Presence of antilingula and its relationship to mandibular foramen-An anatomical study.

Aim: Aim of this study was to evaluate the presence of antilingula and its relationship with mandibular foramen. Materials and Methods: In this study, a total of 50 specimens of dry human hemi-mandibles were studied to analyze the presence and relationship of antilingula to mandibular foramen. A 1-mm fissure bur was used to drill a hole perpendicular to bone from the deepest aspect of the concavity at the center of the mandibular foramen from the medial to lateral side, the drill perforated both the medial and lateral cortex of the mandible. The distance from the antilingula to hole was measured and recorded in both antero-posterior and supero-inferior planes. The data were collected and put to statistical analysis. Results: From this study, it was concluded that the antilingula was present in 90% (n = 45) of mandibles and was absent in 10% (n = 5) of mandibles. Antero-posteriorly, the antilingula was present anterior to mandibular foramen in 22.2% (n = 10) of mandibles, posteriorly in 57.7% (n = 26) of mandibles, and there was complete concordance in 20% (n = 9) of mandibles. The supero-inferior relation shows that antilingula was present superior to mandibular foramen in 97.8% (n = 44) of mandibles, and it was present inferiorly in 2.20 (n = 1) of mandibles. Conclusion: Although vertical ramus osteotomy is not a commonly used procedure in these days. From our study, it was concluded that antilingula was present as an elevation in 90% of cases on the lateral ramus border and the mandibular foramen is present inferior and anterior to the antilingula.

Unusually Pronounced and Expansive Mandibular Foramen. A Incidental Radiological Finding / Foramen Mandibular Inusualmente Pronunciado y Expansivo: Un Hallazgo Radiológico Incidental

SUMMARY: The mandibular foramen and its canal are one of the most important structures in the skull, as they solely supply the mandible through their associated nerves and vessels. Many anatomical variations have been reported in the literature until now, and this case report represents a clear-cut appearance of its shape in a panoramic radiograph, which is not mostly seen in normal panoramic radiographs. These factors are of utmost importance when it comes to performing various surgeries and preventing complications due to their varied anatomy, which will allow dentists to create a better treatment plan and provide better treatments without any complications.

El foramen mandibular y su canal son algunas de las estructuras más importantes del cráneo y cara, ya que a través de ellos la mandíbula es inervada por nervios e irrigada por vasos. Hasta ahora, en la literatura consultada, se han informado de numerosas variaciones anatómicas. En este trabajo reportamos la forma y trayecto del foramen y canal mandibular, obtenidos en una radiografía panorámica, que no es observada normalmente en este tipo de radiografía. Los factores anatómicos son de importancia a la hora de realizar las cirugías para prevenir complicaciones debido a su variada anatomía, permitiendo a los odontólogos crear un mejor plan de tratamiento sin ningún tipo de complicaciones.

Cone Beam CT Assessment of Mandibular Foramen and Mental Foramen Positions as Essential Anatomical Landmarks: A Retrospective Study in Vietnam.

INTRODUCTION: The mandibular foramen (MnF) and the mental foramen (MF) are essential anatomical landmarks that should be considered before any surgical procedures in the mandible. This study aimed to investigate the characteristics of the MnF and MF in relation to adjacent anatomical structures, as well as age and gender differences, using cone beam computed tomography (CBCT) projections. METHODS: The study was conducted from August 2023 to January 2024 at the Can Tho University of Medicine and Pharmacy Hospital, Vietnam. In this retrospective study, 50 CBCT images of Vietnamese patients were randomly taken for various clinical purposes. Furthermore, relevant data, such as gender and age groups, were selected to evaluate the correlations, along with specific inclusion criteria. Patients within the age range of 18-69 with a symmetrical mandible were included. RESULTS: The distance of the MnF-MN was 29.6±5.0 mm (right) and 30.1±4.6 mm (left) in males and 25.0±4.2 mm (right) and 26.3±5.0 mm (left) in females. The distance of the MnF-posterior border of the ramus (P) was 16.2±3.6 mm (right) and 15.0±2.3 mm (left) in males. For females, it was 17.1±2.9 mm (right) and 13.8±1.7 mm (left). The distance of the MF-body mandible (MB) was 15.4±2.4 mm (right) and 15.6±2.0 mm (left) in males and 14.0±2.1 mm (right) and 14.3±1.6 mm (left) in females. The distance of the MF-mandibular midline (MM) was 27.0±2.6 mm (right) and 27.0±2.9 mm (left) in males and 25.3±2.0 mm (right) and 25.1±2.2 mm (left) in females. These distances showed statistically significant differences depending on gender (P<0.05). CONCLUSION: It can be said that CBCT provides comprehensive information about the MnF and the MF for dentists in research and clinical practice.

