Morphometric and morphologic analysis of the mental foramen in a Turkish population with cone beam computed tomography

Yıl 2025, Cilt: 7 Sayı: 2, 132 - 139, 21.03.2025

Sedef Kotanlı , Mehmet Sinan Doğan , Yasemin Yavuz , Mehmet Veysel Kotanlı , Nezif Çelik , Muhammet Bahattin Bingül

https://doi.org/10.38053/acmj.1614898

Öz

Aims: It is critical to know the localization, anatomy and dimensions of mental foramen (MF) to avoid nerve damage during surgical procedures in the mandibular anterior region and to ensure complete local anesthesia for dental procedures. The aim of our study was to retrospectively evaluate the morphological and morphometric features of MF using cone-beam computed tomography (CBCT) and to contribute to the existing data.
Methods: In our study, the location of the MF, its horizontal diameter, its vertical diameter, the distance of the MF to the alveolar crest, the distance to the lower border of the mandible, the distance to the apex of the adjacent tooth and the distance to the midline were evaluated in the CBCT images of 500 patients between the ages of 18-65. In addition, the types of exit of the mental nerve from the MF were examined. Pearson Chi-square test was used to analyze categorical variables. Normally distributed characteristics were compared using the student t test.
Results: In our study, CBCT images of 500 cases, 250 (50%) of which were male and 250 (50%) of which were female were examined (mean age: 37.12±11.91). No significant relationship was found between MF location and gender (p>0.05). In the right mandibular region, a statistically significant difference was found between the vertical and horizontal diameters of the MF (higher in males), the distance to the alveolar crest (higher in males), the distance of the MF to the lower border of the mandible (higher in males), the distance to the midline (higher in males) and gender (p<0.05). No statistically significant relationship was found between MF exit types and gender in the right and left mandibular regions (p>0.05).
Conclusion: It is important to examine the localization, size and distance of MF to neighboring anatomical structures, the presence and dimensions of alveolar loop (AL) with CBCT before procedures with high risk of complications in the interforaminal region.

