Morphometric Analysis of Dry Human Mandibles to Assess the Position of Lingula, Course of the Inferior Alveolar Nerve: In Vitro Study
World Journal of Dentistry
Inadequate knowledge about position of lingula can result in damage to the vital structures related to it. Therefore familiarity about the position of the lingula and course of the nerve along the canal becomes paramount for a maxillofacial surgeon, an implantologist, and also for a dental surgeon. Structural localization of lingula will in turn reduce the incidence of inferior alveolar nerve injury while performing SSRO and also ensure adequate bone thickness on all sides of osteotomized
... t which helps in preventing bad splits. Location of mandibular lingula is variable among different races and within ethnicity have been already reported by various authors in the literature. 6, 7 IntroductIon Sagittal split ramus osteotomy is the most common technique used for correction of mandibular deformities. 1 This osteotomy was first described by Obwegeser and has been modified by Dalpont et al. 2 This versatile technique can be used for correction of asymmetries of mandible in anteroposterior, vertical, and transverse dimensions. Single-stage procedure, broad bony interface, minimal stripping of surrounding muscles, and its versatility in rectification of asymmetries in all three planes of mandible have made this technique the most favorable among maxillofacial surgeons. 2 agittal split ramus osteotomy is a technique sensitive procedure which starts in the lingual cortex of mandible above lingula, proceeds towards anterior border of ramus and inferior border of mandible through buccal cortex between first and second molars. Though various intraoperative complications like hemorrhage, bad splits, and improper alignment of proximal and distal fragments have been reported in literature, one of the major limitations remains paresthesia due to nerve injury. ]  Lingula is a tongue-shaped projection on the medial side of the mandible. It forms a definitive bony landmark while doing SSRO and during inferior alveolar nerve block. 5 Sagittal split ramus osteotomy involves splitting of the mandible and the exact pattern of cut on the lingual side is difficult to predict due to loss of visualization. Injury to the nerve can occur during the medial osteotomy cut adjacent to lingula as the nerve enters the mandibular foramen and during splitting of the mandible during SSRO.