Revista de Odontologia da UNESP
https://revodontolunesp.com.br/journal/rou/article/doi/10.1590/1807-2577.00117
Revista de Odontologia da UNESP
Original Article

The prevalence of mandibular retromolar canals on cone beam computed tomography and its clinical repercussions

Prevalência de canais retromolares mandibulares em exames de tomografia computadorizada de feixe cônico e suas repercussões clínicas

George Borja de FREITAS; Alessandra de FREITAS E SILVA; Luiz Roberto Coutinho MANHÃES JÚNIOR

http://dx.doi.org/10.1590/1807-2577.00117 Rev. odontol. UNESP, vol.46, n3, p.158-163, 2017
PDF
Downloads: 2
Views: 1299

Abstract

Abstract: Introduction: Knowledge on the normal morphology of the human mandible and its possible anatomical variations are of fundamental importance in dental practice, especially in the areas of surgery and implantodontics. The retromolar region is delimited by the anterior margin of the ramus of the mandible, the temporal crest and the distal surface of the last lower molar. In this area, a retromolar canal may be observed emerging through the retromolar foramen.

Objective: This study aims to evaluate the prevalence of retromolar canals in cone beam computed tomography (CBCT) images and to correlate it with their possible clinical repercussions.

Material and method: 300 CBCT images were selected from the Department of Radiology of the São Leopoldo Mandic Dental School. This was an observational descriptive study and all the images were processed and analyzed on XoranCat®.

Result: Of the 300 CFCT scans analyzed, a single mandibular canal was observed in 210 (70.0%). In the remaining 90 cases, anatomical changes were observed relating to this canal, indicating that the prevalence of this condition in this sample was 30%. The prevalence of retromolar canals was observed in 15 patients (5.0%), of which 06 were in males and 09 in females.

Conclusion: The importance of a full knowledge on the anatomy of the retromolar region is herein reiterated due to the high prevalence of surgical procedures in the posterior region of the mandible, which could optimize predictability at treatment planning as well as anesthetic and surgical outcomes, thus minimizing anesthetic failures and surgical accidents.

Keywords

Surgery, anatomy, mandible

Resumo

Resumo: Introdução: O conhecimento da morfologia normal da mandíbula humana e suas possíveis variações anatômicas, que ocorrem, são de fundamental importância na prática odontológica, especialmente nas áreas da cirurgia e implantodontia. A região retromolar é delimitada pela margem anterior do ramo da mandibular, crista temporal e face distal do último molar inferior. Nessa área pode ser observado o canal retromolar que pode emergir pelo forame retromolar.

Objetivo: O presente estudo objetiva avaliar a ocorrência de canais retromolares em exames de tomografia computadorizada de feixe cônico e relaciona-la com suas possíveis repercussões clínicas.

Material e método: Foram selecionadas 300 imagens de TCFC provenientes do Departamento de Radiologia da Faculdade São Leopoldo Mandic. O presente estudo foi do tipo observacional descritivo e todas as imagens foram processadas e trabalhadas no software XoranCat® do próprio equipamento.

Resultado: Dos 300 exames de TCFC analisados, os canais mandibulares eram únicos em 210 (70,0%). Nos demais 90 casos constatou-se a presença alterações anatômicas no canal mandibular, indicando que a taxa de prevalência dessa condição na amostra foi de 30,0%. A ocorrência dos canais retromolares foi observada em 15 pacientes da amostra total (5,0%), sendo 06 pacientes do gênero masculino e 09 pacientes do gênero feminino.

Conclusão: Ratifica-se a importância de um minucioso conhecimento da região retromolar devido a grande prevalência de cirurgias realizadas na região posterior da mandíbula, a fim de ter previsibilidade nos planejamentos e consequentemente otimizar os procedimentos anestésicos e cirúrgicos realizados, minimizando as falhas anestésicas e os acidentes cirúrgicos.
 

Palavras-chave

Cirurgia, anatomia, mandíbula

References

Han SS, Hwang YS. Cone beam CT findings of retromolar canals in a korean population. Surg Radiol Anat. 2014 Nov;36(9):871-6. PMid:24504621. http://dx.doi.org/10.1007/s00276-014-1262-1.

Muinelo-Lorenzo J, Suárez-Quintanilla JA, Fernández-Alonso A, Marsillas-Rascado S, Suárez-Cunqueiro MM. Descriptive study of the bifid mandibular canals and retromolar foramina: cone beam CT vs panoramic radiography. Dentomaxillofac Radiol. 2014;43(5):20140090. PMid:24785820. http://dx.doi.org/10.1259/dmfr.20140090.

Claeys V, Wackens G. Bifid mandibular canal: literature review and case report. Dentomaxillofac Radiol. 2005 Jan;34(1):55-8. PMid:15709108. http://dx.doi.org/10.1259/dmfr/23146121.

Bilecenoglu B, Tuncer N. Clinical and anatomical study of retromolar foramen and canal. J Oral Maxillofac Surg. 2006 Oct;64(10):1493-7. PMid:16982307. http://dx.doi.org/10.1016/j.joms.2006.05.043.

Rossi AC, Freire AR, Prado GB, Prado FB, Botacin PR, Caria PHF. Incidence of retromolar foramen in human mandibles: ethnic and clinical aspects. Int J Morphol. 2012 Sep;30(3):1074-8. http://dx.doi.org/10.4067/S0717-95022012000300051.

Kawai T, Asaumi R, Sato I, Kumazawa Y, Yosue T. Observation of the retromolar foramen and canal of the mandible: a CBCT and macroscopic study. Oral Radiol. 2012 Mar;28(1):10-4. http://dx.doi.org/10.1007/s11282-011-0074-9.

