A simple method to locate mandibular foramen with cone-beam computed tomography and its relevance to oral and maxillofacial surgery: a radio-anatomical study

Al-Shayyab, Mohammad H.

doi:10.1007/s00276-018-2015-3

Cited by 13 publications

(38 citation statements)

References 21 publications

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Section: Discussionsupporting

confidence: 93%

“…The findings of this study indicated an absolute positional bilateral symmetry of the MC and bone thickness in the region of MSSO, and this is in agreement with previous studies (7,8,11). As for gender, gender did not always lead to a significant variation in distances measured in this study, and this is in agreement with recent studies (7,11) and with the fact that genetic and environmental factors may also influence bone size and thickness (8,19). However, measurements recorded in this study were significantly variable according to age and in concordance with the fact that the position of the MC in relation to other landmarks is not constant and affected by imbalanced growth and remodeling occurred with advancing age, characterized by thickening of the buccal and inferior aspects of mandibular bone and resorption of the superior and lingual aspects moving the MC in a superior and lingual direction and leaving a decreased amount of cancellous bone, and shorter ramus and mandibular posterior region (8,20,21).…”

Section: Discussionsupporting

confidence: 93%

“…Patients’ file number, age, and gender were then recorded, and according to their age, they were divided into two groups; young (18–40 years), and adult (> 40 years). This classification border considered the fact, demonstrated in a recent study (8) on the same population, that mandibular growth and remodeling in the vicinity of the IAN goes on until the bone has reached the adult size (40 years), following which the deposition and resorption process is imbalanced and results in a significantly decreased ramus measurements. It would also create comparable cohorts in this study.…”

Section: Methodsmentioning

confidence: 99%

“…Ample literature (8-11) investigated mandibular morphology using various anatomical and radiological methods, and reported variations possibly related to ethnicity, age, gender, dental status and dentofacial skeletal relationships. However, very few published English literature (12,13) investigated the bone thickness and mandibular morphology in the vicinity of the IAN for MSSO using advanced imaging, and reported no significant variations among patients with different dentofacial skeletal relationships.…”

Section: Introductionmentioning

confidence: 99%

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Age and gender variations in the cone-beam computed tomographic location of mandibular canal: Implications for mandibular sagittal split osteotomy

Al-Shayyab¹,

Qabba’ah²,

Alsoleihat³

et al. 2019

Med Oral

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Background Mandibular sagittal split osteotomy (MSSO) may incur unfavorable split and sensorineural injuries. Knowledge of the anatomic location of the mandibular canal (MC) and bone thickness in the region of interest for MSSO, and the possible variations by age and gender can assist in avoiding such complications. Purpose: To study the location of the MC and bone thickness in the region of MSSO by cone-beam computed tomography (CBCT) radiographs and to evaluate the possible variations by age and gender in a Jordanian population. Material and Methods This retrospective radio-anatomical study examined all CBCT radiographs for patients treated over three years at the University of Jordan Hospital, Amman, Jordan. Distances from the MC to the cortical external surfaces and MC diameter (MCD) were measured by a reliable observer at three predetermined regions for MSSO: region (A) [mandibular foramen area], region (B) [mandibular angle area] and region (C) [directly mesial to the second molar]. Gender and age differences in all measurements were then compared using non-parametric Mann-Whitney U test. Results The final study radiographs comprised a total of 202 CBCT belonged to a cohort of 202 subjects; 91 males (45.1%) and 111 (54.9%) females, with mean age (± SD) of 42.94 ± 18.54 years (range 18–90 years). Whereas only the bone thickness superior, buccal and inferior to MC in regions (B) and (C), and MCD in the three regions exhibited significant ( p < 0.05) gender differences, all measured distances exhibited statistically significant ( p < 0.05) differences between young and adult patients. Conclusions The location of MC and bone thickness in the region of MSSO were significantly variable according to age, but exhibited sexual diamorphism only in regions (B) and (C). This fundamental knowledge should be considered during MSSO planning. Key words: Cone-Beam Computed Tomography, mandibular canal, mandibular sagittal split osteotomy.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Age and gender variations in the cone-beam computed tomographic location of mandibular canal: Implications for mandibular sagittal split osteotomy

