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Introduction <p>The retromolar canal (RMC) is a branch of the inferior alveolar canal (IAC), which opens into the retromolar fossa (RMF) via one or multiple foramina. Despite its widely varying incidences in studies conducted globally, the literature on the RMC remains limited. Understanding RMCs is essential in surgical procedures involving the retromolar fossa region, for example, 3rd molar extractions and bone harvesting procedures, to avoid complications. The RMC may also be a potential source of failure of mandibular nerve blocks, as it may provide an alternative pathway for nerves to evade anaesthesia. This study aimed to evaluate the incidence, course, and characteristics of retromolar canals, and to assess for any association with the adjacent tooth using computed cone-beam tomography (CBCT) in the Malaysian Chinese population.</p> Materials and Methods <p>The CBCT images of 361 subjects were evaluated for the presence, course, and morphometric dimensions of RMCs. The incidence of the RMC was deduced from the data collected. In addition, the site predilection, type of RMC, and the average dimensions of the canals; notably the diameter of foramina and origin, average angulation to the IAC, and distance of foramen to buccal and lingual cortices was also derived from the collected data. The type of impaction, last present molar and mesiodistal distance from foramen to adjacent tooth was also noted.</p> Results <p>The RMC was found in 22.71% of subjects (82 out of 361). 15 patients were observed to have bilateral RMCs, resultingly RMCs were found in 97 sites in total. 67.01% of RMCs were right sided (65 out of 97) and 32.99% were left sided (32 out of 97). 40 were in the 18–31 age group, 28 were 32–45 years old, 14 were from 46 to 60 years old. Regarding gender: 54 out of 213 females (25.35%) had RMC, 28 out of 149 males (18.79%) had RMC. The A-type RMC was most common. The average diameter of the RMC foramen was 1.07&#xa0;mm, and 1.15&#xa0;mm at origin. Most canals opened on the lingual aspect of the RMF. The average angulation of RMC from IDC was 52.77°. There was a strong association between the type of RMC and presence of adjacent tooth impaction. There were no associations between the type of RMC with the type of last adjacent tooth, nor between the type of RMC with the type of impaction of last adjacent tooth.</p> Conclusion <p>The incidence of RMCs in the Malaysian Chinese population is found to be relatively high. Due to the high association between type of RMC and presence of adjacent impacted tooth, further studies in different populations and larger sample size might shed more light to the nature of this association. It is important for clinicians to be aware of the presence of retromolar canals to prevent complications and improve patient safety.</p>

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Retromolar Canals on Cone-Beam Computed Tomography: A Study of Incidence, Course, and Characteristics in Malaysian Chinese Population

  • 期刊论文

  • 发表日期：

    2026年3月5日

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  • Isaac Lui Chung Howe,
  • Lee Yue,
  • Prashanti Chippagiri,
  • Syed Sarosh Mahdi,
  • Naveen Jnanendrappa

摘要

Introduction

The retromolar canal (RMC) is a branch of the inferior alveolar canal (IAC), which opens into the retromolar fossa (RMF) via one or multiple foramina. Despite its widely varying incidences in studies conducted globally, the literature on the RMC remains limited. Understanding RMCs is essential in surgical procedures involving the retromolar fossa region, for example, 3rd molar extractions and bone harvesting procedures, to avoid complications. The RMC may also be a potential source of failure of mandibular nerve blocks, as it may provide an alternative pathway for nerves to evade anaesthesia. This study aimed to evaluate the incidence, course, and characteristics of retromolar canals, and to assess for any association with the adjacent tooth using computed cone-beam tomography (CBCT) in the Malaysian Chinese population.

Materials and Methods

The CBCT images of 361 subjects were evaluated for the presence, course, and morphometric dimensions of RMCs. The incidence of the RMC was deduced from the data collected. In addition, the site predilection, type of RMC, and the average dimensions of the canals; notably the diameter of foramina and origin, average angulation to the IAC, and distance of foramen to buccal and lingual cortices was also derived from the collected data. The type of impaction, last present molar and mesiodistal distance from foramen to adjacent tooth was also noted.

Results

The RMC was found in 22.71% of subjects (82 out of 361). 15 patients were observed to have bilateral RMCs, resultingly RMCs were found in 97 sites in total. 67.01% of RMCs were right sided (65 out of 97) and 32.99% were left sided (32 out of 97). 40 were in the 18–31 age group, 28 were 32–45 years old, 14 were from 46 to 60 years old. Regarding gender: 54 out of 213 females (25.35%) had RMC, 28 out of 149 males (18.79%) had RMC. The A-type RMC was most common. The average diameter of the RMC foramen was 1.07 mm, and 1.15 mm at origin. Most canals opened on the lingual aspect of the RMF. The average angulation of RMC from IDC was 52.77°. There was a strong association between the type of RMC and presence of adjacent tooth impaction. There were no associations between the type of RMC with the type of last adjacent tooth, nor between the type of RMC with the type of impaction of last adjacent tooth.

Conclusion

The incidence of RMCs in the Malaysian Chinese population is found to be relatively high. Due to the high association between type of RMC and presence of adjacent impacted tooth, further studies in different populations and larger sample size might shed more light to the nature of this association. It is important for clinicians to be aware of the presence of retromolar canals to prevent complications and improve patient safety.