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Accessory Mandibular Canal
Lisa J. Koenig, BChD, DDS, MS
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Accessory inferior alveolar canal (IAC)
              • Bifid mandibular canal
              • Duplication/division of mandibular canal
            • Definitions

              • Extension of neurovascular canal from normal main mandibular canal or foramen
              • Duplication of mandibular canals were defined by Nortjé et al
                • Type 1: 2 canals originating from 1 foramen
                  • Most common
                • Type 2: Short supplemental upper canal extending to 2nd or 3rd molars
                • Type 3: 2 canals of equal dimension arising from separate foramina in ramus & joining together in molar region
                  • Least common
                • Type 4: Supplemental canal arising in retromolar region
              • Bifid canals were classified by Naitoh et al
                • Retromolar: Foramen of accessory canal exits bone in retromolar region
                • Dental: End of accessory canal reaches apex of 2nd or 3rd molar
                • Forward: Accessory canal arises from superior wall of mandibular canal
                • Buccolingual: Accessory canal arises from buccal or lingual wall of mandibular canal

            IMAGING

            • General Features

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    • Gross Pathologic & Surgical Features

                      CLINICAL ISSUES

                      • Presentation

                        • Demographics

                          • Natural History & Prognosis

                            • Treatment

                              Selected References

                              1. Ogawa A et al: Evaluation by dental cone-beam computed tomography of the incidence and sites of branches of the inferior dental canal that supply mandibular third molars. Br J Oral Maxillofac Surg. 54(10):1116-1120, 2016
                              2. Palma LF et al: Tomographic evaluation of accessory canals penetrating at the inner side of the anterior region of mandibles. J Craniofac Surg. 27(5):1346-9, 2016
                              3. Capote TS et al: Retromolar Canal associated with age, side, sex, bifid mandibular canal, and accessory mental foramen in panoramic radiographs of Brazilians. Anat Res Int. 2015:434083, 2015
                              4. Aps JK: Number of accessory or nutrient canals in the human mandible. Clin Oral Investig. 18(2):671-6, 2014
                              5. Choi YY et al: Double mandibular foramen leading to the accessory canal on the mandibular ramus. Surg Radiol Anat. 36(9):851-5, 2014
                              6. Eshak M et al: Cone beam CT evaluation of the presence of anatomic accessory canals in the jaws. Dentomaxillofac Radiol. 43(4):20130259, 2014
                              7. Han SS et al: The anomalous canal between two accessory foramina on the mandibular ramus: the temporal crest canal. Dentomaxillofac Radiol. 43(7):20140115, 2014
                              8. Muinelo-Lorenzo J et al: Descriptive study of the bifid mandibular canals and retromolar foramina: cone beam CT vs panoramic radiography. Dentomaxillofac Radiol. 43(5):20140090, 2014
                              9. von Arx T et al: Radiographic study of the mandibular retromolar canal: an anatomic structure with clinical importance. J Endod. 37(12):1630-5, 2011
                              10. Kuribayashi A et al: Bifid mandibular canals: cone beam computed tomography evaluation. Dentomaxillofac Radiol. 39(4):235-9, 2010
                              11. Naitoh M et al: Comparison between cone-beam and multislice computed tomography depicting mandibular neurovascular canal structures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 109(1):e25-31, 2010
                              12. Naitoh M et al: Observation of bifid mandibular canal using cone-beam computerized tomography. Int J Oral Maxillofac Implants. 24(1):155-9, 2009
                              13. Rouas P et al: Identification of double mandibular canals: literature review and three case reports with CT scans and cone beam CT. Dentomaxillofac Radiol. 36(1):34-8, 2007
                              14. Fanibunda K et al: The relationship between accessory foramina and tumour spread on the medial mandibular surface. J Anat. 196 ( Pt 1):23-9, 2000
                              15. Nortjé CJ et al: Variations in the normal anatomy of the inferior dental (mandibular) canal: a retrospective study of panoramic radiographs from 3612 routine dental patients. Br J Oral Surg. 15(1):55-63, 1977
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Terminology

                                • Imaging

                                  • Top Differential Diagnoses

                                    • Pathology

                                      • Clinical Issues

                                        TERMINOLOGY

                                        • Synonyms

                                          • Accessory inferior alveolar canal (IAC)
                                          • Bifid mandibular canal
                                          • Duplication/division of mandibular canal
                                        • Definitions

