Bifid mandibular canals: cone beam computed tomography evaluation

Objectives: For surgical procedures involving the posterior mandible, it is important to be familiar with the details of the bifid mandibular canal. To our knowledge, there have been no systematic studies evaluating the bifid mandibular canal using sectional imaging. The purpose of this study is to evaluate the incidence and configuration of the bifid mandibular canal using cone beam CT. Methods: 252 patients (301 mandible sides) underwent cone beam CT between October 2004 and September 2005 and were included in this study. The cone beam CT images were evaluated for the presence and configuration of the bifid mandibular canal. The patterns of bifurcation were classified into four types according to the classification of Nortje et al (Variations in the normal anatomy of the inferior dental (mandibular) canal: a retrospective study of panoramic radiographs from 3612 routine dental patients. Br J Oral Surg 1977; 15: 55-63). The diameter of the accessory canal was classified into two categories: 50% or more and less than 50% of the diameter of the main mandibular canal. Results: Of the 301 subjects, 47 (15.6%) demonstrated a bifid mandibular canal. They were Type I in 2, Type II in 40, Type III in 0, and Type IV in 5 cases. The diameter of the accessory canal was greater than or equal to 50% of the main canal in 23, and less than 50% in 24 cases. Conclusions: On the basis of the cone beam CT, a bifid mandibular canal was found in 15.6% of cases, a markedly higher proportion than found in previous reports using panoramic images. Cone beam CT is considered a suitable modality for detailed evaluation of bifid mandibular canals. Dentomaxillofacial Radiology (2010) 39, 235-239. doi: 10.1259/dmfr/66254780