Evaluation of Vascular Structures in the Anterior Mandible with Cone Beam Computed Tomography

Background: The aim of this article was to evaluate the regional frequency, location, and diameter of the lingual foramen in the anterior mandible using a retrospective analysis of clinically obtained cone-beam computed tomography (CBCT) images. Materials and Methods: Two hundred thirty-four regions of the anterior mandible from 76 patients (41 female and 35 male) were exam-ined retrospectively using CBCT for the presence of endosseous bony canals. The study focused on the lingual foramen, measuring both the maximum diameter of the artery and the diameter of the lingual foramen itself. Additionally, distances were measured between the lingual foramen and the alveolar ridge, tooth apex, mandibular border, and mental foramen. Data were analyzed using ANOVA and inde-pendent sample t-tests to determine statistical significance. The distributions of the measured variables were assessed for normality prior to analysis. Normality was confirmed using appropriate statistical tests, such as the Shapiro-Wilk test, and visual inspection methods, including Q-Q plots. Since the data met the assumptions of normality, parametric tests were deemed appropriate for analysis. Consequently, ANOVA and independent sample t-tests were employed to evaluate the differences among groups and the relationships between variables. This approach allows for more robust statistical infer-ences, leveraging the properties of the normal distribution. Results: The diameters of the lingual artery ranged from 0.3 mm to 1.67 mm, with the majority of lingual foramina (47.62%) located in the midline region. Notably, a quintuple canal was identified in the CBCT scans. The highest measurement of the artery diameter was statistical-ly significant (p < 0.01), along with the longest distance between the lingual foramen and the alveolar ridge (p < 0.05), and the shortest distance between the lingual and mental foramen (p < 0.01), all observed on the right side. These findings highlight the anatomical varia-tions and spatial relationships of the lingual artery and foramina, which are crucial for surgical planning in the anterior mandible. Conclusions: The findings regarding the presence, diameter, and prevalence of vascular canals are critical for oral surgery and must be considered when planning any procedures in the anterior mandible. Notably, we report an uncommon case involving a quintuple lingual canal. To prevent potentially life-threatening bleeding during surgical interventions, it is essential to identify these vascular structures using CBCT prior to mandibular surgery. This proactive approach enhances surgical safety and reduces the risk of complications.