International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 15 , ISSUE 4 ( July-August, 2022 ) > List of Articles


A Cone Beam Computed Tomographic Study on the Location of Mandibular and Mental Foramen in Indian Pediatric Population

Nimisha Vathariparambath

Keywords : Cone beam computed tomography, Mandibular foramen, Mental foramen

Citation Information : Vathariparambath N. A Cone Beam Computed Tomographic Study on the Location of Mandibular and Mental Foramen in Indian Pediatric Population. Int J Clin Pediatr Dent 2022; 15 (4):422-427.

DOI: 10.5005/jp-journals-10005-2413

License: CC BY-NC 4.0

Published Online: 17-12-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim: To determine the location of mandibular foramen (MF) and mental foramen (MeF) in 8–18-year-old children using cone beam computed tomography (CBCT). Materials and methods: Hundred CBCT images of children (8–18 years) were evaluated to determine the shortest distance from MF to the anterior border of ramus (A), posterior border of ramus (P) and inferior border of the mandible (MI), most superior point of the curvature of mandibular notch (MN), occlusal plane of the mandibular permanent molars (O), and the distance from MeF to lower border of mandible (BM) and to the alveolar crest (AC). Results: There was a statistical increase in A-MF, P-MF, MI-MF, MN-MF, and O-MF values with age. MF was found to be 3.53 mm below the occlusal plane in 8–11-year-old children, and it reaches the occlusal plane by 12–14 years of age, and it moves posterior-superiorly 3.58 mm above the occlusal plane in 15–18-year-old individuals. AC-MeF value decreases whereas the BM-MeF value increases with age and there was a significant difference based on sex. Conclusion: The location of the MF is just posterior to the middle of the ramus, it reaches the level of the occlusal plane by the age of 12–14 years, and MF and MeF are shifting posterior-superiorly with increasing age. Clinical significance: The awareness of localization of MF and MeF is of greater importance when administering regional anesthesia in mandible, especially in children. Its position varies according to gender and age, especially during growth spurts. Failure to achieve proper nerve block leading to repeated injection of the local anesthetic solution will not only pose a behavior problem in children but can also lead to systemic toxic level of anesthetic solution being administered. Its accurate position enables more effective local anesthesia and improves child cooperation, minimizing the risk of complications.

