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Background/aim: In this study, we investigated the blink reflex (BR) after simultaneous and asynchronous stimulation of two trigeminal nerve branches. The objective was to characterize the physiology of trigeminal and facial circuits. Materials and methods: We performed three sets of experiments: recording BR response i. after supraorbital nerve stimulation (SON), after mental nerve stimulation (MN), and after simultaneous SON and MN stimulation (SON+MN) in 18 healthy individuals; ii. after MN (at an intensity eliciting BR response) preceding SON at various interstimulus intervals (ISIs) in seven healthy subjects; iii after MN (at sensory threshold) preceding SON at various ISIs. We compared the magnitudes of early and late responses. Results: The R1 amplitude after simultaneous SON+MN stimulation was greater than responses after single stimulation of the same branches. After simultaneous stimulations, the R2 and R2c areas under the curve (AUC) were smaller than the arithmetic sums of R2 and R2c AUC obtained after single stimulations. The second experiment provided a recovery excitability curve. In the third step, we obtained facilitation of R1 and inhibition of late responses. Conclusion: The SON+MN stimulation caused an increased R1 circuit excitability compared to the arithmetic sum of the single stimulations; however, magnitudes of late responses did not potentiate. Thus, we have provided evidence for R1 circuit enhancement by simultaneous stimulation in humans, whereas modulation of late responses exhibited a recovery curve similar to that shown for paired SON stimulation. [ABSTRACT FROM AUTHOR]

Background & Purpose: Anterior loop of the mental nerve is a crucial anatomic feature for anterior mandibular osteotomies and implant placement. In most cases, two-dimensional imaging techniques are insufficient to identify and quantify the mental nerve loop. Any damage to this loop causes paresthesia, numbness, or pain in the area that the mental nerve supplies. Cone beam computed tomography (CBCT) will be used in this study to examine its prevalence. The prevalence will be computed, allowing for the safe placement of implants or osteotomy cuts in the premolar region. Material & Methods: Using CBCT scans of 200 patients undergoing impaction surgery, a cross-sectional research was conducted. Results: The anterior loop in the mental nerve was present in 98.00% of the individuals in our study. Conclusion: In most situations where the mental nerve loop bundle is present, it is safe to leave a margin of 4 mm anterior to the mental foramen to prevent harm to the loop. [ABSTRACT FROM AUTHOR]

Introduction: Mandible also known as the largest and inferior, primary facial bone of the face giving a curved shape to it. It changes its shape and gives variations to the bony structure of the face from birth till older age. Mental foramen is known as the vintage of the mandible and is an important mark of the face for carrying out many diagnostics and surgical processes along with aesthetic procedures of the face. Thus, the present study is designed with an aim to get insight knowledge of position and shape of mental foramen in dry adult human mandible. Material and Method: Totally, 350 bones were studied in 2 years duration. The study was carried out in the Department of Anatomy, Index Medical College Hospital & Research Center over a period of 2 year. The position of mental foramen was studied using an instrument known as digital Vernier Calliper (in mm) while shape was analysed visually. Position of mental foramen was calculated using Statistical package for social sciences (SPSS) software. Results: In our study, the mean and standard deviation of Distance from alveolar crest to upper margin of mental foramen was found to be (13.14±0.42) on right side and (12.42±0.31) on left side. In our study, the mean and standard deviation of Distance from lower border of mandible to lower margin of mental foramen was found to be (16.23±0.53) on right side and (15.41±0.46) on left side. In our study, the mean and standard deviation of Distance from alveolar crest to lower border of mandible was found to be (31.42±0.64) on right side and (30.35±0.57) on left side. In our study, the mean and standard deviation of Vertical diameter of foramen was found to be (2.65±0.31) on right side and (2.42±0.13) on left side. Conclusion: Hence, mental foramen plays a pivotal role in performing major facial surgeries and is an important landmark for several facial procedures performed. [ABSTRACT FROM AUTHOR]

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The usage of xenograft material is widely used in almost all oral cavity bone defects for regenerative and reconstructive purposes. The presented xenograft usage in the following care report enabled good bone defect healing and enabled the preservation of affected premolars. It is quite common to use any possible variations of bone materials to ensure bone defect improved healing. In some cases, the scope of surgeries requires the removal of each cyst within close proximity to various nerves and vessels. The inferior alveolar, infraorbital, lingual, and mental nerves are those most commonly adjacent to most operating sites in jaw bones. The usage of some additional materials such as collagen sponges, bone substitutes, resorbable membranes, or other additional materials are useful in each bone defect reconstruction but should be handled with care, as described in the following case. Before planning their usage, it is important to perform each surgery with close cone beam computed tomography imaging, which is very helpful to establish the scope of each lesion and the proximity of vital structures. There are a lot of factors that might influence any possible nerve damage, especially the different nerve anatomical variations. Even factors including the subperiosteal preparation and compression of adjacent tissues might influence later nerve function. When the lesion is expanding through the buccal cortical plate and when soft tissue fluctuation is present, some special care is needed. Similar to the presented case, a limitation in crushing, blowing, or any irritation of nerve fibers improves later postoperative outcomes. When the wound and surrounding tissues are handled with care, a limited possibility of any damage or paresthesia can occur. When the nerve itself is damaged or cut, loss of function can be permanent. Immediately after or even prophylactic prescription 1–2 days before the surgery of Vitamin B with NSAIDs (Non-steroidal anti-inflammatory drugs) (or other additional supplementary medicaments can improve nerve function in time. Possible nerve damage can be divided into many etiological factors. A quite different situation arises when the nerve is pulled in by the cyst growth into the cyst wall. The presented case report describes the outcomes of a cyst removal from the mandibular basis and treatment modalities. [ABSTRACT FROM AUTHOR]

