Assessment of the Anterior Loop of the Mental Nerve Using Cone Beam Computerized Tomography Scan

The purpose of this study is to use cone-beam computerized tomography (CBCT) scans with oblique-transverse reconstruction modality to measure and compare the anterior loop length (AnLL) of the mental nerve between gender and age groups and to compare the difference between the right and left sides. Sixty-one female and 61 male CBCT scans were randomly selected for each age group: 21-40, 41-60, and 61-80 years. Both right-and left-side AnLLs were measured in each subject using i-CATVision software to measure AnLLs on the oblique transverse plane using multiplanar reconstruction. The anterior loop was identified in 85.2% of cases, with the mean AnLL of the 366 subjects (732 hemimandibles) being 1.46 +/- 1.25 mm with no statistically significant difference between right and left sides or between different gender groups. However, the mean AnLL in the 21-40 year group (1.89 +/- 1.35 mm) was larger than the AnLL in the 41-60 year group (1.35 +/- 1.19 mm) and the 61-80 year group (1.13 +/- 1.08 mm). In conclusion, when placing implants in close proximity to mental foramina, caution is recommended to avoid injury to the inferior alveolar nerve. No fixed distance anteriorly from the mental foramen should be considered safe. Using CBCT scans with the oblique-transverse method to accurately identify and measure the AnLL is of utmost importance in avoiding and protecting its integrity.