Determination of the location of the mental foramen: a critical review

A Comprehensive Analysis of the Radiographic Characteristics and Bilateral Symmetry of the Mental Foramen

OBJECTIVES

There is currently a scarcity of data on the frequency and bilateral symmetry of the position and other characteristics of the mental foramen (MF) and accessory mental foramina in Yemen. The objective of this study was to analyze the position and other characteristics, as well as the symmetry of the MF, in a sample of the Yemeni population.

MATERIALS AND METHODS

A retrospective analysis was conducted on a sample of 500 digital panoramic radiographs (1000 sides). The study examined various characteristics of the MF, including horizontal and vertical positions, shapes, appearances, and the presence of accessory mental foramina. Additionally, the study explored potential associations between these characteristics and variables such as the subject's gender, sides, and symmetry. Data analysis was performed using SPSS, and statistical significance was evaluated using chi-square tests; the p value was set at 0.05.

RESULTS

The horizontal position of the MF was most frequently observed between the first and second lower premolars (63.2%). The vertical position of the MF was predominantly below the apices of the lower premolars (66.2%). The majority of MFs had a round shape (46.3%). In 72% and 75.6% of cases, there was a continuous and descending relationship between the MF and the mandibular canal, respectively. Accessory mental foramina was present in 3.8% of cases. Gender differences were significant for the shape of the MF and the pattern of the canal on the right side. The symmetry rates for various features included horizontal positions (87.4%), vertical positions (82.6%), and shapes (80.4%).

CONCLUSION

The MF is most commonly situated horizontally between the lower premolars and vertically below the apices of these teeth. The majority of MFs showed a round shape and a continuous and descending relationship with the mandibular canal. In most instances, characteristics of the MF were symmetrical on both sides.

Morphometric analysis of the mental foramen in a Syrian population by using cone-beam computed tomography

INTRODUCTION

Anatomical knowledge is crucial for addressing diagnostic challenges, ensuring safe procedures, and avoiding potential risks. Among the various mandibular anatomical landmarks, the mental foramen (MF) is particularly significant for dental procedures, especially surgeries. Therefore, it is essential to conduct a comprehensive radiographic evaluation of this region before performing such procedures. The purpose of this study was to investigate the size of MF and the distances from its border to the alveolar crest (AC) and to the inferior border of the mandible (IBM) in a selected Syrian population by using cone-beam computed tomography (CBCT), and to detect any statistically significant effect of individuals' factors, such as sex, age, dental status, and side on these anatomical parameters.

MATERIAL AND METHODS

The study retrospectively analyzed 200 CBCT scans (400 hemimandibles) from 104 females and 96 males, grouped into three age categories: 20-35, 36-50, and 51-65years. The hemimandibles were classified based on dental status into three groups: dentate, partially edentate, and completely edentate, and by side as right or left.

RESULTS

The study revealed that the average horizontal and vertical diameters of MF were (3.48±0.75mm) and (3.01±0.75mm), respectively. Additionally, the average distances D1 (MF-AC) and D2 (MF-IBM) were (11.01±3.68mm) and (12.51±1.56mm) respectively. The study's findings indicated that age and dental status had a statistically significant effect on all the parameters studied, except for the horizontal diameter. Furthermore, sex had a statistically significant effect on all the parameters, while the side had no effect on any of the parameters investigated.

CONCLUSIONS

The results of this study suggest that an understanding of the morphometry of the mental foramen is essential for clinicians, which may assist them in performing dental procedures more safely and achieving successful local anesthesia. Moreover, individual factors should be taken into consideration.

Mental foramen and apical foramen: A dangerous anatomical proximity

The study evaluated the spatial position of the mental foramen (MF) using 300 cone-beam computed tomography. The spatial position was analyzed with the horizontal location and relative location (distance between apical foramen and MF). The horizontal location was assessed through three positions (positions 1, 2, and 3). The relative location was determined with the x, y, and x coordinates of the root apex of mandibular premolars and the MF. Student's t-test and chi-square were performed. The most common horizontal location (52%) was position 2, which means between the premolars (p < 0.05). The relative location of the MF to the root apex of the second premolar was closer than the first premolar (p < 0.05). The distance between the root tip of the second premolar and the MF was 5.27 mm, with a minimum value of 1.87 mm. Clinicians should be aware of the possible neural results to the mental nerve of an endodontic infection and the extrusion of irrigation solutions.

