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Midline versus paramidline mandibulotomy: a radiological study.

I Shohat1, R Yahalom, L Bedrin

  • 1Department of Oral and Maxillofacial Surgery, The Chaim Sheba Medical Center and The Tel Aviv University School of Dentistry, Israel.

International Journal of Oral and Maxillofacial Surgery
|May 5, 2005
PubMed
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Paramidline mandibulotomy, with wider bone cuts, is preferred over midline approaches for oral cancer surgery. This technique minimizes risks to chewing and swallowing functions and protects teeth.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Surgical Oncology
  • Anatomy

Background:

  • Mandibulotomy provides essential access for deep oral cavity and oropharyngeal tumor resection.
  • Medial mandibulotomy, including midline and paramidline approaches, carries risks such as muscle detachment, leading to masticatory and swallowing dysfunction, and potential damage to central incisors.

Purpose of the Study:

  • To establish anatomical guidelines for optimal bone cut placement during mandibulotomy.
  • To compare the anatomical feasibility of midline versus paramidline mandibulotomy based on dental measurements.

Main Methods:

  • Panoramic radiographs of 100 healthy individuals were analyzed.
  • Measurements included angles and distances between the long axes of central incisors, lateral incisors, and canines.

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Main Results:

  • The angle between the lateral incisor and canine (1-8 degrees) was significantly wider than between central incisors (1-4 degrees).
  • Distances between lateral incisor and canine (1-6.2mm) were also greater than between central incisors (0.5-4.7mm).

Conclusions:

  • Findings suggest that paramidline mandibulotomy, utilizing a wider bone gap, is the preferred surgical approach.
  • This approach may mitigate functional deficits and dental complications associated with midline mandibulotomy.