Accuracy of using the antilingula as a sole determinant of vertical ramus osteotomy position.
OBJECTIVE
The antilingula is an important landmark in mandibular ramus surgery. Its relationship to the lingula provides useful clinical information as to the position of the mandibular foramen and inferior alveolar nerve. The purpose of this study was to determine the reliability of using the antilingula as a guide to osteotomy placement for intraoral vertical ramus osteotomies.


METHODS
Eighteen cadaver mandibles were harvested and the antilingula was identified on each hemimandible by palpating the most prominent bulge on the lateral aspect of the mandible. In addition, the lingula (the entrance of the mandibular neurovascular bundle into the medial aspect of the ascending ramus of the mandible) was identified. A 1 mm fissure bur was used to drill a hole perpendicular to bone, from the deepest aspect of the concavity at the center of the lingula. The drill perforated both the medial and lateral cortices of the mandible. The distance from the antilingula to lingula was measured and recorded in both the anterior-posterior and the superior-inferior planes.


RESULTS
There was complete concordance of the position of the lingula and antilingula in the anterior-posterior dimension in 11.1% of the specimens. In 33% of the specimens, the lingula was found anterior to the antilingula and in 45.6% the lingula was found posterior to the antilingula. There was complete concordance of the lingula and antilingula in the superior-inferior dimension in 2.8% of specimens. The lingula was found superior to the antilingula in 47.2% of the specimens and inferior to the antilingula in 50% of samples.


CONCLUSIONS
In most instances, the position of the lingula was posterior-inferior relative to the position of the antilingula. At a measurement of 5 mm posterior to the antilingula (at the level of the antilingula), there was no risk of damaging the neurovascular bundle in this cadaveric study.
Aziz
Shahid R
SR
Department of Oral and Maxillofacial Surgery, University of Medicine and Dentistry of New Jersey-New Jersey Dental School, Newark, NJ, USA. azizsr@umdnj.edu
Dorfman
Brian J
BJ
Ziccardi
Vincent B
VB
Janal
Malvin
M
D006801:Humans; D008334:Mandible / Q000033:anatomy & histology* / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D012015:Reference Standards; D015203:Reproducibility of Results