Background: The mental foramen (MnF) is the anatomic landmark where the mental neurovascular bundle exits the mandible. Precisely determining the position of the MnF is necessary before all dentoalveolar therapeutic procedures performed in the mandibular premolar area. Materials and Methods: For the study, we performed two ex vivo direct morphometric determinations on dry human dentate and edentate mandibles, and two in vivo imaging morphometric determinations through cone-beam computed tomography (CBCT) and orthopantomography (OPG) in dentate human patients. The following landmarks were used to locate the MnF: the distance between the MnF and the superior border of the mandible (MnF-SB), the distance between the MnF and the inferior border of the mandible (MnF-IB), and the position of the MnF in relation to the root apices of the posterior teeth. The results obtained from these data were processed statistically using the analysis of variance (ANOVA). Results: By direct morphometry on dentate mandibles, the MnF was situated closer to the IB and by direct morphometry on completely edentulous mandibles, the MnF was located closer to the SB. In both direct morphometry studies, the MnF transverse diameter was larger than the vertical one, with the MnF having an oval shape. ANOVA for both direct morphometry studies showed that the distances MnF-IB and MnF-SB significantly vary statistically with interactions and depending on age (p<0.00001). The vertical diameter of the MnF significantly varies statistically depending on age, interactions and between studies, and its transverse diameter varies statistically significantly with interactions and depending on age (p<0.00001). According to OPG and CBCT imaging studies, the MnF was located closer to the IB, and the transverse diameter of the MnF was larger than the vertical diameter; such results are similar to the direct morphometry study performed on dry dentate human mandibles. Regarding the position of the MnF in relation to the root apices, it was most frequently located inferior to the root apices in 79.45% of cases, in 19.23% of cases it was located at the root apices level and in 1.31% of cases it was located superior (coronal) to the root apices. ANOVA for both imaging morphometry studies showed that the MnF-IB distance varies statistically significantly with the interactions, the study, the sex of the patients and their age, the MnF-SB distance varies statistically significantly with the interactions, the study and the patients' age (p<0.05), and the MnF diameters vary statistically significantly with interactions and patient age (p<0.05). Conclusions:The results of this study can help dental practitioners in improving dentoalveolar surgery procedures in the posterior mandible.
Background: The mental foramen (MnF) is the place where the mental nerve and mental artery exit the body of the mandible, being an important landmark for dentoalveolar surgery. Materials and Methods: For the assessment of MnF topography, we performed a direct morphometric study and two morphometric imaging studies through cone-beam computed tomography (CBCT) scans and orthopantomography (OPG). The following locations of the MnF were investigated: anterior to the first premolar, at the first premolar level, between the two premolars, at the second premolar level, between the second premolar and the 6-year molar, and at the level of the mesial root of the 6-year molar. The data obtained were statistically analyzed by chi-squared test. Results: Through direct morphometry on dentate dry human mandibles, no statistically significant differences were found for the number of MnF located between the two premolars, at the level of the second premolar and between the second premolar and the 6-year molar, depending on age and analyzed side. The number of MnF located between the second premolar and the first molar varies statistically significantly in relation to the subject's gender but does not vary statistically significantly depending on age and side. By means of imaging morphometry through OPG, we found that the number of MnF located at the first premolar level, between the two premolars, at the second premolar level and between the second premolar and the 6-year molar varies statistically significantly in relation to the age of the patients. Using imaging morphometry trough CBCT scans, we found that the number of MnF located between the two premolars, at the second premolar level and between the second premolar and the 6-year molar varies statistically significantly according to the age of the patients. Comparing the results obtained from the three studies, we found that only according to age the number of MnF located between premolars and at the level of the second premolar varies statistically significantly. Conclusions: Wide and accurate knowledge of both the MnF topography and the key anatomical landmarks used in locating it proves to be essential and clinically relevant in dentoalveolar and endodontic surgery, and for improving anesthesia techniques.
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