scholarly journals Double Retromolar Canal: a Case Report

2019 ◽  
Vol 21 (5) ◽  
pp. 474-476
Author(s):  
Ana Paula Tulio Manfron ◽  
Alessandra Soares Ditzel ◽  
Flávia Gasparini Kiatake Fontão ◽  
Luciana Rei Azevedo-Alanis
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Imaging Techniques ◽  
Anatomic Variation ◽  
Anatomical Variation ◽  
Third Molar ◽  
Cone Beam ◽  
Oral Rehabilitation ◽  
Computed Tomography Images ◽  
Retromolar Canal

AbstractThe retromolar canal is an anatomical variation of the mandibular canal. Its neurovascular bundle may extend to areas of the temporalis tendon, and areas of buccinator muscle insertion in the alveolar process at lower third molar region, beside the retromolar fossa. The observation of the retromolar canal in conventional radiographs is limited by the presence of increased bone condensation in the region due to overlapping anatomical structures. The use of three-dimensional imaging techniques, such as cone beam computed tomography can contribute significantly for the treatment planning.Some complications may occur in surgical procedures involving the retromolar area when the retromolar canals are present, such as hemorrhage, failure in anesthesia and injuries to nerve branches. This study reported an unusual case of a double retromolar canal on the left side of the mandible, that led  to the change of the treatment planning in a 54-year-old male patient. Furthermore, the clinical and surgical consequences of these findings in oral rehabilitation were discussed. The cone beam computed tomography was  an important diagnostic tool in the observation of the presence and the exact location of retromolar canal. Retromolar canals may be detected on a panoramic radiograph. However, more precise information about the anatomical variation can be shown on cross sectional cone beam computed tomography images. Keywords: Anatomic Variation. Mandible. Cone-Beam Computed Tomography. ResumoO canal retromolar é uma variação anatômica do canal da mandíbula. Seu feixe vásculo-nervoso pode se estender para áreas do tendão do músculo temporal, áreas de inserção do músculo bucinador e no processo alveolar na região do terceiro molar inferior, além da fossa retromolar. A observação do canal retromolar em radiografias convencionais é limitada pela presença de condensação óssea com sobreposição de estruturas anatômicas. Devido a esse fato o uso de técnicas de imagem tridimensionais, como a tomografia computadorizada de feixe cônico, contribuem significativamente para o planejamento do tratamento. Algumas complicações podem ocorrer em procedimentos cirúrgicos envolvendo a região retromolar quando o canal retromolar está presente, como hemorragia, falha na anestesia e lesões aos ramos nervosos. Este estudo relatou um caso incomum de canal retromolar duplo, do lado esquerdo da mandíbula, causando alterações no planejamento clínico do tratamento de um paciente do sexo masculino de 54 anos de idade. Além disso, as consequências clínicas e cirúrgicas desses achados na reabilitação bucal foram discutidas. Atomografia computadorizada de feixe cônico apresentou-se como importante ferramenta diagnóstica na observação da presença e localização exata do canal retromolar. Canais retromolares podem ser detectados em uma radiografia panorâmica. No entanto, informações mais precisas sobre esta variação anatômica podem ser mostradas em imagens de tomografia computadorizada de feixe cônico. Palavras-chave: Variação Anatômica. Mandíbula. Tomografia Computadorizada de Feixe Cônico.AbstractThe retromolar canal is an anatomical variation of the mandibular canal. Its neurovascular bundle may extend to areas of the temporalis tendon, and areas of buccinator muscle insertion in the alveolar process at lower third molar region, beside the retromolar fossa. The observation of the retromolar canal in conventional radiographs is limited by the presence of increased bone condensation in the region due to overlapping anatomical structures. The use of three-dimensional imaging techniques, such as cone beam computed tomography can contribute significantly for the treatment planning.Some complications may occur in surgical procedures involving the retromolar area when the retromolar canals are present, such as hemorrhage, failure in anesthesia and injuries to nerve branches. This study reported an unusual case of a double retromolar canal on the left side of the mandible, that led  to the change of the treatment planning in a 54-year-old male patient. Furthermore, the clinical and surgical consequences of these findings in oral rehabilitation were discussed. The cone beam computed tomography was  an important diagnostic tool in the observation of the presence and the exact location of retromolar canal. Retromolar canals may be detected on a panoramic radiograph. However, more precise information about the anatomical variation can be shown on cross sectional cone beam computed tomography images. Keywords: Anatomic Variation. Mandible. Cone-Beam Computed Tomography. ResumoO canal retromolar é uma variação anatômica do canal da mandíbula. Seu feixe vásculo-nervoso pode se estender para áreas do tendão do músculo temporal, áreas de inserção do músculo bucinador e no processo alveolar na região do terceiro molar inferior, além da fossa retromolar. A observação do canal retromolar em radiografias convencionais é limitada pela presença de condensação óssea com sobreposição de estruturas anatômicas. Devido a esse fato o uso de técnicas de imagem tridimensionais, como a tomografia computadorizada de feixe cônico, contribuem significativamente para o planejamento do tratamento. Algumas complicações podem ocorrer em procedimentos cirúrgicos envolvendo a região retromolar quando o canal retromolar está presente, como hemorragia, falha na anestesia e lesões aos ramos nervosos. Este estudo relatou um caso incomum de canal retromolar duplo, do lado esquerdo da mandíbula, causando alterações no planejamento clínico do tratamento de um paciente do sexo masculino de 54 anos de idade. Além disso, as consequências clínicas e cirúrgicas desses achados na reabilitação bucal foram discutidas. Atomografia computadorizada de feixe cônico apresentou-se como importante ferramenta diagnóstica na observação da presença e localização exata do canal retromolar. Canais retromolares podem ser detectados em uma radiografia panorâmica. No entanto, informações mais precisas sobre esta variação anatômica podem ser mostradas em imagens de tomografia computadorizada de feixe cônico. Palavras-chave: Variação Anatômica. Mandíbula. Tomografia Computadorizada de Feixe Cônico.

