Mandibuler retromolar kanal ve foramenin konik ışınlı bilgisayarlı tomografi ile değerlendirilmesi

Öz

Amaç: Bu çalışmanın amacı, bir Türk popülasyonunda konik-ışınlı bilgisayarlı tomografi (KIBT) kullanılarak retromolar kanal (RMK) ve retromolar foramen (RMF) oluşumunun değerlendirilmesidir.

Materyal ve Metod: Çalışmaya 350 hastanın (177 erkek, 173 kadın, ortalama yaş 31.9, 18-70 yıl arasında değişen) KIBT görüntüleri dahil edildi. RMK, mandibular kanaldan bağımsız olarak ramusta bulunan veya retromolar fossa üzerinde bir foramen ile devamlılık gösteren ve mandibular kanaldan kaynak alnan bir aksesuar kanal olarak tanımlandı. RMK'lar cinsiyet ve taraf dikkate alınarak analiz edildi. İstatistiksel değerlendirmede, bağımsız örnekleri analiz etmek için ki-kare testi kullanıldı. P <0.05 istatistiksel olarak anlamlı kabul edildi.

Bulgular: RMK, hastaların% 11.42'sinde tespit edildi. Bunlardan 11'inde (% 3,14) bilateral, 29'unda unilateral RMK (% 8,28) saptandı. Sağ ve sol taraflar arasında veya cinsiyetler arasında anlamlı bir istatistiksel fark bulunmadı (P> 0.05).

Sonuç: RMK, oral cerrahi uygulayıcılarının bilmesi gereken anatomik bir varyasyondur. Hasarlandığında hipoesteziye ve hastanın gereksiz rahatsızlığına neden olabilir. KIBT, retromolar foramen ve kanalın anatomik özelliklerini ortaya çıkarmak için yararlı bir araçtır.

Anahtar Kelimeler

• Retromolar kanal,retromolar foramen,konik-ışınlı bilgisayarlı tomografi

Evaluation of the retromolar canal and foramina of the mandible with cone-beam computed tomography

Öz

Background: The goal of this study was to investigate the occurrence of retromolar canal (RMC) and retromolar foramen (RMF) using cone-beam computed tomography (CBCT) in a Turkish subpopulation.

Methods: This study included high-resolution CBCT images from 177 male and 173 female, totally 350, with average age of 31.9 years (18 to 70 years). The RMC was defined as an independent accessory canal or arising from the mandibular canal continuous with a foramen on the retromolar fossa. The RMCs were analyzed by considering sex and side. Independet samples statistically analyzed with chi-square test. P<0.05 was considered statistically significant.

Results: The RMC was detected in 11.42% of patients. Of these, 11 patients (3.14%) had  bilateral RMC, while 29 patients (8.28%) had a unilateral RMC. There were no differences between left and right sides or between genders (P>0.05).

Conclusions: RMC is an anatomic variation that performers of oral surgery should be aware of. It could potentially cause hypoesthesia and unnecessary discomfort of patient when injured. CBCT is a useful device to reveal anatomic features of the retromolar foramen and canal.

Anahtar Kelimeler

• Retromolar canal,retromolar foramen,cone-beam computed tomography

Kaynakça

1. 1. Kawai T, Asaumi R, Sato I: Observation of the retromolar foramen and canal of the mandible: a CBCT and macroscopic study. Oral Radiol. 2012;28:10–14
2. 2. Kikuta, S., Iwanaga, J., Nakamura, K. et al. The retromolar canals and foramina: radiographic observation and application to oral surgery. Surg Radiol Anat 2018;40: 647.
3. 3. Schejtman R, Devoto FC, Arias NH. The origin and distribution of the elements of the human mandibular retromolar canal. Arch Oral Biol. 1967;12:1261–7.
4. 4. Sicher H. Oral Anatomy (ed 3). St Louis, MO: Mosby, 1960
5. 5. 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;115:692–9.
6. 6. Kodera H, Hashimoto I. A case of mandibular retromolar canal: elements of nerves and arteries in this canal (Article in Japanese). Kaibogaku Zasshi. 1995;70:23–30.
7. 7. Boronat A, Penarrocha M. Failure of locoregional anesthesia in dental practice. Review of the literature. Med Oral Pathol Oral Cir Bucal. 2006;11:e510–3.
8. 8. Singh S. Aberrant buccal nerve encountered at third molar surgery. Oral Surg Oral Med Oral Pathol. 1981;52:142.

9. 9. von Arx T, Hänni A, Sendi P, Buser D, Bornstein MM. Radiographic study of the mandibular retromolar canal: an anatomic structure with clinical importance. J Endod. 2011b;37:1630–5.
10. 10. Uner D D, Izol B S, Gorus; Z. Correlation between buccal and alveolar bone widths at the central incisors according to cone-beam-computed tomography. Niger J Clin Pract 2019;22:79-84.
11. 11. Han SS, Hwang YS. Cone beam CT findings of retromolar canals in a Korean population. Surg Radiol Anat 2014;36:871–876
12. 12. Kawai T, Asaumi R, Kumazawa Y, Sato I, Yosue T. Observation of the temporal crest canal in the mandibular ramus by cone beam computed tomography and macroscopic study. Int J Comput Assist Radiol Surg 2014;9:295–299
13. 13. 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;28:10–14
14. 14. 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;43:20140090
15. 15. Narayana K, Nayak UA, Ahmed WN, Bhat JG, Devaiah BA. The retromolar foramen and canal in south Indian dry mandibles. Eur J Anat. 2002;6:141–6.
16. 16. Frequency and anatomy of the retromolar canal - implications for the dental practice. Filo K, Schneider T, Kruse AL, et al. Swiss Dent J. 2015;125:278–292.
17. 17. Ossenberg NS. Retromolar foramen of the human mandible. Am J Phys Anthropol. 1987;73:119–28.
18. 18. Bilecenoglu B, Tuncer N. Clinical and anatomical study of ret- romolar foramen and canal. J Oral Maxillofac Surg. 2006;64:1493–7.
19. 19. 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;33:501–507
20. 20. Singh S. Aberrant buccal nerve encountered at third molar surgery. Oral Surg Oral Med Oral Pathol. 1981;52:142.
21. 21. Jablonski NG, Cheng CM, Cheng LC, Cheung HM. Unusual origins of the buccal and mylohyoid nerves. Oral Surg Oral Med Oral Pathol. 1985;60:487–8.
22. 22. Kodera H, Hashimoto I. A case of mandibular retromolar canal: elements of nerves and arteries in this canal (Article in Japanese). Kaibogaku Zasshi. 1995;70:23–30.
23. 23. von Arx T, Lozanoff S. Clinical Oral Anatomy: A Comprehensive Review for Dental Practitioners and Researchers. Cham, Switzerland: Springer International Publishing: 2017.
24. 24. Blanton PL, Jeske AH. The key to profound local anesthesia. J Am Dent Assoc. 2003;134:753–60.
25. 25. Boronat A, Penarrocha M. Failure of locoregional anesthesia in dental practice. Review of the literature. Med Oral Pathol Oral Cir Bucal. 2006;11:e510–3.
26. 26. Üner DD, Izol BS, Ipek F. The evaluation of the prevalence and localizations and of antral septa in people living in and around Diyarbakir using cone beam computed tomography. J Oral Maxillofac Radiol 2018;6:3‐8.