Lingual Foramina Anatomy: An Observational Study in Dry Mandibles

<b>Background/Objectives</b>: The lingual foramina of the mandible serve as passageways for arterial branches that are susceptible to injury during surgical procedures, potentially leading to varying degrees of hemorrhage. The objective of the present study was to contribute to the quantification and classification of lingual foramina using cadaveric dry mandibles in relation to surgical safety and, especially, to the risk of perioperative bleeding. <b>Methods</b>: This study examined the number, diameter, and spatial relationship of lingual foramina to the genial tubercle, alveolar process, and alveolar crest in dry mandibles. Stainless steel wire threads and Digimatic caliper measurements were utilized. Cluster analysis was employed for the classification of foramina into distinct spatial groups. One-way analysis of variance (ANOVA) was used to compare mean values among ≥3 groups. <b>Results</b>: A total of 100 dry mandibles were initially analyzed for the presence of lingual foramina with a diameter of ≥2 mm. In 96 of them (50 dentate and 46 edentulous), 387 lingual foramina (mean: 4.03 per mandible) were recognized; the remaining 4 had smaller lingual foramina (diameter <2 mm). Only 4 mandibles (4.2%) exhibited a single lingual foramen, whereas the remaining 92 (95.8%) displayed multiple foramina (up to nine). The observed lingual foramina had a diameter of 0.44 ± 0.02 mm and were located at distances of 8.74 ± 0.54 mm from the genial tubercle, 14.19 ± 0.87 mm from the alveolar crest, and 14.53 ± 0.84 mm from the inferior border of the mandible. Based on their relationship to the genial tubercle, the foramina were classified into four distinct groups: (i) right (27/387-7%), (ii) proximal (254/387-66%), (iii) superior (81/387-21%), and (iv) left (25/387-6%). The superior group exhibited the largest mean diameter (0.52 ± 0.22 mm, ANOVA <i>p</i> < 0.001). The probability of detecting a lingual foramen was minimized at a distance of 13.00 ± 0.50 mm from the genial tubercle, delineating a relatively safe zone with a lower risk of hemorrhage. <b>Conclusions</b>: This study provides anatomical insights that contribute to appropriate preoperative planning and the minimization of complications during surgical interventions on the mandible.