Determining the position of the lingula and the mandibular foramen using the antilingula in orthognathic surgery.

BACKGROUND: The antilingula located on the lateral surface of the mandibular ramus has been served as a surgical landmark for the mandibular foramen on the medial surface for decades. However, whether the antilingula truly represents the lingula which is the bony prominence overlapping the mandibular foramen, or the foramen itself, is still unclear. This study thus aimed to examine the position of the antilingula in relation to three reference points: the lingula, the anterior and the posterior borders of the mandibular foramen, as well as to the reference plane used in the inferior alveolar nerve block, and to the posterior border of the mandible. METHODS: This observational study was performed in 113 Thai dry mandibles. The antilingula were identified followed by transferring the reference points to the lateral surface. The distances from the antilingula to the reference points, the reference plane and the posterior border of the ramus were then measured. Chi-square test was calculated for side-dependency of the antilingula. Paired t-test was calculated for difference in measurements in left and right sides. RESULTS: The antilingula could be identified in 92.48% of the mandibles with 86.67 - 90.00% accuracy and 86.67% reliability. There was no significant difference in the presence of the antilingula on left and right sides (p = 0.801). Only 2.5% and 0.83% of the antilingula correspond to the lingula and the anterior border of the mandibular foramen, respectively. However, 85% of the reference points were located within 11 mm radius. The antilingula was found located 2.80 mm inferior to the reference plane and 16.84 mm from the posterior border of the ramus. CONCLUSIONS: The antilingula does not concur with the reference points on the medial surface. Our study also suggests that the safe area for vertical osteotomy is 11 mm posterior to the antilingula or at 30% of the length from the posterior border parallel to the occlusal plane. The use of more accurate techniques in localizing the mandibular foramen combined with the antilingula is more recommended than using the antilingula as a sole surgical guide.

Use of Adult Dry Human Mandibles to Study of Mandibular Foramen from Various Bony Landmarks.

Background: Precise knowledge of the mandibular foramen's location is essential for clinical and surgical procedures, especially the inferior alveolar nerve block. Variability in its position concerning different bony landmarks can significantly impact clinical outcomes. Materials and Methods: This study examined 30 Adult dry human mandibles to determine the mandibular foramen's positions in relation to specific bony landmarks: the occlusal plane, posterior border of the ramus, and lingula. Measurements were obtained using a calibrated digital caliper, and statistical analysis was performed. Results: The study revealed significant variations in the position of the mandibular foramen. In relation to the occlusal plane, the mandibular foramen was found at an average height of approximately 15.2 mm (±2.1 mm). Regarding the posterior border of the ramus, it was situated at an average distance of about 18.5 mm (±3.4 mm). In relation to the lingula, the average distance was approximately 21.8 mm (±4.0 mm). These results underscore the considerable individual differences and anatomical variations in the mandibular foramen's location among the studied specimens. Conclusion: The observed variations in the position of the mandibular foramen emphasize the need for clinicians and surgeons to be cognizant of these differences when performing procedures involving the inferior alveolar nerve block. Understanding these anatomical variations is crucial for enhancing clinical precision, reducing complications, and ensuring optimal outcomes.

Topography and morphometry of the infraorbital and mandibular foramen of the common sloth (Bradypus variegatus) for use in the application of perineural anaesthesia.

