Antilingula as a Surgical Reference Point for Vertical Ramus Osteotomy

Purpose. This study investigated the antilingula and its related landmarks, the mandibular rami, by using cone-beam computed tomography (CBCT). Methods. CBCT images of 37 patients (74 sides of the mandibular ramus) were collected. The landmarks of antilingula (AntiL), anterior ramus (A), posterior ramus (P), superior ramus (S), and inferior ramus (I) were identified. The distances (A-AntiL, P-AntiL, S-AntiL, and I-AntiL) were statistically evaluated according to gender, side (right and left), and skeletal patterns. Results. The distance from the antilingula to the anterior (A-AntiL) border of the ramus was significantly longer on the right side (14.69 mm) than on the left side (13.97 mm). Male patients had longer AntiL-P, AntiL-I, and S-I distances (18.96, 40.07, and 54.94 mm, respectively) than did female patients (16.66, 35, and 47.54 mm, respectively). Regarding skeletal patterns, the classes can be ordered as follows in terms of the measurements: class III>class II>class I. However, the differences between the classes were nonsignificant. Pearson correlation analysis revealed that gender and S-I distance were strongly correlated (r=0.667); specifically, male patients had a longer S-I distance. A-AntiL and A-P also exhibited a strong correlation (r=0.796). Conclusion. Antilingula-related distances did not differ between skeletal patterns. Among antilingula-related variables, A-AntiL could serve as a favorable measuring point during operation