Evaluation of the Location of Mandibular Foramen as an Anatomic Landmark Using CBCT Images: A Pioneering Study in an Iranian Population

Abbas Shokri,Atena Karimi,Jalal Poorolajal,Farzaneh Ostovarrad,Sepideh Falah-Kooshki

doi:10.14295/bds.2014.v17i4.1006

Abbas Shokri, Atena Karimi + Show 3 more

Open Access

https://doi.org/10.14295/bds.2014.v17i4.1006

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Abstract

Objective: Mandibular foramen (MF) is located on the internal surface of the ramus through which blood vessels and nerves pass. Determination of the anatomic position of the MF is very important in inferior alveolar nerve block anesthesia (IANBA), ramus osteotomy and surgical procedures of the posterior angle of mandibular ramus. The aim of this study was to determine anatomic position of the MF using anatomic landmarks on the three dimensional CBCT images. Material and Methods: A total of 103 CBCT images was evaluated. The NNT Viewer software program was used to measure the distances between the lines tangent on the MF periphery and the anterior border of the ramus, the posterior border of the ramus, the inferior border of the mandible, and the coronoid notch in mm by to age and gender. Results: The results showed a slight difference in anatomic dimensions between the right and left sides, with no significant differences. The anatomic dimensions of the MF on both sides were a little bigger in males than in females. There were no significant differences in the anatomic dimensions of superior-inferior and anterior-posterior dimensions of the left and right sides in different age groups. Conclusion: No significant changes occur in the position of the MF with age. The anatomic differences between males and females should be taken into account during IANBA procedures. Males have bigger jaws than females; therefore, there is a longer distance between the MF and the anatomic landmarks evaluated. Keywords: Mandibular Foramen; Anatomic Landmarks; Cone-Beam Computed Tomography

Highlights

Inferior alveolar nerve block anesthesia (IANBA) is the main procedure for the local anesthesia of teeth
The results show no significant difference in the anatomic dimensions measured using the CBCT technique by the two observers
There is a minimum risk of trauma to the inferior alveolar nerve in this region during the vertical osteotomy procedures of the mandibular ramus as was the case in our study. In both genders on both the sides, the mandibular foramen (MF) was located in the upper third of the ramus in the vertical dimension and at the border of the posterior one-third and the middle one-third in the horizontal dimension

Summary

Introduction

Inferior alveolar nerve block anesthesia (IANBA) is the main procedure for the local anesthesia of teeth. Various problems have been reported during IANBA procedures, including fracture of the needle, rupture of blood vessels, skin necrosis, diplopia and nerve injuries [1,2,3,4,5]. Various techniques have been reported for the anesthesia of the inferior alveolar nerve [3,7]; a more accurate injection for the IANBA does not necessarily increase the success rate [8,9]. The height, angle and length of these anatomic structures of the oral cavity, used as reference points, are useful to help locate the MF in the IANBA technique

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Discussion

Conclusion