Prevalence of Bifid Mandibular Canal in Cone-Beam Computed Tomography in Patients of the UNAB Viña del Mar Dental Clinic

The mandibular canal is an anatomical structure that extends bilaterally in the mandible, starting from the mandibular foramen passing through the mandibular angle to the mentonian foramen. The canal contains the inferior alveolar vasculo-nerve bundle. These components are responsible for somatosensory sensations and blood supply to the mandibular teeth, interdental papilla, and periodontal and alveolar bone tissues. An anatomical variable of the mandibular canal is one that presents with one or more canals originating in the mandibular canal and that presents a wide variability in its topographic distribution, where it can be found described in the literature as bifid and trifid mandibular canals, which is commonly ignored and misdiagnosed in dental practice​​. It has been described that during embryonic development there are 3 lower dental nerves that when fused form a single nerve, so the existence of bifid or trifid canals is a consequence of an incomplete fusion of these nerves. The existence of anatomical variants may present a challenge in oral surgery and the risk of complications such as excessive bleeding, hematoma and sensitivity alterations in the retromolar area, which may occur during implantology treatments, preprosthetic surgery, orthognathic surgeries, osteotomies and extractions. Finally, within the postoperative period, the possibilities of fibrous tissue formation in relation to the implants, sensitivity alterations and bleeding increase. Therefore, it is important to identify the anatomy of the mandibular canal and its relationship with other structures to avoid such complications. To make a correct diagnosis, technologies have emerged that have facilitated the study of the mandibular canal, such as panoramic radiography and cone beam computed tomography (CBCT). CBCT is increasingly being used as a diagnostic tool in dentistry, especially in oral surgery, allowing high-resolution three-dimensional images, since, unlike panoramic radiographs, these represent with higher quality the anatomical structures of the jaw ​​. This is evidenced by prevalence studies in which panoramic radiographs have shown a low prevalence of bifid mandibular canal ranging from 0.08% to 0.95%. However, those using images obtained from CBCT have reported incidence rates of bifid mandibular canal ranging from 18% to 25%. This study aims to determine the prevalence of BMC in a local population using CBCT, analyze its correlation with gender and affected side, and compare findings with previous studies.