The midline mandibular lingual canal : importance in implant surgery

Abstract

PURPOSE : To determine the position and occurrence of the midline mandibular canal (MLC) in the various age, sex, population and dentition groups. The average distances from the MLC to a planned mandibular midline implant and the inferior mandibular border were measured. MATERIALS AND METHODS : Cone beam computed tomography (CBCT) was used to scan 122 mandibles (31 black males; 28 black females; 32 white males and 31 white females). Midsagittal sections in the reconstructed images of edentulous mandibles or sagittal sections through the socket of the 41 tooth (FDI nomenclature) in dentate mandibles were made. A measurement of 6 mm across buccolingually (BL) was delineated with the caliper tool indicating the minimum dimensions for placement of an implant. In dentate cases where the BL distance was in excess of 6 mm, the caliper was placed across the deepest part of the socket as a marker to determine the bone dimension available below the socket for implant placement. From these markers a vertical line was dropped to the MLC to measure the available bone. RESULTS : The MLC was a consistent finding within the anterior mandible. A statistical significant difference in bone availability amongst the sexes and with dentition pattern was found indicating that edentulous female patients were particularly at risk of injury to the vessels of the midline lingual canal during implants in that area. CONCLUSION : Immediate implants in the position of lower central incisors are regarded as a safe procedure as is the placement of interforaminal implants in the anterior mandible. Clinicians should however take note of the position of the midline mandibular lingual canal and approach this area with caution, especially if the alveolar ridge is to be reduced before implant placement.