A CBCT Assessment of the Incidence and Location of the Lingual Foramen in the Anterior Mandible

Abstract

The purpose of this article is to assess the incidence of lingual foramina and associated vasculature in the anterior mandible to improve the understanding of their locations for dental implant placement. Intra-operative bleeding can be a significant complication. Pre-surgical assessment of the surgical site should be performed to identify anatomical landmarks. This can prevent a potential life-threatening haemorrhage that may compromise the airway. Nutrient canals can occur in the anterior mandible and have been reported to cause significant bleeding if violated. Using cone beam computerized tomography (CBCT) this study defines the anatomical locales in the mandible. CBCTs of 70 patients were obtained and examined for the presence of lingual foramina. The distance of lingual foramina to the inferior border of the mandible, bifurcations and propensity for the midline were assessed. Lingual foramina were found in all of the examined mandibles with variable configurations. CBCT may be important in planning for surgical procedures in the anterior mandible to prevent an unexpected hemorrhage. The present study is limited by its sample size, method of assessment and confinement to a geographical population. The results will need validation in further studies which may incorporate multiple assessment techniques and a larger sample size with to include greater geographical distribution. Future work may seek to describe emanations of the terminus of the sublingual artery.

Dental implant in anterior mandible according to mandibular lingual foramens and lingual mucosal vessels: using fusion volumetric images from computed tomography and magnetic resonance imaging

“…We used fusion volumetric images in 26 Japanese subjects. The results of MLFs were consistent with other studies, with the number of MLFs distributed between 2 and 6, most predominantly below the incisors, followed by the premolars and finally the canines [ 10 , 11 , 13 , 29 ]. When we considered sex differences, we found similar findings to those of Yildirim [ 31 ] who state that women have slightly lower values in each of the variables analyzed.…”

“…Some investigators supported that canals occur in the anterior mandible and had been reported to cause significant bleeding if violated [ 9 ]. The mandibular lingual foramens (MLFs) were the potential anatomical complication for dental implant placement in the anterior mandible [ 10 ]. They were described as the small foramina in the midline of the mandibular lingual region.…”

Impacted Mandibular Fracture: A Report of a Rare Case

“…Splaying of the mandible after the bi-condylar fracture could be responsible for buccal impacted fracture with lingual obliquity. Though not many anatomical variations are found in the anterior mandible, the aetiology of oblique impacted fracture is unknown [ 11 , 12 ]. Yet, Pawar et al reported two cases of comminuted mandibular fractures caused by high-speed vehicle crashes [ 13 ]…”

Incidence neurosensory deficit in mandibular fractures

“…Studies have demonstrated that closed reduction can help prevent post-treatment nerve injury [ 14 ]. While anatomical variations in the course of the inferior alveolar nerve exist, there are no studies presenting these variations in IAN injuries [ 15 , 16 , 17 , 18 , 19 ].…”