Abstract
In any surgical procedure, proper consideration to anatomical structures along with their precise position is of utmost importance. One such anatomical region in anterior mandible is anterior loop of mental nerve. The dental procedure carried out in anterior mandible can lead to neurosensory disturbances if this loop is injured. The presence of anterior loop have been made using conventional imaging modalities like panoramic and periapical radiography, however, limitations of two-dimensional imaging results in either over- or underestimation of the actual size making its use restricted. Cone Beam Computed Tomography is a gold standard threedimensional imaging modality that allows generating multi-planar slices of an area of interest; its accuracy for analysis and linear measurements of craniofacial structures have been confirmed by several studies. This paper highlights the role of accurate and thorough assessment of the inter-foraminal region and anterior loop of the mental nerve prior to any surgical procedure especially in anterior mandible to avert any neurological complications.
 Bangladesh Journal of Medical Science Vol.18(4) 2019 p.689-695
Highlights
Scrupulous knowledge of anatomical structures and their precise location is of utmost importance during any surgical procedures
In few cases, inferior alveolar nerve (IAN) can extend beyond mental foramen like an intra-osseous anterior loop, which traverses upwards, outwards and backwards of the IAN originating from the mandibular canal to exit the mental foramen and is called the “Anterior Loop (AL) of the mental nerve”
Incisive canal presents as a single round hypodense image with a width smaller than 3mm; AL has a diameter greater than 3mm or when two round hypodense areas are seen, one casting the lumen of the mandibular canal that traverses the mental foramen anteriorly and inferiorly, and the other showing the loop of the mandibular canal, leading to the externalization of the IAN.[13] (Figure 3) The length of the AL can be measured by a wide array of techniques
Summary
Scrupulous knowledge of anatomical structures and their precise location is of utmost importance during any surgical procedures. 6mm distance from the most anterior point of the mental foramen is considered as most reliable to avoid any neurological complication and injury.22Hence precise knowledge is needed to establish the exact location of AL of the mental nerve to avoid any neurological complications
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