Background and objective: In surgical dentistry, shape, location, position, and extent of the anterior loop of mental foramen plays a deliberately imperative landmark during an osteotomy procedure. To evade any neurological disturbance during implant surgery radiological assessment is compulsory. Therefore, the aim of the study was to assess the position and level of mental nerve for placement of implants using Cone-beam computed tomography & Panoramic radiography in the Saudi population. Materials and methods: A total of 150 CBCT and Panoramic radiographs were taken from the patients who visited the Department of Oral Medicine and Radiology. The data collection was done by using the same radiographic pieces of equipment for both CBCT and Panoramic radiographs. CBCT images taken from Kodak 9000 3D, Carestream Health, Inc., New York, USA, and Panoramic Radiographs taken from Panoramic Planmeca ProMax, Helsinki, Finland (Vujanovic-Eskenazi et al., 2015). The Chi-square test student test was used for statistical analysis. Results: The most frequent shape and location of mental foramen in both CBCT and Panoramic radiographs were oval and in between the first and second premolar, both in CBCT & PR views. The visibility of mental loop on CBCT & PR view showed that; visibility of mental loop in CBCT was higher with 42(56%) as compared with PR view 26(34.66%) with statistically significant p-value 0.014. The mean length of the mental loop on CBCT was statistically significant (p = 0.001). But the mean distance from the lower point of the mental foramen to the lower border of the mandible was not statistically significant. Conclusion: Based on the results of the present study; the visibility of the mental loop and its extension is more in CBCT as compared with PR views. Therefore, we recommended CBCT, during of implant surgery.

Numb chin syndrome (NCS) is a rare sensory neuropathy resulting from inferior alveolar or mental nerve injury. It manifests as hypoesthesia, paraesthesia, or, rarely, as pain in the chin and lower lip. Several case reports suggest that sickle cell disease (SCD) could be a cause of NCS. However, information about NCS is scarce in this population. Our objectives were to synthesize all the available literature relevant to NCS in SCD and to propose recommendations for diagnosis and management based on the best available evidence. A systematic review was performed on several databases to identify all relevant publications on NCS in adults and children with SCD. We identified 73 publications; fourteen reports met the inclusion/exclusion criteria. These described 33 unique patients. Most episodes of NCS occurred in the context of typical veno-occlusive crises that involved the mandibular area. Radiological signs of bone infarction were found on some imaging, but not all. Neuropathy management was mostly directed toward the underlying cause. Overall, these observations suggest that vaso-occlusion and bone infarction could be important pathophysiological mechanisms of NCS. However, depending on the individual context, we recommend a careful evaluation to rule out differential causes, including infections, local tumors, metastatic disease, and stroke. [ABSTRACT FROM AUTHOR]

Background: Assessing the exact location of Mental foramen (MF) is of paramount importance from clinicians point of view during diagnostic, surgical or operative procedures. This study aimed to determine and ascertain the position, symmetry and anatomical proximity of MFs to mandibular teeth among Kashmiri population. Materials and Methods: In total, 90 panoramic radiographs were evaluated from January 2020 to July 2022, of which 50 were males and 40 were females. Radiographic images were evaluated to ascertain the position, symmetry and anatomical proximity of MFs to mandibular teeth. Unpaired t test and Kruskal-Wallis H test were employed for statistical analysis. Results: The most common location of MF was below the apex of the second premolar on both right (72.2%) as well as on the left side (68.8%) followed by the presence of MF between first and second premolar at 15.5 % and 20 % on right and left side respectively. There was no statistical significant difference and association between the location of MF on right and left side, or between gender or age groups. The mental foramen was symmetrical in 65 patients (72.22%) and asymmetrical in 25 patients (27.78%). Conclusions: There is a need of accurate radiographic identification and determining the positional variation of MF for isolation of mental nerves and vessels when administering local anesthesia and performing surgeries. These findings highlight the need for clinicians to be aware of the exact position of the MF in treatment planning and while performing non-surgical and surgical procedures. [ABSTRACT FROM AUTHOR]

Introduction: Safe and effective procedures in the perioral region rely on a clear understanding of the facial anatomy, as insufficient knowledge of this aspect can lead to severe complications. Materials and methods: We performed thorough layer-by-layer dissections of the perioral region on 11 freshly formalinized cadaver heads. Dissections were performed between 2020 and 2022 in the dissection laboratory of the Anatomy Department, where the ethical conducts were regulated by "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania, and fall under its jurisdiction. Dissections were digitally photographed and edited without altering the scientific content. By performing minute dissections, a considerable amount of attention has been paid to the trajectory and diameter of the superior and inferior labial arteries and their relations with the surrounding structures. Results: We demonstrated the presence of the fibro-muscular compartment above the philtrum, where the superior labial artery passes and gives off the columellar and septal branches, and where it can be compressed in case of either the migration of the filler or quick bolus injections of substance. We also emphasized the importance of the labial salivary glands as risk elements in the perioral region. The depth of the inferior labial artery varied between 4.1-5.4 mm and that of the superior labial artery between 4.8-5.6 mm. Discussion: Safe and complication-free procedures require an exact knowledge of the anatomy of the main neurovascular bundle of each facial region and their anatomical variability should be highlighted. Conclusions: The clinically relevant anatomical observations and descriptions of landmarks presented in our research serves as crucial information for plastic, reconstructive and aesthetic surgeons and dentists. Doppler ultrasound imaging has a considerable potential for both diminishing the risk and facilitating the prompt treatment of complications, especially because it is an affordable, repeatable, quick and reliable procedure. Cadaveric dissection for anatomy training provides an unparalleled opportunity to precisely understand the structure of actual human tissue and the clinical and structural relationships between the multitude of anatomical risk elements. [ABSTRACT FROM AUTHOR]

