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PubMed2004

[Criteria for applying lingualized occlusion by the condition of residual alveolar ridge].

Lingualized occlusion is applied to patients with alveolar ridge resorption, and it is considered that this occlusion is functionally useful and should be applied to cases with alveolar ridge resorption. However, selection criteria supported by evidence for what conditions of the alveolar ridge lingualized occlusion should be selected do not exist. For that reason, we conducted an investigation on choosing lingualized occlusion. As a result, no differences were noted in subjects with a good alveolar ridge condition while a sufficient lingualized occlusion effect was obtained in subjects with a poor alveolar ridge condition, suggesting that efficient mastication could be attained. The following indexes were examined as the criteria for applying lingualized occlusion: The ratio of the residual alveolar ridge should be less than approximately 0.5, in which the distance between the inferior border of the mental foramen and the superior border of the mandibular bone should be less than half the distance between the inferior border of the mental foramen and the inferior border of the mandibular bone. The supporting area of the denture base should be less than approximately 2,000 mm(2). Though the effect can be expected when applying lingualized occlusion under these criteria, they are one standard, and cannot be applied in all cases. In clinical cases, it is important to grasp the local and the whole-body conditions of the patient in order to choose denture occlusion.

English Abstract↗

PubMed1993

[Study of the location of mandibular mental foremen in modern and neolithic adult]

37 cases of mandible of Neolithic adult that both sexes without missing teeth,alveolar bone were studied.The result showed that the location of the mental foramen below the apex of the lower second premolar was the most common(67.97%) in the modern adult,and the location of the mental foramen below between the apex of the lower second premolar and the first molar was the most common (64.86%) in the neolithic adult.

Journal Article↗

PubMed2002

Influence of age and gender on radiomorphometric indices of the mandible in removable denture wearers.

The objective of this study was to measure and assess a number of radiomorphometric indices of the mandibular removable denture wearers taking into account age and gender. In a total of 136 dental panoramic radiographs (DPR) the following parameters were evaluated: MI = thickness of the mandibular cortex below the mental foramen, AI = thickness at the antegonion and GI = thickness at gonion; PMI = MI/distance between the low border of the mandible and the low border of the mental foramen, and MCI = mandibular cortical index, based on the assessment of the 3 categories of cortical appearance due to the resorptive changes. There were 40 male patients (mean age 72.7; range 56 to 84 years) and 96 female patients (mean age 69.7; range 48 to 86 years). Patients were grouped according to age into three age groups (1 = less than 65 years; 2 = 65-75 years; 3 = more than 75 years). The results revealed that MI, PMI, AI and GI showed a general downward trend with age for the both sexes until 75 years of age when the mean values of GI, AI and MI begun to fall down sharply for females compared to males. The difference was significant between age groups and gender for GI and AI. Only two categories (C2 and C3) of MCI have been recognized in our study sample, due to the relatively old age groups of patients with removable dentures. However, significantly higher incidence of C3 existed in the oldest group of females.

Aged↗

PubMed1996

Atypical incisive nerve: clinical report.

A 68-year-old Caucasian man complained of discomfort from two implants placed in the anterior mandibular area. Examination of cross-sectional computerized tomography images revealed the passage of a distinct structure, surrounded by cortical bone, which extended from the right mental foramen anteriorly and passed through the lower part of the right and left implants. The structure, which was identified as the incisive nerve, also emerged from the left mental foramen and advanced toward the midline. This nerve plexus is usually delicate and not detectable by conventional radiography or computerized tomography. The possibility of nerve variations in the anterior region of the mandible must be considered to prevent possible trauma to the adjacent tissues when placing implants.

Adult↗

PubMed1978

Histoquantitation on small jaw specimens.

A study is carried out to evaluate the possibility of obtaining a measure of bone mass and bone activity by histoquantitation on small jaw specimens. The material consisted of bone autopsy specimens from premolar regions of mandibles and regions above maxillary second incisors. Microradiograms of 100-micrometer-thick buccal-lingual ground sections were used. Quantitation of bone mass (bone area in percent), bone coarseness (total bone surface/bone area), and bone activity (resorption surfaces/total bone surface) was done in well-defined areas of cortical and trabecular bone by an electronic point-counting system. The analysis indicates that: (1) no further information or accuracy is obtained from measurements of large areas than of small areas of cortical or trabecular bone, (2) the bone mass in the buccal cortex anterior to the mental foramen is independent of side and state of dentition, and (3) maxillary specimens are unsuitable for quantitation of bone mass. A small bone specimen taken anterior to the mental foramen seems to be suitable for histoquantitation, when a reliable and representative measure of bone mass and bone activity in the mandible is desired for analysis of intermandibular differences.

Bone Resorption↗

PubMed1999

[The chin hole. Position and correlation with other mandibular parameters].

