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http://dx.doi.org/10.5624/isd.20220001

Prevalence and extension of the anterior loop of the mental nerve in different populations and CBCT imaging settings: A systematic review and meta-analysis  

Hadilou, Mahdi (Student Research Committee, Faculty of Dentistry, Tabriz University of Medical Sciences)
Gholami, Leila (Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia)
Ghojazadeh, Morteza (Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences)
Emadi, Naghmeh (Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences)
Publication Information
Imaging Science in Dentistry / v.52, no.2, 2022 , pp. 141-153 More about this Journal
Abstract
Purpose: This study aimed to identify the prevalence and extension of the anterior loop (AL) of the mental nerve in different populations and according to different cone-beam computed tomography (CBCT) imaging settings. Materials and Methods: Medline/PubMed, Embase, Scopus, Web of Science, and ProQuest were searched. The main inclusion criterion was ALs evaluated in CBCT images. The quality of studies was assessed with the Joanna Briggs Institute risk of bias checklist. Subgroup analyses were conducted for sex, side, continent, voxel size, field of view, and type of CBCT-reconstruction images with a random-effects model. Results: Sixty-three studies with 13,743 participants (27,075 hemimandibles) were included. An AL was found in 40.6% (95% CI: 32.8%-48.9%, P<0.05) of participants and 36.0% (95% CI: 27.5%-45.5%, P<0.05) of hemimandibles, in 34.9% (95% CI: 25.1%-46.2%, P<0.05) of males and 34.5% (95% CI: 23.5%-47.4%, P<0.05) of females. The average length of ALs was 2.39 mm (95% CI: 2.07-2.70 mm, P<0.05). Their extension was 2.13 mm (95% CI: 1.54-2.73 mm, P<0.05) in males and 1.85 mm (95% CI: 1.35-2.36 mm, P<0.05) in females. Significant differences were observed regarding the prevalence and length of ALs among continents and for its measured length on different CBCT-reconstruction images, but not between other subgroups. Conclusion: AL was a relatively common finding. The voxel size and fields of view of CBCT devices were adequate for assessing AL; however, a 2-mm safety margin from anatomical structures(such as the AL) could be recommended to be considered when using CBCT imaging.
Keywords
Inferior Alveolar Canal; Mandibular Nerve; Cone-Beam Computed Tomography; Systematic Review;
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1 Sakhdari S, Hafezi L, Esmaili M. Prevalence of the inferior alveolar nerve's anterior loop and mandibular incisive canal by use of cone beam computed tomography (CBCT) in an Iranian population. J Res Dent Maxillofac Sci 2016; 1: 14-21.   DOI
2 do Couto-Filho CE, de Moraes PH, Alonso MB, Haiter-Neto F, Olate S, de Albergaria-Barbosa JR. Accuracy in the diagnosis of the mental nerve loop. a comparative study between panoramic radiography and cone beam computed tomography. Int J Morphol 2015; 33: 327-32.   DOI
3 Ritter L, Neugebauer J, Mischkowski RA, Dreiseidler T, Rothamel D, Richter U, et al. Evaluation of the course of the inferior alveolar nerve in the mental foramen by cone beam computed tomography. Int J Oral Maxillofac Implants 2012; 27: 1014-21.
4 Puri A, Verma P, Mahejan P, Bansal A, Kohli S, Faraz S. CBCT evaluation of the vital mandibular interforaminal anatomical structures. Ann Maxillofac Surg 2020; 10: 149-57.   DOI
5 Chibber N, Singh S, Sudan S, Anand M. CBCT use to evaluate vital mandibular inter-foramin anatomical structures. Indian J Public Health Res Dev 2020; 11: 650-4.
