A morphometric study of the mandibular foramen in dry adult human mandibles in a black Malawian population / Un estudio morfométrico del foramen mandibular en mandíbulas humanas adultas secas en una población malauí negra

SUMMARY: The inferior alveolar nerve block (IANB) technique is a common technique performed on patients in dental surgery, placement of mandibular implants and other procedures involving the mandible. Precise identification of the mandibular foramen (MF) is essential for dental surgeons to accurately administer local anesthetics. Inaccurate localization of the mandibular foramen may result in IANB failure and injury to neurovascular tissues. Therefore, this study aimed at investigating the precise location of the MF from various anatomical land marks in dry adult human mandibles of Malawian population. The study was conducted on 29 dry adult human mandibles of unknown sex of Malawian origin from the Anatomy Division collection of human skeletons housed in the Biomedical Sciences Department, College of Medicine, University of Malawi. To determine the position of the mandibular foramen, distances from mandibular foramen to anterior margin, posterior margin, mandibular notch, gonial angle and mandibular base using a Vernier caliper were measured. The mean distance of the MF from posterior margin of mandibular ramus was 11.26±1.22 mm (right side) and 11.47±1.35 mm (left side), from the anterior margin 20.85±3.12 mm (right side) and 20.85±3.22 mm (left side) mandibles. The mean distance between mandibular notch (MN) and MF was 23.87±2.61 mm (right side) and 23.53 ± 2.65 mm (left side). The mean distance between mandibular base (MB) and MF for the right and left were 28.47 ± 2.90 mm and 27.85 ± 2.99 mm respectively. The inferior limit of the mandibular foramen was located at 24.69 ± 3.65 mm (right side) and 24.25 ± 2.77 mm (left side) to the angle (AG) of the mandible. The findings of this study show that the anterior margin mean distance from the MF for both right and left mandibles seem to be bilateral symmetrical suggesting the interpretation that the needle for IANB could be inserted at about 21 mm from the anterior margin to the MF in an adult of Malawian origin during surgery.

RESUMEN: La técnica de bloqueo del nervio alveolar inferior (IANB) es una técnica común que se realiza en pacientes en cirugía dental, colocación de implantes mandibulares y otros procedimientos que involucran la mandíbula. La identificación precisa del foramen mandibular (MF) es esencial para que los cirujanos dentistas administren con precisión anestésicos locales. La localización inexacta del foramen mandibular puede resultar en una falla de la IANB y lesión de los tejidos neurovasculares. Por lo tanto, este estudio tuvo como objetivo investigar la ubicación precisa de la MF de varias marcas anatómicas en las mandíbulas humanas adultas secas de la población de Malawi. El estudio se llevó a cabo en 29 mandíbulas humanas adultas secas de sexo desconocido de origen malauí de la colección de esqueletos humanos de la División de Anatomía del Departamento de Ciencias Biomédicas de la Facultad de Medicina de la Universidad de Malawi. Para determinar la posición del foramen mandibular, se midieron las distancias desde el foramen mandibular hasta el margen anterior, margen posterior, incisura mandibular, ángulo gonial y base mandibular utilizando un calibre Vernier. La distancia media del MF desde el margen posterior de la rama mandibular fue de 11,26 ± 1,22 mm (lado derecho) y 11,47 ± 1,35 mm (lado izquierdo), desde el margen anterior 20,85 ± 3,12 mm (lado derecho) y 20,85 ± 3,22 mm (lado izquierdo) lado) mandíbulas. La distancia media entre la muesca mandibular (MN) y MF fue de 23,87 ± 2,61 mm (lado derecho) y 23,53 ± 2,65 mm (lado izquierdo). La distancia media entre la base mandibular (MB) y MF para la derecha y la izquierda fue de 28,47 ± 2,90 mm y 27,85 ± 2,99 mm, respectiva- mente. El límite inferior del foramen mandibular se ubicó a 24,69 ± 3,65 mm (lado derecho) y 24,25 ± 2,77 mm (lado izquierdo) del ángulo (AG) de la mandíbula. Los resultados de este estudio mues- tran que la distancia media del margen anterior desde el MF para las mandíbulas derecha e izquierda parece ser simétrica bilateral, lo que sugiere la interpretación de que la aguja para IANB podría insertarse a unos 21 mm del margen anterior al MF en una adulto de origen malauí durante la cirugía.

Prevalence and morphometric analysis of double mental foramen and double mandibular foramen from digital panoramic radiographs / Prevalencia y análisis morfométrico de foramen mental y foramen mandibular dobles a través de radiografías panorámicas digitales

The morphological variations of the mental foramen (MF) and mandibular foramen (MBF) have been studied for several years, and the prevalence and morphometric characteristics of double and triple foramina have been reported. The objective of this study was to establish the prevalence of variations in the MF and MBF, and to carry out a morphometric analysis of a Chilean population using digital panoramic radiographs. The study included 927 radiographs; the observed prevalence of double MF was 2.58 %, while the prevalence of double MBF was 1.51 %. No cases of triple foramina were found. In men, double MF was found more frequently in the left hemiarch (64.28 % of cases), while in women it was more frequent in the right hemiarch (80 %). Double MBF was found more frequently in the right hemiarch in women (80 % of cases), while the distribution between left and right in men was even. The mean area, width and height of the double MF were 5.46 mm2, 2.77 mm and 2.57 mm respectively. The means of the same morphometric measurements in double MBF were 6.37 mm2, 2.27 mm and 3.19 mm respectively. In both foramina, statistically significant differences were only found between the height of the foramen and the age of the subjects, with the observation that the greater the subject's age, the smaller the height. Dental surgeons must take these anatomical variants into consideration in clinical and surgical actions; timely diagnosis by radiograph is important to avoid possible complications.