Langlais RP, Broadus R, Glass BJ. Bifid mandibular canals in panoramic radiographs. J Am Dent Assoc. 1985 Jun;110(6):923-6. PMid:3860553. http://dx.doi.org/10.14219/jada.archive.1985.0033.

Patil S, Matsuda Y, Nakajima K, Araki K, Okano T. Retromolar canals as observed on cone-beam computed tomography: their incidence, course, and characteristics. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 May;115(5):692-9. PMid:23601225. http://dx.doi.org/10.1016/j.oooo.2013.02.012.

Rodella LF, Buffoli B, Labanca M, Rezzani R. A review of the mandibular and maxillary nerve supplies and their clinical relevance. Arch Oral Biol. 2012 Apr;57(4):323-34. PMid:21996489. http://dx.doi.org/10.1016/j.archoralbio.2011.09.007.

Sawyer DR, Kiely ML. Retromolar foramen: a mandibular variant important to dentistry. Ann Dent. 1991;50(1):16-8. PMid:1872586.

Kodera H, Hashimoto I. A case of mandibular retromolar canal: elements of nerves and arteries in this canal. Kaibogaku Zasshi. 1995 Feb;70(1):23-30. PMid:7785408.

Sonick M, Abrahams J, Faiella RA. A comparison of the accuracy of periapical, panoramic, and computerized tomographic radiographs in locating the mandibular canal. Int J Oral Maxillofac Implants [Internet]. 1994;9(4):455-60 [cited 2010 July 6]. Available from: http://www.sonickdmd.com/wp-content/uploads/2012/05/JOMI-1994-A-Comparison-of-the-Accuracy-of-Periapica.pdf

Cavalcanti MGP. Tomografia computadorizada por feixe cônico. 2nd ed. São Paulo: Livraria Editora Santos; 2014.

Angelopoulos C, Thomas S, Hechler S, Parissis N, Hlavacek M. Comparison between digital panoramic radiography and cone-beam computed tomography for the identification of the mandibular canal as part of presurgical dental implant assessment. J Oral Maxillofac Surg. 2008 Oct;66(10):2130-5. PMid:18848113. http://dx.doi.org/10.1016/j.joms.2008.06.021.

Chávez-Lomeli ME, Mansilla-Lory J, Pompa JA, Kjaer I. The human mandibular canal arises from three separate canals innervating different tooth groups. J Dent Res. 1996 Aug;75(8):1540-4. PMid:8906121. http://dx.doi.org/10.1177/00220345960750080401.

Sanchis JM, Peñarrocha M, Soler F. Bifid mandibular canal. J Oral Maxillofac Surg. 2003 Apr;61(4):422-4. PMid:12684957. http://dx.doi.org/10.1053/joms.2003.50004.

Nortjé CJ, Farman AG, V Joubert JJ. The radiographic appearance of the inferior dental canal: an additional variation. Br J Oral Surg. 1977 Nov;15(2):171-2. PMid:271020. http://dx.doi.org/10.1016/0007-117X(77)90050-6.

Santos O Jr, Pinheiro LR, Umetsubo OS, Sales MA, Cavalcanti MG. Assessment of open source software for CBCT in detecting additional mental foramina. Braz Oral Res. 2013 Apr;27(2):128-35. PMid:23459775. http://dx.doi.org/10.1590/S1806-83242013005000003.

Orhan K, Aksoy S, Bilecenoglu B, Sakul BU, Paksoy CS. Evaluation of bifid mandibular canals with cone beam computed tomography in a Turkish adult population: a retrospective study. Surg Radiol Anat. 2011 Aug;33(6):501-7. PMid:21161224. http://dx.doi.org/10.1007/s00276-010-0761-y.

Oliveira-Santos C, Souza PH, Azambuja Berti-Couto S, Stinkens L, Moyaert K, Rubira-Bullen IRF, et al. Assessment of variations of the mandibular canal through cone beam computed tomography. Clin Oral Investig. 2012 Apr;16(2):387-93. PMid:21448636. http://dx.doi.org/10.1007/s00784-011-0544-9.

Kim MS, Yoon SJ, Park HW, Kang JH, Yang SY, Moon YH, et al. A false presence of bifid mandibular canals in panoramic radiographs. Dentomaxillofac Radiol. 2011 Oct;40(7):434-8. PMid:21960401. http://dx.doi.org/10.1259/dmfr/87414410.

Schejtman R, Devoto FC, Arias NH. The origin and distribution of the elements of the human mandibular retromolar canal. Arch Oral Biol. 1967;12(11):1261-8. PMid:5234232. http://dx.doi.org/10.1016/0003-9969(67)90127-6.

Lizio G, Pelliccioni GA, Ghigi G, Fanelli A, Marchetti C. Radiographic assessment of the mandibular retromolar canal using cone-beam computed tomography. Acta Odontol Scand. 2013 May-Jul;71(3-4):650-5. PMid:22809124. http://dx.doi.org/10.3109/00016357.2012.704393.

Orhan AI, Orhan K, Aksoy S, Ozgül O, Horasan S, Arslan A, et al. Evaluation of perimandibular neurovascularization with accessory mental foramina using cone-beam computed tomography in children. J Craniofac Surg. 2013 Jul;24(4):e365-9. PMid:23851871. http://dx.doi.org/10.1097/SCS.0b013e3182902f49.

Khan MA, Agarwal S, Mandloi RS. Prevalence of retromolar foramen in dried mandible along with morphometric and analytical study in North India. Natl J Med Dental Res. 2013;2:11-4.
 

595a2fb20e8825604780248d rou Articles
Links & Downloads
1807-2577 (Electronic)
Rev. odontol. UNESP ©2024 All rights reserved.

Rev. odontol. UNESP

Share this page
Page Sections