Anterior Loop Of Mental Nerve Research Articles

Assessment of the Anterior Loop and Pattern of Entry of Mental Nerve Into the Mental Foramen: A Radiographic Study of Panoramic Images.

The precise location of the mental foramina is an essential landmark in planning the position of dental implants in the anterior mandible. Injury to inferior alveolar nerve during anterior mandibular implant surgery causes altered sensation which greatly affects patient satisfaction. In this study, we assessed the prevalence of anterior loop of mental nerve and the pattern of entry of mental nerve into the mental foramen. Three hundred panoramic radiographs (600 hemimandibles) obtained from records maintained in the Department of Oral Medicine and Radiology were randomly selected for the study. The radiographs were evaluated by two independent observers for the pattern of entry of mental nerve into the mental foramen on either side of the mandible and for the presence or absence of anterior loop of mental nerve. The most prevalent pattern of mental nerve observed was Straight pattern which totals to 67.5% followed by Anterior loop pattern (18.8%) and then the Perpendicular pattern (13.7%). There was no significant association between the gender and subtypes of looping pattern on the left and right side and a highly significant association between the side of the mandible and loop pattern was observed by Chi square test. The Anterior loop pattern of mental nerve has been found in 18.8% of the population suggesting to accurate planning with three-dimensional imaging techniques to avoid injury to mental nerve during dental implant placement and other surgical procedure involving the interforaminal region of the mandible.

Anatomical Variations of the Mandibular Canal and Mental Foramen in Full Edentulous Iranian Subpopulation: A Cone-Beam Computed Tomographic Study

Background: This study sought to determine the anatomical variations of the mental foramen (MF) and the mandibular canal (MC) in the full edentulous Iranian subpopulation using cone-beam computed tomography (CBCT). These variations can have significant clinical implications in dental implant surgery. Methods: This descriptive cross-sectional study evaluated the mandible CBCT scans of 384 completely edentulous patients that required dental implant treatment. The CBCT scans were retrieved from four radiology clinics in Tehran, Iran, using quota sampling. The reconstructed images were evaluated to determine the dimensions and position of the MC and its cortication at the site of the mandibular first molar, the branching of the MC, the existence of the anterior loop of the mental nerve, and anatomical variations of the MF. The correlations of variables with age and gender were analyzed using the independent t-test, chi-square test, and analysis of variance based on the type of the variable. Results: The cortication of the MC at the site of the mandibular first molar was present in 72.9% of the cases and was significantly more common in male patients (P = 0.0001). Bifid mandibular canal, accessory MF, and anterior loop of mental nerve were present in 9.9%, 65%, and 54.7% of the samples, respectively, and they had no significant correlation with age/gender. The mean MC diameter, the mean MF height, and the mean distance from the inferior border of the mandible to the center of MF were all significantly higher in male patients (P

Comparative Accuracy of Panoramic Radiograph and Cone-beam Computed Tomography Images in Identification and Measurement of the Anterior Loop of Mental Nerve: A Meta-analysis and Review of the Literature

Comparative Accuracy of Panoramic Radiograph and Cone-beam Computed Tomography Images in Identification and Measurement of the Anterior Loop of Mental Nerve: A Meta-analysis and Review of the Literature

A Retrospective Study on Identification of Anterior Loop Pattern of Mental Nerve Entry into Mental Foramen in Digital Orthopantomography among South Indian Population

Background: In the premolar location of mandible, the mental nerve's entry into the mental foramen pattern is a significant landmark. Different patterns of mental nerve entrance have been discovered. The current experiment was attempted to detect the different entry routes of the mental nerve into the mandible using panoramic radiographs, which are employed in pre-surgical evaluation.
 Materials and Methods: The current study used a total of 200 panoramic radiographs collected for diagnostic purposes. The location and entrance pattern of the mental nerve on the both sides were noted on the radiographs. Straight, looping, and perpendicular entry patterns were identified in the data. The data is tabulated and statistically analysed in SPSS software using Chi-square.
 Results: The existence of an anterior loop was determined to be the most usual pattern of entry of the mental nerve, accounting for 79 percent of the total radiographs examined 21 percent , and a perpendicular pattern 6 percent. The p value is 0.432 and p value 0.309, with respect to age and gender respectively which is statistically not significant.
 Conclusion: The findings obtained from the study within the limits, it can be stated that the straight pattern of anterior loop of mental nerve was the most common. A panoramic radiograph may be a viable radiological tool for detecting the existence of an anterior loop that should be confirmed in order to plan surgical treatments in the mandibular premolar region prior to surgery.

