Foramen mandibulae'nin morfometrik özellikleri ve klinik önemi
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Dosyalar
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Foramen mandibulae a.v.n. alveolaris inferior’un canalis mandibulae’ya giriş noktası olması nedeniyle, bir çok diş hekimliği ve maxillofacial cerrahi prosedüründe önem taşır. Sagittal split ramus osteotomi, ortognatik cerrahi, mandibular travma yönetimi, benign ve malign lezyonların çıkarılması, preprotetik cerrahi ve mandibular anestezi işlemlerinde sinir hasarı ve başka komplikasyonların önlenmesi açısından for. mandibulae’nin konumu ve morfometrik bulgularına hakim olunması oldukça önemlidir. Lingula mandibulae, for. mandibulae ve n. alveolaris inferior ile komşuluğundan dolayı oldukça önemli bir yapıdır. Klinikte for. mandibulae’nin konumunun tespitinde kılavuz alınan noktalar arasında önemli bir yere sahiptir. Çalışmanın amacı for. mandibulae ve lingula mandibulae’nin morfometrik ölçümlerini yaparak for. mandibulae’nin lokalizasyonu hakkında bu bölge üzerinde çalışan araştırmacı ve klinisyenlere ışık tutmaktır.
Yöntem: Ege Üniversitesi Tıp Fakültesi Anatomi Anabilim Dalı Makroskopi Salonu’nda bulunan 99 adet kuru mandibula üzerinde 0,01 mm duyarlılıktaki dijital kumpas ve 1 derece duyarlılıktaki gonyometre kullanılarak morfometrik ölçümler yapıldı.
Bulgular: For. mandibulae ramus mandibulae’nin ön-arka genişliğinin orta noktasının hafif posteriorunda ve ramus mandibulae yüksekliğinin orta noktasının hafif superiorunda yer almaktadır. Ramus mandibulae’nin margo anterior’una uzaklığı ortalama 16,60 mm, margo posterior’una uzaklığı ortalama 13,36 mm, foramenin transvers çapı 2,98 mm, sagital çapı 3,86 mm bulundu. Lingula mandibulae’nin margo anterior’a uzaklığı 16,51 mm, margo posterior’a uzaklığı 15,04 mm, yükseklği ortalama 8,14 mm bulundu. Mandibula açısı ortalama 123 derece, lingula mandibulae açısı ortalama 26 derece bulundu. Molar okluzal hat seviyesi %54,2 oranında lingula mandibulae tepe noktası ile for. mandibulae girişi arasında, %34,3 oranında for. mandibulae girişinden daha aşağıda olduğu görüldü. Ayrıca aynı mandibulanın sağ ve sol tarafında molar okluzal hat seviyesinin farklı olabildiği görüldü. Lingula mandibulae tiplerinin görülme sıklıkları truncated %36,6, triangular %33, nodular %15,7, assimilated %14,7’dir. Ramus kalınlığı for. mandibulae’nin anteriorunda ortalama 7,86 mm, for. mandibulae hizasında ortalama 4,72 mm, posteriorunda 5,50 mm bulundu.
Sonuç: Yaptığımız ölçümler ve daha önce yapılan çalışmaların sonuçları değerlendirildiğinde, for. mandibulae ve lingula mandibulae’nin ramus mandibula üzerindeki konumunun değişkenlik gösterebildiği görülmüştür. Çalışmamızın literatüre katkısı olacağını ve bu alanda çalışan klinisyenlere ışık tutacağını düşünüyoruz.
