Radiographic localization of mandibular anesthesia landmarks

doi:10.1016/S1079-2104(98)90131-7

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology

Volume 86, Issue 2, August 1998, Pages 234-241

https://doi.org/10.1016/S1079-2104(98)90131-7 Get rights and content

Abstract

The objective of this study was to assess whether bony landmarks used for the standard inferior alveolar nerve block can be used to accurately determine the position of the mandibular foramen and whether panoramic radiographs are appropriate for this purpose. A total of 11 landmarks from 79 panoramic radiographs and 70 corresponding cases of oblique (45-degree) cephalometric radiographs were examined. Ten measurements of the distance from each landmark to the mandibular foramen, as well as 6 ratios from these distances, were calculated from all radiographs. The results showed that the position of the mandibular foramen was highly individualistic and not consistently related to traditional clinical landmarks. Panoramic radiographs were as good as oblique cephalometric radiographs for the locating of the mandibular foramen. No age or gender correlations were found. It was concluded that the mandibular foramen can be localized in panoramic radiographs but that its relation to bony landmarks is highly variable.

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Cited by (77)

Sexual dimorphism and mandibular foramen: A CT-Scan study in a sample of Cameroonian population; clinical features
2021, Advances in Oral and Maxillofacial Surgery
The mandibular foramen (MF) is an important anatomical structure during procedures such as anesthesia of the inferior alveolar nerve and surgical acts, including mandibular osteotomies. Many authors have shown that it is essential to know the morphometric characteristics of the MF because the inferior alveolar nerve which passes through it could be damaged in dental practice or explain a failure of anesthesia. Our objective is to determine the morphometric characteristics of the mandibular foramen as a function of sex in a population of Cameroonian individuals.
A retrospective study of CT scans of the craniofacial mass was carried out at the Yaoundé central hospital and at the Yaoundé cathedral medical center. We collected socio-demographic data and 05 dependent variables on 210 hemi mandibles (distance from the MF to the anterior edge, to the posterior edge, to the mandibular notch, to the basilar rim and to the molar occlusal plane). Student's t-test was used for data analysis with a significance level P < 0.05.
In total, it was 105 CT of the craniofacial mass of Cameroonian subjects, ie 74.2% of men and 25.8% of women. The MF was bilateral in all of our participants in our survey and positioned 19.4 mm from the anterior edge of the mandible in men and 19.2 mm in women. In our sample, 25.8% of subjects presented a left accessory mandibular foramen.
the MF delivers passage to the inferior alveolar nerve which is called upon during anesthesia by trunk block. This study showed differences in the location of the mandibular foramen with measurements taken in Caucasian individuals.
Intraosseous Anesthesia Using Dynamic Navigation Technology
2020, Journal of Endodontics
Citation Excerpt :
Primary IANB anesthetic techniques heavily rely on the neuroanatomic landmarks of the trigeminal nerve. After mucosal penetration, the delivery is completed in a blind manner without a lot of room to manipulate according to the variations in anatomy31. In the presence of heavy buccal fat and flaring of the ramus of the mandibular, the risks of hematoma, trismus, and postoperative paresthesia or neuralgia can be substantial32,33.
This study presents a novel method to deliver intraosseous anesthesia using dynamic navigation technology. The study aimed to evaluate its safety and 3-dimensional (3D) accuracy in comparison to traditional freehand injection of intraosseous anesthesia.
Six identical sets of 3D-printed surgical jaw models (TrueJaw; DELendo, Santa Barbara, CA) comprising simulated alveolar and dental anatomy with 54 interradicular sites were used in this study. The injection sites were equally distributed based on the range of the inter-radicular distance (ie, 1.5–2.5 mm, 2.5–3.5 mm, and 3.5–4.5 mm). A board-certified endodontist randomly completed intraosseous drilling at inter-radicular sites of varying distance using freehand technique and the Navident dynamic navigation system (ClaroNav, Toronto, Ontario, Canada) with the X-Tip system (Dentsply Sirona, York, PA). The rate of root perforation associated with inter-radicular distance was compared between the 2 groups using the Fisher exact test. Two-dimensional (2D) and 3D horizontal, vertical, and angulation discrepancies between the planned and dynamically navigated guide sleeves were digitally measured using superimposed cone-beam computed tomographic scans. Analysis of variance models were used to determine if the interdental distance was associated with the accuracy measures from the dynamic navigation system. The significance level was set at 0.05.
