Locating the Mandibular Lingula Using Cone-Beam Computed Tomography: A Literature Review

Abstract

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.

Three‐dimensional evaluation of mandibular lingula: Comparisons of skeletal angle classifications and growth patterns

“…CBCT investigations have proven helpful in studying the ML, offering improved visualization and precise anatomical assessments. [12][13][14]17,[22][23][24] Nevertheless, the results remain controversial, particularly concerning the correlation between genders, angle Even though some studies reported no significant differences between male and female patients, 14,22 our results were consistent with other studies, which have detected such differences and indicated relatively more minor mandibles and, consequently, smaller measurements of the mandibular lingula (ML) in women. The controversy among studies stems from several factors, including participant age, race variations and the reference planes employed for measurements.…”

“…A sample size of 25 samples per group was determined using G*Power software version 3.1.9.6 (Franz Faul, Kiel University, Germany) based on previous studies, [11][12][13][14] considering their average effect size of 0.37. The significance level (alpha) was set at 5% with β at 0.02 (power of 0.98) to achieve the desired effect size of 0.37 using one-way ANOVA power analysis.…”

“…The occlusal plane was selected as the reference plane in the present study, which is suggested to provide more accurate measurements regarding the ML-PBR. 12 In the present study, the vertical distance between the mandibular lingula (ML) and the occlusal plane (OP) was also assessed, as this measurement serves as a guide for determining the insertion point of the needle during an inferior alveolar nerve block (IANB) procedure. Our results regarding the ML-OP distance differ from previous research that suggested an insertion point located 9 mm above the occlusal plane, as they found the ML to be approximately 8.9 mm above the OP.…”

“…5 Moreover, safeguarding this vital structure is paramount during surgical procedures involving ramus osteotomies, such as the sagittal split ramus osteotomy, which represents the most frequently utilized approach for surgically correcting mandibular deformities. 6 In light of the clinical relevance and significance of the mandibular lingula (ML), extensive evaluations of this landmark and its variations have been conducted utilizing various methods, including direct observation of dry skulls, 4,7 2D 8,9 and 3D [10][11][12][13][14] imaging techniques. The studies conducted on dry skulls suffer from a lack of information regarding the age and gender of the samples, which presents a challenge in interpreting their results.…”

“…Consequently, in recent years, techniques such as 3D cone beam computed tomography (CBCT) have gained popularity due to their high accuracy while minimizing patient exposure to excessive radiation doses. [10][11][12][13][14]17,18 The findings in this field have been controversial due to variations in the evaluation techniques employed and the need for consistent reference planes defined in these studies. 2,4,13,17,[19][20][21][22][23][24][25] These controversies include not only the absolute values of the measurements regarding the ML reference point, but also the correlation between factors such as gender, angle classification and growth pattern on the ML position.…”