scholarly journals Bifid canals: identification of three clinical cases using cone-beam computed tomography images

2018 ◽  
Vol 66 (3) ◽  
pp. 263-266
Author(s):  
Paulo de Camargo MORAES ◽  
Daniela Prata TACCHELLI ◽  
Rubens Gonçalves TEIXEIRA ◽  
Luciana Butini OLIVEIRA ◽  
José Luiz Cintra JUNQUEIRA
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Third Molar ◽  
Anatomical Variations ◽  
Mandibular Canal ◽  
Cone Beam ◽  
Bone Lesions ◽  
Computed Tomography Images ◽  
First Case ◽  
Clinical Cases

ABSTRACT Anatomical variations of mandibular canal have rarely been reported in the literature. The aim of this paper is to present three clinical cases of bifid mandibular canal diagnosed with cone-beam computed tomography (CBCT) as well as discuss its clinical implications. The first case is very interesting due to its anatomic variation verified in a panoramic radiograph during orthodontic planning, mimicking an odontogenic tumor. The second and the third cases were identified during tomographic evaluation for third molar exodontia. The diagnosis of bifid canals is extremely relevant in order to avoid complications during surgical procedures and implant placement as well as anesthesia failures which cause pain, paresthesia and bleeding. Furthermore, the shape of these anatomical variations can be confused with bone lesions.

scholarly journals Importance of cone beam computed tomography in the diagnosis of root perforation: a case report

2021 ◽  
Vol 10 (2) ◽  
pp. e25010211320
Author(s):  
Sandy Rabelo Lima ◽  
Denise Hélen Imaculada Pereira de Oliveira ◽  
Francisca Damares da Silva Mesquita ◽  
Eduardo José Guerra Seabra ◽  
Patrícia Bittencourt Dutra dos Santos ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Imaging Techniques ◽  
Correct Diagnosis ◽  
Cone Beam ◽  
Histopathological Analysis ◽  
State University ◽  
Oral Rehabilitation ◽  
Dental Imaging ◽  
Periodontal Tissues

Endodontic perforations are defined as a iatrogenic mechanical communication between the root canal and supporting periodontal tissues. Dental imaging techniques are essential for satisfactory detection of these conditions. The purpose of this study was to describe the clinical case of a patient diagnosed with endo-periodontal cystic lesion by endodontic perforation by cone beam computed tomography (CBCT). A 67-year-old female patient who required oral rehabilitation treatment with an implant-supported denture in the posterior mandible was seen at the Dental Clinic of the State University of Rio Grande do Norte (UERN). Based on the data collected during clinical examination, complementary tests were requested for assessment of his overall dental condition. Periapical radiography revealed the presence of a lesion in the apex of tooth 22, which was associated with an endodontic lesion. CBCT showed a lateral lesion caused by root perforation suffered during prior endodontic treatment. After histopathological analysis, the diagnosis was a radicular cyst. This study highlights the importance of CBCT imaging for establishment of the correct diagnosis, treatment planning, and prevention of complications.

