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Determining the safety margin of mandibular lingula in sagittal split ramus osteotomy

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Abstract

Purpose

The anatomical position of the lingula is clinically very important to prevent injuries during sagittal split ramus osteotomy. Our study aims to evaluate the localisation of the lingula by cone beam computed tomography (CBCT) and to compare the localisation of the lingula between malocclusion, gender, and lingula types.

Methods

A retrospective study was conducted to evaluate the shape and location of the lingula using CBCT. A total of 250 CBCT images were included in this study. The lingula was classified as nodular, assimilated, truncated, or triangular type. Six defined distances from the top of the lingula were measured: anterior border of the ramus (L-A), posterior border of the ramus (L-P), internal oblique ridge (L-IOR), mandibular notch (L-N), and distal surface of the mandibular second molar (L-M2) and occlusal plane (L-OP). The measured distances were compared between gender, malocclusion, and lingula types.

Results

The most common type of lingula was nodular (32.4%). The L-N, L-P, L-M2, and L-OP distances between genders were statistically higher in male patients than in female patients. The L-IOR, L-M2, and L-OP distances exhibited statistically significant differences found between malocclusions. No statistically significant difference was found when the distances of the lingula to the anatomical points were compared between the lingula types.

Conclusion

These variations in positioning of the lingula depending on the dysmorphoses are developing towards a systematic 3D examination before any mandibular osteotomy to precisely visualize the position and shape of the lingula.

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Data availability

Data available upon request.

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Funding

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Eskişehir Osmangazi University, Faculty of Dentistry, Eskişehir, Turkey

    Gorkem Tekin, Nesrin Saruhan Kose, Omur Dereci, Yasin Caglar Kosar & Gizem Caliskan

  2. Department of Orthodontics, Eskişehir Osmangazi University, Faculty of Dentistry, Eskişehir, Turkey

    Mehmet Ugurlu

  3. Specialist in Oral and Maxillofacial Surgeon, Private Practice, Eskişehir, Turkey

    Gunay Gojayeva

Authors
  1. Gorkem Tekin
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  2. Nesrin Saruhan Kose
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Contributions

All the authors have made substantial contributions to the study. GT and NSK: research development and data analysis. MU: tomographic analysis. GT, YCK, GG, GC, NSK, and OD: manuscript writing and editing.

Corresponding author

Correspondence to Gorkem Tekin.

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Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. The study procedure was approved by the Osmangazi University Ethics Committee, Eskişehir, Turkey (Approval No. 2020/18).

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Informed consent was obtained from the patients.

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Tekin, G., Kose, N.S., Ugurlu, M. et al. Determining the safety margin of mandibular lingula in sagittal split ramus osteotomy. Surg Radiol Anat 46, 159–166 (2024). https://doi.org/10.1007/s00276-023-03291-9

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  • DOI: https://doi.org/10.1007/s00276-023-03291-9

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