Systematic review and meta-analysis of frequency and diameters of midline lingual foramina

Abstract

Lingual mandibular foramina represent an anatomical feature found on the oral bone sur- face of the mandible. These structures host vascular and nervous anastomosis derived from the branches of the submental artery, lingual artery and the mylohyoid nerve. Studies on cadavers and on radiological images in-vivo reported the content, the frequency and the dimension of these foramina [1]. In surgical practice, this area is considered to be in low-risk from potential accidents, but reports in english-language literature showed intra-operative massive bleeding when implant interventions occurred in this area [2]. This systematic review and meta-analy- sis aims to summarize qualitatively and quantitatively the features of the lingual foramina on the midline of the inferior jaw. Systematic review and meta-analysis has been performed com- plying the PRISMA statement, and registered on PROSPERO database. The frequency rate of the foramina were resulted to have a point estimate of 0.965. The means of the diameters were shown to have a point estimate of 0.840 with a standard error of 0.06. The results showed a sig- nificant high frequency that has been reported in literature of this variation, presenting a con- sistent diameter dimensions, sign of significant caliber of the related vessels and nerves. Even if this variation is underestimated in current textbooks of oral anatomy, this evidence based anat- omy [3] study suggests an accurate pre-surgical planning as well as a proper risk management preparation to minimize intra-operatory-and post-operatory injures.