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      Significance of localization of mandibular foramen in an inferior alveolar nerve block

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          Abstract

          Background:

          The mandibular foramen (MF) is an opening on the internal surface of the ramus for divisions of the mandibular vessels and nerve to pass. The aim of this study is to determine the position of the MF from various anatomical landmarks in several dry adult mandibles.

          Materials and Methods:

          A total of 102 human dry mandibles were examined, of which 93 were of dentulous and 9 were of edentulous. The measurements were taken from the anterior border of the ramus (coronoid notch) to the midportion of the MF and then from the midportion of the MF to the other landmarks such as internal oblique ridge, inferior border, sigmoid notch, and condyle were measured and recorded.

          Results:

          The data were compared using Student's t-test. The MF is positioned at a mean distance of 19 mm (with SD 2.34) from coronoid notch of the anterior border of the ramus. Superio-inferiorly from the condyle to the inferior border MF is situated 5 mm inferior to the midpoint of condyle to the inferior border distance (ramus height).

          Conclusion:

          We conclude that failures in the anesthesia of the inferior alveolar nerve are due to the operator error and not due to the anatomical variation.

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          Most cited references23

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          Bifid mandibular nerve as a possible cause of inadequate anesthesia in the mandible.

          Failure to achieve complete mandibular anesthesia is a problem that often occurs. The explanations include faulty anesthetic solutions, faulty technique, and anatomic or physiologic variations. Bifurcation of the mandibular nerve, rarely mentioned in the literature, may be a cause of inadequate anesthesia in a small percentage of cases.
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            A study of the position of the mandibular foramen in the adult human mandible.

            Eighty dry, adult human mandibles of East Indian ethnic origin and bilateral eruption of third molar teeth were examined to measure the location of the mandibular foramen. The position of the foramen was found to be variable. However, the foramen was predominantly located at the anteroposterior midpoint of the ramus halfway between the mandibular notch and the lower surface of the mandible and two thirds of the way down a line joining the coronoid process to the angle of the mandible. In the majority of the mandibles studied the foramen was located below the occlusal surfaces of the molar teeth. It is concluded that the marked variability in the position of the mandibular foramen may be responsible for an occasional failure to block the inferior alveolar nerve.
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              The mandibular foramen: its anteroposterior position.

              This study has been conducted on forty-five Asiatic skulls and sixty-two mixed skulls of black and white Americans to determine the anteroposterior relationship of the mandibular foramen. The mean size of the anterior dimension was greater than the mean size of the posterior dimension of the ramus in all instances. The mandibular foramen was found to be located in the third quadrant anteroposteriorly. The lingula was located just anterior to the mandibular foramen. There was no right- or left-side dominance in the ramus size and position of the mandibular foramen. No appreciable difference was noted in the location of mandibular foramen in the two groups studied.
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                Author and article information

                Journal
                J Nat Sci Biol Med
                J Nat Sci Biol Med
                JNSBM
                Journal of Natural Science, Biology, and Medicine
                Medknow Publications & Media Pvt Ltd (India )
                0976-9668
                2229-7707
                Jul-Dec 2012
                : 3
                : 2
                : 156-160
                Affiliations
                [1] Department of Oral and Maxillofacial Surgery, Vinayaka Mission's Sankaracharya Dental College, Ariyanoor, Salem, Tamil Nadu, India
                Author notes
                Address for correspondence: Dr. K. Thangavelu, Vairam Hospital, EB Colony, Namakkal 637 001, Tamil Nadu, India. E-mail: vairamhealthcare@ 123456yahoo.co.in
                Article
                JNSBM-3-156
                10.4103/0976-9668.101896
                3510910
                23225978
                3a309e96-cf7e-4796-8ddc-dab4293e09dc
                Copyright: © Journal of Natural Science, Biology and Medicine

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Article

                Life sciences
                inferior alveolar nerve,mandible foramen,failure of anesthesia
                Life sciences
                inferior alveolar nerve, mandible foramen, failure of anesthesia

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