scholarly journals The elusive retromolar foramen and retromolar canal: A CBCT study

2021 ◽  
Vol 7 (3) ◽  
pp. 118-124
Author(s):  
Vijeta Pannalal ◽  
Abhijeet Deoghare ◽  
Chinar Fating ◽  
Satyendra Jha

This study aims to evaluate the presence of retromolar foramen (RMF) and retromolar canal (RMC) in the mandible using cone beam computed tomography (CBCT) in Chhattishgarh population and to correlate its possible clinical impact. 175 CBCT images were collected from which 100 bilateral CBCT images of patients were retrospectively selected from the Department of Oral Medicine and Radiology of the Chhattishgarh Dental College and Research Institute and evaluated bilaterally which were taken for diagnostic purposes from maxillofacial radiology clinic and data were statistically analyzed. This was an observational descriptive study and all the images were processed and analyzed on CS3D imaging software. The data was analyzed using chi square test. The prevalence of RMF and RMC was observed in 8.5%, of which 10 were in females and 7 in males. The RMCs traversed in different directions – horizontal, vertical and angular. Based on the subjective assessment, each of these canals was further subclassified into straight and curved canal. In the present study in 12 of the cases angular curved type was found and in 3 cases, vertical straight was noticed. The bifurcation of the inferior alveolar nerve (IAN) canal was observed in 15% of the scans and remaining 85% had single mandibular canal. The proximity of RMF from buccal and lingual cortical plates was found buccally in 16 cases and in single case was found to be lingually. Position of RMF might change with the presence and absence of third molar. The absence of third molar results in anteriorly located RMF. In majority of cases it was found that RMF was located more buccal than lingual. The parameters considered in the current study will guide the oral and maxillofacial surgeons while giving incisions in 3molar impacted cases, other pathologies and ease to preserve the retromolar foramen.

2017 ◽  
Vol 49 (2) ◽  
pp. 59
Author(s):  
David Buntoro Kamadjaja ◽  
Djodi Asmara ◽  
Gita Khairana

Background: Odontectomy of lower third molar has a potential risk for inferior alveolar nerve impairment. Paresthesia of inferior alveolar nerve has often been associated with close relationship between the apex of lower third molar and mandibular canal. Rood and Shehab’s category has been commonly used for radiological prediction of inferior alveolar nerve injury following third molar surgery. Purpose: This study aimed to determine whether there was correlation between Rood and Shehab’s radiographic features and the incidence of inferior alveolar nerve paraesthesia following odontectomy of lower third molar. Method: This was a retrospective cross-sectional study, using data obtained from the dental record of patients who had undergone odontectomy of lower third molars in Dental hospital of Universitas Airlangga during 2 years period. Samples were cases that, from presurgical radiograph, showed close relationship between lower third molar roots and mandibular canal. The case and non-case groups were assigned based on the presence of paraesthesia and non-paraesthesia of inferior alveolar nerves, respectively. Based on Rood and Shehab’s category, the samples collected were then classified into two groups which were those whose relationship matched and did not match with the category, respectively. Data were analyzed using Chi-square correlation test. Result: Of 975 odontectomy cases included in this study, 80 cases were taken as study samples consisting of 15 and 65 cases assigned, respectively, as case and non-case. The 32 cases matched with the criteria of Rood and Shehab's category while the remainder of 48 cases did not. Of 32 cases which met the criteria of Rood and Shehab’s relationship, only 5 cases showed paraesthesia, whereas out of 48 cases which did not met the criteria 10 cases showed paraesthesia. Statistical analysis showed significance value of 0.770 (p>0.05) indicating that there was no significant correlation between relations of third molar root and mandibular canal, based on Rood and Shehab’s category, and the incidence of inferior alveolar nerve paraesthesia. Conclusion: There was no correlation between Rood and Shehab’s radiographic features and the incidence of paraesthesia of inferior alveolar nerve following odontectomy of lower third molars.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Bhagath Kumar Potu ◽  
Vinod Kumar ◽  
Abdel-Halim Salem ◽  
Marwan Abu-Hijleh