6 Eren H, Orhan K, Bagis N, Nalcaci R, Misirli M, Hincal E. Cone beam computed tomography evaluation of mandibular canal anterior loop morphology and volume in a group of Turkish patients. Biotechnol Biotechnol Equip 2016; 30: 346-53.   DOI
7 Demir A, Izgi E, Pekiner F. Anterior loop of the mental foramen in a Turkish subpopulation with dentate patients: a cone beam computed tomography study. J Marmara Univ Inst Health Sci 2015; 5: 231-8.
8 do Carmo Oliveira M, Tedesco TK, Gimenez T, Allegrini S Jr. Analysis of the frequency of visualization of morphological variations in anatomical bone features in the mandibular interforaminal region through cone-beam computed tomography. Surg Radiol Anat 2018; 40: 1119-31.   DOI
9 Kastala RK, David CM, Jayapal N. Momentousness of the mental loop: a comparative study. Contemp Clin Dent 2019; 10: 86-92.   DOI
10 Filo K, Schneider T, Locher MC, Kruse AL, Lubbers HT. The inferior alveolar nerve's loop at the mental foramen and its implications for surgery. J Am Dent Assoc 2014; 145: 260-9.   DOI
11 Wei X, Gu P, Hao Y, Wang J. Detection and characterization of anterior loop, accessory mental foramen, and lateral lingual foramen by using cone beam computed tomography. J Prosthet Dent 2020; 124: 365-71.   DOI
12 Rodricks D, Phulambrikar T, Singh S, Gupta A. Evaluation of incidence of mental nerve loop in Central India population using cone beam computed tomography. Indian J Dent Res 2018; 29: 627-33.   DOI
13 Dos Santos Oliveira R, Maria Gomes Oliveira A, Cintra Junqueira JL, Kuhl Panzarella F. Association between the anatomy of the mandibular canal and facial types: a cone-beam computed tomography analysis. Int J Dent 2018; 2018: 5481383.   DOI
14 de Oliveira-Santos C, Souza PH, de Azambuja Berti-Couto S, Stinkens L, Moyaert K, Rubira-Bullen IR, et al. Assessment of variations of the mandibular canal through cone beam computed tomography. Clin Oral Investig 2012; 16: 387-93.   DOI
15 Alyami OS, Alotaibi MS, Koppolu P, Alosaimy A, Abdulghani A, Swapna LA, et al. Anterior loop of the mental nerve in Saudi sample in Riyadh, KSA. A cone beam computerized tomography study. Saudi Dent J 2021; 33: 124-30.   DOI
16 Goller Bulut D, Kose E. Available bone morphology and status of neural structures in the mandibular interforaminal region: three-dimensional analysis of anatomical structures. Surg Radiol Anat 2018; 40: 1243-52.   DOI
17 Roshene R, Kumar J. Radiological study on the anterior loop of inferior alveolar nerve. Indian J Public Health Res Develop 2019; 10: 595-9.   DOI
18 von Arx T, Hafliger J, Chappuis V. Neurosensory disturbances following bone harvesting in the symphysis: a prospective clinical study. Clin Oral Implants Res 2005; 16: 432-9.   DOI
19 Kheir MK, Sheikhi M. Assessment of the anterior loop of mental nerve in an Iranian population using cone beam computed tomography scan. Dent Res J (Isfahan) 2017; 14: 418-22.   DOI
20 J PC, Marimuthu T, C K, Devadoss P, Kumar SM. Prevalence and measurement of anterior loop of the mandibular canal using CBCT: a cross sectional study. Clin Implant Dent Relat Res 2018; 20: 531-4.   DOI
21 Rosa MB, Sotto-Maior BS, Machado Vde C, Francischone CE. Retrospective study of the anterior loop of the inferior alveolar nerve and the incisive canal using cone beam computed tomography. Int J Oral Maxillofac Implants 2013; 28: 388-92.   DOI
22 Chen JC, Lin LM, Geist JR, Chen JY, Chen CH, Chen YK. A retrospective comparison of the location and diameter of the inferior alveolar canal at the mental foramen and length of the anterior loop between American and Taiwanese cohorts using CBCT. Surg Radiol Anat 2013; 35: 11-8.   DOI
