Morphological analysis of mandibular foramen through anatomical planes: implications for inferior alveolar nerve block
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Error in localization of mandibular foramen is attributed to a high failure rate of inferior alveolar nerve block in clinical dentistry. We hypothesized that a remodelled approach towards exploring the morphology of mandibular foramen would be useful. In the present study, the location of the mandibular foramen was analysed with respect to the anatomical planes across the ramus of the mandible and also with respect to the quadrants on the medial surface of ramus of mandible. The study was conducted on 50 dry human mandibles of unknown age and sex. The anatomical planes were defined and drawn on the mandibles. Measurements were made with digital Vernier callipers and findings were noted. It was observed that the most consistent position of the mandibular foramen was along the vertical plane, however, the foramen was most likely to be localized along the oblique plane. Morphological analysis of the foramen with respect to the anatomical planes as well as the quadrants on the medial surface of ramus led to the analysis that occlusion plane should be the preferred plane of approach. Moreover, a rectangular area on the medial surface of the ramus was identified posterior to the mid-point of occlusion plane (8 mm above mid-point, 6 mm below mid-point and 6 mm behind mid-point) where the incidence of location of the foramen was significantly high. The findings of this study may potentially reduce the failure rate of inferior alveolar nerve block and clinical complications thereof.
KeywordsMandibular foramen Morphology Anatomical planes Quadrants Inferior alveolar nerve block
The authors express heartfelt gratitude to all the residents and faculty members of the Department of Anatomy, All India Institute of Medical Sciences, Phulwarisharif, Patna, India for their unconditional support throughout the study. We are grateful to the authorities of All India Institute of Medical Sciences, Phulwarisharif, Patna, India for their kind cooperation during the course of this study.
RKN: Project designing and development, data collection and analysis, manuscript writing and editing. SKG: Project designing and development, data collection and analysis, manuscript writing and editing.
None to declare.
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
The authors hereby declare that the study was conducted only after approval had been obtained from the Ethical Committee of All India Institute of Medical Sciences, Patna whose guidelines are in accordance with the Declaration of Helsinki (1964) and all subsequent revisions.
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