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. 2020 Aug;23(3):357-361.
doi: 10.1111/ocr.12372. Epub 2020 Mar 10.

Median Lingual Foramen, a new midmandibular cephalometric landmark

David Vandekerckhove  1 , Dionne Deibel  1 , Shankeeth Vinayahalingam  1 , Gilles Claeys  1 , Tae-Geon Kwon  2 , Stefaan Bergé  1 , Tong Xi  1
Affiliations

Median Lingual Foramen, a new midmandibular cephalometric landmark

David Vandekerckhove et al. Orthod Craniofac Res. 2020 Aug.

Abstract

Purpose: In asymmetrical mandibles, it is often challenging to identify the mandibular midline. The median lingual foramen (MLF) is located at the midline of the anterior mandible. The purpose of this study is to evaluate the reproducibility of identifying the MLF compared to conventional landmarks on cone beam computed tomography's (CBCT's) to mark the mandibular midline.

Material and methods: Ten symmetrical class II, 10 symmetrical class III, ten asymmetrical class II and 10 asymmetrical class III patients were included. On CBCTs, the cephalometric landmarks menton, pogonion, genial tubercle and MLF were identified twice by two observers.

Results: A high intra- and interobserver reproducibility was found for all landmarks, the highest being the MLF. The gain in accuracy is 0.998 mm, 0.824 mm and 0.361 mm compared to pogonion, genial tubercle and menton, respectively (P-value <.05).

Conclusion: MLF is a reliable and reproducible landmark to indicate the midline of the mandible, particularly in Class II asymmetric mandibles.

Keywords: asymmetric; cephalometric landmark; mandible; orthognathic surgery.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
A, (upper left): This illustration displayed a radiolucent canal perforating the lingual side of the cortex in the midsagittal region of the mandible. Note the cortical outline which is situated towards the cancellous bone that surrounds the canal. B, (upper right): Median Lingual Foramen (MLF) is first plotted on the most cranial axial slice that showed an irregular form of the lingual cortex. C, (lower left): The sagittal slice that dissected the previously plotted landmark is selected. MLF is replotted at the junction of the lingual cortical bone of the mandible and the most cranial bone surrounding the radiolucent canal. The red line is constructed to aid the identification of the MLF. Whenever there is more than one canal present, the superior canal will be used (MLFsu) as opposed to the inferior canal (MLFinf). D, (lower right): As a final step, the position of MLF is checked on the coronal slice
Figure 2
Figure 2
Scatterplots showing the interobserver agreement in the latero‐lateral dimension (X‐axis) for Median Lingual Foramen, Menton, Pogonion and Genial Tubercle. The closer the dots situated to the diagonal, the higher the agreement
See this image and copyright information in PMC

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