DOI: 10.14744/ejmi.2019.44846 EJMI 2019;3(3):189–195 Research Article Analysis of Average Index Values of Mandible Seher Yilmaz,1 Adem Tokpinar,1 Mustafa Tastan,2 Sukru Ates,2 Muhammet Degermenci,2 Demet Unalmis,2 Dilara Patat,3 Hatice Susar1 1Department of Anatomy, Bozok University Faculty of Medicine, Yozgat, Turkey 2Department of Anatomy, Erciyes University Faculty of Medicine, Kayseri, Turkey 3Department of Anatomy, Lokman Hekim University Faculty of Medicine, Ankara, Turkey Abstract Objectives: Mandible is the only viscerocranium bone moving in the skull. Mandible is active in speech and chewing functions; important bone for many areas such as anatomy, dentistry, anthropology, plastic and reconstructive surgery, jaw surgery. The aim of this study is to determine the average index values of the mandible and to contribute to the literature. Methods: This study was carried out using digital calipers with a sensitivity of 0.01 millimeter (mm) on 15 mandibular dry bone specimens in Anatomy Department of Erciyes University. Age and gender were not differentiated in dry bone samples. Measurements were made on the mandible, mainly on the location of the mental foramen and mandibular foramen, and on the other 20 reference points of the mandible. Results: In our study, there was no statistically significant difference when bilateral mandible data were compared (p>0.05). The average length of the mandibular foramen to the deepest point of the mandibular notch was found to be 20.39 mm on the right and 19.90 mm on the left. Conclusion: Knowing the normal anatomic structure and morphometric values of the mandibular bone well may avoid any possible complications during operations in this area. Keywords: Mandible, mandibular foramen, mental foramen, morphometry Cite This Article: Yilmaz S, Tokpinar A, Tastan M, Ates S, Degermenci M, Unalmis D, et al. Analysis of Average Index Values of Mandible. EJMI 2019;3(3):189–195. esides the functions such as chewing and speaking, the by the two corpus unions, the mandible becomes a single Baesthetically important mandible; He has always been bone.[2] The mandible is a U-shaped bone with teeth on it.[3] interested in many clinical branches such as anatomy, an- The mandible is the largest and only movable bone of the thropology, plastic and reconstructive surgery, jaw surgery, skeleton. Os mandibulae open the contents of the teeth, otolaryngology surgery, and dentistry. Especially in recent horizontally arranged with the corpus mandibulae at the years, the clinical importance of the mandible has increased rear of the two pieces of ramus mandibulae. The corpus in order to meet the functional and aesthetic needs of the mandibulae, the body of the mandible, is similar to a horse- shoe.[4,5] The hole in the middle of the inner face is called increasing treatment methods. the foramen mandibulae and canalis continues in the During the formation of the mandible, this bone is in two mandibulae. A portion of the canalis mandibulae, which parts, right and left. In the anterior mid-section of the cor- ends with a foramen mentality that is the hole in the lower pus of the two sides of the corpus is called the symphysis part of the outer 2nd premolar, is also found in the corpus mandibulae.[1] In the sympathetic mandible region formed mandibulae.[1] Foramen mentale. a.v.n. mentalis passes.[6] Address for correspondence: Seher Yilmaz, MD. Bozok Universitesi Tip Fakultesi, Anatomi Anabilim Dali, Yozgat, Turkey Phone: +90 354 212 62 01 E-mail: [email protected] Submitted Date: February 03, 2019 Accepted Date: April 16, 2019 Available Online Date: May 13, 2019 ©Copyright 2019 by Eurasian Journal of Medicine and Investigation - Available online at www.ejmi.org OPEN ACCESS This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. 190 Yilmaz et al., Analysis of Average Index Values of Mandible / doi: 10.14744/ejmi.2019.44846 Corpus mandibulae prolongs and expands during devel- create.[3] Good knowledge of the normal morphology, di- opment. mensions, angles, channels and physical characteristics of The mandible completes the development by first showing the mandible may be clinically important to prevent com- expansion. Then, respectively, the longitudinal and height plications that may occur during and after surgical proce- improvements are completed. The first 2-year rapid devel- dures. opment after birth is followed by a lower rate between 3-6 In this study, it is aimed to make detailed morphometric years of age.[7] The size and evaluation of the mandible is measurements on mandibular bones. Most of the anatom- important for the implants to be applied to the mandible. ical parameters that should be considered during surgical Implant surgery aims to restore aesthetics by providing interventions have been described and it is thought that adequate chewing and speaking function. It is important these measurements will help surgeons to perform suc- to investigate the relationship between bone size and cessfully and anesthesia. morphology, location of the foramen mentale and canalis mandibulae, as well as other important anatomical struc- Methods tures, as well as determining the location, height and width The measurements were made by using a digital caliper of the mandible for preoperative planning.