                                          • Extension of neurovascular canal from normal main mandibular canal or foramen
                                          • Duplication of mandibular canals were defined by Nortjé et al
                                            • Type 1: 2 canals originating from 1 foramen
                                              • Most common
                                            • Type 2: Short supplemental upper canal extending to 2nd or 3rd molars
                                            • Type 3: 2 canals of equal dimension arising from separate foramina in ramus & joining together in molar region
                                              • Least common
                                            • Type 4: Supplemental canal arising in retromolar region
                                          • Bifid canals were classified by Naitoh et al
                                            • Retromolar: Foramen of accessory canal exits bone in retromolar region
                                            • Dental: End of accessory canal reaches apex of 2nd or 3rd molar
                                            • Forward: Accessory canal arises from superior wall of mandibular canal
                                            • Buccolingual: Accessory canal arises from buccal or lingual wall of mandibular canal

                                        IMAGING

                                        • General Features

                                          • Imaging Recommendations

                                            DIFFERENTIAL DIAGNOSIS

                                              PATHOLOGY

                                              • General Features

                                                • Gross Pathologic & Surgical Features

                                                  CLINICAL ISSUES

                                                  • Presentation

                                                    • Demographics

                                                      • Natural History & Prognosis

                                                        • Treatment

                                                          Selected References

                                                          1. Ogawa A et al: Evaluation by dental cone-beam computed tomography of the incidence and sites of branches of the inferior dental canal that supply mandibular third molars. Br J Oral Maxillofac Surg. 54(10):1116-1120, 2016
                                                          2. Palma LF et al: Tomographic evaluation of accessory canals penetrating at the inner side of the anterior region of mandibles. J Craniofac Surg. 27(5):1346-9, 2016
                                                          3. Capote TS et al: Retromolar Canal associated with age, side, sex, bifid mandibular canal, and accessory mental foramen in panoramic radiographs of Brazilians. Anat Res Int. 2015:434083, 2015
                                                          4. Aps JK: Number of accessory or nutrient canals in the human mandible. Clin Oral Investig. 18(2):671-6, 2014
                                                          5. Choi YY et al: Double mandibular foramen leading to the accessory canal on the mandibular ramus. Surg Radiol Anat. 36(9):851-5, 2014
                                                          6. Eshak M et al: Cone beam CT evaluation of the presence of anatomic accessory canals in the jaws. Dentomaxillofac Radiol. 43(4):20130259, 2014
                                                          7. Han SS et al: The anomalous canal between two accessory foramina on the mandibular ramus: the temporal crest canal. Dentomaxillofac Radiol. 43(7):20140115, 2014
                                                          8. Muinelo-Lorenzo J et al: Descriptive study of the bifid mandibular canals and retromolar foramina: cone beam CT vs panoramic radiography. Dentomaxillofac Radiol. 43(5):20140090, 2014
                                                          9. von Arx T et al: Radiographic study of the mandibular retromolar canal: an anatomic structure with clinical importance. J Endod. 37(12):1630-5, 2011
                                                          10. Kuribayashi A et al: Bifid mandibular canals: cone beam computed tomography evaluation. Dentomaxillofac Radiol. 39(4):235-9, 2010
                                                          11. Naitoh M et al: Comparison between cone-beam and multislice computed tomography depicting mandibular neurovascular canal structures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 109(1):e25-31, 2010
                                                          12. Naitoh M et al: Observation of bifid mandibular canal using cone-beam computerized tomography. Int J Oral Maxillofac Implants. 24(1):155-9, 2009
                                                          13. Rouas P et al: Identification of double mandibular canals: literature review and three case reports with CT scans and cone beam CT. Dentomaxillofac Radiol. 36(1):34-8, 2007
                                                          14. Fanibunda K et al: The relationship between accessory foramina and tumour spread on the medial mandibular surface. J Anat. 196 ( Pt 1):23-9, 2000
                                                          15. Nortjé CJ et al: Variations in the normal anatomy of the inferior dental (mandibular) canal: a retrospective study of panoramic radiographs from 3612 routine dental patients. Br J Oral Surg. 15(1):55-63, 1977