Mental Foramen Position, Shape, Continuity, and Symmetry Among Malocclusion Patients: A Radiographic Study

INTRODUCTION

Many dental treatments need exact knowledge of the anatomical location of the mental foramen (MF). This retrospective research uses orthopantomograph (OPG) to assess the MF of orthodontic patients in Saudi Arabia and their position, symmetry, shape, and connectivity.

MATERIALS AND METHOD

One hundred and eighty panoramic radiographs of patients having orthodontic treatment were analyzed for the location, form, symmetry, as well as bilateral preservation of the MF. The patients were of varied ages, genders, and degrees of malocclusion and were divided into three classes: Class I (60), Class II (60), and Class III (60). Chi-squared tests and other descriptive statistics were employed to examine the data for statistical significance.

RESULT

When looking at the right side of the mouth, the most frequent location for MF was position 3 (between the apexes of the first and second premolars; 50.6%), whereas on the left side, it was location 4 (near the apical of the second premolar; 47.2%). The most typical form of MF has an irregular shape. MF location on the left side and continuity types differed significantly across malocclusion groups (p<0.05).

CONCLUSION

 OPGs of Saudi orthodontic patients demonstrated a significant variability of position and continuity of the MF across different classes of malocclusion. The third most frequent position was between the first and second premolars, while the shape of MF showed variation across the age of the patients. Hence, this precise comprehension of the anatomical and morphological diversity of the MF is of utmost significance for dental professionals.

Present Status and Future Directions - Surgical Endodontics

Endodontic surgery encompasses several procedures for the treatment of teeth with a history of failed root canal treatment, such as root-end surgery, crown- and root resections, surgical perforation repair, and intentional replantation. Endodontic microsurgery is the evolution of the traditional apicoectomy techniques and incorporates high magnification, ultrasonic root-end preparation and root-end filling with biocompatible filling materials. Modern endodontic surgery uses the dental operating microscope, incorporates cone-beam computed tomography (CBCT) for preoperative diagnosis and treatment planning, and has adopted piezoelectric approaches to osteotomy and root manipulation. Crown- and root resection techniques have benefitted from the same technological advances. This review focuses on the current state of root-end surgery by comparing the techniques and materials applied during endodontic microsurgery to the most widely used earlier methods and materials. The most recent additions to the clinical protocol and technical improvements are discussed, and an outlook on future directions is given. While non-surgical retreatment remains the first choice to address most cases with a history of endodontic failure, modern endodontic microsurgery has become a predictable and minimally invasive alternative for the retention of natural teeth.

Shape and anatomical relationship of the mental foramen to the mandibular premolars in an Indian sub-population: a retrospective CBCT analysis

Objectives

This study assessed the shape and anatomical relationship of the mental foramen (MF) to mandibular posterior teeth in an Indian sub-population.

Materials and Methods

In total, 475 existing cone-beam computed tomography records exhibiting 950 MFs and including the bilateral presence of mandibular premolars and first molars were assessed. Images were evaluated 3-dimensionally to ascertain the position, shape, and anatomical proximity of MFs to mandibular teeth. The position and shape of MFs were measured and calculated. The Pythagorean theorem was used to calculate the distance between the root apex of the mandibular teeth and the MF.

Results

MFs exhibited a predominantly round shape (left: 67% and right: 65%) followed by oval (left: 30% and right: 31%) in both males and females and in different age groups. The root apices of mandibular second premolars (left: 71% and right: 62%) were closest to the MF, followed by distal to the first premolars and mesial to the second premolars. The mean vertical distance between the MF and the nearest tooth apex calculated on sagittal sections was 2.20 mm on the right side and 2.32 mm on the left side; no significant difference was found according to sex or age. The distance between the apices of the teeth and the MF was ≥ 4 mm (left; 4.09 ± 1.27 mm and right; 4.01 ± 1.15 mm).

Conclusions

These findings highlight the need for clinicians to be aware of the location of the MF in treatment planning and while performing non-surgical and surgical endodontic procedures.

