The midline mandibular lingual canal: Importance in implant surgery

Purpose: The study aims to determine if midline mandibular dental implants pose a risk for the midline lingual canal (MLC). Materials and Methods: Cone beam computed tomography was used to scan 122 mandibles (31 black males; 28 black females; 32 white males and 31 white females). Midsagittal sections in the reconstructed images were made. A measurement of 6mm across bucco-lingually was delineated as the minimum dimensions for implant placement. In dentate cases with a bucco-lingual distance in excess of 6mm, the measurement was across the apex of the socket to determine the bone dimension available below the socket for implant placement. From these markers a vertical line was dropped to the MLC to measure the available bone. Results: The MLC was a consistent finding. A statistical significant difference in bone availability among the sexes and dentition pattern was found, indicating that midline implants in edentulous females posed a risk of injury to the vessels of the MLC. Conclusion: Implants in the position of lower central incisors are regarded as a safe procedure. Clinicians should however take note of the position of the midline mandibular lingual canal and approach this area with caution, especially if the alveolar ridge is to be reduced before implant placement.