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.
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.
Segmental bony defects of the mandible constitute a complete loss of the regional part of the mandible. Although several types of customized three-dimension-printed mandible prostheses (CMPs) have been developed, this technique has yet to be widely used. We used CMP with a pressure-reducing device (PRD) to investigate its clinical applicability. First, we used the finite element analysis (FEA). We designed four models of CMP (P1 to P4), and the result showed that CMP with posterior PRD deployment (P4 group) had the maximum total deformation in the protrusion and right excursion positions, and in clenching and left excursion positions, posterior screws had the minimum von Mises stress. Second, the P4 CMP-PRD was produced using LaserCUSING from titanium alloy (Ti-6Al-4V). The fracture test result revealed that the maximum static pressure that could be withstood was 189 N, and a fatigue test was conducted for 5,000,000 cycles. Third, animal study was conducted on five male 4-month-old Lanyu pigs. Four animals completed the experiment. Two animals had CMP exposure in the oral cavity, but there was no significant inflammation, and one animal had a rear wing fracture. According to a CT scan, the lingual cortex of the mandible crawled along the CMP surface, and a bony front-to-back connection was noted in one animal. A histological examination indicated that CMP was significantly less reactive than control materials (
p
=
0.0170
). Adequate PRD deployment in CMP may solve a challenge associated with CMP, thus promoting its use in clinical practice.
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