Anatomical and radiographic assessment of variations of the mental foramen and their impact on success of local anaesthesia administration
DOI:
https://doi.org/10.18203/2320-6012.ijrms20260595Keywords:
Mental foramen, Anatomical variation, Local anesthesia, Panoramic radiography, Dental anatomyAbstract
Background: Successful local anesthesia in dental practice relies heavily on precise knowledge of mandibular anatomical landmarks, particularly the mental foramen. Variations in the position, shape and number of the mental foramen may contribute to anesthetic failure and neurovascular complications during dental procedures. Understanding these variations is therefore essential for improving clinical outcomes.
Methods: This descriptive cross-sectional study was conducted in the Department of Dentistry at Rangpur Medical College Dental Unit from March 2024 to February 2025. A total of 120 patients undergoing mandibular radiographic evaluation for diagnostic or treatment purposes were included using a convenient sampling technique. Digital panoramic radiographs were assessed bilaterally, resulting in evaluation of 240 mandibular sides.
Results: The majority of patients were aged 26–35 years (35.8%), with a slight male predominance (55.8%). The mental foramen was most commonly located between the first and second premolars (42.1%), followed by a position below the second premolar (40.4%). Oval-shaped mental foramina were most frequent (54.6%), while irregular shapes were rare. A single mental foramen was observed in 90.8% of patients, whereas accessory mental foramina were present in 9.2%. Bilateral symmetry was noted in 64.2% of cases, while 35.8% showed asymmetry, often requiring modification of local anesthetic techniques.
Conclusion: Anatomical variations of the mental foramen are common and clinically significant. Routine radiographic evaluation can enhance the accuracy of local anesthetic administration and reduce the risk of anesthetic failure and nerve-related complications.
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References
Cellina M, Martinenghi C, De Nardi S, Palamenghi A, Cè M. Anatomy of the mental foramen: relationship among different metrical parameters for accurate localization. Appl Sci. 2023;13(16):9235. DOI: https://doi.org/10.3390/app13169235
Sferlazza L, Zaccheo F, Campogrande ME, Petroni G, Cicconetti A. Common anatomical variations of neurovascular canals and foramina relevant to oral surgeons: a review. Anatomia. 2022;1(1):91-106. DOI: https://doi.org/10.3390/anatomia1010010
Le LN, Do TT, Truong LT, Truong MH, Nguyen LM. Cone beam CT assessment of mandibular foramen and Mental foramen positions as essential anatomical landmarks: A retrospective study in Vietnam. Cureus. 2024;16(4):587. DOI: https://doi.org/10.7759/cureus.59337
Nalbantoğlu AM, Yanık D, Albay S. Location and anatomic characteristics of mental foramen in dry adult human mandibles. ADO Klinik Bilimler Dergisi. 2024;13(1):51-8. DOI: https://doi.org/10.54617/adoklinikbilimler.1177886
Bruna-Mejias A, Nova-Baeza P, Torres-Riquelme F, Delgado-Retamal MF. Morphological Characteristics of the Double Mental Foramen and Its Relevance in Clinical Practice: An Observational Study. Diagnostics. 2024;14(12):1277.