Prevalence and extension of the anterior loop of the mental nerve in different populations and CBCT imaging settings: A systematic review and meta-analysis

Purpose

Materials and Methods

Results

Conclusion

Structural Features of the Mental Foramen in a Saudi Subpopulation: A Retrospective CBCT Study

Introduction

Accurate and precise knowledge about the position, size, and shape of the mental foramen (MF) are critical in avoiding procedural complications. The MF's anatomical features vary among different ethnic groups, and various radiographic techniques have been used to determine these variations.

Aims

To evaluate the MF's shape, vertical and horizontal positions, and distance from the border of the mandible. To evaluate the differences among genders as they pertain to the right and left sides of the mandible and research the bilateral symmetry regarding the same variables.

Materials and Methods

Cone beam computer tomography (CBCT) scans of 155 Saudi patients (69 males and 86 females) who visited the college of dentistry's clinics were obtained from the college database for this retrospective study. All the scans were analyzed by 3 calibrated examiners. The data collected was analyzed statistically, and results were obtained.

Results

The MF was located under the mandibular second premolar in 56.9% of cases, whereas in 26.9% of cases, it was located between the first and second mandibular premolar. The most prevalent position was below the level of the apices of the mandibular premolar teeth (87.2%). The round shape was most frequent (44.9%) compared to the H-oval (34.7%) and V-oval (20.4%). The V-oval shape was more frequent in males, while the H-oval shape was more frequent in females. The average distance from the center of the MF to the mandibular border was 14.03 ± 1.58 mm, with males exhibiting a greater distance than females. Overall, there were no significant differences between the bilateral symmetry and the right and left sides for all parameters.

Conclusion

The most common position of the MF was under the root apex of the mandibular second premolar, with an average distance of about 14 mm from the border of the mandible. The position and shape of the MF were the same bilaterally in the majority of individuals.

Mental Foramen and Anterior Loop Anatomic Characteristics: A Systematic Review and Meta-analysis of Cross-sectional Imaging Studies

INTRODUCTION

The present study aimed to review the epidemiologic, topographic, and morphometric aspects of the mental foramen (MF) and anterior loop (AL) on cone-beam computed tomographic imaging studies.

METHODS

An International Prospective Register of Systematic Reviews (PROSPERO)-registered systematic review (CRD42018112991) was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two reviewers independently performed data extraction from observational studies that evaluated MF and AL on 7 electronic databases. MedCalc (MedCalc Software bv, Ostend, Belgium) software was used to perform a meta-analysis with a 95% confidence level.

RESULTS

Of 1545 articles, 66 met the inclusion criteria, totaling 14,233 patients from 5 continents, with a total of 6655 females and 5884 males (some studies did not report sex), with an age range between 8 and 89 years. The most prevalent shapes of MF were oval (48.72%) and circular (44.36%), and the most frequent horizontal positions were between premolars (43.66%) and in line with the long axis of the second premolar (43.12%).

CONCLUSIONS

Based on the articles that assessed AL, the mean prevalence was 43.18%, with most studies reporting bilateral localization as the most prevalent.

The Proximity of Mental Foramen to Mandibular First Premolar Teeth: Cone Beam Computed Tomography Analysis in Turkish Population

Background/Aim: The aim of this study was to evaluate the proximity of the mental foramen (MF) to the roots of the mandibular first premolar teeth in the Turkish population according to gender and different age groups.

Material and Methods: The study was conducted on 385 samples of 242 patients who presented at the Dicle University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology. The proximity of the MF to mandibular first premolar teeth was examined on cone beam computed tomography (CBCT) images. Two-way Anova variance analysis was used in the statistical analyses of the data.

Results: According to the analysis results, no statistically significant difference was determined between the age and gender groups (p>0.05). In the evaluation of the gender groups, the mean value was 6.6997 mm for females and 6.5445 mm for males.

Conclusions: With 3-dimensional imaging technology, the CBCT system provides detailed information about the MF localization. This method has shown that the localization of the MF could change associated with variables such as age and gender.

Evaluation of the Distance between the Mental Foramen and the Mandibular Edge: Cone Beam Computed Tomography Analysis in Turkish Population

Background/Aim: The aim of this study was to evaluate the distance between the mental foramen and the upper and lower edges of the mandible in the Turkish population according to different gender and age groups.