23 Chappidi V, Swapna L, Dheeraj V, Nikitha G, Kanakagiri M. Evaluation of morphometric variations in mental foramen and prevalence of anterior loop in South Indian population - a CBCT study. J Indian Acad Oral Med Radiol 2019; 31: 134-9.   DOI
24 Mukhia N, Birur NP, Shubhasini AR, Shubha G, Keerthi G. Dimensional measurement accuracy of 3-dimensional models from cone beam computed tomography using different voxel sizes. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132: 361-9.   DOI
25 Icen M, Orhan K, Seker C, Geduk G, Cakmak Ozlu F, Cengiz M. Comparison of CBCT with different voxel sizes and intraoral scanner for detection of periodontal defects: an in vitro study. Dentomaxillofac Radiol 2020; 49: 20190197.   DOI
26 Kamburoglu K, Kursun S. A comparison of the diagnostic accuracy of CBCT images of different voxel resolutions used to detect simulated small internal resorption cavities. Int Endod J 2010; 43: 798-807.   DOI
27 von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 2008; 61: 344-9.   DOI
28 Koivisto T, Chiona D, Milroy LL, McClanahan SB, Ahmad M, Bowles WR. Mandibular canal location: cone-beam computed tomography examination. J Endod 2016; 42: 1018-21.   DOI
29 Vujanovic-Eskenazi A, Valero-James JM, Sanchez-Garces MA, Gay-Escoda C. A retrospective radiographic evaluation of the anterior loop of the mental nerve: comparison between panoramic radiography and cone beam computerized tomography. Med Oral Patol Oral Cir Bucal 2015; 20: e239-45.
30 Xie L, Li T, Chen J, Yin D, Wang W, Xie Z. Cone-beam CT assessment of implant-related anatomy landmarks of the anterior mandible in a Chinese population. Surg Radiol Anat 2019; 41: 927-34.   DOI
31 Karnasuta P, Plianrungsi J, Denkongpon I, Horsimasathaporn N, Chayutthanabun P, Weerachartwattana J, et al. Cone-beam computed tomography investigation of crucial mandibular canal variations in Thais. Oral Radiol 2017; 33: 219-26.   DOI
32 Prakash O, Srivastava PK, Jyoti B, Mushtaq R, Vyas T, Usha P. Radiographic evaluation of anterior loop of inferior alveolar nerve: a cone-beam computer tomography study. Niger J Surg 2018; 24: 90-4.   DOI
33 Tofino-Medina JH, Arriola-Guillen LE, Rodriguez-Cardenas YA, Aliaga-Del Castillo A, Ruiz-Mora GA, Guerrero ME. Frequency of accessory mental foramen and anatomical variability of mental nerve anterior loop in a Peruvian population: a retrospective cone-beam computed tomography study. J Oral Res 2020; 9: 202-11.   DOI
34 Mishra SK, Nahar R, Gaddale R, Chowdhary R. Identification of anterior loop in different populations to avoid nerve injury during surgical procedures - a systematic review and meta-analysis. Oral Maxillofac Surg 2021; 25: 159-74.   DOI
35 Parnia F, Moslehifard E, Hafezeqoran A, Mahboub F, Mojaver-Kahnamoui H. Characteristics of anatomical landmarks in the mandibular interforaminal region: a cone-beam computed tomography study. Med Oral Patol Oral Cir Bucal 2012; 17: e420-5.
36 Haghanifar S, Moudi E, Bijani A, Lavasani S, Lameh A. Mandibular canal and its incisive branch: a CBCT study. World Fam Med J 2017; 15: 133-40.
37 do Nascimento EH, Dos Anjos Pontual ML, Dos Anjos Pontual A, da Cruz Perez DE, Figueiroa JN, Frazao MA, et al. Assessment of the anterior loop of the mandibular canal: a study using cone-beam computed tomography. Imaging Sci Dent 2016; 46: 69-75.   DOI
38 Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71.
