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Skeletal maturation and the location of the mandibular foramen within the ramus mandibulae

Reifung des Skeletts und Lage des Foramen mandibulae innerhalb des Ramus mandibulae

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Abstract

Purpose

It is well documented that the mandible does not grow at a constant rate. There are significant correlations between the increase of mandibular size and cervical vertebral maturation. The peak growth velocity of the mandible occurs after the third stage of cervical vertebral maturation. The location of the mandibular foramen (MF) and its changes subsequent to growth are of great interest to clinicians as they relate to the anesthesia of the inferior alveolar nerve and to mandibular surgical procedures. Therefore, the aim of the present study was to assess the influence of the mandibular growth spurt on the location of the MF in various skeletal growth patterns.

Methods

Panoramic and lateral cephalometric radiographs of 98 (32 orthognathic, 50 retrognathic, 16 prognathic) patients before and after the growth peak were collected. For each subject, the maturational stage of the cervical vertebrae was defined on successive lateral cephalograms and the vertical and horizontal position of the MF was evaluated on two panoramic radiographs, one before and one after the growth peak.

Results

The MF-Post/MF-Ant ratio (MF distance to the posterior border of the ramus/MF distance to the anterior border of the ramus) significantly increased after the growth peak in orthognathic and retrognathic subjects (P = 0.015 and 0.02, respectively). This ratio did not significantly increase in prognathic subjects (P = 0.882). No statistically significant changes in the vertical position of the MF were found in the three groups after the growth spurt.

Conclusion

The horizontal position of the MF moves in an anterior direction in orthognathic and retrognathic subjects during the mandibular growth spurt. The vertical position of the mandibular foramen remains unchanged during this period.

Zusammenfassung

Ziel

Dass der Unterkiefer nicht mit konstanter Geschwindigkeit wächst, ist eindeutig belegt. Es gibt signifikante Korrelationen zwischen dem Größenwachstum des Unterkiefers und der Reifung der Halswirbelsäule. Die maximale Wachstumsgeschwindigkeit erreicht der Unterkiefer nach der dritten Stufe der Halswirbelreifung. Die Lage des Foramen mandibulae (MF) und seine wachstumsbedingten Veränderungen sind für klinische Therapeuten von besonderem Interesse, denn sie stehen im Zusammenhang mit der Anästhesie des N. alveolaris inferior und mit chirurgischen Eingriffen am Unterkiefer. Ziel der hier vorgestellten Studie war es daher, den Einfluss des mandibulären Wachstumsschubs auf die Lage des MF bei verschiedenen skelettalen Wachstumsmustern zu untersuchen.

Methoden

Von 98 Patienten (32 orthognath, 50 retrognath, 16 prognath) wurden Orthopanthomogramme und seitliche Fernröntgenaufnahmen vor und nach dem Wachstumsmaximum angefertigt. Bei jedem Probanden wurde das Reifestadium der Halswirbel auf aufeinanderfolgenden seitlichen Fernröntgenbildern bestimmt. Die vertikale und horizontale Position der MF wurde auf 2 Panoramaröntgenbildern bewertet, eines vor und eines nach dem Wachstumsmaximum.

Ergebnisse

Das MF-Post/MF-Ant-Verhältnis (MF-Abstand zum hinteren Rand des Ramus/MF-Abstand zum vorderen Rand des Ramus) nahm nach dem Wachstumsmaximum bei orthognathen und retrognathen Patienten signifikant zu (p =0,015 bzw. 0,02). Bei prognathen Probanden nahm dieses Verhältnis nicht signifikant zu (p =0,882). In den 3 Gruppen wurden nach dem Wachstumsschub keine statistisch signifikanten Veränderungen der vertikalen Position der MF festgestellt.

Schlussfolgerung

Die horizontale Position der MF verschiebt sich bei orthognathen und retrognathen Probanden während des mandibulären Wachstumsschubs nach vorn. Die vertikale Position des Foramen mandibulae bleibt in diesem Zeitraum unverändert.

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Acknowledgements

The authors thank the vice-chancellery of Shiraz University of Medical Sciences, for supporting the research (grant number: 15093). The authors thank Dr. Vossoughi from the Dental Research Development Center, for the statistical analysis. We would also like to thank Dr. Saeed Afzalan, an undergraduate student of dentistry, for his help in better presentation of the figures of this article.

Funding

Shiraz University of Medical Sciences (grant number 15093).

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

    Najmeh Movahhedian

  2. Orthodontic Research Center, Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

    Ahmadreza Sardarian

  3. Dentist, Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

    Arsalan Hosseini

  4. Orthodontic Research Center, Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

    Shahla Momeni Danaei

  5. Oral and Dental Disease Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

    Shahram Hamedani

Authors
  1. Najmeh Movahhedian
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  2. Ahmadreza Sardarian
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  3. Arsalan Hosseini
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  4. Shahla Momeni Danaei
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Contributions

N. Movahhedian: Project development, Data collection, Data analysis, Manuscript writing/editing. A.R. Sardarian: Project development, Data management, Data analysis, Manuscript writing. A. Hosseini: Project development, Data collection, Data analysis. Sh. Momeni Danaei: Data collection, Data analysis. Sh. Hamedani: Data analysis, Manuscript writing/editing.

Corresponding author

Correspondence to Shahram Hamedani.

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Conflict of interest

N. Movahhedian, A. Sardarian, A. Hosseini, S. Momeni Danaei and S. Hamedani declare that they have no competing interests.

Ethical standards

Ethical Committee of Shiraz University of Medical Science approved the research (code number 1397.195). Consent to participate: Written informed consent was obtained from all patients or their guardians at the time of orthodontic treatment for possible use of their anonymous information in the research.

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Movahhedian, N., Sardarian, A., Hosseini, A. et al. Skeletal maturation and the location of the mandibular foramen within the ramus mandibulae. J Orofac Orthop 83 (Suppl 1), 56–64 (2022). https://doi.org/10.1007/s00056-021-00368-1

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  • DOI: https://doi.org/10.1007/s00056-021-00368-1

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