The retromolar foramen (RMF) is a rare anatomical structure situated in the retromolar fossa behind the third molar tooth. When it is present, the foramen is connected with the mandibular canal and is believed to transmit neurovascular structures that provide accessory source to the mandibular molars and the buccal area. Reports from the literature show that the presence of RMF could pose a challenge in complete blockage of the inferior alveolar nerve during mandibular surgeries. We report the incidence of retromolar foramen from ninety-four dry mandibles of south-eastern part of Karnataka State, India. The foramen was observed in 11 mandibles out of 94 included in the study (11.7%). In three mandibles, the foramen was present bilaterally (3.2%) and in three it was on the left side (3.2%) and in five it was on the right side (5.3%). For the first time, we also measured the dimensions of the retromolar area and distance of the foramen from third molar tooth to understand its risks during the surgical extraction of the lower third molar tooth. A thorough review of the literature has also been done to compare the present findings with the studies reported from the various populations.


2021 ◽  
Vol 7 (3) ◽  
pp. 125-130
Author(s):  
Srujana Daniella Remulla ◽  
Jyothirmai Koneru ◽  
Sudhakara Reddy ◽  
Ramesh Tatapudi ◽  
Geetanjali Darna ◽  
...  

The purpose of the study was to correlate the accuracy of Roods and Shehab signs in an intraoral periapical radiograph (IOPAR) with Cone-beam computed tomography (CBCT) findings to indicate Cone-beam computed tomography only in high-risk conditions.70 impacted mandibular third molar teeth in 58 patients above 18 years with intraoral periapical radiographs presenting with one or more root and canal signs of Rood and Shehab criteria were included in the study. Winter's classification was recorded, and the patients were exposed to a Cone-beam computed tomographic scan. True canal – tooth relationship was assessed in the sectional images. Pearson Chi-square test was used to correlate periapical radiograph and tomographic findings, and an unpaired t-test was applied for descriptive analysis.Rood and Shehab canal criteria in the periapical radiographs were significantly correlated to direct contact of an impacted lower third molar with the canal (p< 0.05) and loss of cortication of Mandibular canal (p< 0.05) on the cone-beam computed tomography. Cone-beam computed tomography is recommended to assess the periapical radiographs with canal risk markers pre-operatively to help avoid iatrogenic complications.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Ticiana Sidorenko de O. Capote ◽  
Marcela de Almeida Gonçalves ◽  
Juliana Álvares Duarte Bonini Campos

Background. The retromolar canal (RMC) is an anatomical variation that can cause complications in dental procedures. Method. The RMC was evaluated according to age, sex, and presence of accessory mandibular canal and accessory mental foramen, on both sides in 500 panoramic radiographs, belonging to individuals at the age of 7 to 20 years. The associations of interest were studied through Fisher’s Exact Test and Pearson’s Chi-Square Test, and the correlation was studied through Pearson’s Correlation Coefficient (r). The significance level used was 5%. Results. The RMC was observed in 44 radiographs (8.8%), and out of those 24 were females. There was no statistically significant association between the RMC and age (p>0.05; Fisher’s Exact Test), sex (p=0.787; Pearson’s Chi-Square Test), amount of mandibular canals and mental foramina, on both sides (p>0.05; Pearson’s Chi-Square Test). There was a significant association between RMC and side, the higher frequency of the canal being on the right side (p<0.05; Fisher’s Exact Test). Conclusions. Despite the low occurrence of the RMC, its identification and the verification of its dimensions and path are relevant, mainly in cases when anesthetic and surgical procedures can present failures or difficulties.


Tomography ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. 219-227
Author(s):  
Yen-Wen Shen ◽  
Wan-Chun Chang ◽  
Heng-Li Huang ◽  
Ming-Tzu Tsai ◽  
Lih-Jyh Fuh ◽  
...  