Las variaciones morfológicas del foramen mental (FM) y mandibular (FMB) han sido estudiadas durante varios años, reportándose su prevalencia y las características morfométricas de forámenes dobles y triples. El objetivo de este estudio fue establecer la prevalencia de variaciones de los FM y FMB y realizar un análisis morfométrico a través de radiografías panorámicas digitales de una muestra de población chilena. En el estudio se incluyeron 927 radiografías y se observó una prevalencia de FM doble de 2,58 %, mientras que la prevalencia de FMB doble fue de 1,51 %. No se encontraron casos de forámenes triples. En hombres, el FM doble se encontró mayoritariamente en la hemiarcada izquierda (64,28 % de los casos), mientras que en mujeres fue en la hemiarcada derecha (80% de los casos). Para el caso de los FMB dobles, en mujeres se presentó mayoritariamente en la hemiarcada derecha (80 % de los casos), mientras que en hombres fue equitativo en ambos lados. El promedio del área, ancho y alto de los FM dobles fue de 5,46 mm2, 2,77 mm y 2,57 mm, respectivamente. Asimismo, los promedios de estas medidas morfométricas para el FMB doble fueron 6,37 mm2, 2,27 mm y 3,19 mm, respectivamente. Para ambos forámenes sólo se encontraron diferencias estadísticamente significativas entre el alto y la edad de los sujetos, observando que, a mayor edad menor era el alto del foramen. Los cirujanos dentistas deben tener en consideración estas variantes anatómicas para la realización de distintas acciones clínicas y quirúrgicas, su diagnóstico radiográfico oportuno es importante para prevenir posibles complicaciones.

Morphological Study of Accessory Foramina in Dry Mandible and Its Clinical Significance

Background: To provide anatomical information on theposition and incidence of accessory foramina in mandible asthey are important for dental surgeons and anesthetists inachieving complete nerve blocks and for avoiding injury toneurovascular structures passing through them.Objective: To study the incidence of accessory foramina in drymandible in population of Bihar & compare it with incidenceamong various races of the world.Materials & Methods: Present study is a cross sectional studywhich has been carried out on 56 dried fully ossified adulthuman mandibles, which were examined in the Department ofAnatomy and Forensic Medicine of Indira Gandhi Institute ofMedical Sciences, Patna, Bihar. The age of the bones used inthe study was not predetermined. Only fully ossified dried,macerated and thoroughly cleaned mandibles which werecomplete in all respects, in order to give the correctobservations, were included in the study while the mandibleshaving any deformity or pathology were excluded. Theaccessory foramina and their positions were observed.Results: Accessory mandibular foramina were found in 55.36%, accessory mental in 23.22 %, and retromolar in 17.85% ofthe cases. The accessory foramen observed most commonly inright side (39.28%) followed by bilateral (37.5%) then left side(19.65%).Conclusion: The anatomical variability of incidence andposition of accessory foramina should be considered as theymay be used to give additional locoregional anesthesia in caseof failed mandibular blocks. Knowledge of the commonestpositions will be beneficial for oncologists and oromaxillofacialsurgeons in planning graft implants.

Prevention of hematoma on the floor of the mouth during dental implant surgery in the anterior mandible / 口腔疾病防治

Objective@# To explore the cause and preventive measures of floor-of-mouth hematoma after dental implant placement. @*Methods@#The prevention of hematoma of the floor of the mouth in a case of lower anterior teeth implant placement was analyzed, and the literature was reviewed.@*Results@# Four mandibular vascular canals were found on the lingual side of the anterior mandible before dental surgery in the reported case. Two of them were quite thick (1.4 mm and 1.0 mm, respectively) and were located adjacent to the crest of the alveolar bone and superior to the mental spine. These two thick endosseous branches from the sublingual artery were dissected and ligated , and there was no obvious hematoma in the patients immediately after the operation and at the postoperative 3 d review. The results of the literature review show that the incidence of endosseous branches from the lingual vascular canal of the mandible is 90%-100%. The distribution of the vessels on the lingual side of the mandible is highly variable and adjacent to the lingual cortical plate. Accidental injury of the lingual cortical plate during implant surgery would probably lead to bleeding or hematoma on the floor of the mouth. @*Conclusion @#Mastering the anatomy of blood vessels on the floor of the mouth, elaboratively examining preoperative three-dimensional radiographic imaging, and cautiously exploring the lower jaw bone morphology after flap elevation are preventive measures to avoid damage to the arterial supply on the lingual side of the anterior lower jaw and to prevent complications of hematoma in the floor of the mouth.

