Journal of Oral Implantology February 2014 - (Page 19)

RESEARCH Altered Position of the Medial Lingual Nutritional Foramina at Different Stages of Alveolar Ridge Atrophy Nora Valerie Lautner, MD1* Erwin Bernauer, MD, DMD2 Christian Krenkel, MD, DMD3 Alexander Gaggl, MD, DMD3 To determine the altered location of the medial lingual nutritional foramina in different stages of bone resorption, 55 cadaveric mandibles were selected for this study from a total of 1532. Prevalence, location of the foramen (lingual, cranial, labial), application of Atwood classification (grades 1-6), and macroanatomic dissections were tools of this examination. An increasing grade of atrophy leads to a shift in position of the medial lingual nutritional foramen. Key Words: implants, hemorrhage, bone resorption INTRODUCTION A trophy of the jawbone after tooth loss is a very common oral disease.1 Oral implantology or distraction osteogenesis are basic surgical procedures in oral and maxillofacial surgery but are not without their complications. The lingual side of the mandibular midline, in particular, is an anatomic area where hemorrhagic accidents often occur when using surgical techniques, such as implant insertion.2 The small bony foramina on the lingual side are named differently by several authors: interalveolar foramina by Tsusaki et al,3 medial lingual foramen by Tagaya et al4 and McDonnell et al,5 superior genial spinal foramen by Vandewalle et al,6 or lingual foramen by Liang et al.7 Various studies were performed on the frequency,4,6,7 positions,6,7 diameters,7 and content of the foramina,4,6,7 but in the overall patient population different grades of dentitions exist. In preoperative planning the operator has to consider the degree of 1 Paracelsus Medical University, Salzburg, Austria, and Eberhard Karls University Tuebingen, Germany. 2 Paracelsus Medical School Salzburg, Landesklinikum, Austria. 3 Department of Oral & Maxillofacial Surgery, Paracelsus Medical School Salzburg, Landesklinikum, Austria. * Corresponding author, e-mail: nora.lautner@pmu.ac.at DOI: 10.1563/AAID-JOI-D-11-00175 osseous atrophy, and care should be taken to recognize the mandibular situations. Therefore, the question arises as to whether or not severe atrophy of alveolar bone creates an increased risk of bleeding in the lingual mandibular midline region due to changes in anatomic conditions. MATERIAL AND METHODS In the first instance, 3 wet specimens with strong atrophy of the alveolar crest near the medial lingual nutritional foramina region were selected from an anatomic collection. The superficial layers of the floor of the mouth were dissected, fat tissue was removed, and the sublingual artery was prepared on the left and right sides of the mandible. The branches of the medial and lateral interalveolar artery were also demonstrated with their bony entrance (Figure 1). The nerves and veins were removed. Injecting red latex into the femoral artery displayed the course of the arteries in the specimens, especially in the mandible, namely the supraspinal artery, medial interalveolar artery, and sublingual artery. In the next step, 1532 dry specimens from the University of Innsbruck were examined. The first criterion was the existence of the medial lingual nutritional foramen of the medial interalveolar Journal of Oral Implantology 19

Table of Contents for the Digital Edition of Journal of Oral Implantology February 2014

Evolution of Bone Grafting for Improved Predictability
Electrochemical Behavior of Titanium in Artificial Saliva: Influence of pH
Efficacy of Antibacterial Sealing Gel and O-Ring to Prevent Microleakage at the Implant
Wired/Classic and Wireless/Periotest ‘‘M’’ Instruments: An In Vitro Assessment of
Altered Position of the Medial Lingual Nutritional Foramina at Different Stages of Alveolar
Genotoxicity of Endosseous Implants Using Two Cellular Lineages In Vitro
Implants With Internal Hexagon and Conical Implant-Abutment Connections: An In Vitro
Stress Distribution Around Maxillary Anterior Implants as a Factor of Labial Bone Thickness
Peri-Implant Biomechanical Responses to Standard, Short-Wide, and Mini Implants
Removal Torque Analysis of Implants in Rabbit Tibia After Topical Application of
Nonprocessed Adipose Tissue Graft in the Treatment of Peri-Implant Osseous Defects in
Assessment of the Effect of Two Occlusal Concepts for Implant-Supported Fixed
Nerve Damage Assessment Following Implant Placement in Human Cadaver Jaws:
Dental Implants: Early Versus Standard Two-Stage Loading (Animal Study)
Intravenous Sedation for Implant Surgery: Midazolam, Butorphanol, and
Nanocrystalline Hydroxyapatite-Based Material Already Contributes to Implant Stability
Two Neglected Biologic Risk Factors in Bone Grafting and Implantology: High Low-Density

Journal of Oral Implantology February 2014