Topography of the lingual foramen using micro-computed tomography for improving safety during implant placement of anterior mandibular region

Abstract

The aim of this study was to determine the location and size of the lingual foramina and the course of their canals using micro-computed tomography. Twenty Korean mandibles were scanned using a micro-computed tomography system and reconstructed three-dimensionally to enable observation of the lingual foramina and their canals. Four mandibles (20%) had a single foramen at the lingual side of the mandibular midline, 8 mandibles (40%) had 2 foramina, and 5 mandibles (25%) had 3 foramina. Three mandibles (15%) had 4 small foramina with short canals. The foramina were classified as either superior lingual foramina or inferior lingual foramina according to their vertical location relative to the mental spine. The diameters of superior lingual foramina and inferior lingual foramina were 0.75 ± 0.36 and 0.73 ± 0.38 mm (mean ± SD), respectively. The distances from the inferior border of the mandible to superior lingual foramina and inferior lingual foramina were 12.58 ± 2.49 and 6.43 ± 3.08 mm, respectively. Ten canals (21%) traveled upward to the labial side, 24 canals (51%) downward, and 13 canals (28%) parallel to it. Ten mandibles (50%) had lateral foramina.With regard to implant surgery of the anterior mandibular region, the most hazardous zones for lingual foramina are 0 to 2 mm from the midline, the upper 3 to 17 mm from the inferior border of the mandible, and the anterior 0 to 7 mm from the lingual side. Careful preoperative planning taking into account the anatomical location of these foramina might help to avoid complications due to damage to the foramina, their canals, and their contents.