The location of mandibular foramen relative to the occlusal plane: a study on anatolian dry mandible

Abstract

Purpose: The study aims to evaluate the location of mandibular foramen (MF) with respect to the occlusal plane (OP) and its location on the ramus using Anatolian dry mandibles. Materials and Methods: A total of 115 dry mandibles with mandibular molars were analyzed. The distance between the MF and the OP was examined with a flat metal plate. Group A was above the OP; group L was at level, and group B was below the OP. The distances between the MF and anterior border (A-MF), sigmoid notch (U-MF), posterior border (P-MF), and lower border (L-MF) were measured. The symmetry between the two sides was examined. Pearson chi-square and Student's t-test were performed for statistical analysis. Results: According to the analysis, 50.23% of MF was located below the OP (p<0.05). The mean distances of Groups A and B were 3.45 and 4.78 mm, respectively. There was no difference between the left and right in groups (p>0.05). The distance A-MF was 14.71 mm. There was no statistical difference between the distances A-MF and P-MF or U-MF and L-MF. Conclusion: Half of the MF (50.23%) was located below the occlusal plane with a mean distance of 4.78 mm. It may be helpful to place the needle 3-4 mm above the OP and 1.5-2 mm back of the anterior border to obtain a successful inferior alveolar nerve block. The MF was located at the center of the medial surface of the ramus.

Keywords

• anatomy
• mandible
• mandibular foramen
• mandibular nerve
• occlusal plane

References

1. Kaufman E, Weinstein P, Milgrom P. Difficulties in achieving local anesthesia. J Am Dent Assoc 1984;108:205-8. google scholar
2. Sawadogo A, Coulibaly M, Quilodran C, Bationo R, Konsem T, Ella B. Success rate of first attempt 4% articaine para-apical anesthesia for the extraction of mandibular wisdom teeth. J Stomatol Oral Maxillofac Surg 2018;119:486-8. google scholar
3. Malamed SF (2020) Handbook of local anesthesia. 7th edn. Elsevier, St. Louis. google scholar
4. Palti DG, Almeida CMD, Rodrigues ADC, Andreo JC, Lima JEO. Anesthetic technique for inferior alveolar nerve block: a new approach. J Appl Oral Sci 2011;19:11-5. google scholar
5. Hwang TJ, Hsu SC, Huang QF, Guo MK. Age changes in location of mandibular foramen. Zhonghua Ya Yi Xue Hui Za Zhi 1990;9:98-103. google scholar
6. Iwanaga J, Choi PJ, Vetter M, Patel M, Kikuta S, Oskouian RJ, Tubbs RS. Anatomical study of the lingual nerve and inferior alveolar nerve in the pterygomandibular space: complications of the inferior alveolar nerve block. Cureus 2018;10:e3109. google scholar
7. Nicholson ML. A study of the position of the mandibular foramen in the adult human mandible. Anat Rec 1985;212:110-2. google scholar
8. Prado FB, Groppo FC, Volpato MC, Caria PHF. Morphological changes in the position of the mandibular foramen in dentate and edentate Brazilian subjects. Clin Anat 2010;23:394-8. google scholar

9. Palma LF, Almeida FSO, Lombardi LA, Cavalli MA, de Moraes LOC. Is the inferior occlusal plane a reliable anatomic landmark for inferior alveolar nerve block? A study on dry mandibles of Brazilian adults. Morphologie 2020;104:59-63. google scholar
10. Thangavelu K, Kannan R, Kumar NS, Rethish E, Sabitha S, Sayeeganesh N. Significance of localization of mandibular foramen in an inferior alveolar nerve block. J Nat Sci Biol Med 2012;3:156-60. google scholar
11. Al-Shayyab MH. A simple method to locate mandibular foramen with cone-beam computed tomography and its relevance to oral and maxillofacial surgery: a radio-anatomical study. Surg Radiol Anat 2018;40:625-34. google scholar
12. Altunsoy M, Aglarci OS, Ok E, Nur BG, Gungor E, Colak M. Localization of the mandibular foramen of 8-18 years old children and youths with cone-beam computed tomography. J Pediatric Dent 2014;2:44-8. google scholar
13. Blacher J, Van DaHuvel S, Parashar V, Mitchell JC. Variation in location of the mandibular foramen/inferior alveolar nerve complex given anatomic landmarks using cone-beam computed tomographic scans. J Endod 2016;42:393-6. google scholar
14. Feuerstein D, Costa-Mendes L, Esclassan R, Marty M, Vaysse F, Noirrit E. The mandibular plane: a stable reference to localize the mandibular foramen, even during growth. Oral Radiol 2020;36:69-9. google scholar
15. Zhou C, Jeon TH, Jun SH, Kwon JJ. Evaluation of mandibular lingula and foramen location using 3-dimensional mandible models reconstructed by cone-beam computed tomography. Maxillofac Plast Reconstr Surg 2017;39:1-7. google scholar
16. Oguz O, Bozkir MG. Evaluation of location of mandibular and mental foramina in dry, young, adult human male, dentulous mandibles. West Ind Med J 2002;51:14-6. google scholar
17. Mbajiorgu EF, Ekanem AU. A study of the position of the mandibular foramen in adult black Zimbabwean mandibles. Cent Afr J Med 2000;46:184-90. google scholar
18. Mwaniki DL, Hassanali J. The position of mandibular and mental foramina in Kenyan African mandibles. East Afr Med J 1992;69:210-3. google scholar
19. Jansisyanont P, Apinhasmit W, Chompoopong S. Shape, height, and location of the lingula for sagittal ramus osteotomy in Thais. Clin Anat 2009;22:787-93. google scholar
20. Russa A, Fabian F. Position of the mandibular foramen in adult male Tanzania mandibles. Ital J Anat Embryol 2014;119:163-8. google scholar
21. Afsar A, Haas DA, Rossouw PE, Wood RE. Radiographic localization of mandibular anesthesia landmarks. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86:234-41. google scholar
22. Kositbowornchai S, Siritapetawee M, Damrongrungruang T, Khongkankong W, Chatrchaiwiwatana S, Khamanarong K, Chanthaooplee T. Shape of the lingula and its localization by panoramic radiograph versus dry mandibular measurement. Surg Radiol Anat 2007;29:689-94. google scholar
23. Jang HY, Han SJ. Measurement of mandibular lingula location using cone-beam computed tomography and internal oblique ridge-guided inferior alveolar nerve block. J Korean Assoc Oral Maxillofac Surg 2019;45:158-66. google scholar
24. Bunyarit SS, Ying RPY, Kadir BA, Nizam MM, Rahman M. Dental intervention perspective: Anatomical Variation of Mental and Mandibular Foramen in Selected Malay Patients. Bangladesh J Med Sci 2016;15:450-4 google scholar
25. Kang SH, Byun IY, Kim JH, Park HK, Kim MK. Three-dimensional anatomic analysis of mandibular foramen with mandibular anatomic landmarks for inferior alveolar nerve block anesthesia. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:17-23. google scholar
26. Monnazzi MS, Passeri LA, Gabrielli MFR, Bolini PDA, De Carvalho WRS, da Costa Machado H. Anatomic study of the mandibular foramen, lingula and antilingula in dry mandibles, and its statistical relationship between the true lingula and the antilingula. Int J Oral Maxillofac Surg 2012;41:74-8. google scholar
27. Beltrão, P. Treatment of Class II deep overbite with multiloop edgewise arch-wire (MEAW) therapy. Principles in contemporary orthodontics. Rijeka, Croatia: InTech 2011;55-78. google scholar