Morphometric analysis of the mandibular lingual foramina using cone-beam computed tomography in elderly Korean / Análisis morfométrico de los forámenes linguales mandibulares mediante tomografía computarizada de haz cónico en adultos mayores coreanos

SUMMARY: The aim of this study was to determine the morphologic characteristics of the lingual foramen and lateral lingual foramen using cone-beam CT in elderly Korean. Cone-beam CT images were obtained from 80 Korean older than 50 years (mean age, 65.2 years). The prevalence of the lingual and lateral lingual foramina at the lingual aspect of the mandible was determined. The diameter and height to the upper margin of the foramina from the mandibular inferior margin, and the bone height to the alveolar crest from the mandibular inferior margin were measured. In addition, the location of the lateral lingual foramen, the direction of its canal, and the presence of communication with the mandibular canal were evaluated. All of elderly Korean possessed at least one lingual foramen, with two or three foramina occurring in 77.5 % of Korean. A lateral lingual foramen was observed in 91.3 % of Korean, with the prevalence being highest at the second premolar in dentulous cases (21.6 %; 33/153). The very high frequencies of these foramina were attributable to high frequencies of relatively small-diameter inferior lingual foramen and lateral lingual foramen in the incisor region. The prevalence of a large-diameter (≥1 mm) superior lingual foramen was high, at 31.0 %. A large-diameter lateral lingual foramen in the premolar region occurred at a frequency of 17.0 %; communication with the mandibular canal was observed in 70.0 % of these cases. These quantitative data on the lingual and lateral lingual foramina of the mandible provide valuable information that could help to avoid surgical complications during implant placement in elderly Korean.

RESUMEN: El objetivo de este estudio fue determinar las características morfológicas del foramen lingual y del foramen lingual lateral mediante TC de haz cónico en adultos mayores coreanos. Se obtuvieron imágenes de TC de haz cónico de 80 coreanos mayores de 50 años (edad media, 65,2 años). Se determinó la prevalencia de los forámenes linguales y linguales laterales en la cara lingual de la mandíbula. Se midió el diámetro y la altura hasta el margen superior de los forámenes desde el margen inferior mandibular, y la altura ósea hasta la cresta alveolar desde el margen inferior mandibular. Además, se evaluó la ubicación del foramen lingual lateral, la dirección de su canal y la presencia de comunicación con el canal mandibular. Todos los adultos mayores coreanos tenían al menos un foramen lingual, con dos o tres forámenes en el 77,5 %. Se observó un foramen lingual lateral en el 91,3 %, siendo la prevalencia más alta en el segundo premolar en casos dentados (21,6 %; 33/ 153). Las mayores frecuencias de estos forámenes se atribuyeron a altas frecuencias de foramen lingual inferior y foramen lingual lateral de diámetro relativamente pequeño en la región de los incisivos. La prevalencia de un foramen lingual superior de gran diámetro (≥1 mm) fue alta, del 31,0 %. Un foramen lingual lateral de gran diámetro en la región premolar ocurrió con una frecuencia del 17,0 %; se observó comunicación con el canal mandibular en el 70,0 % de estos casos. Estos datos cuantitativos sobre los forámenes linguales y linguales laterales de la mandíbula proporcionan información valiosa que podría ayudar a evitar complicaciones quirúrgicas durante la colocación de implantes en adultos mayores coreanos.

Anatomical evaluation of the medial lingual foramen using cone-beam computed tomography: a retrospective study / Avaliação anatômica do forame lingual medial usando tomografia computadorizada de feixe cônico: um estudo retrospectivo

ABSTRACT Objective: To evaluate the frequency of medial lingual foramina present in the cortex of the mandible using cone beam computed tomography (CBCT). Methods: A total of 953 CBTC exams of the mandible were evaluated to determine the presence of canals in the mandibular midline, canal location in relation to the mental spine, canal diameter, distance to the base and alveolar crest of the mandible, trajectory of the canal, and coincidence measurements of the panoramic image containing the location of the canal in relation to the mental spine. Results: Foramina were located in three positions: above the mental spine (FSS) 89.2%, below the mental spine (FIS) 67.9%, and other positions (FOP) 21.3%. Non-edentulous individuals had a significantly higher number of FSS than did edentulous individuals (P<0.001). Male individuals presented a significantly greater distance from the FSS (P=0.001), FIS (P=0.045) and FOP (p=0.002) to the base of the mandible than female individuals. Younger individuals presented a significantly higher distance from the FSS (P=0.001) and FIS (P=0.001) to the alveolar crest of the mandible. Male individuals had a significantly greater FIS (P=0.002) and FOP (P=0.001) diameter than female individuals. Male individuals had a significantly higher number of bifurcations in FOP than female individuals (P=0.017). Conclusion: CBCT supplies the provider with a detailed assessment of the foramina and canals, which improves the quality of surgical planning and mitigates the chances of surgical intercurrences.