39 Hogg KD. Mandibular anatomical structures. In: Ho CC. Practical procedures in implant dentistry. Hoboken: Wiley-Blackwell; 2021. p. 59-72.
40 Greenstein G, Tarnow D. The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review. J Periodontol 2006; 77: 1933-43.   DOI
41 Balaguer-Marti JC, Penarrocha-Oltra D, Balaguer-Martinez J, Penarrocha-Diago M. Immediate bleeding complications in dental implants: a systematic review. Med Oral Patol Oral Cir Bucal 2015; 20: e231-8.
42 Padmanabhan H, Kumar AV, Shivashankar K. Incidence of neurosensory disturbance in mandibular implant surgery - a meta-analysis. J Indian Prosthodont Soc 2020; 20: 17-26.   DOI
43 Aminoshariae A, Su A, Kulild JC. Determination of the location of the mental foramen: a critical review. J Endod 2014; 40: 471-5.   DOI
44 Velasco-Torres M, Padial-Molina M, Avila-Ortiz G, Garcia-Delgado R, Catena A, Galindo-Moreno P. Inferior alveolar nerve trajectory, mental foramen location and incidence of mental nerve anterior loop. Med Oral Patol Oral Cir Bucal 2017; 22: e630-5.
45 Iyengar AR, Patil S, Nagesh KS, Mehkri S, Manchanda A. Detection of anterior loop and other patterns of entry of mental nerve into the mental foramen: a radiographic study in panoramic images. J Dent Implant 2013; 3: 21-5.   DOI
46 Gawlikowska-Sroka A, Stocki L, Dabrowski P, Kwiatkowska B, Szczurowski J, Czerwinski F. Topography of the mental foramen in human skulls originating from different time periods. Homo 2013; 64: 286-95.   DOI
47 de Brito AC, Nejaim Y, de Freitas DQ, de Oliveira Santos C. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal. Imaging Sci Dent 2016; 46: 159-65.   DOI
48 Phraisukwisarn P, Asvanund P, Kretapirom K. Measurement of anterior loop of inferior alveolar nerve using cone beam computed tomography (CBCT). M Dent J 2017; 37: 81-7.
49 Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid Based Healthc 2015; 13: 147-53.   DOI
50 Ferreira Barbosa DA, Barros ID, Teixeira RC, Menezes Pimenta AV, Kurita LM, Barros Silva PG, et al. Imaging aspects of the mandibular incisive canal: a PROSPERO-registered systematic review and meta-analysis of cone beam computed tomography studies. Int J Oral Maxillofac Implants 2019; 34: 423-33.   DOI
51 Vieira CL, Veloso SD, Lopes FF. Location of the course of the mandibular canal, anterior loop and accessory mental foramen through cone-beam computed tomography. Surg Radiol Anat 2018; 40: 1411-7.   DOI
52 Genu PR, Vasconcellos RJ, Oliveira BP, Vasconcelos BC, Delgado NC. Analysis of anatomical landmarks of the mandibular interforaminal region using CBCT in a Brazilian population. Braz J Oral Sci 2014; 13: 303-7.   DOI
53 Sinha S, Kandula S, Sangamesh NC, Rout P, Mishra S, Bajoria AA. Assessment of the anterior loop of the mandibular canal using cone-beam computed tomography in Eastern India: a record-based study. J Int Soc Prev Community Dent 2019; 9: 290-5.   DOI
54 Krishnan U, Monsour P, Thaha K, Lalloo R, Moule A. A limited field cone-beam computed tomography-based evaluation of the mental foramen, accessory mental foramina, anterior loop, lateral lingual foramen, and lateral lingual canal. J Endod 2018; 44: 946-51.   DOI
55 Lee JE, Lee YJ, Jin SH, Kim Y, Kook YA, Ko Y, et al. Topographic analysis of the mandibular symphysis in a normal occlusion population using cone-beam computed tomography. Exp Ther Med 2015; 10: 2150-6.   DOI
56 Sahman H, Sisman Y. Anterior loop of the inferior alveolar canal: a cone-beam computerized tomography study of 494 cases. J Oral Implantol 2016; 42: 333-6.   DOI