A morphometric study of mandibular foramen in dry adult human mandibles of indian population in telangana state

Background: Mandibular foramen is an irregular foramen located just above the centre of the medial surface ofthe ramus of the mandible. Mandibular foramen is leading to mandibular canal through which inferior nerveand vessels will transmit and supply the teeth of lower jaw.The Mandibular foramen is an important anatomical landmark for the inferior nerve blocks, mandibularosteotomies and implant treatment. The inferior nerve block is the commonest local anaesthetic techniquewhich is used for anaesthetizing lower jaw in various surgical and dental procedures on mandible andmandibular teeth such as removal of impaction, reduction of fractures and tooth extraction. Inferior alveolarnerve block failure is not uncommon and it occurs even with experienced hands due to variations in position ofmandibular foramen.A thorough knowledge of anatomy of mandibular foramen is very essential hence aim of this study was todetermine the exact position of mandibular foramen by studying dry adult human mandibles of telanganapopulation.Material and methods: The present study was conducted using 60 dry adult human mandibles obtained fromanatomy department of Shadan institute of medical sciences,Hyderabad and VRK womens medicalcollege,Hyderabad. The data was tabulated and statistically analysed.Result: The mean distance of mandibular foramen to anterior border of ramus (MF-AB)was16.67±2.73mm(R)and16.56±2.52mm(L),to posterior border of ramus(MF-PB) was 12.67±2.37mm(R) and 13.03±2.43mm(L),to mandibularnotch (MF-MN) 21.04±2.95mm(R) and 20.24±2.94mm(L),to angle of mandible was 23.005±3.92mm(R) and22.36±3.89mm,base of mandible or inferior border (MF-MB) was 24.38±3.86mm(R) and 24.42±4.44mm(L), tip ofcoronoid process (MF-CrT) 35.68±3.25mm(R) and 35.19±3.47mm (L).Conclusion: The present study gives a fair knowledge of the position of mandibular foramen and provides usefulinformation for successful local anaesthesia ( inferior nerve block),to the maxillofacial surgeons,radiologistsand oncologists performing operations on the mandible to prevent complications and misinterpretations

Evaluation of Gender Based Morphological and Morphometric Features of Mental Foramen Using CBCT Radiographs

Back ground: Awareness regarding varied and detailedmorphological and morphometric features of mental foramen isof pivotal importance for orthodontists, cosmetic andreconstructive surgeons etc. for avoidance of any inadvertenttrauma, post-surgical neurovascular complications andmorbidity.Aim: To study gender based differences in variousmorphological and morph metric features of mental foramen.Method: In this study we have selected 800 patients. Thepresent study was carried out on CBCT scans procured fromthe Dental Hospitals in Jaipur, Rajasthan. A detailed study ofmorphometric features of mental foramen along with otherparameters of the mandible was carried out on the coronal,axial and sagittal views of CBCT scans using “CS 3D Imagingv3.5.7”. Patients were divided in groups based on age.Results: No significant relationships between age and genderof the patients (p>0.05) and position of mental foramen on theright and left side. MF-S to be significantly longer in males ascompared to females in Group I whereas in Group III, MF-Swas significantly more in males than females on both the sides(p<0.001).Conclusion: Position 6 is considered to be the least commonposition

Morphometry of the mandibular foramen applied to local anesthesia in hoary fox (Lycalopex vetulus) / Morfometria do forame mandibular aplicada à anestesia local em raposa-do-campo (Lycalopex vetulus)

Great part of the veterinary care in wild carnivores is intended to treat the dental disorders, and oral cavity disorders may generally affect the animal health as a whole. It is factual that knowing the location of the mandibular foramen is vital for local anesthetic block of the inferior alveolar nerve, however, there is still no data on the morphometry of the hoary fox mandibular foramen. The aim was describing morphometry of the mandibular foramen of this species and associating its position with anatomic reference points in the mandible, thus providing support for more effective local anesthetic block of the inferior alveolar nerve in such species. Four adult jaws of Lycalopex vetulus were used. Radiography and biometrics of the hemimandibulas were performed. The rostral third of the jaw body in a lateral view presented three mental foramens, being a rostral, a medium and a caudal. Each hemimandibula presented I3/C1/PM4/M3. The angle of the mandible was marked by the masseteric fossa, the angular incisure, the angular process and the mandibular foramen, and this last one located perpendicularly to the dorsal edge of the angular incisures in medial view. In this view, the crevice to the milohyoid nerve, projected in the caudodorso rostral direction, was also evidenced. The ramus of the mandible was characterized by the presence of the condylar and coronoid processes, and by the dorsal and ventral mandibular incisions. Statistical analyzes did not present significant differences between the antimeres of the studied animals, and the penetration of the needle perpendicularly to the dorsal end of the angular incision on average 8.79mm, overlapped to the medial face of the angle of the mandible could be indicated. Alternatively, the access may also be achieved by inserting the needle in an average of 17.69mm perpendicular to the dorsal end of the angular process, in contact with the medial aspect of the angle of the mandible, and in caudo-rostral projection, also allowing a better anesthetic blockade of the inferior alveolar nerve in L. vetulus. It can also be concluded that the masseteric fossa, the dorsal and ventral mandibular angles, the crevice to the milohyoid nerve, the ramus of the mandible and the mandibular foramen presented differences in their topographic descriptions when compared to the other canids.(AU)

