Evaluation of the Lingual Canals of Mandible in Cone Beam Computed Tomography

This study aims to assess the frequency of the lingual foramina and canals relative to their location on the mandibular cortical plate and also to closely inspect the course of the lingual canals inside the mandibular body using 3D reconstruction of the evaluated area. A retrospective study was conducted with 55 cone bean computed tomography (CBCT) scans in order to analyze the location, number, course and anastomosing pattern of the lingual canals. A total number of 165 lingual canals (LCs) were recorded from 55 patients, as follows: 94 median (MLC), 16 paramedian (PLC) and 55 lateral lingual canals (LLC). MLCs were a constant finding in all 55 patients (100% of the cases), PLCs were present in 15 patients (27.3% of the cases), and LLCs were identified in 35 patients (63.3% of the cases). The anastomosing pattern of the MLC, in which a supraspinous canal anastomosed with an infraspinous canal, was found in 10.9% of the cases (6 of 55 patients),. The LLCs were anastomosed with the mandibular incisive canal (MIC) in 56.3% of the cases (31 of 55 LLCs) and with the mandibular canal (MC) in 3.6% of the cases (2 of 55 LLCs). CBCT revealed itself to be a reliable tool for evaluating the intramandibular topography of the LCs. The anastomosing pattern of the lingual canals might raise the question whether the LCs could be responsible for incomplete anesthesia after conventional mandibular block by carrying sensory innervation from the mylohyoid nerve to the inferior alveolar nerve.