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      Morphometric study on mandibular foramen and incidence of accessory mandibular foramen in mandibles of south Indian population and its clinical implications in inferior alveolar nerve block

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          Abstract

          The mandibular foramen is a landmark for procedures like inferior alveolar nerve block, mandibular implant treatment, and mandibular osteotomies. The present study was aimed to identify the precise location of the mandibular foramen and the incidence of accessory mandibular foramen in dry adult mandibles of South Indian population. The distance of mandibular foramen from the anterior border of the ramus, posterior border of the ramus, mandibular notch, base of the mandible, third molar, and apex of retromolar trigone was measured with a vernier caliper in 204 mandibles. The mean distance of mandibular foramen from the anterior border of ramus of mandible was 17.11±2.74 mm on the right side and 17.41±3.05 mm on the left side, from posterior border was 10.47±2.11 mm on the right side and 9.68±2.03 mm on the left side, from mandibular notch was 21.74±2.74 mm on the right side and 21.92±3.33 mm on the left side, from the base of the ramus was 22.33±3.32 mm on the right side and 25.35±4.5 mm on the left side, from the third molar tooth was 22.84±3.94 mm on the right side and 23.23±4.21 mm on the left side, from the apex of retromolar trigone was 12.27±12.13 mm on the right side and 12.13±2.35 mm on the left side. Accessory mandibular foramen was present in 32.36% of mandibles. Knowledge of location mandibular foramen is useful to the maxillofacial surgeons, oncologists and radiologists.

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          Morphometric analysis of implant-related anatomy in Caucasian skulls.

          Sequelae related to implant placement/advanced bone grafting procedures are a result of injury to surrounding anatomic structures. Damage may not necessarily lead to implant failure; however, it is the most common cause of legal action against the practitioner. This study aimed to describe morphological aspects and variations of the anatomy directly related to implant treatment. Morphometric analyses were performed in 22 Caucasian skulls. Measurements of the mental foramen (MF) included height (MF-H), width (MF-W), and location in relation to other known anatomical landmarks. Presence or absence of anterior loops (AL) of the inferior alveolar nerve (IAN) was determined, and the mesial extent of the loop was measured. Additional measurements included height (G-H), width (G-W), thickness (G-T), and volume (G-V) of monocortical onlay grafts harvested from the mandibular symphysis area, and thickness of the lateral wall (T-LW) of the maxillary sinus. The independent samples t test, and a two-tailed t test with equal variance were utilized to determine statistical significance to a level of P < 0.05. Multiple regression analyses were performed to determine if each one of these measurements was affected by age and gender. The most common location of the MF in relation to teeth was found to be below the apices of mandibular premolars. The mean MF-H was 3.47 +/- 0.71 mm and the mean MF-W was 3.59 +/- 0.8 mm. The mean distance from the MF to other anatomical landmarks were: MF-CEJ = 15.52 +/- 2.37 mm, MF to the most apical portion of the lower cortex of the mandible = 12.0 +/- 1.67 mm, MF to the midline = 27.61+/- 2.29 mm, and MF-MF = 55.23 +/- 5.34 mm. A high prevalence of AL was found (88%); symmetric occurrence was a common finding (76.2%), with a mean length of 4.13 +/- 2.04 mm. The mean size of symphyseal grafts was: G-H = 9.45 +/- 1.08 mm, G-W = 14.5 +/- 3.0 mm, and G-T = 6.15 +/- 1.04 mm, with an average G-V of 857.55 +/- 283.97 mm3 (range: 352 to 1,200 mm3). The mean T-LW of the maxillary sinus was 0.91 +/- 0.43 mm. Implant-related anatomy must be carefully evaluated before treatment due to considerable variations among individuals, in order to prevent injury to surrounding anatomical structures and possible damage.
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            The human mandibular canal arises from three separate canals innervating different tooth groups.

