Fenestration of the Mandibular Buccal Cortex by the Inferior Alveolar Bundle: A Case Report

Abstract

A precise knowledge of the anatomy of the Mandibular Canal is essential while performing oral surgical procedures in order to avoid any risk of injury to the inferior alveolar neurovascular bundle. The presence of anatomical variations associated with the mandibular canal has great clinical implications during such surgical procedures. Various anatomical variations may not be well appreciated entirely in two-dimensional images like Orthopantomograph (OPG). In such cases, Cone Beam Computed Tomography (CBCT) plays a crucial role in facilitating the localization of anatomic structures, their significant variations and provides data concerning bone morphology. In this case report, A 27 year old male patient reported with the chief complaint of intermittent pain in left lower back region of the mouth. Clinical and radiographic examination (OPG) revealed impacted lower third molar in the left back region of the jaw. While raising a full thickness mucoperiosteal flap, we encountered fenestration of the left mandibular buccal cortex by the inferior alveolar nerve which is a 6th reported case without pathology. The aim of this article is to add on a rare anatomical variation in the existing literature i.e. fenestration of the mandibular buccal cortex by the inferior alveolar bundle, encountered accidently during exposing mandibular third molar and confirmed by cone beam computed tomography (CBCT).