Assessment of mandibular vascular canals by dental CT

PURPOSE: Sublingual artery and its branches run in the floor of the mouth and prone to substantial bleeding when injured during an implantation procedure. These branches enter the mandible from the lingual side and run through bony canals in the mandible. The purpose of this investigation is to evaluate the frequency, diameter, direction and position of lingual canals by dental CT. MATERIALS AND METHODS: 26 patients who underwent dental CT of the mandible before implantation were included in this study. Tomographic examination was performed in a transverse plane parallel to the mandibular base by bone algorithm. Multiplanar reconstructions were obtained in the sagittal and coronal oblique planes. RESULTS: All patients demonstrated at least one canal, and 8 patients had two or more canals. Two of the patients presented with four canals. The typical lingual canal locations were the middle of the mandible and the premolar regions. The mean diameter of the lingual canals was 0.8 mm +/- 0.2 mm in the middle, 0.6 mm +/- 0.1 mm in the premolar regions. The direction of median canal was anterior and slightly caudal. Lateral canals were directed in a medial manner. CONCLUSION: Before the dental implantation procedure, beside the relationships of implant with the important anatomic structures, lingual vascular canals should also be evaluated. Dental CT examination easily demonstrates the presence, position, direction and size of the lingual canals. By ensuring that radiologists and dentists are aware of these canals and their importance, bleeding complications during the placement of implants could be avoided.