title: The clinical relevance of bifid and trifid mandibular canals.
abstract: BACKGROUND
  Bifid mandibular canals (BMC) and trifid mandibular canals (TMC) are variations on the normal anatomy with incidences ranging from 0.08% to 65.0%. Such aberrations have an important clinical impact. For example, an extra mandibular canal may explain inadequate anesthesia, especially when two mandibular foramina are involved. Furthermore, during mandibular surgery, a second, or even third, neurovascular bundle may be damaged causing paresthesia, neuroma development, or bleeding.
  
  
  METHODS
  Two cases are presented in this article. One patient had a BMC on both sites, and the other patient had a TMC on one site and a BMC on the other site.
  
  
  CONCLUSIONS
  Initial screening for the presence of a BMC or TMC can be executed by conventional panoramic radiography. BMCs or TMCs are diagnosed, before executing mandibular surgery; additional CBCT scanning is indicated.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Radboud University Nijmegen Medical Centre 590, P.O. Box 9101, NL-6500, HB Nijmegen, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Mizbah
authors.forename: N
authors.initials: N
authors.lastname: Gerlach
authors.forename: T J
authors.initials: TJ
authors.lastname: Maal
authors.forename: S J
authors.initials: SJ
authors.lastname: Bergé
authors.forename: Gert J
authors.initials: GJ
authors.lastname: Meijer
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008334:Mandible / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D008340:Mandibular Nerve / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D008403:Mass Screening; D011862:Radiography, Panoramic; D012307:Risk Factors; D055815:Young Adult