Anahtar Kelimeler

mental foremen, anterior loop, CBCT

Kaynakça

• Gungor E, Aglarci OS, Unal M, Dogan MS, Guven S. Evaluation of mental foramen location in the 10–70 years age range using cone beam computed tomography. Niger J Clin Pract. 2017;20(1):88-92. doi:10.4103/ 1119-3077.178915
• Rastogi T, Mehta P, Ravina MS. A radiographic study of mental foramen. J Advances in Oral Health. 2024;1(1):11.
• Ezirganlı Ş, Ozer K, Sari F, Kirmali O, Kara M. Mental foramenin lokalizasyonun radyografik olarak değerlendirilmesi. Cumhuriyet Dental J. 2011;13(2):96-100.
• Haghanifar S, Rokouei M. Radiographic evaluation of the mental foramen in a selected Iranian population. Indian J Dent Res. 2009;20(2): 150-152. doi:10.4103/0970-9290.52886
• Carruth P, He J, Benson BW, Schneiderman ED. Analysis of the size and position of the mental foramen using the CS 9000 cone-beam computed tomographic unit. J Endod. 2015;41(7):1032-1036. doi:10.1016/j.joen. 2015.02.025
• Von Arx T, Friedli M, Sendi P, Lozanoff S, Bornstein MM. Location and dimensions of the mental foramen: a radiographic analysis by using cone-beam computed tomography. J Endod. 2013;39(12):1522-1528. doi: 10.1016/j.joen.2013.07.033
• Kalender AK, Orhan K, and Aksoy U, Evaluation of the mental foramen and accessory mental foramen in Turkish patients using cone-beam computed tomography images reconstructed from a volumetric rendering program. Clin Anat. 2012;25(5):584-592. doi:10.1002/ca.21277
• Singh P, Kumar A, Kumar A. Study of position, shape, size, incidence of mental foramen and accessory mental foramen and its clinical significance. Eur J Cardiovasc Med. 2024;14(3):1286-1290.
• Soman C, Alotaibi WM, Alotaibi SM, Alahmadi GK, Alqhtani NRR. Morphological assessment of the anterior loop in the region of mental foramen using cone beam computed tomography. Int J Morphol. 2024; 1(2):2.
• Krishnan DT, Joylin K, Packiaraj I, et al. Assessment of the anterior loop and pattern of entry of mental nerve into the mental foramen: a radiographic study of panoramic images. Cureus. 2024;16(3):e55600. doi:10.7759/cureus.55600
• Uchida Y, Noguchi N, Goto M, et al. Measurement of anterior loop length for the mandibular canal and diameter of the mandibular incisive canal to avoid nerve damage when installing endosseous implants in the interforaminal region: a second attempt introducing cone beam computed tomography. J Oral Maxillofac Surg. 2009;67(4):744-750. doi: 10.1016/j.joms.2008.05.352
• Sahman H, Sisman Y. Anterior loop of the inferior alveolar canal: a cone-beam computerized tomography study of 494 cases. J Oral Implantol. 2016;42(4):333-336. doi:10.1563/aaid-joi-D-15-00038
• Xu Y, Suo N, Tian X, et al. Anatomic study on mental canal and incisive nerve canal in interforaminal region in Chinese population. Surg Radiol Anat. 2015;37(6):585-589. doi:10.1007/s00276-014-1402-7
• Filo K, Schneider T, Locher MC, Kruse AL, Lübbers HT. The inferior alveolar nerve's loop at the mental foramen and its implications for surgery. J Am Dent Assoc. 2014;145(3):260-269. doi:10.14219/jada.2013.34
• White SC, Pharoah MJ. Oral radiology: principles and interpretation. 2013: Elsevier Health Sciences. 2013.
• Chong BS, Gohil K, Pawar R, Makdissi J. Anatomical relationship between mental foramen, mandibular teeth and risk of nerve injury with endodontic treatment. Clin Oral Investig. 2017;21(1):381-387. doi: 10.1007/s00784-016-1801-8
• Neiva RF, Gapski R, Wang HL. Morphometric analysis of implant-related anatomy in Caucasian skulls. J Periodontol. 2004;75(8):1061-1067. doi:10.1902/jop.2004.75.8.1061
• Udhaya K, Saraladevi K, Sridhar J. The morphometric analysis of the mental foramen in adult dry human mandibles: a study on the South Indian population. J Clin Diagn Res. 2013;7(8):1547-1551. doi:10.7860/JCDR/2013/6060.3207
• Naitoh M, Nakahara K, Hiraiwa Y, Aimiya H, Gotoh K, Ariji E. Observation of buccal foramen in mandibular body using cone-beam computed tomography. Okajimas Folia Anat Jpn. 2009;86(1):25-29. doi: 10.2535/ofaj.86.25
• Oguz O, Bozkir M. Evaluation of location of mandibular and mental foramina in dry, young, adult human male, dentulous mandibles. West Indian Med J. 2002;51(1):14-16.
• Ertuğrul A, Sahin H, Kara S. Doğu Anadolu Bölgesinde yaşayan hastaların mandibular interforaminal alanda mental foramenin karakteristiği: konik ışınlı bilgisayarlı tomografi çalışması. Cumhuriyet Dental J. 2013;16(4):252-260.
• Nalçaci R, Öztürk F, Sökücü O. A comparison of two-dimensional radiography and three-dimensional computed tomography in angular cephalometric measurements. Dentomaxillofac Radiol. 2010;39(2):100-106. doi:10.1259/dmfr/82724776
• Yim JH, Ryu DM, Lee BS, Kwon YD. Analysis of digitalized panorama and cone beam computed tomographic image distortion for the diagnosis of dental implant surgery. J Craniofac Surg. 2011;22(2):669-673. doi:10.1097/SCS.0b013e31820745a7
