Abstract
Purpose
This study used spiral computed tomography to identify the anterior loop of the inferior alveolar nerve, and to measure its length and position in Chinese. This information may be useful to safely install endosseous implants in the most distal area of the interforaminal region.
Methods
Sixty-eight Chinese patients were included in this retrospective study. Patients were scanned by 64-slice spiral computed tomography, and the prevalence, length, and position of the anterior loop were assessed using the multiplanar capabilities of software.
Results
An anterior loop could be identified in 83.1 % of the cases, with a mean length of 2.09 mm (range 0–5.31 mm). The mean distance from the superior border of the mental foramen to the alveolar crest was 13.00 mm, and the mean distance from the superior border of the origin of the anterior loop to the alveolar crest was 17.83 mm.
Conclusions
The anterior loop was highly prevalent in Chinese, and the length of the anterior loop was highly variable. Therefore, we recommend that drilling commences from a location approximately 5.5 mm mesially from the mental foramen, when installing implants in the most distal interforaminal area.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Apostolakis D, Brown JE (2012) The anterior loop of the inferior alveolar nerve: prevalence, measurement of its length and a recommendation for interforaminal implant installation based on cone beam CT imaging. Clin Oral Implants Res 23:1022–1030
Bavitz JB, Harn SD, Hansen CA et al (1993) An anatomical study of mental neurovascular bundle-implant relationships. Int J Oral Maxillofac Implants 8:563–567
Benninger B, Miller D, Maharathi A et al (2011) Dental implant placement investigation: is the anterior loop of the mental nerve clinically relevant? J Oral Maxillofac Surg 69:182–185
Chan HL, Misch K, Wang HL (2010) Dental imaging in implant treatment planning. Implant Dent 19:288–298
de Oliveira Junior MR, Saud AL, Fonseca DR et al (2011) Morphometrical analysis of the human mandibular canal: a CT investigation. Surg Radiol Anats 33:345–352
Fatemitabar SA, Nikgoo A (2010) Multichannel computed tomography versus cone-beam computed tomography: linear accuracy of in vitro measurements of the maxilla for implant placement. Int J Oral Maxillofac Implants 25:499–505
Greenstein G, Tarnow D (2006) The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review. J Periodontol 77:1933–1943
Guo JL, Su L, Zhao JL et al (2009) Location of mental foramen based on soft- and hard-tissue landmarks in a Chinese population. J Craniofac Surg 20:2235–2237
Hatcher DC (2010) Operational principles for cone-beam computed tomography. J Am Dent Assoc 141(Suppl 3):3S–6S
Hwang K, Lee WJ, Song YB et al (2005) Vulnerability of the inferior alveolar nerve and mental nerve during genioplasty: an anatomic study. J Craniofac Surg 16:10–14 (discussion 14)
Jacobs R, Mraiwa N, van Steenberghe D et al (2002) Appearance, location, course, and morphology of the mandibular incisive canal: an assessment on spiral CT scan. Dentomaxillofac Radiol 31:322–327
Jacobs R, Mraiwa N, Van Steenberghe D et al (2004) Appearance of the mandibular incisive canal on panoramic radiographs. Surg Radiol Anat 26:329–333
Kamburoglu K, Kilic C, Ozen T et al (2009) Measurements of mandibular canal region obtained by cone-beam computed tomography: a cadaveric study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107:e34–e42
Kaya Y, Sencimen M, Sahin S et al (2008) Retrospective radiographic evaluation of the anterior loop of the mental nerve: comparison between panoramic radiography and spiral computerized tomography. Int J Oral Maxillofac Implants 23:919–925
Kim IS, Kim SG, Kim YK et al (2006) Position of the mental foramen in a Korean population: a clinical and radiographic study. Implant Dent 15:404–411
Kuzmanovic DV, Payne AG, Kieser JA et al (2003) Anterior loop of the mental nerve: a morphological and radiographic study. Clin Oral Implants Res 14:464–471
Loubele M, Van Assche N, Carpentier K et al (2008) Comparative localized linear accuracy of small-field cone-beam CT and multislice CT for alveolar bone measurements. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105:512–518
Makris N, Stamatakis H, Syriopoulos K et al (2010) Evaluation of the visibility and the course of the mandibular incisive canal and the lingual foramen using cone-beam computed tomography. Clin Oral Implants Res 21:766–771
Naitoh M, Nakahara K, Suenaga Y et al (2010) Comparison between cone-beam and multislice computed tomography depicting mandibular neurovascular canal structures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109:e25–e31
Neiva RF, Gapski R, Wang HL (2004) Morphometric analysis of implant-related anatomy in Caucasian skulls. J Periodontol 75:1061–1067
Ngeow WC, Dionysius DD, Ishak H et al (2009) A radiographic study on the visualization of the anterior loop in dentate subjects of different age groups. J Oral Sci 51:231–237
Ngeow WC, Yuzawati Y (2003) The location of the mental foramen in a selected Malay population. J Oral Sci 45:171–175
Parnia F, Moslehifard E, Hafezeqoran A et al (2012) Characteristics of anatomical landmarks in the mandibular interforaminal region: a cone-beam computed tomography study. Med Oral Patol Oral Cir Bucal 17:e420–e425
Pires CA, Bissada NF, Becker JJ et al (2012) Mandibular incisive canal: cone beam computed tomography. Clin Implant Dent Relat Res 14:67–73
Sankar DK, Bhanu SP, Susan PJ (2011) Morphometrical and morphological study of mental foramen in dry dentulous mandibles of South Andhra population of India. Indian J Dent Res 22:542–546
Santini A, Alayan I (2012) A comparative anthropometric study of the position of the mental foramen in three populations. Br Dent J 212:E7
Shah S, Vaze S, Kinhal K (2010) A variation in the position of the mental foramen: a case report. J Maxillofac Oral Surg 9:307–309
Uchida Y, Noguchi N, Goto M et al (2009) Measurement of anterior loop length for the mandibular canal and diameter of the mandibular incisive canal to avoid nerve damage when installing endosseous implants in the interforaminal region: a second attempt introducing cone beam computed tomography. J Oral Maxillofac Surg 67:744–750
Uchida Y, Yamashita Y, Goto M et al (2007) Measurement of anterior loop length for the mandibular canal and diameter of the mandibular incisive canal to avoid nerve when installing endosseous implants in the interforaminal region. J Oral Maxillofac Surg 65:1772–1779
Watanabe H, Mohammad Abdul M, Kurabayashi T et al (2010) Mandible size and morphology determined with CT on a premise of dental implant operation. Surg Radiol Anat 32:343–349
Conflict of interest
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Li, X., Jin, ZK., Zhao, H. et al. The prevalence, length and position of the anterior loop of the inferior alveolar nerve in Chinese, assessed by spiral computed tomography. Surg Radiol Anat 35, 823–830 (2013). https://doi.org/10.1007/s00276-013-1104-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-013-1104-6