Morphology of the bifid mandibular canal and its relationship with mandibular third molar: A retrospective cone-beam computed tomography study.

PURPOSE: To investigate the prevalence and morphological characteristics of bifid mandibular canal (BMC) using cone-beam computed tomography (CBCT) in a Greek population and to explore its relationship with mandibular third molar (MTM), given the potential implications for surgical planning during MTM procedures.

MATERIALS AND

METHODS

This retrospective study included CBCT scans of 793 patients (1329 mandibular sides) obtained between 2016 and 2024 for preoperative assessment of MTM extraction. CBCT scans were evaluated bilaterally in coronal, sagittal, axial, and cross-sectional planes by a panel of three experienced oral and maxillofacial radiologists using a standardized assessment protocol. BMC was classified into five types according to its anatomical course. Associations between BMC presence, canal type, age, gender, interface with the MTM, and canal distance from the tooth were analyzed using chi-square and Fisher exact tests (P < 0.05).

RESULTS

BMC was identified in 123 patients (15.5%) and on 139 mandibular sides (10.5%). The retromolar canal was the predominant type (90.7%), followed by forward (4.3%), dental (3.6%), and trifid canal (1.4%); no buccolingual canal was detected. No statistically significant associations were observed between BMC presence and age or gender. Canal type showed a statistically significant association with its interface with the MTM (P = 0.003), whereas canal distance from the tooth was not significantly associated with canal type.

CONCLUSION

BMC was relatively common in this Greek population, with retromolar canal predominating. CBCT assessment may provide useful supplementary information during preoperative evaluation of MTM to help identify anatomical variations relevant to surgical management.