Variation of Mandibular Canal Branching Related to Anatomical Regions in Mandible: A Radiographic Study Without Contrast.

Purpose: Screening mandibular canal branches and awareness of these possible canal branches is vital for patient safety and surgical success. The aim of this study was to evaluate the prevalence and localization of mandibular canal branching (MCB).

Methods: This is an institutional and retrospective cohort study of patients who presented for evaluation of cone beam computed tomography (CBCT) between 2019 and 2020. The prevalence of MCB and the related foramina was estimated according to anatomical regions. Predictor variables were gender, age, anatomical region, and side of branches. Outcome variable of the study was MCB. Thus, multiple correspondence analysis was performed to determine the relationships between the categories of the variables, as well as between variables.

Results: CBCT images were obtained from 180 patients (n = 360 hemimandible; 90 males, 90 females). MCB was observed in 130 (72.2%) of 180 patients (mean age = 38.2 ± 11.8 years). MCB was observed in 63 (48.5%) males and 67 (51.5%) females, and the prevalence of MCB did not differ significantly according to gender (P = .618). MCB was mostly observed in the molar region (69 branches, 34.3%). Foramina were detected in 60 of 248 branches (24.19%) and were mostly observed in the retromolar region (28 foramina, 46.7%). "Quadrafid" branching was detected in 2 females (1.11%). Female patients aged 19-38 years were more prone to have MCB in molar and retromolar regions. MCB was more likely to occur bilaterally. There was also a high positive correlation among the MCB, side, and anatomical regions.

Conclusions: MCB is not a rare anatomical variation, and even quadrafid branching can be observed in the hemimandible. CBCT images should be examined carefully for possible MCB to minimize postoperative complications during dental surgery.