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

Incidence of the mandibular accessory foramina in Brazilian population

In adults, the mandibular accessory foramina are variables and are located on the medial surface of the mandible in positions above or below of the mandibular foramen. The aim of this study was to evaluate the incidence of the mandibular accessory foramina in Brazilians human mandibles and discuss the clinical aspects related to the presence of these foramina. Were evaluated 222 mandibles, adults, irrespective of gender. Was observed that 27.93% and 43.24% of the mandibles presented at least one mandibular accessory foramina located on the medial surface in position below and above, respectively, of the mandibular foramen. Unilaterally, the mandibular accessory foramina were observed below and above of the mandibular foramen in 22.07% and 25.22%, of the mandibles, respectively, and 5.85% and 18.02% bilaterally, respectively. This study demonstrated that the incidence of mandibular accessory foramen in the Brazilian population is significant and should be considered in the planning and execution of procedures in several areas of dental clinical practice in order to avoid complications.

Morphological analysis of the lingula in dry mandiblesof individuals in Southern Brazil

The lingula of the mandible is a small-tongue-shaped bone projection overlaying the mandibular foramen, andit is clinically significant in oral and maxillofacial surgical procedures. This study aims to analyze the shapesof the lingula and its relationship with the surface of the mandibular ramus, and to record data about thepopulation in Southern Brazil. The maxillofacial study of the lingula in 80 dry mandibles in adult individualswas conducted. The lingula of the two rami of each mandible were assessed and classified in the followingshapes: triangular, truncated, nodular and assimilated. The triangular shape was analyzed according to itsdirection in relation to the condyle or the posterior region of the mandible posterior ramus, and also accordingto its relationship with the inner surface of the mandibular ramus: assimilated, free or partially free. Theoccurrence of accessory mandibular foramens in each mandibular ramus was also recorded. The triangularshape of the lingula was found in 66 sides (41.3%), seeing that in 21 mandibles (42 sides) it was noticed bothon the right side and the left side, whereas 13 occurred on the right side and 11 on the left side, unilaterally.The truncated lingula was present on 58 sides (36.3%), and the nodular lingula was noticed on 17 sides(10.5%); as to the assimilated lingula it was found on 19 sides (11.9%). Accessory foramens were foundin 11.3 and 3.8% of the right and left mandibular rami, respectively. Considering that the lingula showsmorphological variants in different populations, these results include significant data of the population in theSouth of Brazil regarding the morphometric study of the mandible, also playing a role to avoid failure of theanesthetic surgical block of the inferior alveolar nerve.

Location of the mental foramen in dry mandibles of adultindividuals in Southern Brazil

The mental foramen (MF) guides the mental nerve which is responsible for the sensible innervation of themandibular area. It is important to know the anatomical variations of the MF for locational blockage of theincisor nerve in periapical surgeries involving molars and premolars, and in other buccomaxillofacial surgicalprocedures as well. This study aims to analyze variations in the MF site in dry mandibles of adult subjects inSouthern Brazil. Eighty mandibles were analyzed, and the measurements of the distance from the sagittalmidline to the center of the MF (MLF); the distance from the lower rim of the mandible to the center ofthe MF (LRF); the location of the MF relative to its alignment with the mandible teeth, and the incidenceof double mental foramens (DMF) were checked. The analyzed parameters were related to each mandible’slaterality. Statistical analysis was carried out through Student’s t test. Results indicate that the prevalentposition of the MF in the right and left sides was posterior to the first premolar. There was no significantdifference between the right and left sides regarding MLF, and LRF showed a significant difference betweensides, greater on the right side. There was a prevalence of the DMF on the right side of the mandibles. Theseresults are important for the preparation and conduction of surgical procedures in order to prevent injury tothe involved neurovascular structures.