International Journal of Anatomy and Research, Int J Anat Res 2016, Vol 4(1):1967-71. ISSN 2321-4287 Original Research Article DOI: http://dx.doi.org/10.16965/ijar.2016.122 AN ANATOMICAL STUDY ON THE POSITION OF MANDIBULAR FORAMEN IN 100 DRY MANDIBLES Gopalakrishna. K *1, Deepalaxmi S 2, Somashekara S.C 3, Rathna B.S 4. *1,2 Assistant Professor, Department of Anatomy, Malabar Medical College and Research Centre, Modakkallur, Atholi, Kozhikode, Kerala, India. 3 Professor, Department of Pharmacology, Malabar Medical College and Research Centre, Modakkallur, Atholi, Kozhikode, Kerala, India. 4 Professor, Department of Anatomy, Malabar Medical College and Research Centre, Modakkallur, Atholi, Kozhikode, Kerala, India. ABSTRACT Background: Mandibular foramen is leading to mandibular canal through which inferior alveolar nerve and vessels will transmit and supply the teeth of lower jaw.Inferior alveolar nerve block is common anesthetic procedure prior to dental surgeries on lower jaw. Failure in mandibular anesthesia or injury to neurovascular bundle may be resulted by inaccurate localization of mandibular foramen. Hence this study is aimed to locate the mandibular foramen and its distances from different bone landmarks on internal surface of ramus of dry mandible of South Indian origin. Objective: Study to determine the precise position of mandibular foramen in 100 dry mandibles, which is essential for successful inferior alveolar nerve block prior to dental procedures. Materials and Methods: This descriptive study was done on 100 dentulous South Indian origin adult dry human mandibles of unknown sex and age. Distance of mandibular foramen from the mandibular notch, anterior border of the ramus of mandible, posterior border of the ramus of the mandible(angle of mandible), posterior border of the 3rd molar socket and meeting point of base with posterior border of ramus were measured. Further observation regarding the presence of accessory mandibular foramen was done. The observations were tabulated and descriptive statistics was used analyze the data. Result: In the present study, totally 100 mandibular foramina and 18 accessory foramina were observed in the 100 mandible. The mean distance of mandibular foramina to anterior border of ramus is 14.63±3.16 (R) mm and 15.31±3.11 mm(L), to posterior border is (R):12.34±3.10 mm and (L):13.51±3.92 mm, to mandibular notch is (R):21.23±4.56 mm and (L):21.16±3.12 mm, to angle of mandible (R):22.14±3.18 mm and (L):22.1±4.12 mm, to posterior border of 3rd molar socket is (R):14.37±3.16 mm and (L):19.26±2.57 mm. Conclusion: The present study on the precise location of mandibular foramen and on the incidence of accessory mandibular foramen will help the dental surgeons for more successful anesthesia and to perform safer surgeries on the ramus of mandible. KEY WORDS: Mandibular Foramen, Inferior Alveolar Nerve Block, Mandibular Notch. Address for Correspondence: Dr. Gopalakrishna. K, Assistant Professor, Department of Anatomy, Malabar Medical College and Research Centre, Modakkallur, Atholi, Kozhikode - 673315, Kerala, India. Ph: 09747059273 E-Mail: [email protected] Access this Article online Quick Response code Web site: International Journal of Anatomy and Research ISSN 2321-4287 www.ijmhr.org/ijar.htm Received: 28 Jan 2016 Accepted: 12 Feb 2016 Peer Review: 29 Jan 2016 Published (O): 29 Feb 2016 DOI: 10.16965/ijar.2016.122 Revised: None Published (P): 29 Feb 2016 Int J Anat Res 2016, 4(1):1967-71. ISSN 2321-4287 1967 Gopalakrishna. K et al. ANATOMICAL STUDY ON THE POSITION OF MANDIBULAR FORAMEN IN 100 DRY MANDIBLES. INTRODUCTION 2. Anterior border of the ramus of mandible Mandibular foramen is an irregular foramen 3. Posterior border of the ramus of the mandible located just above the center of the medial 4. Posterior border of the 3rd molar socket. surface of the ramus of the mandible. Mandibu- 5. Meeting point of base with posterior border lar foramen is leading to mandibular canal of ramus (Angle of mandible). through which inferior alveolar nerve and ves- Further observation was done for the presence sels will transmit and supply the teeth of lower of accessory mandibular foramen. The distances jaw [1]. Inferior alveolar nerve block is a com- from the mandibular foramen to various bone mon anesthetic procedure prior to dental sur- landmarks were recorded as an average of three geries on lower jaw. The success of this independent measurements. The mean and technique highly depends on the needle tip to standard deviation were calculated separately the MF at the time of anaesthetic injection [3]. for right and left sides and tabulated [8]. Failure in Mandibular anesthesia and injury to neurovascular bundle may be resulted by RESULTS