Assessment of infraorbital foramen position using computed tomography-scan in a cohort of Cameroonian adults: landmarks in facial surgery and anesthesiology.

Introduction: the infraorbital foramen (IOF) is a hole located in the maxillary bone and delivering passage to the infra orbital vascular-nervous bundle. It is an essential structure in the management of orofacial pathologies. Its precise location allows optimal anesthesia of the infraorbital nerve during cleft lip and palate surgery or alcoholization during the management of essential V2 neuralgia. The aim of our research was to determine the morphology and morphometry of the infraorbital foramen in a sample of the Cameroonian population. Methods: we included 208 CT-scans of patients meeting our search criteria. We determined the shape of the IOF and evaluated the transverse and vertical diameters of the IOF. We assessed the distance of the IOF from the maxillary alveolar crest and the infraorbital margin. The Student test was used to determine the association between different variables. The P-value of 0.05 was considered significant and the confidence interval was 95%. Results: male subjects represented 52.4% (n=109) of our participants and the mean age of our population was 26 years ± 7.3. The mean transverse diameter of the left IOF was 1.97 mm ± 0.51 while 1.78 mm ± 0.53. The IOF was more often medial to the lateral palpebral commissure-nasal wing line on the left and right (78.8% and 72.6%, respectively). Our sample showed that in 54.6% (n=113) of subjects, the IOF was oval on the left side, whereas on the right side, the IOF was oval in 52.3% (n=109) of patients. Conclusion: our study showed that to locate the IOF in a Cameroonian individual, one must palpate the vestibular mucosa opposite the maxillary first molar. Then, one must follow the line passing over this tooth, the IOF is located at about 7 mm from the infra-orbital border and 16 mm from the lateral nasal wall. We have shown that the IOF is located medial to the line connecting the nasal wing to the external palpebral commissure.

Radiographic Evaluation of Impacted Third Mandibular Molar According to the Classification of Winter, Pell and Gregory in a Sample of Cameroonian Population.

Background: The extraction of impacted third molars (M3) is a common surgical procedure in dentistry and oral surgery. Various complications, including inferior alveolar nerve (IAN) damage, may occur during and after extraction of this tooth. Radiographic examination should provide information about the M3 itself, but also about the surrounding bony structure and the relationship of the roots to the IAN and the adjacent second molar, which is often traumatized during this extraction. The aim of our study was to evaluate the depth and angulation of impacted mandibular third molars (M3) from panoramic radiographs, according to the classifications proposed by Winter and Pell & Gregory. Methods: Radiographic signs present on the orthopantomogram showing M3 depth, and retromandibular available space according to the Pell & Gregory classification were evaluated. Evaluation of the M3 angulation relative to the M2 according to Winter's classification was also done. Student's t test was used to determine the association between side or sex and different variables. Results: The depth of impaction of the M3 crown was level A accounting for 54.4% (n=260) of the PR while level B constituted 35.7% (n=171) of the images. Regarding the availability of retromandibular space, Class I constituted 36.8% (n=176). The Class II accounted for 55.9% (n=267) of PR. Conclusion: Our study showed that 54.4% of M3 were located at the same level as the occlusal plane of the second molar, while in 56% of PR the space between the second molar and the ramus of the mandible is less than the mesiodistal diameter of the third molar. This research showed that 23.1% of M3 had a level of vertical angulation, a level that allows for less painful luxation of the impacted molars. These results seem to show a relatively high level of difficulty in mobilizing and extracting M3 from Cameroonian patients.

Sexual dimorphism and infraorbital foramen: a computerized tomography-scan study in a cohort of Senegalese population.

BACKGROUND: The infraorbital foramen (IOF) is an essential anatomical structure for maxillary block anesthesia in dental practice and maxillofacial surgery. The literature also reports the importance of knowing the morphometric characteristics of the IOF because it can be damaged. The aim of our study was to determine anthropometric characteristics of infraorbital foramen in Senegalese population in relationship with the sex. METHODS: A total of 87 CT-Scan of patients were included in our sample and data collected from patient's cerebral CT-Scan. The transverse and vertical diameters of the IOF and its distance to the nearest point of the infraorbital margin, lateral nasal border and lower border of the maxillary were measured, and the shape determined. RESULTS: Eighty-seven CT-scan of patients were analyzed. This research showed that the transverse diameter of the left IOF in female subjects was 5.05±0.205 and 4.97±0.22 in male patients. The mean vertical diameter of the right foramen found in our study was 5.30±0.191 for the female subject and 5.28 mm±0.137 for the men foramen was located at 46% on the line above the 2nd premolar. The right IOF was round in 52% of subjects. An accessory IOF was found in 20% of female subjects. CONCLUSIONS: Knowledge of the precise anatomical location of IOF is important in surgical procedures and reduce the relative risks during clinical procedures. This study showed many differences in the location of the IOF with Caucasians measurements done.