A maior parte dos atendimentos veterinários em carnívoros silvestres destina-se ao tratamento das afecções dentárias, sendo que doenças de cavidade oral podem afetar a saúde do animal como um todo. É factível que o conhecimento da localização do forame mandibular é essencial para o bloqueio anestésico local do nervo alveolar inferior, entretanto, ainda são inexistentes dados sobre a morfometria do forame mandibular de raposa-do-campo. Objetivou-se descrever a morfometria do forame mandibular desta espécie, e correlacionar sua posição com pontos de referência anatômica na mandíbula, oferecendo subsídio para um bloqueio anestésico local mais efetivo do nervo alveolar inferior nesta espécie. Foram utilizadas quatro mandíbulas de cadáveres adultos de Lycalopex vetulus. Realizou-se a radiografia e as biometrias das hemimandíbulas. O terço rostral do corpo da mandíbula em uma vista lateral apresentou três forames mentuais, sendo um rostral, um médio e um caudal. Cada hemimandíbula apresentou I3/C1/PM4/M3. O ângulo da mandíbula foi marcado pela fossa massetérica, pela incisura angular, pelo processo angular e pelo forame mandibular, e este último localizado perpendicularmente ao extremo dorsal da incisura angular em vista medial. Nesta vista, também se evidenciou o sulco para o nervo milohióideo, projetado em sentido caudodorsorostral. O ramo da mandíbula foi caracterizado pela presença dos processos condilar e coronóide, e pelas incisuras mandibulares dorsal e ventral. As análises estatísticas não apresentaram diferenças significantes entre os antímeros dos animais estudados, podendo-se indicar a penetração da agulha perpendicularmente ao extremo dorsal da incisura angular em média 8,79mm, justaposto à face medial do ângulo da mandíbula. Alternativamente, o acesso também poderá ser realizado introduzindo a agulha em média 17,69mm de forma perpendicular ao extremo dorsal do processo angular, em contato com a face medial do ângulo da mandíbula, e em projeção caudorostral, permitindo também um melhor bloqueio anestésico do nervo alveolar inferior na L. vetulus. Também se pode concluir que a fossa massetérica, as incisuras angular, mandibulares dorsal e ventral, o sulco para o nervo milohióideo, o ramo da mandíbula e o forame mandibular apresentaram diferenças em suas descrições topográficas quando comparados aos demais canídeos.(AU)

Cross Sectional Analysis Of Occurrence Of Accessory Mandibular Foramina And Their Positional Variations In Dry Mandibles

Background: During lower jaw surgeries, inferior alveolar nerve block is given at mandibular foramen level.However, additional foramina are found on medial surface of ramus of mandible, through which branches ofinferior alveolar nerve and vessels pass. Location of accessory foramina varies widely which could lead toiatrogenic injuries to neurovascular structures in this region.Aim and objective: Precise information of variations in number of mandibular foramen and position of theseaccessory foramina relative to mandibular foramen help dental surgeons to avoid injuries to inferior alveolarnerve and vessels. Hence, this study aimed at analyzing position of accessory foramina osteologically in Gujarat’spopulation.Materials and Methods: Three hundred dry mandibles of unknown sexes, and bearing all teeth or intact alveolarmargin were included in the study. Numerical variations in the form of accessory foramina were found in 42% ofthe mandibles; 17% on the right side; 17.66% on the left side; and in 7.33% mandibles accessory foramina werepresent on both sides. The laterality distribution of accessory mandibular foramina was found to be insignificantstatistically. More number of accessory foramina was located antero-superior to mandibular foramen. Retromolarforamina were found in 15% mandibles; however, laterality distribution of retromolar foramina was statisticallyinsignificant.Conclusion: Latrogenic injuries of inferior alveolar neurovascular structures could better be avoided with preciseidea of position of accessory foramina, which may ease the work of dental surgeon

Contribuição topográfica do forame e língula mandibular em procedimentos cirúrgicos no ramo da mandíbula / Topographic contribution of the foramen and mandibular lingula in mandibular ramus surgeries

Objetivo: analisar a topografia e biometria do forame mandibular e da lingula mandibular em crânios secos para verificar sua variabilidade e determinar suas posições topográficas. Material e Método: Para analisar as distâncias, foram realizadas medições utilizando um paquímetro digital Mitutoyo® devidamente calibrado para coletar a distância em milímetros, do centro do forame até as quatro margens (anterior, posterior, superior e inferior) do ramo mandibular (N = 176). Realizamos as medidas do forame mandibular em milímetros para determinar sua geometria externa. A lingula mandibular (N = 76) foi estudada quanto à sua localização topográfica e forma quando sua estrutura é preservada. Todos os dados foram documentados em um protocolo de coleta de dados com o objetivo de desenhar diagramas esquemáticos e arquivar as fotografias dos casos e a análise dos resultados. Resultados: em relação à frequência, o forame estava presente em todos os casos (100%), em ambos os lados da superfície medial do nervo mandibular. O número de forames de cada lado é único: foram observados 175 casos (99,5%). Apenas um forame (0,5%) era o dobro do lado direito. Em relação à sua posição em relação às margens da mandíbula, na maioria delas, está localizada próxima à margem inferior, variando entre 9,6 mm e 39,1 mm, com média de 26,0 mm. A margem posterior da mandíbula variou entre 6,8 mm e 24,0 mm, com média de 12,30 mm. A lingula mandibular dos maxilares foi analisada em 32 maxilares (64 casos), com formato triangular (55%), presente na maioria dos casos (86%) e posição ântero-superior em 43% deles. Conclusões: o forame mandibular é um elemento anatômico importante para o sucesso da técnica de bloqueio do nervo alveolar inferior. Sua estrutura acessória, a lingula mandibular, é uma posição de referência em cirurgia ortognática; devido à sua localização e aspecto, serve como um escudo protetor para o feixe neurovascular alveolar inferior