Material and Methods: A total of 1756 samples of 878 patients who presented at the Dentomaxillofacial Radiology Department of the Dentistry Faculty of Dicle University were included in the study for evaluation of the distance between the mental foramen and the upper and lower edges of the mandible. The cone beam computed tomography (CBCT) images were taken using an I-CAT Vision device (Imaging Science International, Hatfield, USA). Multiple variance analysis was used in the statistical analyses of the data.

Results: A statistically significant difference was identified between the genders in respect of the distance of the external edge of the mental foramen from the upper edge of the mandible (p=0,000). In the evaluations of the different age groups, no statistically significant difference was determined. A statistically significant difference was determined between the gender and age groups in respect of the distance of the mental foramen from the lower edge of the mandible (p=0,000).

Conclusions: The distance of the mental foramen from the upper and lower edges of the mandible can show variations according to age and gender. Therefore, the use of CBCT as a 3-dimensional imaging method with a low radiation dose is recommended.

Evaluation of Mental Foramen with Cone Beam Computed Tomography: A Systematic Review of Literature

Purpose

The aim of this systematic review is to assess whether the anatomy of mental foramen is precisely evaluable with cone beam computed tomography (CBCT) before implantation in humans.

Methods

A systematic review was carried out to evaluate the anatomy of mental foramen (size, position, symmetry, anterior loop, and accessory mental foramen or multiple mental foramina). According to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, an electronic search of three databases (Medline, Web of Science, and Cochrane Library) was undertaken until June 2020 and was supplemented by manual searching. Two reviewers will independently perform the processes of study inclusion, data extraction, and quality assessment. Systematic reviews, studies about children, and case reports were excluded. Only studies using CBCT to do preoperative evaluation were selected.

Results

From 728 potentially eligible articles, 72 were included in the qualitative analysis and quantitative synthesis. This systematic review provided an assessment of the anatomy of the mental foramen. The mental foramen was located mostly between the two premolars (between 50.4% and 61.95%) or apically to the second premolar (from 50.3% to 57.9%). The mean diameter of the mental foramen was bigger in males than in females; the difference between them could reach 0.62 mm. The anterior loop seemed to be longer in males (between 0.87 ± 1.81 and 7.25 ± 2.02 mm) than in females (between 0.81 ± 1.18 and 6.52 ± 1.63 mm) and with the presence of teeth (from 0.91 ± 1.18 to 2.55 ± 1.28 for dentate people and from 0.25 ± 0.61 to 2.40 ± 0.88 mm for edentate population). The anterior loop and the accessory mental foramina were detected more frequently with CBCT than panoramic X-ray: only between 0.0 and 48.6% AMFs detected with CBCT were also seen with panoramic images. Clinical Significance. The mental foramen (MF) is an important landmark for local anesthesia and surgical and implantology procedures. Its location, morphology, and anatomical variations need to be considered to avoid mental nerve injury. The aim of this review is to evaluate the mental foramen using CBCT through a systematic literature review to improve knowledge of this complex area for the clinician.

Biometric analysis of apical surgery-related anatomy of mandibular first molars: a cone-beam computed tomography study in a Mongoloid population

Objective

To evaluate the apical surgery-related anatomy of two-rooted and three-rooted mandibular first molars (MFMs) in a Mongoloid population.

Methods

A total of 502 cone-beam computed tomographic images were used to evaluate the root configuration, the distance from the buccal bone to each root, root dimensions, and the complete root resection distance at the resection level for roots of MFMs.

Results

The prevalence of two-rooted and three-rooted MFMs was 85.1% and 14.9%, respectively. At the resection level, the distance from the buccal bone to the mesial and distal roots of two-rooted MFMs was 2.24 and 3.15 mm, respectively, while the distance was 2.44, 2.01, and 8.55 mm for the mesial, distobuccal, and distolingual roots of three-rooted MFMs, respectively. The distance from the buccal bone to each root was longer in men than in women. The largest distance for complete root resection was detected for the distal root in two-rooted MFMs and for the distolingual root in three-rooted MFMs.

