Antegonial notch

Antegonial Notch
Lateral view of the mandible showing antegonial notch, labelled as 17
Details
Precursor	Mandibular arch (first pharyngeal arch)
System	Skeletal system
Artery	Facial artery
Vein	Facial vein
Nerve	Marginal mandibular branch of the facial nerve (proximity)
Lymph	Submandibular lymph nodes (proximity)
Anatomical terminology [ edit on Wikidata]

The antegonial notch is a subtle indentation located on the inferior border of the mandible, immediately anterior to the angle of the mandible. It marks the transition between the inferior border of the mandibular body and the anterior border of the mandibular ramus.

Anatomy

The prominence of the antegonial notch varies considerably among individuals based on factors like age, sex, and ethnicity. ^[1] It typically presents as a shallow concavity but can occasionally be more pronounced. In adults, the depth of the notch varies with an average of 2.0±1.1 mm. ^{[2] [3]} Its clinical importance stems primarily from its close relationship with the facial artery, a major vessel supplying blood to the face.

The facial artery typically crosses the inferior border of the mandible just anterior to the masseter muscle's insertion. In most instances, this crossing occurs at or in close proximity to the antegonial notch. This anatomical association has clinical relevance in various surgical procedures involving the face and mandible. The facial artery's pulse can be palpated against the mandible at this location. ^{[4] [5]}

Certain craniofacial syndromes, such as hemifacial microsomia, can result in asymmetry or underdevelopment of the mandible, which may affect the appearance and prominence of the antegonial notch on the affected side. ^[6] Its morphology can also be affected by fractures, tumors and other pathological processes. ^{[7] [8]}

Clinical Significance

• Surgery : Surgeons performing procedures such as rhytidectomy (facelift surgery), orthognathic surgery (corrective jaw surgery), or managing mandibular trauma must be aware of the facial artery's position relative to the antegonial notch to prevent inadvertent injury. ^{[9] [10] [11]}
• Radiology : The antegonial notch serves as a useful anatomical landmark when interpreting radiographs (X-rays) and computed tomography (CT) scans of the mandible.
• Forensic Science : In certain cases, the antegonial notch may be employed as a reference point in forensic facial reconstruction.
• The depth of antegonial notch is an indicator of mandibular growth potential. ^{[12] [13]}

References

1. Porwolik, M.; Porwolik, K.; Domagała, Z. A.; Woźniak, S.; Dąbrowski, P.; Kacała, R.; Kordecki, H.; Chmielewski, P.; Faraj, S. Abu; Gworys, B. (2015). "Typology of the antegonial notch in the human mandible". Folia Morphologica. 74 (3): 365–371. doi: 10.5603/FM.2015.0055 . ISSN   1644-3284. PMID   26339819.
2. Kolodziej, Ronald P.; Southard, Thomas E.; Southard, Karin A.; Casko, John S.; Jakobsen, Jane R. (2002-04-01). "Evaluation of antegonial notch depth for growth prediction". American Journal of Orthodontics and Dentofacial Orthopedics. 121 (4): 357–363. doi:10.1067/mod.2002.121561. ISSN   0889-5406. PMID   11997759.
3. Schütz, Christian; Denes, Balazs J.; Kiliaridis, Stavros; Antonarakis, Gregory S. (2022). "Mandibular antegonial notch depth in postpubertal individuals: A longitudinal cohort study". Clinical and Experimental Dental Research. 8 (4): 923–930. doi:10.1002/cre2.577. ISSN   2057-4347. PMC   9382058 . PMID   35488722.
4. Barral, Jean-Pierre; Croibier, Alain (2011-01-01), Barral, Jean-Pierre; Croibier, Alain (eds.), "16 - The facial artery", Visceral Vascular Manipulations, Oxford: Churchill Livingstone, pp. 143–146, doi:10.1016/b978-0-7020-4351-2.00016-8, ISBN   978-0-7020-4351-2 , retrieved 2024-12-20
5. Sykes, Jonathan M.; Riedler, Kiersten L.; Cotofana, Sebastian; Palhazi, Peter (2020-08-01). "Superficial and Deep Facial Anatomy and Its Implications for Rhytidectomy". Facial Plastic Surgery Clinics of North America. Facelift Surgical Techniques. 28 (3): 243–251. doi:10.1016/j.fsc.2020.03.005. ISSN   1064-7406. PMID   32503712.
6. Zhang, Ming; Zhao, Qing; Chen, Yang-Xi (2006-04-01). "[Dimensional differences in craniofacial morphologies of prepubescence Class II patients with deep and shallow mandibular antegonial notching]". Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi Kouqiang Yixue Zazhi = West China Journal of Stomatology. 24 (2): 142–145. ISSN   1000-1182. PMID   16704093.
7. Gorlin, Robert J.; Cohen Jr., M. Michael; Hennekam, Raoul C.M. (2001-09-27). Syndromes of the Head and Neck. Oxford University Press. ISBN   978-0-19-974772-6.
8. Becker, M. H.; Coccaro, P. J.; Converse, J. M. (1976-10-01). "Antegonial notching of the mandible: an often overlooked mandibular deformity in congenital and acquired disorders". Radiology. 121 (1): 149–151. doi:10.1148/121.1.149. ISSN   0033-8419. PMID   959529.
9. Iwanaga, Joe; Shiromoto, Koshi; Tubbs, R. Shane (2020-01-01). "Releasing incisions of the buccal periosteum adjacent to the lower molar teeth can injure the facial artery: an anatomical study". Surgical and Radiologic Anatomy. 42 (1): 31–34. doi:10.1007/s00276-019-02319-3. ISSN   1279-8517. PMID   31538246.
10. Proffit, William R.; White, Raymond P.; Sarver, David M. (2003). Contemporary treatment of dentofacial deformity. St. Louis: Mosby. ISBN   978-0-323-01697-1.
11. Peterson's principles of oral and maxillofacial surgery (3rd ed.). Shelton: People's medical publ. house. 2012. ISBN   978-1-60795-111-7.
12. Kolodziej, Ronald P.; Southard, Thomas E.; Southard, Karin A.; Casko, John S.; Jakobsen, Jane R. (2002-04-01). "Evaluation of antegonial notch depth for growth prediction". American Journal of Orthodontics and Dentofacial Orthopedics. 121 (4): 357–363. doi:10.1067/mod.2002.121561. ISSN   0889-5406. PMID   11997759.
13. Singer, C. P.; Mamandras, A. H.; Hunter, W. S. (1987-02-01). "The depth of the mandibular antegonial notch as an indicator of mandibular growth potential". American Journal of Orthodontics and Dentofacial Orthopedics. 91 (2): 117–124. doi:10.1016/0889-5406(87)90468-9. ISSN   0889-5406. PMID   3468794.