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Anatomical Study of Mandibular Canal Branches: New Analysis Method of Their Distribution and Structure


Masachika Takiguchi, DDS – Department of Anatomy, Tokyo Medical University, Tokyo, Japan

Iwao Sato, PhD, Adjunct Professor – Department of Anatomy, Tokyo Medical University, Tokyo, Japan

Yoko Miwa, DDS, PhD – Department of Anatomy, The Nippon Dental University, School of Life Dentistry at Tokyo, Tokyo, Japan

Shinichi Kawata, MS – Department of Anatomy, Tokyo Medical University, Tokyo, Japan

Masahiro Itoh, MD, PhD – Department of Anatomy, Tokyo Medical University, Tokyo, Japan


Purpose of the Study: Damage to the branches bifurcating from the mandibular canal is a possible risk of dental implant treatment. Therefore, many radiological analyses have been performed. However, detailed observation of the side branches where hard and soft tissues are mixed has not been sufficiently performed, and association between the nerves and the vasculature remains unclear. Therefore, in this study, we evaluated the mandibular canal branches using a new multilateral method of cone-beam computed tomography (CBCT) analysis followed by immunohistochemical analysis of the soft tissues contained in the same region to detect the trabeculae, nerves, and vasculature that are useful for dental implant treatment and oral surgery.

Methods: A total of 100 cadavers that were preserved in the Department of Anatomy of Tokyo Medical University (50 cadavers) and in the Department of Anatomy of Nippon Dental University (50 cadavers) were used in this study. CBCT images were obtained from the heads of the cadavers and analyzed on an image analysis software. An immunohistochemical analysis of the mandibular canal branches was also performed. This study was a collaborative investigation between both universities.

Results: The new multilateral evaluation method of the mandibular canal branches using CBCT analysis revealed a significant difference between the dentulous and edentulous samples in mainly the anterior regions of the mandibular canal, where branches contained nerves and blood vessels (P < 0.01).

Conclusion: In addition to conventional examinations and diagnoses, this new multilateral assessment method would be effective in avoiding medical malpractice with patients and maximizing the benefits of functional recovery through treatment effects. This new analysis method in this study for distribution and structure of the mandibular branches is expected to provide safer implant treatment in the future.

Articles: 1. Apostolakis D, Brown JE. The dimensions of the mandibular incisive canal and its spatial relationship to various anatomical landmarks of the mandible: A study using cone beam computed tomography. Int J Oral Maxillofac Implants. 2013; 28: 117-124. 2. von Arx T, Hänni A, Sendi P, Buser D, Bornstein MM. Radiographic study of the mandibular retromolar canal: an anatomic structure with clinical importance. J Endod. 2011;37:1630-1635. 3. de Castro MAA, Barra SG, Vich MOL, Abreu MHG, Mesquita RA. Mandibular canal branching assessed with cone beam computed tomography. Radiol Med. 2018; 123: 601-608.

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