Conclusions

The prevalence of three-rooted MFMs is common in the Mongoloid population. The distance from the buccal bone to root apex differs according to root configurations and sex. Surgical access to the distolingual root is difficult because of the long access distance.

Location of the Mandibular Incisive Canal Related to the Placement of Dental Implants: A Case Report

Cone-beam computerized tomography (CBCT) can show an uncommon mandibular incisive canal that cannot be detected by panoramic radiography, which is used preoperatively to form the initial plan of the size and length of an implant fixture for surgical placement in the mandibular interforaminal area. Determination of the position and anatomical configuration of the mandibular incisive canal is challenging. The purpose of this case report is to discuss anatomical variations in the mandibular incisive canal and the mental canal by reviewing previous studies. Furthermore, we propose that the anterior loop length of the mental canal near the mental foramen, as well as the diameter of the mandibular incisive canal, should be verified by CBCT prior to performing implant surgery in the anterior mandibular area to prevent possible nerve damage.

Cone beam computed tomography study on the relation between mental foramen and roots of mandibular teeth, presence of anterior loop and satellite foramina

PURPOSE

To investigate the position of the mental foramen based on its relation with the roots of the mandibular teeth and quantify the prevalence of anterior loop and satellite foramina in the mandible in cone beam computed tomography (CBCT) scans.

METHODS

The sample consisted of 400 CBCT scans of males (n=190) and females (n=210) from Moscow, Russia. Using the system proposed by Tebo and Telford (1950), the position of the mental foramen was classified into: I) mesial to the mandibular first premolar; II) at the apex of the mandibular first premolar; III) between the roots of the mandibular first and second premolars; IV) at the apex of the mandibular second premolar; V) between the roots of the mandibular second premolar and first molar; and VI) at the apex of the roots of the mandibular first molar. Additionally, the images were assessed to investigate the prevalence of the anterior loop of the mandibular canal and the presence of satellite foramina.

RESULTS

Mental foramen position class III was the most prevalent (61%) followed by class IV (27%), II (8%), I, V and VI (together <4%). Statistically significant differences were not detected between males and females (P<0.05). In Russian males and females, the anterior loop of the mandibular canal was found in 15.78% and 3%, respectively; while satellite foramina were found in 31.58% and 19.62%, respectively.

CONCLUSION

The spatial position of the mental foramen and the morphological alterations of the mandibular canal and adjacent foramina must be known prior to surgical interventions in the mandible.

Morphometric Analysis of the Mental Foramen Using Cone-Beam Computed Tomography

This study evaluated the effects of age and sex on the location and size of the mental foramen (MF). A total of 104 cone-beam computed tomography (CBCT) scans from patients' aged 18–80 years were selected. Images were evaluated using the following parameters: position and size of the MF, and Distances A (distance from the upper limit of the MF to the apex of the first lower premolar), B (distance from the upper cortical border of the MF to the alveolar crest), and C (distance from the border of the MF to the base of the mandible). Results revealed that the location of the MF was predominantly apical (44.4%), between the long axes of the premolars, at an average distance of 4.92 mm from the root of the first lower premolar. The height of the MF was significantly different between both sexes (3.41 and 2.99 mm, resp.; mean height: 3.11 mm; P=0.003). The MF was located on average at 11.21 mm from the alveolar crest and 12.31 mm from the base of the mandible; the former measurement was significantly different between both sexes (13.13 and 11.98 mm, resp.; P ≤ 0.001). In conclusion, the location of the MF was predominantly apical between the long axes of the premolars, and the mean size and distance of the MF were greater in men.

Assessment of the Mental Foramen Location in a Sample of Fully Dentate Lebanese Adults Using Cone-beam Computed Tomography Technology

Objective:

The literature reports that the location of mental foramen shows differences among races. The aim of this study was to assess the mental foramen position in a sample of Lebanese population using cone-beam computed tomography (CBCT) technology.

Materials and methods:

In this study, we investigated CBCT images of 50 fully dentate Lebanese adults (23 males and 27 females). We assessed the horizontal position of the mental foramen in relation with the mandibular premolars in both right and left sides and the vertical position by measuring the distance from the upper border of the foramen to the inferior border of the body of the mandible. The data obtained were statistically analyzed using Chi-square test, and two-sided t-test. Statistical significance was set at p < 0.05.

