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Case Reports
. 2012 Mar;16(1):147-51.
doi: 10.1007/s10006-011-0278-5. Epub 2011 Jun 23.

The clinical relevance of bifid and trifid mandibular canals

K Mizbah  1 , N Gerlach, T J Maal, S J Bergé, Gert J Meijer
Affiliations
Case Reports

The clinical relevance of bifid and trifid mandibular canals

K Mizbah et al. Oral Maxillofac Surg. 2012 Mar.

Abstract

Background: Bifid mandibular canals (BMC) and trifid mandibular canals (TMC) are variations on the normal anatomy with incidences ranging from 0.08% to 65.0%. Such aberrations have an important clinical impact. For example, an extra mandibular canal may explain inadequate anesthesia, especially when two mandibular foramina are involved. Furthermore, during mandibular surgery, a second, or even third, neurovascular bundle may be damaged causing paresthesia, neuroma development, or bleeding.

Case report: Two cases are presented in this article. One patient had a BMC on both sites, and the other patient had a TMC on one site and a BMC on the other site.

Discussion: Initial screening for the presence of a BMC or TMC can be executed by conventional panoramic radiography. BMCs or TMCs are diagnosed, before executing mandibular surgery; additional CBCT scanning is indicated.

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Figures

Fig. 1
Fig. 1
a Panoramic radiograph. b Coronal cross section. c Axial cross section
Fig. 2
Fig. 2
Panoramic radiograph showing the two mandibular canals (see arrows)
Fig. 3
Fig. 3
Showing coronal cross sections. a Before the splitting of the canal. b The bifurcation just started. c Showing two separate canals. d Vertical course of the retromolar canal
Fig. 4
Fig. 4
Reconstruction with nerve tracking showing the bifid and trifid mandibular canals
See this image and copyright information in PMC

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