title: Tomographic analysis of the interalveolar space and thickness of the vestibular cortical bone in the parasymphyseal region of adult human mandibles.
abstract: OBJECTIVE
  The aim of this study was to determine by computed tomography (CT) the interalveolar distance on mandible relative to the canine, first and second pre-molar, and the thickness of the cortical bone in the same region.
  
  
  METHODS
  A hundred adult cadaveric dentate human hemi-mandibles were examined. A point (P) above the upper margin of the mental foramen was determined, the height at which monocortical screws are inserted to place miniplate according to the technique to treat mandibular fracture. Then, points A, B and C at the same height as point P, referring to the dental units namely canine, first and second pre-molars were marked to determine the CT cut level to measure cortical bone thickness and the interalveolar distance.
  
  
  RESULTS
  The figures showed no statistically significant difference between the sides. The thickness of the vestibular cortical bone was less than 3.0 mm in 96% of the samples. In 91% of the samples the interalveolar distance between canine, first and second pre-molars was greater than 2 mm, a potentially safe condition to insert 2.0-mm diameter monocortical screws at the study points.
  
  
  CONCLUSIONS
  The individual actual anatomy of the region where screws are to be inserted above the mental foramen is important to perform the technique safely. We believe that the minimal cortical thickness to obtain sufficient screw anchorage should be studied in order to determine the actually safe shortest screw length. It is important to minimize the risk of tooth root damage or nerve injury and the amount of titanium in the human tissues.
authors.affiliation: Departamento De Ciências Da Vida (DCV), Universidade do Estado da Bahia (UNEB), Rua Silveira Martins, 2555, Cabula, Salvador, Bahia, CEP 41195001, Brazil. atson@uneb.br
authors.forename: Atson Carlos
authors.initials: AC
authors.lastname: de Souza Fernandes
authors.forename: Sandra
authors.initials: S
authors.lastname: de Quadros Uzeda-Gonzalez
authors.forename: Ricardo Luiz
authors.initials: RL
authors.lastname: Smith
authors.forename: Luis Garcia
authors.initials: LG
authors.lastname: Alonso
authors.forename: Fabio Mota
authors.initials: FM
authors.lastname: Gonzalez
authors.forename: Marcos Vinicius
authors.initials: MV
authors.lastname: Santos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008334:Mandible / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000601:surgery; D008337:Mandibular Fractures / Q000601:surgery; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014070:Tooth / Q000000981:diagnostic imaging
references.citation: Plast Reconstr Surg. 1986 May;77(5):729-36
references.pmid: 3517906
references.citation: Rev Stomatol Chir Maxillofac. 1976 Dec;77(8):971-6
references.pmid: 1071237
references.citation: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Mar;87(3):369-74
references.pmid: 10102603
references.citation: Rev Stomatol Chir Maxillofac. 1976 Apr-May;77(3):569-76
references.pmid: 1066802
references.citation: Am J Orthod Dentofacial Orthop. 2009 Apr;135(4):486-94
references.pmid: 19361735
references.citation: Rev Stomatol Chir Maxillofac. 1976 Apr-May;77(3):577-82
references.pmid: 1066803
references.citation: Br J Oral Maxillofac Surg. 2000 Feb;38(1):70-5
references.pmid: 10783453
references.citation: Br J Oral Maxillofac Surg. 1996 Apr;34(2):166-73
references.pmid: 8861293
references.citation: Implant Dent. 2000;9(2):120-5
references.pmid: 11307391
references.citation: J Maxillofac Surg. 1973 Jun;1(2):79-84
references.pmid: 4520558
references.citation: J Maxillofac Surg. 1978 Feb;6(1):14-21
references.pmid: 274501
references.citation: Angle Orthod. 2009 Jan;79(1):37-45
references.pmid: 19123704
references.citation: Int J Oral Maxillofac Implants. 1993;8(3):295-300
references.pmid: 8225464
references.citation: Int J Oral Maxillofac Implants. 1989 Winter;4(4):327-32
references.pmid: 2639861
references.citation: J Oral Maxillofac Surg. 2002 Feb;60(2):167-70
references.pmid: 11815915
references.citation: Int J Periodontics Restorative Dent. 1996 Feb;16(1):40-5
references.pmid: 8631609
references.citation: Rev Prat. 1992 Feb 1;42(3):321-3
references.pmid: 1579822
references.citation: Otolaryngol Clin North Am. 1987 Aug;20(3):607-20
references.pmid: 3317206
references.citation: J Craniomaxillofac Surg. 1999 Aug;27(4):252-5
references.pmid: 10626259
references.citation: Ann Plast Surg. 1992 May;28(5):414-9
references.pmid: 1622016
references.citation: Rev Stomatol Chir Maxillofac. 1976 Jan-Feb;77(1):252-5
references.pmid: 1064096