Results:

In our sample, the mental foramen was mostly found in line with the second mandibular premolar in both sides and the mean distance from the superior border of the foramen to the inferior border of the body of the mandible was 13.0120 ± 0.98487 mm on the right and 13.0728 ± 0.96029 mm on the left.

Conclusion:

Within the limits of this study, we concluded that in our sample of Lebanese population, there was substantial variability in the mental foramen location.

Relationship between the Mental Foramen, Mandibular Canal, and the Surgical Access Line of the Mandibular Posterior Teeth: A Cone-beam Computed Tomographic Analysis

INTRODUCTION

The purpose of this study was to investigate the relationships between the location of the mental foramen (MF) and the mandibular canal (MC) and the surgical access line (SAL) of the mandibular posterior teeth using cone-beam computed tomographic (CBCT) scans.

METHODS

CBCT scans of 204 subjects ranging in age from 18-76 years old were evaluated. The vertical and horizontal distances from the MF to the SAL of the mandibular premolars and first molars and the vertical distance from the MC to the SAL of the second premolars and first molars were measured via CBCT scans.

RESULTS

The average vertical distance between the MF and the SALs showed significant increases sequentially from the first premolars to the distal roots of the first molars, and the shortest average distance of 2.74 mm was obtained for the first premolars. The SALs of the second premolars were the closest to the MF in the horizontal direction with an average distance of 1.5 mm. In 19.9% of the cases, the vertical and horizontal distances between the MF and the SALs of the second premolars were less than 2 mm. In addition, the MF was located superior to the root apices in 6.62% of the cases. The majority of the SALs were located at a vertical distance from the MC that was more than 2 mm. Men and women exhibited significant differences in both the horizontal distance from the MF to the SALs of the first premolars and the vertical distance from the MC to the SALs of the second premolars.

CONCLUSIONS

To improve the success of endodontic microsurgery, adequate knowledge of the anatomic relationships between the location of the MF and MC and the SAL of the mandibular posterior teeth is indispensable to surgeons.

Determination of the position of mental foramen and frequency of anterior loop in Saudi population. A retrospective CBCT study

Objectives

To determine the position of mental foramen (MF) and frequency of anterior loop (AL) using dental cone beam computed tomography (CBCT).

Materials and methods

The study involved the evaluation of 302 CBCT scans (196 males, 106 females). The position of MF was determined with respect to adjacent teeth, nearest root apex of adjacent teeth and mandibular borders. MF position was also assessed based on gender and age. In addition, prevalence of anterior loop was evaluated by categorizing the inferior alveolar canal (IAC) patterns into linear, perpendicular and anterior looping.

Results

The study revealed that the most common position of MF was below the apex of 2nd premolar accounting for a total of 52.8% of scans whereas, only 29.6% observed MF between 1st and 2nd premolar (p > 0.05). 38.7% of MF were located at a distance of 1–3 mm from the nearest root apex (2nd premolar), followed by a distance of less than 1 mm in 17.05 of cases. 63.2% of foramen on left side of the mandible were observed below the apex of 2nd premolar in females (p = 0.023). Statistically significant findings were observed with regards to position of MF in different age groups (p < 0.05). The most common IAC pattern observed was linear in nature which accounted for 46.2% of cases followed by perpendicular pattern (38.6%). AL was found only in 15.2% of cases.

Conclusions

Our sample population most commonly exhibited MF below the apex of 2nd premolar with linear IAC pattern. AL was regarded as the least common pattern in Saudi population.

The influence of bone mineral density and bisphosphonate therapy on the determinants of oral health and changes on dental panoramic radiographs in postmenopausal women

OBJECTIVES

The aim of this study was to assess the determinants of oral health including the number of decayed, missing, and filled teeth (DMFT) and periodontal indices in postmenopausal women with osteoporosis, osteoporosis treated with bisphosphonate therapy, and control group and to examine the correlation between dental panoramic indices (Mental Index-MI, Mandibular Cortical Index-MCI) and bone mineral density in these three groups of patients.

