Evaluation of the Size and Location of the Genial Plexus, Related to Age, Sex and Dental Presence, in Implant Surgeries

João Henrique Scotti Alérico,Carlos Eduardo Francischone,Francisco Antoninho Alérico,Bruno Salles Sotto-Maior,Karina Lopes Devito,Neuza Maria Souza Picorelli Assis

doi:10.4236/jbise.2017.1010035

Abstract

Generally being considered as a safe area for surgical approaches, the region between the mental foramina presents important anatomical structures. The objective of this study was to measure the dimensions of the genial plexus and its three-dimensional location in CBCT images, correlating the characteristics of this structure with dental presence, sex and age of patients. A total of 149 cone beam computer tomography (CBCT) scans of dentate (n = 74) and edentulous patients (n = 75) were selected, 59 male and 90 female, aged 18 - 86 years. Measurements of width and length of the genial canal were performed, and the shortest distances of the genial plexus were determined in relation to the alveolar bone crest, the buccal cortical bone and the base of the mandible. The results indicated significant differences between the dentate and edentulous groups for the mandibular canal length (p = 0.030), distance from alveolar crest (p < 0.001), and distance from buccal cortical bone (p < 0.001), with significantly higher values in dentate patients. As for gender, the distances between the genial plexus and the alveolar bone crest (p < 0.001) and the buccal cortical bone (p = 0.028) were significantly shorter for females. Regarding age, only the distance between the genial plexus and the alveolar crest showed a significant difference (p < 0.001), and the smallest values were measured in the older patients. It can be concluded that there are variations of the genial plexus in relation to gender, age and between edentulous and dentate patients. Therefore, the anterior region of the mandible, especially the midline should be observed with caution when undergoing surgical procedures, such as removal of bone grafts and installation of dental implants.

Highlights

The anterior region of the mandible is considered safe as a bone graft donor area and for the installation of dental implants [1, 2], some studies have reported accidents and the potential risk of associated complications to surgical interventions in [3, 4]
The objective of this study was to measure the dimensions of the genial plexus and its three-dimensional location in cone beam computer tomography (CBCT) images, correlating the characteristics of this structure with dental presence, sex and age of patients
The incisive canal and the genial plexus contain terminal branches of nerves and blood vessels that feed the teeth of the intermental region, the intraosseous space and the vestibular gingiva of the symphysis region [7, 8]

Summary

Introduction

The anterior region of the mandible is considered safe as a bone graft donor area and for the installation of dental implants [1, 2], some studies have reported accidents and the potential risk of associated complications to surgical interventions in [3, 4]. Anatomic structures such as the incisive canal and the genial plexus [5, 6] are main responsible for these complications. In addition to anastomoses [10], the presence of another anatomical accident called the genial plexus [11] or upper and lower genial foramen [3], or lingual foramen which jointly contributes to the crossed neurovascularization at the level of the mandibular midline [3, 9]

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Results

Conclusion