Balaban Emre, Köse Taha Emre, Günaçar Dilara Nil, Naralan Muhammed Enes, Gonca Merve
Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Recep Tayyip Erdogan University, Rize, Turkey.
Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Recep Tayyip Erdogan University, Rize, Turkey.
BMC Oral Health. 2025 Mar 26;25(1):430. doi: 10.1186/s12903-025-05788-8.
The aim of this study is to evaluate the relationship between anatomical reference points used during orthognathic surgery and to minimize the risks of iatrogenic neurovascular damage.
This retrospective study included cone-beam computed tomography (CBCT) images involving the mandible from patients who visited Recep Tayyip Erdoğan University Faculty of Dentistry between January 2018 and September 2023. The age range of the included individuals was set between 18 and 80 years. Horizontal and vertical distances between mandibular anatomical structures, such as the lingula mandibula (LM), mandibular foramen (MF), antilingula (AL), and surrounding structures were measured using CBCT software. Individuals with intraosseous pathology, insufficient image quality, or a history of surgical/orthodontic treatment were excluded from the study.
A total of 240 hemimandibles from 120 patients were analyzed (55.83% female, 44.17% male; mean age: 46.78 ± 15.30 years). Significant differences were identified in LM positions according to different AL types. The LM was found to be more inferior and posterior relative to hill and ridge type ALs, while it was more anterior relative to plateau type ALs. In 26.25% of mandibular rami, AL was not detected.
The position of the AL can serve as a guide in determining the osteotomy line during inferior vertical ramus osteotomy (IVRO). However, relying solely on AL as a reference point may increase the risk of inferior alveolar nerve (IAN) injury. Preoperative tomographic evaluations to determine the relationships among LM, MF, and AL can provide a safer approach in surgical planning, reduce complications, and help protect neurovascular structures.
本研究旨在评估正颌外科手术中使用的解剖学参考点之间的关系，并将医源性神经血管损伤的风险降至最低。
这项回顾性研究纳入了2018年1月至2023年9月期间在雷杰普·塔伊普·埃尔多安大学牙科学院就诊的患者的下颌骨锥形束计算机断层扫描（CBCT）图像。纳入个体的年龄范围设定为18至80岁。使用CBCT软件测量下颌骨解剖结构之间的水平和垂直距离，如下颌小舌（LM）、下颌孔（MF）、反小舌（AL）及周围结构。骨内病变、图像质量不佳或有手术/正畸治疗史的个体被排除在研究之外。
共分析了120例患者的240个半侧下颌骨（女性占55.83%，男性占44.17%；平均年龄：46.78±15.30岁）。根据不同的AL类型，LM位置存在显著差异。发现LM相对于山丘型和嵴型AL更靠下和靠后，而相对于平台型AL更靠前。在26.25%的下颌支中未检测到AL。
AL的位置可作为确定下颌支垂直截骨术（IVRO）截骨线的指导。然而，仅依靠AL作为参考点可能会增加下牙槽神经（IAN）损伤的风险。术前进行断层扫描评估以确定LM、MF和AL之间的关系，可为手术规划提供更安全的方法，减少并发症，并有助于保护神经血管结构。