MATERIALS AND METHODS

The presented non-interventional study involved 120 postmenopausal women: women with osteoporosis (O) (n = 45), women with osteoporosis treated with bisphosphonates (OBP) (n = 45), and control group (C) (n = 30). DMFT, plaque, gingival and papilla bleeding index, pocket depth, clinical attachment loss, and the presence of periodontitis were evaluated for each patient. MI and MCI of all participants were measured on a dental panoramic radiograph.

RESULTS

Group OBP showed significantly higher gingival, bleeding index and deeper pocket depth than C and/or O group. No significant differences were found in MI (p = .303) or MCI (p = .06) in all the examined groups. Also, there were no significant differences between the three groups in the presence of periodontitis as well as in the DMFT index.

CONCLUSION

BP therapy could have a negative influence on periodontal health. Further, MI and MCI are not precise diagnostic tools for diagnosing low BMD in postmenopausal women.

CLINICAL RELEVANCE

BP therapy could have a negative influence on the determinants of oral health in postmenopausal women with osteoporosis.

Anatomical characteristics and visibility of mental foramen and accessory mental foramen: Panoramic radiography vs. cone beam CT

Background

The mental foramen (MF) is a small foramen located in the anterolateral region of the mandible through which the mental nerve and vessels emerge. The knowledge on the anatomic characteristics and variations of MF is very important in surgical procedures involving that area. The aim of this study was two-fold: firstly, to analyze the anatomic characteristics of MF and the presence of accessory mental foramen (AMF) using CBCT and, secondly, to compare the capability of CBCT and PAN in terms of MF and AMF visualization, as well as influencing factors.

Material and Methods

A sample of 344 CBCT scans was analyzed for presence and characteristics (i.e. diameter, area, shape, exit angle) of MF and AMF. Subsequently, corresponding PANs were analyzed to ascertain whether MF and AMF were visible.

Results

Out of the 344 patients, 344 (100%) MFs and 45 (13%) AMFs were observed on CBCT. Regarding gender, MF diameter and area, MF-MIB and MF-MSB distances, and exit angle were all significantly higher in males. Also, statistically significant differences were found in terms of age and dental status. Statistically significant differences in MF long and short diameters and MF area were found with respect to AMF presence (p=.021, p=.008, p=.021). Only 83.87% of the MFs and 45.83% of the AMFs identified on CBCT were also visible on PANs. MF diameter, shape, exit angle, and age had a significant influence on MF visualization on PAN (B=.43, p=.005; B=-.55, p=.020; B=.20, p=.008; B=.61, p=.005).

Conclusions

PAN is not an adequate technique to properly identify MF and AMF. Diameter, shape, exit angle, and age are all factors influencing MF visualization on PAN images. For surgery involving the MF anatomical region, a preoperative radiological study with CBCT is of crucial importance to avoid complications.

Key words:Mental foramen, accessory mental foramen, mandibular anatomy, cone beam computed tomography, panoramic radiography.

Analysis of the mental foramen using cone beam computerized tomography

<title>Abstract</title><sec><title>Introduction</title><p>Knowledge of the anatomical structures located in the region between the mental foramina is of critical importance in pre-operative planning.</p></sec><sec><title>Objective</title><p>To evaluate the position of the mental foramen relative to the apices of the teeth and the distance to the edges of the mandible, using cone beam computerized tomography.</p></sec><sec><title>Material and method</title><p>One hundred cone beam computerized tomographs of the mandible were evaluated; the tomographs were taken using a single tomographic device. Each image chosen was evaluated repeatedly from both sides of the mandible, the position of the mental foramen, indicating the region in which the foramen was found and the measures of the mental foramen, the lingual cortex and the mandibular base. Initially, the data were analyzed descriptively. A value of <italic>p</italic><0.05 was chosen as the level of significance.</p></sec><sec><title>Result</title><p>Forty-two percent of the mental foramina were located in the apex of the second pre-molar. The lingual margin of the mental foramen was located, on average, 3.1mm from the lingual cortex. The lower margin of the mental foramen was located 7.25 mm above the lower edge of the mandible.</p></sec><sec><title>Conclusion</title><p>The mental foramen was located more frequently at a level of the apices of the second pre-molars, with a distance to the lingual cortex, on average, of 3.1mm and to the base of the mandible, on average, of 7.25 mm.</p></sec>