Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey.
Surg Radiol Anat. 2024 Oct;46(10):1663-1672. doi: 10.1007/s00276-024-03460-4. Epub 2024 Aug 16.
Various anatomical variations of the inferior alveolar canal increase the incidence of surgical complications; Therefore, this study aimed to evaluate the frequency and configuration of bifid and trifid mandibular canals using cone beam computed tomography (CBCT) in the Turkish subpopulation.
The inferior alveolar canal was evaluated on 1014 hemi-mandibles in the CBCT (I-CAT 3D Imaging System) images of 513 patients. The frequency and configuration of the bifid and trifid mandibular canal (MC) were examined. The relationship between bifid MC configuration and dental status and age groups was analyzed. The distance of the accessory canal to the buccal and lingual walls and the alveolar crest was measured. The diameter of the main canal and accessory canal was measured and its relationship with dental status and age groups was evaluated.
Bifid MC was found in 266 hemi-mandibles (24.7%) and 212 (41.3%) of 513 patients. The most common type of bifid MC was the retromolar canal (87 sides), followed by the forward canal without confluence (41; 4%) and the dental canal (34; 3.4%). 10 of the dental canals were opening to the 1st molar, 14 of the 2nd molars, and 10 of the 3rd molars. The number of retromolar foramina was 1 on 56 sides, 2 on 15 sides, and 3 on 4 sides. Forward canal without confluence was more common in edentulous patients than in dentulous patients, while the dental canal was more common in dentulous patients. The main canal diameter was 3.53 ± 0.97 mm and the bifid MC diameter was 1.82 ± 0.70 mm. Distance of the bifid MC to the lingual wall was higher in the > 64 years group than in the 18-39 years group (p = 0.022). Distance of the bifid MC to the alveolar crest was lower in the > 64 years group compared to the 18-39 years group and 40-64 years group (p = 0.015). The main canal diameter was higher in the 40-64 years group than in the 18-39 years group (p = 0.012).
Bifid MC has a high prevalence, occurring in almost one in two patients. Dental and retromolar types, which are close to the teeth, are more common, and this increases the possibility of complications. CBCT is the most accurate imaging technique used to detect and define these variations.
下颌管的各种解剖变异增加了手术并发症的发生率；因此，本研究旨在使用锥形束 CT（CBCT）评估土耳其人群下颌管的二分叉和三分叉的频率和形态。
在 513 名患者的 1014 个半下颌 CBCT（I-CAT 3D 成像系统）图像中评估了下颌管。检查了二分叉和三分叉下颌管（MC）的频率和形态。分析了二分叉 MC 形态与牙齿状况和年龄组之间的关系。测量了副根管与颊侧和舌侧壁及牙槽嵴的距离。测量了主根管和副根管的直径，并评估了其与牙齿状况和年龄组的关系。
266 个半下颌（24.7%）和 513 个患者中的 212 个（41.3%）发现二分叉 MC。最常见的二分叉 MC 类型是磨牙后管（87 侧），其次是无汇合的前管（41 侧；4%）和牙管（34 侧；3.4%）。10 个牙管通向第 1 磨牙，14 个通向第 2 磨牙，10 个通向第 3 磨牙。56 侧有 1 个磨牙后孔，15 侧有 2 个磨牙后孔，4 侧有 3 个磨牙后孔。无汇合的前管在无牙患者中比在有牙患者中更常见，而牙管在有牙患者中更常见。主根管直径为 3.53±0.97mm，二分叉 MC 直径为 1.82±0.70mm。二分叉 MC 与舌侧壁的距离在>64 岁组高于 18-39 岁组（p=0.022）。与 18-39 岁组和 40-64 岁组相比，>64 岁组的二分叉 MC 与牙槽嵴的距离更低（p=0.015）。40-64 岁组的主根管直径高于 18-39 岁组（p=0.012）。
二分叉 MC 的患病率很高，几乎每两个患者中就有一个。靠近牙齿的牙型和磨牙后型更为常见，这增加了并发症的可能性。CBCT 是检测和定义这些变异最准确的成像技术。
