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A simple method to locate mandibular foramen: preliminary radiological study.

Olivier Trost¹, Vivien Salignon, Nicolas Cheynel

¹Laboratory of Anatomy, INSERM U-887 Motricité Plasticité, Faculty of Medicine, University of Burgundy, Dijon, France. olivier.trost@chu-dijon.fr

Surgical and Radiologic Anatomy : SRA

|March 11, 2010

Summary

The mandibular foramen is typically located in the inferior two-thirds of the ramus, offering a safety zone for surgeons performing vertical ramus osteotomy (VRO) to minimize nerve damage.

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Area of Science:

Oral and Maxillofacial Surgery
Anatomy
Radiology

Background:

The position of the mandibular foramen on the medial aspect of the mandibular ramus is variable.
Accurate landmark identification is crucial for oral and maxillofacial surgeons, particularly in vertical ramus osteotomy (VRO).

Purpose of the Study:

To analyze the position of the mandibular foramen.
To establish simple and reliable surgical landmarks for VRO procedures.

Main Methods:

A radio-anatomical study using panoramic X-rays of 46 mandibles.
Measurements of horizontal (x/l ratio) and vertical (y/h ratio) positions of the mandibular foramen relative to ramus borders and sigmoid notch.
Calculations to minimize magnification and image distortion.

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Main Results:

Mandibular foramen located in the ventral and inferior two-thirds of the ramus, with peaks at 0.30-0.35 for vertical (y/h) and 0.35 for horizontal (x/l) ratios.
No significant differences observed based on side, sex, or age.
The posterior and superior thirds of the ramus represent a 'safety zone' where the foramen is rarely found.

Conclusions:

The posterior and superior thirds of the mandibular ramus serve as a predictable "safety zone" for VRO.
Utilizing this safety zone can reduce the probability of inferior alveolar nerve morbidity during VRO.