Objective: To determine the horizontal and vertical locations and dimensions of the mental foramen (MF) in digital panoramic images (DPI), and to evaluate the effect of impacted mandibular cuspids (IMC) on the position of the MF. Materials and Methods: 715 Digital panoramic images were obtained from the archives of oral radiology clinics of the College of Dentistry, Jouf University. Altogether 236 DPI that met inclusion and exclusion criteria were investigated. One specialist principal investigator examined and analyzed the DPI on a computer screen for horizontal location, average position, and vertical location of the MF. Results: The most common horizontal location of MF with the apices of the teeth in the non-impacted group (NIG) was found to be c = 64.70%, and in the impacted group (IG) d = 47.10%. The average magnitude of MF relative to the apex of second bicuspid in the NIG was found to be 47.10% on the mesial side, and in IG 44.10% on the distal side. The average vertical distance of MF from the lower border of the mandible to the lower border of MF (DLM) in NIG was 14.13 mm (SD ± 1.75 mm), and in IG was 16.85 mm (SD ± 3.06 mm). The average vertical distance of MF from the alveolar crest to the superior border of MF (DAC) in NIG was 6.56 mm (SD ± 2.02 mm), and in IG was 6.67 mm (SD ± 2.28 mm). Conclusion: The impacted mandibular cuspid has a definite influence on the location and position of the MF.

The aim of this study is to reveal the morphometry of the mental nerve to describe a safe zone for minimizing mental nerve damage during transoral endoscopic thyroidectomy-vestibular approach (TOETVA). This study was performed on 12 cadavers. Localization of mental foramen according to teeth, distances of buccogingival sulcus-lip (BG--L), mental foramen-midline (MF-Midline), mental foramen -- buccogingival sulcus (MF -- BG), commissure -- branching point (Cm -- Br), branching point - vertical projection of branching point on lower lip (Br -- LVP), vertical projection of branching point on lower lip -- commissure (LVP -- Cm), commissure -- midline (Cm -- midline), angles of mental (AM), angular (AA) and labial branches (AL) and branching patterns were recorded. Type 1 was mostly found as branching pattern in this study (45.8 %). A new branching pattern (type 9) was found on one cadaver. Mental foramen was mostly located at level of second premolar teeth. According to morphometric results of this study; superolateral to course of angular branch and infero-medial to course of mental branch of mental nerve on lower lip after exiting the mental foramen were described as safe zones during surgery for preserving mental nerve and its branches. [ABSTRACT FROM AUTHOR]

The usage of xenograft material is widely used in almost all oral cavity bone defects for regenerative and reconstructive purposes. The presented xenograft usage in the following care report enabled good bone defect healing and enabled the preservation of affected premolars. It is quite common to use any possible variations of bone materials to ensure bone defect improved healing. In some cases, the scope of surgeries requires the removal of each cyst within close proximity to various nerves and vessels. The inferior alveolar, infraorbital, lingual, and mental nerves are those most commonly adjacent to most operating sites in jaw bones. The usage of some additional materials such as collagen sponges, bone substitutes, resorbable membranes, or other additional materials are useful in each bone defect reconstruction but should be handled with care, as described in the following case. Before planning their usage, it is important to perform each surgery with close cone beam computed tomography imaging, which is very helpful to establish the scope of each lesion and the proximity of vital structures. There are a lot of factors that might influence any possible nerve damage, especially the different nerve anatomical variations. Even factors including the subperiosteal preparation and compression of adjacent tissues might influence later nerve function. When the lesion is expanding through the buccal cortical plate and when soft tissue fluctuation is present, some special care is needed. Similar to the presented case, a limitation in crushing, blowing, or any irritation of nerve fibers improves later postoperative outcomes. When the wound and surrounding tissues are handled with care, a limited possibility of any damage or paresthesia can occur. When the nerve itself is damaged or cut, loss of function can be permanent. Immediately after or even prophylactic prescription 1–2 days before the surgery of Vitamin B with NSAIDs (Non-steroidal anti-inflammatory drugs) (or other additional supplementary medicaments can improve nerve function in time. Possible nerve damage can be divided into many etiological factors. A quite different situation arises when the nerve is pulled in by the cyst growth into the cyst wall. The presented case report describes the outcomes of a cyst removal from the mandibular basis and treatment modalities.

