Presence Of Accessory Mental Foramen Research Articles

Location and Anatomic Characteristics of Mental Foramen in Dry Adult Human Mandibles

Aim: This study aims to investigate the mental foramen (MF) location, the presence of accessory MF, and the effect of dentition on morphometric parameters using dry adult human mandibles. 
 Materials and Methods: A total of 249 dry adult human mandibles (116 dentate,133 edentate) were used. The location and number of the MF were recorded. The distances of the MF to the symphysis, posterior border of ramus, alveolar crest, and mandibular basis were measured. The symmetry of MF was examined. Student’s t-tests and Kolmogorov-Smirnov were used for statistical analysis. 
 Results: The presence of dentition affected the relative superoinferior location of MF on the corpus. No statistical difference was detected in the anteroposterior position of the MF between dentate and edentate mandibles (p>0.05). The most frequent position of the MF was the alignment of the second premolar. The prevalence of accessory MF was 4.41%, while the bilateral positioning of it was 0.40%. The symmetrical location of the MF was 83.62%. 
 Conclusion: The prevalence of bilateral positioning of the accessory MF in the Turkish dry mandibles was 0.40%. The presence of dentition affected the relative location of MF on the corpus in the superoinferior aspect. The clinician should be considered different locations, and the presence of accessory foramen in the surgical and endodontic treatments.

Left Accessory Mental Foramen in Dry Mandibles in Department of Anatomy in a Medical College: A Descriptive Cross-sectional Study.

The presence of accessory mental foramen is one of the anatomical variations in the mandible. The occurrence of accessory mental foramen can differ in terms of number, shape, and size or there can even be an absence of it. The aim of this study was to find out the prevalence of left accessory mental foramen in dry mandibles in the Department of Anatomy of a medical college. This descriptive cross-sectional study was conducted in a medical college among dry mandibles from 10 January 2021 to 10 June 2021. Ethical approval was obtained from the Institutional Review Committee (Reference number: 207202005). Intact dry mandibles were studied for the prevalence of left accessory mental foramen. A convenience sampling technique was used. Point estimate and 90% Confidence Interval were calculated. Among 47 dry mandibles, the prevalence of left accessory mental foramen was found to be 4 (8.51%) (1.81-15.21, 90% Confidence Interval). The mean diameter of the left accessory foramen was found to be 1.02±0.03 mm. The prevalence of left accessory mental foramen in mandibles was similar to the studies done in similar settings.

Examination of presence and location of the accessory mental foramen, and its implications on the mental nerve block

Objectives: It is clinically essential to know the location of accessory mental foramen in the mental nerve anesthesia. The aim of this study was to determine the frequency of accessory mental foramen and examining its morphometric properties. Methods: A total of 35 adult mandibles of unknown age, gender, and ethnicity were examined. The presence of accessory mental foramen of the mandible was investigated bilaterally. In cases with the accessory mental foramen, its localization, number, and distance relative to the mental foramen were evaluated. Results: Eleven (15.71%) accessory mental foramens were detected in the 35 mandibles (70 sides) examined. Six (54.55%) of the accessory mental foramens were on the left side, and 5 (45.45%) were on the right side. Conclusion: Knowing the frequency and localization of the accessory mental foramen will make the mental nerve block more effective and facilitate surgical procedures. It should be kept in mind that the presence of accessory mental foramen should be considered in cases where mental nerve block applications are insufficient.

Assessment of accessory mental foramen using cone-beam computed tomography and its clinical relevance

