Abstract
Background
Mandibular angle reduction surgery is widely used for aesthetic purposes. Because inferior alveolar nerve injury is a common complication of this surgery, the anatomical location of this nerve must be known before surgery. This study investigated the relative location of the inferior alveolar nerve in mesofacial and brachyfacial groups.
Methods
Panoramic views of patients were divided into Groups A (gonial angle < 120°) and B (gonial angle > 120°). For the analysis, the magnification of each image was standardized and the following parameters were measured: (1) gonial angle; (2) distance from the alveolar ridge at the center of the first and second premolars and first and second molars to (a) the inferior margin of the inferior alveolar canal and (b) the inferior margin of the mandible; (3) distance from the posterior alveolar ridge to the gonial angle and to (a) on the same line; (4) size of the first and second molars.
Results
Statistical analysis showed that there were no significant differences (P > 0.05) between Group A and Group B with respect to the distance from the alveolar ridge to the inferior alveolar canal in the first premolar, second premolar, and first molar. The differences between Group A and Group B with respect to the distance from the alveolar ridge to the inferior margin of the mandible for the second premolar, first molar, second molar and gonial angle were 0.7, 1.5, 2.8, and 7.0 mm, respectively (P < 0.05). The differences between Group A and Group B with respect to the distances from the inferior margin of the inferior alveolar canal to the inferior margin of the mandible for the same landmarks were 0.7, 1.1, 1.3, and 5.7 mm, respectively (P < 0.05).
Conclusion
The difference in length from the alveolar ridge to the mandibular canal between the two groups was minimal, but the length to the gonial angle differed significantly. These results will help reduce inferior alveolar nerve injury during mandibular angle reduction surgery.
Level of Evidence IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Li J, Hsu Y, Khadka A, Hu J, Wang D, Wang Q (2011) Contouring of a square jaw on a short face by narrowing and sliding genioplasty combined with mandibular outer cortex ostectomy in orientals. Plast Reconstr Surg 127:2083–2092
Baek SM, Kim SS, Bindiger A (1989) The prominent mandibular angle: pre-operative management, operative technique, and results in 42 patients. Plast Reconstr Surg 83:272–280
Yang DB, Park CG (1991) Mandibular contouring surgery for purely aesthetic reasons. Aesthetic Plast Surg 15:53–60
Hsu Y, Li J, Hu J, Luo E, Hsu MS, Zhu S (2010) Correction of a square jaw with low angles using mandibular “V-line” ostectomy combined with outer cortex ostectomy. Oral Surg Oral Med Oral Pathol Endod 109:197–202
Yang DB, Song HS, Park CG (1995) Unfavorable results and their resolution in mandibular contouring surgery. Aesthetic Plast Surg 19:93–102
Yoon ES, Seo YS, Kang DH, Koo SH, Park SH (2006) Analysis of incidences and types of complications in mandibular angle ostectomy in Koreans. Ann Plast Surg 57:541–544
Kane AA, Lo LJ, Chen YR, Hsu KH, Noordhoff MS (2000) The course of the inferior alveolar nerve in the normal human mandibular ramus and in patients presented for cosmetic reduction of the mandibular angles. Plast Reconstr Surg 106:1162–1174
Kieser JA, Paulin M, Law B (2004) Intrabony course of the inferior alveolar nerve in the edentulous mandible. Clin Anat 17:107–111
Choi KY, Yang JD, Chung HY, Cho BC (2012) Current concepts in mandibular condyle fracture management. Part I: overview of condylar fracture. Arch Plast Surg 39:291–300
Kim SK, Han JH, Kim JT (2001) Classification and treatment of prominent mandibular angles. Aesthetic Plast Surg 25:382–387
Baek SM, Baek RM, Shin MS (1994) Refinements in aesthetic contouring of the prominent mandibular angle. Aesthetic Plast Surg 18:283–289
Jin H, Park SH, Kim BH (2007) Sagittal split ramus osteotomy with mandible reduction. Plast Reoconstr Surg 119:662–669
Lo LJ, Wong FH, Chen YR (2004) The position of the inferior alveolar nerve at the mandibular angle: an anatomic consideration for aesthetic mandibular angle reduction. Ann Plast Surg 53:50–55
Kim ST, Hu KS, Song WC, Kang MK, Park HD, Kim HJ (2009) Location of the mandibular canal and the topography of its neurovascular structures. J Craniofac Surg 20:936–939
Choi HM (2009) A study of the mandibular canal angle and the location of the mental foramen on a panoramic radiograph. Korean J Oral Maxillofac Radiol 39:89–92
Kim JD, Kim JS (2007) A study of the mandibular canal in digital panoramic radiographic images of a selected Korean population. Korean J Oral Maxillofac Radiol 37:9–14
Gowgiel JM (1992) The position and course of the mandibular canal. J Oral Implantol 18(4):383–385
Kilic C, Kamburoglu K, Ozen T, Balcioglu HA, Kurt B, Kutoglu T, Ozan H (2010) The position of the mandibular canal and the histologic feature of the inferior alveolar nerve. Clin Anat 23:34–42
Sadler TW (2010) Langman’s medical embryology. Lippincott Williams & Wilkins, Baltimore, pp 127–130
Conflict of interest
The authors have no conflicts of interest to declare.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cho, I.G., Chung, J.Y., Lee, J.W. et al. Anatomical Study of the Mandibular Angle and Body in Wide Mandibular Angle Cases. Aesth Plast Surg 38, 933–940 (2014). https://doi.org/10.1007/s00266-014-0370-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-014-0370-y