• The Journal of Advanced Prosthodontics
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• v.9 no.6
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• pp.470-475
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• 2017

PURPOSE. The purpose of this study was to identify the complex course of the mandibular canal using 3D reconstruction of microCT images and to provide the diagram for clinicians to help them understand at the interforaminal region in Korean. MATERIALS AND METHODS. Twenty-six hemimandibles obtained from cadavers were examined using microCT, and the images were reconstructed. At both the midpoint of mental foramen and the tip of anterior loop, the bucco-lingual position, the height from the mandibular inferior border, the horizontal distance between two points, and position relative to tooth site on the mandibular canal were measured. The angle that the mental canal diverges from the mandibular canal was measured in posterior-superior and lateral-superior direction. RESULTS. The buccal distance from the mandibular canal was significantly much shorter than lingual distance at both the mental foramen and the tip of anterior loop. The mandibular canal at the tip of anterior loop was significantly located closer to buccal side and higher than at the mental foramen. And the mental canal most commonly diverged from the mandibular canal below the first premolar by approximately $50^{\circ}$ posterior-superior and $41^{\circ}$ lateral-superior direction, which had with a mean length of 5.19 mm in front of the mental foramen, and exited to the mental foramen below the second premolar. CONCLUSION. These results suggest that it could form a hazardous tetrahedron space at the interforaminal region, thus, the clinician need to pay attention to the width of a premolar tooth from the mental foramen during dental implant placement.

• Imaging Science in Dentistry
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• v.46 no.3
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• pp.159-165
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• 2016

Purpose: The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Materials and Methods: Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. Results: In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. Conclusion: CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region.

• Imaging Science in Dentistry
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• v.39 no.2
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• pp.81-87
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• 2009

Purpose: To evaluate the anteroposterior length and buccal angle of the anterior loop, and the size and location of the mental foramen using cone beam computed tomography (CBCT). Materials and Methods: 100 CBCT images from 87 adults (43 males and 44 females) ranging in age from 20 to 73 years (average 50 years) with edentulous ridge of the mandibular premolar region were obtained. Axial, sagittal, coronal images were reconstructed from Dental and Block Images of CBCT. The anteroposterior length, shape and buccal angle of the anterior loop, and the size and location of the mental foramen were calculated from reconstructed images of axial, sagittal and coronal CBCT. Results: The anteroposterior length and buccal angle of the mental canal was 4.0${\pm}$1.2mm, 37.8${\pm}$11.60$^{\circ}$respectively. The loop type with straight course was the most common shape of the mental canal. The location of the mental foramen below the apex of the lower second premolar (78%) was the most common. The maximum size of the mental foramen was 4.6${\pm}$1.0 mm in width and 3.0${\pm}$0.6 mm in height. The inner size of the mental canal was 2.6${\pm}$0.6 mm in width and 2.1 mm${\pm}$0.4 mm in height. Conclusion: CBCT is useful to evaluate the anterior loop and mental foramen of the mandibular canal. Safe guideline of 4 mm from the most anterior point of the mental foramen is recommended for implant and surgical treatment. (Korean J Oral Maxillofac Radiol 2009; 39: 81-7)

• Imaging Science in Dentistry
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• v.46 no.2
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• pp.69-75
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• 2016

Purpose: Sufficient area in the interforaminal region is required for dental implant placement, and the anterior loop of the mandibular canal is located within the limits of this area. The aim of this study was to evaluate the prevalence and extent of the anterior loop in a Brazilian sample population using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images from 250 patients (500 hemimandibles) obtained for various clinical indications were randomly selected and evaluated to determine the presence and length of the anterior loop. The length of the anterior loop was then compared based on gender, age, and the side of the mandible. The data were analyzed using the Pearson chi-square test and linear regression analysis. Results: An anterior loop was identified in 41.6% of the cases, and its length ranged from 0.25 mm to 4.00 mm (mean, $1.1{\pm}0.8mm$). The loop had a greater mean length and was significantly more prevalent in males (p=0.014). No significant differences were found between the right and left sides regarding length (p=0.696) or prevalence (p=0.650). Conclusion: In this study, a high prevalence of the anterior loop of the mandibular canal was found, and although its length varied greatly, in most cases it was less than 1 mm long. Although this is a prevalent anatomical variation, safety limits for the placement of implants in this region cannot be established before an accurate evaluation using imaging techniques in order to identify and preserve the neurovascular bundles.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.317-326
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• 2011

The mental foramen and anterior loop of the mandibular canal are important landmarks for mandibular surgical procedures. The purpose of this study was to analyze the shape and position of the mental foramen and anterior loop of the mandibular canal on the computed tomography (CT) images, and apply the results clinically. CT images of 96 patients (33 male, 36 female, age range 17~43 years, mean $24.6{\pm}4.99$ years) were enrolled. The horizontal and vertical position of the mental foramen, as well as the distance from the root apices were measured. The distance of the anterior loop of the mandibular canal to the root apices, and the buccal angle were measured. The mental foramen was found mostly below the second premolar observed in 81 cases (46.0%), between the first and second premolars in 67 cases (38.0%), and between the second premolar and first molar in 19 cases (10.2%). The mean distance between the mental foramen and the lower border of the mandible was $12.20{\pm}1.77$ mm, the mean distance between the mental foramen and root apex was $5.16{\pm}0.98$ mm. The mean distance of the anterior loop of the mandibular canal was $5.80{\pm}2.00$ mm. The buccal angle measured at $47.7{\pm}9.07^{\circ}$. The distance between the root apex and mental foramen measured as $5.16{\pm}0.98$ mm on panoramic radiography, and $6.2{\pm}3.07$ mm on CT. The mean distance between the mental foramen and mandibular canal was $5.39{\pm}1.62$ mm. When performing surgical procedures such as installing dental implants, it is important to minimize surgical trauma, especially the risk of damage to the mental nerve. To optimize the surgical outcome, a careful assessment of the shape and position of the mental foramen and the anterior loop of the mandibular canal must be made. CT images are useful for finding such anatomic structures.

• Imaging Science in Dentistry
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• v.46 no.4
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• pp.297-297
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• 2016

• Imaging Science in Dentistry
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• v.52 no.2
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• pp.141-153
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• 2022

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.