Morphological Study of the Mandibular Lingula and Antilingula by Cone-Beam Computed Tomography

Abstract

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.

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.…”

“…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.…”

“…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 10–14 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.…”