Clinical anatomy and surgical significance of the lingual foramina and their canals

Abstract

The lingual foramina and canals can be categorized as median or lateral based on their relation to the midline of the mandible. Investigation of the mandibular lingual region is often done with gross anatomical dissections of cadavers, 2D panoramic radiographic imaging, CT, and cone beam CT (CBCT). While gross studies are the most reliable at qualifying canal contents and course, CBCT proved to be superior to other radiographic techniques for visualizing lingual foramina and canals. The submental and sublingual arteries, and their branches are found in the lingual vascular canals. There is tremendous variation between individuals in terms of the course of the lingual canals and their anastomosis with other vascular canals. Performing the dental implantation procedures in the anterior and posterior regions of the mandible can result in perforation of the lingual cortex, which could injure the arteries that lie within the lingual canal. If hemorrhage occurs, it could lead to life-threatening upper airway obstruction. Pre-surgical investigation to identify the diameter of the lingual foramina and canal as well as their distance from the alveolar process might be necessary to prevent hemorrhage for all patients. Clin. Anat. 30:194-204, 2017. © 2017 Wiley Periodicals, Inc.

Investigation of the presence and variation of the ascending mental artery: Conventional dissections and ultrasonographic study

“…The mental artery that emerges from the mental foramen is very small and does not play any significant role in providing blood to the chin. The mental artery may be able to receive blood from the labiomental artery when the inferior alveolar artery is partially occluded and the blood supply to the central area of the mandibular teeth is insufficient …”

Review of Risk Assessment of Major Anatomical Variations in Clinical Dentistry

“…There are two groups of LF differentiated by their location on the mandible, that is, the median lingual foramen (MLF) and lateral lingual foramen (LLF: Figs. ) (He et al ). The MLF is located usually on the mandible's midline, whereas the LLF is in the canine or premolar area largely (Tagaya et al ; Kim et al ; Yildirim et al ; Sanomiya Ikuta et al ).…”

“…Cadaveric studies of the dry mandible and clinical studies using CBCT have found consistently that up to 99% of individuals had the MLF (McDonnell et al ; von Arx et al ; He et al ).…”

“…The mandible's anatomical variations, for example, those in the accessory mental, lingual, retromolar, and accessory mandibular foramina, and double mandibular canal (Das and Suri ; Rouas et al ; Imada et al ; Iwanaga et al ; He et al ; Kikuta et al ) can lead to unexpected surgical complications when they are overlooked in preoperative diagnosis, the most common of which in clinical dentistry are hemorrhage and paresthesias. For more than a decade, a number of anatomical, radiological, and clinical studies have shown the potential complications caused by such variants' injury that are not always symptomatic, although some may cause symptoms as well as major disorders.…”

A Novel Method for Observation of the Mandibular Foramen: Application to a Better Understanding of Dental Anatomy

“…Cone‐beam computed tomography (CBCT), which is often required in daily practice, gives oral and maxillofacial surgeons much morphological information about hard tissue. During the past decade, many anatomical and radiological studies using CBCT have been published (Kalender et al, ; Park and Lee, ; Wang et al, ; Ciftci et al, ; He et al, ; Iwanaga et al, ) and three‐dimensional images have enabled us to understand details of surface anatomical structures such as the location of accessory foramina and the running course of canals inside the bones. However, no methods for studying the bone canal without radiography have been established, and endoscopy could be a new method for observing the canal walls.…”