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. 2025 Apr 18;25(1):601.
doi: 10.1186/s12903-025-05686-z.

Evaluation of submandibular fossa depth and mandibular canal relationship with cone-beam computed tomography

Elif Sadik  1 , Zerrin Unal Erzurumlu  2 , Yasin Yasa  2 , Büsra Nur Gokkurt Yilmaz  2
Affiliations

Evaluation of submandibular fossa depth and mandibular canal relationship with cone-beam computed tomography

Elif Sadik et al. BMC Oral Health. .

Abstract

Background: Before performing surgical procedures in the posterior mandible, which contains vital structures, it is essential to have detailed knowledge of the morphology, depth, types, and variations of the submandibular fossa (SMF), as well as the precise course of the mandibular canal (MC) to avoid a possible perforation. The aim of this study was to evaluate the relationship between the depth and types of SMF, and the MC position using cone beam computed tomography (CBCT) images in a sample of Turkish individuals.

Methods: The depth and type of SMF, and relative position of the MC to the deepest point of the SMF (classified as inferior, parallel, or superior), were retrospectively evaluated on cross-sectional CBCT images. The Wilcoxon Signed Rank Test, Mann-Whitney U test, Spearman correlation coefficient, Kruskal-Wallis H test, and Chi-square test were used to analysis of the variables. A p value of less than 0.05 was accepted as significant.

Results: The submandibular fossa depth (SMFD) was measured on the left and right sides of CBCT images of 610 patients (358 female, 252 male). A significant difference was observed between the left and right sides for mean SMFD (1.93 ± 0.65 and 1.98 ± 0.67, respectively) (p = 0.001). The mean SMFD values were found to be significantly higher in males than in females on both sides (p < 0.001). The position of the MC in relation to the deepest point of the SMF was most frequently observed to be inferior. The lowest mean SMFD value was observed in the parallel position on the left and right sides (1.79 ± 0.56 and 1.77 ± 0.53, respectively).

Conclusions: The anatomical data obtained from this study contribute to the existing literature on SMFD and its relationship with the MC. It is recommended that these anatomical structures be evaluated radiologically before surgical procedures to prevent complications.

Keywords: CBCT; Mandibular Canal; Radiographic examination; Submandibular fossa.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This research protocol was approved by the Clinical Research Ethical Committee of Ordu University with the assignment protocol number 2023/79. All research procedures were conducted in accordance with the relevant guidelines and regulations set forth in the Declaration of Helsinki. This study was conducted retrospectively and did not contain any personally identifiable information. Informed consent to anonymized data release was obtained from all patients included in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Measurement of submandibular fossa depth on cross-sectional images
Fig. 2
Fig. 2
Position of the mandibular canal (MC) relative to the deepest point of the submandibular fossa. a. Inferior position; the upper border of the MC is below the reference line (b) Parallel position; the reference line is in contact with the MC (c) Superior position; the lower border of the MC is above the reference line. (The blue line is the reference line. The MC is indicated by a red dot.)
Fig. 3
Fig. 3
Correlation graphs for left and right SMFD values with age
Fig. 4
Fig. 4
Distribution of left and right SMFD according to types
See this image and copyright information in PMC

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