Unilateral triple mandibular canal with double mandibular foramen: cone-beam computed tomography findings of an unexpected anatomical variant

The mandibular canal is a bony channel located within the spongiosa of the mandible. The main structure contained in the mandibular canal is the inferior alveolar nerve. The inferior alveolar nerve is a very important structure that requires due consideration during dental or surgical procedures involving the mandible. Therefore, a detailed morphological analysis of the mandibular canal should be carried out before any surgical procedure in the mandibular region in order to avoid complications and to reduce the risk of inadequate local nerve blocking. The human mandible typically has a single mandibular canal on each side; however, accessory mandibular canals have been described previously in the literature. The most common variant of the mandibular canal is the bifid mandibular canal, which has a prevalence ranging from 10% to 66% on cone-beam computed tomography (CBCT) examinations. A rare variant of bifid mandibular canal is the trifid canal, accounting for less than 6% of all bifid canals. In some cases, the bifid and trifid mandibular canals are associated with a double mandibular foramen, which is a rare anatomical variant with a reported incidence of 1.35% on CBCT images. Herein, we present the interesting CBCT images of an unexpected anatomical variant characterised by unilateral triple mandibular canal with double mandibular foramen in a young Caucasian woman.