The Position of the Mandibular Canal and Histologic Feature of the Inferior Alveolar Nerve

The inferior alveolar nerve is the one of the large branches of the mandibular division of the trigeminal nerve. It is vulnerable during surgical procedures of the mandible. Despite its importance, no anatomical and histological examination has been conducted to provide a detailed cross-sectional morphology of the mandibular canal according to dental status. Therefore, the present study aimed to identify the position of the mandibular canal through direct measurement and to determine the branches of the inferior alveolar nerve through histologic examination. The area between the anterior margin of the third molar and the anterior margin of the second premolar of dentulous, partially dentulous, and edentulous hemimandible specimens (n = 49) from 26 human cadavers was serially sectioned into seven segments, and specific distances were measured using digital calipers. Following this, 5-mu m cross-sections were prepared along the mandibular canal and mental foramen, and examined by fluorescence microscopy. The mandibular canal was located at a mean distance of 10.52 mm above the inferior margin of the mandible. The mean maximum diameters of the mandibular canal, inferior alveolar nerve, inferior alveolar artery, and inferior alveolar vein were 2.52, 1.84, 0.42, and 0.58 mm, respectively. This study found that the inferior alveolar nerve often gives rise to several branches at each level (range 0-3). To minimize the risk of injury, knowledge of the small branches of the nerve and of the detailed findings regarding the position of the mandibular canal reported here should be considered when planning mandibular surgery, especially during implant placement. Clin. Anat. 23:34-42, 2010. (C) 2009 Wiley-Liss, Inc.