title: Multiple accessory foramina of the mandibular ramus: risk factor for oral surgery.
abstract: A 27-year-old female was referred to our hospital with a chief complaint of removal of an impacted right mandibular third molar. Panoramic radiography showed two small circular radiolucencies on the right mandibular ramus. Computed tomography revealed that one of the radiolucencies was an accessory foramen located lateral to the mandibular ramus, and the other radiolucency was an accessory foramen located medial to the ramus; it was also connected to the mylohyoid groove. Continuity with the mandibular canal was confirmed for both accessory foramina. After explaining the risks of extraction, the patient decided against surgery and the impacted tooth was left in situ. Most patients have at least one or more accessory foramina in the mandible; however, accessory foramina of the lateral aspect of the mandibular ramus have not been reported. The high resolution of cone-beam computed tomography and three-dimensional reconstructed images enable improved detection of accessory foramina. Therefore, additional accessory foramina that are similar to those found in the present case could be found in the future using such imaging modalities.
authors.affiliation: Dental and Oral Medical Center, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan. iwanaga_jyou@med.kurume-u.ac.jp.|Department of Dental and Oral Surgery, Saiseikai-Hita Hospital, Hita, Oita, 877-1292, Japan. iwanaga_jyou@med.kurume-u.ac.jp.
authors.forename: Joe
authors.initials: J
authors.lastname: Iwanaga
authors.affiliation: Dental and Oral Medical Center, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.|Department of Dental and Oral Surgery, Saiseikai-Hita Hospital, Hita, Oita, 877-1292, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Dental and Oral Medical Center, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.|Department of Dental and Oral Surgery, Saiseikai-Hita Hospital, Hita, Oita, 877-1292, Japan.
authors.forename: Yushi
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Dental and Oral Medical Center, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Kikuta
authors.affiliation: Dental and Oral Medical Center, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Iwamoto
authors.affiliation: Dental and Oral Medical Center, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
authors.forename: Jingo
authors.initials: J
authors.lastname: Kusukawa
mesh_terms: D000328:Adult; D063405:Anatomic Variation; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D008334:Mandible / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D019647:Oral Surgical Procedures; D011862:Radiography, Panoramic
keywords: Accessory foramen; Cone-beam computed tomography; Mandible; Osteotomy; Third molar