Abstract
Variations in Inferior Alveolar Nerve branching are reported ranging from bi to trifurcation and from unilateral to bilateral in the mandible. The extra branch or branches of the Inferior Alveolar Nerve end up within the mandible. Here we add one more variation of the Inferior Alveolar Nerve in which the extra branch exits outside the mandible on the lateral aspect of the angle via Novel Aberrant Mandibular Angle Foramen.
We would like to add some more interesting findings in relation to OPG which was reported in this case. Retrospectively reexamining the OPG, there is bifurcation of inferior alveolar nerve canal (IANC) started from mandibular foramen on the left side of the ramus. Superior canal traverse inferiorly and is only traceable up to the root of the second molar. The inferior one or the main canal run anteriorly up to the mental foramen.
As we can clearly see in the clinical picture in case report by I. Khan et al. , there is a neurovascular bundle coming out from this NAMAF suggesting a branch which arises from the main inferior alveolar nerve and which possibly supplies the buccal soft tissue.
In CBCT section 66 of the Fig. 1 in case report by I. Khan et al. , two canals can be easily detected and from section 64 to 58 NAMAF and main IANC can be seen. In section 56 to 48 only the main IANC is seen. As the CBCT images not provided section beyond 66, it is not possible to trace canals route up to mandibular foramen. It would have been interesting to see a picture just before the bifurcation, at the bifurcation and at the exit of NAMAF.
Many variations ( Fig. 1 a-f) in the inferior alveolar nerve anatomy are described in the image by KT Wolf et al.[ ]. We added either one of two possible variations ( Fig. 1 g) in addition to the described variations by KT Wolf et al. [ ]. For the clinicians it is also important to note that any conservative surgery done at the area of bifurcation region would need additional delivery of local anesthesia to act on the additional branch.
