A tridimensional study using cuts at a low temperature of the infratemporal region

Abstract

Although the infratemporal region is well defined anatomically, its complex topography has been the subject of numerous, and sometimes, opposite works. That is the reason why it appeared necessary for the authors to re-evaluate this topic using the original method of Combelles and Boyer, allowing to define three referential planes, and thereby, a tridimensional shape and the volume of this region. This study allows to conclude that the infratemporal region is a triangular prism with an horizontal main axis 47 mm long. Its anterior base has a mean area of 733 mm2. The posterior top consists of the Juvara slot and has a mean area of 490 mm2. This infratemporal prism contains another one, the pterygomandibular space, prismatic too. It widens out from coronoïd plane (93 mm2) to mandibular foramen plane (169 mm2) before ending as a narrow groove between the neck of the mandibular condyle and the interpterygoïd fascia. The volume of the pterygomandibular space is quite superior to the value usually reported in the dental literature. It is of 4.8 ml to 5.8 ml according to denture. These results point out the opportunity to accomodate more important volumes of anesthesic solutions, than the 1.8 ml usually performed, without any leak out of the infratemporal region.

Comparative Evaluation of 1.8 mL and 3.6 mL of 2% Lidocaine with 1:200,000 Epinephrine for Inferior Alveolar Nerve Block in Patients with Irreversible Pulpitis: A Prospective, Randomized Single-blind Study

“…Kohler et al (16) suggested from a clinical observation that two 1.8-mL cartridges (3.6 mL) more adequately fill the pterygomandibular space. Madrid et al (17) reported that the ''volume of the pterygomandibular space is quite superior to the value usually reported in the dental literature.'' Some authors have suggested increasing the amount of local anesthetic solution in order to increase the anesthetic success.…”

The Pterygomandibular Space: A Volumetric Evaluation Using the Novel A-Silicone Injections Method

“…In the literature, there is a single and non-correlated data point on the volume of the PM. For example, according to Madrid et al (1993) [ 32 ], the volume of the PM is superior to the value usually reported in the dental literature. An amount of 4.8 to 5.8 mL of anesthetic solution is sufficient for filling the PM according to denture.…”

“…We considered that this study is limited to dimensions assessed using unfixed material and by injecting and layer-by-layer dissection. Using materials that are prone to expansion or a temperature regime that differs sharply from the intravital body temperature, a sharp distortion of the boundaries is possible, as well as a decrease or increase in tissue resistance [ 32 ].…”