[8] measuring 0.01 millimeters (mm) on 15 mandible bones Nervus alveolaris inferior originates from the fifth head in the anatomy laboratory of Erciyes University Medical nerve called trigeminus. N. trigeminus is the largest head Faculty. Age and gender were not differentiated when se- pair nerve and contains both motor and sensory branches. lecting mandibula bones to be used. Both sides data were The Nervus trigeminus starts as radix sensoria and radix measured symmetrically and fractures, pathology and motoria on the anterior aspect of pons and passes the pos- wear from the mandibular bones were not included in the terior fossa crania to the fossa crania media and passes over study. the upper part of the apex partis petrosa which belongs to os temporale. He is responsible for the motor innervation Measurement Variables of chewing muscles while receiving senses from most of 1. Distance from the deepest point of the inner edge of the head. There are three major branches of N. trigeminus, the foramen mandibulae to the deepest point of the in- n. ophthalmicus, n. maxillaris, n. It is mandibularis`. N. alve- cissura mandibulae olaris inferior, n. mandibularis is one of the posterior root branches and moves from the foramen ovale to the fora- 2. Distance from the deepest point of the inner edge of men mandible. M. pterygoideus passes through the me- the foramen mandibulae to the most protruding point dial of the lateralis and then passes between the ligamen- of the angulus mandibulae tum sphenomandibulare and ramus mandibulae into the 3. Distance from the deepest point of the inner edge of canalis alveolaris inferior.[1,9] Foramen mentale. a.v.n. men- the foramen mandibulae to the inner corner of the up- talis passes. Accurate determination of the anatomical po- per edge of the caput mandible. sition of Foramen mental is very important in periodontal 4. The length of the line leading from the deepest point of surgery, flap surgery of lower teeth, retrograde amalgam the inner edge of the foramen mandibulae to the rear filling application, surgical orthodontics and surgery of edge of the ramus mandibulae lower lip. N. mentalis injuries can cause temporary or per- 5. The length of the line leading from the deepest point of manent sensitivity, temperature and tactile changes in the the inner edge of the foramen mandibulae to the ramus regions of innervation.[6] Dentists often use n. alveolaris in- ferior blockade in invasive procedures related to the teeth mandibulae leading edge (linea obliqua) in the mandible. In this application, the anesthetic agent is 6. The length of the line leading from the deepest point of injected around the foramen mandibulae and if the nerve the inner edge of the foramen mandibulae to the lower block is successful, all the teeth in the mandibula corre- edge of the corpus mandibulae spond to the median plate. The sensation loss is observed 7. Foramen mentale with the distance between the sym- in the jaw and lower lip, which is innervated through the phisis mandibulae nerve mentalis and ramus incisivus, which are the branches 8. Distance of foramen mentale with the between the of N. alveolaris inferior. The anatomical location and mor- other side foramen mentale phometry of the foramen mandibulae through which the 9. Distance between the foramen mentale and the lower nervus alveolaris inferior passes are very important in the anesthesia applications of the mandible. However, if the edge of the corpus mandible injector is advanced too far posteriorly during injection, gl. 10. Distance between the foramen mentale and the ramus parotidea (parotid gland) can cause damage and unilateral mandibular posterior edge functional paralysis in the branches of the nerve facialis can 11. Distance between the foramen mentale and the upper EJMI 191 edge of the corpus mandible Results 12. Distance of between processus condylaris and gonion When the data obtained from bilateral mandible bone were 13. Distance of between processus coronoideus and caput compared, no statistically significant difference was found mandibulae (processus condylaris) (p>0.05). The mean length between the foramen mandibu- 14. Distance of between caput mandibulae and gnathion lae and the deepest point of the incissura mandibulae was 15. Height of symphisis mandibulae 20.39 mm on the right and 19.90 mm on the left. The dis- 16. Processus coronoideus with the distance between the tance between the processus condylaris and gonion was other side processus coronoideus recorded as 57.39 mm on the right and 56.69 mm on the left.