The retromolar canal is an anatomical variation that occurs in the mandibular bone. The retromolar canal typically originates in the mandibular canal on the distal side of the third molar and extends forward and upward to the retromolar foramen (RMF), which contains the neurovascular bundle. Accidentally damaging the neurovascular bundle in the retromolar canal during the extraction of the third molar, dental implant surgery, or maxillofacial orthognathic surgery may lead to subsequent complications such as incomplete local anesthesia, paresthesia, and bleeding during operation. The objective of this study was to investigate the prevalence of the RMF in the Taiwanese population in a medical center by using dental cone-beam computed tomography (CBCT) and to identify the position of the RMF in the mandibular bone. The dental CBCT images for the mandibular bone of 68 hemi-mandible were uploaded to the medical imaging software Mimics 15.1 to determine the prevalence of the RMF in the Taiwanese population and the three positional parameters of the RMF in the mandibular bone: (1) The diameter of the RMF, (2) the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the second molar, and (3) the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal. Seven RMFs were observed in the 68 hemi-mandibles. Thus, the RMF prevalence was 10.3%. In addition, the diameter of the RMF was 1.41 ± 0.30 mm (mean ± standard deviation), the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the the second molar was 12.93 ± 2.87 mm, and the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal below second molar was 13.62 ± 1.3487 mm. This study determined the prevalence of the RMF in the Taiwanese population in a medical center and its relative position in the mandibular bone. This information can provide clinicians with a reference for posterior mandible anesthesia and surgery to ensure medical safety.


2014 ◽  
Vol 15 (6) ◽  
pp. 740-745
Author(s):  
Mojdeh Mehdizadeh ◽  
Navid Ahmadi ◽  
Mahsa Jamshidi

ABSTRACT Objectives Exact location of the inferior alveolar nerve (IAN) bundle is very important. The aim of this study is to evaluate the relationship between the mandibular third molar and the mandibular canal by cone-beam computed tomography. Study design This was a cross-sectional study with convenience sampling. 94 mandibular CBCTs performed with CSANEX 3D machine (Soredex, Finland) and 3D system chosen. Vertical and horizontal relationship between the mandibular canal and the third molar depicted by 3D, panoramic reformat view of CBCT and cross-sectional view. Cross-sectional view was our gold standard and other view evaluated by it. Results There were significant differences between the vertical and horizontal relation of nerve and tooth in all views (p < 0.001). Conclusion The results showed differences in the position of the inferior alveolar nerve with different views of CBCT, so CBCT images are not quite reliable and have possibility of error. How to cite this article Mehdizadeh M, Ahmadi N, Jamshidi M. Evaluation of the Relationship between Mandibular Third Molar and Mandibular Canal by Different Algorithms of Cone-beam Computed Tomography. J Contemp Dent Pract 2014;15(6):740-745.


2013 ◽  
Vol 02 (04) ◽  
pp. 195-199
Author(s):  
Amar Jayanthi A. ◽  
Arunkumar K G.

Abstract Background and aim: The variations in the course and communicating branches of musculocutaneous nerve is of clinical importance in the treatment of recurrent compression neuropathies and in the diagnosis of median nerve lesions. Most of the reports on anatomical variations of musculocutaneous nerve are single case studies and such studies with emphasis on gender difference in a sample of Keralite population are rarely reported. The objective of the present study is to observe the variations in the course of musculocutaneous nerve with special reference to communications with other nerves of the arm and to study the correlation between gender and variations of the nerve. Materials and Methods: Two hundred and sixty four arms were dissected in the department of Anatomy, Government medical college, Thrissur and studied for variations of muculocutaneous nerve. Analysis was done with epi info, using proportions, confidence interval and Chi Square test. The communications noted were classified using the available classifications of Le Minor, Venieratos and Anagnostopoulou and Choi et al. Results: Nerve variations were seen in 24.2 % cases which include, absence of the nerve (3.4%), nerve not piercing coracobrachialis (12.4%) and communication to median nerve (15.1 %). All the variations observed were statistically not significant. The embryological basis for the axonal pathfinding is considered as a result of both guidance molecules and electrical activity that change the calcium homeostasis within the growth cone to regulate growth cone turning. Conclusion: Variations that were observed in the present study may give sufficient and relevant data on the nerves, among Keralite population in which studies are few.


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