Mandibular Lingula Research Articles

Poster 204: Sensory Disturbance of the Lower Lip After 100 Cases of Sagittal Splitting Ramus Osteotomy–The Relationship Between Mandibular Canal and Osteotomy Line

Statement of the ProblemSagittal splitting ramus osteotomy (SSRO) has much indication as one of the basic operations for maxillofacial deformities. However, postoperative sensory disturbance of lower lip can be often seen, and the cause is thought about in various ways. We studied the relations between development of postoperative sensory disturbances and anatomical positions of mandibular canals.Materials and MethodsWe examined it about 100 patients (200 sides: Male 32 cases, Female 68 cases) who operated in SSRO at Second Department of Oral and Maxillofacial Surgery of Osaka Dental University Hospital in from 2004 to 2006.Method of Data AnalysisWe examined preoperative standardized CT images that fixed horizontal plane and occulusal plane vertically. We measured distance from the medial border of the lateral cortex of the mandibular ramus at the slice under 5 mm of the mandibular lingula to the mandibular canal.ResultsWe founded the postoperative sensory disturbances of lower lip in 138 sides among 200 sides. The disturbances were recognized most in a range from 1.0 mm to 2.0 mm. Those disturbances decreased with time and only remained 23 sides after six months postoperative. At the time, the disturbances were recognized most in a range from 1.0 mm to 2.0 mm.ConclusionIt was suggested that there are correlation in the relations between postoperative sensory disturbances of lower lip and anatomical positions of mandibular canals. Statement of the ProblemSagittal splitting ramus osteotomy (SSRO) has much indication as one of the basic operations for maxillofacial deformities. However, postoperative sensory disturbance of lower lip can be often seen, and the cause is thought about in various ways. We studied the relations between development of postoperative sensory disturbances and anatomical positions of mandibular canals. Sagittal splitting ramus osteotomy (SSRO) has much indication as one of the basic operations for maxillofacial deformities. However, postoperative sensory disturbance of lower lip can be often seen, and the cause is thought about in various ways. We studied the relations between development of postoperative sensory disturbances and anatomical positions of mandibular canals. Materials and MethodsWe examined it about 100 patients (200 sides: Male 32 cases, Female 68 cases) who operated in SSRO at Second Department of Oral and Maxillofacial Surgery of Osaka Dental University Hospital in from 2004 to 2006. We examined it about 100 patients (200 sides: Male 32 cases, Female 68 cases) who operated in SSRO at Second Department of Oral and Maxillofacial Surgery of Osaka Dental University Hospital in from 2004 to 2006. Method of Data AnalysisWe examined preoperative standardized CT images that fixed horizontal plane and occulusal plane vertically. We measured distance from the medial border of the lateral cortex of the mandibular ramus at the slice under 5 mm of the mandibular lingula to the mandibular canal. We examined preoperative standardized CT images that fixed horizontal plane and occulusal plane vertically. We measured distance from the medial border of the lateral cortex of the mandibular ramus at the slice under 5 mm of the mandibular lingula to the mandibular canal. ResultsWe founded the postoperative sensory disturbances of lower lip in 138 sides among 200 sides. The disturbances were recognized most in a range from 1.0 mm to 2.0 mm. Those disturbances decreased with time and only remained 23 sides after six months postoperative. At the time, the disturbances were recognized most in a range from 1.0 mm to 2.0 mm. We founded the postoperative sensory disturbances of lower lip in 138 sides among 200 sides. The disturbances were recognized most in a range from 1.0 mm to 2.0 mm. Those disturbances decreased with time and only remained 23 sides after six months postoperative. At the time, the disturbances were recognized most in a range from 1.0 mm to 2.0 mm. ConclusionIt was suggested that there are correlation in the relations between postoperative sensory disturbances of lower lip and anatomical positions of mandibular canals. It was suggested that there are correlation in the relations between postoperative sensory disturbances of lower lip and anatomical positions of mandibular canals.

Macroscopic Anatomy of the Sphenomandibular Ligament Related to the Inferior Alveolar Nerve Block

We performed macroscopic observations of the sphenomandibular ligaments, and measured the space that is surrounded by the mandibular ramus and the ligament by using computed tomography. The materials used in this study were 40 heads of 40 adult cadavers. The cadaver head was cut on the mid sagittal plane. The medial pterygoid muscles of the cadavers were removed to observe the ligaments. The attaching style of the sphenomandibular ligament to the mandibular ramus was classified into three types: Type I (5 in 40 samples; attached only to the mandibular lingula), Type II (12 in 40 samples; attached to the mandibular lingula and extended toward the rear part of the internal surface of the mandibular ramus), and Type III (23 in 40 samples; attached to the mandibular lingula and toward the posterior border of the mandibular ramus). There was no statistical difference in the length of the ligament among the three types. However, Type III showed the largest width, and the space was approximately eight and three times as large as those of Type I and II, respectively. This indicated that the Type III ligament covered a larger area over the mandibular foramen than Type I. These results suggest that the three-dimensional morphology of the sphenomandibular ligament, as represented by Type III, may affect the effectiveness of anesthesia.