In surgical dentistry, shape, location, position, and extent of the anterior loop of mental foramen plays a deliberately imperative landmark during an osteotomy procedure. To evade any neurological disturbance during implant surgery radiological assessment is compulsory. Therefore, the aim of the study was to assess the position and level of mental nerve for placement of implants using Cone-beam computed tomography & Panoramic radiography in the Saudi population. A total of 150 CBCT and Panoramic radiographs were taken from the patients who visited the Department of Oral Medicine and Radiology. The data collection was done by using the same radiographic pieces of equipment for both CBCT and Panoramic radiographs. CBCT images taken from Kodak 9000 3D, Carestream Health, Inc., New York, USA, and Panoramic Radiographs taken from Panoramic Planmeca ProMax, Helsinki, Finland (Vujanovic-Eskenazi et al., 2015). The Chi-square test student test was used for statistical analysis. The most frequent shape and location of mental foramen in both CBCT and Panoramic radiographs were oval and in between the first and second premolar, both in CBCT & PR views. The visibility of mental loop on CBCT & PR view showed that; visibility of mental loop in CBCT was higher with 42(56%) as compared with PR view 26(34.66%) with statistically significant p-value 0.014. The mean length of the mental loop on CBCT was statistically significant (p = 0.001). But the mean distance from the lower point of the mental foramen to the lower border of the mandible was not statistically significant. Based on the results of the present study; the visibility of the mental loop and its extension is more in CBCT as compared with PR views. Therefore, we recommended CBCT, during of implant surgery. [ABSTRACT FROM AUTHOR]

Dear Editor, Damage to the inferior alveolar nerve causes numb chin syndrome. It is indicative of an aggressive lymphoproliferative disease or metastatic malignancy when no obvious mandibular cause can be discerned [1]. Sickle cell disease is an autosomal recessive disorder that results in glutamic acid being substituted by valine at the 6th position of the β-globin chain of the haemoglobin molecule [2]. Change in the morphology of the erythrocyte due to polymerisation of deoxygenated haemoglobin results in acute and chronic complication of the disease out of which mental nerve neuropathy and numb chin syndrome are rarely encountered [3]. A 24-year-old female, a known case of sickle cell “SS” pattern diagnosed 4 years earlier presented to us with the complaints of severe backache, pain in extremities, fever, numbness of lower lip and chin of 2 days duration. There was no history of cough, expectoration, breathlessness or burning micturition. On examination she was conscious and oriented, pulse was 102/min, blood pressure was 100/70 mmHg, respiratory rate was 36/minute and her oxygen saturation was 93% on room air. Central nervous system examination showed loss of sensation localised to the lower lip and chin. Cranial nerves were intact and no abnormal findings were present on motor system examination. On auscultation air entry was equal on both sides and normal heart sounds were heard. The abdomen was soft and non tender with no organomegaly. Her laboratory investigation were suggestive of a haemoglobin level of 6.4 mg/dL, mean corpuscular volume of 54 fL, white blood cells count of 12,300/cumm, platelet count of 83,000/cumm, Serum glutamic-oxalacetic transaminase of 96 IU/L, serum glutamic-pyruvic transaminase of 45 IU/L, serum bilirubin of 1.6 mg/dL, serum protein of 5.4 mg/dL, urea of 17 mg/dL, creatinine of 0.4 mg/dL, sodium of 143 mmol/L and potassium of 4.0 mmol/L. Chest X-ray and ultrasound of abdomen and pelvis revealed no abnormality. In view of numb chin syndrome Magnetic Resonance Imaging (MRI) of temporomandibular joint and brain was done, which were normal [Table/Fig-1,2]. With no positive finding at local site or on imaging studies she was treated with blood transfusions, amoxicillin plus clavulanic acid, levofloxacin, hydroxyurea, folic acid, zinc supplementation, sodium bicarbonate tablets, i.v. fluids and analgesics. Within the next 48 hours she improved significantly with a resolution in most of her symptoms but persistence of numbness in the lower lip and jaw and was discharged. The numbness gradually improved on subsequent follow-up with complete recovery in a span of 6 months. Numb chin syndrome is a rare complication involving the inferior alveolar nerve; a branch of the mandibular division of the 5th nerve. It enters the mandible via the mandibular foramen and then divides into incisor and mental branches [4]. The mental nerve travels through the mental foramen and bends at the levels of the canines to supply the skin of the lower lip, chin, mucous membrane of the lateral gum, lower lip and teeth. Thermo analgesia, paraesthesia and hypoesthesia following the involvement of the mental nerve in the areas supplied by it is the common presentation of numb chin syndrome [5]. This syndrome has been encountered in cases of occult malignancies, lymphoproliferative disorders, post viral infection, in lymes disease, giant cell arteritis, sarcoidosis, amyloidosis and postdental procedures and dental anaesthesia. In the present case, numb chin syndrome occurred as a rare consequence of sickle cell disease. It may range from acute mandibular crisis to acute mandibular osteomyelitis. In sickle cell crisis, abnormal red blood cells block the mental artery thus causing ischaemia or infarction of the mental nerve [6]. Numbness may also be experienced secondary to compression of the inferior alveolar nerve as a result of periosteal inflammation in the mandibular canal [7]. Infarction of the nerve in the region of the mental foramen during crisis has been hypothesised as a cause for delayed recovery [8]. In current case, numb chin syndrome occurred as a rare consequence of sickle cell disease.