Objective: to analyze the topography and biometrics of the mandibular foramen and mandibular lingula in dry skulls to verify their variability and to determine their topographic positions. Material and method: to analyze the distances, measurements were made using a properly calibrated Mitutoyo® digital caliper to collect the distance in millimeters, from the center of the foramen to the four margins (anterior, posterior, superior and inferior) of the mandibular ramus (N=176). We performed the measurements of the mandibular foramen in millimeters to determine its external geometry. The mandibular lingula (N=76) was studied regarding its topographical location and shape when its structure was preserved. All data were documented in a data collection protocol aimed at drawing schematic diagrams and archiving the photographs of the cases and the analysis of the results. Results: in relation to the frequency, the foramen was present in all cases (100%), on both sides on the medial surface of the mandibular ramus. The number of foramen on each side is unique: 175 cases (99.5%) were observed. Only one foramen (0.5%) was double on the right side. Regarding its position in relation to the margins of the jaw, in most of them, it is located near the inferior margin, having varied between 9.6mm and 39.1mm, with an average of 26.0mm. The posterior margin of the jaw varied between 6.8mm and 24.0mm, with an average of 12.30mm. The mandibular lingula of the jaws were analyzed in 32 jaws (64 cases), having triangular shape (55%), present in most cases (86%) and in anterosuperior position in 43% of them. Conclusions: the mandibular foramen is an important anatomical element for the success of the inferior alveolar nerve block technique. Its accessory structure, the mandibular lingula, is a reference position in orthognathic surgery; due to its location and aspect, it serves as a protective shield for the inferior alveolar neurovascular bundle

Measurement of mandibular lingula location using cone-beam computed tomography and internal oblique ridge-guided inferior alveolar nerve block

OBJECTIVES: Inferior alveolar nerve block (IANB) is the most frequently used treatment for mandibular molars. Successful IANB requires insertion of the dental needle near the mandibular foramen. In this study, we aimed to analyze the anatomic location of the mandibular lingula and evaluate the effects of internal oblique ridge (IOR)-guided IANB. MATERIALS AND METHODS: The location of the mandibular lingula was measured using cone-beam computed tomography images of the mandibles obtained from 125 patients. We measured the distances from the occlusal plane to the lingula and from the IOR to the lingula in 250 mandibular rami. Based on the mean of these distances, alternative anesthesia was carried out on 300 patients, and the success rate of the technique was evaluated. RESULTS: The mean vertical distance was 8.85±2.59 mm, and the mean horizontal distance was 14.68±1.44 mm. The vertical (P<0.001) and the horizontal (P<0.05) distances showed significant differences between the sex groups. The success rate of the IOR-guided technique was 97.3%. CONCLUSION: IANB-based location of mandibular lingula showed a high success rate. From this study, we concluded that analysis of the anatomic locations for mandibular lingula and IOR-guided IANB are useful for restorative and surgical dental procedures of the mandibular molars.

A Study Of Mandibular Foramen In North Indian Population

Background: Mandibular foramen (MF), present on the medial surface of ramus of the mandible, leads to themandibular canal through which inferior alveolar nerve (IAN) and vessels transmit. IAN block is a commonanaesthetic procedure before dental and reconstructive surgeries. Surgeons usually do IAN block in their clinicsand encounter failure of block because of variable position of MF.Objective: The present study was carried out to find the most common position of MF in north Indian population.Materials and Methods: Study was done on 50 dry adult human mandibles of unknown sex and age of northIndian origin. Height was measured from the angle of the mandible to the highest point on condyloid process.Mid point of the line joining these points was noted. The position of MF was observed in relation to pre noted midpoint.Results: MF was placed below the level of mid point in 40 mandibles (80%).Conclusion: The knowledge of most common position of MF will help the surgeons to reduce the chance ofunsuccessful IAN block.

Anatomical study of the location of the antilingula, lingula, and mandibular foramen for vertical ramus osteotomy / 대한악안면성형재건외과학회지

BACKGROUND: The purpose of this study was to identify the location of the antilingula, lingula, and mandibular foramen in Korean cadavers and to promote safe and accurate surgery without damage to the inferior alveolar neurovascular bundle (IANB) when performing a vertical ramus osteotomy (VRO). METHODS: This study was conducted on the dried mandibles of 20 adult cadavers. Digital calipers were used to measure the distances from the anatomical reference points (antilingula, lingula, and mandibular foramen). RESULT: The antilingula was located at the anterior 44% and superior 31% in the ramus. The lingula was located at the anterior 55% and superior 30% in the ramus. The mandibular foramen was located at the anterior 58% and superior 46% in the ramus. Regarding the positional relationship with the antilingula, the lingula was located 0.54 mm superior and 4.19 mm posterior, and the mandibular foramen was located 6.95 mm inferior and 4.98 mm posterior. The results suggested that in order to prevent damage to the IANB, osteotomy should be performed in the posterior region of ramus at least 29% of the total horizontal length of the ramus. CONCLUSION: Using only the antilingula as a reference point is not guaranteed to IANB injury. However, it is still important as a helpful reference point for the surgeon in the surgical field.