A local anaesthetic block performed in cranial and mandibular foramina contributes towards analgesia and the reduction of systemic anaesthesia in procedures in the oral cavity. However, anatomical differences between in wild animals may require adaptations to the anaesthetic and surgical manoeuvres of the head used in domestic animals. With that in mind, we aimed to describe the topography and morphometry of the infraorbital and mandibular foramina in Bradypus variegatus, to support perineural anaesthetic approaches in the cranio-mandibular region of this species. We demonstrated that in B. variegatus there is no significant variability in the morphometric data, allowing access to the studied foramina to occur in a similar way in adult individuals. Finally, we understand that the techniques for the infraorbital and mandibular foramen needed to be adapted due to the anatomical singularities of the species, which culminated in new reference points for more assertive needle positioning.

The location of mandibular foramen relative to the occlusal plane: a study on anatolian dry mandible.

Purpose: The study aims to evaluate the location of mandibular foramen (MF) with respect to the occlusal plane (OP) and its location on the ramus using Anatolian dry mandibles. Materials and methods: A total of 115 dry mandibles with mandibular molars were analyzed. The distance between the MF and the OP was examined with a flat metal plate. Group A was above the OP; group L was at level, and group B was below the OP. The distances between the MF and anterior border (A-MF), sigmoid notch (U-MF), posterior border (P-MF), and lower border (L-MF) were measured. The symmetry between the two sides was examined. Pearson chi-square and Student's t-test were performed for statistical analysis. Results: According to the analysis, 50.23% of MF was located below the OP (p<0.05). The mean distances of Groups A and B were 3.45 and 4.78 mm, respectively. There was no difference between the left and right in groups (p>0.05). The distance A-MF was 14.71 mm. There was no statistical difference between the distances A-MF and P-MF or U-MF and L-MF. Conclusion: Half of the MF (50.23%) was located below the occlusal plane with a mean distance of 4.78 mm. It may be helpful to place the needle 3-4 mm above the OP and 1.5-2 mm back of the anterior border to obtain a successful inferior alveolar nerve block. The MF was located at the center of the medial surface of the ramus.

Computed Tomographic Analysis of Position of Mandibular Canal and Mandibular Foramen in Patients with Mandibular Asymmetry.

Introduction: Mandibular osteotomies in facial asymmetry are complicated by the abnormal position and course of inferior alveolar nerve. This manuscript aims to evaluate the possible variations in the preoperative positions of mandibular canal and mandibular foramen in patients with mandibular asymmetry due to condylar hyperplasia or condylar hypoplasia. Materials & Methods: This study included 15 patients with mandibular asymmetry due to condylar hyperplasia or condylar hypoplasia for which bilateral sagittal split osteotomy (BSSO) was performed as a corrective procedure. The presence/absence and extent of postoperative neurosensory deficiency was recorded subjectively and objectively. The measurements were done using multiplanar reconstruction (MPR) of three-dimensional radiographic imaging and were compared to normal subjects. Discussion: The results revealed that the mandibular canal was closer to the buccal cortex on the affected side and the inferior border on both sides in the region of second molar in condylar hyperplasia. In condylar hypoplasia, the canal was nearer to the inferior border and the alveolar crest in relation to second and third molars respectively on the affected and contralateral sides.The mandibular foramen was also more superior to the occlusal plane on both sides in both condylar hyperplasia and hypoplasia. Conclusion: Based on the study outcomes, the authors propose that assessment of the positions of mandibular canal and mandibular foramen is crucial to avoid postoperative neurosensory deficiencies.

Topographical anatomy of the mandibular foramen in the dromedary camels (Camelus dromedarius): an extraoral approach for the inferior alveolar nerve blocks.

