Evaluation of Endosseous Canals in the Anterior Mandible by using CBCT: An uncommon case of a quintuple lingual canal

Abstract Purpose: The aim of this article was to evaluate the regional frequency, location, and diameter of lingual foramen in the anterior mandible using a retrospective analysis of clinically obtained cone-beam computed tomography (CBCT) images. Methods: Two hundred thirty-four regions based on CBCT, of the anterior mandible of 76 patients (41 female and 35 male) were examined retrospectively for the presence of endosseous bony canals. The lingual foramen was examined for the measurements of the maximum diameter of the artery and the diameter of the lingual foramen. We measured the distance between the lingual foramen and the alveolar ridge, the tooth apex, the mandibular border, and the mental foramen. Data were analysed using ANOVA and independent sample t-tests. Results: The range of the diameters of the lingual artery varied from 0.3 to 1.67 mm. Most lingual foramina (47.62%) were found in the midline region. The quintuple canal was observed on CBCT scans. The highest measurement of the diameter of the artery (p< .01), the longest distance between lingual foramen (p< .05) and alveolar ridge, and the nearest distance between lingual and mental foramen (p< .01) were found at the right side. Conclusion: The findings related to the presence, diameter, and prevalence of vascular canals, revealed significant results for oral surgery, and should not be ignored when planning any operation in the anterior mandible. We present an uncommon case with a quintuple lingual canal. In order to prevent life-threatening bleeding, it is imperative to detect these vessels with CBCT before mandibular surgery.