BACKGROUND: The present study analyzes the position of mental foramen, in order to research possible correlations with other mandibular parameters. METHODS: The study has been conducted on 76 dry mandibles, for each mandible we have measured the exact position of the mental forum respect the other mandibular parameters. Both linear and angular relations and misurations have been made. RESULTS AND CONCLUSIONS: The results obtained confirm that the mental foramen maintains its position by increasing GoGn. The results did not show particularly significant aspects in comparison with the literature on the subject, thus confirming other authors' opinion.

Adolescent↗

PubMed1993

Detection of cancer recurrence in irradiated mandible using positron emission tomography.

Positron emission tomography (PET) is a promising method for pretherapeutic assessment of spread of squamous cell carcinomas (SCC) in the head and neck. A 41-year-old man with a history of operated and irradiated SCC of the tongue presented 4 years later with symptoms and signs of mandibular osteoradionecrosis. No changes related to malignancy could be seen in panoramic radiographs or computed tomography scanning with contrast enhancement. Since a biopsy of the involved region was positive for SCC, a PET study with [18F]fluorodeoxyglucose (FDG) was performed. In dynamic PET images, intensive uptake of FDG was seen in a small area close to the right mental foramen. A hemimandibulectomy with reconstruction using a free vascularized graft from iliac crest was performed. In the resected specimen, histological examination showed a 1.2-mm focus of SCC in the soft tissue and bone around the mental foramen. These findings indicate that FDG-PET might be useful for presurgical evaluation of cancer recurrence in a previously irradiated mandible, especially if PET can accurately differentiate viable tumor tissue from radiation-induced fibrosis and inflammation.

Adult↗

PubMed1996

Height of mandibular basal bone in dentate and edentulous subjects.

Age-related differences in the height of the mandibular basal bone were compared between young and old dentate subjects and between dentate and old edentulous subjects by means of panoramic radiographs. The distances of the mental foramen and mandibular canal from the lower border of the mandible, when measured, showed the mandibular basal bones in old dentate and in old edentulous men to be higher than those of young dentate men in the molar region (P < 0.05). The height of the basal bone below the mental foramen was smaller in old edentulous women than in young and old dentate women (P < 0.05). A slight bone deposition along the lower border of the mandible in the molar region seems to take place with increasing age. The mental foramina of edentulous women move toward the lower border of the mandible as a result of alveolar bone resorption.

Adolescent↗

PubMed2004

Appearance of the mandibular incisive canal on panoramic radiographs.

Panoramic radiographs are routinely used in the dental office for various diagnostic purposes. This study aimed to evaluate the visibility of neurovascular structures in the mandibular interforaminal region on such radiographs. Panoramic radiographs were obtained with a Cranex Tome (Soredex) from 545 consecutive patients using a standard exposure and positioning protocol. For visibility scoring of neurovascular structures, a four-point rating scale was used. The mandibular canal and the mental foramen could be observed in the majority of the cases with good visibility. The lingual foramen was visualized in 71% of the cases, with good visibility in 12%. An incisive canal was identified in 15% of the images, with good visibility in only 1%. An anatomical variation to be considered is the anterior looping of the mental nerve (in 11% of images). Panoramic radiographs can be used for visualization of the mental foramen and a potential anterior looping but not for locating the mandibular incisive canal. To verify its existence for preoperative planning purposes, cross-sectional imaging modalities (HR-CT or spiral tomography) should be preferred.

Adult↗

PubMed2002

Appearance, location, course, and morphology of the mandibular incisive canal: an assessment on spiral CT scan.

OBJECTIVES: To assess the appearance, location, and course of the incisive canal as compared to other anatomical landmarks on spiral CT of the mandible. METHODS: Study material included 230 spiral CT scans taken for preoperative planning of implant placement in the posterior mandible. All scanning was performed using a standard exposure and patient positioning protocol. Axial, panoramic, and reformatted cross-sectional images were carefully examined. Visibility of the incisive canal and other anatomical landmarks was scored using a four-point rating scale. The vertical and buccolingual diameter of the outer contour as well the diameter of the inner contour of the incisive canal were measured using a digital sliding caliper. RESULTS: An incisive canal was identified in 93% of the cases, with good visibility in 22% of the cases. Mean (s.d.) vertical diameter, buccolingual diameter, and inner diameter of the incisive canal were 4.7 (1.1), 3.7 (0.7), and 1.1 (0.3) mm respectively. The mandibular canal, mental foramen, lingual foramen, and anterior looping appeared in 98, 100, 82 and 7% of the images respectively. CONCLUSIONS: A well-defined incisive canal could be detected in the majority of spiral CT scans. Its radiographic detection remained lower than for the mandibular canal or mental foramen, but higher than for the visibility of the lingual foramen. Visualisation of the incisive canal and the occasional presence of an anterior looping, demonstrates the potential value of cross-sectional imaging of the anterior mandible for presurgical planning purposes.