Introduction: Accessory mental foramen (AMF) is defined as any additional opening on the anterior surface of the mandible body that is connected to the mandibular canal. The presence of AMF is an important anatomical parameter when planning the therapy to avoid neurovascular bundle injury and other complications. Cone-beam computed tomography (CBCT) provides an accurate, three-dimensional determining of the position, its dimensions and the relation of AMF to the mental foramen (MF), as well as the distinction from nutritive openings. Material and Methods: The research was carried out at the Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, as a retrospective study where 148 CBCT images were analyzed. The analysis of the position of AMF, the relation to and the distance from the MF were made on cross-sectional and axial images. Only those openings that have had a clear connection with the mandibular canal were counted as AMF. Results: AMF was present in 12 (8.11%) patients. In most cases, AMF was positioned superior to MF, in 27% of patients. There was no significant statistical difference between sex and the jaw side. The average distance of AMF from MF was 4.52 ± 2.21 mm. In most cases, AMF is round shaped (60%). The average value of the surface area is 1.62 ± 1.14 mm2. Discussion and Conclusion: Timely detection of AMF using CBCT contributes to the diagnosis and planning of appropriate dentures, surgical technique, preventing possible damage to adjacent anatomical structures, or some other therapy.

Cone-beam computed tomographic evaluation of accessory mental foramen in a Turkish population.

The aim of this study was to evaluate the frequency and location of accessory mental foramen (AMF) in a Turkish population using cone beam computerized tomography (CBCT). CBCT images of 1005 patients were retrospectively reviewed from the archive of the Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Izmir Katip Celebi University. The prevalence, size, and localization of AMFs were assessed according to gender and age. In addition, the vertical and horizontal dimension of the mental foramen (MF) with and without AMF was measured to investigate the relationship between MF dimensions and the presence and absence of AMF. The average distance between the MF and AMF was also calculated. All measurements were then analyzed statistically. A total of 149 AMFs in 123 (12.23%) patients were identified on the CBCT images of the 1005 patients reviewed. There was no significant correlation between presence of AMF and gender (p = 0.152). The most common localization of an AMF with respect to the MF was posterio-inferior (n = 52; 34.89%). A statistically significant difference was also found between the vertical and horizontal dimensions of the MF with and without AMF (p < 0.05). The results of this study demonstrate the high prevalence of AMF in the studied Turkish population. Considering the high prevalence and the structures passing through it, recognition of AMF and its detection using CBCT is important to prevent complications that may occur during and after surgical procedures.

Location of the course of the mandibular canal, anterior loop and accessory mental foramen through cone-beam computed tomography.

This study aimed at identifying the course of the mandibular canal, the presence of anterior loop and accessory mental foramen, as well as verifying the association between these variables through the analysis of cone beam computed tomography (CBCT) exams. CBCT images were analyzed to identify the type of mandibular canal path, classified into three types: (I) catenary; (II) progressive descending; and (III) straight. In addition, the presence of anterior loop and accessory mental foramen was analyzed. The variables were summarized by measures of absolute frequency, relative, mean and standard deviation. The Chi square and Fisher's exact tests were used in the comparative analysis of the frequency distribution. The level of significance was 5%. The most frequent mandibular canal course was straight type (74.4%), followed by catenary (19.4%) and finally the progressive descending (6.2%). It was observed a prevalence of 10.2% for anterior loop and 7.9% for accessory mental foramen. There was no association between the presence of anterior loop (P = 0.798) and accessory mental foramen (P 0.480) with the mandibular canal course pattern, as well as no association between the anterior loop and the presence of the accessory mental foramen (P = 0.407). The CBCT analysis is the best methodology for the investigation and localization of mandibular anatomical variations, which provides a good image quality of the bone tissue and details of the anatomical structures, reducing the risk of injury to the lower alveolar vascular-nervous bundle and, consequently, cause paralysis and hemorrhage in the anterior region of the mandible and adjacent structures.

Evaluation of accessory mental foramina morphology with cone-beam computed tomography.