Understanding the clinical anatomy of the head is essential for performing proper inferior alveolar nerve (IAN) block anesthesia to facilitate invasive dental procedures in camels. However, osteometric data related to the IAN in camels are lacking. This study was carried out to accurately locate the mandibular foramen (MF) and the course of the IAN in the camel head and to establish an approach for its localization in clinical practice. To achieve these aims, eight osteometric measurements were used to determine the location of the MF in relation to its surrounding structures in six cadaveric skulls of adult camels. Four camel heads were dissected, and the course of the IAN inside the mandibular canal was studied. In addition, four heads were used as a trial for the extraoral approach to the IAN block using contrast radiographs based on established metric indices. Dissection of the four camel heads revealed that the MF was located near the intersection of two lines passing through the occlusal surface of the mandibular cheek teeth and at the midpoint of the zygomatic process of the temporal bone. Significant differences were not observed between the right and left mandibles. Successful deposition of the contrast medium near the MF was observed in all examined specimens. This study reports a new, simple approach to reaching the IAN at the MF. However, further clinical validation of the proposed technique is required.

An Anatomical Study of Dry Mandibles to Determine the Important Surgical Reference Points in Ramus Osteotomy - An Evaluative Study.

Introduction: The variable relation and clinical significance of mandibular foramen (MF) and Lingula with inferior alveolar neurovascular bundle (IANB) is important for dental surgeons. Knowing the landmarks on the ramus of the mandible is of paramount importance to perform the surgery without causing damage to the neurovascular bundle. Materials and Methods: This study was conducted on 85 dry adult mandibles of unknown sex and age. The distances were measured from the anatomical reference points (anti-Lingula, Lingula and MF) using digital callipers. Results: The distance from the anti-Lingula to the anterior border of the ramus (A) was significantly longer on the right side (14.91 mm) than on the left side (14.5 mm). There was a significant difference in mean distances between the anti-Lingula and MF of both the sides (P ≤ 0.005). No significant difference was noted in the distances between the Lingula and the Anti-Lingula, observed for the posterior (B, P = 0.75) and the inferior margin of the mandible (D, P = 0.54). However we found correlation of vertical distances of anti-Lingula with Lingula and MF exhibited moderate positive correlation. Discussion: The IANB is prone to damage during mandibular surgery. Using anti-Lingula alone as a reference point is not guaranteed, but it is still an important anatomical landmark for the surgeon to operate.

Locating the Mandibular Lingula Using Cone-Beam Computed Tomography: A Literature Review.

This study aimed to review the literature on adult mandibular lingula (ML) locations and related distances determined using cone-beam computed tomography (CBCT). A search was conducted for studies on CBCT using the following databases: PubMed, Web of Science, and Embase. The search results were limited to studies published between 1970 and 2021. The inclusion criteria were the investigation of ML location, CBCT, and participants aged ≥18 years. Eligible studies were examined for the distances from the lingual tip to the anterior ramus border, posterior ramus border, sigmoid notch, inferior ramus border, and occlusal plane. Eight studies on CBCT qualified for inclusion in the study. The mean distances from the ML to the anterior ramus border were 15.57 to 20 mm. In most of these, the ML was located above the occlusal plane. No significant differences were observed in the location and related distances for the ML among patients of different sexes, ethnicities, or skeletal patterns.

Morphological Study of the Mandibular Lingula and Antilingula by Cone-Beam Computed Tomography.

The patterns of the lingula and antilingula are crucial surgical reference points for ramus osteotomy. Cone-beam computed tomography (CBCT) provides three-dimensional images, and patient radiation dose is significantly lower for CBCT than for medical CT. The morphology of the mandibular lingula and antilingula of ninety patients (180 sides) were investigated using CBCT. The lingula were classified as having triangular, truncated, nodular, and assimilated shapes. The antilingula were classified as having hill, ridge, plateau, and plain shapes. The patients' sex, skeletal patterns (Classes I, II, and III), and right and left sides were recorded. The most to least common lingula shapes were nodular (37.8%), followed by truncated (32.8%), triangular (24.4%), and assimilated (5%). The most to least common antilingulae were hill (62.8%), plain (18.9%), plateau (13.9%), and ridge (4.4%) patterns, respectively. The lingula and antilingula had identical patterns on both sides in 47 (52.2%) and 46 patients (51.1%), respectively. Sex and skeletal pattern were not significantly correlated to lingula and antilingula shapes. No significant correlation was observed between lingula and antilingula shapes.

