Study of Mandibular Foramen in Adult Human Mandible Bones: An Osteological Study

Introduction: The mandibular foramen is located on the medial surface of the ramus of mandible through which inferior alveolar nerve and vessels pass and supply the lower jaw. For dentists inferior alveolar nerve block is important to anesthetize the lower jaw for conducting various surgical procedures. Aims: To determine the accurate position of mandibular foramen through which inferior alveolar nerve and vessels were passing and supply the lower jaw and its clinical importance. Methods: This study was conducted on 35 dry mandible bones consisting of 70 mandibular foramens of unknown sex. All the important parameters were studied using vernier caliper. Results: The mean distance of mandibular foramen from mandibular notch was 21.00 mm on right side and 20.29 mm on left side, from posterior border was 12.63 mm on right side and 12.37 mm on left side, from angle of mandible was 20.60 mm on right side and 20.46 mm on left side, from base of the mandible was 23.57 mm on right side and 23.6 mm on left side, from anterior border was 16.74 mm on right side and 16.89 mm on left side. Conclusion: The accurate position of mandibular foramen varies. The knowledge of the average distance of mandibular foramen from various landmarks is useful for dental anesthesia and also helps to avoid complications.

Topographical Landmarks for Identification of Inferior Alveolar Nerve and its Surgical Implications - a Cadaveric Study

Background: Inferior alveolar nerve, which arises from the posterior division of the mandibular nerve, contains both sensory and motor fibres. The intraosseous course of the nerve is variable. Mandibular foramen is situated on the medial surface of the mandibular ramus. It is an important anatomical landmark for procedures like sagittal split osteotomies and inferior alveolar nerve block.Methods: The precise location of mandibular foramen was studied by the dissection of formalin fixed cadavers available for undergraduate dissection for a period of two years fron 2014-2016. Results: The mandibular foramen was 21±3.33 mm superior to the gonion at an angle of 980±50 with the base of the mandible. The mandibular foramen was 20.13±3.1 mm inferior to the lowest point of the mandibular notch. Accessory mandibular foramen was observed in 9.37% of the samples dissected.Conclusion: The present study explains the position of mandibular foramen in relation to prominent bony landmarks and the knowledge about the mandibular foramen, helps dental surgeons during inferior alveolar nerve blocks and split osteotomies.Practical implications: Failure rate of the inferior alveolar nerve block has been reported to be approximately 20-25%. A thorough anatomical knowledge of the mandibular ramus is essential for inferior alveolar nerve blocks and sagittal split osteotomies, since they are technically difficult procedures and as they are also associated with a higher incidence of complications.

Gross Morphological and Sex Wise Morphometrical Studies on Mandible of Adult Blue Bull (Boselaphus tragocamelus)

Background: The Blue bull (Boselaphus tragocamelus) is one of the biggest antelopes in Asia and is widely distributed in both the forests and adjoining villages with enough green grass.Methods: The present study was carried out on the mandible of six specimens of adult Blue bull (Boselaphus tragocamelus) of either sex. The biometrical parameters were measured by scale, graduated tape and digital Vernier’s caliper. The statistical analysis of the recorded data was done by independent samples t-Test with Systat Software Inc, USA and SPSS 16.0 version software.Result: The mandible of Blue bull consisted of two rami, i.e. horizontal and vertical rami. The two halves of this bone fused incompletely at the mandibular symphysis, situated at the midline. The average length of horizontal ramus of mandible was found to be 24.7±1.02 cm in female, which was significantly less (P less than 0.05) than that of males, where it was recorded as 35.4±1.97 cm. Similarly, the average thickness of vertical ramus at the base was found to be 0.53±0.001 cm in female, which was significantly less (P less than 0.05) than that of males, where it was recorded as 0.80±0.002 cm. The average cranio-caudal length of mandibular notch was found to be 1.32±0.01 cm in female, which was significantly less (P less than 0.05) than that of males, where it was recorded as 1.44±0.02 cm. Most of the biometrical observations on different parameters of mandible of Blue bull were having significantly (P less than 0.05) more values in males than females. Conclusion: Most of the biometrical observations on different parameters of mandible of Blue bull were having significantly (p less than 0.05) more values in males than females. The present gross and biometrical studies would be useful to the wild life professionals for determination of sex of this animal and solving vetero-legal cases related with this species.

Mandibular foramen location

Objective: This study proposed to locate the mandibular foramen position by using cone beam computed tomography (CBCT) imaging, based on landmarks used at inferior alveolar nerve block (IANB) technique in order to increase the success rate of this procedure. Materials and methods: 58 mandibular foramina of 29 adult patients were evaluated. Linear and angular CBCT measurements were defined for the mandibular foramen based on the IANB technique. The measurements were performed by two radiologists. Data analyses consisted of verifying the normality, obtaining the mean value of all patients and comparing the data obtained between male and female patients. Results: Student’s t and Mann-Whitney’s U tests were used to calculate the mean mandibular foramen position. The three mean position measurements of the mandibular foramen were 13.5 mm above the occlusal plan (15.5 mm for male and 11.7 mm for female patients), 14.6 mm below the mandibular notch (14.9 mm for male and 13.7 mm for female patients) and 14.2 mm from the anterior border of mandibular ramus (14.6 mm for male and 13.8 mm for female patients). The angle formed by the molar lines and contralateral premolar lines was 25.8° and the angle formed by the molar lines and contralateral second premolar/molar lines was 31.5°. Conclusion: CBCT images were a useful method to provide the measurements of the mandibular foramen position based on landmarks used by the IANB technique. We encourage the use of these measurements as reference to increase the clinical success when performing the IANB technique.