57 von Arx T, Friedli M, Sendi P, Lozanoff S, Bornstein MM. Location and dimensions of the mental foramen: a radiographic analysis by using cone-beam computed tomography. J Endod 2013; 39: 1522-8.   DOI
58 Shalash M, Khallaf ME, Ali AR. Position and dimensions of the mental foramen and presence of the anterior loop in the Egyptian population: a retrospective CBCT study. Bull Natl Res Cent 2020; 44: 110.   DOI
59 Abidullah M, Kaur P, Karthikeyan P, Koppolu P, Kaur R. Assessment of different patterns of entry of mental nerve in mental foramen: a cone beam computed tomography study. World J Dent 2018; 9: 382-6.   DOI
60 Kung CY, Wang YM, Chan CP, Ju YR, Pan WL. Evaluation of the mandibular lingual canal and anterior loop length to minimize complications associated with anterior mandibular surgeries: a cone-beam computed tomography study. J Oral Maxillofac Surg 2017; 75: 2116.e1-13.
61 Torres MG, Campos PS, Segundo NP, Navarro M, Crusoe-Rebello I. Accuracy of linear measurements in cone beam computed tomography with different voxel sizes. Implant Dent 2012; 21: 150-5.   DOI
62 Panjnoush M, Rabiee ZS, Kheirandish Y. Assessment of location and anatomical characteristics of mental foramen, anterior loop and mandibular incisive canal using cone beam computed tomography. J Dent(Tehran) 2016; 13: 126-32.
63 Yang XW, Zhang FF, Li YH, Wei B, Gong Y. Characteristics of intrabony nerve canals in mandibular interforaminal region by using cone-beam computed tomography and a recommendation of safe zone for implant and bone harvesting. Clin Implant Dent Relat Res 2017; 19: 530-8.   DOI
64 Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21: 1539-58.   DOI
65 Lu CI, Won J, Al-Ardah A, Santana R, Rice D, Lozada J. Assessment of the anterior loop of the mental nerve using cone beam computerized tomography scan. J Oral Implantol 2015; 41: 632-9.   DOI
66 Sridhar M, Dhanraj M, Nesappan T, Jain A. A retrospective radiographic evaluation of incisive canal and anterior loop of mental nerve using cone beam computed tomography. Drug Invent Today 2018; 10: 1656-60.
67 Fokas G, Vaughn VM, Scarfe WC, Bornstein MM. Accuracy of linear measurements on CBCT images related to presurgical implant treatment planning: a systematic review. Clin Oral Implants Res 2018; 29 Suppl 16: 393-415.
68 Damstra J, Fourie Z, Huddleston Slater JJ, Ren Y. Accuracy of linear measurements from cone-beam computed tomography-derived surface models of different voxel sizes. Am J Orthod Dentofacial Orthop 2010; 137: 16.e1-6.   DOI
69 Ganguly R, Ramesh A, Pagni S. The accuracy of linear measurements of maxillary and mandibular edentulous sites in cone-beam computed tomography images with different fields of view and voxel sizes under simulated clinical conditions. Imaging Sci Dent 2016; 46: 93-101.   DOI
70 Kajan ZD, Salari A. Presence and course of the mandibular incisive canal and presence of the anterior loop in cone beam computed tomography images of an Iranian population. Oral Radiol 2012; 28: 55-61.   DOI
71 Siddiqui Z, Rai S, Ranjan V. Efficacy and evaluation of cone beam computed tomography in determining the prevalence and length of anterior loop of inferior alveolar nerve in North Indian population. J Indian Acad Oral Med Radiol 2018; 30: 32-7.   DOI
72 Shokry SM, Salam ZA, Alshaib S, Al Mohaimeed ZZ. Comparing the apparent length of the anterior loop on panoramic radiographs and a new tracing technique on three-dimensional cone-beam computed tomographic images. Int J Clin Den Sci 2016; 7: 1-5.
