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The Anatomical Location of the Mandibular Canal: Its Relationship to the Sagittal Ramus Osteotomy
Published in Niall MH McLeod, Peter A Brennan, 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
Forty-five dried adult Asian (sex and age unknown) intact mandibles with nearly complete dentitions were sectioned—first along the midline (to create a hemimandible) and then at defined standardised points perpendicular to the sagittal plane: just posterior to mental foramen, just anterior to mandibular foramen and at three equal intervals between these two sites. The size and position of the mandibular canal in relation to the lingual cortex, buccal cortex and the inferior border of the mandible was measured with calipers.
Head and neck
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
The mandibular periosteum does not need to be excised unless it is directly involved. Tumour can spread within the mandible either through the medulla or permeative spread along the mandibular canal. Trismus (suggestive of pterygoid involvement) and pain radiating to the ear or temple (auriculotemporal nerve) or lower lip (mental nerve) are poor prognostic signs.
Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The capsule of the temporomandibular joint is loose and its lateral surface is reinforced by the temporomandibular ligament. On the inner aspect of the mandible lie the digastric fossa for the anterior digastric muscle, mylohyoid line for the mylohyoid muscle, lingula for the attachment of the sphenomandibular ligament and submandibular fossa, mylohyoid groove for the mylohyoid nerve and vessels, and mandibular foramen for the inferior alveolar nerve and vessels (Plates 3.8b and 3.28). These neurovascular structures pass distally in the mandibular canal and provide innervation to the mandibular teeth. Within the mandibular canal, the mental nerve branches from the inferior alveolar nerve and exits through the mental foramen to reach the outer surface of the mandible and innervate the chin and lower lip.
Visibility of anatomical landmarks in the region of the mandibular third molar, a comparison between a low-dose and default protocol of CBCT
Published in Acta Odontologica Scandinavica, 2023
Josefine Cederhag, Durer Iskanderani, Per Alstergren, Xie-Qi Shi, Kristina Hellén-Halme
The present study found no significant differences between the default and experimental protocols regarding root morphology or the relationship and proximity between the third molar and mandibular canal. Likewise, the substantial to almost perfect intra- and interobserver agreement for all observers further confirms the reliability of identifying these landmarks. Comparative literature is limited; however, two non-clinical studies on CBCT imaging of the mandibular canal can be noted: Neves et al. [28] showed that the region providing best visibility of the canal was the dentulous mandibular region of third molars, and Zaki et al. [47], that the tube current necessary for adequate visibility of the canal was higher than otherwise needed in low-dose protocols. Both studies advocated the potential of using dose protocols tailored to the purpose of the investigation, since Zaki et al. [47], opined that some reduction in tube current was still possible. This is consistent with the suggestions of Pauwels et al. [21,43] that exposure protocols should be selected according to diagnostic requirements for the level of contrast and detail.
Reliability of radiographic findings in large FOV CBCTs of mandibular third molars as basis for pre-operative patient information
Published in Acta Odontologica Scandinavica, 2022
Louise Hauge Matzen, Lars Schropp, Louise Hermann, Janne Ingerslev, Ann Wenzel
Forty-six cases (22.0%) had at least one of the three clinical signs for a close relation between the mandibular canal and the tooth and were included in the generated clinical variable contact. The relationship between contact and the radiographic canal-related variables can be seen in Table 5. The highest PPV (0.33–0.43) and LR+ (1.8–3.5) were found for all observers when the canal was positioned between the roots of the third molar. This means that in 33–43% of cases assessed in CBCT with the canal positioned between the roots of a third molar, the IAN was either visible, there were grooves in the root complex from the nerve, and/or the patient experienced a post-operative sensory disturbance in the innervation area of the IAN. Likewise, the risk of one of these ‘complications’ is 1.8–3.5 among observers.
Is it possible to extract lower third molars with infiltration anaesthesia techniques using articaine? A double-blind randomized clinical trial
Published in Acta Odontologica Scandinavica, 2021
Rui Figueiredo, Stavros Sofos, Eduardo Soriano-Pons, Octavi Camps-Font, Gemma Sanmarti-García, Cosme Gay-Escoda, Eduard Valmaseda-Castellón
An important issue that needs to be considered is the choice of local anaesthetic. Articaine has a faster onset and better diffusion through bone than lidocaine [10,23]. For example, Corbett et al. [24] found different results regarding the time until the patient reported lip numbness, probably because the local anaesthetic was lidocaine. The longer onset time recorded in the present sample is probably related to the fact that the anaesthetic solution was delivered next to the buccal bone plate, which is especially thick in the posterior area of the mandible. Therefore, the anaesthetic solution takes longer to diffuse through the bone and reach the inferior alveolar nerve, in contrast with IANB, which places the solution in the area where the inferior alveolar nerve enters the mandibular canal. The INF group patients’ buccal injection points (between the first and second molars) were slightly distal to those described by El-Kholey [13]. The available data on the success rates of other infiltration areas closer to the third molar region is scarce and comes from cohort studies that did not include a control group using IANB [5–7]. Thus, in our opinion, future research to determine the ideal injection point is needed, since this variable is likely to influence the anaesthetic success rate.