Prevalence of Bifid Mandibular Canals in a United States Dental School Population

Objective: The mandibular canal, which houses the inferior alveolar neurovascular bundle, is a critical anatomic structure that needs to be accurately identified for mandibular dental procedures such as dental implant placement, extractions, and endodontic procedures. Damage to the mandibular neurovascular bundle can cause both neurologic damage and bleeding concerns. “Bifid” mandibular canals are a normal anatomic variation of mandibular canals. The purpose of this study is to identify the prevalence of bifid canals, use the Naitoh classification system to classify the bifid canals, and to measure the height of alveolar bone above the most superior portion of the mandibular canal. Other factors such as gender and ethnicity were evaluated for association with bifid canal prevalence.Methods: Retrospective analysis of 1,006 mandibular CBCT scans of patients treated at the Temple Kornberg School of dentistry were analyzed using Xelis software. Age, gender, ethnicity, and dentition status were recorded for each patient in the study. For each scan the right and left mandibular canals were identified as singular or bifid, and the height of alveolar bone above the most superior border of the mandibular canal at the right and left first molar position was recorded. Descriptive statistics, bivariate analyses, and multivariable regression analyses were performed using “R” statistical software. Results: After exclusion, 558 CBCT scans were included in the study. Of the 558 patients, 247 were male and 311 were female. Based on ethnicity: there were 170 African Americans, 53 Asians, 263 Caucasians, and 72 Hispanics. 76 of the patients had a complete mandibular dentition, and 482 were missing at least 1 tooth in the mandible. The prevalence of bifid mandibular canals in the study population was 12.54%. There was no significant difference in the prevalence of bifid canals in relation to gender or ethnicity. The height of alveolar bone above the most superior border of the mandibular canal at the first molar position ranged from (2.2mm to 28.4mm) with an average of 15.25mm. There was a significantly greater height of alveolar bone in fully dentate compared to partially edentulous patients (p < 0.001), and there was a significant negative correlation between alveolar bone height above the mandibular canal and age (p <0.045). Conclusions: Bifid mandibular canals are present in 12.54% the population studied, and the prevalence does not vary by gender, or ethnicity as past studies have proposed. Further, alveolar height above the mandibular canal decreases with age and tooth loss. Therefore, it is critically important to obtain CBCT imaging of the mandible before performing implant, oral surgical, or endodontic procedures to prevent neurosensory and/or bleeding complications and improve patient care.

Grantor dc:publisher

Temple University. Libraries

Year dc:date.issued

2024

Author dc:creator

• Gartley, Shamus

Advisor dc:contributor.advisor

• Hsiao, Yueh J.

Committee members dc:contributor.committeemember

• Chialastri, Susan M.
• Yang, Jie

• Dentistry

Statement dc:rights

• IN COPYRIGHT- This Rights Statement can be used for an Item that is in copyright. Using this statement implies that the organization making this Item available has determined that the Item is in copyright and either is the rights-holder, has obtained permission from the rights-holder(s) to make their Work(s) available, or makes the Item available under an exception or limitation to copyright (including Fair Use) that entitles it to make the Item available.

Licence dc:rights.uri

• http://rightsstatements.org/vocab/InC/1.0/

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/20.500.12613/10223

OAI identifier oai:identifier

oai:scholarshare.temple.edu:20.500.12613/10223