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Lingual concavities in the mandible: a morphological study using cross-sectional analysis determined by CBCT
Hans-Joachim Nickenig1, Manfred Wichmann2, Stephan Eitner2
1Department of Oral and Maxillofacial Plastic Surgery and Interdisciplinary Department of Oral Surgery and Implantology (Head: Professor. J.E. Zöller, MD, DMD), University of Cologne, Kerpenerstr. 62, 50931 Cologne, Germany.
Lingual undercuts are common in the edentulous mandible, affecting 68% of molar regions. Identifying these mandibular bone features is crucial for safe dental implant placement and avoiding complications.
Area of Science:
- Oral and Maxillofacial Surgery
- Dental Implantology
- Anatomical Studies
Background:
- Lingual undercuts in the edentulous mandible can lead to complications during dental implant insertion, including hemorrhage and parapharyngeal space infections.
- Understanding the prevalence and characteristics of these anatomical variations is essential for surgical planning.
Purpose of the Study:
- To determine the occurrence and extent of lingual undercuts in the molar and premolar/canine regions of the edentulous mandible.
- To analyze the association between mandibular morphology and the presence of lingual undercuts.
Main Methods:
- Analysis of 716 cross-sections from the edentulous molar region and 215 from the premolar/canine region.
- Classification of mandibular morphology into U- (undercut), P- (parallel), and C- (convex) configurations based on alveolar ridge shape.
- Measurement of lingual concavity depth, angle, and other morphological parameters.
Main Results:
- Lingual undercuts were prevalent in 68% of the edentulous molar regions, with higher prevalence in the second molar region (90%) compared to the first molar region (56%).
- A deep position of the inferior alveolar nerve near the basal cortical bone was significantly associated with the presence of lingual undercuts.
Conclusions:
- Lingual undercuts are a frequent anatomical finding in the edentulous mandible.
- Three-dimensional radiographic analysis aids in identifying lingual undercuts, enabling prevention of lingual cortical bone perforation during dental implant procedures.
