Double mandible coronoid process: a very unusual feature.

PURPOSE: The double coronoid process (DCP) is a very unusual feature in patient. The literature, which briefly describes just only one case. Being this a very unusual feature, the aim of the paper is to describe the finding, discuss the anatomic, radiological, and clinical characteristics of a DCP. METHODS: A 61-year-old-woman with no significant medical history, extraoral and intraoral examination was unremarkable. Following panoramic radiography (PR) for assessment of periodontal support and pre-implant planning suspicious radiopaque area in the mandibular notch on the left side was observed. Cone-Beam Computed Tomography (CBCT) and Magnetic resonance imaging (MRI) were subsequently performed. RESULTS: No signs and symptoms of syndromes or medical records with a relevant contribution to the DCP existence and the patient denied any type of facial trauma. CBCT image showed the structure found on the PR was indeed a DCP and it was not superimposed on the mandibular notch area, MRI was performed to investigate soft tissue components and temporomandibular joint (TMJ) or other alterations. CONCLUSION: DPC is extremely rare with the only case reported in the literature within the same comparison parameters. In this case images revealed the muscles, articular surfaces and articular disc were well preserved, and no other alterations were found.

Cleft lip and palate cause large variations in size and location of the posterior superior alveolar canal.

OBJECTIVE: The aim of this study was to evaluate the posterior superior alveolar canal (PSAC) in patients with cleft lip and palate (CLP) as compared to patients with no cleft lip and palate (NC) using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This was a retrospective multicenter study based on two steps: (1) evaluating intra- and inter-calibration and (2) detecting the presence or absence of PSAC and its location, diameter, and anastomosis with anterior superior alveolar canal. RESULTS: A total of 300 patients were selected for the study, out of which 150 were categorized as CLP (75 men, 75 women; mean age: 29.8 years) and 150 were categorized as NC (75 men, 75 women; mean age: 40.3 years). PSAC in patients with CLP and NC was visible in 100% of the cases, in men and women, bilaterally. PSAC location in CLP was middle and upper third of the maxillary sinus as compared to NC (lower third) (chi-squared < 0.001). PSAC mean diameter in CLP was 1.12 mm. It was larger compared to 0.6 mm in NC (t-test < 0.0001). CONCLUSION: PSAC location in patients with CLP was predominantly in the middle and upper third of the maxillary sinus, compared with NC. PSAC mean diameter in CLP was 1.12 mm. It was larger compared to that of 0.6 mm in NC. CLINICAL RELEVANCE: These anatomical variations in CLP are important and should be acknowledged by surgeons for the following reasons: (1) to perform pre-surgical planning, (2) to avoid bleeding, and (3) to avoid neurosensory alterations.

Prevalence of retromolar canal and its association with mandibular molars: study in CBCT.

OBJECTIVE: Investigate the presence and characteristics of the retromolar canal and association with mandibular molars using cone-beam computed tomography (CBCT). STUDY DESIGN: CBCT images of 200 consecutive patients were analyzed using the Anatomage Invivo 5® software. Retromolar canal present evaluated the type of trajectory, buccal or lingual location, uni or bilateral, origin and final diameters. Pearson's Chi square test was used to verify the association between the retromolar canal and the presence of the third molar (p ≤ 0.05). RESULTS: The prevalence of the retromolar canal was 24.5%. The oblique trajectory was the most common (33.3% on the right side and 50% on the left side). Buccal location was the most frequent (right side 50% and left side 70%). The unilateral canal was the most frequent (77.6%). As for the caliber, the diameters vary from 1.12 to 2.37 mm. Regarding the association between the retromolar canal and the third molar, there was no statistically significant difference (right side p = 0.60 and left side p = 0.90). CONCLUSION: The retromolar canal is not a rare anatomical variation showing a prevalence of 24.5%. Surgical procedures should consider the presence of the retromolar canal to avoid excessive bleeding, considering its significant caliber.