MANDIBLE

1. MANDIBLE
Dr. Rajnandini Adhikary
MDS 1st Year
Department Of Periodontology &
Oral Implantology

2. INTRODUCTION
 The MANDIBLE, or lower jaw, is the largest and
strongest bone of the face.
 It is HORSE SHOE shaped bone connected to the skull
by TEMPORO MANDIBULAR JOINT.
 It is the only movable bone of the skull

3. EMBRYONIC DEVELOPMENT:

4. Pre Natal Development Of Mandible

9. ANATOMY

10. PARTS OF MANDIBLE:
 RAMUS
 BODY
 ANGLE
 CONDYLE PROCESS
 CORONOID PROCESS
 ALVEOLAR PROCESS

11. RAMUS:
 Quadrilateral in shape
 Two surfaces:Lateral and Medial
 Four borders:Upper,Lower,
Anterior,Posterior
 Coronoid and condylar processes

12. MEDIAL AND LATERAL BORDERS

13.  Lateral:oblique
 Medial:Mandibular foramen,
mandibular canal,Lingula
mylohyoid groove
 Upper border-thin,mandibular notch
 Lower border-base,continuous border
at the angle.

14. CORONOID PROCESS:
flattened triangular upward projection –Anterosuperior
part of ramus
anterior border- anterior border of ramus
posterior border- bounds the MANDIBULAR
NOTCH

15. CONDYLOID PROCESS:
Upward projection - POSTEROSUPERIOR
part of ramus
UPPER END - HEAD which is covered with
FIBROCARTILAGE
ARTICULATES with TEMPORAL BONE
TEMPEROMANDIBULAR JOINT

16. BODY OF MANDIBLE
 Outer and Inner surface
 Upper and Lower border
OUTER SURFACE
 Symphysis menti
 Mental protuberance
 Mental foramen
 Oblique line
 Incisive fossa

17. Inner surface
 Mylohoid Line
 Sub Mandibular Fossa
 Sub Lingual Fossa
 Superior and inferior genial tubercles
 Mylohoid groove
Upper border-Sockets
Lower border-base,digastric fossa

19. FORAMINAAND OTHER RELATIONS
TO NERVES AND VESSELS:

20. NERVE SUPPLY:
 MANDIBULAR NERVE:

22. VASCULAR SUPPLY
 Maxillary artery
 It is divided into 3 parts by Lateral pterygoids
 Mandibular
 Pterygoid
 pterygopalatine

23. MAXILLARY ARTERY

26. VENOUS SUPPLY

28. LYMPHATIC DRAINAGE

36. Local Anaesthetic techniques
 Due to dense cortical bone
LOCAL INFILTRATION is of very poor effect
HENCE block technique is preferred techniques
 INFERIOR ALVEOLAR NERVE BLOCK
 BUCCAL NERVE BLOCK
 MANDIBULAR NERVE BLOCK:
GOW GATES TECHNIQUE

37.  VAZIRANI AKINOSI CLOSED MOUTH
TECHNIQUE
 MENTAL NERVE BLOCK
 INCISIVE NERVE BLOCK

38. INFERIOR ALVEOLAR NERVE
BLOCK
 Mandibular Nerve Block

39.  AREAANESTHETIZED BY INFERIOR ALVEOLAR NERVE
 A

40. LANDMARKS:
1.Coronoid Notch(greatest concavity
on the anterior border of Ramus)
2.Pterygomandibular raphe
3.Occlusal plane of mandibular posterior.

41. TECHNIQUES:

42. COMPLICATIONS:
 HEMATOMA
 TRISMUS
 TRANSIENT FACIAL PALSY

43. BUCCAL NERVE BLOCK
 NERVE ANESTHETIZED:BUCCAL NERVE
 AREA ANESTHETIZED

44. TECHNIQUES:

45. COMPLICATIONS;
 HEMATOMA
 No subjective change due to the small size
of anesthetized area.

46. GOW GATES TECNIQUES
 NERVE ANESTHETIZED:
1.INFERIOR ALVEOLAR
2.MENTAL
3.INCISIVE
4.LINGUAL
5.MYLOHYOID
6.AURICULOTEMPORAL
7.BUCCAL

48. LANDMARKS

49. TECHNIQUES:

50. COMPLICATIONS:
 HEMATOMA
 TEMPORARY PARALYSIS OF CRANIAL NERVE III

51. VAZIRANI-AKINOSI CLOSED MOUTH
 Indicated where there is limited mandibular opening
 NERVES ANESTHETIZED:
1.INFERIOR ALVEOLAR
2.INCISIVE
3.MENTAL
4.LINGUAL
5.MYLOHYOID

53. LANDMARKS:
 MUCOGINGIVAL JUNCTION OF
MAXILLARY THIRD MOLAR
 MAXILLARY TUBEROSITY
 CORONOID NOTCH

54. TECNNIQUES:

55. MENTAL NERVE BLOCK
 NERVE ANESTHETIZED: MENTAL NERVE

56. TECHNIQUES:

57. INCISIVE NERVE BLOCK
 NERVE ANESTHETIZED:
MENTAL
INCISIVE
 ANESTHETIZED PULPAL NERVE FIBRES
TO PREMOLARS,CANINE,INCISORS

59. TECHNIQUE:

60. CLINICAL OBSERVATIONS:
 Presence of an unusually large or high
genital tubercle.
 These could approximate deep osseous defects
also prevent lingual osseous recontouring
during PERIODONTAL SURGERY.

61.  Mandible is mainly fractured at canine socket.
 Involvement of INFERIOR ALVEOLAR
nerve in the callous may cause NEURALGIC PAIN.

62. BONE DENSITY AND PATTERN
 Unlike maxilla, a force distribution unit
MANDIBLE is a force absorption unit
 In a dentate mandible the outer cortical bone is denser
and thicker
while the trabecular bone is more course and dense

63.  It is more dense near the teeth
 Between teeth it is denser towards crest and
less dense towards apex.

65.  IN 1988 MISCH proposed four bone density
Groups based on macroscopic cortical and
Trabecular bone characteristic:

70. SPACE INFECTIONS:

71. MANDIBULAR SPACES:
SUBMENTAL SPACE:

74. SUBMANDIBULAR SPACE

77. BUCCAL SPACE:

79. TREATMENT

80. SUBLINGUAL SPACE:

81. INCISION AND DRAINAGE

82. References
 B D CHAURASIA’S HUMAN ANATOMY
HEAD.NECK AND BRAIN VOLUME 3
3rd edition
 CARRANZA’S CLINICAL PERIODONTOLOGY
11th edition
 HANDBOOK OF LOCAL ANESTHESIA
STANLEY F. MALAMAD 6th edition
 TEXTBOOK OF ORAL AND MAXILLOFACIAL SURGERY
NEELIMAANIL MALICK 2nd edition
 HUMAN EMBROLOGY 11th edition INDERBIR SINGH

83.  MISCH’S COMTEMPORARY IMPLANT DENTISTRY
4TH Edition

84. THANK YOU