Evaluation of neurovascular anatomical variation in the anterior mandible in North Indian population: A CBCT assessment

Abstract

Introduction: The purpose of this retrospective study was to determine the visibility, location and other morphometric features of lingual foramina on CBCT along with its age wise and gender wise correlation.

Material and methods: A total of 250 patients were included in the study. Cross-sectional CBCT images of the mandible in the midline were used to locate and define each detected lingual foramen and canal. Descriptive statistics including tables and graphs were used. Genderwise and Age wise correlations were analyzed using Chi-square tests.

Results: The number, direction, length, diameter, distance from alveolar crest and inferior borders of mandible were evaluated. Genderwise Lingual foramen was most frequently located in the mandibular midline, above genial tubercle (81.7%). Agewise it was found to be significant (p = 0.019). Genderwise length of canal was found to be significant (p = 0.022). Genderwise diameter of canal at midpoint was found to be very highly significant (p < 0.001) and at innermost point was found to significant. (p = 0.037) Genderwise and Agewise distance between orifice of canal and alveolar crest was found to be very highly significant. (p < 0.001) Genderwise and Agewise distance between innermost point of canal and alveolar crest was found to be highly significant (p = 0.001) and very highly significant (p < 0.001) respectively.

Conclusion: Clinicians may consider CBCT for procedures with a risk of hemorrhagic and neurosensory complications such as dental implant placement in the anterior mandible.

Keywords: Anterior mandible; CBCT; Dental implants; Lingual foramen.

© 2022 Published by Elsevier B.V. on behalf of Craniofacial Research Foundation.

Figures

Fig. 1

CBCT images showing different types of the lingual foramen and lingual canals as seen on sagittal planes A. Single lingual canal above genial tubercle. B. Single lingual canal below genial tubercle. C. Single lingual canal located above the genial tubercle with a bifurcation in the posterior most part. D. Multiple- Two canals-one above the genial tubercle, other located below genial tubercle, one oriented downwards and another upwards. E. Multiple- Intersection of two separate canals ;one—oriented downwards—located above the genial tubercle, other—oriented upwards—located below genial tubercle. F.Multiple- Cross-section image of canal is a representation of two parallel canals. G.Multiple- Intersection of two separate canals; one exiting through the lingual cortical plate and one through the labial. H.Multiple- Three canals. I. a and b- Multiple- 1 canal labial 1 canal superior to genial tubercle and one canal perpendicular to alveolar crest. J. Multiple- One canal above the genial tubercle and one below the genial tubercle with anastomosis.

Fig. 2

CBCT image showing diameter of lingual canal as seen on sagittal planes. A. At orifice, B. At Mid level C. At Innermost point of the lingual canal.

Fig. 3

CBCT image showing vertical distance of lingual canal to the alveolar crest and to the inferior border of mandible as seen on sagittal planes.