            The purpose of this study was to describe the prenatal formation of the human mandibular canal. Since bony canals develop in prenatal life around the nerve paths, it was assumed that the canal pattern could reflect the pattern of innervation of the dentition. Mapping of this early canal pattern does not appear to have been undertaken before. The material consisted of anthropological mandibles from the National Institute of Anthropology and History, Mexico City. A total of 302 human hemimandibles from the latter half of the prenatal period was investigated. The length, measured from the mental symphysis to the mandibular condyle, ranged from 28 to 60 mm. The dento-alveolar maturity was classified in two stages according to the appearance of alveolar sockets of deciduous and first permanent molars. The mandibles were radiographed with guttapercha points inserted into the canal openings (foramina) on the lingual surfaces of the mandibular rami. The study showed that the canal to the incisors appeared first, followed by the canal to the primary molars, and last by the one or more canals to the first permanent molars. In the most mature group, three different canals always occurred in each hemimandible. The canals were directed from the lingual surface of the mandibular ramus toward the different tooth groups. The inferior alveolar nerve presumably occurs in the mandible as three individual nerve paths originating at different stages of development. It is suggested that rapid prenatal growth and remodeling in the ramus region result in a gradual coalescence of the canal entrances that is obvious at birth. It is hypothesized that the pattern of tooth agenesis within the three groups of teeth is related to the three separate paths of innervation of the dentition.
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              Evaluation of location of mandibular and mental foramina in dry, young, adult human male, dentulous mandibles.

              The present study was undertaken to determine the precise location of the mental and mandibular foramina and the surrounding anatomic landmarks. Measurements were made on both right and left sides of each of 34 dried young Turkish adult (30-40 years old) human male mandibles. The mandibles were moderately robust and were from dentulous subjects. The results obtained in the study showed that the distance of the mandibular foramen to the angle of the anterior ramus were 16.9 mm on the right and 16.78 mm on the left. The distance to the posterior side of the ramus was 14.09 mm on the right, and 14.37 mm on the left. The narrowest anteroposterior diameters were 32.8 mm on the right and 32.05 mm on the left. The mandibular foramen is 0.5 mm posterior to the centre of the ramus on the right and 0.75 mm on the left. The distance of the lowest point of mandibular notch to the foramen was 22.37 mm on the right and 22.17 mm on the left. The distance from the mandibular foramen to the inferior border of the ramus in the mid position of the ramus was 30.97 mm on the right and 29.75 mm on the left. The average angle of the mandible (gonial angle) was 120.17 degrees on both sides. The distance of the mental foramen to the inferior border of the mandible was 14.61 mm and 14.29 mm on the right and left, respectively. Its distance to the superior border was 13.62 mm on the right and 14.62 mm on the left. The horizontal dimensions of the mental foramen was 2.93 mm on the right, 3.14 mm on the left and its vertical dimension was 2.38 mm on the right and 2.64 mm on the left. The mental foramen was located below the root of the second premolar in 21 bones (61.76%) on the right and 17 bones (50%) on the left while in the remaining mandibles, the foramen was present between the roots of the first and second premolars in 13 bones (38.2%) on the right and in 17 (50%) on the left. The average angle of the mental foramen was 96.82 degrees.
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                Author and article information

                Journal
                Anat Cell Biol
                Anat Cell Biol
                ACB
                Anatomy & Cell Biology
                Korean Association of Anatomists
                2093-3665
                2093-3673
                December 2016
                31 December 2016
                : 49
                : 4
                : 241-248
                Affiliations
                [1 ]Department of Anatomy, Dhanalakshmi Srinivasan Medical College and Hospital, Siruvachur, Perambalur, India.
                [2 ]Department of Conservative Dentistry and Endodontics, Adhiparasakthi Melmaruvathur Dental College, Melmaruvathur, India.
                Author notes
                Corresponding author: R. Shalini. Department of Anatomy, Dhanalakshmi Srinivasan Medical College and Hospital, Siruvachur, Perambalur, Tamil Nadu 621212, India. Tel: +98-41657895, liniram80@ 123456yahoo.com
                Article
                10.5115/acb.2016.49.4.241
                5266106
                28127498
                5a256963-a600-4ecc-a663-9f7b657e4b89
                Copyright © 2016. Anatomy & Cell Biology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 03 August 2016
                : 09 September 2016
                : 08 December 2016
                Categories
                Original Article
                Applied Anatomy

                Cell biology
                mandible,mandibular foramen,mandibular notch,accessory mandibular foramen,inferior alveolar nerve block

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