Al-Shayyab¹,

Qabba’ah²,

Alsoleihat³

et al. 2019

Med Oral

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“…According to [8] the mandibular foramen cannot be palpated clinically and its location is variable at the medial surface of the mandibular ramus. Nevertheless, determining its exact location is very important to the oral and maxillofacial surgeon for the relevant anesthetic and surgical ramus procedures.…”

Section: Introductionmentioning

confidence: 99%

Position of the Mandibular Foramen in Different Facial Shapes Assessed by Cone-Beam Computed Tomography - A Cross-Sectional Retrospective Study

Correa¹,

Motta²,

Silva³

et al. 2019

TODENTJ

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Purpose: The mandibular foramen, located on the internal surface of the mandibular ramus, is an important anatomical landmark for the success during the inferior alveolar nerve block. This cross-sectional retrospective study aimed to evaluate the location of the mandibular foramen through Cone-Beam Computed Tomography (CBCT) in different facial shapes. Materials and Methods: The determination of the location of the mandibular foramen was performed using CBCT of mesocephalic, dolichocephalic and brachycephalic patients (n=40 each). The ramus width (W), the distance from the mandibular foramen to the deepest point of the anterior border of the mandibular ramus (D), the distance from the mandibular foramen to the lowest point of the mandibular notch (V) and the distance from the inferior border of the mandible to the lowest point in of the mandibular border (R), as well as the ratios W/D and V/R, were measured. ANCOVA, two-way ANOVA and Chi-square tests were used to analyze the variation among the facial shapes. Results: The ramus width (W) was greater (p<0.0001) in the brachycephalic (28.4±0.5 mm) than in both mesocephalic (26.8±0.36 mm) and dolichocephalic (25.5±0.39 mm) patients. D (p=0.0433) and R (p=0.0072) were also greater in the brachycephalic (17.7±0.36 mm; 43.4±0.75 mm, respectively) than dolichocephalic (16.5±0.3 mm; 40.3±0.63 mm, respectively), but both did not differ from mesocephalic (17.3±0.36 mm; 41.8±0.66 mm, respectively) patients. The other measurements (V, W/D and R/V) did not significantly differ among facial shapes. Conclusion: The localization of the mandibular foramen was, in the horizontal direction, more posterior in the brachycephalic patients and, in the vertical direction, higher in the dolichocephalic patients, when compared to the other groups analyzed. Thus, the anatomic data found in this study may help dentists to increase the success of the inferior alveolar nerve block and prevent surgical complications.

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The mandibular plane: a stable reference to localize the mandibular foramen, even during growth

et al. 2019

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Objectives The location of the mandibular foramen is essential for the quality of the inferior alveolar nerve block anaesthesia and has often been studied with contradictory results over the years. The aim of this study was to locate the mandibular foramen, according to the dental age of the subject, through 3D analysis. Methods Three-dimensional images were reconstructed from mandibular computed tomography of 260 children, adolescents and adults. The occlusal plane was determined as the average plane passing through the buccal cusps of mandibular molars, premolars, and canines, and through the incisor edge. The mandibular foramen was located three dimensionally in relation to the anterior edge of the ramus (or coronoid notch), the sagittal plane and the occlusal plane. Results All along mandibular growth, the three distances defining the relative position of the mandibular foramen showed negligible changes. The mandibular foramen is located from − 0.4 to 2.9 mm above the occlusal plane. The distance between the mandibular foramen and the leading edge of the mandibular ramus ranged from 17 to 19.5 mm. The angle between the ramus and the sagittal plane ranged from 3° to 5.4°. Conclusion In our sample, and using the occlusal plane and the anterior edge of the ramus as anatomical references, the location of the mandibular foramen was considered to be similar in all patients regardless of age.

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A simple method to locate mandibular foramen with cone-beam computed tomography and its relevance to oral and maxillofacial surgery: a radio-anatomical study

Abstract: This study suggested the '40% rule' to locate the 'target area' for IAN block and 'safety zone' for ramus osteotomies approached extra-orally.

Cited by 13 publications

References 21 publications

Age and gender variations in the cone-beam computed tomographic location of mandibular canal: Implications for mandibular sagittal split osteotomy

Age and gender variations in the cone-beam computed tomographic location of mandibular canal: Implications for mandibular sagittal split osteotomy

Position of the Mandibular Foramen in Different Facial Shapes Assessed by Cone-Beam Computed Tomography - A Cross-Sectional Retrospective Study

The mandibular plane: a stable reference to localize the mandibular foramen, even during growth

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