A detailed radiomorphometric analysis of the mandibular foramen, lingula and anti-lingula with a special emphasis on mandibular prognathism.

INTRODUCTION: The aim of this study was to evaluate radiomorphometric differences of mandibular foramen (MF), lingula (Li), and anti-lingula (AL) between prognathic and non-prognathic patients, using cone-beam computed tomography (CBCT). METHODS: A total of 228 3D CBCT images of 57 prognathic and 57 non-prognathic patients were retrospectively evaluated. The distances between MF or Li to occlusal plane (OP), anterior border of ramus (AR), posterior border of ramus (PR), sigmoid notch (SN), gonion (Go) and distances Li to MF were measured. The presence of AL, and the distances to Li were also assessed in both groups. RESULTS: In prognathic patients the mean distances of MF-AR and Li-PR were lesser, and Li-OP was greater (p < 0.05). However, distances from MF or Li to the other ramal landmarks were similar in both groups (p > 0.05). Presence of AL was found at 53 sides in prognathic and 20 sides in non-prognathic groups (p < 0.05). The horizontal distance of Li-MF was greater in prognathic patients (p < 0.05). On the other hand, there was no difference between groups regarding the horizontal distance of Li-Al, and the vertical distances of Li-MF and Li-AL (p > 0.05). CONCLUSION: The present study provided valuable data regarding morphological differences of MF-AR, Li-MF and Li-OP, which should be considered in the preoperative assessment of patients with mandibular prognathism. Presence of AL was more common in prognathic patients and mainly located above Li. 3D CBCT applications facilitated assessment of AL and its relationship with Li.

Sexual dimorphism of inferior alveolar canal location: A record- based CBCT Study in Eastern India.

Background: Sex determination from unidentified skeletal remains a daunting task in forensic odontology. The mandible is the strongest and most durable of bones available for post-mortem profiling and its morphometric characteristics have been investigated. Less explored is the location of the mandibular canal which in a few populations has shown gender dimorphism. Aim: The present cross-sectional study explores sexual dimorphism in an eastern Indian population of Odisha from an analysis of cone-beam CT system (CBCT) images for the relative position of the mandibular canal and its foramina. Method and Materials: A total of 120 CBCT images from either gender (1:1 ratio) of adult dentate individuals aged 18-60 years were analysed for the relative position of the mandibular canal. Ten measurements (8- coronal and 2- from axial slices) concerning the mandibular canal; at the level of the mandibular foramen, mandibular first molar and mental foramen were performed. Unpaired Student's t-test was employed to compare variables between the sexes at P < 0.05 level of significance. Results: The results revealed statistically significant differences (P < 0.05) between the genders in most of the variables (8/10), with higher mean values in males compared to females except in the distance between mandibular foramen and anterior border of the ramus (2.648 ± 0.67 mm in females, 2.527 ± 0.75 mm in males) and in the distance between the canal and lingual cortical plate in the region of the first molar (14.515 ± 1.33 mm in females, 14.288 ± 2.01 mm in males). Conclusion: The relative position of the mandibular canal and its associated foramina show sexual dimorphism in an adult eastern Indian population.

Localization of mandibular foramen - a comparison between dry bones and orthopantomogram.