inaccurate localization of mandibular foramen A total of 100 dentulous adult dry human man- or by marked variability in their location [2-4]. dibles were studied for the position of mandibu- Usually by palpation of lingual [5] or by using lar foramen. The minimum, maximum, average radiographs [6,7] the localization of foramen is and standard deviation values of the various done. Hence this study is aimed to locate the parameters which were studied on either side mandibular foramen and its distances from of the mandible are shown in Table 2. different bone landmarks on internal surface of The mean distance of mandibular foramen from, ramus of dry mandible. As the dry mandibles were obtained from Malabar medical college 1. Mandibular notch is 21.23mm on right side Calicut, the study gives the position of mandibu- and 21.16 mm on left side lar foramen in the local population. 2. Anterior border of the ramus of mandible is 14.63 mm on right side and 15.31 mm on left MATERIALS AND METHODS side This descriptive study was performed with the 3. Posterior border of the ramus of the mandible approbation by the Institutional Ethical Commit- is 12.34 mm on right side and 13.51 mm on left tee of Malabar Medical College and Research side Centre, Calicut (MMCRC/IEC/2013/ dated 4. Posterior border of the 3rd molar socket is 04.11.2013). A total of 100 dentulous adult dry 22.14 mm on right side and 19.26mm on left side human mandibles of unknown sex and age were 5. Angle of mandible is 22.14 mm on right side collected and studied in Department of Anatomy, and 22.10 mm on left side Malabar Medical College and Research, Calicut. Accessory mandibular foramina was observed Mandibles with sockets for third molar teeth, in the 15 mandible. those regular in shape, and devoid of deformi- Fig. 1: Showing the morphological features of the ties were selected. The damaged bones and mandible. those having pathological abnormalities were excluded. The mandibles were observed for the presence, prevalence rate and laterality of mandibular foramen. Magnifying lens, metallic probe, Vernier calipers of 1/20 mm accuracy were used for taking measurements. Irrespective of shape of lingula, the center of mandibular fora- men was taken as reference point. The position of the center of mandibular foramen was measured from various landmarks like, 1. Mandibular notch Int J Anat Res 2016, 4(1):1967-71. ISSN 2321-4287 1968 Gopalakrishna. K et al. ANATOMICAL STUDY ON THE POSITION OF MANDIBULAR FORAMEN IN 100 DRY MANDIBLES. Fig. 2: Showing the mandibular and accessory Table 3: The comparisons of results of different studies mandibular foramen. on mandibular foramen. Position of Prajnaparamitasa Varshasheno C.Lavanyavar Padmavat]hi G mandibular Side Present study manta et al [9] y et al [10] ma et al [11] et al [12] foramen Anterior border to Right 15.72±2.92 16.1 16.52 16.8±2.8 14.63±3.16 mandibular foramen Left 16.23±2.88 16.3 16.94 16.9±2.5 15.31±3.11 Posterior border to Right 13.29±1.74 11.7 13.35 11.7±2.0 12.34±3.10 mandibular foramen Left 12.73±2.04 11.3 13.46 12.1±2.4 13.51±3.92 Mandibular notch Right 22.70±3.00 23.6 23.39 22.0±3.0 21.23±4.56 to mandibular foramen Left 22.27±2.92 23.6 24.41 22.3±3.4 21.16±3.12 Angle of mandible Right 21.54±2.92 - - 22.6±3.4 22.14±3.18 to mandibular foramen Left 21.13±3.43 - - 22.2±2.9 22.1±4.12 Posterior border of Right - - 15.6 - 14.37±3.16 3rd molar socket to mandibular Left - - 18.7 - 19.26±2.57 foramen Table 1: General findings of present study on mandibular DISCUSSION foramen. The location of mandibular foramen is clinically Sl.No Findings Description Numbers Percent Total crucial in achieving inferior alveolar block. Sample size Failure of locate neurovascular bundle will Right 100 100% 100 1 (n=100) result due to inaccurate localization of mandibu- Bones mandible Left 100 100% lar foramen. In the present study, the location of the mandibular foramen and its distances Incidence of Right 100 100% 100 2 mandibular from different bony landmarks on mandibles of Foramina foramen. Left 100 100% South Indian origin was done. This study was Incidence compared with the studies done in other parts One per bone 18 - 18 3 accessory of India and also one study from Pakistan to Foramina foramen Two per bone 0 - know any geographical difference. According to Pragna Paramitha et al [9] study Table 2: Position of mandibular foramen from different bone landmarks. on 60 mandibles from North part of India, the mandibular foramen was located 15.75±2.92 mm Position of Mean Standard Max-Min Sl.No Side (R) and 16.23±2.88mm(L) from the anterior mandibular foramen (mm) deviation (mm) border, 13.29±1.74mm (R) and 12.73±2.04mm Anterior border to Right 14.63 3.16 12.4-21.5 (L) from the posterior border.