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      The mandibular plane: a stable reference to localize the mandibular foramen, even during growth

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          Abstract

          Objectives

          The location of the mandibular foramen is essential for the quality of the inferior alveolar nerve block anaesthesia and has often been studied with contradictory results over the years. The aim of this study was to locate the mandibular foramen, according to the dental age of the subject, through 3D analysis.

          Methods

          Three-dimensional images were reconstructed from mandibular computed tomography of 260 children, adolescents and adults. The occlusal plane was determined as the average plane passing through the buccal cusps of mandibular molars, premolars, and canines, and through the incisor edge. The mandibular foramen was located three dimensionally in relation to the anterior edge of the ramus (or coronoid notch), the sagittal plane and the occlusal plane.

          Results

          All along mandibular growth, the three distances defining the relative position of the mandibular foramen showed negligible changes. The mandibular foramen is located from − 0.4 to 2.9 mm above the occlusal plane. The distance between the mandibular foramen and the leading edge of the mandibular ramus ranged from 17 to 19.5 mm. The angle between the ramus and the sagittal plane ranged from 3° to 5.4°.

          Conclusion

          In our sample, and using the occlusal plane and the anterior edge of the ramus as anatomical references, the location of the mandibular foramen was considered to be similar in all patients regardless of age.

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          Most cited references28

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

          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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            Anatomic study of the mandibular foramen, lingula and antilingula in dry mandibles, and its statistical relationship between the true lingula and the antilingula.

            The authors verified the anatomical location of the mandibular foramen, lingula and antilingula in dry mandibles, aiming to obtain information that could be used when performing mandibular osteotomies. Forty-four mandibles (88 sides) were evaluated. The distances were measured using a sliding calliper, with the mandibles fixed in a reproducible position. Results showed that the mandibular foramen is on average 5.82 mm below the lingula. Regarding the statistical comparison between the mandibular foramen entrance and the antilingula position, there is no correlation between the position of those two structures in the studied sample. The mandibular foramen is slightly posterior in relation to the centre of the ramus. The lingula is an important anatomic landmark for ramus surgery, and for determining the distance to the mandibular foramen entrance. The use of the antilingula as a landmark for the position of the vertical ramus osteotomy is not recommended.
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              Failure of inferior alveolar nerve block in endodontics

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                Author and article information

                Contributors
                remi.esclassan@ki.se
                Journal
                Oral Radiol
                Oral Radiol
                Oral Radiology
                Springer Singapore (Singapore )
                0911-6028
                1613-9674
                3 April 2019
                3 April 2019
                2020
                : 36
                : 1
                : 69-79
                Affiliations
                [1 ]GRID grid.411175.7, ISNI 0000 0001 1457 2980, Department of Paediatric Dentistry, Dental Faculty, , Paul Sabatier University and University Hospital of Toulouse, ; Toulouse, France
                [2 ]GRID grid.411175.7, ISNI 0000 0001 1457 2980, Department of Oral Surgery, Dental Faculty, , Paul Sabatier University and University Hospital of Toulouse, ; Toulouse, France
                [3 ]GRID grid.411175.7, ISNI 0000 0001 1457 2980, Department of Prosthodontics, Dental Faculty, , Paul Sabatier University and University Hospital of Toulouse, ; Toulouse, France
                [4 ]GRID grid.15781.3a, ISNI 0000 0001 0723 035X, Molecular Anthropology and Image Synthesis Laboratory (CNRS), UMR 5288 CNRS, Paul Sabatier University, ; Toulouse, France
                [5 ]GRID grid.4714.6, ISNI 0000 0004 1937 0626, Department of Dental Medicine, Karolinska Institutet, ; Huddinge, Sweden
                Author information
                http://orcid.org/0000-0002-6605-9967
                Article
                381
                10.1007/s11282-019-00381-6
                6942014
                30945083
                4cf57902-5255-464b-aa36-db36b72c04c3
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 6 November 2017
                : 12 March 2019
                Categories
                Original Article
                Custom metadata
                © Japanese Society for Oral and Maxillofacial Radiology and Springer Nature Singapore Pte Ltd. 2020

                Radiology & Imaging
                mandibular foramen,mandibular plane,cbct
                Radiology & Imaging
                mandibular foramen, mandibular plane, cbct

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