PDF Share
  1. Braga RRS, Silva LMT, Galvanini PA, et al. Analysis of the mandibular foramen position and its implications to the inferior alveolar nerve block. Rev Odontol Bras Central 2014;23(67):181–184. DOI: 10.36065/robrac.v23i67.754
  2. Gray H, Williams PL. (editor), Gray's Anatomy—The Anatomical Basis of Medicine and Surgery. 38th ed. New York: Churchill Livingston; 1995. p. 578.
  3. Fehrenbach MJ, Herring SW. Bone, Illustrated Anatomy of the Head and Neck. 4th ed. Washington: Elsevier; 2002. p. 65–70.
  4. Suragimath A, Suragimath G, Murlasiddiah SK. Radiographic location of mental foramen in a randomly selected population of Maharashtra. J Indian Acad Oral Med Radiol 2016;28:11–16. DOI: 10.4103/0972-1363.189989
  5. Altunsoy M, Aglarci OS, Ok E, et al. Localization of the mandibular foramen of 8-18 years old children and youths with cone-beam computed tomography. J Pediatr Dent 2014;2(2):44–48. DOI: 10.4103/2321-6646.137677
  6. Benham NR. The cephalometric position of the mandibular foramen with age. ASDC J Dent Child 1976;43(4):233–237.
  7. Krishnamurthy NH, Unnikrishnan S, Ramachandra JA, et al. Evaluation of relative position of mandibular foramen in children as a reference for inferior alveolar nerve block using orthopantamograph. J Clin Diagn Res 2017;11(3):ZC71–ZC74. DOI: 10.7860/JCDR/2017/25453.9585
  8. Dhillon JK, Kalra G. Cone-beam computed tomography: an innovative tool in pediatric dentistry. J Pediatr Dent 2013;1:27–31. DOI: 10.4103/WKMP-0028.117440
  9. Poonacha KS, Shigli AL, Indushekar KR. Relative position of the mandibular foramen in different age groups of children: a radiographic study. J Indian Soc Pedod Prev Dent 2010;28(3):173–178. DOI: 10.4103/0970-4388.73798
  10. Sheikhi M, Kheir MK. CBCT assessment of mental foramen position relative to anatomical landmarks. Int J Dent 2016;1–4. DOI: 10.1155/2016/5821048
  11. Patil K, Guledgud MV, Bhattacharya PT. Reliability of panoramic radiographs in the localization of mandibular foramen. J Clin Diagn Res 2015;9(5):ZC35–ZC38. DOI: 10.7860/JCDR/2015/11641.5893
  12. Gungor K, Ozturk M, Semiz M, et al. A radiographic study of location of mental foramen in a selected Turkish population on panoramic radiograph. Coll Antropol 2006;30(4):801–815.
  13. Kilarkaje N, Nayak SR, Narayan P, et al. The location of the mandibular foramen maintains absolute bilateral symmetry in mandibles of different age-groups. Hong Kong Dent J 2005;2:35–37.
  14. Cantekin K, Sekerci AE, Miloglu O, et al. Identification of the mandibular landmarks in a pediatric population. Med Oral Patol Oral Cir Bucal 2014;19(2):e136–e141. DOI: 10.4317/medoral.18980
  15. Przesmycka A, Tomczyk J. Differentiation of root canal morphology—a review of the literature. Anthropol review 2016;79(3):221–239. DOI: 10.1515/anre-2016-0018
  16. Tsai HH. Panoramic radiographic findings of the mandibular foramen from deciduous to early permanent dentition. J Clin Pediatr Dent 2004;28(3):215–219. DOI: 10.17796/jcpd.28.3.gt48634942137234
  17. Thangavelu K, Kannan R, Kumar NS, et al. Significance of localization of mandibular foramen in an inferior alveolar nerve block. J Nat Sci Biol Med 2012;3(2):156–160. DOI: 10.4103/0976-9668.101896
  18. Afsar A, Haas DA, Rossouw PE, et al. Radiographic localization of mandibular anesthesia landmarks. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86(2):234–241. DOI: 10.1016/s1079-2104(98)90131-7
  19. Hetson G, Share J, Frommer J, et al. Statistical evaluation of the position of the mandibular foramen. Oral Surg Oral Med Oral Pathol 1988;65(1):32–34. DOI: 10.1016/0030-4220(88)90187-9
  20. Mwaniki DL, Hassanali J. The position of mandibular and mental foramina in Kenyan African mandibles. East Afr Med J 1992;69(4):210–213.
  21. Oguz O, Bozkir MG. Evaluation of location of mandibular and mental foramina in dry, young, adult human male, dentulous mandibles. West Indian Med J 2002;51(1):14–16.
  22. Hayward J, Richardson ER, Malhotra SK. The mandibular foramen: its anteroposterior position. Oral Surg Oral Med Oral Pathol 1977;44(6):837–843. DOI: 10.1016/0030-4220(77)90027-5
  23. Bremer G. Measurements of special significance in connection with anesthesia of the inferior alveolar nerve. Oral Surg Oral Med Oral Pathol 1952;5(9):966–988. DOI: 10.1016/0030-4220(52)90050-9
  24. Pereira PDN, Fernandes Â, Gugisch RC, et al. Radiographic assessment of the mandibular foramen in children: focus on anesthetic procedures. Arch Oral Res 2013;9(3):279–283.
  25. Ashkenazi M, Taubman L, Gavish A. Age-associated changes of the mandibular foramen position in anteroposterior dimension and the mandibular angle in dry human mandibles. Anat Rec 2011;294(8):1319–1325.
  26. Hwang TJ, Hsu SC, Huang QF, et al. Age changes in location of mandibular foramen. Zhonghua Ya Yi Xue Hui Za Zhi 1990;9:98–103.
  27. Kalender A, Orhan K, Aksoy U. Evaluation of the mental foramen and accessory mental foramen in Turkish patients using cone-beam computed tomography images reconstructed from a volumetric rendering program. Clin Anat 2012;25(5):584–592. DOI: 10.1002/ca.21277
  28. Gershenson A, Nathan H, Luchansky E. Mental foramen and mental nerve: changes with age. Acta Anat 1986;126(1):21–28. DOI: 10.1159/000146181
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.