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THE STUDY BY USING THE COMPUTERIZED TOMOGRAPHY IMAGING IN ORDER TO ACCESS TO MANDIBULAR FORAMEN WHILE INFERIOR ALVEOLAR NERVE ANESTHESIA  

Kim, Ji-Kwang (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University)
Gu, Hong (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University)
An, Jin-Suk (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University)
Kook, Min-Suk (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University)
Park, Hong-Ju (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University)
Oh, Hee-Kyun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Chonnam National University)
Cho, Jin-Hyoung (Dental Science Research Institute)
Publication Information
Journal of the Korean Association of Oral and Maxillofacial Surgeons / v.32, no.6, 2006 , pp. 566-574 More about this Journal
Abstract
Purpose : This study was performed to provide an anatomical information of the mandibular ramus for the successful inferior alveolar nerve block. Three dimensional images were reconstructed from the computerized tomography (CT) and the anatomical evaluation of the mandibular ramus was done. Materials and methods : Sixty-four patients who had been taken the facial CT scans from 2000, Jan to 2003, June was selected. The patients who had the anterior or posterior teeth misssing, edentulous ridge, and jaw fracture were excepted. In the occulusal plane, the lingual surface angle (LSA) between the mid-sagittal plane and the mandibular molar lingual surface from the 2nd premolar to the 2nd molar, the inner ramal surface angle (IRSA), the maximum inner ramal surface angle (MxIRSA), and the outer ramal surface angle (ORSA) to the-mid sagittal plane were measured. The inner ramal surface angle in the ligular tip level (IRSA-L) and the outer ramal surface angle in the ligular tip level (ORSA-L), the ramal length (RL), and the anterior ramal length (ARL) were also measured in the lingular tip level. Results : In the lingular tip level, the mean IRSA-L and ORSA-L were $28.6{\pm}6.3^{\circ}$ and $17.9{\pm}4.9^{\circ}$ respectively. The larger was the IRSA, the larger was the ORSA. In the lingular tip level, the mean ramal length was 35.8${\pm}$3.4 mm. The larger was the IRSA-L, the shorter was the ramal length. On the lingular tip level, the mean anterior ramal length from anterior ramus to lingular tip was 19.6${\pm}$3.3 mm. when the ramal length was longer, the anterior ramal length was also longer. On the lingular tip level, there was positive correlation vetween the IRSA and the ORSA, negative correlation between the IRSA and the ramal length, and positive correlation between the ramal length and the lingular tip level to the anterior ramus. There was no statistical meaning of data between sex and age. Conclusion : In the clinical view of the results so far achieved, if the direction of needle is closer to posterior it is able to contact bone on lingular tip when the internal surface of ramus is wided outer.
Keywords
Computerized tomography (CT); ORSA; IRSA; LSA; RL; ARL;
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1 Wong MK, Jacobsen PL: Reasons for local anesthesia failures. JADA 1992;123:69-73
2 Robertson WD: Clinical evaluation of mandibular conduction anesthesia. Gen Dent 1979;27:49-51
3 Chapnick I: Nerve supply to the mandibular dentition: a review. J Can Dent Assoc 19804;6:446-448
4 Nicholson MI: A study of the position of the mandibular foramen in the adult human mandible. Anat Rec 1985;212:110-112   DOI   ScienceOn
5 남일우: 한국인의 하악공에 관한 해부학적 연구. 대한치과의사협회지 1964;4:51-58
6 Miranda KS, Wong, Reter L. Jacobsen: Reasons for local anesthesia failure. JADA 1992;123:69-73
7 Schafer EA, Symington J, Bryce TH: Quain's Elements of Anatomy, 11th Ed. Vol. IV, part 1. Longmans, Green & Co. London 1915;104
8 Pataky L Jr: The use of panoramic images in daily routine nerve block analgesia. Fogorvosi Szemle 1998;91:137-141
9 Malamed SF: Handbook of local anesthesia. St. Louis, C.V. Mosby Co 1980;162-163, 181
10 Afsar A, Haas DA, Rossouw PE, Wood RE: Radiographic localization of mandibular anesthesia landmarks. Oral Surg Oral Med Oral Pathol Oral Radiol & Endod 1998;86:234-241   DOI   ScienceOn
11 서병서, 이재훈, 김경욱: 정상교합자와 하악 전돌증 환자에서 panorama상의 하악공의 위치에 대한 비교연구. 대한악안면성형재건외과학회지 2002;24:244-251
12 Grover PS, Lorton L: Bifid mandibular nerve as a possible cause of inadequate anesthesia in the mandible. J Oral Maxillofac Surg 1983;41:177-179   DOI   ScienceOn
13 Hayward J, Richardson ER, Malhorta SK: The mandibular foramen. Its anteroposterior position. Oral Surgery 1979;44:837-843   DOI   ScienceOn
14 Levy TP: An accessment of the Gow-Gates mandibular block for third molar surgery. J Am Dent Assoc 1981;103:37-41   DOI
15 Garg A, Townsend G: Anatomical variation of the sphenomandibular ligament. Aust Endod J 2001;27:22-24   DOI   ScienceOn
16 Last RJ: Anatomy, Regional and Applied, 6th ed. Churchill Livingstone, Edinburgh 1978;572
17 Williams PL, Warwick: Gray's Anatomy, 36th Ed. Churchill Livingstone, Edingburgh 1980;316
18 김형곤, 이의웅, 윤중호: 한국인 성인 하악공의 전후 위치적계측 및 방사선 계측학적 연구. 대한구강악안면외과학회지 1982;8:137-145
19 Miller JA: Studies on the location of the lingular, mandibular foramen & mental foramen. Its anteroposterior position. Oral Surgery 1953;115:349-358
20 Gabriel AC: Some anatomical features of the mandible. J Anat 1958;92:580-586