RESUMO Objetivo: Avaliar a frequência dos forames linguais mediais presentes na cortical da mandíbula por meio da tomografia computadorizada de feixe cônico (TCFC). Métodos: Um total de 953 exames de TCFC da mandíbula foram avaliados para determinar a presença de canais na linha média mandibular, localização do canal em relação ao tubérculo geniano, diâmetro do canal, distância à base e crista alveolar da mandíbula, trajetória da canal e medidas de coincidência da imagem panorâmica contendo a localização do canal em relação ao tubérculo geniano. Resultados: Os forames localizaram-se em três posições: acima do tubérculo (FSS) 89,2%, abaixo do tubérculo (FIS) 67,9% e outras posições (FOP) 21,3%. Indivíduos não edêntulos apresentaram um número significativamente maior de FSS do que indivíduos edêntulos (P <0,001). Indivíduos do sexo masculino apresentaram distâncias significativamente maior do FSS (P = 0,001), FIS (P = 0,045) e FOP (p = 0,002) até a base da mandíbula do que indivíduos do sexo feminino. Os indivíduos mais jovens apresentaram uma distância significativamente maior do FSS (P = 0,001) e FIS (P = 0,001) até a crista alveolar da mandíbula. Indivíduos do sexo masculino tiveram um diâmetro de FIS (P = 0,002) e FOP (P = 0,001) significativamente maior do que indivíduos do sexo feminino. Indivíduos do sexo masculino tiveram um número significativamente maior de bifurcações no FOP do que indivíduos do sexo feminino (P = 0,017). Conclusão: a TCFC fornece ao profissional uma avaliação detalhada dos forames e canais, o que melhora a qualidade do planejamento cirúrgico e diminui as chances de intercorrências.

Study Of Distribution Of Various Accessory Foramina In 100 Human Mandibles Of South India

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.

Influencia de dientes remanentes en la presencia y morfometría de forámenes y canales en relación a las espinas mentales / Influence of remnant teeth in the presence and morphometry of foramina and canals in relation to mental spine

La zona anterior de la mandíbula, con frecuencia es intervenida desde el punto de vista quirúrgico (instalación de implantes oseointegrados, mentoplastias, genioplastias, profundizaciones de vestíbulo y flanco lingual, fracturas, etc.). Se ha descrito la presencia de vasos que penetran la tabla ósea lingual en la zona mediana mandibular, los cuales se relacionan con forámenes vasculares. La pérdida dentaria en la zona anterior mandibular podría influir en el tamaño de los forámenes y canales debido a la degeneración de los vasos incisivos provenientes de la arteria alveolar inferior. El objetivo fue evaluar la relación entre presencia y ausencia de dientes remanentes en el grupo V con la presencia y morfometría de forámenes y canales ubicados en cercanía a las espinas mentales. Se estudiaron 95 mandíbulas humanas secas, con sexo y edad indeterminada. Se midió el área de los forámenes y la longitud de los canales utilizando el programa Photoshop CS3 extended. Se obtuvo un total de 53 mandíbulas dentadas en el grupo V y 42 mandíbulas desdentadas en el grupo V. El 95,7% de la muestra tuvo al menos un foramen en relación a las espinas mentales. Se vio que los forámenes con mayor frecuencia de aparición fueron los superiores a las espinas mentales superiores en 75 mandíbulas, forámenes inferiores a las espinas mentales inferiores en 72 mandíbulas y los forámenes entre las espinas mentales en 26 mandíbulas. No se encontró asociación entre la presencia y ausencia de dientes con la frecuencia de forámenes en las tres posiciones estudiadas. Se observó que el foramen inferior a espinas mentales tuvo un diámetro mayor en mandíbulas dentadas (valor p= 0,0194) y la longitud del canal superior a las espinas mentales superiores fue significativamente más largo en mandíbulas desdentadas (valor p= 0,0206).

The anterior mandibular body is an anatomical area that is often subjected to surgery such as for installation of osseointegrated implants, mentoplasty, genioplasty, fractures, among others. The presence of vessels that penetrates through foraminas at its midline from the lingual table has been described. Tooth loss in the anterior mandibular zone may influence the size of the foramina and canals due to the atrophy of incisors vessels that originates from the inferior alveolar artery. The aim was to evaluate the relationship between presence and absence of remaining teeth in group V, with the presence and morphometry of foramina and canals located in proximity to the mental spines. We studied 95 dry human mandibles with indeterminate sex and age. We measured the area of the foraminas and the length of the canals using the program Photoshop CS3 Extended. We obtained a total of 53 dentate and 42 edentulous mandibles in group V. In 95.7% of the sample had the presence of at least one foramina relative to the mental spines. The foramina that was found more often, tended to be upper to the superior mental spines, in a total of 75 mandibles; lower to the inferior mental spines in 72 mandibles and between the mental spines in 26 mandibles. There was no association between the presence and absence of teeth versus the frequency of the foramina in the three positions established. It was seen that the foramina lower to the inferior mental spine had a greater diameter in dentate mandibles (p-value= 0.0194) and the canal upper to the superior mental spines was significantly longer in the edentulous mandibles (p-value= 0.079).

