Lingual Foramina and Canals of the Mandible: Anatomic Variations in a Lebanese Population

CBCT Evaluation of Lingual Foramen and its Anatomic Variations in Northeast Indian Population

Background

The identification of nearby neurovascular structures is a vital part of dental implant treatment planning. Commonly two implants are placed in the mandibular inter foraminal region to support the overdenture. Placing dental implants in this region is considered relatively safe. The purpose of this study was to employ cone beam computed tomography (CBCT) on a representative sample of Northeast Indians to find out the location and distribution of lingual foramen in the anterior mandible.

Study Design

A total of 104 CBCT scans were performed using the Cranex 3D CBCT system. Three Oral and Maxillofacial Radiologists agreed on a visibility grade for assessing the lingual foramen using a 3-point scale. The number and presence of foramina were noted. On cross-sectional pictures, the distance in millimeters between the crest of the alveolar ridge and the superior cortical margin of the foramen was determined. Furthermore, the analysis of the distribution of lingual foramina in terms of frequency and percentages was performed.

Results

Scan results showed that the lingual foramen was clearly visible in 65.4% of cases, somewhat visible in 12.5% of scans, and not visible at all in 22.1% of cases. Half of the people in the study had two foramina, whereas 27.9 percent had one and 22.1 percent had none. The mean distance from the crest of the alveolar ridge was 10.84 mm in males whereas 9.91 mm in females.

Conclusion

The Northeast Indian population exhibits an unusually high prevalence of lingual foramen in the anterior portion of the mandible. This research will aid in the precise pre-operative identification of the position and number of lingual foramina prior to surgical treatments involving the midline of the mandible.

Morphometric Analysis of the Midline Mandibular Lingual Canal and Mandibular Lingual Foramina: A Cone Beam Computed Tomography (CBCT) Evaluation

BACKGROUND

This study aimed to evaluate the midline mandibular lingual canals and foramina and their anatomic variations using CBCT scans.

METHODS

This study used retrospective analysis. A total of 320 CBCT scans were used to evaluate the study parameters, which comprised the presence or absence of the mandibular lingual foramen (MLF)/mandibular lingual canal (MLC) and its category, the distance between the buccal cortex and the start of the MLC, the distance between the inferior border of the mandible and the superior border of the foramen at its lingual and buccal terminals. The length and diameter of each canal at its lingual and buccal terminals.

RESULTS

MLC was found in all included CBCT scans. Out of 320 included CBCT scans, a single canal was represented by 30.9%, double canals (Supra with Infra -spinosum) configuration appeared in 54.7%, and triple canals (Supra-Inter-Infra) represented 14.7%. The supraspinosum canals averaged 5.81 ± 2.08 mm in length and 0.87 ± 0.30 mm in diameter at the lingual terminal. In terms of the number of canals, there was a significant difference between men and women (p ≤ 0.001), with 60% of the men in the sample having double canals and 43.1% of the women having single canals. Moreover, the male gender had a higher prevalence of triple canals (21.3% vs. 8.1%) than females. Males and females were distributed equally among the supraspinosum canals, with no statistically significant difference (p ≤ 0.7). A considerable increase in the finding of interspinosum and infraspinosum canals was seen in the male sample (p ≤ 0.001).

CONCLUSIONS

midline mandibular canals were found in all investigated CBCTs of the sample of both sexes; however, the anatomy and location of the MLF and canals varied significantly among the Saudi population.

Systematic review and meta-analysis of lingual foramina anatomy and surgical-related aspects on cone-beam computed tomography: a PROSPERO-registered study

PURPOSE

This study aimed to summarize the evidence regarding lingual foramen (LF) characteristics using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

A registered systematic review (#42,019,145,962) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. An electronic search without date or language restrictions was performed in five databases, including grey literature (Google Scholar and ProQuest). The Meta-Analysis of Statistics Assessment and Review Instrument was used to evaluate the selected studies.

RESULTS

A total of 6641 articles were identified, and 26 studies (8255 CBCT scans) were selected after a three-step selection process. There was a female predominance, and age ranged between 10 and 93 years. A total of 4336 LFs were observed among men (n = 2042) and women (n = 2294). Of this LF-related sample, 43.5% of the studies were from Asia, followed by Europe (33.5%), North America (14%), and South America (9%). Different distances from the LF to the alveolar crest (11.04-20.4 mm), buccal (4.73-4.91 mm), and lingual (8.75 mm) cortices and the inferior border of the mandible (8.48-26.59 mm) were evaluated.

CONCLUSION

In summary, this systematic review found that LF is an anatomical structure with a high prevalence among the included studies (greater than 90%), regardless of the population evaluated. The occurrence of at least one LF was the most common pattern.

The lingual foramina, a potential risk in oral surgery. A retrospective analysis of location and anatomic variability

OBJECTIVE

This study evaluates the mandibular lingual foramina (LF) using computed tomographic imaging data from a large Central European cohort, focusing on the most relevant anatomical parameters. We aimed to examine whether there are differences in key parameters between ethnic groups, or based on age and gender. Additionally, we analyze the potential effect of tooth loss on the LF and discuss risk management options before and during surgery.

METHODS

460 CT scans of adults (273 females and 186 males) were examined. The number, the location and the diameter of the median and lateral LF were assessed for each patient. The data was analyzed statistically, whereby a p-value lower than 0.05 was considered as significant.

RESULTS

Median and lateral LF were present in 95,9%, and 38,9% of patients, respectively. Male patients had a greater number of LF than females. While the majority of median LF (62%) was located above the mental spine, the majority of lateral LF was located below (84%). The diameter of lateral LF (1,15 mm ± 0,33) was smaller than for median LF (1,22 mm ± 0,35), as well the lateral canals (4,8 mm ± 1,28) were shorter than the median canals (5,32 mm ± 1,74). Lateral LF were equidistant to the symphysis (13,89 ± 3,63 mm) on either side. Critical diameter size >1 mm was found in about 2/3 of our cases. The distance from the foramen to the residual ridge was ∼7 mm less in edentulous patients compared to dentulous patients.

CONCLUSION

The median LF is a near-obligatory structure of the mandible, while the lateral LF is a frequently encountered structure. Age does not seem to affect the frequency of LF. Edentulous patients did not show differences regarding the presence of the LF, but their vertical osseous dimension was diminished by 7 mm and they may, therefore, be at an increased risk of adverse surgical incidents. The main findings of this study relate to the substantial variability in the anatomy and location of the LF and confirm with previous studies. As the LF can be reliably detected using CT/CBCT, the use of three-dimensional-imaging is recommended prior to conducting oral surgery. Careful pre-operative planning and accurate anatomical information may help to avoid surgical complications. To ascertain the potential significance of ethnicity on LF, more data need to be collected using standardized methodologies. A definitive conclusion on the impact of ethnicity on LF thus cannot currently be drawn based on the results of our study and those available from the published medical literature.