Introduction: The final portion of the inferior alveolar nerve (IAN), the mental nerve (MN), is a general somatic afferent nerve that provides sensation to the lip, chin, and gingival tissue. Three patterns of MN have been observed – straight, perpendicular or vertical, and anterior loop (AL) of MN. The interforaminal region of the mandible possesses a MN with a path that creates an AL before entering the mental foramina. The aim of the study is to evaluate the presence of AL of MN using cone-beam computed tomography (CBCT) and to measure the length of the AL of MN, if present, also to evaluate the prevalence of other anatomical patterns of MN – straight and vertical patterns. Materials and Methods: Mandible CBCT of 400 patients with the age of 20 years onward was included in the study. The images obtained were assessed for the different patterns of MN – straight, vertical, and ALs. The statistical analysis was done using the Chi-square test, paired t-test, and sample t-test. Results: Out of 400 CBCT scans comprising 800 hemimandibles, straight pattern was observed in 67.1%, vertical pattern in 26%, and Anterior Loop in 6.9%. The prevalence of AL pattern was 6.9%. AL length was found to be in a range of 2.4–6.6 mm. Discussion: Surgical trauma or injury to the AL of MN is possible during implant surgery in the interforaminal area of the mandible if AL is not assessed preoperatively. [ABSTRACT FROM AUTHOR]

To determine the horizontal and vertical locations and dimensions of the mental foramen (MF) in digital panoramic images (DPI), and to evaluate the effect of impacted mandibular cuspids (IMC) on the position of the MF. 715 Digital panoramic images were obtained from the archives of oral radiology clinics of the College of Dentistry, Jouf University. Altogether 236 DPI that met inclusion and exclusion criteria were investigated. One specialist principal investigator examined and analyzed the DPI on a computer screen for horizontal location, average position, and vertical location of the MF. The most common horizontal location of MF with the apices of the teeth in the non-impacted group (NIG) was found to be c = 64.70%, and in the impacted group (IG) d = 47.10%. The average magnitude of MF relative to the apex of second bicuspid in the NIG was found to be 47.10% on the mesial side, and in IG 44.10% on the distal side. The average vertical distance of MF from the lower border of the mandible to the lower border of MF (DLM) in NIG was 14.13 mm (SD ± 1.75 mm), and in IG was 16.85 mm (SD ± 3.06 mm). The average vertical distance of MF from the alveolar crest to the superior border of MF (DAC) in NIG was 6.56 mm (SD ± 2.02 mm), and in IG was 6.67 mm (SD ± 2.28 mm). The impacted mandibular cuspid has a definite influence on the location and position of the MF. [ABSTRACT FROM AUTHOR]

Numb chin syndrome (NCS) is a rare sensory neuropathy resulting from inferior alveolar or mental nerve injury. It manifests as hypoesthesia, paraesthesia, or, rarely, as pain in the chin and lower lip. Several case reports suggest that sickle cell disease (SCD) could be a cause of NCS. However, information about NCS is scarce in this population. Our objectives were to synthesize all the available literature relevant to NCS in SCD and to propose recommendations for diagnosis and management based on the best available evidence. A systematic review was performed on several databases to identify all relevant publications on NCS in adults and children with SCD. We identified 73 publications; fourteen reports met the inclusion/exclusion criteria. These described 33 unique patients. Most episodes of NCS occurred in the context of typical veno-occlusive crises that involved the mandibular area. Radiological signs of bone infarction were found on some imaging, but not all. Neuropathy management was mostly directed toward the underlying cause. Overall, these observations suggest that vaso-occlusion and bone infarction could be important pathophysiological mechanisms of NCS. However, depending on the individual context, we recommend a careful evaluation to rule out differential causes, including infections, local tumors, metastatic disease, and stroke.

The article presents a case of a patient in which an asymptomatic intraosseous tumor of the mental nerve area was removed. The result of histopathologic examination confirmed the initial diagnosis of post-traumatic neuroma.

Background and Objectives The mental foramen which is located on the anterior surface of the mandible is a bilateral opening transmitting mental nerves and vessels that supply important structures around. However, it is reported that the location of mental foramen varies across different races and genders, the awareness of which is vital in surgical interventions, anesthetic applications, and various other invasive procedures. Hence, the objectives of the present study were to study the location, size, and shape of mental foramina in dry human mandibles and to study the incidence of accessory mental foramina in human mandibles. Materials and Methods One hundred eighty dried mandibles were observed for the location, size, and shape of mental foramen. Digital Vernier calipers were used to measure the distance of right and left mental foramen from various locations like alveolar crest, symphysis menti, lower border of mandible, and posterior border of the ramus of mandible. The data were analyzed using SPSS 20 software. The position and number of accessory mental foramen were determined. Results The various positions of mental foramina studied revealed the most common type to be type IV as per the Tebo and Telford classification. The average horizontal diameter was slightly higher than the average vertical diameter in maj’ority of the bones. Accessory mental foramina were observed in 3 mandibles. Conclusion The mental foramen was most commonly situated along the longitudinal axis of second premolar tooth and the shape of the mental foramen was found to be oval in 95% of the bones studied.

