs RS, Iwanaga J (2017) Clinical anatomy and surgical significance of the lingual foramina and their canals. Clinical Anat 30:194–204. https://doi.org/10.1002/ca.22824

    Article  Google Scholar 

  12. Jacobs R, Souza PH, De Berti-Couto AS, et al (2004) Appearance of the mandibular incisive canal on panoramic radiographs. Surg Rad Anat 26:329–333. https://doi.org/10.1007/s00276-004-0242-2

    Article  CAS  Google Scholar 

  13. Jalili MR, Esmaeelinejad M, Bayat M, Aghdasi MM (2012) Appearance of anatomical structures of mandible on panoramic radiographs in Iranian population. Acta Odontol Scand 70:384–389. https://doi.org/10.3109/00016357.2011.629625

    Article  PubMed  Google Scholar 

  14. Juodzbalys G, Wang HL, Sabalys G (2010) Anatomy of mandibular vital structures. Part II: mandibular incisive canal, mental foramen and associated neurovascular bundles in relation with dental implantology. J Oral Maxillofac Res 1:1–10. https://doi.org/10.5037/jomr.2010.1103

    Article  Google Scholar 

  15. Kalpidis CD, Setayesh RM (2004) Hemorrhaging associated with endosseous implant placement in the anterior mandible: a review of the literature. J Periodontol 75:631–645. https://doi.org/10.1902/jop.2004.75.5.631

    Article  PubMed  Google Scholar 

  16. Katakami K, Mishima A, Shiozaki K, Shimoda S, Hamada Y, Kobayashi K (2008) Characteristics of accessory mental foramina observed on limited cone-beam computed tomography images. J Endodon 34:1441–1445. https://doi.org/10.1016/j.joen.2008.08.033

    Article  Google Scholar 

  17. Kuzmanovic DV, Payne AG, Kieser JA, Dias GJ (2003) Anterior loop of the mental nerve: a morphological and radiographic study. Clin Oral Impl Res 14:464–471. https://doi.org/10.1034/j.1600-0501.2003.00869.x

    Article  Google Scholar 

  18. Lauhr G, Coutant JC, Normand E, Laurenjoye M, Ella B (2015) Bilateral absence of mental foramen in a living human subject. Surg Rad Anat 37:403–405. https://doi.org/10.1007/s00276-014-1347-x

    Article  Google Scholar 

  19. Liang X, Jacobs R, Lambrichts I, Vandewalle G (2007) Lingual foramina on the mandibular midline revisited: a macroanatomical study. Clinical Anat 20:246–251. https://doi.org/10.1002/ca.20357

    Article  CAS  Google Scholar 

  20. Liang X, Jacobs R, Corpas LS, Semal P, Lambrichts I (2009) Chronologic and geographic variability of neurovascular structures in the human mandible. Forensic Sci Int 190:24–32. https://doi.org/10.1016/j.forsciint.2009.05.006

    Article  CAS  PubMed  Google Scholar 

  21. Liang X, Jacobs R, Hassan B, Li L, Pauwels R, Corpas L et al (2010) A comparative evaluation of cone beam computed tomography (CBCT) and multi-slice CT (MSCT) Part I. On subjective image quality. Eur J Radiol 75:265–269. https://doi.org/10.1016/ejrad.2009.03.042

    Article  PubMed  Google Scholar 

  22. Limongelli L, Tempesta A, Crincoli V, Favia G (2015) Massive. lingual and sublingual haematoma following postextractive flapless implant placement in the anterior mandible. Case reports in dentistry 17:1–4. https://doi.org/10.1155/2015/839098

    Article  Google Scholar 

  23. Longoni S, Sartori M, Braun M et al (2007) Lingual vascular canals of the mandible: the risk of bleeding complications during implant procedures. Implant Dent 16:131–138. https://doi.org/10.1097/ID.0b013e31805009d5

    Article  PubMed  Google Scholar 

  24. Ludlow JB, Davies-Ludlow LE, Brooks SL, Howerton WB (2006) Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. Dentomaxillofac Radiol 35(4):219–226. https://doi.org/10.1259/dmfr/14340323

    Article  CAS  PubMed  Google Scholar 

  25. Makris N, Stamatakis H, Syriopoulos K, Tsiklakis K, van der Stelt PF (2010) Evaluation of the visibility and the course of the mandibular incisive canal and the lingual foramen using cone-beam computed tomography. Clin Oral Implants Res 21:766–771. https://doi.org/10.1111/j.1600-0501.2009.01903.x

    Article  PubMed  Google Scholar 

  26. Manikandhan R, Mathew PC, Naveenkumar J, Anantanarayanan PA. (2010) A rare variation in the course of the inferior alveolar nerve. Int J Oral Maxillofac Surg 39:185–187.https://doi.org/10.1016/j.ijom.2009.12.007

    Article  CAS  PubMed  Google Scholar 

  27. Mardinger O, Chaushu G, Arensburg B, Taicher S, Kaffe I (2000) Anatomic and radiologic course of the mandibular incisive canal. Surg Rad Anat 22:157–161

    Article  CAS  Google Scholar 

  28. Mraiwa N, Jacobs R, Moerman P, Lambrichts I, van Steenberghe D, Quirynen M (2003) Presence and course of the incisive canal in the human mandibular interforaminal region: two-dimensional imaging versus anatomical observations. Surg Rad Anat 25:416–423. https://doi.org/10.1007/s00276-003-0152-8

    Article  CAS  Google Scholar 

  29. Murlimanju BV, Prakash KG, Samiullah D et al (2012) Accessory neurovascular foramina on the lingual surface of mandible: incidence, topography, and clinical implications. Indian J Dent Res 23:433–435. https://doi.org/10.4103/0970-9290.102252