Adolescent↗

PubMed1989

The effect of a custom edentulous impression tray on lingual sulcus depth.

An acrylic resin custom edentulous impression tray and standardized irreversible hydrocolloid impression technique were used. Ten impressions were made, after which the lingual border of the tray was reduced by 1.5 mm before the next series of impressions was made. This was done three times. Impressions were cast in a miter box. The plaster blocks so obtained were sectioned in the (a) retromylohyoid region, (b) 10 mm anterior, and (c) in the region of the mental foramen. In the retromylohyoid region there was a significant difference between the flange length after each reduction of the custom tray (p less than 0.01). Ten millimeters anteriorly the differences after each reduction except between the first and second reduction were less significant. In the region of the mental foramen there was a significant difference after the first reduction, but there was no significant difference between the flange lengths obtained thereafter.

Adult↗

PubMed1997

Development of Meckel's cartilage in the symphyseal region in man.

BACKGROUND: The aim of this work is to clarify the aspects which are at present most controversial about the development of the anterior segments of Meckel's cartilage, such as the role of and determination of the area that is incorporated in the development of the human mandible. METHODS: Light microscope studies were done on 25 embryos and human fetuses from the collection of the Institute of Embryology at the University Complutense of Madrid and the Department of Morphological Science from the University of Granada. Specimen length was between 18 and 125 mm crown-rump. RESULTS: During the embryonic period, Meckel's cartilages were placed in the midline of the mandibular arch but fusion was not observed between them. Ossification of Meckel's cartilage begins at the end of the embryonic period and is completed in the fetal period and the portion that participates in mandibular formation is determined. This segment extends from the mental foramen to near the midline of the mandible. In this region, on the dorsal surface of the symphysis, cartilaginous nodules that originate from Meckel's cartilage are isolated. CONCLUSIONS: The ventral portions of Meckel's cartilage do not fuse in the midline of the mandibular arch. These present endo- and perichondral ossification and the section from the mental foramen to near the midline (mandibular symphysis) participates in mandibular formation. The ventral ends of Meckel's cartilage, i.e., the ends nearest the midline, do not ossify and remain isolated on the dorsal surface of the fetal mandibular symphysis.

Cartilage↗

PubMed1994

Mineral density in the mandibles of partially and totally edentate postmenopausal women.

Mineral density of the cortical bone in four regions and the spongiosa distal from the mental foramen of the mandible was determined by quantitative computed tomography (QCT) for 77 postmenopausal, 48-56-yr-old women. Of these women, 42 were totally edentulous and 35 had teeth in region d35-d45. The bone mineral densities of different regions of these two groups were compared. Mineral density of the cortical bone on lingual and buccal sides, distal from the mental foramen, was significantly higher among those who had been edentate 12-23 yr than among dentate subjects. No differences were found between those who had been edentate less than 12 or over 23 yr and the dentate group. This study indicates that muscular activity during different phases of edentulousness regulates the density of bone in regions where muscles are attached.

Alveolar Bone Loss↗

PubMed2001

Clinical application of a new compact CT system to assess 3-D images for the preoperative treatment planning of implants in the posterior mandible A case report.

When treatment planning before placing dental implants in the posterior region of the mandible, the locations of the inferior alveolar nerve and mental foramen need to be ascertained, as they determine the bone height available and the implant length selected. The purpose of this study was to introduce the clinical application of a newly developed compact computed tomography system (Ortho-CT) to assess three-dimensional (3-D) images for the preoperative treatment planning of implants in the posterior region of the mandible. To evaluate the 3-D images, we scanned using the Ortho-CT system the mandible with a radiopaque template placed in the posterior region. The Ortho-CT images provided excellent information for evaluating the morphology of the mandible, and for showing the location of the inferior alveolar nerve, mental foramen and the relationship of the template to the bone. We consider that Ortho-CT is a useful aid to preoperative treatment planning of implant therapy in the mandible.

Contrast Media↗

PubMed1996

Radiographic evaluation of mandibular posterior implant sites: correlation between panoramic and tomographic determinations.

The purpose of the present study was to compare bone height determinations of implant sites by different radiographic techniques. Available bone height was measured in regions posterior to the mental foramen on panoramic radiographs, and on tomographs where the faciolingual dimension was at least 5mm. The bone heights were recorded at 401 edentulous and dentate sites in 100 patients. The overall mean bone height (m +/- SD) was 11.25 +/- 3.29 mm on panoramic radiographs and 8.81 +/- 3.38 mm on tomographs. The correlation between the two radiographic techniques ranged from 0.36 to 0.91 if the material was stratified according to factors such as height of available bone, age, gender and the presence of teeth. Gender was significantly correlated to panoramic and tomographic measurements in all regions. However, the precision of predicted tomographic measurements by using a linear regression model was not significantly increased by including gender as an explanatory variable. For evaluation of available bone height in mandibular regions posterior to the mental foramen, tomography is recommended for all prospective implant sites.