Forâmen lingual lateral – relato de dois casos clínicos através da tomografia computadorizada de feixe cônico / Lateral lingual foramina (LLF) – two case reports with the use of cone beam computed tomography (CBCT)

O reconhecimento do forâmen lingual lateral (FLL) e muito importante, especialmente na implantodontia. Assim, a tomografia computadorizada feixe cônico (TCFC) permite a visualização de estruturas anatômicas nao detectadas na radiografia convencional, com o FLL. Este artigo relata dois casos de FLL ambos no lado direito em dois pacientes distintos. Ambos os exames foram obtidos pelo I-Cat e avaliados no programa I-Cat Vision. A injúria aos vasos que atravessam a FLL pode causar hematoma no assoalho bucal e, em situações mais graves, a obstrução das vias aéreas superiores

Lateral lingual foramen (LLF) recognition is very important, especially to dental implant practitioners. In this way, cone-beam computed tomography (CBCT) allows visualization of anatomic structures not detected in conventional radiography, such as LLF. This paper reports two LLF cases both at the right side in two different patients. Both exams were obtained through I-CAT Classic device and evaluated with the I-CAT Vision software. Injuries to LLF contained vascular bundles might cause hematoma at the floor of the mouth and, in worst cases, subsequent upper airway obstruction.

Relación del foramen lingual con espinas mentonianas y evaluación del conducto lingual mediante radiografías intra y extraorales / Relationship between lingual foramen and mental spines, and evaluation of lingual canal by using intra and extra-oral radiographs

La literatura tradicional odontológica describe la ubicación radiográfica del foramen lingual en la cara lingual de la mandíbula, de ubicación media entre las espinas mentonianas (apófisis geni) en radiografías periapicales y panorámicas. Tradicionalmente se señala que las espinas mentonianas son las responsables del área radiopaca que rodea al foramen lingual. La ubicación radiográfica en posición mediana del foramen lingual con respecto a las espinas mentonianas es objeto de controversia. El objetivo de la presente investigación fue determinar la relación del foramen lingual con las espinas mentonianas en observación directa de mandíbulas secas, y mediante radiografías periapicales y panorámicas de las mismas, determinar la trayectoria del conducto lingual en tomografías lineales de la zona, y describir su representación radiográfica desde la perspectiva absorso-proyeccional. Esta investigación demostró la no concordancia radiográfica entre las espinas mentonianas y el área radiopaca que rodea al foramen lingual.

Radiological location of lingual foramen is described by traditional dental literature in the median line in the lingual aspect of the mandible, between mental spines, both in periapical and panoramic radiographs. Traditionally the radiopaque area surrounding the lingual foramen is described as produced by mental spines. This interpretation currently is controversial. The aim of this study was to determine the relationship of lingual foramen with mental spines by looking directly at the dry mandibles, and by looking at periapical and panoramic radiographs; to determine trajectory of lingual canal by using linear tomographies of the area of interest, and describe radiographic representation from the absorption projectional point of view. This investigation demonstrated that the radiopaque area surrounding the lingual foramen is not produced by mental spines.

Anatomical structure of lingual foramen in cone beam computed tomography / 대한구강악안면방사선학회지

PURPOSE: To evaluate whether cone beam computed tomography can depict the distribution, position, frequency, relative vertical dimension, and the diameter of the lingual foramen and direction of lingual bone canal. MATERIALS AND METHODS: Cone beam computed tomography of mandible was performed on 25 males and 25 females with no history of any orthodontic treatments or any other dental surgeries. A statistical comparison was done on the mean values of males and females. RESULTS: In the location and distribution of lingual foramina, median lingual foramen was found in all subjects and lateral lingual foramen in 58%. In the lateral lingual foramen, bilateral type was found in 28% and unilateral type in 30%. In the number of lingual foramina, median lingual foramen had two foramina and lateral lingual foramen had one foramen, mostly. In the relative mean vertical dimension of lingual foramina, median lingual foramen was 0.03+/-0.08, and both lateral lingual foramina was 0.20+/-0.04. The mean diameter of lingual foramina, median lingual foramen was 0.9 mm+/-0.28, right lateral lingual foramen was 0.92 mm+/-0.23, and left lateral lingual foramen was 0.88 mm+/-0.27. The most frequent direction of the lingual bone canals, median lingual bone canal proceeded in anteroinferior direction and lateral lingual bone canal in anterosuperolateral direction. CONCLUSION: Cone beam computed tomography can be helpful for surgery and implantation on the mandibular area. Radiologist should be aware of this anatomical feature and its possible implications.