J Korean Assoc Oral Maxillofac Surg.  2013 Dec;39(6):263-268. 10.5125/jkaoms.2013.39.6.263.

Distribution of the lingual foramina in mandibular cortical bone in Koreans

• Kim DH
• Kim MY
• Kim CH

• KMID: 1960975
• DOI: http://doi.org/10.5125/jkaoms.2013.39.6.263

Abstract

OBJECTIVES
The interforminal region, between the mandibular foramen, is known as a relatively safe area that is free of anatomic structures, such as inferior alveolar nerve, submandibular fossa, and lingual side of the mandible is occasionally neglected for its low clinical importance. Even in the case of a severely constricted alveolus, perforation of the lingual cortical bone had been intended. However, anterior extension of the inferior alveolar canal, important anatomic structure, such as concavity of lingual bone, lingual foramina, and lingual canal, has recently been reported through various studies, and untypical bleeding by perforation of the lingual plate on implantation has also been reported. Therefore, in this study, we performed radiographic and statistical analysis on distribution and appearance frequencies of the lingual foramina that causes perforation of the mandibular lingual cortical bone to prevent complications, such as untypical bleeding, during surgical procedure.
MATERIALS AND METHODS
We measured the horizontal length from a midline of the mandible to the lingual foramina, as well as the horizontal length from the alveolar crest to the lingual foramina and from the lingual foramina to the mandibular border by multi-detector computed tomography of 187 patients, who visited Dankook University Dental Hospital for various reasons from January 1, 2008 to August 31, 2012.
RESULTS
From a total of 187 human mandibles, 110 (58.8%) mandibles had lingual foramina; 39 (20.9%) had bilateral lingual foramen; 34 (18.2%) had the only left lingual foramen; and 37 (19.8%) had the only right lingual foramen.
CONCLUSION
When there is consistent bleeding during a surgical procedure, clinicians must consider damages on the branches of the sublingual artery, which penetrate the lingual foramina. Also, when there is a lingual foramina larger than 1 mm in diameter on a pre-implantation computed tomography, clinicians must beware of vessel damage. In order to prevent these complications and progress with a safe surgical procedure, a thorough radiographic examination before the surgery is indispensable. Further, clinicians should retract lingual flap definitely to confirm the shape of the lingual bone and existence of the lingual foramina.

Keyword

Mandible; Dental implant; Computed tomography; Hemorrhage; Trigeminal nerve injuries

MeSH Terms

Arteries
Dental Implants
Hemorrhage
Humans
Hyoid Bone
Mandible
Mandibular Nerve
Trigeminal Nerve Injuries
Dental Implants

Figure

• 

  Fig. 1 Reference lines used in measurement on the coronal views of multi detector computed tomography. (C: third horizontal reference line, V: vertical reference line, B: second horizontal reference line, A: first horizontal reference line, VD1: vertical distance 1, VD2: vertical distance 2)

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  Fig. 2 Reference lines used in measurement on the axial views of multi detector computed tomography. (M: midline of mandible, H: vertical base line, HD: horizontal distance from midline to lingual foramina)

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  Fig. 3 Vertical distance from mandible border to lingual foramina (vertical distance 2, VD2) according to the distance from the midline.

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