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Abstract

Objective: Before a surgical intervention in the mandibular interforaminal area, it is important to have a full understanding of the anatomy of the mandibular anterior segment. The evaluation of anatomical structures, variations and pathologies is performed with radiological imaging methods. Today, cone beam computed tomography (CBCT) is an imaging method which offers all the features necessary for this. In addition to its importance in surgical applications, it is also valuable in terms of anatomical studies thanks to the reliability of its measurements and the fact that it allows for a three-dimensional evaluation. The mental foramen and anterior loop are some of the most significant anatomical structures in the lower jaw. The aim of this study was to determine the characteristics of mental foramen according to age and gender in a Turkish population and to evaluate anterior loop length and the frequency of anterior loop. Methods: In this retrospective study, CBCT images from 148 patients (89 females and 59 males) were examined. Images of the mental foramen and interforaminal area of patients who were over 18 years of age were included in the study, while images with mandibular pathology and without occlusal closure to at least premolar teeth were excluded. Linear measurements of the mental foramen were repeated three weeks later by the same observer. Descriptive statistics (mean, standard deviation) and the Kolmogorov-Smirnov, Kruskal-Wallis, Mann-Whitney U, ANOVA tests and the t-test were used to evaluate the data. Results: The morphological and morphometric features of the mental foramen, which is a characteristic structure in mandibular bone, were determined. No statistically significant difference was found between the age groups in the morphometric characteristics of the mental foramen, but a statistically significant difference was found according to gender. The most frequently detected oval shape and P3, and P4 positions were similar to the other studies conducted in Turkish populations. The prevalence of anterior loop was 58%. Conclusion: Detailed preliminary analysis focusing on anesthesia and surgical interventions is important in order to avoid possible complications.

References

1. Aminoshariae A, Su A, Kulild JC. Determination of the location of the mental foramen: A critical review. J Endod. 2014; 40(4):471-5.

2. 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):529-33.

3. Greenstein G, Tarnow D. The mental foramen and nerve: Clinical and anatomical factors related to dental implant placement: A literature review. J Periodontol. 2006; 77(12):1933-43.

4. Laher AE, Wells M, Motara F, Kramer E, Moolla M, Mahomed Z. Finding the mental foramen. Surg Radiol Anat. 2016; 38(4):469-76.

5. Al-Shayyab MH, Alsoleihat F, Dar-Odeh NS, Ryalat S, Baqain ZH. The mental foramen I: Radiographic study of the anterior-posterior position and shape in Iraqi population. Int J Morphol. 2015; 33(1):149-57.

6. 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):1522-8.

7. Dosi T, Vahanwala S, Gupta D. Assessment of the effect of dimensions of the mandibular ramus and mental foramen on age and gender using digital panoramic radiographs: A retrospective study. Contemp Clin Dent. 2018; 9(3):343-8.

8. Demir A, Izgi E, Pekiner FN. Anterior loop of the mental foramen in a Turkish subpopulation with dentate patients: A cone beam computed tomography study. Clin Exp Health Sci. 2015; 5(4):231-8.

9. 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):1022-30.

10. Jacobs R, Mraiwa N, Van Steenberghe D, Sanderink G, Quirynen M. Appearance of the mandibular incisive canal on panoramic radiographs. Surg Radiol Anat. 2004; 26(4):329-33.

11. Kaya Y, Sencimen M, Sahin S, Okcu KM, Dogan N, Bahcecitapar M. Retrospective radiographic evaluation of the anterior loop of the mental nerve: Comparison between panoramic radiography and spiral computerized tomography. Int J Oral Maxillofac Implants. 2008; 23(5):919-25.

12. Neiva RF, Gapski R, Wang HL. Morphometric analysis of implant-related anatomy in Caucasian skulls. J Periodontol. 2004; 75(8):1061-7.

13. Watanabe H, Mohammad Abdul M, Kurabayashi T, Aoki H. Mandible size and morphology determined with CT on a premise of dental implant operation. Surg Radiol Anat. 2010; 32(4):343-9.

14. Dreiseidler T, Mischkowski RA, Neugebauer J, Ritter L, Zöller JE. Comparison of conebeam imaging with orthopantomography and computerized tomography for assessment in presurgical implant dentistry. Int J Oral Maxillofac Implants. 2009; 24(2):216-25.

15. Vujanovic-Eskenazi A, Valero-James JM, Sánchez- Garcés MA, Gay-Escoda C. A retrospective radiographic evaluation of the anterior loop of the mental nerve: Comparison between panoramic radiography and cone beam computerized tomography. Med Oral Patol Oral Cir Bucal. 2015; 20(2):e239-45.

16. Çağlayan F, S ümbüllü M A, A kgül H M, A ltun 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):2227-30.

17. Alias A, Ibrahim A, Abu Bakar SN, Shafie MS, Das S, Mohd Nor F. Morphometric and morphological study of mental foramen in the Malaysian population: Anatomy and forensic implications. Int Med J Malaysia. 2017; 16(2):47-53.

18. Goyushov S, Tözüm MD, Tözüm TF. Accessory mental/buccal foramina: Case report and review of literature. Implant Dent. 2017; 26(5):796-801.

19. Kalender A, Orhan K, 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):584-92.

20. Gungor K, Ozturk M, Semiz M, Brooks SL. A radiographic study of location of mental foramen in a selected Turkish population on panoramic radiograph. Coll Antropol. 2006; 30(4):801-5.

21. Sekerci AE, Sahman H, Sisman Y, Aksu Y. Morphometric analysis of the mental foramen in a Turkish population based on multi-slice computed tomography. J Oral Maxillofac Radiol. 2013; 1(1):2-7.

22. Yeşilyurt H, Aydinlioglu A, Kavakli A, Ekinci N, Eroglu C, Hacialiogullari M, Diyarbakirli S. Local differences in the position of the mental foramen. Folia Morphol (Warsz). 2008; 67(1):32-5.

23. Hasan T. Characteristics of the mental foramen in different populations. Internet J Biol Anthropol. 2010; 4(2);6914.

24. Şahin S, Kaya Y, Şençimen M, Saygun I, Altuğ HA. Retrospective radiographic evaluation of the interforaminal region with spiral computerized tomography: Adequacy for dental implant placement related to age and dental status. Gülhane Med J. 2010; 52(2):69-75.

25. 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):823-30.

26. 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):260-9.

27. Prados-Frutos JC, Salinas-Goodier C, Manchón Á, Rojo R. Anterior loop of the mental nerve, mental foramen and incisive nerve emergency: Tr idimensional assessment and surgical applications. Surg Radiol Anat. 2017; 39(2):169- 175.

28. Uchida Y, Noguchi N, Goto M, Yamashita Y, Hanihara T, Takamori H, Sato I, Kawai T, Yosue T. 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):744-50.

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