A cone beam computed tomography study on the anatomical position of accessory mandibular foramina in Jiangxi adults / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study used cone beam computed tomography (CBCT) to access the distribution and position of accessory mandibular foramina in the mandibular body of Jiangxi adults, and some safety rules of operation for clinics were provided.</p><p><b>METHODS</b>Two hundred CBCT image subjects of Jiangxi adults were selected, which were divided into 4 groups by age with the same sex ratio. The number and position of accessory mandibular foramina in mandibular anterior teeth, premolars and molars region were described and the relationship between accessory mandibular foramina incidence and factors of age, gender and lateral were analyzed.</p><p><b>RESULTS</b>A total of 1 123 accessory mandibular foramina were found, with a mean of 5.62±2.10 per person. The accessory mandibular foramina incidence decreased from the mesial region to the distal, and the lingual was higher than the buccal. There was no significant difference in the number of accessory mandibular foramina in male and female (P=0.195). However, the number of accessory mandibular foramina was negatively correlated with age (r(s)=-0.301). Three highest frequency regions of accessory mandibular foramina were mandibular symphysis area (98.0%), lingual alveolar area of lower medial (88.0%) and lateral incisors and inferior area of lingual premolar (55.0%).</p><p><b>CONCLUSIONS</b>Accessory mandibular foramina are widely presented in the body of everyone's mandible, addition attention should be paid to avoid the complications causing by the damage of canal contents in the clinics.</p>

An Anatomical Study and Clinical Correlations of Mandibular Foramen in Dry Adult Human Mandibles of North Indian Origin.

Background: The mandibular foramen is located on the medial surface of ramus of mandible. It transmits inferior alveolar nerve. Inferior alveolar nerve block is a common procedure done by dental practitioners while doing various surgeries on mandible. The aim of this study is to determine the position of mandibular foramen in respect to various landmarks present on mandible. Methods: 30 adult human dry mandibles of north Indian origin were studied. The position of mandibular foramen from various landmarks was measured on both sides of mandibular ramus. Results: In our study we found the mean distance from the mandibular foramen to the anterior border of the ramus was 16.06±1.99 mm and 16.13±2.10 mm on the right and left sides respectively and from the mandibular foramen to the posterior border of the ramus was 12.02±1.99 mm and 11.10±1.95 mm on the right and left sides respectively. The mandibular foramen was situated at a mean distance of 1.36±0.77 mm on the right side and 1.47±0.72 mm on the left side, posterior to the midpoint of width of the ramus and at a mean distance of 3.37±1.37 mm on the right side and 3.10±1.41 mm on the left side, superior to the midpoint of vertical height of the ramus. Conclusion: In present study localization of mandibular foramen presented great variation. However if we keep these anatomical landmarks in our mind we can accurately locate the position of mandibular foramen and this will help us to create successful anesthesia and to perform good surgeries on mandible

Localization of mandibular foramen relative to landmarks in East Indian mandibles.

Context: The position of mandibular foramen (MF) is an important anatomical landmark for effective anesthesia in dentistry for many procedures, including dental extraction from the lower jaw and putting mandibular implants. Several causes have been examined in this context, and the uncertainty in the location of the MF has been examined to be a major factor for the high failure rate of anesthesia and complications of the orthodontic procedure. Aims: The purpose of this study was to examine and analyze the position of the MF relative to six bony landmarks on the ramus in the population of Jharkhand. Subjects and Methods: The different parameters were measured in 30 dry adult’s mandibles that were obtained from the Department of Anatomy. The data were tabulated and statistically analyzed. Statistical Analysis Used: Paired t‑test. Results: The mean distance between the MF and the respective landmarks was noted as 16.00 ± 3.50 mm for the anterior border, 10.21 ± 2.34 mm for the posterior border, 20.48 ± 3.89 mm for the superior border, 24.15 ± 4.97 mm for the inferior border, 33.46 ± 6.08 mm for the condyle, and 12.31 ± 4.88 mm for the internal oblique ridge for the right side. On the left side, these distances were 16.27 ± 3.9 for the anterior border, 10.28 ± 5.24 for the posterior border, 20.15 ± 3.8 for superior border, 24.86 ± 4.04 for inferior border 32.48 ± 4.73 for condyle, and 10.93 ± 4.06 for the inferior oblique ridge. Statistically, there was no significant difference in the distance to either side from selected 5 landmarks, the only exception being the condyle. Conclusions: Condyle and internal oblique ridge have been shown to be two new landmarks that may be used to find MF. Bilateral symmetry has been shown for all landmarks except for condyle.

