ABSTRACT
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.
ABSTRACT
Introduction: Any unnamed opening is termed as Accessory foramen. Mandible being the strongest bone of theskull is pervaded by many accessory foramina other than mandibular and mental foramen. In the present studyaccessory mandibular, mental, retromolar and lingual foramina are distinguished and clinical implications arediscussed. The presence of such foramina if not identified during clinical practice may cause complications.Hence our study is done to find out the incidence and distribution of various accessory foramina of mandibleamong South Indians.Materials and Methods: The study was done on 100 adult dry human mandibles of South Indian origin obtainedfrom first MBBS students. The location and distribution of various accessory foramina were carefully observed,noted and tabulated.Results: Accessory foramen was found in 93% of mandibles. Accessory lingual foramen was found in 93 mandibles,with supraspinous foramen in 84%, accessory mandibular foramen in 34%, accessory mental foramen in 12%and retromolar foramen in 6%.Conclusion: Presence of accessory foramina may cause failure of anaesthesia during inferior alveolar nerveblock and haemorrhage during mandibular reconstruction surgeries owing to the neurovascular structurespassing through these accessory foramina. The clinicians should be aware about the presence of such accessoryforamina during the procedures.
ABSTRACT
The Retromolar foramen/canal are one of the non-metric variants of the mandible located in the retromolarfossa of the mandible behind the 3rd molar of mandible. These are obviously of profound dental and surgicalimportance. The aim of the study was to know the prevalence of retromolar canal/foramen in north Indianpopulation. In the present study, 35 dry mandibles of unknown sex of north Indian origin were examined bynaked eyes to know the incidence of retromolar foramen/canal. The retromolar foramen/canal was found in 6mandibles (17.14%), bilaterally in 2 mandibles and unilaterally in 4 mandibles. We conclude that retromolarforamen /canal is of profound clinical importance.
ABSTRACT
Background: The retromolar foramen is one of the most important non-metrical anatomical variants in the mandible. The present study describes the incidence of retromolar foramen in South Indian adult dried mandibles and its clinical relevance. Methods: One hundred South Indian adult dried mandibles of unknown sex were studied at the Department of Anatomy, MVJ Medical College, Bangalore for the presence of retromolar foramen. Its location, size, shape, distance of the foramen if present from the posterior border of socket for 3rd molar tooth, anterior border of ramus of the mandible were measured. Results: Retromolar foramen was present in 16 (16%) of the mandibles. Out of the 16 mandibles, it was present bilaterally in 3 (3%) mandibles and unilaterally in 13 (13%) mandibles (In 3 (3%) on the right side and in 10 (10%) on the left side). The mean diameter of the foramen was 1.33mm (range - 1.10-1.92 mm). It was oval in shape in 9 (9%) and rounded in shape in 7 (7%) mandibles. The mean distance of retromolar foramen from the posterior border of socket for 3rd molar tooth and anterior border of ramus were 6.15 mm (2.23-12.10) and 8.02 mm (3.24-13.12) respectively. Conclusions: The knowledge about the incidence of the retromolar foramen is important for dental surgeons during various anaesthetic, implantation and surgical procedures of the mandible, especially during extraction of the lower last molar tooth.
ABSTRACT
Retromolar foramen is found in the triangular area behind the lower last molar tooth and it allows the passage of neurovascular bundle that contribute to the nutrition and innervations of the pulp and periodontium of the lower teeth. In the present study one hundred and twenty mandibles were examined for the presence of retromolar foramen .Retromolar foramen was found in two mandibles bilaterally and in thirteen mandibles unilaterally (in 10 on the right side and in 3 on the left side). The distance between posterior third molar to the retromolar foramen was found to be an average of 9.8mm on the right side and 8.05mm on the left side. Distance between anterior border of ramus to retromolar foramen was found to be an average of 5.68mm on the right side and 5.77 on the left side. Retromolar foramen is surgically very significant. Knowledge of this anatomical variation can prevent complications in anaesthesia and surgical procedures in this area.
ABSTRACT
It has been known that the retromolar foramen is a rare anatomic variation observed in the retromolar triangle, a small triangular shaped region posterior to the mandibular third molar. Due to the neurovascular bundle passing through the retromolar foramen, this anatomical structure must be kept in mind during surgical approaches regarding the retromolar area and mandible. Therefore, the authors investigated the morphology of retromolar triangle and the existence and location of retromolar foramen in Korean. And these results were compared with that of other races. We used 308 sides of 154 Korean dry mandibles, unknown gender and age. The retromolar triangle presented predominantly a triangular shape (84.1%), and the maximum height and width were 13.7 mm and 7.1 mm, respectively. In 144 of the 308 sides, the retromolar foramen was observed (46.8%). The existence of the retromolar foramen was seen the same frequency in both sides, and based on a midsagittal line of the retromolar triangle, the retromolar foramen located in more buccal side (75%) than lingual side. The mean distance between the retromolar foramen and the distal edge of the last tooth were found to be 10.3 mm and 6.9 mm, respectively for the second and third molars. According to the present study, the northeast Asians including Korean population show the highest rate of the incidence of the retromolar foramen than other races. The findings suggest that practitioners should take the retromolar foramen into account in surgical procedures involving the retromolar area to protect the patient from the complications such as bleeding or nerve damage.
Subject(s)
Humans , Anatomic Variation , Asian People , Racial Groups , Hemorrhage , Incidence , Mandible , Molar, Third , ToothABSTRACT
Retromolar area in the mandible has considerable surgical importance for dental surgeons. The anatomy of this area has not received much attention in standard texts of Anatomy. A variant foramen called retromolar foramen has been described in the literature. This foramen transmits a neurovascular bundle. Presence of this neurovascular bundle poses a risk in the surgical procedures carried out for impacted lower third molar tooth extraction. The dental surgeon should also be aware of occasional presence of this neurovascular bundle in retromolar area while infiltrating local anesthetic agents. The present study was conducted on 71 dry mandibles and 10 cadaveric specimens. In dry mandibles, the boundaries and dimensions of retromolar trigone were studied. Prevalence of retromolar foramen was recorded. The distance of retromolar foramen, if present was recorded from posterior border of socket for third molar and second molar teeth respectively. In cadavers, retromolar areas were dissected and structures related were observed.