Introduction: The precise location of the mental foramina is an essential landmark in planning the position of dental implants in the anterior mandible. Injury to inferior alveolar nerve during anterior mandibular implant surgery causes altered sensation which greatly affects patient satisfaction., Methods: In this study, we assessed the prevalence of anterior loop of mental nerve and the pattern of entry of mental nerve into the mental foramen. Three hundred panoramic radiographs (600 hemimandibles) obtained from records maintained in the Department of Oral Medicine and Radiology were randomly selected for the study. The radiographs were evaluated by two independent observers for the pattern of entry of mental nerve into the mental foramen on either side of the mandible and for the presence or absence of anterior loop of mental nerve., Results: The most prevalent pattern of mental nerve observed was Straight pattern which totals to 67.5% followed by Anterior loop pattern (18.8%) and then the Perpendicular pattern (13.7%). There was no significant association between the gender and subtypes of looping pattern on the left and right side and a highly significant association between the side of the mandible and loop pattern was observed by Chi square test., Conclusion: The Anterior loop pattern of mental nerve has been found in 18.8% of the population suggesting to accurate planning with three-dimensional imaging techniques to avoid injury to mental nerve during dental implant placement and other surgical procedure involving the interforaminal region of the mandible., Competing Interests: The authors have declared financial relationships, which are detailed in the next section., (Copyright © 2024, Thiruvenkata Krishnan et al.)

Introduction and aim: Mandible usually has a bilateral oval or circular mental foramen [MF] situated on the anterolateral aspect of the body of mandible. Variations of the MF are often encountered ranging from difference in incidence, shape, size, position and supernumerary [accessory MF] to even complete absence. So, the aim of the present study was to evaluate the incidence and the anatomical features of the mental foramen and the accessory mental foramen. Materials & method : 61 dry human mandibles of unknown sex were examined. Size and distance of mental foramen and accessory mental foramen from symphysis menti [Mandibular midline], inferior border of the mandible, posterior border of ramus and superior border of body of mandible were measured using vernier calliper and statistically analyzed by mean and standard deviation. Results : Bilateral mental foramina [MF] were present in all 61 [100%] mandibles. Out of 122 mental foramina [MF], 86 [70.5%] were round and 36 [29.5%] were oval in shape. Approximately half [47.54%] of MF were present below the apex of 2nd premolar tooth. MF was located approximately half way between alveolar crest and mandibular body. Bilateral AMF were present in 1.64% mandibles. All 5 AMFs were round in shape. AMF was separated from MF by a median distance of 2mm. Conclusion: The knowledge about incidence and variability in position of mental foramen and accessory mental foramen is important in order to avoid nerve damage in connection with surgical procedure and to achieve complete effect of anaesthesia after mental nerve block

Context: Anatomical literature has described the anterior loop being an extension of the mental nerve which is present anterior to the mental foramen while the caudal loop has been described as the distance between the lower border of the mental foramen and the lowest point of the mandibular canal. The knowledge and identification of the anterior and caudal loop of the mental nerve are important in surgical procedures performed around the mental foramen to avoid inadvertent damage to these vital structures resulting in postoperative complications. Aim: The present study was conducted to determine the incidence and measurement of mental nerve loop in the mandibular arches using cone beam computed tomography (CBCT). Settings and Design: A total of 200 CBCT images were retrieved and inspected for the presence of the mental nerve loop. The length of the anterior loop was measured by counting the number of consecutive contiguous vertical cross sections displaying two round hypodense images. This number was multiplied by the thickness of the slices. The caudal loop was measured as the distance between the lower border of the mental foramen and the lowest point of mandibular canal. Statistical Analysis Used: Shapiro–Wilk test and Mann–Whitney U-test were used. P < 0.05 was considered statistically significant. Results: 57.5% (n = 200 scans) presented with the anterior loop of the mental nerve with a mean length of 0.50 mm and 0.37 mm on the right side and left side, respectively. All the samples of CBCT scans taken were having caudal loop extension with a mean length of 3.53 mm. Conclusion: A considerable number of individuals (57.5%) in the present study presented with the anterior loop of the mental nerve. CBCT was found to be an effective imaging modality for the detection of anterior loop of the mental nerve.

Background: Mental foramen (MF) is an important landmark for administration of local anesthesia in surgical procedures involving the mandible. Additional mental foramina, called accessory mental foramina (AMF) transmitting branches of mental nerve, have been reported. Detection of AMFs in presurgical imaging may reduce postoperative pain in dental surgical procedures. Aim: The aim of the study was to study the incidence and morphometric analysis of accessory MF in the dry human mandibles of South Indian population. Materials and Methods: Two hundred and sixty dry human mandibles were studied for the presence, location, shape of AMF, and its relation to MF. The horizontal diameter of AMF, and its distance from symphysis menti, the posterior border of mandible and from the base of mandible were measured and statistically analyzed. Results and Conclusions: In our study, AMF were present in 8.85% mandibles (unilateral - 7.6% [4.6% - left, 2.69% - right] and bilateral 1.6%). The most common position was below the second premolar (48.1%). AMF were round in shape (74%) and was often located either superomedial or inferolateral to MF. Their transverse diameter ranged from 0.5 to 1 mm. The AMF were situated at a mean distance of 2.96 mm from MF, 23.47 mm from symphysis menti, 11.24 mm from the lower border of the body of the mandible, and 57.35 mm from the posterior border of ramus of mandible. The knowledge of the presence of AMF and its dimensions would enable the clinicians to do mandibular procedures carefully and avoid injury to the branches of mental nerve that may be passing through it.

