Tomographic studies of human jaws to assess potentials for preserving the blood supply in rim mandibulectomies.

Rim mandibulectomy, resecting the aveolar segment of the mandible while preserving the inferior cortical arch, has been shown to be a biologically and surgically sound procedure. In order to study the surgical anatomy of the mandible and determine the reproducibility of the anatomic markers and neurovascular supply, we studied serial tomographic cuts of 50 living human mandibles (21 males, 29 females; ages 17 to 87). The dentition was complete in 13, partial in 30, and edentulous in 7. The review showed that the location of anatomic structures was symmetrical in all these adult patients regardless of age, sex, or extent of dentition. (The only significant difference was in the height of the alveolus, which was decreased in edentulous patients.) The data show that in performing a rim mandibulectomy, the blood supply may be preserved in most patients if at least 11 mm of vertical height is preserved of the inferior cortex of the body of the mandible.