Bifid Mandibular Canal: Radiographic Observation and Clinical Relevance: A Case Report

When performing the inferior alveolar nerve block anesthesia, surgeon often faced a difficulty of the surgical operation due to the incomplete anesthesia. One of the reason is the variety of mandibular canal anatomy. Up to now, there are some reports of index cases about bifid mandibular canal among mandibular canal anatomic variation, and some classification is applied according to anatomical location and configuration. When surgical operation is performed involving mandible such as dantal implant treatment, extraction of an impacted third molar, sagittal split ramus osteotomy, etc, the position of mandibular canal should be considered. Bifid mandibular canal clinically causes troublesome cases of anesthesia when inferior alvelor nerve block, especially is performed extraction of an impacted third molar. Therefore, It is important for clinicians to recognize the presence of bifid canals on radiographys. Nowadays, the position of mandibular canal can be measured precisely by using Dental CT. It is not found by panorama image but is found by Dental CT sometimes. Among the patients, which take panorama and Dental CT simultaneously, for tooth extraction of lower impacted third molar in our department, we report the case that did not identifying in panorama but identifying it in Dental CT.