Mandibular canal

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A Moment in History

Georg Eduard Von Rindfleisch
(1836 – 1908)

German pathologist and histologist of Bavarian nobility ancestry. Rindfleisch studied medicine in Würzburg, Berlin, and Heidelberg, earning his MD in 1859 with the thesis “De Vasorum Genesi” (on the generation of vessels) under the tutelage of Rudolf Virchow (1821 - 1902). He then continued as a assistant to Virchow in a newly founded institute in Berlin. He then moved to Breslau in 1861 as an assistant to Rudolf Heidenhain (1834–1897), becoming a professor of pathological anatomy. In 1865 he became full professor in Bonn and in 1874 in Würzburg, where a new pathological institute was built according to his design (completed in 1878), where he worked until his retirement in 1906.

He was the first to describe the inflammatory background of multiple sclerosis in 1863, when he noted that demyelinated lesions have in their center small vessels that are surrounded by a leukocyte inflammatory infiltrate.

After extensive investigations, he suspected an infectious origin of tuberculosis - even before Robert Koch's detection of the tuberculosis bacillus in 1892. Rindfleisch 's special achievement is the description of the morphologically conspicuous macrophages in typhoid inflammation. His distinction between myocardial infarction and myocarditis in 1890 is also of lasting importance.

Associated eponyms

"Rindfleisch's folds": Usually a single semilunar fold of the serous surface of the pericardium around the origin of the aorta. Also known as the plica semilunaris aortæ.

"Rindfleisch's cells": Historical (and obsolete) name for eosinophilic leukocytes.

Personal note: G. Rindfleisch’s book “Traité D' Histologie Pathologique” 2nd edition (1873) is now part of my library. This book was translated from German to French by Dr. Frédéric Gross (1844-1927) , Associate Professor of the Medicine Faculty in Nancy, France. The book is dedicated to Dr. Theodore Billroth (1829-1894), an important surgeon whose pioneering work on subtotal gastrectomies paved the way for today’s robotic bariatric surgery. Dr. Miranda.

Sources:
1. "Stedmans Medical Eponyms" Forbis, P.; Bartolucci, SL; 1998 Williams and Wilkins
2. "Rindfleisch, Georg Eduard von (bayerischer Adel?)" Deutsche Biographie
3. "The pathology of multiple sclerosis and its evolution" Lassmann H. (1999) Philos Trans R Soc Lond B Biol Sci. 354 (1390): 1635–40.
4. “Traité D' Histologie Pathologique” G.E.
Rindfleisch 2nd Ed (1873) Ballieres et Fils. Paris, Translated by F Gross

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Details: Written by: Fernanda Cortes, DDS, MSc; Published: May 04, 2017; Hits: 3495

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The mandibular canal is a long, bilateral canal which runs along and within the mandible. This canal transports the inferior alveolar neurovascular bundle. The mandible is known vernacularly as the “jawbone” or “lower jaw”.

The mandibular canal starts on the medial surface of the mandibular ramus at the mandibular foramen (Figure A, arrow) descends anteroinferiorly through the body of the mandible until it ends in the mental foramen at the buccal (anterior) surface of the mandible, usually in the area between the premolars (Figure B, arrow).

Before exiting, the canal forms an “anterior loop” projected anterior to the mental foramen prior to changing its direction back and outwards in direction to the buccal plate (Figure C, red line). This last portion of the canal is called the “mental canal”.

A frequent anatomical variation is the presence of a bifid mandibular canal (recent studies indicate it has a prevalence of around 16%).

Different anatomical studies show that the mandibular canal not only finishes at the mental foramen, but it could divide itself giving an incisive canal which runs anteriorly onto the incisal region (Figure C, yellow line). When it doesn’t continue as an incisal canal, the neurovascular elements go anteriorly through the cells of the spongy bone tissue.

The presence of this Incisal canal has surgical relevance, and knowledge of its exact location and anatomical parameters has a high importance on reducing complications of surgical procedures in the mental area such as dental implants, bone lesions removal and bone harvesting among others, all which could damage the incisal canal and the neurovascular bundle inside it.

With the latest use of CBCT (Cone Beam Computed Tomography) technology to evaluate anatomical structures, the presence of this canal has showed to be high (92-100%) and its length can vary from reaching only the premolar area or even the central mandibular incisors in the least of cases.

Sources:
1. Haas LF, Dutra K, Porporatti AL, Mezzomo LA, De Luca Canto G, Flores-Mir C, Corrêa M. Anatomical variations of mandibular canal detected by panoramic radiography and CT: a systematic review and meta-analysis. Dentomaxillofac Radiol. 2016;45(2):20150310.
2. Kong N, Hui M, Miao F, Yuan H, Du Y, Chen N. Mandibular incisive canal in Han Chinese using cone beam computed tomography. Surg Radiol Anat. 2016 Nov 11. [Epub ahead of print] Int J Oral Maxillofac Surg. 2016 Sep;45(9):1142-6.
3. Rouvierre H, Delmas A. Anatomía humana: Descriptiva, topográfica y funcional. Cabeza y cuello. Volumen 1. 11° ed. España: Masson, S.A.;2005. P. 114.
4. Von Arx T, Lozanoff S. Clinical Oral Anatomy: A Comprehensive Review for Dental Practitioners and researchers. Switzerland: Springer; 2016. P 323- 390
Article and image provided by Prof. M. Fernanda Cortes, DDS, MsC.

Mandibular canal

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