Comprehensive review of the incisive branch of the inferior alveolar nerve

Abstract

The incisive branch of the inferior alveolar nerve is a vital anatomical structure within the anterior mandible that has not been thoroughly defined and outlined in reports in the literature until recent years. Advances in radiological imaging, particularly the widespread use of cone-beam computed tomography has allowed for accurate visualization of the mandibular incisive canal (MIC) and its associated incisive branch of the inferior alveolar nerve. Surgical damage to the MIC, which could result in hemorrhage and sensory disturbance, may occur in commonly practiced oral and maxillofacial procedures, such as chin bone harvesting, implant placement, fracture repair and removal of pathologic entities of the anterior mandible. Knowledge of both the presence, dimensions and location of the incisive branch is a vital component to pre and peri-operative planning of oral and maxillofacial surgeries performed within the mandible, particularly within the interforaminal zone. In this article, the terminology, anatomy, imaging, surgical consideration, and pathology of the incisive branch will be discussed.

Detection Rate and Variability in Measurement of Mandibular Incisive Canal on Cone-Beam Computed Tomography: A Study of 220 Dentate Hemi-Mandibles from Italy

“…The MIC represents the anterior continuation of the mandibular canal beyond the mental foramen and contains the intraosseous extension of the inferior alveolar neurovascular bundle, particularly the mandibular incisive nerve [ 5 ]. The mandibular incisive nerve is the terminal branch of the inferior alveolar nerve, and it provides innervation to the mandibular anterior teeth, including the first premolars [ 4 , 5 , 6 , 7 ].…”

“…The most common complications due to surgical damage to the neurovascular bundle of the MIC are discomfort, pain, and neurosensory disturbances in the anterior mandible [ 1 , 5 , 9 , 10 , 11 ]. Reported complications are usually transient, although, in some cases, they can persist for a long period [ 1 , 9 , 10 , 11 ].…”

“…In clinical practice, the most commonly used radiological technique for morphological assessment of the MIC is cone-beam computed tomography (CBCT) [ 3 , 4 , 5 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ] ( Figure 1 ).…”

“…Although other imaging techniques could be used in the anatomical evaluation of the mandible [ 24 , 25 , 26 , 27 ], the main advantages that make CBCT particularly suitable for accurate morphological analysis of the MIC are its high spatial resolution and the limited radiation dose delivered to patients [ 3 , 4 , 5 ].…”

“…Several studies have investigated the presence, size, and position of the MIC on CBCT images [ 1 , 2 , 3 , 4 , 5 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. However, to our knowledge, no CBCT study has evaluated the presence, size, and distance of the MIC from adjacent anatomical landmarks, and the observer variability of MIC measurements, in the dentate mandibles of Caucasian (Italian) patients.…”