IMPORTANCE OF BIFID MANDIBULAR CANAL IN IMPLANTOLOGY AND IN ORAL SURGERY: REVIEW OF THE LITERATURE AND REPORT OF THREE CASES

Yıl 2017, Cilt: 20 Sayı: 3, 198 - 203, 22.12.2017

Nihat Akbulut Sibel Akbulut Bengi Oztas Sebnem Kursun Emrah Soylu Orhan Guven

https://doi.org/10.7126/cumudj.369382

Öz

The mandibular canal or the
inferior alveolar canal typically extends from the mandibular foramen to the mental foramen and includes the
inferior alveolar artery, vein and the inferior alveolar nerve. During
embryonic development three canals fuse to form a single canal. Failure of
these canals to fuse can explain presence of multiple canals in some
individuals. It is important to localize the course of the mandibular canal at
the site of implant placement as altered sensation of the inferior lip due to
inferior alveolar nerve injury. It is one of the most serious complication of
mandibular implant surgery. Also the
difficulty in performing mandibular anesthesia is the other problematic issue
for patients and the clinicians.

The purpose of this study is to call
attention to a rare anatomical variation. This case report reveals an unusual
variant of the bifid mandibular canals. Three new cases, two of which are in
the same family, have been presented.

Anahtar Kelimeler

Bifid mandibular canal, implant surgery, third molar extraction, inferior alveolar nerve, mandibular canals

Bifid Mandibuler Kanalin İmplantoloji ve Oral Cerrahideki Önemi: Üç Vaka Raporu ile Birlikte Literatürün Gözden Geçirilmesi

Öz

Mandibuler kanal veya inferior alveoler kanal inferior
alveoler arter, ven ve inferior alveoler siniri içerecek şekilde tipik olarak
mandibuler foramenden mental foramene kadar uzanır. Emriyolojik gelişim
sırasında üç kanal tek bir kanal formu şeklinde füzyona uğrar. Bu kanalların
füzyona uğramasındaki başarısızlık bazı bireylerdeki çoklu kanalların varlığını
açıklayabilir. İnferior alveoler sinir yaralanması sebebiyle alt dudak duyu değişikliğinde
olduğu gibi implant yerleşim bölgesindeki mandibuler kanalın seyrinin
lokalizasyonu önemlidir. Bu, mandibuler implant cerrahisinin çok ciddi
komplikasyonundan biridir. Aynı zamanda mandibuler anestezi uygulamasındaki
zorluk, hastalar ve klinisyenler için başka bir problematik bir konudur.

Bu çalışmanın amacı nadir görülen bir anatomik varyasyona
dikkat çekmektir.  Bu vaka raporu bifid
mandibuler kanalların alışılmamış varyantını ortaya çıkarmaktadır. Üç yeni
vaka, ikisi aynı aileden olmak üzere, sunulmuştur.

Anahtar Kelimeler

Bifid mandibuler kanal, implant cerrahisi, üçüncü molar çekimi, inferior alveoler sinir, mandibuler kanallar

Kaynakça

• 1. Rouas P, Nancy J, Bar D. Identification of double mandibular canals: literature review and three case reports with CT scans and cone beam CT. Dentomaxillofac Radiol 2007; 36: 34–38.
• 2. Sıcher H, Dubrul EL. Oral Anatomy. USA, Mosby Co.Sixth edition. 1975 pp. 53.
• 3. Worth HM. Normal radiographic appearances of the teeth and jaws and variations within the normal. Principals and practice of oral radiologic interpretation. Chicago, IL: Year Book Medical Publishers, Inc.;1963, pp 15-79.
• 4. Lamas Pelayo J, Peñarrocha Diago M, Martí Bowen E, Peñarrocha Diago M. Intraoperative complications during oral implantology. Med Oral Patol Oral Cir Bucal. 2008; 13: E239-43.
• 5. Karamifar K, Shahidi S, Tondari A. Bilateral bifid mandibular canal: report of two cases. Indian J Dent Res. 2009; 20: 235-7.
• 6. Auluck A, Mupparapu M. Multiple mandibular nerve canals: Radiographic observations and clinical relevance. Report of 6 cases. Quintessence Int 2007; 38: 781–787.
• 7. Nortje CJ, Farman AG, Grotepass FW. Variation in the normal anatomy of inferior dental (mandibular) canal: A retrospective study of panoramic radiographs from 3612 routine dental patients. Br J Oral Surg 1977; 15(1)55–63.
• 8. Langlais RP, Broadus R, Glass BJ. Bifid mandibular canals in panoramic radiographs. J Am Dent Assoc 1985; 110:923–926.
• 9. Wadhwani P, Mathur RM, Kohli M, Sahu R. Mandibular canal variant:a case report. J Oral Pathol Med 2008; 37: 122–124.
• 10. 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
• 11. Durst JH, Snow JE. Multiple mandibular canals: oddities or fairly common anomalies? Oral Surg Oral Med Oral Pathol 1980; 49: 272–273.
• 12. Grover PS, Lorton L. Bifid mandibular nerve as a possible cause of inadequate anaesthesia in the mandible. J Oral Maxillofac Surg 1983; 41: 177–179.
• 13. Sanchis JM, Penarrocha M, Soler F. Bifid mandibular canal. J Oral Maxillofac Surg 2003;61: 422–424.
• 14. Kiyak, H.A., Beach, B.H., Worthington, P., Taylor, T., Bolender, C. & Evans, J. (1990) Psychological impact of osseointegrated dental implants. International Journal of Oral and Maxillofacial Implants 5: 61–69.
• 15. Bartling, R., Freeman, K. & Kraut, R.A. (1999) The incidence of altered sensation of the mental nevre after mandibular implant placement. Journal of Oral and Maxillofacial Surgery 57: 1408–1412.
• 16. Ellies, L.G. (1992) Altered sensation followingmandibular implant surgery: a retrospective study. Journal of Prosthetic Dentistry 68: 664–671.
• 17. Auluck A, Ahsan A, Pai KM, Shetty C. Anatomical variations in developing mandibular nerve canal: a report of three cases. Neuroanatomy 2005; 4:28-30.
• 18. Meechan JG. How to over come failed local anaesthesia. Br. Dent. J. 1999; 186: 15–20.