Objectives: The purpose of this study is to evaluate the most common appearance, horizontal and vertical positions of the mental foramen (MF), using the panoramic radiographs in a selected population of Karachi (Pakistan). As this is relevant to consider prior to plan any maxillofacial surgical procedures in order to avoid nerve injuries. Study Design: Cross-sectional study. Setting: Radiology Department of the Dr. Ishrat ul Ebad khan institute of oral health sciences (Dow University of Health Sciences). Period: 25th September to 5th November 2018. Material & Methods: Total 500 panoramic images were assessed. The study was divided in to the two group i.e. male and female adult patients in which the appearance, anterior-posterior positions and the superior-inferior positions of the MF was analyzed on the panoramic radiographs. Results: Total 500 OPG were accessed, the age ranges between 12 years to 73 years, 229 were male, 271 were females, and majority of MF were separated type (n=341, 68.2%) on right side and (n=373, 74.6%) on left side. And the most common superioinferior position of the MF on both sides were position 2 (below the level of apices of 1st and 2nd premolar) on right side (n=387, 77.4%) and on left side (n=376, 75.2%), and the most common anterio-posterior position of the MF on both the right and left side is position 4 ( M.F lies in the line of 2nd premolars), on right side (n=269, 53.8%) and on left side (n=255, 51%). Conclusion: In this study the “separated type” was the most common type of appearance in both genders and the most frequent superio-inferior position of the MF is below the level of apices of 1st and 2nd premolar on both right and left sides. And the most common anterior-posterior position is within the line of longitudinal axis of 2nd premolar on both sides. [ABSTRACT FROM AUTHOR]

Background: Information on the dimensions of the anterior loop of mental nerve is important for dental implant placement. Aims: The purpose of this study was to determine the total length of anterior loop of mental nerve from the mental foramen. Materials and Methods: CBCT data of 150 patients were evaluated. Results: We found that the anterior loop was absent in 56.4% of patients on the left side and 61.7% patients on the right side. 19.5% of the total patients (29 patients) had up to 4 mm length of the loop which was exactly same on both right and left sides. The remaining 16.8% on the left side (25 patients) and 14.1% on the right side (21 patients) had the length of the loop ranging between 4.1 and 8 mm. The rest 7.4% of patients on the left side and 4.7% patients on the right side had more than 8 mm of the loop length. Conclusions: Based on this study, the dimensions of the anterior loop are variable and hold great significance in dental implant planning in the mandibular premolar region. [ABSTRACT FROM AUTHOR]

Background: Injury of the trigeminal nerve in oral and maxillofacial surgery can occur. Schwann cell mitochondria are regulators in the development, maintenance and regeneration of peripheral nerve axons. Evidence shows that after the nerve injury, mitochondrial bioenergetic dysfunction occurs and is associated with pain, neuropathy and nerve regeneration deficit. A challenge for research is to individuate new therapies able to normalise mitochondrial and energetic metabolism to aid nerve recovery after damage. Photobiomodulation therapy can be an interesting candidate, because it is a technique involving cell manipulation through the photonic energy of a non-ionising light source (visible and NIR light), which produces a nonthermal therapeutic effect on the stressed tissue. Methods: The review was based on the following questions: (1) Can photo-biomodulation by red and NIR light affect mitochondrial bioenergetics? (2) Can photobiomodulation support damage to the trigeminal nerve branches? (preclinical and clinical studies), and, if yes, (3) What is the best photobiomodulatory therapy for the recovery of the trigeminal nerve branches? The papers were searched using the PubMed, Scopus and Cochrane databases. This review followed the ARRIVE-2.0, PRISMA and Cochrane RoB-2 guidelines. Results and conclusions: The reliability of photobiomodulatory event strongly bases on biological and physical-chemical evidence. Its principal player is the mitochondrion, whether its cytochromes are directly involved as a photoacceptor or indirectly through a vibrational and energetic variation of bound water: water as the photoacceptor. The 808-nm and 100 J/cm2 (0.07 W; 2.5 W/cm2; pulsed 50 Hz; 27 J per point; 80 s) on rats and 800-nm and 0.2 W/cm2 (0.2 W; 12 J/cm2; 12 J per point; 60 s, CW) on humans resulted as trustworthy therapies, which could be supported by extensive studies.

Several studies have shown that fibroblast growth factor-2 (FGF2) can directly affect axon regeneration after peripheral nerve damage. In this study, we performed sensory tests and histological analyses to study the effect of recombinant human FGF-2 (rhFGF2) treatment on damaged mental nerves. The mental nerves of 6-week-old male Sprague-Dawley rats were crush-injured for 1 minute and then treated with 10 or 50 μg/mL rhFGF2 or PBS in crush injury area with a mini Osmotic pump. Sensory test using von Frey filaments at 1 week revealed the presence of sensory degeneration based on decreased gap score and increased difference score. However, at 2 weeks, the gap score and difference score were significantly rebounded in the mental nerve crush group treated with 10 μg/mL rhFGF2. Interestingly, treatment with 10 μg/mL rhFGF had a more obviously positive effect on the gap score than treatment with 50 μg/mL rhFGF2. In addition, retrograde neuronal tracing with Dil revealed a significant increase in nerve regeneration in the trigeminal ganglion at 2 and 4 weeks in the rhFGF2 groups (10 μg/mL and 50 μg/mL) than in the PBS group. The 10 μg/mL rhFGF2 group also showed an obviously robust regeneration in axon density in the mental nerve at 4 weeks. Our results demonstrate that 10 μg/mL rhFGF induces mental nerve regeneration and sensory recovery after mental nerve crush injury.

