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Mandibular landmarks as an aid in minimizing injury to the marginal mandibular branch: A metric and geometric anatomical study
Author(s) -
Potgieter W.,
Meiring J.H.,
Boon J.M.,
Pretorius E.,
Pretorius J.P.,
Becker P.J.
Publication year - 2005
Publication title -
clinical anatomy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.667
H-Index - 71
eISSN - 1098-2353
pISSN - 0897-3806
DOI - 10.1002/ca.20099
Subject(s) - medicine , mandible (arthropod mouthpart) , anatomy , mandibular nerve , temporomandibular joint , orthodontics , metric (unit) , point (geometry) , molar , geometry , mathematics , biology , operations management , botany , economics , genus
Iatrogenic injury to the marginal mandibular branch is an important reason for medicolegal actions. The aim of this study was to determine the distance of the marginal mandibular branch to the inferior border of the mandible as well as variation of nerve position in relation to this border. The marginal mandibular branch was dissected carefully in a number of 36 facial halves. Three points were identified on the inferior border of the mandibular ramus: Point A at the angle of the mandible, Point B just anterior to the facial artery, and Point C, 2 cm anterior to Point B. A metric and geometric morphometric analysis, including thin‐plate spline and relative warp analysis was done to determine the variation of nerve position in relation to these three bony landmarks. The metric study indicated a median distance from Point A to the nerve 2.3 mm inferior to Point A, 2.4 mm superior to Point B, and 10.7 mm superior to Point C. The shape analysis indicated that variation in the position of the nerve occurs most commonly at Points A and B. We conclude that these mandibular landmarks may assist surgeons in minimizing marginal mandibular branch injury and patient discomfort. Clin. Anat. 18:171–178, 2005. © 2005 Wiley‐Liss, Inc.