Mandibular foramen location and lingula height in dentate dry mandibles, and its relationship with cephalic index / Localización del foramen mandibular y altura de la língula mandibular en mandíbulas dentadas secas, y su relación con el índice cefálico

The mandibular foramen and its lingula is a major landmark when administering anesthetic or performing surgical procedures. The objective of this study was to determine whether the topological features of the mandibular foramen (MF) and lingula varied in mandibles from skulls of different cephalic indexes. The location of the mandibular foramen referred to the longitudinal borders of the mandibular ramus (MR), height of the foramen (Hf) referred to the occlusal line of the second molar, and the height of the lingula (Hl) were determined in a total of one hundred and five dry mandibles from skulls identified as dolicho- meso- and brachycephalic. On average MF in brachycephalic mandibles was closest to the anterior border of MR. Hf in brachy-, meso- and dolichocephalic mandibles were -0.22 mm, -4.04 mm and -4,01mm, respectively. The lingula in brachycephalic specimens was considerably shorter (0.78 mm) than in dolichocephalic ones (1.84 mm). Inferior alveolar nerve block should be carried out using shorter needles, inserting it 4mm above the occlusion level of the molar teeth. The ramus of brachicephalic mandibles were significantly less wide those of dolicho- and mesocephalic ones. If the height of the lingula is to be used as a reference to judge the level of the medial horizontal cut to carry out sagittal split ramus osteotomy, special attention should be given to the patient's cephalic index.

El foramen mandibular y la língula son los puntos anatómicos más importantes a considerar en la administración de anestesia troncular o la realización de procedimientos quirúrgicos en la mandíbula. El objeivo fue determinar si las características topológicas del foramen mandibular (FM) y la língula mandibular presentan variaciones en las mandíbulas de cráneos con diferentes índices cefálicos. Fueron utilizados 105 mandíbulas secas, pertenecientes a cráneos identificados como dolico, meso y braquicéfalos. En cada caso, se relacionaron la ubicación del FM con los márgenes longitudinales de la rama mandibular (RM) y la altura del foramen (Af) con la línea oclusal del segundo molar. Además, se determinó la altura de la língula (Al). En promedio, el FM de mandíbulas braquicefálicas se encontró más cerca del margen anterior de la RM. La Af en mandíbulas braqui, meso y dolicocéfalas fue de -0,22 mm, -4,04 mm y -4,01 mm, respectivamente. La língula mandibular en muestras braquicefálicas, fue considerablemente más corta (0,78 mm) que en las dolicocéfalas (1,84 mm). El bloqueo del nervio alveolar inferior debe llevarse a cabo usando agujas cortas, insertándolas 4 mm por encima del nivel de oclusión de los dientes molares. La rama de las mandíbulas braquicefálicas fueron significativamente menos anchas que en cráneos dolico y mesocefálicos. Si la altura de la língula mandibular se utilizará como referencia para determinar el nivel del corte medial horizontal para realizar la osteotomía sagital de la rama mandibular, se debe dar especial atención al índice cefálico del paciente.

Location of Mandibular Foramen in Correlation with the Gonial Angle in Indian Population: A Morphometric Study for Surgical Practices.

Background: The mandibular foramen, is the emerging point of the neurovascular bundle which makes it fundamental for performing anaesthetic techniques for desensitization of the mandible in oral surgery interventions. The knowledge of position of mandibular foramen is neccessary while anaesthetizing palate during periodontal procedures, tooth extractions and maxillofacial surgeries. Objective: The present study was carried out to identify the position and location of mandibular foramen in relation to the angle of mandible (gonial angle) in adult human mandibles of Indian origin . Materials and Methods: The study was conducted on 300 adult human dry skulls of Indian Population. Angle of mandible, Distance of mandibular foramen from angle of mandible and Angle of mandibular foramen with the base of mandible were measured. Measurements were done with Steel measuring tape and Mylometer. The data was Statistically analysed. Results and Conclusion: The Mean value of the angle of mandible (Gonial Angle) was 121.870 ± 6.220. The Mean value of the distance of mandibular foramen from angle of mandible was 22.78± 4.05 mm. The angle of mandibular foramen was Mean ± standard deviation of 82.240± 6.870. The morphometric correlation of the parameters analyzed in the mandibles showed a statistically significant Pearson correlation. Regression line was also derived.

Evaluation of the location of mandibular foramen as an anatomic landmark using CBCT images: a pioneering study in an iranian population / Avaliação da localização do forame mandibular como referência anatômica, por meio de imagens CBCT: um estudopioneiro na população iraniana

Objective: Mandibular foramen (MF) is located on the internal surface of the ramus through which blood vessels and nerves pass. Determination of the anatomic position of the MF is very important in inferior alveolar nerve block anesthesia (IANBA), ramus osteotomy and surgical procedures of the posterior angle of mandibular ramus. The aim of this study was to determine anatomic position of the MF using anatomic landmarks on the three dimensional CBCT images. Material and Methods: A total of 103 CBCT images was evaluated. The NNT Viewer software program was used to measure the distances between the lines tangent on the MF periphery and the anterior border of the ramus, the posterior border of the ramus, the inferior border of the mandible, and the coronoid notch in mm by to age and gender. Results: The results showed a slight difference in anatomic dimensions between the right and left sides, with no significant differences. The anatomic dimensions of the MF on both sides were a little bigger in males than in females. There were no significant differences in the anatomic dimensions of superior inferior and anterior-posterior dimensions of the left and right sides in different age groups. Conclusion: No significant changes occur in the position of the MF with age. The anatomic differences between males and females should be taken into account during IANBA procedures. Males have bigger jaws than females; therefore, there is a longer distance between the MF and the anatomic landmarks evaluated...

