Morphometric study of lingual foramina in macerated mandibles to assist in implant placement in the anterior mandibular region
Abstract
The object of our study was to contribute to anatomical knowledge of this region with data on the prevalence, number and location of lingual foramina (LF) in dentate and edentate macerated mandibles from Brazilian individuals, differentiating them by sex and race. In this way we hope to help dental surgeons with their planning prior to implant placement in the anterior mandibular region. 103 macerated mandibles were analysed. The prevalence, number and location of LF were analysed in the median (MLF) and lateral (LLF) regions and the median (AMLF) and lateral (ALLF) alveolar process regions. Measurements for their location were taken with a digital calliper. 99% of the mandibles presented at least 1 MLF, 82.5% at least 1 LLF, and the frequency of ALLF was 67%. In dentate mandibles, MLF were located in the region superior to the genial spine, and in edentate mandibles in the regions superior and inferior to the genial spine. LLF were located in the middle region in both dentate and edentate mandibles. The height of the symphysis was significantly greater in dentate than in edentate cases. The distance from the alveolar crest (AC) to the MLF was significantly greater in dentate than in edentate mandibles. LF are constant structures, with MLF found more frequently than LLF. Mandibles which present a smaller measured distance from the base of mandible to AC present MFL and LLF closer to AC, implying a greater risk of complication during implant placement. (Folia Morphol 2018; 77, 2: 310–322)
Keywords: lingual foraminamandibleimplant placementmorphometry
References
- Alves N, Cândido PL. Anatomia para o curso de odontologia geral e específica. 4ª Ed. Gen-Santos, São Paulo 2016.
- Flanagan D. Important arterial supply of the mandible, control of an arterial hemorrhage, and report of a hemorrhagic incident. J Oral Implantol. 2003; 29(4): 165–173.
- Friberg B, Jemt T, Lekholm U. Early failures in 4,641 consecutively placed Brånemark dental implants: a study from stage 1 surgery to the connection of completed prostheses. Int J Oral Maxillofac Implants. 1991; 6(2): 142–146.
- Hofschneider U, Tepper G, Gahleitner A, et al. Assessment of the blood supply to the mental region for reduction of bleeding complications during implant surgery in the interforaminal region. Int J Oral Maxillofac Implants. 1999; 14(3): 379–383.
- Ivanoff CJ, Gröndahl K, Bergström C, et al. Influence of bicortical or monocortical anchorage on maxillary implant stability: a 15-year retrospective study of Brånemark System implants. Int J Oral Maxillofac Implants. 2000; 15(1): 103–110.
- Kalpidis CD, Konstantinidis AB. Critical hemorrhage in the floor of the mouth during implant placement in the first mandibular premolar position: a case report. Implant Dent. 2005; 14(2): 117–124.
- Katranji A, Misch K, Wang HL. Cortical bone thickness in dentate and edentulous human cadavers. J Periodontol. 2007; 78(5): 874–878.
- Kawai T, Asaumi R, Sato I, et al. Classification of the lingual foramina and their bony canals in the median region of the mandible: cone beam computed tomography observations of dry Japanese mandibles. Oral Radiology. 2007; 23(2): 42–48.
- Kim H, Choi B, Lee H, et al. Morphological study of the mental spine, lingual foramen and nutrient foramen and innominate foramen in Korean mandibles. Korean J Phys Anthropol. 1993; 6(1): 129–140.
- Kingsmill VJ, Boyde A. Variation in the apparent density of human mandibular bone with age and dental status. J Anat. 1998; 192 ( Pt 2): 233–244.
- Kusum CK, Mody PV, Nooji D, et al. Interforaminal hemorrhage during anterior mandibular implant placement: An overview. Dent Res J (Isfahan). 2015; 12(4): 291–300.
- Liang X, Jacobs R, Lambrichts I, et al. Lingual foramina on the mandibular midline revisited: a macroanatomical study. Clin Anat. 2007; 20(3): 246–251.
- Lustig JP, London D, Dor BL, et al. Ultrasound identification and quantitative measurement of blood supply to the anterior part of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96(5): 625–629.
- Mason ME, Triplett RG, Alfonso WF. Life-threatening hemorrhage from placement of a dental implant. J Oral Maxillofac Surg. 1990; 48(2): 201–204.
- McDonnell D, Reza Nouri M, Todd ME. The mandibular lingual foramen: a consistent arterial foramen in the middle of the mandible. J Anat. 1994; 184 ( Pt 2): 363–369.
- Mordenfeld A, Andersson L, Bergström B. Hemorrhage in the floor of the mouth during implant placement in the edentulous mandible: a case report. Int J Oral Maxillofac Implants. 1997; 12(4): 558–561.
- Motoyoshi M, Inaba M, Ono A, et al. The effect of cortical bone thickness on the stability of orthodontic mini-implants and on the stress distribution in surrounding bone. Int J Oral Maxillofac Surg. 2009; 38(1): 13–18.
- Murlimanju BV, Prakash KG, Samiullah D, et al. Accessory neurovascular foramina on the lingual surface of mandible: incidence, topography, and clinical implications. Indian J Dent Res. 2012; 23(3): 433.
- Natsis K, Repousi E, Asouhidou I, et al. Foramina of the anterior mandible in dentate and edentulous mandibles. Folia Morphol. 2016; 75(2): 204–210.
- Przystańska A, Bruska M. Anatomical classification of accessory foramina in human mandibles of adults, infants, and fetuses. Anat Sci Int. 2012; 87(3): 141–149.
- Przystańska A, Bruska M. Foramina on the internal aspect of the alveolar part of the mandible. Folia Morphol. 2005; 64(2): 89–91.
- Ratschew C, Czernicky W, Watzek G. Life threatening hemorrhage during placement of dental implants in the mandible. A case report. Deutsch Zahnärtztliche Zeitschrift. 1994; 49: 67–67.
- Rosano G, Taschieri S, Gaudy JF, et al. Anatomic assessment of the anterior mandible and relative hemorrhage risk in implant dentistry: a cadaveric study. Clin Oral Implants Res. 2009; 20(8): 791–795.
- Woo BM, Al-Bustani S, Ueeck BA. Floor of mouth haemorrhage and life-threatening airway obstruction during immediate implant placement in the anterior mandible. Int J Oral Maxillofac Surg. 2006; 35(10): 961–964.
- Worthington P, Bolender CL, Taylor TD. The Swedish system of osseointegrated implants: problems and complications encountered during a 4-year trial period. Int J Oral Maxillofac Implants. 1987; 2(2): 77–84.