Using Panoramic Radiograph for Identification of Mandibular Structures: A Study on Bangladeshi Population

Background: Panoramic view of radiograph or Orthopantomogram (OPG) is useful in the aspect of surgery done in mandible, as many visible landmarks can be found in a single tomographic image.
 Objectives: To evaluate the visibility of anatomical structures of mandible in OPG and to determine the relationship of age and gender with this.
 Materials and Methods: It was a cross-sectional study and was conducted in dental OPD of Noakhali General Hospital from January 2019 to June 2019, six-month period. Data were analyzed by SPSS version 20.
 Results: A Total of 272 OPGs were examined of patients (female 165, male107), having age range of 7-90 years. Here highest visible structure was mandibular canal (about 97.4%) followed by mental foramen and mandibular foramen, where visibility was 92.3% and 87.5% respectively. Anterior loop of mental nerve and incisive canal were seen in 33.5% and 31.6% cases respectively. Only in 15.1% OPG, lingual foramen was visible. There is no significant relationship between gender and visibility of structures (p>0.05). Age and visibility of landmarks showed significant relation only in case of mental foramen and mandibular canal (p<0.05).
 Conclusion: Panoramic view or orthopantomogram is very efficient to detect many anatomic points in adults.
 KYAMC Journal Vol. 11, No.-3, October 2020, Page 133-136

Cone beam imaging – an imperative arm in implant planning

Recently, Dental implants have taken the dental rehabilitation to another level. Dental implants are highly preferred over other rehabilitation techniques, as they have a more conservative approach with minimal damage to other adjacent structures. The aim of the study was to evaluate the prevalence of anatomical variations in maxilla and mandible on CBCT images of patients referred for dental implants. In our study, a total of 102 CBCT images comprising of 60 males & and 42 females with mean age of 50 years & 45 years were analysed. We found that in approximately 50% of the cases, the anterior loop of mental nerve was seen and lingual foramen was identified in the anterior part of the mandible in about 20% cases. Two-dimensional radiographs have been used for a long time as the only diagnostic tool in implant dentistry. However, radiographs may seem to be adequate for patients with wide residual ridges but CBCT effectively brings together prosthetic and surgical considerations which are important for beauty, restoration and prosthetic indices.

Anterior Loop of the Mental Nerve- Unlooping its Importance in Dentistry

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

Evaluation of the Dimensions of Anterior Loop of Mental Nerve in CBCT: A Radiographic Analysis.

Information on the dimensions of the anterior loop of mental nerve is important for dental implant placement. The purpose of this study was to determine the total length of anterior loop of mental nerve from the mental foramen. CBCT data of 150 patients were evaluated. We found that the anterior loop was absent in 56.4% of patients on the left side and 61.7% patients on the right side. 19.5% of the total patients (29 patients) had up to 4mm length of the loop which was exactly same on both right and left sides. The remaining 16.8% on the left side (25 patients) and 14.1% on the right side (21 patients) had the length of the loop ranging between 4.1 and 8mm. The rest 7.4% of patients on the left side and 4.7% patients on the right side had more than 8mm of the loop length. Based on this study, the dimensions of the anterior loop are variable and hold great significance in dental implant planning in the mandibular premolar region.

Assessment of the anterior loop of mental nerve in an Iranian population using cone beam computed tomography scan.

The anterior loop is an important structure in the interforaminal area of the mandible. The aim of the present study was to assess the prevalence and length of the anterior loop of mental nerve using cone beam computed tomography (CBCT) scan and to compare the differences between age, gender, and side. A total of 180 projections were analyzed in different sectional planes. The inferior alveolar nerve was determined. To measure the length of anterior loop in tangential plane, two parallel lines from the anterior point of mental foramen and anterior point of anterior loop were drawn. The distance between these two lines was measured by drawing a perpendicular line on them. The data were analyzed by SPSS (version 22). McNemar's test, Chi-square test, and t-test were performed to compare the significance of findings regarding side, age, and gender. P < 0.05 was considered statistically significant. The results showed that 32.8% of images had anterior loop. The mean lengths of anterior loop in the right and left sides were 2.69 mm (standard deviation [SD] = 1.56) and 2.36 mm (SD = 1.16), respectively. There were no statistically significant differences between the mean lengths of the anterior loop in both sides (P = 0.18). Great care is required when placing implants in proximity to mental foramen to avoid anterior loop injury. Because of the variations of anterior loop length in each patient, a fixed distance anterior to the mental foramen is not safe, and the anterior loop length should be determined for each individual. The use of CBCT provides accurate measurements of the length of anterior loop.

