Abstract
INTRODUCTION: The involvement of the Accessory Lingual Ducts, with their corresponding neurovascular contents, during the collection of bone blocks in the chin area may be the cause of neurosensory and hemorrhagic complications.
OBJECTIVE: The objective of this study is to determine, through the study of conical beam tomographic images of the anterior region of the jaw, the anatomical characteristics of these bone ducts within the boundaries of this autogenous bone donor zone in that area.
METHODOLGY: 50 conical beam tomographic examinations of the chin region . In each one they were identified and analyzed, when present, in their anatomical characteristics of the Accessory Lingual Ducts in the midline. to determine how deep they are and if it is possible to obtain bone blocks 4 mm and 6 mm thick without damaging their integrity. The values were compared between groups according to sex, age and examined side.
RESULTS: When the chin line was used to obtain bone tissue, the Accessory Lingual Ducts were affected from 11.7% to 52% depending on the thickness, from 04 or 06 mm, of the collected block. No significant variations were detected according to the sex, age or side studied. Conclusion: when the Accessory Lingual Ducts are present, the Anterior Jaw region should not be considered a safe surgical zone. The planning of the collection of bone blocks in the Mentonian Region should be carried out using exclusively tomographic images of appropriate quality.
References
1- Misch CE. Injertos Mandibulares en bloque a partir de hueso donante: sínfisis y rama. En: Misch CE. Implantología Contemporánea. Barcelona, España: Elsevier, 2009: 975 -1012.
2- Nkenke E, Radespiel-Troger M, Wiltfang J, Schultze-Mosgau S, Winkler G, Neukam FW. Morbidity of harvesting of retromolar bone grafts: a prospective study. Clinical Oral Implants Research 2002;13: 514– 521
3- Misch CM. Autogenous bone: is it still the gold standard? Implant Dent. 2010; 19:361.
4- Misch CM, Misch CE, Resnik RR, Ismail YH. Reconstruction of maxillary alveolar defects with mandibular symphysis grafts for dental implants: a preliminary procedural report. Int J Oral Maxillofac Implants 1992; 7:360-6.
5- Mazzonetto R, Kluppel LE, Lopez R.: Princípios biológicos aplicados as Cirurgias Reconstrutivas. In Mazzonetto R: Reconstruções Em Implantodontia: protocolos clínicos para o sucesso e previsibilidade. Nova Odessa: Napoleão, 2009:88-104.
6- Di Bari, Coronelli R, Cicconetti A. Radiographic evaluation of the symphysis menti as a donor site for an autologous bone graft in pre-implant surgery. Imaging Sci Dent. Sep 2013; 43(3): 135–143.
7- Netto HD, Chessa J, Nascimento FF, Mazzonetto R. Técnica Cirúrgica para a Remoção de Enxertos Autógenos Intrabucais. In Mazzonetto R: Reconstruções Em Implantodontia: protocolos clínicos para o sucesso e previsibilidade. Nova Odessa: Napoleão, 2009:126 – 172
8- Liang X, Lambrichts I, Corpas L, Politis C, Vrielinck L, Ma GW et al. Neurovascular disturbance associated with Implant Placement in the Anterior Mandible and its Surgical Implications: literature review including Report of a case. Chin J Dent Res 2008;11 :56-64.
9- Verdugo F, Simonian K, Smith McDonald R, Nowzari H. Quantitation of mandibular symphysis volume as a source of bone grafting. Clin Implant Dent Relat Res. 2010; 12:99–104.
10- Pommer B, Tepper G, Gahleitner A, Zechner W, Watzek G. New safety margins for chin bone harvesting based on the course of the mandibular incisive canal in CT. Clin Oral Implants Res. 2008;19:1312–16.
11- Al-Faraje L. Anterior Mandible. In: Al-Faraje, L. Surgical and Radiologic Anatomy for Oral Implantology. Quintessence, 2013;6:170-201.
12- Raghoebar GM, Meijndert L, Kalk WW, Vissink A. Morbidity of Mandibular Bone Harvesting: A Comparative Study. Int J Oral Maxillofac Implants 2007; 22:359-365.
13- Nóia C, Ortega-Lopez R, Olate S, Duque T, Moraes M, Mazzonetto R. Prospective Clinical Assesment of Morbity AFter Chin Bone Harvest. J Craniofac Surg 2011; 22:2195-8.
14- Cranin, A.N., Katzap, M., Demirdjan, E. & Ley, J. Autogenous bone ridge augmentation using the mandibular symphysis as a donor. The Journal of Oral Implantology 2001;27: 43-7.
15- Di Stephano DA, Cazzaniga A, De Stavola L. Injertos Intraorales. En: Di Stephano DA, Cazzaniga A. Injertos Oseos en las Reconstrucciones Pre y Periimplantares. Amolca, 2013. p. 141 – 200.
16- Tepper G, Hofschneider UB, Gahleitner A, Ulm C. Computed tomographic diagnosis and localization of bone canals in the mandibular interforaminal region for prevention of bleeding complications during implant surgery. Int J Oral Maxillofac Implants 2001;16: 68–72.
17- Vandewalle G, Liang X, Jacobs R, Lambrichts I. Macroanatomical and radiographic characteristics of the superior genial spinal Conducto and its bony canal. Int J Oral Maxillofac Implants 2006; 21:581–586.
18- Sgrott E, Moreira R. Mandibula. In: Sgrott E, Moreira R. Anatomia Aplicada à Implantodontia, Sao Paulo: Santos, 2010; 25 – 59.
19- Mraiwa N, Jacobs R, van Steenberghe D, Quirynen M. Clinical assessment and surgical implications of anatomic challenges in the anterior mandible. Clin Implant Dent Relat Res 2003;5:219–225.

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