Accessory mental foramen (AMF) is the extra mental foramen (MF) located in the mandible. The recognition of AMF is important to avoid complications during surgical procedures involving MF and cheeks. This study aimed to determine the prevalence, localization, and size of AMF by using cone-beam computed tomography (CBCT). CBCT images of 645 patients over 13-14 years (male 281; female 364) were retrospectively evaluated. The CBCT images were obtained using Promax 3D® (Planmeca, Helsinki, Finland) device with automated exposure parameters varying depending on the cases. Statistical analysis was performed using descriptive statistics, chi-square test and t-test. AMF was detected in 75 (11.6%) patients. There was no significant difference between the presence of AMF and gender (P = 0.57, P > 0.05). Majority of the cases (n = 67, 88.8%) consisted of single AMF, while double AMF was observed in 6 (10%) and triple AMF in 2 (1.2%) patients. The most common location of AMF with respect to MF was posterio-inferior (n = 57, 67.1%), and AMF placed at the root line of first molar tooth in 45 cases (52.9%). AMF can be seen in the mandible one in every ten patients being single in most cases. Considering the high prevalence and present morphological features, AMF should be detected by CBCT before surgical operations, particularly in implant planning for the prevention of possible complications.

Location of Mental Foramen in a Selected Iranian Population: A CBCT Assessment

Mental foramen (MF) is an important anatomic landmark in dentistry and knowledge about its variable locations (L) and type of emergence (TE), has an effect on the sufficiency of local anesthesia and safety of surgical procedures. The aim of this study was to evaluate the L and TE of this radiographic landmark as well as the presence of accessory MF, by means of cone-beam computed tomography (CBCT). In this cross sectional study, a total of 156 CBCT images were retrieved from the archive of a private radiology clinic and were then evaluated for the position of MF and its TE and the existence of accessory foramina in the body of mandible. The extracted information was compared in both genders, in both sides of mandible and among three different age groups (20-29, 30-44 and 45-59 years). The Pearson chi-square and Fisher's Exact tests were used for statistical analysis. The level of significance was set at 0.05. Second premolar was the most common anterolateral L of MF; in general, 48.7% of right and 51.9% of left MFs were located at the apex of second premolar. Anterior and straight ET were more common in right and left side, respectively. Accessory MF was present in only 8 (5.1%) of cases. The possible presence of accessory MF should not be overlooked for avoiding the occurrence of a neurosensory disturbance during surgery and implant insertion.

Anatomical analyses of mandibular structure using three-dimensional facial ct for effectiveness and prevention of complications in genioglossus advancement

Genioglossus advancement (GA) is one of popular procedure for the treatment of obstructive sleep apnea (OSA). This procedure is usually performed with mandibular osteotomy and advancement of genial tubercle (GT). The purposes of this study were to measure and analyze the position and dimension of GT, mental foramen (MF) and accessory mental foramen (AMF). And to make a reference in designing a location of the osteotomy during GA. Two hundreds and ten patients were included who performed 3D facial CT and the genial tubercle and mental foramen were evaluated in the CT. Subjects were divided into 4 groups by genders and skeletal type. Seven variables were measured, including: (1) height of GT (GTH); (2) width of GT (GTW); (3) distance from apices of lower incisors to superior border of GT (Li-SGT); (4) distance from inferior border of GT to inferior border of mandible (IGT-IBM); (5) thickness of anterior mandible (MT); (6) distance from symphysis of mandible to MF (S-MF); and (7) distance from superior border of GT to inferior border of mandible (SGT- IBM). In addition, the presence of AMF was analyzed. All the parameters showed big personal differences. There was no differences in GTW and Li-SGT among groups ( p > .05). Class I male showed longer GTH, MT and SGT-IBM than class I female ( p < .05). IGT-IBM and S-MF were longer in class II male than in class I female ( p < .05). Li-SGT showed personal variation with less than 7 mm in 62 cases, 7–10 mm in 122 cases, and more than 10 mm in 26 cases. IGT-IBM also showed variation with less than 10 mm in 61 cases, more than 10 mm in 149 cases. AMF were observed in 14 patients. The osteotomy for effective GA without dental complication may not be possible in some patients because of short Li-SGT. AMF were observed in some patients. The variable position and dimensions of the GT, MF and AMF among patients suggest the need for 3D facial CT before attempting GA to treat OSA. These findings may be helpful for the surgeons to design the osteotomies in the anterior mandible for the treatment of OSA. Financial Disclosure Information: The authors have no funding or financial relationships to disclose. Conflicts of interest: The authors have no conflicts of interest to report.