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The major complication in dental implant surgery is loss of sensation due to damage to the inferior alveolar nerve resulting from poor characterization of the location of the mandibular canal and the traveling course of the inferior alveolar nerve, artery, and vein therein. The purposes of this study were to determine the buccolingual location of the mandibular canal and to verify the topography of the inferior alveolar nerve, artery, and vein therein by three-dimensional reconstruction of these structures. Sixty-two mandible sides were used for this study. The buccolingual location of the mandibular canal was classified into 3 types: type 1 (70%), where the canal follows the lingual cortical plate at the mandibular ramus and body; type 2 (15%), where the canal follows the middle of the ramus behind the second molar and the lingual plate passing through the second and first molars; and type 3 (15%), where the canal follows the middle or the lingual one third of the mandible from the ramus to the body. Three-dimensional reconstruction of the mandibular canal revealed that the inferior alveolar vessel traveled above the inferior alveolar nerve in 8 cases (80%), with the inferior alveolar artery being lingual to the inferior alveolar vein, and in 2 cases (20%) where the inferior alveolar vessel was buccal to the nerve.

Surgical or therapeutic interventions in areas of high extramuscular and intramuscular nerve density can increase the efficacy and safety of botulinum toxin injections and neurotomy. Intramuscular nerve branching patterns should be taken into consideration during triceps surae resection.

The infraorbital nerve (ION) is the terminal branch of the maxillary nerve; it supplies the skin and mucous membranes of the middle portion of the face. This nerve is vulnerable to injury during surgical procedures of the middle face. Severe pain and loss of sense are noted in patients whose infraorbital nerve is damaged. In the study presented here, we investigated the branching pattern and topography of the ION, about which little is currently known, by dissecting 43 hemifaces of Korean cadavers. In most cases, the infraorbital artery was located in the middle (73.8%) and superficial to the ION bundle (73.8%) at its exit from the infraorbital canal. The ION produced four main branches, the inferior palpebral, internal nasal, external nasal, and superior labial branches. The superior labial branch was the largest branch of the ION produced the most sub-branches. These sub-branches were divided into the medial and lateral branches depending upon the area that they supplied. We were able to classify four types of branching pattern of the external and internal nasal branch and the medial and lateral sub-branches of the superior labial branch of the ION at the site of their emergence through the infraorbital foramen (types I-IV). Type I, where all four branches are separated occurred the most frequently (42.1%). These findings will help to preserve the ION while performing certain types of maxillofacial surgery, such as removal of a tumor from the upper jaw and fracture of the upper jaw.

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