EXAMINATION OF THE MANDIBULAR LATERAL LINGUAL CANAL WITH CONE BEAM COMPUTED TOMOGRAPHY AND ITS RELATIONSHIP WITH ANATOMICAL STRUCTURES

Year 2025, Volume: 49 Issue: 2, 89 - 94, 28.08.2025

Tansu Çimen , Yunus Yiğit Saka , Ayşe Gökçen Sargın Durakoğlu , Onurcem Duruel

Abstract

Background and Aim: The mandible contains many accessory foramina and canals, particularly on the lingual side. There are two main categories of accessory foramina on the lingual side: medial and lateral lingual foramina. The canal structures of these foramina have been labelled "vascular canals" due to their arterial content. The aim of this study to evaluate the presence of lateral lingual canal, diameter, number and position of the lateral lingual foramen using cone beam computed tomography (CBCT).
Materials and Methods: In this study, CBCT images of 250 patients who met our inclusion criteria were retrospectively analysed.
Results: Lateral lingual canal (LLC) was detected on the right in 53.2% of the patients and on the left in 57.6%. The mean diameter of the lateral lingual foramina (LLF) on the right and left sides was 0.65 ± 0.24 mm and 0.69 ± 0.23 mm, respectively and the number of canals was mono in 88.6% of the right and 92.1% of the left. LLF was observed more frequently in the second premolar region. The mean values of the distance of the right LLF to the midline of the mandible and the alveolar crest top were 14.30 ± 3.73 mm and 21.07 ± 4.13 mm, respectively. The mean values of the distance of the left LLF to the midline of the mandible and the top of the alveolar crest were 14.61 ± 3.50 mm and 20.65 ± 4.92 mm, respectively.
Conclusion: CBCT is recommended for preoperative imaging to determine the location and size of LLF to avoid any possible surgical complications. These vital structures must be assessed using precise CBCT evaluation.

