The mental spines are bony prominences found in the lingual surface of anterior mandible, and usually they are arranged in two groups, superior pair and inferior pair. Mostly they are asymptomatic, but sometimes they may interfere with the prosthodontic treatment or with some surgeries. The lingual foramen can be found in different locations around the mental spines, and they are very important vital organ because they transmit nerves and arteries, which may cause a serious problem during some types of surgeries in this region such as implant placement. Here, we report a case of 55-year-old, Kurdish woman with elongated superior mental spine with bilaterally lingual foramina located distally to lower central incisors, that have been seen during a routine CBCT scan. The length of the spine was 6.4 mm, the height was 5.5 mm and the width was 1.9 mm. So, any dentist wants to perform any type of surgery in sublingual and submental regions should be careful of such anatomical variations.

Background: The mental foramen is one of the most critical anatomical structures in the body of mandible, and its determination is very significant before anesthesia administration, implant placement, orthodontic treatment, and even diagnosis. This study aims to determine the mental foramen by visibility, size, shape, number, and location, in patients with different skeletal occlusions in Duhok Governorate, in order to prevent any undesirable surgical and dental anesthetic complications. Materials and Methods: This prospective cross-sectional study conducted for the period from June 2018 to February 2019, at the x-ray unit of Duhok Specialized Dental Center. Sixty patients participated in this study, 31 males and 29 females. The mean age was 38 years. Digital panoramic radiography used for determination of the mental foramen and a cephalometric radiograph used for determination of skeletal malocclusion by Steiner Analysis. Those patients categorized into three groups: Class I, Class II and Class III of skeletal occlusions. Results: The results showed, Class I were 31 patients (%51.67), Class II 24 patients (40%) and Class III 5 patients (8.33%). The mental foramina appeared in most of the cases (99.17%). The overall mean diameter in all cases was 2.32 mm. The most dominant shape type was circular (50.42%). About the number, the single type was most of all (89.92%). The most appeared position of the foramen concerning the lower premolars was below the 2nd premolar (44.53%). There was symmetry in the position of the mental foramen in Class I (83.87%) & Class III (100%), while in Class II was non-symmetrical (29.17%). The overall mean distance of the foramen from the upper border of the mandible was 18.1 mm and from the lower border of the mandible was 12.39 mm. Finally, the overall mean distance of foramen from the midline was 31.75 mm for both sides. Conclusion: The determination of mental foramen by digital panoramic radiography is of great importance, to avoid any unnecessary problems, before the local anesthesia injection, oral surgery, dental implantation, orthodontic treatment.