The rate of root perforation was significantly higher for the freehand group than the dynamic navigation (22% vs 0%, P < .05). For dynamic navigation, the 2D entry deviation was 0.71 mm (95% confidence interval [CI], 0.56–0.87). The mean 2D horizontal deviation was 0.96 mm (95% CI, 0.79–1.14), and the mean 2D vertical deviation was 0.70 mm (95% CI, 0.55–0.84). The 3D deviation at the tip was on an average 1.23 mm (95% CI, 1.05–1.42). The overall 3D angular deviation was on average 1.36° (95% CI, 1.15–1.56). The inter-radicular distance was not significantly associated with any 2D or 3D discrepancies.
Successful and accurate drilling of dynamically navigated intraosseous delivery occurred in 100% of injection sites irrespective of the inter-radicular distance. It was significantly safer in comparison to freehand intraosseous drilling to prevent injury of the roots of the adjacent teeth in close proximity.
Is the inferior occlusal plane a reliable anatomic landmark for inferior alveolar nerve block? A study on dry mandibles of Brazilian adults
2020, Morphologie
Citation Excerpt :
Successful local anesthesia is paramount to most dental procedures. Despite the techniques for maxillary teeth being considered relatively easy and simple, the ones for mandibular teeth are admittedly more complex and challenging [1,2]. The inferior alveolar nerve block (IANB), or Halsted block, is the more common mandibular regional anesthesia.
To investigate the relationship between the mandibular foramen (MF) and the inferior occlusal plane (IOP) of anatomic specimens, in order to guide clinicians in the inferior alveolar nerve block (IANB).
Eighty-two dry mandibles (totally or partially toothed) of Brazilian adults were selected, totalizing 66 left and 66 right antimeres. A flat plate of rigid PVC plastic was placed on the occlusal surfaces of posterior teeth and pressure was then manually applied to simulate the IOP. Following, the perpendicular distance from the IOP to the lowest point of the MF was measured by the use of a digital caliper, adopting negative values inferiorly and positive values superiorly.
Regarding the antimeres, the majority of the lowest limits of the MF was below the IOP (right: 86.4%, left: 81.8%) with a mean of −4.2 mm (± 4.8) in the right and −4.1 mm (± 4.8) in the left ones, without any statistical significance. Considering both sexes, no statistically significant difference was obtained between them.
The IOP seems not to be a good anatomical landmark to localize the MF and, its turn, to guide clinicians during the IANB for Brazilian adults, given the marked topographic variations.
Étudier la relation entre le foramen mandibulaire (FM) et le plan occlusal inférieur (POI) des spécimens anatomiques, afin de guider les cliniciens dans le bloc nerveux alvéolaire inférieur (BNAI).
Quatre-vingt-deux mandibules sèches (totalement ou partiellement dentées) d’adultes brésiliens ont été sélectionnées, totalisant 66 antimères gauches et 66 antimères droits. Une plaque plate en plastique PVC rigide a été placée sur les surfaces occlusales des dents postérieures et une pression a ensuite été appliquée manuellement pour simuler le POI. Ensuite, la distance perpendiculaire entre la POI et le point le plus bas de la FM a été mesurée à l’aide d’un pied à coulisse numérique, en adoptant des valeurs négatives inférieures et des valeurs positives supérieurs.
En ce qui concerne les antimères, la majorité des limites inférieures de la FM était inférieure à la POI (droite : 86,4 %, gauche : 81,8 %) avec une moyenne de −4,2 mm (± 4,8) à droite et de −4,1 mm (± 4,8) dans ceux de gauche, sans aucune signification statistique. Considérant les deux sexes, aucune différence statistiquement significative n’a été retrouvée
La POI ne semble pas être un bon repère anatomique pour localiser la FM et, à son tour, guider les cliniciens lors de la BNAI pour les adultes brésiliens, compte tenu des variations topographiques marquées.
Position of the mandibular foramen in relation to the occlusal plane in children with skeletal class malocclusion
2024, European Journal of Anatomy
The location of mandibular foramen relative to the occlusal plane: a study on anatolian dry mandible
2024, European Oral Research
Position of the mandibular foramen in relation to the occlusal plane in children with skeletal class malocclusion
2023, Research Square

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^☆: These data were presented at the 1998 meeting of the American Association for Dental Research.

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Radiographic localization of mandibular anesthesia landmarks☆

Abstract

J Am Dent Assoc

J Oral Maxillofac Surg

J Am Dent Assoc

J Am Dent Assoc

J Am Dent Assoc

Oral Surg Oral Med Oral Pathol

Oral Surg Oral Med Oral Pathol

Oral Surg Oral Med Oral Pathol

Oral Surg Oral Med Oral Pathol

Am J Orthod Dentofacial Orthop