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Evaluation of Mandibular Lingual Foramina Related to Dental Implant Treatment With Computerized Tomography: A Multicenter Clinical Study

Yildirim, Yagmur D. DDS, PhD*; Güncü, Güliz N. DDS, PhD; Galindo-Moreno, Pablo DDS, PhD; Velasco-Torres, Miguel DDS, PhD§; Juodzbalys, Gintaras DDS, PhD; Kubilius, Marius DDS; Gervickas, Albinas DDS, PhD#; Al-Hezaimi, Khalid DDS, MS**; Al-Sadhan, Ra'ed DDS, MS††; Yilmaz, Hasan Güney DDS, PhD‡‡; Asar, Neset Volkan DDS, PhD§§; Karabulut, Erdem PhD‖‖; Wang, Hom-Lay DDS, MS, PhD¶¶; Tözüm, Tolga F. DDS, PhD##

doi: 10.1097/ID.0000000000000012
Basic and Clinical Research

Background: Bleeding can be one of the severe complications during implant placement or other surgeries. Presurgical assessment of the area should be performed precisely. Thus, we examined lingual vascular canals of the mandible using dental computerized tomography (CT); define the anatomical characteristics of canals and the relationship with mandibular bone.

Methods: One thousand sixty-one foramina in 639 patients, in 5 dental clinics, were included in this multicenter study. Distance between crest and lingual foramen, tooth apex and lingual foramen, distance from mandibular border, diameter of lingual foramen, canal type, anastomosis, and location of foramen were examined.

Results: Foramen was 18.33 ± 5.45 mm below the bony crest and 17.40 ± 7.52 mm from the mandibular border, with men showing larger measurements. The mean diameter of lingual foramina was 0.89 ± 0.40 mm; 76.8% canal type was mono; 51.8% patients presented with median lingual canal-foramen (MLC) and 21.1% with lateral lingual foramen. Diameter of MLC was statistically larger.

Conclusions: With a large sample group, results represented that lingual foramina could be visualized with dental CT, providing useful data for mandibular implant surgeries. Findings suggest that vascular canals and several anastomoses exist in the anterior mandible extending through premolar and molar regions as well. It is imperative to consider these vessels with the dental CT before and during the mandibular surgery to prevent threatening hemorrhage.

*Clinical Instructor, Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.

Associate Professor, Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.

Associate Professor, Department of Oral Surgery and Implant Dentistry, University of Granada, Granada, Spain.

§Assistant Professor, Department of Oral Radiology, University of Granada, Granada, Spain.

Professor, Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Research Investigator, Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.

#Assistant Professor, Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.

**Associate Professor and Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, Department of Periodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.

††Associate Professor, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.

‡‡Associate Professor, Department of Periodontology, Faculty of Dentistry, Near East University, Mersin 10, Turkey.

§§Clinical Instructor, Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey.

‖‖Associate Professor, Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

¶¶Professor and Director, Department of Periodontics and Oral Medicine, School of Dentistry, The University of Michigan, Ann Arbor, MI.

##Professor, Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey.

Reprint requests and correspondence to: Tolga F. Tözüm, DDS, PhD, Department of Periodontology, Faculty of Dentistry, Hacettepe University, 3rd Floor, Sihhiye, Ankara 06100, Turkey, Phone: +90-312-305-2237, Fax: +90-312-310 4440, E-mail: ttozum@hacettepe.edu.tr

© 2014 by Lippincott Williams & Wilkins, Inc.