Avoidance of the Mandibular Nerve with Implant Placement: A New “Mental Loop”

Abstract

It is not often that authors write a letter to point out an error regarding their own recently published article. 1 Jensen O.T. Adams M.W. Cottam J.R. et al. The All on 4 Shelf: Mandible. J Oral Maxillofac Surg. 2011; 69: 175 Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar It concerns the anterior loop of the mental nerve, 2 Ngeow W.C. Dionysius D.D. Ishak H. et al. A radiographic study on the visualization of the anterior loop in dentate subjects of different age groups. J Oral Sci. 2009; 51: 231 Crossref PubMed Scopus (55) Google Scholar , 3 Uchida Y. Yamashita Y. Goto M. et al. 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. J Oral Maxillofac Surg. 2007; 65: 1772 Abstract Full Text Full Text PDF PubMed Scopus (72) Google Scholar , 4 Kuzmanovic D.V. Payne A.G. Kieser J.A. et al. Anterior loop of the mental nerve: A morphological and radiographic study. Clin Oral Implants Res. 2003; 14: 464 Crossref PubMed Scopus (99) Google Scholar a finding apparently more of tradition and practice than of anatomical science, as noted by the adjacent article written in the same issue by Benninger et al entitled, “Dental Implant Placement Investigation: Is the Anterior Loop of the Mental Nerve Clinically Relevant?” 5 Benninger B. Miller D. Maharathi A. et al. Dental implant placement investigation: Is the anterior loop of the mental nerve clinically relevant?. J Oral Maxillofac Surg. 2011; 69: 182 Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar Benninger et al found that the mental nerve seldom extended anterior more than 1 mm and most often had no anterior loop at all. This confirmed another cadaver study performed by Rosenquist, who essentially determined this same finding in which an anterior loop was only found twice in 58 subjects. 6 Rosenquist B. Is there an anterior loop of the inferior alveolar nerve?. Int J Periodontics Restorative Dent. 1996; 16: 40 PubMed Google Scholar The All on 4 Shelf: MandibleJournal of Oral and Maxillofacial SurgeryVol. 69Issue 1PreviewThe use of full arch alveolar reduction as an aide to doing All on 4 implant restoration in the mandible is presented. The osteoplasty is described as a flat “shelf” on which to place the restoration. The shelf approach is used to establish optimal implant position and angulation as well as to define anatomy to maximize implant fixation for immediate load prosthetics. Full-Text PDF Dental Implant Placement Investigation: Is the Anterior Loop of the Mental Nerve Clinically Relevant?Journal of Oral and Maxillofacial SurgeryVol. 69Issue 1PreviewThe mental nerve is a general somatic afferent nerve with the purpose of providing sensation to the lip, chin, and gingiva. It derives from the inferior alveolar nerve, which is a branch from posterior trunk of V3 (mandibular) of the trigeminal nerve (CN V). The anterior loop is described as an extension of the mental nerve that is mesial to the mental foramina. Full-Text PDF