The Location of the Mandibular Foramen as a Guide in Mandibular Block Anesthesia in Children by Age: A Radiographic Analysis

Abstract

Knowing the correct location of the mandibular foramen (MF) is a significant factor in the success of inferior alveolar nerve block (IANB). The primary clinical guide for this anesthesia in children with continued growth and development may be the location of MF. The present study was carried out retrospectively on panoramic radiographs of children aged 5-14 years. Three linear measurements were performed on panoramic radiographs to evaluate the distance of the MF to the occlusal plane (OP), anterior border of the ramus (ABR), and mandibular base (MB). The participants’ ages were divided into five groups: (G1) 5-6 years, (G2) 7-8 years, (G3) 9-10 years, (G4) 11-12 years, and (G5) 13-14 years. The results revealed a statistically significant increase in the mean values from G2 to G4 in all measurements. However, it was determined that there were no statistically significant differences between G1 and G2 and between G4 and G5 by the mean measurement values, respectively. Besides, the results of the measurements did not significantly differ by sex. Overall, it was concluded that MF was slightly below OP under 8 years of age and moves in the posterosuperior direction until the permanent dentition period. This result may guide clinicians in IANB in children.

Keywords

• mandibular foramen
• children
• panoramic radiography
• inferior alveolar nerve
• local anesthesia

References

1. 1. Akbari F, Ghoochani TZ, Sharifi-Rayeni A, Hos-seini MS, Askary A. The Use of Panoramic and Cephalometric Images to Guide Needle Placement for Inferior Alveolar Nerve Block in 7- to 12-Years-Old Children. Dent Hypothe-ses. 2019;10:40-6.
2. 2. Krishnamurthy NH, Unnikrishnan S, Ramach-andra JA, Arali V. Evaluation of Relative Po-sition of Mandibular Foramen in Children as a Reference for Inferior Alveolar Nerve Block using Orthopantamograph. J Clin Diagn Res. 2017;11(3):ZC71-ZC74.
3. 3. Mohavved T, Makarem A, Imanimoghadd-am M, Anbiaee N, Sarrafshirazi AR, Shakeri MT. Locating the mandibular foramen rela-tive to the occlusal plane using panoram-ic radiography. J Appl Sci. 2011;11:573–8.
4. 4. Chandran S, Peedikayil FC, Chandru TP, Kottayi S, John S. Relative position of man-dibular foramen in 4–9-year-old children: A retrospective study. SRM J Res Dent Sci. 2021;12(1):13-6.
5. 5. Park H-S, Lee JH. A comparative study on the location of the mandibular foramen in CBCT of normal occlusion and skeletal class II and III malocclusion. Maxillofac Plast Reconstr Surg. 2015;37:1-9.
6. 6. Kilarkaje N, Nayak SR, Narayan P, Prabhu LV. The location of the mandibular foramen maintains absolute bilateral symmetry in mandibles of different age-groups. Hong Kong Dent J. 2005;2:35–7