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Evaluation of the Anatomic Position of the Mandibular Canal Regarding to the Segments of the Mandibular Sagittal Split Ramus Osteotomy to Diminish the Possibility of Injuries: a Pilot Study J Oral Maxillofac Res 2022;13(4):e2 doi:10.5037/jomr.2022.13402 Abstract | HTML | PDF | XML |
Evaluation of the Anatomic Position of the Mandibular Canal Regarding to the Segments of the Mandibular Sagittal Split Ramus Osteotomy to Diminish the Possibility of Injuries: a Pilot Study
1Federal University of Rio Grande do Norte (UFRN), Brazil.
2Oral and Maxillofacial Surgeon at a Private Practice, São Paulo, SP, Brazil.
3Departamento de Ortodontia da Universidade Católica de Viseu, Viseu, Portugal.
4Oral Maxillofacial and Trauma Surgery of the “Hospital Universitário Onofre Lopes”, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
5Periodontics and Oral Medicine Department, University of Michigan, Ann Arbor, USA.
Corresponding Author:
University of Michigan School of Dentistry
1011 North Ave., Ann Arbor - MI, 48109
USA
E-mail: gustfernandes@gmail.com
ABSTRACT
Objectives: This pilot study evaluated the relationship between inferior alveolar nerve location through computed tomography scan and intraoperative inferior alveolar nerve entrapment after bilateral sagittal split osteotomy.
Material and Methods: Overall, 20 helicoidal computed tomography scans were evaluated in patients with facial deformities who underwent to bilateral sagittal split osteotomy (BSSO). The distance from the mandibular canal to the internal surface of the buccal and lingual cortical bone, mandibular thickness, bone density and proportion of medullary and cortical bone in 3 regions were evaluated. During the intraoperative period, the segment to which the nerve remained adhered after performing BSSO was analysed, and the data correlated.
Results: The distance from the mandibular canal to the buccal cortical bone showed a mean of 2.6 mm when the inferior alveolar nerve was adhered to the distal segment and mean of 0.7 mm when the nerve was adhered to the proximal segment. The thickness was 11.2 mm and 9.8 mm when the nerve was adhered the distal the proximal segments respectively. Mandibular thickness, distance from the mandibular canal to the buccal and lingual cortical were statistically related to intraoperative nerve entrapment (P < 0.05).
Conclusions: Narrow jaws and the distance from the mandibular canal to buccal cortical bone less than 2 mm increases the risk of the inferior alveolar nerve entrapment in bilateral sagittal split osteotomy.
J Oral Maxillofac Res 2022;13(4):e2
doi: 10.5037/jomr.2022.13402
Accepted for publication: 21 December 2022
Keywords: anatomy; mandibular nerve; orthognathic surgery; sagittal split ramus osteotomy.
To cite this article: Evaluation of the Anatomic Position of the Mandibular Canal Regarding to the Segments of the Mandibular Sagittal Split Ramus Osteotomy to Diminish the Possibility of Injuries: a Pilot Study J Oral Maxillofac Res 2022;13(4):e2 URL: http://www.ejomr.org/JOMR/archives/2022/4/e2/v13n4e2ht.htm |
Received: 18 November 2022 | Accepted: 21 December 2022 | Published: 31 December 2022
Copyright: © The Author(s). Published by JOMR under CC BY-NC-ND 3.0 licence, 2022.