An inferior alveolar nerve block is a usual practice by a dental practitioner. Panoramic radiography is a widely used technique in dentistry to get a clear and comprehensive view before planning any treatment. The study aimed to compare the morphometric localization of mandibular foramen (MF) on dry bones and orthopantomogram. The study was designed in two phases: a morphometric study on dry human mandibles (phase I) and orthopantomograms of the same dry human mandibles (phase II). The study materials were 200 dry north Indian human mandibles belonging to unknown sex obtained from the Department of Anatomy. Descriptive statistics, including range, mean±standard deviation, paired t-test to compare dry bones and orthopantomogram, Pearson's correlation coefficient, and measurement error, were used. T-test was applied separately to compare the right and left sides of dry bones. The distance of mandibular foramen from the posterior border and lower border is shorter on the right side than on the left. Its distance from the anterior border and the mandibular notch was greater on the right side. On panoramic radiographs, the distance of MF from nearby anatomical landmarks on the mandible was highly unreliable except for the mandibular notch. Our findings demonstrate a statistically significant difference between distances on dry bone and OPG but no statistically significant difference between MF-notch on both sides and MF-AB on the right side. As a result, a surgeon can rely upon a mandibular notch to locate mandibular foramen during clinical procedures. Magnification is an inbuilt property of OPG; for precise localization of MF, it is advisable to proceed with advanced three-dimensional techniques to protect viable anatomical structures.

Radiographic characteristics of the maxillomandibular complex in neufibromatosis: short communication and literature review.

OBJECTIVE: To report radiographic characteristics of a case of a patient with neurofibromatosis involving the maxillomandibular complex and to point out other dental radiographic characteristics that are found in the scientific literature to help the dentist when faced with a case of neurofibromatosis. SHORT COMMUNICATION: Male, 31 years old, referred for radiographic examination. During anamnesis and physical examination, lesions were noted, which were papules and café-au-lait patches larger than 1 cm on the trunk and upper limbs, further to Lisch nodules (brown spots on the iris) and axillary and inguinal ephelides. When investigating the history of the disease, the patient reported the presence of such skin atlterations since birth and mentioned that his mother had been diagnosed with neurofibromatosis. During radiographic evaluation, a significant increase in the caliber of the mandibular canal and mental foramen was observed, bilaterally. CONCLUSION: Completing the combination of skin characteristics present in the patient, anamnesis data and current history of the disease with interpretation of radiographic alterations, it was possible to arrive at the diagnostic hypothesis of Neurofibromatosis type 1 and correct clinical management. Therefore, it is extremely important for the dentist to be aware of the clinical, physical and radiographic characteristics that this condition presents for the correct management and success of dental treatment.

Morphological Investigation of Mandibular Lingula: A Literature Review.

PURPOSE: The purpose of the study was to review the literature on the shape of the mandibular lingula. METHODS: English articles published from 1970 to 2021 in databases (PubMed, Web of Science, and Embase) were selected. Articles meeting the search strategy were evaluated based on the eligibility criteria (participants aged 18 years and over). Dry mandibles and cone beam computed tomography (CBCT) images were used as research materials. The shapes of mandibular lingula were classified as triangular, truncated, nodular, and assimilated. RESULTS: Based on the eligibility criteria, 10 articles (six with dry mandibles and four with CBCT images) were selected for full-text reading and detailed examination. In the dry mandible group, triangular, truncated, nodular, and assimilated lingula were observed on 446, 398, 232, and 69 sides, respectively. In the CBCT group, nodular, truncated, triangular, and assimilated lingula were observed on 892, 517, 267, and 88 sides, respectively. Therefore, the most common lingula types in the dry mandible and CBCT groups were different. The assimilated type was the least common in both groups. CONCLUSION: In the dry mandible group, the most common lingula type was triangular, followed by truncated, nodular, and assimilated types. In the CBCT group, the most common lingula type was nodular, followed by truncated, triangular, and assimilated types. There were no significant differences in lingula types between the left and right sides of the mandible.

A Cone Beam Computed Tomographic Study on the Location of Mandibular and Mental Foramen in Indian Pediatric Population.

