Morphological Assessment of Mandible: Way to Effective Anaesthesia

• KANIKA GUPTA,*  
• Ajitpal Singh,  
• PRADHUMAN VERMA

Abstract

Mandible is the largest bone in human skull, forming the lower jawline and shaping the contour of the inferior third of the face. The internal surface of the ramus is punctured by the mandibular foramen, situated halfway between the anterior and posterior borders of the ramus at the level of the occlusal surfaces of the lower teeth, and through which the inferior alveolar nerve and vessels enter the mandibular canal, ultimately terminating at the mental foramen. The mandibular canal is present as a single conduit in most individuals, but may vary with regard to shape (oval, round, or pear-shaped) and whether an accessory canal can be identified (canal bifurcation). Such anatomical variations, along with operator technique, are a cause of failed inferior alveolar nerve block (IANB) anaesthesia. By following the landmarks, the anaesthetic solution is delivered as close as possible to the mandibular foramen. In children, repeated injection of the local anaesthetic solution due to failure of IANB can be a tedious task as it may result in a negative behaviour of the child and there exists the risk of administering the solution above the recommended safe dose. Literature lacks the data about varying position of mandibular foramen from childhood till adolescence. Thus keeping this in mind, this review was conducted to assess the changing positions of mandibular foramen in relation to child’s growth and development from childhood to adolescence using radiographical techniques.

Keywords

Children; Adolescents; Mandibular Foramen; Inferior Alveolar Nerve Block