Detection of anatomical variations in mandible by panoramic radiography

Aim: To assess the visibility, frequency and gender variations of mandibular canal, mental foramen, anterior loop of mental nerve, incisive canal and lingual foramen in Indian population. Material and Methods: Retrospective analysis of total 300 panoramic radiographs were selected for the study. Radiographs were analysed for the mandibular canal, mental foramen, anterior loop of mental nerve, incisive canal and lingual foramen by two independent observers and scores were recorded. Intra and inter-examiner reliability was assessed by kappa-statistics percentages of observations were obtained and Chi-square test was used to find out association of age and gender with visibility of anatomical landmarks. Results: The mandibular canal was visible in 100% of the 300 cases. Anterior looping of the mental nerve was not visible in 90% (270) of the cases, with 1.3% having good visibility. The mental foramen was moderately visible in 66% cases. The lingual foramen could not be visualized in 95.3% of the cases, with poor visibility in 0.7%. An incisive canal was observed in 33% of the cases, good visibility with only 1.3%. Contingency tables with Chi-square test showed that gender does not exert any effect on the visibility of the anatomical structures in the mental interforaminal region ( P > 0.05). Chi-square test reveled, significant difference exist between age and visibility of mandibular canal ( P Conclusion: The important conclusion drawn from the present study is that as far as mandibular canal and mental foramen is concerned, panoramic images provide sufficient information. However, it is insufficient for detection of interforamina structures especially for presurgical implant planning in the mental region and may need to be supplemented with three dimensional imaging for better visualization of the area.

Evaluation of the anterior loop of the mental nerve incidence and extension in different age groups in Sulaimania city using digital panoramic imaging system

The anterior loop of mental nerve is commonly described as that part of the neurovascular bundle that transverses anterior and inferior to the mental foramen only to loop back to exit the mental foramen. The aim of the study is to evaluate the incidence and extension of anterior loop of mental nerve by using digital panoramic imaging system to avoid nerve damage during different surgical procedures in dentistry. Materials and Method: Panoramic image was taken for all 400 patients and stored in the computer. Then Horizontal and Vertical for the anterior loop extension when exist was measured and recorded in a special case sheet prepared for each subject. Results: Results indicated that out of 400 patients there were only 25 patients (6.25%) having anterior of the inferior alveolar nerve, 14 cases (56%) of them were males and 11 cases (44%) were females. The extension of the anterior loop of mental nerve was with wide range, for horizontal extension it was 1.3-6.36mm with significant difference between right and left sides, and with vertical extension was between 1.44 -5.98mm with no significant difference between the right and left sides. Conclusion: No significant difference among subjects according to sex and the pattern of visualization of the anterior loop was shown. The anterior loop was visible in 6.25% of the dental panoramic radiographs with 3.5% for males and 2.75% for females.

Appearance of anatomical structures of mandible on panoramic radiographs in Iranian population

Purpose.Currently panoramic radiography is used for diagnosis of dental and bone lesions, but anatomical structures also can be seen and may be useful in dental managements. This study aimed to investigate the visibility of some important mandibular features relating to neurovascular structures in Iranian population. Materials and methods. Panoramic radiographs were taken by Planmeca machine from 412 patients using standard exposure. The position of patient was in compliance with standard protocol. Then mandibular incisive canal was evaluated and data were analyzed statistically. Results. Mental foramen, anterior loop of mental nerve and incisive canal could be observed in 84.2, 66 and 51.7% of the cases. Respectively, lingual foramen was observed in only 6.1% of the radiographs. Gender doesn't affect on the visibility of these structures. There was a relationship between mandibular foramen and canal with age. Conclusion. Mandibular incisive canal was considered in 51.7% of cases, it was observed that the result obtained was more than those of other researches.

Assessment of variations of the mandibular canal through cone beam computed tomography

The neurovascular bundle may be vulnerable during surgical procedures involving the mandible, especially when anatomical variations are present. Increased demand of implant surgeries, wider availability of three-dimensional exams, and lack of clear definitions in the literature indicate that features of anatomical variations should be revisited. The objective of the study was to evaluate features of anatomical variations related to mandibular canal (MC), such as bifid canals, anterior loop of mental nerve, and corticalization of MC. Additionally, bone trabeculation at the submandibular gland fossa region (SGF) was assessed and related to visibility of MC. Cone beam computed tomography exams from 100 patients (200 hemimandibles) were analyzed and the following parameters were registered: diameter and corticalization of MC; trabeculation in SGF region; presence of bifid MC, position of bifurcations, diameter, and direction of bifid canals; and measurement of anterior loops by two methods. Corticalization of the MC was observed in 59% of hemimandibles. In 23%, MC could be identified despite absence of corticalization. Diameter of MC was between 2.1 and 4mm for nearly three quarters of the sample. In 80% of the sample trabeculation at the SGF was either decreased or not visible, and such cases showed correlation with absence of MC corticalization. Bifid MC affected 19% of the patients, mostly associated with additional mental foramina. Clinically significant anterior loop (>2mm of anterior extension) was observed in 22-28%, depending on the method. Our findings, together with previously reported limitations of conventional exams, draw attention to the unpredictability related to anatomical variations in neurovascularization, showing the contribution of individual assessment through different views of three-dimensional imaging prior to surgical procedures in the mandible.