Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jan;109(1):e32-6. doi:
10.1016/j.tripleo.2009.08.035.
Parnia F1,
Fard EM,
Mahboub F,
Hafezeqoran A,
Gavgani FE.
The aim of this study was
to evaluate submandibular fossa volume from multislice CT scans of patients
requiring endosseous implants.
One hundred spiral
computed tomographic (CT) preoperative examinations of patients requiring
assessment the lower jaw before implant placement were retrospectively evaluated
to determine anatomical variations in bone morphology in the submandibular fossa
region. Reformatted cross-sectional images tangential to the mandibular dental
arch and distal to the mental foramen border were selected. The deepest area of
submandibular fossa or concavity depth was measured on all of the images. To
measure the concavity depth, a tangent line was first derived to the lingual
surface of the fossa and the deepest point was then selected by moving a
perpendicular line across the tangent line.
Within our sample we
could classify the depth of the submandibular gland fossa as a function of the
lingual concavity depth over a range up to a maximum value of 6.6 mm. Mandibular
lingual concavity depth could be divided into 3 groups. A lingual concavity
(depth > or =2 mm) was observed in 80% of the jaws. In 20% of the cases, there
were flat depressions less than 2 mm in depth (Type I) and in 52% of the cases
the concavities were 2 to 3 mm deep (Type II). About 28% of the examined regions
showed significant concavities of more than 3 mm (Type III). The obtained
distribution as a function of the depth did not reveal any dependence on age and
gender of patients examined by this study (P > .05).
Mandibles with any
lingual concavity pose a potential increased risk of lingual cortical
perforation during surgery, particularly endosseous implant placement.
Cross-sectional imaging provides excellent delineation of mandibular anatomy and
important information on the depth of the submandibular gland fossa in the
preoperative assessment of the posterior mandible for dental implant fixture
placement and other surgical procedures.
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Xin Wei, DDS, PhD, MS 1st edition 04/14/2013, last revision 04/14/2014