Morphological and vascular assessment of mandibular nutrient foramina using cone beam computed tomography and Color Doppler ultrasonography

Abstract One of the anatomical variations found in the mandible is the presence of nutrient foramina. Failure to correctly identify these structures and understand their characteristics may lead to complications during surgical procedures. The aim of this study was to evaluate the presence and morphological characteristics of nutrient foramina using cone beam computed tomography and to assess the presence of detectable colour-flow signals using color Doppler ultrasonography. This observational study consisted of a retrospective cone beam computed tomography assessment of 538 eligible patients, followed by a prospective color Doppler ultrasonography examination of all 45 patients in whom at least one nutrient foramen was identified, comprising a total of 73 nutrient foramina. No statistically significant difference was found in the distribution of nutrient foramina according to sex. A significant association was observed between right- and left-sided nutrient foramen presence ( P < 0.001). In the primary analysis, nutrient foramina diameter analyzed as a continuous predictor was significantly associated with the presence of a detectable colour-flow signal, with each 0.1-mm increase in diameter associated with higher odds of signal detection (OR = 5.22, 95% CI: 2.75–9.93; P < 0.001). Nutrient foramina may be clinically relevant structures. While cone beam computed tomography enables detailed morphological evaluation, color Doppler ultrasonography may provide complementary information regarding detectable colour-flow signals under the applied imaging settings. The combined use of these methods provides complementary morphological and colour-flow information regarding nutrient foramina, while the potential surgical relevance of these findings requires prospective clinical validation.