Keywords

CBCT , lateral lingual canal , lateral lingual foramen

References

• 1. Pommer B, Tepper G, Gahleitner A, Zechner W, Watzek G. New safety margins for chin bone harvesting based on the course of the mandibular incisive canal in CT. Clin Oral Implants Res 2008; 19: 1312-1316.
• 2. Woo BM, Al-Bustani S, Ueeck BA. Floor of mouth haemorrhage and life-threatening airway obstruction during immediate implant placement in the anterior mandible. Int J Oral Maxillofac Surg 2006; 35: 961-964.
• 3. Dubois L, de Lange J, Baas E, Van Ingen J. Excessive bleeding in the floor of the mouth after endosseus implant placement: a report of two cases. Int J Oral Maxillofac Surg 2010; 39: 412-415.
• 4. Darriba MA, Mendonça-Caridad JJ. Profuse bleeding and lifethreatening airway obstruction after placement of mandibular dental implants. J Oral Maxillofac Surg 1997; 55: 1328-1330.
• 5. Panula K, Oikarinen K. Severe hemorrhage after implant surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 87: 2.
• 6. Loukas M, Kinsella CR Jr, Kapos T, Tubbs RS, Ramachandra S. Anatomical variation in arterial supply of the mandible with special regard to implant placement. Int J Oral Maxillofac Surg 2008; 37: 367-371.
• 7. Niamtu J 3rd. Near-fatal airway obstruction after routine implant placement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 92: 597-600.
• 8. Naitoh M, Hiraiwa Y, Aimiya H, Gotoh K, Ariji E. Accessory mental foramen assessment using cone-beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 289-294.
• 9. He P, Truong MK, Adeeb N, Tubbs RS, Iwanaga J. Clinical anatomy and surgical significance of the lingual foramina and their canals. Clin Anat 2017; 30: 194-204.
• 10. Nakajima K, Tagaya A, Otonari-Yamamoto M, Seki K, Araki K, Sano T et al. Composition of the blood supply in the sublingual and submandibular spaces and its relationship to the lateral lingual foramen of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117: 32–38.
• 11. Pires CA, Bissada NF, Becker JJ, Kanawati A, Landers MA. Mandibular incisive canal: cone beam computed tomography. Clin Implant Dent Relat Res 2012; 14: 67-73.
• 12. Spin-Neto R, Stavropoulos A, Dias Pereira LA, Marcantonio E Jr, Wenzel A. Fate of autologous and fresh-frozen allogeneic block bone grafts used for ridge augmentation. A CBCT-based analysis. Clin Oral Implants Res 2013; 24: 167-173.
• 13. Cremonini CC, Dumas M, Pannuti C, Lima LA, Cavalcanti MG. Assessment of the availability of bone volume for grafting in the donor retromolar region using computed tomography: a pilot study. Int J Oral Maxillofac Implants 2010; 25: 374-378.
• 14. Verdugo F, Simonian K, D’Addona A, Pontón J, Nowzari H. Human bone repair after mandibular symphysis block harvesting: a clinical and tomographic study. J Periodontol 2010; 81: 702-709.
• 15. Verdugo F, Simonian K, Frydman A, D’Addona A, Pontón J. Longterm block graft stability in thin periodontal biotype patients: a clinical and tomographic study. Int J Oral Maxillofac Implants 2011; 26: 325-332.
• 16. McDonnell D, Reza Nouri M, Todd ME. The mandibular lingual foramen: a consistent arterial foramen in the middle of the mandible. J Anat 1994; 184: 363-369.
• 17. Hofschneider U, Tepper G, Gahleitner A, Ulm C. Assessment of the blood supply to the mental region for reduction of bleeding complications during implant surgery in the interforaminal region. Int J Oral Maxillofac Implants 1999; 14: 379-383.
• 18. Liang X, Jacobs R, Lambrichts I, Vandewalle G. Lingual foramina on the mandibular midline revisited: a macroanatomical study. Clin Anat 2007; 20: 246-251.
• 19. Rosano G, Taschieri S, Gaudy JF, Testori T, Del Fabbro M. Anatomic assessment of the anterior mandible and relative hemorrhage risk in implant dentistry: a cadaveric study. Clin Oral Implants Res 2009; 20: 791-795.
• 20. Gahleitner A, Hofschneider U, Tepper G, Pretterklieber M, Schick S, Zauza K et al. Lingual vascular canals of the mandible: evaluation with dental CT. Radiology 2001; 220: 186–189.
• 21. Forni A, Sánchez-Garcés MA, Gay-Escoda C. Identification of the mental neurovascular bundle: a comparative study of panoramic radiography and computer tomography. Implant Dent 2012; 21: 516-521.
• 22. Pancer B, Garaicoa-Pazmiño C, Bashutski JD. Accessory mandibular foramen during dental implant placement: case report and review of literature. Implant Dent 2014; 23: 116-124.
• 23. Naitoh M, Nakahara K, Suenaga Y, Gotoh K, Kondo S, Ariji E. Comparison between cone-beam and multislice computed tomography depicting mandibular neurovascular canal structures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: 25-31.
• 24. Taschieri S, Corbella S, Silnovic A, Francetti L, Messina C, Sconfienza LM et al. Frequency and anatomic variability of the mandibular lingual foramina: a cone-beam CT study. BMC Med Imaging 2022; 22: 12.
• 25. Moshfeghi M, Gandomi S, Mansouri H, Yadshoghi N. Lingual Foramen of the Mandible on Cone-Beam Computed Tomography Scans: A Study of Anatomical Variations in an Iranian Population. Front Dent 2021; 18: 20.
• 26. Sahman H, Sekerci AE, Ertas ET. Lateral lingual vascular canals of the mandible: a CBCT study of 500 cases. Surg Radiol Anat 2014; 36: 865-870.
• 27. Sanomiya Ikuta CR, Paes da Silva Ramos Fernandes LM, Poleti ML, Alvares Capelozza AL, Fischer Rubira-Bullen IR. Anatomical Study of the Posterior Mandible: Lateral Lingual Foramina in Cone Beam Computed Tomography. Implant Dent 2016; 25: 247-251.
• 28. Yildirim YD, Güncü GN, Galindo-Moreno P, Velasco-Torres M, Juodzbalys G, Kubilius M et al. Evaluation of mandibular lingual foramina related to dental implant treatment with computerized tomography: a multicenter clinical study. Implant Dent 2014; 23: 57–63.
• 29. Wei X, Gu P, Hao Y, Wang J. Detection and characterization of anterior loop, accessory mental foramen, and lateral lingual foramen by using cone beam computed tomography. J Prosthet Dent 2020; 124: 365-371.
• 30. Kawai T, Asaumi R, Sato I, Yoshida S, Yosue T. Classification of the lingual foramina and their bony canals in the median region of the mandible: cone beam computed tomography observations of dry Japanese mandibles. Oral radiology 2007; 23: 42-48.
• 31. Liang X, Jacobs R, Corpas LS, Semal P, Lambrichts I. Chronologic and geographic variability of neurovascular structures in the human mandible. Forensic Sci Int 2009; 190: 24-32.