Mandibular anatomy related to sagittal split ramus osteotomy in Koreans.

Sagittal split ramus osteotomy (SSRO) is one of the surgical techniques used to correct mandibular deformities. In order to prevent many surgical anatomical problems, we observed the anatomical structures related to SSRO. In dry mandibles of Koreans, lingular tips were located somewhat posteriorly and superiorly on the mandibular ramus. On the coronal sections of mandible, the mean cortical width of facial cortex was increased toward the ramus region while the lingual cortex was thinnest in the ramus region. On the same sections, all the fusion points of the buccal and lingual cortical plate were located above the mandibular lingula and beneath the mandibular notch. So, performing the SSRO on Koreans, medial horizontal osteotomy should be done through the superior aspect of the mandibular lingula. The cut line is extended 5-8 mm posterior to the mandibular lingula to preserve sufficient cortical width to strengthen the involved osseous segments and reduce possible surgical complications.

Gerodermia osteodysplastica: Report on two patients and surgical correction of facial deformity

We present four individuals with Gerodermia Osteodysplastica in a Jewish family from Morocco confirming the autosomal recessive inheritance of the disorder. Three previously unreported findings are described: a) enlarged funnel-shaped mandibular lingula; b) extension of the mandibular premolar and molar roots below the inferior dental canal, and of the second molars into the lower border of mandibular cortical bone; and c) hypercementosis of the maxillary incisors and mandibular molars surrounded by a radiolucent halo in several teeth. The facial deformity resulting from maxillary hypoplasia and mandibular prognathism was corrected by orthognathic surgery: Le Fort I maxillary osteotomy and vertical mandibular osteotomy.

Development of the human sphenomandibular ligament.

The development and arrangement of the sphenomandibular ligament of 60 human embryos and fetuses were studied. Meckel's cartilage appeared as a single, continuous fibrous structure lying between the mandibular lingula and the malleus of the middle ear in fetuses of 210 mm crown-rump length (22 weeks of age) and over. This structure constitutes the malleolomandibular ligament, and two clearly differentiated portions bound by the tympanosquamosal fissure could be seen: a juxtaarticular portion, inserted on the posterior edge of the interpterygoid aponeurosis, and a tympanic portion, onto which the disc of the temporomandibular joint inserted. Some of the authors consider that if tension is applied to the sphenomandibular ligament this may injure the middle ear. The anatomical arrangement of the sphenomandibular ligament could explain these injuries.

Trigeminal neuralgia—treatment of the third division by radiologically controlled cryoblockade of the inferior dental nerve at the mandibular lingula: A study of 31 cases

Cryoblockade of the peripheral nerve affected by trigeminal neuralgia is an established technique for treatment. Freezing the inferior dental nerve using C-arm image-intensification control, and a nerve stimulator to guide the slim Spembly Lloyd probe, offers an additional technique for treatment of a small number of patients with trigeminal neuralgia. This paper reports the results of 31 cryoblockades of the inferior dental nerve in 11 patients.

An analysis of the variations in position of the greater palatine foramen in the adult human skull.

Three hundred dry, adult human skulls, of East Indian ethnic background, and homogenous in arch form and full eruption of third molars, were examined to measure the location of the greater palatine foramen. The greater palatine foramen was found consistently to lie 1.5 cm from the palatal midline and 0.19 cm from the posterior border of the hard palate. This relationship is suggested as a more accurate method of locating the foramen clinically. The usually accepted description (opposite the second molar) of the relative position of the greater palatine foramen to the upper teeth held in only 9.7% of the skulls studied. This study shows the most common position of the foramen to be opposite or distal to the third molar (57%). The direction of opening of the foramen into the oral cavity was observed to be in an inferior or vertical direction in 247 (82%) of the 300 skulls; in 53 (18%) of the skulls the direction was anterior or horizontal. A bony projection, similar to the mandibular lingula, was observed extending from the posterior margin of the foramen in 95 (16%) of the 600 separate foramina examined. The bilateral symmetry between the sides of the skulls studied was remarkable.

The cranial attachment of the sphenomandibular (tympanomandibular) ligament.

AbstractThe sphenomandibular (tympanomandibular) ligament develops from Meckel's cartilage between the future petrotympanic fissure and the mandibular lingula. The superior attachment of this ligament has been described to attach to the sphenoidal spine.Fifty‐one cadaver half heads were dissected to study the superior attachment of this ligament. Forty‐five of the 51 ligaments were found to be attached in the area of the petrotympanic fissure, not directly to the sphenoidal spine. Six of the specimens had a thin fibrous slip which fanned out medially to the sphenoidal spine.Twelve additional cadaver specimens were decalcified and cut in various planes through the temporomandibular joint. All specimens showed a fibrous continuation of the ligament through the petrotympanic and/or squamotympanic fissures with an attachment to the malleus in the middle ear. When tension was applied to the ligament the malleus was seen to move.A 115 mm human fetus head was dissected. A ligamentous structure was seen to run from the medial side of the mandibular ramus to the future squamotympanic fissure area. When observed microscopically the ligament was continuous through the fissure and attached to the malleus.