Adult↗

PubMed2000

The course of the inferior alveolar nerve in the normal human mandibular ramus and in patients presenting for cosmetic reduction of the mandibular angles.

This study was undertaken to quantify the path of the inferior alveolar nerve in the normal human mandible and in the mandibles of patients presenting for cosmetic reduction of the mandibular angles. The goals were: (1) to provide normative information that would assist the surgeon in avoiding injury to the nerve during surgery; (2) to characterize gender differences in the normal population; and (3) to compare the course of the nerve in the normal population to its course in a group of patients who presented with a complaint of "square face." The study was based upon the computerized tomographic scans of 10 normal patients (six men, four women) and 8 patients (all women) complaining of "square face." Using AnalyzePC 2.5 imaging software, the mandibles were segmented and the position of the nerve was recorded within its osseous canal in the mandibular ramus on each axial slice in which it was identifiable. Distances were calculated between the nerve and the anterior, posterior, lateral, and medial cortices. The positions of the lateral ramus prominence and the lowest point on the sigmoid notch were also recorded. The position of the mental foramen was recorded in relation to the nearest tooth, and the three-dimensional surface distances from the foramen to the alveolar bone, the inferior border of the mandible, and the mandibular symphysis were determined. The distances from the entrance of the nerve into the mandible to the lateral ramus prominence and the lowest point on the sigmoid notch were calculated. Summary statistics were obtained, comparing differences in gender. The nerve was identifiable in each ramus over a mean distance of 12.7 mm. On average, the lateral ramus prominence was 0.3 mm higher on the caudad-cephalad axis than the point at which the nerve entered the bone, whereas the location of the lowest point on the sigmoid notch was 16.6 mm above the nerve. The average distances from the nerve to the anterior, posterior, medial, and lateral cortices were 11.6, 12.1, 1.8, and 4.7 mm, respectively. Gender differences were significant for all of these except the medial cortex to nerve distance. On average, the mental foramen exited the body of the mandible immediately below the second premolar and the average surface distances from the foramen to the symphysis, the most cephalad alveolar bone, and the inferior border of the body were 30.9, 14.2, and 19.3 mm, respectively. With regard to the patients presenting for mandibular angle reduction, there were a few statistically significant but small scalar differences from normal controls.

Adolescent↗

PubMed2001

[Cortical thickness of the mandible with special reference to miniplate osteosynthesis. Morphometric analysis of autopsy material].

Thirty-two human mandibles were marked with three typical fracture lines: a low condylar fracture, a fracture of the mandibular angle, and one through the mental foramen on each side. The mandibles were sectioned at the fixation sites of the miniplate screws. The thickness of the cortical layer was measured with a scaled magnifying glass at the points of anthropological interest and at the marked screw holes. The inferior cortical layer turned out to be thickest in the anterior area. In contrast, it was very thin at the mandibular angle, which might explain the higher complication rate in treating fractures in this region. The thickness of the lingual cortex increased up to the symphysis, whereas the buccal cortical layer showed a decline in size from the mandibular angle up to the chin. The cortical bone at the alveolar ridge was porous. The cortical supply for miniplate osteosynthesis at the condylus ranged from 1.1 mm up to 1.74 mm, which seems to be limited, but due to the small diameter of the condylus most common screws obtain additional anchorage in the inner cortex. The thickness of the cortical layer at the mandibular angle increased from 1.47 mm at the ramus up to 1.97 mm at the beginning of the corpus, reaching 2.14-2.38 mm for the lower plate at the mental foramen. The results for the upper plate were slightly lower.

Bone Plates↗

PubMed1987

Retromolar foramen of the human mandible.

Analysis of retromolar foramen (RMF) in a large series of mandibles (N 2500) was undertaken to provide descriptive statistics for this variant. RMF of diameter 0.5 mm or greater were scored. Consistent with other data on accessory canals in the facial skeleton, RMF was found to occur more commonly in native populations of North America than in other populations (Africa, Europe, India, northeast Asia). The ratio of bilateral to unilateral occurrences was shown to increase with population incidence, a pattern consistent with the theoretical model of an epigenetic (threshold "quasicontinuous") variant. Male-female differences were not found. Age profiles were characterized by a marked peak in the adolescent cohort. In some populations RMF showed a positive intertrait correlation with accessory mandibular foramen and with accessory mental foramen, but correlations with presence/absence of third molar and three-rooted first molar were not found. With refinements in scoring criteria and, ideally, better evidence of its heritability, RMF should be useful along with other minor cranial variants for ethnohistorical studies.

Adolescent↗