The basics: surgical anatomy of the mandible
Placing dental implants requires access to bone tissue (usually by raising a flap) to achieve an osteotomy. The handling of soft tissues (gingiva and alveolar mucosa), and bone osteotomy must respect some anatomical structures to avoid injuries leading to damage which may be difficult to manage: reversible or irreversible nerve injury, hemorrhage, and intrusion into unwanted anatomical areas. The risk level (high, moderate, low) and the approach to prevention will be described.
This region is usually considered at low risk for surgical damage. However, some anatomical structures have to be identified.
The incisive canal (Figs 3.1 and 3.2) is an anterior extension of the mandibular canal with neurovascular content. The lesion of this structure usually has no clinical consequences except in the first premolar area and sometimes in the canine area.
The lingual foramen (Fig. 3.3) can be observed on X-rays or CT scan in more than 80% of subjects near the mental spines. A branch of the sublingual artery enters the foramen to sup/>