Bifid Inferior Alveolar Nerve Case report

Dr Mehdi Oonchi (DDS, DMD),  Surrey Canada

 

 

 

 

In human’s lower jaw there are two canals on each side called mandible canals, which transmits the inferior alveolar artery, vein and the inferior alveolar nerve. Occurrence of bifid mandible canals is caused by incomplete fusion of these nerves in early developments of the lower Jaw or mandible in some patients. This has a very important clinical implication which can cause serious side effects if not diagnosed properly. 1

 

 

When a dentist decides to extract lower wisdom teeth, careful examination of the radiographic records or x-rays must be carried out in order to diagnose close proximity of the inferior Alveolar nerve with respect to the roots of the lower wisdom teeth and also looking for any signs of bifid nerves.

Wisdom teeth surgery is an elective surgery and  if the patient is asymptomatic third molar surgery should be avoided when Bifid nerve is suspected  in order to minimize the serious consequences of damage to the nerve. If the wisdom teeth need to be taken out, patient should be referred to an Oral Surgeon specialist and cone beam CT Scan should be obtained before the surgery. Extreme care must be taken when there are bifid canals. Alternatively decoronation could be a viable option.

The lower wisdom tooth may infringe on or be within the canal itself. As a second neurovascular bundle may be contained within the bifid canals, serious complications such as traumatic neuroma, temporary or permanent loss of sensation, and bleeding could arise because of failure to recognize the presence of this anomaly and its implications.2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References:

 

1-J Oral Pathol Med.2008 Feb;37(2):122-4

2-Mandibular canal variant: a case report

Wadhwani, R. M. Mathur, M. Kohli, R. Sahu