• Khojastepour L, Mirbeigi S, Mirhadi S, Safaee A. Location of mental foramen in a selected Iranian population: a CBCT assessment. Iran Endod J. 2015;10(2):117-121.
• Nalbantoğlu AM, Yanık D, Albay S. Location and anatomic characteristics of mental foramen in dry adult human mandibles. ADO Klinik Bilimler Dergisi. 2024;13(1):51-58. doi:10.54617/adoklinikbilimler. 1177886
• Elmansori A, Ambarak OOM, Annaas AH, Greiw AS, Salih RF. Morphometric analysis of the mental foramen in libyan population using cone-beam computed tomography. Scholastic: J Nat Med Education. 2024;3:7-16.
• Santini A, Alayan I. A comparative anthropometric study of the position of the mental foramen in three populations. Br Dent J. 2012;212(4):E7. doi:10.1038/sj.bdj.2012.143
• Mahabob MN, Sukena SA, Al Otaibi ARM, Bello SM, Fathima AM. Assessment of the mental foramen location in a sample of Saudi Al Hasa, population using cone-beam computed tomography technology: a retrospective study. J Oral Res. 2021;10(3):1-9.
• Srivastava KC. A CBCT aided assessment for the location of mental foramen and the emergence pattern of mental nerve in different dentition status of the Saudi Arabian population. Brazilian Dent Sci. 2021;24(1):10-P. doi:10.14295/bds.2021.v24i1.2372
• Apinhasmit W, Methathrathip D, Chompoopong S, Sangvichien S. Mental foramen in Thais: an anatomical variation related to gender and side. Surg Radiol Anat. 2006;28(5):529-533. doi:10.1007/s00276-006-0119-7
• Çaglayan F, Sümbüllü MA, Akgül HM, Altun O. Morphometric and morphologic evaluation of the mental foramen in relation to age and sex: an anatomic cone beam computed tomography study. J Craniofac Surg. 2014;25(6):2227-2230. doi:10.1097/SCS.0000000000001080
• Haktanır A, Ilgaz K, Turhan-Haktanır N. Evaluation of mental foramina in adult living crania with MDCT. Surg Radiol Anat. 2010;32(4):351-356. doi:10.1007/s00276-009-0572-1
• Evlice BK. Diş hekimliği uygulamalarında osteoporoz. Arşiv Kaynak Tarama Dergisi. 2013;22(3):273-282.
• Al-Mahalawy H, Al-Aithan H, Al-Kari B, Al-Jandan B, Shujaat S. Determination of the position of mental foramen and frequency of anterior loop in Saudi population. A retrospective CBCT study. Saudi Dent J. 2017;29(1):29-35. doi:10.1016/j.sdentj.2017.01.001
• Yang XW, Zhang FF, Li YH, Wei B, Gong Y. Characteristics of intrabony nerve canals in mandibular interforaminal region by using cone-beam computed tomography and a recommendation of safe zone for implant and bone harvesting. Clin Implant Dent Relat Res. 2017;19(3):530-538. doi:10.1111/cid.12474
• Apostolakis D, Brown JE. The anterior loop of the inferior alveolar nerve: prevalence, measurement of its length and a recommendation for interforaminal implant installation based on cone beam CT imaging. Clin Oral Implants Res. 2012;23(9):1022-1030. doi:10.1111/j.1600-0501.2011. 02261.x
• Raju N, Zhang W, Jadhav A, Ioannou A, Eswaran S, Weltman R. Cone-beam computed tomography analysis of the prevalence, length, and passage of the anterior loop of the mandibular canal. J Oral Implantol. 2019;45(6):463-468. doi:10.1563/aaid-joi-D-18-00236
• Othman B, Zahid T. Mental nerve anterior loop detection in panoramic and cone beam computed tomography radiograph for safe dental implant placement. Cureus. 2022;14(10):e30687. doi:10.7759/cureus.30687
• Rodricks D, Phulambrikar T, Singh SK, Gupta A. Evaluation of incidence of mental nerve loop in Central India population using cone beam computed tomography. Indian J Dent Res. 2018;29(5):627-633. doi: 10.4103/ijdr.IJDR_50_17
• Alyami OS, Alotaibi MS, Koppolu P, et al. Anterior loop of the mental nerve in Saudi sample in Riyadh, KSA. A cone beam computerized tomography study. Saudi Dent J. 2021;33(3):124-130. doi:10.1016/j.sdentj.2020.03.001
• De Brito ACR, Nejaim Y, De Freitas DQ, De Oliveira Santos C. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal. Imaging Sci Dent. 2016;46(3):159-165. doi:10.5624/isd.2016.46.3.159
• Sinha S, Kandula S, Sangamesh NC, Rout P, Mishra S, Bajoria AA. Assessment of the anterior loop of the mandibular canal using cone-beam computed tomography in Eastern India: a record-based study. J Int Soc Prev Community Dent. 2019;9(3):290-295. doi:10.4103/jispcd.JISPCD_83_19
• Li X, Jin ZK, Zhao H, Yang K, Duan JM, Wang WJ. The prevalence, length and position of the anterior loop of the inferior alveolar nerve in Chinese, assessed by spiral computed tomography. Surg Radiol Anat. 2013;35(9):823-830. doi:10.1007/s00276-013-1104-6
• Sahu S, Hellwig D, Morrison Z, Hughes J, Sadleir RJ. Contrast-free visualization of distal trigeminal nerve segments using MR neurography. J Neuroimaging. 2024;34(5):595-602. doi:10.1111/jon.13230