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http://dx.doi.org/10.5125/jkaoms.2013.39.6.263

Distribution of the lingual foramina in mandibular cortical bone in Koreans  

Kim, Dae Hyun (Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University)
Kim, Moon Yong (Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University)
Kim, Chul-Hwan (Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University)
Publication Information
Journal of the Korean Association of Oral and Maxillofacial Surgeons / v.39, no.6, 2013 , pp. 263-268 More about this Journal
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.
Keywords
Mandible; Dental implant; Computed tomography; Hemorrhage; Trigeminal nerve injuries;
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1 Goldstein BH. Acute dissecting hematoma: a complication of oral and maxillofacial surgery. J Oral Surg 1981;39:40-3.
2 Dreiseidler T, Mischkowski RA, Neugebauer J, Ritter L, Zöller JE. Comparison of cone-beam imaging with orthopantomography and computerized tomography for assessment in presurgical implant dentistry. Int J Oral Maxillofac Implants 2009;24:216-25.
3 Kim HJ, Choi BY, LeeHY, Chung IH. Morphological study of the mental spine, lingual foramen and nutrient foramen and innominate foramen in Korean mandibles. Korean J Phys Anthropol 1993;6:129-40.   DOI
4 Loukas M, Kinsella CR Jr, Kapos T, Tubbs RS, Ramachandra S. Anatomical variation in arterial supply of the mandible with special regard to implant placement. Int J Oral Maxillofac Surg 2008;37:367-71.   DOI   ScienceOn
5 Liang X, Jacobs R, Lambrichts I, Vandewalle G. Lingual foramina on the mandibular midline revisited: a macroanatomical study. Clin Anat 2007;20:246-51.   DOI   ScienceOn
6 Krenkel C, Holzner K. Lingual bone perforation as causal factor in a threatening hemorrhage of the mouth floor due to a single tooth implant in the canine region. Quintessenz 1986;37:1003-8.
7 Isaacson TJ. Sublingual hematoma formation during immediate placement of mandibular endosseous implants. J Am Dent Assoc 2004;135:168-72.   DOI   ScienceOn
8 Givol N, Chaushu G, Halamish-Shani T, Taicher S. Emergency tracheostomy following life-threatening hemorrhage in the floor of the mouth during immediate implant placement in the mandibular canine region. J Periodontol 2000;71:1893-5.   DOI   ScienceOn
9 Budihardja AS, Pytlik C, Haarmann S, Holzle F. Hemorrhage in the floor of the mouth after second-stage surgery: case report. Implant Dent 2006;15:148-52.   DOI   ScienceOn
10 Ferneini E, Gady J, Lieblich SE. Floor of mouth hematoma after posterior mandibular implants placement: a casereport. J Oral Maxillofac Surg 2009;67:1552-4.   DOI   ScienceOn
11 Mardinger O, Manor Y, Mijiritsky E, Hirshberg A. Lingual perimandibular vessels associated with life-threatening bleeding: an anatomic study. Int J Oral Maxillofac Implants 2007;22:127-31.
12 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;14:117-24.   DOI   ScienceOn
13 Woo BM, Al-Bustani S, Ueeck BA. Floor of mouth haemorrhage and life-threatening airway obstruction during immediate implant placement inthe anterior mandible. Int J Oral Maxillofac Surg 2006;35:961-4.   DOI   ScienceOn
14 Mordenfeld A, Andersson L, Bergstrom B. Hemorrhage in the floor of the mouth during implant placement in the edentulous mandible: a case report. Int J Oral Maxillofac Implants 1997;12:558-61.
15 Kattan B, Snyder HS. Lingual artery hematoma resulting in upper airway obstruction. J Emerg Med 1991;9:421-4.   DOI   ScienceOn
16 Kalpidis CD, Setayesh RM. Hemorrhaging associated with endosseous implant placement in the anterior mandible: a review of the literature. J Periodontol 2004;75:631-45.   DOI   ScienceOn
17 McDonnell D, Reza Nouri M, Todd ME. The mandibular lingual foramen: a consistent arterial foramen in the middle of the mandible. J Anat 1994;184:363-9.
18 Yoshida S, Kawai T, Okutsu K, Yosue T, Takamori H, Sunohara M, et al. The appearance of foramen in the internal aspect of the mental region of mandible from Japanese cadavers and dry skulls under macroscopic observation and three-dimensional CT images. Okajimas Folia Anat Jpn 2005;82:83-7.   DOI   ScienceOn
19 Tepper G, Hofschneider UB, Gahleitner A, Ulm C. Computed tomographic diagnosis and localization of bone canals in the mandibular interforaminal region for prevention of bleeding complications during implant surgery. Int J Oral Maxillofac Implants 2001;16:68-72.
20 Gahleitner A, Hofschneider U, Tepper G, Pretterklieber M, Schick S, Zauza K, et al. Lingual vascular canals of the mandible: evaluation with dental CT. Radiology 2001;220:186-9.   DOI   ScienceOn
21 Kawai T, Sato I, Yosue T, Takamori H, Sunohara M. Anastomosis between the inferior alveolar artery branches and submental artery in human mandible. Surg Radiol Anat 2006;28:308-10.   DOI
22 Lustig JP, London D, Dor BL, Yanko R. 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;96:625-9.   DOI   ScienceOn
23 Tagaya A, Matsuda Y, Nakajima K, Seki K, Okano T. Assessment of the blood supply to the lingual surface of the mandible for reduction of bleeding during implant surgery. Clin Oral Implants Res 2009;20:351-5.   DOI   ScienceOn
24 Shiller WR, Wiswell OB. Lingual foramina of the mandible. Anat Rec 1954;119:387-90.   DOI   ScienceOn
25 Laboda G. Life-threatening hemorrhage after placement of an endosseous implant: report of case. J Am Dent Assoc 1990;121:599-600.   DOI
26 Abrahams JJ, Hayt MW. Dental CT in pathologic changes of the maxillo-mandibular region. Radiologe 1999;39:1035-43.   DOI
27 Dula K, Buser D, Porcellini B, Berthold H, Schwarz M. Computed tomography/oral implantology (I). Dental CT: a program for the computed tomographic imaging of the jaws: the principles and exposure technic. Schweiz Monatsschr Zahnmed 1994;104:450-9.
28 Angelopoulos C, Scarfe WC, Farman AG. A comparison of maxillofacial CBCT and medical CT. Atlas Oral Maxillofac Surg Clin North Am 2012;20:1-17.   DOI   ScienceOn
29 Mason ME, Triplett RG, Alfonso WF. Life-threatening hemorrhage from placement of a dental implant. J Oral Maxillofac Surg 1990;48:201-4.   DOI
30 Niamtu J 3rd. Near-fatal airway obstruction after routine implant placement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:597-600.   DOI   ScienceOn
31 Liang X, Jacobs R, Lambrichts I, Vandewalle G, van Oostveldt D, Schepers E, et al. Microanatomical and histological assessment of the content of superior genial spinal foramen and its bony canal. Dentomaxillofac Radiol 2005;34:362-8.   DOI   ScienceOn