Abstract
Background The posterior region of the mandible is more often related to iatrogenic errors, but the interforaminal region is also not spared for neurovascular complications. This study aimed to use CBCT images to evaluate the prevalence of anterior nerve looping and its variations with age, gender, and dentition status. Methods This retrospective study was carried out by studying 600 CBCT scans retrieved from archival records of a CBCT center in Lucknow. The scans were inspected by two trained investigators. The length of the anterior loop was measured using the measuring tool of Carestream 3D imaging software. Descriptive and analytical tests were performed. Results The prevalence of the anterior loop of the inferior alveolar nerve was found to be 56%. The prevalence was found to be more on the right side (29.0%) compared to the left side (27.0%). The most common anterior looping of the inferior alveolar nerve was type 3 followed by type 1. Males were found to have significantly higher loops compared to females. The number of loops was found to decrease significantly with age. The mean length of the loop was found to vary from 1.14 to 1.61 mm. Conclusion The anterior looping of IAN is very much prevalent in the Lucknow population. The use of the CBCT technique and appropriate preplanning prior to surgery or implant placement should be performed to prevent nerve injury.
Highlights
Background. e posterior region of the mandible is more often related to iatrogenic errors, but the interforaminal region is not spared for neurovascular complications. is study aimed to use Cone-beam computed tomography (CBCT) images to evaluate the prevalence of anterior nerve looping and its variations with age, gender, and dentition status
E inferior alveolar nerve is a mandibular nerve branch. e inferior alveolar nerve may extend beyond the mental foramen in an anterior and inferior direction, curving back to the foramen and forming a loop, which has been termed the anterior loop of the inferior alveolar nerve, of the mental nerve, or the mandibular canal [4,5,6]. e prevalence of the inferior alveolar nerve anterior loop has been found to be highly variable ranging from 22% to 94% [7, 8]
Limited studies have been carried out to assess the variations of the anterior loop in Indian populations using advanced radiographic techniques. e aim of this study was to use CBCT images to evaluate the prevalence of anterior nerve looping and compare the mean values of anterior extension of the alveolar loop on right and left sides according to age, gender, and dentition status. e study findings will enable surgical implantologists to accurately locate the course of the inferior alveolar nerve thereby preventing iatrogenic injuries to the nerve
Summary
Assessment of Anterior Loop of Inferior Alveolar Nerve and Its Anatomic Variations with Age, Gender, and Dentition Status in Indian Population: A CBCT Study. Is study aimed to use CBCT images to evaluate the prevalence of anterior nerve looping and its variations with age, gender, and dentition status. E aim of this study was to use CBCT images to evaluate the prevalence of anterior nerve looping and compare the mean values of anterior extension of the alveolar loop on right and left sides according to age, gender, and dentition status. E images of 600 subjects (who had undergone CBCT examination showing the mandibular premolar/molar region) were retrieved from the archival records and inspected for the presence of the mental nerve loop. ANOVA and independent sample t-tests were performed for comparison of mean length of anterior loop of the inferior alveolar nerve.
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