scholarly journals Incidence and Anatomical Properties of Retromolar Canal in an Iranian Population: A Cone-Beam Computed Tomography Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
N. Nikkerdar ◽  
A. Golshah ◽  
M. Norouzi ◽  
S. Falah-Kooshki
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Third Molar ◽  
Iranian Population ◽  
Cone Beam ◽  
Third Molars ◽  
The Third ◽  
The Mean ◽  
Anatomical Properties ◽  
Retromolar Canal

Objectives. Retromolar canal (RC) is an anatomic structure, and due to increasing demand for surgical procedure in the retromolar area of the mandible, the identification of the retromolar canal has become an issue of clinical concern. It can innervate the third molar and some of the muscles around the posterior segment of the mandible, complicating surgical procedures in the retromolar area and root canal treatment of third molars. The aim of this study was to evaluate the incidence and anatomical properties of RC in a western Iranian population using cone-beam computed tomography (CBCT) images. Materials and Methods. Two hundred bilateral CBCT images were collected and screened in the three spatial planes for the presence of an RC. Anatomical properties and location of the RCs were assessed according to their course and distance from the surrounding structures. The relationship between the presence of RC and age, sex, side, and presence of second and third molars was also evaluated. Independent samples t-test, ANOVA, Tukey’s post hoc test, paired t-test, and chi-square were used to compare groups. Results. At least one RC was observed in 22% of the mandibles. Its bilateral incidence was 5.5%. Two major types of canals were detected, namely, type I, following a straight or curved course from the mandibular canal (MC) to the retromolar area (47.3%), and type II, coursing from the retromolar area to the radicular part of the third molar (52.7%). Regarding linear measurements, the mean RC diameter and the mean distance to the MC, second, and third molars were 0.68 ± 0.31, 13.7 ± 2.8, 15.3 ± 3.0, and 7.3 ± 2.3 mm, respectively. Conclusion. Based on the results of this study, RC was found in 22% of the cases; thus, it should be considered as a normal anatomical variation in the Iranian population rather than a rare finding.

scholarly journals Intrusion of maxillary molar roots into the maxillary sinus in a sample of the Egyptian population using cone beam computed tomography

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Esraa Ahmed Eid ◽  
Fatma Mostafa El-Badawy ◽  
Walaa Mohamed Hamed
Keyword(s):  
Computed Tomography ◽  
Maxillary Sinus ◽  
Cone Beam Computed Tomography ◽  
Third Molar ◽  
Cone Beam ◽  
Egyptian Population ◽  
Maxillary Molar ◽  
Maxillary Sinus Floor ◽  
Sinus Floor ◽  
The Right

Abstract Background The proximity of the maxillary sinus floor to the maxillary molar roots increases the probability of oroantral communication on conducting any surgical or endodontic procedure in the involved area. The aim of this study is to evaluate the relationship between each maxillary molar root and maxillary sinus floor using cone beam computed tomography. Predicting the probability of protrusion of each root into the sinus will consequently predict the probability of occurrence of the oroantral fistula in a sample of the Egyptian population. Results The total number of roots located outside the sinus was 121 (35.3%), while those contacting the sinus floor were 80 (23.3%) and those intruded the sinus were 141 (41.2%). The percentage of root intrusion into the sinus in males (56.9%) was significantly (p = 0.01) higher than females (42.9%). The probability of root intrusion in the left molars (54.2%) was non-significantly (p = 0.067) higher than that of the right side (44.3%). As for the type of tooth, the second molar showed the highest probability of root intrusion into the sinus (55.3%) followed by the third molars (52.6%) then the first molars (40.9). According to the type of root, the mesiobuccal root showed the highest probability of intrusion into the sinus (50.9%) followed by the palatal root (49.1%) then the distobuccal root (47.4%). However, the difference in both type of tooth and type of root was statistically non-significant (p = 0.051 and 0.869 respectively). As for the individual root with the highest probability of intrusion, the mesio-buccal root of the right third molar is the most frequent root to intrude the sinus (71.4%) and the mesio-buccal root of the right first molar is the least frequent (22.7%). Conclusions In a sample of the Egyptian population, males exhibit higher probability of root protrusion into the sinus than females. The side and type of tooth are of higher impact on the probability of its intrusion into the sinus compared to the type of root. Left second molars are at a higher risk of oroantral communications on surgical or endodontic procedures compared to other molars due to its highest probability of intrusion into the sinus.

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