Objective: Because mandibular foramen is the entrance for the inferior alveolar nerve, artery and vein to the mandibular canal, it is of great importance in many dental and maxillofacial surgical procedures. In order to prevent nerve damage and other complications from occurring in procedures such as sagittal split ramus osteotomy, orthognathic surgery, mandibular trauma management, removal of benign and malignant lesions, preprosthetic surgery and mandibular anesthesia, being knowledgeable about the location and morphometric findings of the mandibula is of great significance. Lingula is a very important structure, because of its close proximity to the mandibular foramen and inferior alveolar nerve. In the clinic, lingula has an important place among landmarks used in determining the location of the mandibular foramen. The purpose of the study is to guide researchers and clinicians working on this region for the localization of the mandibular foramen by performing the morphometric measurements of the mandibular foramen and lingula. Methods: Morphometric measurements were performed on 99 dry mandibles in Ege University School of Medicine, Department of Anatomy, using a digital caliper with accuracy of 0,01 mm and a goniometer with accuracy of 1 degree. Results: The mandibular foramen is located slightly posterior to the midpoint of the anterior-posterior width of the ramus of mandible, and slightly superior to the midpoint of the height of the ramus of mandible. The mean distance of the mandibular foramen from the anterior and posterior margins of the ramus of mandible was 16,60 mm and 13,36 mm respectively. Its transverse and sagittal diameters were 2,98 mm and 3,86 mm respectively. The mean distance of lingula from the anterior and posterior margins of ramus of mandible was 16,51 mm and 15,04 mm respectively and its height was 8,14 mm on average. While the mean mandibular angle was 123 degrees, the mean lingula angle was 26 degrees. The level of molar occlusal line was between the tip of lingula and the entrance of the mandibular foramen in 54,2% of the cases, and lower than the entrance of the mandibular foramen in 34,3% of the cases. It was also observed that the level of the molar occlusal line could be different on the right and left sides of the same mandible. The incidence of lingula was 36,6% for the truncated type, 33% for the triangular type, 15,7% for the nodular type and 14,7% for the assimilated type. The average thickness of the ramus was 7,86 mm in the anterior of the mandibular foramen, 4,72 mm at the level of foramen and 5,50 mm in the posterior of the foramen. Conclusion: The analysis of the measurements we made and the results of previous studies demonstrated that the location of the mandibular foramen and the lingula on the ramus of mandible might vary. We believe that our study will contribute to the literature and provide guidance for clinicians working in this field.
Objective: Because mandibular foramen is the entrance for the inferior alveolar nerve, artery and vein to the mandibular canal, it is of great importance in many dental and maxillofacial surgical procedures. In order to prevent nerve damage and other complications from occurring in procedures such as sagittal split ramus osteotomy, orthognathic surgery, mandibular trauma management, removal of benign and malignant lesions, preprosthetic surgery and mandibular anesthesia, being knowledgeable about the location and morphometric findings of the mandibula is of great significance. Lingula is a very important structure, because of its close proximity to the mandibular foramen and inferior alveolar nerve. In the clinic, lingula has an important place among landmarks used in determining the location of the mandibular foramen. The purpose of the study is to guide researchers and clinicians working on this region for the localization of the mandibular foramen by performing the morphometric measurements of the mandibular foramen and lingula. Methods: Morphometric measurements were performed on 99 dry mandibles in Ege University School of Medicine, Department of Anatomy, using a digital caliper with accuracy of 0,01 mm and a goniometer with accuracy of 1 degree. Results: The mandibular foramen is located slightly posterior to the midpoint of the anterior-posterior width of the ramus of mandible, and slightly superior to the midpoint of the height of the ramus of mandible. The mean distance of the mandibular foramen from the anterior and posterior margins of the ramus of mandible was 16,60 mm and 13,36 mm respectively. Its transverse and sagittal diameters were 2,98 mm and 3,86 mm respectively. The mean distance of lingula from the anterior and posterior margins of ramus of mandible was 16,51 mm and 15,04 mm respectively and its height was 8,14 mm on average. While the mean mandibular angle was 123 degrees, the mean lingula angle was 26 degrees. The level of molar occlusal line was between the tip of lingula and the entrance of the mandibular foramen in 54,2% of the cases, and lower than the entrance of the mandibular foramen in 34,3% of the cases. It was also observed that the level of the molar occlusal line could be different on the right and left sides of the same mandible. The incidence of lingula was 36,6% for the truncated type, 33% for the triangular type, 15,7% for the nodular type and 14,7% for the assimilated type. The average thickness of the ramus was 7,86 mm in the anterior of the mandibular foramen, 4,72 mm at the level of foramen and 5,50 mm in the posterior of the foramen. Conclusion: The analysis of the measurements we made and the results of previous studies demonstrated that the location of the mandibular foramen and the lingula on the ramus of mandible might vary. We believe that our study will contribute to the literature and provide guidance for clinicians working in this field.
Açıklama
Anahtar Kelimeler
Foramen Mandibulae, Lingula Mandibule, Mandibulae, N. Alveolaris Inferior, Mandibular Foramen, Lingula, Mandibula, Inferior Alveolar Nerve
