The Study of Antilingula and Its Relation to the Lingula and Mandibular Foramen, the Presence of Mylohyoid Bridging in Dry Mandibles of South Indian Population

Abstract

Background and Objectives The mandibular foramen and the lingula, because of their relation to the inferior alveolar nerve are of clinical significance for the orodental surgeons. Identification of the antilingula is important in mandibular ramus surgery in which the medial surface of the ramus is not visualized. Methods The present study includes adult dry 50 mandibles of unknown age and sex. The measurements were taken using vernier calipers. The points taken for measurements were most prominent point on antilingula, tip of lingula, most anterior, posterior and inferior points of mandibular foramen. The measurements were denoted as A, B, C and D which represent the anterior, posterior, superior and inferior distances. Results Antilingula was present on right side in 25 and on left side in 28 mandibles. There was a significant difference in distances in mean between the antilingula and mandibular foramen of both the sides (p \ 0.001). Retromolar foramen was observed in 6 mandibles. Mylohyoid bridging was seen in 3 mandibles. Conclusion The mandibular foramen was located posterosuperior to the antilingula on both the sides. There was no statistical significance in the distances between the lingula and the antilingula. Therefore antilingula can be used as an important surgical landmark for locating the mandibular foramen in mandibular ramus osteotomies.

Anatomical study of the location of the antilingula, lingula, and mandibular foramen for vertical ramus osteotomy

“…In a study by Apinhasmit et al [ 9 ] using 92 dry mandibles, the antilingula was found in 80.4% of the patients, and it was confirmed that the antilingula was primarily present in the anterior-inferior region of the lingula. In a study by Hosapatna et al [ 12 ] using 50 South Indian dry mandibles, it was confirmed that the mandibular foramen existed in the posterosuperior region of the antilingula, in contrast to the findings of previous studies. In the present study, the lingula was present in posterosuperior region of the antilingula.…”

“…To prevent this complication, there have been several attempts to develop novel surgical techniques to avoid damage to the IANB during osteotomy of the lateral side of the ramus, such as VRO, inverted L-osteotomy, and C-shaped osteotomy. In order to identify the theoretical basis of these surgical techniques, there have been many studies to determine the anatomical location of the IANB in the lateral side of ramus [ 3 – 6 , 8 – 12 ].…”

“…There were several considerations when defining the anatomical measurement points in this study. In some studies, the antilingula was not observed, and it was thought that there was difficulty in setting the antilingula [ 3 , 5 , 6 , 9 , 12 ]. However, our study demonstrated that the antilingula was the most prominent part of the lateral side of the ramus, which was found by both visual and palpation methods, and was observed on both sides of the mandible (40 sites) in 20 cadavers.…”

Antilingula as a Surgical Reference Point for Vertical Ramus Osteotomy

“…Hosapatna et al [ 18 ] studied 50 dry mandibles and observed that the antilingula was located on the right side of 25 of the mandibles and on the left side of 28 of the mandibles. Hsiao et al [ 19 ] reported the bilateral presence of the antilingula in 67.8% of those studied.…”

Clinical anatomy of the nerve to the mylohyoid

“…Endoscopy has used to visualize the mandibular foramen and related structures and demonstrated that the mylohyoid groove could be doubled, narrowed, or occasionally covered by a bony bridge [29]. The frequency of mylohyoid bridging has been reported as 10.99% (21/191) [30], 10.0% (4/40) [31], and 6.0% (3/50) [32]. Fabian concluded that the formation of the medial wall of the mandibular foramen and/or attachment of the sphenomandibular ligament onto the lingula leads to variations in location of the mylohyoid groove [33].…”