Dimension and Location of the Mandibular Lingula: Comparisons of Gender and Skeletal Patterns Using Cone-Beam Computed Tomography

Abstract

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.

Correlation between the Mandibular Lingula Position and Some Anatomical Landmarks in Cone Beam CT

“…The vertical distance between the lower mandibular margin and Spix’s spine (VDLiMB) was measured on the frontal plane passing through the apex of Spix’s spine as the distance from the apex of the Li to the lowest point of the mandible [ 3 , 6 , 26 , 27 ].…”

“…The strengths of correlations were described for the absolute values of the ratios of the compared variables as follows: very weak (0–0.19), weak (0.20–0.39), moderate (0.40–0. 59), strong (0.60–0.79), and very strong (0.80–1.0) [ 3 ].…”

“…Because of its relation to nervous and vascular structures, since the inferior alveolar nerve (IAN) enters the MF at the Li position, understanding the structures related to the Li position is crucial. The study of the Li features provides significant information related to oral and maxillofacial surgical procedures, such as sagittal split ramus osteotomy (SSRO), intraoral vertical ramus osteotomy (IVRO) [ 3 ], inverted-L osteotomy [ 4 ], orthognathic surgery, mandibular trauma management, eradication of benign and malignant lesions, pre-prosthetic surgery [ 5 ], cyst removals in mandibular ramus, temporomandibular, and joint reconstruction [ 5 ]. If oral and maxillofacial surgeons do not identify the lingula correctly, intraoperative complications, such as bleeding, unfavorable fractures, and nerve injuries, could occur [ 6 ].…”

Antilingula as a Surgical Reference Point for Vertical Ramus Osteotomy

“…Previous studies [11][12][13] have demonstrated the relationship between the position of the antilingula and that of the lingula and mandibular foramen. Scholars [13][14][15] have suggested that the position of the antilingula-which can be seen during operation-exhibited a stable relationship with the position of the mandibular foramen.…”

Cone Beam Computed Tomography Based Sex Estimation by Volume of Odontoid Process of The Second Cervical Vertebra

“…As well as the mental foramen, other studies have evaluated different structures by using CBCT for predicting sex. Position of the mandibular lingual [16], volume of the mandibular condyle [17] and angulations of the mandibular fossa and articular tubercle [18] are structures which were shown to be useful to estimate the sex of individuals. However, it is known that bone structures of the temporomandibular joints (TMJ) are often subject to being affected by degenerative processes (e.g.…”