Anastomosis of mandibular lingual bony canals in CBCT images

Objectives: Identifying location, presence and anastomosis of lingual neurovascular canals is important to safe surgical/anesthetic procedures in the mandible. The goal was to study the characteristics of neurovascular bony canals which penetrate the lingual mandibular cortex and may anastomose with mental foramen and/or incisive canals. Methods: 150 mandible CBCT exams were analyzed (99 female/51male/mean age 36.8yrs), by two examiners. Images were re-evaluated one month later. The parameters were: presence of lingual canals/foramina, location, diameter, length and anastomosis. Results: The results showed total of 86 identified bony canals: unilateral right 25, unilateral left 19, bilateral 21and 85 cases were negative. Therefore, the bony canal was present in 65 out of 150 exams (43.3%). Double or multiple foramina/canals were not identified. The mean canal length and diameter was 5.2mm (2.0-10mm) and 0.6mm (0.3-1.1mm) respectively. It was not found double or multiple foramina/canals. From the 86 identified bony canals, 18 anastomosed with mental foramen, 11 with mental foramen and incisive canal, and 57 with incisive canal. The intra and interobserver agreement was high (Kappa 0.89). Conclusions: Anastomoses with incisive canal were more frequent. It is important that the professional takes into account the characteristics of the lingual vascularization of mandible, mainly the anastomosis, to prevent post surgical and/or anesthesia problems. Radiologists should be able to recognize these anatomic features on CBCT images. (Supported by CAPES).