73 Apostolakis D, Brown JE. 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 2012; 23: 1022-30.   DOI
74 Chen Z, Chen D, Tang L, Wang F. Relationship between the position of the mental foramen and the anterior loop of the inferior alveolar nerve as determined by cone beam computed tomography combined with mimics. J Comput Assist Tomogr 2015; 39: 86-93.   DOI
75 Raju N, Zhang W, Jadhav A, Ioannou A, Eswaran S, Weltman R. Cone-beam computed tomography analysis of the prevalence, length, and passage of the anterior loop of the mandibular canal. J Oral Implantol 2019; 45: 463-8.   DOI
76 Dhumad OS, Saliem SS. Anterior loop presence and extension using cone-beam computed tomography. Indian J Public Health Res Dev 2019; 10: 764-7.   DOI
77 Munn Z, Stern C, Aromataris E, Lockwood C, Jordan Z. What kind of systematic review should I conduct? A proposed typology and guidance for systematic reviewers in the medical and health sciences. BMC Med Res Methodol 2018; 18: 5.   DOI
78 Freire-Maia B, Machado VD, Valerio CS, Custodio AL, Manzi FR, Junqueira JL. Evaluation of the accuracy of linear measurements on multi-slice and cone beam computed tomography scans to detect the mandibular canal during bilateral sagittal split osteotomy of the mandible. Int J Oral Maxillofac Surg 2017; 46: 296-302.
79 Marieiro LM, Deluiz D, Ferreira DC, Tannure PN, editors. Measurement of distance between the mental foramina using cone-beam computed tomography: a pilot study with a possible method for planning mandibular implants. Pesqui Bras Odontopediatria Clin Integr 2017; 17: e3328.
80 Al-Mahalawy H, Al-Aithan H, Al-Kari B, Al-Jandan B, Shujaat S. Determination of the position of mental foramen and frequency of anterior loop in Saudi population. A retrospective CBCT study. Saudi Dent J 2017; 29: 29-35.   DOI
81 Eachempati P, Nagraj SK, Chien DC, Lin CC, Soe HH, KS KK. Radiographic evaluation of the anterior loop of the mental nerve: comparison between orthopantomograph and coneveam CT - a pilot study. Res J Pharm Biol Chem Sci 2017; 8: 2044-50.
82 Moghddam MR, Davoudmanesh Z, Azizi N, Rakhshan V, Shariati M. Prevalence and length of the anterior loop of the inferior alveolar nerve in Iranians. J Oral Implantol 2017; 43: 333-6.   DOI
83 Gala V, Tirpude V, Shah D, Doshi A, Fernandes G. A retrospective cone beam computed tomography (CBCT) study of the assessment of the length of the anterior loop of the inferior alveolar nerve. Int J S Res Sci Tech 2018; 4: 828-32.
84 Wong SK, Patil PG. Measuring anterior loop length of the inferior alveolar nerve to estimate safe zone in implant planning: a CBCT study in a Malaysian population. J Prosthet Dent 2018; 120: 210-3.   DOI
85 Bosykh YY, Turkina AY, Franco RP, Franco A, Makeeva MK. Cone beam computed tomography study on the relation between mental foramen and roots of mandibular teeth, presence of anterior loop and satellite foramina. Morphologie 2019; 103: 65-71.
86 Gupta A, Pubreja L, Malik R, Gupta N. Evaluation of the dimensions of anterior loop of mental nerve in CBCT: a radiographic analysis. J Maxillofac Oral Surg 2020; 19: 168-72.   DOI