    Article  CAS  PubMed  Google Scholar 

  30. Naitoh M, Hiraiwa Y, Aimiya H, Gotoh K, Ariji E (2009) Accessory mental foramen assessment using cone-beam computed tomography. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 107:289–294. https://doi.org/10.1016/j.tripleo.2008.09.010

    Article  PubMed  Google Scholar 

  31. Nascimento EH, Dos Anjos Pontual ML, Dos Anjos Pontual A et al (2016) Assessment of the anterior loop of the mandibular canal: a study using cone-beam computed tomography. Imaging Sci Dent 46:69–75. https://doi.org/10.5624/isd.2016.46.2.69

    Article  PubMed  PubMed Central  Google Scholar 

  32. Neves FS, Nascimento MC, Oliveira ML, Almeida SM, Bóscolo FN. (2014) Comparative analysis of mandibular anatomical variations between panoramic radiography and cone beam computed tomography. J Oral Maxillofac Surg 18:419–24. https://doi.org/10.1007/s10006-013-0428-z.

    Article  Google Scholar 

  33. Ngeow WC, Dionysius DD, Ishak H, Nambiar PA (2009) A radiographic study on the visualization of the anterior loop in dentate subjects of different age groups. J Oral Sci 51:231–237. https://doi.org/10.2334/josnusd.51.231

    Article  PubMed  Google Scholar 

  34. Obradovic O, Todorovic L, Pesic V, Pejkovic B, Vitanovic V (1993) Morphometric analysis of mandibular canal: clinical aspects. Bulletin du Groupement international pour la recherche Scientifique en Stomatologie Odontologie 36:109–113

    CAS  PubMed  Google Scholar 

  35. Oliveira-Santos C, Souza PH, De Berti-Couto AS, et al (2011) Characterisation of additional mental foramina through cone beam computed tomography. J Oral Rehabilit 38:595–600. https://doi.org/10.1111/j.1365-2842.2010.02186.x

    Article  Google Scholar 

  36. Oliveira-Santos C, Capelozza AL, Dezzoti MS, Fischer CM, Poleti ML, Rubira-Bullen IR (2011) Visibility of the mandibular canal on CBCT cross-sectional images. J Appl Oral Sci 19: 240–243. https://doi.org/10.1590/S1678-77572011000300011

    Article  PubMed  PubMed Central  Google Scholar 

  37. Oliveira-Santos C, Souza PH, de Berti-Couto AS, et al (2012) Assessment of variations of the mandibular canal through cone beam computed tomography. Clin Oral Investig 16:387–393. https://doi.org/10.1007/s00784-011-0544-9

    Article  PubMed  Google Scholar 

  38. Pires CA, Bissada NF, Becker JJ, Kanawati A, Landers MA (2012) Mandibular incisive canal: cone beam computed tomography. Clin Implant Dent Relat Res 14:67–73.https://doi.org/10.1111/j.1708-8208.2009.00228.x

    Article  PubMed  Google Scholar 

  39. Sawyer DR, Kiely ML, Pyle MA (1998) The frequency of accessory mental foramina in four ethnic groups. Archives Oral biol 43:417–420. https://doi.org/10.1016/S0003-9969(98)00012-0

    Article  CAS  Google Scholar 

  40. Silva Ramos Fernandes LM, Capelozza AL, Rubira-Bullen IR (2011) Absence and hypoplasia of the mental foramen detected in CBCT images: a case report. Surg Rad Anat 33:731–734. https://doi.org/10.1007/s00276-011-0795-9

    Article  Google Scholar 

  41. Uchida Y, Noguchi N, Goto M et al (2009) Measurement of anterior loop length for the mandibular canal and diameter of the mandibular incisive canal to avoid nerve damage when installing endosseous implants in the interforaminal region: a second attempt introducing cone beam computed tomography. J Oral Maxillofac Surg 67:744–750. https://doi.org/10.1016/j.joms.2008.05.352

    Article  PubMed  Google Scholar 

  42. von Arx T, Matter D, Buser D, Bornstein MM (2011) Evaluation of location and dimensions of lingual foramina using limited cone-beam computed tomography. J Oral Maxillofac Surg 69(11):2777–2785.https://doi.org/10.1016/j.joms.2011.06.198

    Article  Google Scholar 

  43. von Arx T, Friedli M, Sendi P, Lozanoff S, Bornstein MM (2013) Location and dimensions of the mental foramen: a radiographic analysis by using cone-beam computed tomography 39(12):1522–1528. https://doi.org/10.1016/j.joen.2013.07.033

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

To the two radiological centers located in the cities of Varginha, State of Minas Gerais, and Ribeirão Preto, State of São Paulo, in Brazil, for giving time, space, and radiology documentation for the accomplishment of these researches.

Author information

Authors and Affiliations

Authors

Contributions

MCO: development of protocol/design and analysis of CT scans; TKT: data and statistical analysis; TG: contribution in text configuration and data collection; SA: manuscript writing/editing and supervisor of the work.

Corresponding author

Correspondence to Sergio Allegrini Jr.

Ethics declarations

Conflict of interest

The authors have stated explicitly that there are no conflicts of interest in connection with this article.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

do Carmo Oliveira, M., Tedesco, T.K., Gimenez, T. et al. Analysis of the frequency of visualization of morphological variations in anatomical bone features in the mandibular interforaminal region through cone-beam computed tomography. Surg Radiol Anat 40, 1119–1131 (2018). https://doi.org/10.1007/s00276-018-2040-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-018-2040-2

Keywords

Navigation