Aims In part I of the article, a detailed description of the anatomical variations of the mandibular canal and the foramina of the mandible was given. The aim of part II is to discuss the clinical relevance of the anatomical variations. Materials and methods A literature review was carried out, and five cases of mandibular canal variations are reported. Results Anatomical variations of the mandibular canal and foramina of the mandible are reported in bibliography. Bifid and double mandibular canals have been firstly reported in 1973. Since then, the anatomical variations of the mandibular canal have been described by case reports, cadaveric and retrospective radiological studies. It has been proved that the inferior alveolar nerve gives communication fibers to other nerves and extraosseous branches, before entering the mandibular canal, whereas even if it enters the mandible, it branches during its course into the canal. Also, the supplementary innervation of mandibular teeth and periodontal tissues by the long buccal and mylohyoid nerves has been suggested. Several authors also reported the existence of retromolar foramen and supplementary buccal and lingual foramina and their important role either in vascularisation or innervation. Conclusions The neurovascular contents of the mandibular canals and foramina gain more importance in oral surgery and implantology because these components are vulnerable to damage during implant placement and sagittal split osteotomy surgery, and complications may occur during the surgery (i.e. unsuspected bleeding, nerve injury). Also, clinicians should be aware of accessory foramina or canals of the mandible in understanding failed inferior alveolar nerve block.
SUMMARYIn literature, anatomical variations of the inferior alveolar nerve branches (infratemporal, extraosseous and intraosseous) are reported and their importance in clinical practice is discussed too. The spatial vessels’ position in relationship with the nerve in the mandibular canal was explored, which is of clinical significance in impacted third molar and implant surgery. It is believed that the neurovascular content of the main mandibular canal follows any variations of the mandibular canal i.e. bifid mandibular, retromolar and accessory mental canals. Retrospective studies and case reports reported the presence of multiple foramina on the medial surface of the ramus, near the main mandibular foramen. In some cases, one supplementary mandibular foramen was found to be connected with the lower third molar, which is called “temporal crest canal”. Others found an accessory mandibular foramen that led into a second mandibular canal which joined the main mandibular canal (double) anteriorly. The bony canals contained a terminal branch of the anterior trunk of the mandibular nerve or a branch of inferior alveolar nerve before it entered the mandibular foramen.The aim of the study was to describe and classify anatomical structures of the mandibular canal and posterior foramina of the mandible through an extensive review of the corresponding studies via the PubMed, Scopus and Google Scholar databases.
The study aims to report a technique for the extraction of an anterior maxillary root with simultaneous immediate implant placement and immediate loading with provisional non‐functional restoration. Due to a root fracture of a maxillary lateral incisor (#22), a semilunar flap was utilised to create a bony window in the apical area of the tooth and gently extract the remaining portion of the root through the alveolar socket. This technique is recommended in cases of immediate implant placement in fresh extraction sites where coronal bony bridge is intact. Then an implant was placed and the apical bony defect was repaired with guided bone regeneration. The loading of the implant with a temporary implant restoration within 24 h was applied without functional occlusal contacts. The placement of the permanent restoration was scheduled for 6 months later. After 1 year, a clinical and radiographic examination showed a normal peri‐implant bone level and a successful aesthetic effect. Furthermore, after four years the patient was examined and the implant is still showing good functional and aesthetic outcome. The preservation of the coronal bony anatomy, periosteum and soft tissues during the immediate implant placement is a major contributing factor to a desired aesthetic effect, which is enhanced with the option of immediate non‐functional loading. The described surgical approach preserves the advantages of immediate implant placement in fresh extraction sites in the maxillary aesthetic zone without intrasulcular incision and mucoperiosteal flap elevation while minimising the bony injuries during the extraction of the tooth.
Supernumerary molars are occasionally found in a preoperative radiographic third molar evaluation. The presence of a supernumerary molar is rare and is usually impacted. Clinicians should be aware of the diagnosis and treatment of this entity. Aim of the article is to present a case of a 22 years old nonsyndromic female who was referred for a preventive extraction of third molars. The presurgical radiographic examination revealed the existence of an unilateral double impaction of a fourth and third molars in the right posterior mandible. The simultaneous surgical extraction of the fourth and third mandibular molars was performed without any postoperative complications. The preoperative radiographic evaluation was of crucial importance for the surgery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.