IntroductionThe mental foramen (MF) is a funnel-like opening located on the lateral aspect of the mandible. It is an important anatomical landmark through which the inferior alveolar nerve and vessel bundles pass. Once the nerve leaves the MF, it branches to innervate the anterior teeth and neighboring structures. The blood vessels supply the soft tissues of the lower jaw. Surgeons must establish the position of the MF accurately because any invasive procedure performed in this oral and maxillofacial region may damage the neurovascular bundles and cause serious sequelae, such as labiomandibular paresthesia or anesthesia [1,2]. Knowledge of the precise position of the MF would also facilitate a mental nerve block.Although root canal therapy is the primary method to treat endodontic diseases, its rate of success is less than 100% and some patients require periapical surgery [3,4]. Because the MF is located near the root apices of the mandibular premolars, periapical surgery performed in this region may damage the neurovascular bundles. Thus, it is important to explore the precise position of the MF and its relationship with peripheral structures. However, previous studies of the MF, which were performed on human cadavers [5,6] or using panoramic radiographs [7,8], had some shortcomings. Sample sizes were relatively small, and the superimposition of structures on radiographs made it difficult to identify the three-dimensional (3D) relationships between the MF and root apices.Recently, cone-beam computed tomography (CBCT) has been introduced to dental practice. It has shown several advantages, such as improved spatial resolution and reduced radiation dose. This technique has significantly improved the 3D imaging of osseous structures [9,10]. Due to these superiorities, CBCT has been utilized frequently in dental practice, such as for the diagnosis of endodontic diseases and the planning of periapical surgery and implant placement. A large CBCT database has thus accumulated, allowing the analysis of particular features in a large sample. CBCT also enables the visualization of 3D structures from different directions, and the ability to avoid superimposition allows the relationships between peripheral structures to be identified clearly. No significant difference in measurements of mandibular anatomy made with CBCT software or calipers has been found [11][12][13]. Hence, the exploration of the precise location of the MF could be facilitated by the use of CBCT images. The aim of this study was to investigate the position of the MF and its relationship to
AbstractBackgroud: This study investigated the anatomic relationship between mental foramen and peripheral structures using cone-beam computed tomography.
Methods:In total, 172 cone-beam computed tomography images were evaluated. Mental foramen number, size, and form were recorded, and their three-dimensional relationships with mandibular premolar root apices were investigated. The percentile position of each mental foramen relative to bony reference points was measure...