Objetivo: O forame mandibular (FM) localiza-se na superfície interna do ramo mandíbula, onde passam vasos sanguíneos e nervos. A determinação da posição anatômica do FM é muito importante para anestesia por bloqueio do nervo alveolar inferior (ABNAI), durante osteotomiano ramo da mandíbula e para procedimentos cirúrgicos do ângulo posterior do ramo mandibular. O objetivo deste estudo foi determinar a posição anatômica do FM utilizando referências anatômicas em imagens tridimensionais de CBCT. Material e Métodos: Um total de 103 imagens de CBCTforam avaliadas. O programa de software NNT Viewer foi utilizado para medir as distâncias em milímetros entre as linhas tangentes na periferia do FM e borda anterior do ramo, borda posterior do ramo, borda inferior da mandíbula e processo coronóide, em relação à idade e o gênero. Resultados: Os resultados mostraram uma ligeira diferença de dimensões anatômicas entre os lados direito e esquerdo, sem diferenças significativas. As dimensões anatômicas do FM em ambos os lados foram um pouco maior no sexo masculino do que no feminino. Não houve diferenças significativas nas dimensões anatômicas superior-inferior e ânteroposterior, tanto do lado direito quanto esquerdo,em diferentes faixas etárias. Conclusão: Mudanças significativas na posição do FM não são observadas em função da faixa etária. As diferenças anatômicas entre homens e mulheres devem ser levadas em consideração durante procedimento ABNAI. Mandíbulas maiores são encontradas no gênero masculino, portanto, há uma maior distância entre o FM e as referências anatômicas avaliadas...

Conservative neural symmetry of the caprine mandible / 대한수의학회지

Fifteen dry dentate and complete mandible samples from the White Rasquera goat breed were studied for symmetry. Thirty-one landmarks were digitally located on the images of the lateral and medial aspects of each hemimandible. Distances between these landmarks allowed the evaluation of the whole hemimandible and also the neural mandible. In the studied samples, the mandible was rather symmetrical, especially in the medial neural part, and in general, there was no side dominance. Only the diastema differed significantly between the sides, and this was related to the rostral part (incisive arch). The incisive region was the least symmetrical region of the caprine mandible, indicating a modular structure more conservative for the neural part. If unsigned asymmetry is interpreted as a measure of developmental stability, then the studied breed presented a marked ability to develop in good fitness despite the harsh environment. The measurements presented here can also be used as a reference for researchers designing experimental studies, especially on mandibular catch-up growth, and as an aid for zooarchaeologists comparing results from dead animals with those from living goat populations.

Location of the mandibular foramen according to the amount of dental alveoli / Localización del foramen mandibular según la cantidad de los alvéolos dentales

The aim of this study was to analyze the anatomotopographic location of the mandibular foramen in the right and left ramus, and to verify the influence of the amount of dental alveoli on the foramen position. Thirty-five adult dry human mandibles of Araraquara Dental School, UNESP - São Paulo State University were assessed, with or without dental alveoli. Measurements were obtained, using a ruler and a digital caliper. The following distances were measured: FI - distance between the lowest point of the mandibular incisure and the mandibular foramen (F point); FB - distance between the mandibular base and F point; FP - distance between the posterior margin of the ramus and F point; FA - distance between the anterior margin of the ramus and F point; FT - distance between the apex of the retromolar trigone and F point. The Mann-Whitney test was used to compare each measurement according to hemi-arch, and the Kruskal-Wallis test was used to analyze the influence of the presence of alveoli on the measures. For multiple comparison, Dunn's method was used. There was no statistically significant difference in the location of the mandibular foramen when compared to the right and left hemi-arches. The amount of dental alveoli influenced, significantly, only on FA and FP distances. Thus, it was concluded that the right and left mandibular ramus showed symmetry in the location of the mandibular foramen, and the amount of alveoli influenced on the distances of the anterior and posterior margins of the mandibular ramus, in relation to the mandibular foramen.

El objetivo de este trabajo fue evaluar la posición anátomo-topográfica del foramen mandibular en ambas ramas de la mandíbula y verificar la influencia de la cantidad de alvéolos dentales en la posición del foramen. Se evaluaron 35 mandíbulas humanas secas de individuos adultos de la Facultad de Odontología de Araraquara, Universidade Estadual Paulista - UNESP, con o sin alvéolos dentales. Se utilizó regla y calibrador digital para realizar las mediciones de las distancias entre: el punto más profundo de la incisura de la mandíbula y el foramen mandibular (FI); base de la mandíbula y el foramen (FB); margen posterior de la rama mandibular y el foramen mandibular (FP); margen anterior de la rama mandibular y el foramen (FA) y la distancia entre el vértice del trígono retromolar y el foramen mandibular (FT). Para la comparación de cada medida según hemiarcada se realizó el test de Mann-Whitney y para la influencia de la presencia de alvéolos en las medidas se utilizó el test de Kruskal-Wallis y para comparación múltiple el método de Dunn. No hubo diferencia estadística significativa en la localización del foramen mandibular al comparar el hemiarco mandibular derecho con el izquierdo. La cantidad de alvéolos dentales interfirió, de manera significativa, sólo en las distancias FA y FP. Se concluyó que las ramas mandibulares derecha e izquierda presentan simetría en el posicionamiento del foramen mandibular y la cantidad de alvéolos interfirió en las distancias de las márgenes anterior y posterior de la rama mandibular en relación con el foramen de la mandíbula.