Ghandourah AO, Badaoud MB, Dahlawi A, Alghamdi A, Alhazmi F, Sembawa SN, Demyati AK. A radiographic analysis of the location of the mental foramen. The Saudi Dental J. 2023;35(4):354. DOI: https://doi.org/10.1016/j.sdentj.2023.03.001
Yanık D, Nalbantoğlu AM. Mental foramen and apical foramen: A dangerous anatomical proximity. Australian Endodon J. 2024;50(2):352-8. DOI: https://doi.org/10.1111/aej.12852
Sheth K, Banga KS, Pawar AM, Gutmann JL, Kim HC. Shape and anatomical relationship of the mental foramen to the mandibular premolars in an Indian sub-population: a retrospective CBCT analysis. Rest Dentist Endodon. 2022;47(1):359. DOI: https://doi.org/10.5395/rde.2022.47.e1
Mallahi E, Abesi F, Rajaei-Rad F, Gholinia H. Anatomical characteristics of mental foramen and canal: A cone-beam computed tomography analysis. J Clin Experim Dentist. 2024;16(8):1004. DOI: https://doi.org/10.4317/medoral.61861
Fechney A, Clarke DE. Evaluation of Injectate Distribution of the Middle Mental Nerve Block Within the Mandibular Canal in a Cadaveric Canine Model. J Veter Dent. 2025;42(1):41-7. DOI: https://doi.org/10.1177/08987564241293188
Alazemi A, Al Muhairi E, Alharbi N, Abdunabi F, Mashyakhy M. Evaluation of mental foramen and mandibular canal course and location in an Emirati subpopulation. Int Dental J. 2024;74(5):1142-50. DOI: https://doi.org/10.1016/j.identj.2024.03.014
Ravindranadh G, Rao SB, Kommanda RK. Study of mental foramen in dry human mandibles of adult and its significance: an anatomical study. Int J Heal Sci. 2022;3:2285-92. DOI: https://doi.org/10.53730/ijhs.v6nS3.6000
Thomaidi ZM, Tsatsarelis C, Papadopoulos V. Accessory Mental Foramina in Dry Mandibles: An Observational Study Along with Systematic Review and Meta-Analysis. Dentist J. 2025;13(3):94. DOI: https://doi.org/10.3390/dj13030094
Adisen MZ, Aydogdu M. Evaluation of mandibular canal and mental foramen variations on cone-beam computed tomography images. J Dental Res Rev. 2022;9(1):14-8. DOI: https://doi.org/10.4103/jdrr.jdrr_9_21
Eskef KM, Zraiki SS. Morphometric analysis of the mental foramen in a Syrian population by using cone-beam computed tomography. Morphologie. 2024;108(363):100914. DOI: https://doi.org/10.1016/j.morpho.2024.100914
Khalifa S. Assessment of position, shape and radiographic appearance of the mental foramen in terms of gender: A radiographic study. Egyptian Dental J. 2022;68(3):2199-207. DOI: https://doi.org/10.21608/edj.2022.124684.2003
Skrzat J, Ryniewicz W, Goncerz G, Kozerska M. Anatomical features of the mandibular canal and their clinical significance—review of literature. Folia Medica Cracoviensia. 2023;63(3):157-70. DOI: https://doi.org/10.24425/fmc.2023.147220
Bruna-Mejias A, Nova-Baeza P, Torres-Riquelme F, Delgado-Retamal MF, Orellana-Donoso M, Suazo-Santibañez A, Sepulveda-Loyola W, Valdés-Orrego I, Sanchis-Gimeno J, Valenzuela-Fuenzalida JJ. Morphological characteristics of the double mental foramen and its relevance in clinical practice: an observational study. Diagnostics. 2024 ;14(12):1277. DOI: https://doi.org/10.3390/diagnostics14121277
Niños VA. CBCT evaluation of unilateral accessory mental foramina: under reported anatomic variant in children. Int J Odontostomat. 2022;16(3):441-6. DOI: https://doi.org/10.4067/S0718-381X2022000300441
Bagheri S, Shokuhifar M, Moradinejad M, Razavi M, Hashemi Ashtiani A, Baratvand B. Associations between the 3D position of the mental foramen with sagittal skeletal relationships (classes I, II and III) and vertical facial growth patterns (normal, long and short faces) in different ages and sexes: a retrospective cohort study of 360 CBCTs. BMC Oral Health. 2023;23(1):968. DOI: https://doi.org/10.1186/s12903-023-03719-z
Roi CI, Roi A, Riviș M. Considerations and New Perspectives of Locoregional Anesthesia in Dentistry. InAnesthesiology-New Insights. Intech Open. 2024;4:678.
Alali YS, Mohammed WA, Alotaibi SM, Alshehri S, Alshayban M. Accuracy of mandibular foramen localization using digital orthopantomogram (OPG) in middle eastern population. Diagnostics. 2024;14(19):2173. DOI: https://doi.org/10.3390/diagnostics14192173
Menditti D, Menditti VS, Amodio M, Cataldo G, Menditti M, Baldi A. The real anatomy of mandibular canal: new features and prospectives in oral and maxillofacial surgery. In Vivo. 2025;39(5):2883-92. DOI: https://doi.org/10.21873/invivo.14088
Challana A, Saini J, Choudhary OP. Topographic anatomy in relation to local anesthesia and applied anatomical landmarks of domestic animals. Training Man. 2024;5:610.