Objective. The study aimed to investigate and measure the anatomical relationship between the mandibular lingula (Li) and skeletal patterns using cone-beam computed tomography (CBCT). Materials and Methods. In total, 72 participants (23 men and 49 women) were categorized into three groups according to their skeletal patterns (specifically, the A point–nasion–B point (ANB]) angle) as follows: Class I (0° < ANB < 4°), Class II (ANB ≥ 4°), and Class III (ANB ≤ 0°). The CBCT images of 144 rami were collected, and the distance from the Li to the external oblique ridge (Li-EOR), internal oblique ridge (Li-IOR), posterior border of the ramus (Li-PBR), inferior border of the ramus (Li-IBR), sigmoid notch (Li-Sm), and mandibular foramen (Li-MF) was examined. The Li-hMF (horizontal distance from the Li to the MF) and Li-vMF (vertical distance from the Li to the MF) were measured. The comparisons of gender, side (right and left), and skeletal patterns were then evaluated by statistical analysis. Results. The values of the Li-EOR and Li-PBR (19.99 mm and 15.93 mm, respectively) were significantly higher in men than in women (18.85 mm and 14.89 mm, respectively). Moreover, the Li-IBR was higher in men (32.91 mm) than in women (30.40 mm). Both sides (right and left) and skeletal patterns demonstrated that the Li-EOR, Li-IOR, and Li-PBR were not significantly different. Pearson’s correlation test reported a strong correlation between the Li-EOR and Li-IOR (r=0.610). Conclusion. The distances from mandibula lingula to the external oblique ridge, posterior border of ramus, and inferior border of ramus were significantly longer in men than in women. Similarly, both horizontal and vertical distances from the lingula to the mandibular foramen were significantly longer in men than in women. Therefore, the results demonstrated that the Li was longer and more protruding in men than in women. With respect to the horizontal distance from the mandibular lingula to the mandibular foramen, of the three types of the skeletal system (Class I, Class II, and Class III), Class III was the significantly largest.
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.
Purpose. This study investigated the relationship between the shortest buccal bone marrow of the ramus and skeletal patterns. Materials and Methods. Using cone-beam computed tomography data (specifically, the A point-nasion-B point (ANB) angle), we divided patients into three groups as follows: skeletal class I ( 0 ° < ANB < 4 ° ), class II (ANB: ≥4°), and class III (ANB: ≤0°). Sixteen vertical sections in the coronal plane were taken starting from slice 0 (original intact mandibular canal) anteriorly at 2 mm intervals to slice 15 (30 mm). The thickness of the mandible (M) and shortest buccal bone marrow (SBM) were measured. The data of SBM were divided into two groups ( SBM ≥ 1 mm and SBM < 1 mm ). For each skeletal pattern, an SBM value < 1 mm was considered to indicate a high possibility of postoperative nerve paresthesia and bad split. Results. The three skeletal pattern groups also did not significantly differ in their M values for all sections. The mean SBM values of class III (0.91–2.11 mm) at 6–16 mm anterior to the mandibular foramen were significantly smaller than those of class II (1.53–3.17 mm). Comparing the occurrence ratio of SBM < 1 mm , the highest and lowest probabilities in class III (55% and 21.7%, respectively) were significantly larger at 6–20 mm anterior to the mandibular foramen than those in class II (28.3% and 5%, respectively). Conclusion. Class III had a significantly shorter SBM distance and higher SBM occurrence probability than class II at the mandibular ramus region, implying that class III participants are more likely than class II participants to have nerve paresthesia and bad split after sagittal split ramus osteotomy.
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