Aim: To determine the location of mandibular foramen (MF) and mental foramen (MeF) in 8-18-year-old children using cone beam computed tomography (CBCT). Materials and methods: Hundred CBCT images of children (8-18 years) were evaluated to determine the shortest distance from MF to the anterior border of ramus (A), posterior border of ramus (P) and inferior border of the mandible (MI), most superior point of the curvature of mandibular notch (MN), occlusal plane of the mandibular permanent molars (O), and the distance from MeF to lower border of mandible (BM) and to the alveolar crest (AC). Results: There was a statistical increase in A-MF, P-MF, MI-MF, MN-MF, and O-MF values with age. MF was found to be 3.53 mm below the occlusal plane in 8-11-year-old children, and it reaches the occlusal plane by 12-14 years of age, and it moves posterior-superiorly 3.58 mm above the occlusal plane in 15-18-year-old individuals. AC-MeF value decreases whereas the BM-MeF value increases with age and there was a significant difference based on sex. Conclusion: The location of the MF is just posterior to the middle of the ramus, it reaches the level of the occlusal plane by the age of 12-14 years, and MF and MeF are shifting posterior-superiorly with increasing age. Clinical significance: The awareness of localization of MF and MeF is of greater importance when administering regional anesthesia in mandible, especially in children. Its position varies according to gender and age, especially during growth spurts. Failure to achieve proper nerve block leading to repeated injection of the local anesthetic solution will not only pose a behavior problem in children but can also lead to systemic toxic level of anesthetic solution being administered. Its accurate position enables more effective local anesthesia and improves child cooperation, minimizing the risk of complications. How to cite this article: Vathariparambath N, Krishnamurthy NH, Chikkanarasaiah N. A Cone Beam Computed Tomographic Study on the Location of Mandibular and Mental Foramen in Indian Pediatric Population. Int J Clin Pediatr Dent 2022;15(4):422-427.

Sexual dimorphism and geographical variance: their impact on the reliability of the antilingula as a landmark in human mandibular surgery.

The intraoral vertical ramus osteotomy (IVRO) is an orthognathic procedure that is used to correct dentofacial abnormalities, and is performed by approaching the lateral aspect of the mandibular ramus. This approach, however, precludes visualisation of the inferior alveolar nerve (IAN) on the medial side, thereby placing it at risk of iatrogenic damage. The antilingula, a bony prominence on the lateral mandibular ramus, has been proposed as a landmark for prediction of the IAN's location during IVRO. The current study aimed to evaluate the variation in incidence and position of the antilingula, and therefore to determine its suitability as a surgical landmark during IVRO. The study included 480 dry hemimandibles from eight geographical populations from the Duckworth Collection in Cambridge. Skulls were sexed by visual analysis of dimorphic traits. Positional relations were determined through the digitisation of nine anatomical landmarks. The antilingula was identified in all specimens. No significant difference was identified in the positional relation between the antilingula and mandibular foramen between sexes, but multiple differences were identified in this relation between geographical populations. Our data showed that, irrespective of geographical variation, an osteotomy performed 8mm posterior to the antilingula would avoid the mandibular foramen in 98.8% of cases.

Mandibular canal versus inferior alveolar canal: A Delphi study.

The general principles of anatomical terminology indicate that the "mandibular canal" should be named the "inferior alveolar canal" as it accommodates the inferior alveolar neurovascular bundles. Therefore, we performed a Delphi study to evaluate the current understanding and use of the terminology in different geographical regions and areas of expertise and to determine the appropriate terminology for this bony canal. A Delphi panel was formed and questions sent and answered via email about: field of expertise (anatomy, oral surgery/oral and maxillofacial (OMF) surgery, oral radiology/OMF radiology, plastic surgery, ENT surgery, or dentistry with the exception of oral/OMF surgery and oral/OMF radiology), years of experience in the field of expertise, country currently working in, "what is the name of the bony canal that contains the inferior alveolar neurovascular bundle," and "what should the structure above be called, in general?" A total of 52 participants responded to the questionnaire. Half or more of the experts in anatomy, oral/OMF surgery, and ENT/plastic surgery considered "mandibular canal" to be the most appropriate name for this bony canal. In contrast, more than half of all experts in oral/OMF radiology and dentistry, that is, most fields of dentistry, considered "either mandibular canal or inferior alveolar canal" to be the appropriate name. The results of the Delphi study and general principles suggest that an alternative term for the "mandibular canal" should be "inferior alveolar canal."