The retromolar canals and foramina: radiographic observation and application to oral surgery.

Surg Radiol Anat. 2018 Jun;40(6):647-652. doi: 10.1007/s00276-018-2005-5. Epub 2018 Mar 29.

Kikuta S, Iwanaga J, Nakamura K, Hino K, Nakamura M, Kusukawa J.

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Abstract

PURPOSE:

The retromolar canal (RMC) and foramen (RMF) are anatomic variants in the retromolar area of the mandible. The purpose of this study was to clarify the relationship between the RMC and RMF and related complications, and to reveal how the RMC could impact the mandibular anatomy using cone-beam computed tomography (CBCT) and panoramic images (PAN).

MATERIALS AND METHODS:

CBCT and PAN images of 50 patients were retrospectively analyzed to investigate the morphology of the RMC and RMF, and their impact on impacted third molar surgery and orthognathic surgery.

RESULTS:

In PAN images, neither the RMC nor RMF was detected. In CBCT images, the RMCs were detected in 26% (13/50) of the patients. A double RMC was detected on one side of one patient. The diameter of the RMC ranged from 0.8 to 2.9 mm (mean; 1.5 ± 0.6 mm), and the RMF ranged from 0.6 to 2.3 mm (mean; 1.1 ± 0.5 mm). No patients experienced unexpected bleeding. Unilateral postoperative hypoesthesia of the buccal gingiva in the molar region was reported in 6.7% of patients with the RMC.

CONCLUSIONS:

Hypoesthesia of the buccal gingiva in the lower molar region may be the main complication when the RMC is damaged.

KEYWORDS:

Anatomic variation; Cone-beam computed tomography; Mandible; Oral surgery; Retromolar canal; Retromolar foramen