Gambaran multilokular ameloblastoma dengan pola soap-bubble dan kajian pustaka mengenai variasi gambaran radiografi ameloblastoma

Objectives: Ameloblastoma is classified as unicystic, multicystic and solid based on its characteristic. This article is aimed to report a case of ameloblastoma in posterior mandibula, analyze its radiographic appearance and emphasize on describing its other available variations. Case Report: A 39-years-old male patient came to Dadi Keluarga Hospital Purwokerto with complaint of swelling on the posterior lower jaw. The swelling was painless and has been felt since 4 years ago. Asymmetrical face was discovered. On panoramic radiograph, a well-defined radiolucent mass appears with radiopaque septation in the posterior region, the teeth were depressed, the lesion has expanded to the left coronoid process and mandibular notch. Conclusion: Based on panoramic radiographic examination the image of ameloblastoma in this case is seemed as multilocular in the posterior region, expanding to the left posterior and imaging of multilocular ameloblastoma on the left posterior region showing destruction of coronoid process and mandibular notch with soap-bubble pattern.

Feasibility of Using Masticatory Muscles to Assess Skeletal Muscle Mass in Patients with Oral Cavity Cancer

Background Sarcopenia is typically assessed using abdominal computed tomography (CT) scans, which are not obtained routinely in patients with oral cavity cancer. In order to investigate the feasibility of using masticatory muscles to assess general skeletal muscle mass (SMM) in oral cancer patients, we aimed to correlate the masticatory SMM evaluated on head and neck CT-images with the SMM measurement at the level of L3 on abdominal CT-scans. Methods The abdominal and head and neck CT-scans of the oral cavity squamous cell carcinoma (OSCC, n = 54) and trauma (n = 50) patients were analyzed retrospectively. All muscles at the L3 level were delineated on abdominal CT scans, and skeletal muscles at the mandibular notch level and C3 level were delineated on head and neck CT scans. Cross-sectional area (CSA) of the muscles at the mandibular notch and C3 level were compared to skeletal muscle CSA at the L3 level using linear regression, and a multivariate linear regression model was also calculated. Results The OSCC patients had significantly smaller muscle CSA at the mandibular notch level than trauma patients (1221.4 vs. 1512.2 mm2, p = 0.006). Masticatory muscle CSA strongly predicted the L3 muscle CSA (r = 0.880, p < 0.001), and this correlation was stronger in the multivariate model including age, body weight, and sex (r = 0.898, p < 0.001). Conclusions Evaluation of the masticatory skeletal muscle mass on head and neck CT images is simple, feasible, and may be an alternative to abdominal CT scans. Assessment of masticatory muscle at mandibular notch can be performed using routinely obtained scans without additional imaging or cost. Identifying patients at risk of being sarcopenic may select oral cancer patients for nutritional intervention and appropriate treatment modality to improve their prognosis.

Evaluation of the mandibular notch angle in three-dimensional virtual models as a parameter for determining age and sexual dimorphism

<p><strong>Objective</strong>: The objective of this study was to analyze the opening of the mandibular notch angle (MNA) as a possible tool for predicting sex and estimating age so as to contribute to forensic anthropological studies. <strong>Material and Methods</strong>: For this, 60 cone beam computed tomographs (CBCT) belonging to the UNESP ICT Radiology archive, were selected: 5 female and 5 male for each decade of life, beginning on twenties until there seventies, totalizing 30 female and 30 male. Three-dimensional models were generated for each exam and measurements were performed with three-dimensional angular measuring tools using OnDemand 3D software (Cybermed Inc., Tustin, CA, USA) on the MNA. The MNA was measured considering the posteriormost portion of the coronoid process, the lowest point of the mandibular notch, and the anteriormost point of the condylar process of the mandible. The Mann-Whitney test was performed with the intention of establishing the possible comparative relationships between the values of angular measurements and sex. <strong>Results</strong>: No statistically significant differences were found between mandibular incision measurements in both sexes, as well as when comparing the angular measurements of the mandibular incisions and the different age groups studied, when a Kruskall-Wallis test was performed. <strong>Conclusion</strong>: It was concluded that the structure being evaluated did not appear to be an instrument capable of contributing to forensic anthropology evaluations.</p><p><strong>Keywords</strong>:</p><p> X-ray computed tomography; Forensic anthropology; Legal dentistry; Determination of age by skeleton; Analysis for determination of sex.</p>