Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr;31(4):352-359.
doi: 10.1111/clr.13573. Epub 2020 Jan 27.

Ultrasonographic characterization of lingual structures pertinent to oral, periodontal, and implant surgery

Shayan Barootchi  1 , Hsun-Liang Chan  1 , Sharon S Namazi  2 , Hom-Lay Wang  1 , Oliver D Kripfgans  3   4
Affiliations

Ultrasonographic characterization of lingual structures pertinent to oral, periodontal, and implant surgery

Shayan Barootchi et al. Clin Oral Implants Res. 2020 Apr.

Abstract

Objectives: Increased applications of ridge augmentation in the lingual posterior mandible call for an urgent need to study its anatomy. Therefore, our first aim was to validate ultrasound in measuring the mandibular lingual structures in human cadavers. Secondarily, to test its feasibility in imaging the lingual nerve in live humans.

Materials and methods: Nine fresh un-embalmed fully/partially edentulous cadaver heads were utilized for aim 1. Three areas in the lingual mandible were imaged (mandibular premolar, molar, and retromolar). Immediately after, biopsies were harvested from each site. The thickness of the mucosa, mylohyoid muscle, and lingual nerve diameter was measured via ultrasound and statistically compared to histology. Similarly, the lingual nerve in live humans was also imaged.

Results: None of the differences between the ultrasound and histology measurements reached statistical significance (p > .05). The mean mucosal thickness via ultrasound and histology was 1.45 ± 0.49 and 1.39 ± 0.50 mm, 5 mm lingual to the mylohyoid muscle attachment. At 10 mm beyond the attachment, the ultrasound and histologic values were 1.54 ± 0.48 and 1.37 ± 0.49, respectively. The mean muscle thickness measured via ultrasound and histology was 2.31 ± 0.56 and 2.25 ± 0.47 mm, at the 5 mm distance. At the 10 mm distance, the measurements were 2.46 ± 0.56 and 2.36 ± 0.5 mm, respectively. The mean ultrasonic lingual nerve diameter was 2.38 ± 0.44 mm, versus 2.43 ± 0.42 mm, with histology. The lingual nerve diameter on 19 live humans averaged to 2.01 ± 0.35 mm (1.4-3.1 mm).

Conclusions: Within its limitations, ultrasound accurately measured mandibular lingual soft tissue structures on cadavers, and the lingual nerve on live humans.

Keywords: alveolar ridge; anatomy; dental implant; diagnosis; ultrasonography.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest:

The authors do not have any financial interests, either directly or indirectly, in the products or information listed in the paper. The study was supported by grants from the Delta Dental Foundation (PAF01878), the Osteology Foundation (PAF06301), Department of Periodontics and Oral Medicine Clinical Research Supplemental Research Grant, School of Dentistry Research Collaborative Award (U054647) and a NIDCR grant (1R21DE027765).

Figures

Figure 1.
Figure 1.
Schematic illustration of the measurements performed on ultrasound and histology on the fresh human cadaveric specimens.
Figure 2.
Figure 2.
Ultrasound images of (A) the mylohyoid muscle and adjacent structures and (B) the lingual nerve. M: mucosa; SLG: sublingual gland; Att: mylohyoid muscle attachment; MM: mylohyoid muscle; LP: lingual plate of the mandible; N: lingual nerve.
Figure 3.
Figure 3.
Histology images of the lingual nerve (A), mucosa (B), and the mylohyoid muscle (C).
Figure 4.
Figure 4.
An obtained ultrasound image of the lingual nerve in a live human subject.
Figure 5.
Figure 5.
Scatter plot displaying the distribution of the lingual nerve diameters in live patients.
See this image and copyright information in PMC

References

    1. Al-Amery SM, Ngeow WC, Nambiar P, & Naidu M (2018). A pilot study on the effects of direct contact of two different surgical burs on the cadaveric lingual nerve. Int J Oral Maxillofac Surg, 47(9), 1153–1160. doi: 10.1016/j.ijom.2018.04.013 - DOI - PubMed
    1. Annibali S, Ripari M, La Monaca G, Tonoli F, & Cristalli MP (2009). Local accidents in dental implant surgery: prevention and treatment. Int J Periodontics Restorative Dent, 29(3), 325–331. - PubMed
    1. Askar H, Di Gianfilippo R, Ravida A, Tattan M, Majzoub J, & Wang HL (2019). Incidence and severity of postoperative complications following oral, periodontal, and implant surgeries: A retrospective study. J Periodontol. doi: 10.1002/JPER.18-0658 - DOI - PubMed
    1. Balasubramanian S, Paneerselvam E, Guruprasad T, Pathumai M, Abraham S, & Krishnakumar Raja VB (2017). Efficacy of Exclusive Lingual Nerve Block versus Conventional Inferior Alveolar Nerve Block in Achieving Lingual Soft-tissue Anesthesia. Ann Maxillofac Surg, 7(2), 250–255. doi: 10.4103/ams.ams_65_17 - DOI - PMC - PubMed
    1. Bataineh AB (2001). Sensory nerve impairment following mandibular third molar surgery. J Oral Maxillofac Surg, 59(9), 1012–1017; discussion 1017. doi:S0278–2391(01)58639–5 [pii] 10.1053/joms.2001.25827 - DOI - PubMed

Substances