Background: Mental foramina are located bilaterally in the antero-lateral aspect of the body of mandible. It transmits mental nerve, and vessels. The location, shape, size, direction and number of mental foramen in human mandibles are subject of variation. Aims and Objective: To establish the location, shape, size, direction and incidence of mental foramen (MF) in dry human mandibles of Nepalese population. Materials and Methods: One hundred dry human mandibles of unknown age and sex were selected randomly. Shape, size, position of MF with respect to tooth and other anatomical landmark were determined. Student paired t-test was used for specific statistical analysis. Results: In most cases (61%), the MF was oval in shape & situated below the apex of second premolar (58% on right side and 69% on left side). Various parameters investigated were, the horizontal distance between (1) base of mandible and MF was 12.24 mm on right and 12.26mm on the left, (2) alveolar margin and MF was 13.95 mm on right &13.75 mm on left (3) symphysis menti of mandible and MF was 26.71 mm on right and 26.49 mm on left, (4) posterior border of mandible and MF was 65.34 mm on right and 65.68mm on left. Conclusion: By the knowledge of position, shape, size, direction and distance of the mental foramen from various landmarks and the presence of the accessory foramen may be of much use to dental surgeons.

Objectives: Trigeminal postherpetic neuralgia (TPHN) often presents with moderate to severe pain, hyperalgesia, and allodynia. Conventional analgesic treatments are poorly effective, which seriously affects the quality of life. This retrospective study aimed to evaluate the efficacy of pulsed radiofrequency (PRF) for the treatment of TPHN. Methods: A total of 90 TPHN patients were selected between January 2014 and December 2016 in the Department of Pain Management, Shengjing Hospital, China Medical University. Patients were randomly divided into two groups according to the order of enrollment (n = 45 per group): group A, peripheral nerve (supraorbital nerve, infraorbital nerve and mental nerve) PRF; group B, gasserian ganglion PRF. Follow-up assessments of visual analogue scale (VAS) pain assessment, SF-36 health status questionnaire, total efficiency rate, and drug dosage of anticonvulsants and opioid analgesics were performed at time points of 1 week, 1 month, 3 months, 6 months, and 1 year after surgery. Results: At each postsurgery time point, the VAS decreased, SF-36 (physical and mental components) increased, and drug dosage of anticonvulsants and opioids analgesics decreased in both treatment groups; values at each time point were significantly different from presurgery values (P < 0.05). Compared with group A, VAS decreased, SF-36 increased, and dosage of anticonvulsants and opioids analgesics decreased significantly in group B (P < 0.05). The total efficiency rates one year after surgery in group A and group B were 68.9 and 86.7%, respectively. The total efficiency rate of group B was statistically higher than that of group A (P < 0.05). Conclusion: PRF relieved TPHN, and gasserian ganglion PRF was more effective than peripheral nerve PRF. The method was effective and improved the quality of life of the patients. PRF is recommended as a treatment for TPHN. [ABSTRACT FROM AUTHOR]

The objective of the study was to investigate the position, position symmetry, shape and number of the mental foramen in a heterogeneous South African population. Knowledge of the precise position of MF in maxillofacial surgery is critical for an accurate local anaesthesia; and can provide a landmark in forensic or medico legal cases. Dry adult human mandibles (n = 325) were selected and classified by ancestry. The sample comprised male-to-female ratio of 1.2:1. Observations were made for the position, position symmetry, shape and number of the mental foramen. There was a substantial to perfect agreement (p < 0.001) for most observations, except for the shape of the MF on the right side of the mandible that had a fair agreement (K = 0.25; P > 0.05). PIV of the MF is shown as the most prevalent position. PIII and IV were commonly observed in males and females respectively. PII was commonly observed in the males of European descent, while PIII was observed in male African and Mixed descents and female European descents. There was no significant difference in the symmetric analysis of MF amongst male and female (p = 0.059) and between ancestry (p = 0.455). But also, an oval shape of MF was the most common across subpopulations and ancestries, with 2 (2%) and 3 (0.46%) of the AMFs present. This study is the first comprehensive description of the MF in the South African population, and could be very useful in forensic anthropology in the South Africa population. [ABSTRACT FROM AUTHOR]

Background and aim: Mental nerve injury is one of the challenges of implant surgeries in the anterior mandibular region, which leads to complications such as paresthesia of the lip and chin. The present study aimed to evaluate the prevalence of the Inferior Alveolar Nerve's (IAN) anterior loop and mandibular incisive canal by use of CBCT. Materials and Methods: In this descriptive study, 200 high resolution CBCT images of the patients referring to a private oral and maxillofacial radiology center were evaluated. The images were obtained by NewTom Giano unit and were measured in NNT viewer software. Reconstructed panoramic-like images were prepared, and upon the detection of the anterior loop, cross sectional slices were made and dimensions of the anterior loop were calculated by counting the cross sections. In addition, the maximum diameter of the incisive canal was measured, and the location of this diameter was determined on the cross sections relative to dental roots. Data were analyzed by Chi-Square test. Results: In the 200 evaluated subjects, the prevalence of the anterior loop, with the minimum length of 3mm, was estimated to be 19% and the prevalence of the incisive canal was valued to be 87.5%. No significant correlation was detected between the presence of the anterior loop and age, gender, dental status and side of the jaw. Also, no significant association was detected between the presence of the incisive canal and age, gender and dental status (p=0/597,p=0/492,p=0/643) respectively. The maximum diameter of the incisive canal was 5.3 mm which was located between the first and second premolars. Conclusion: Considering the results, it seems that evaluation and measurement of the length of the IAN's anterior loop and the diameter of the incisive nerve by CBCT are necessary steps to prevent nerve injuries during surgical procedures in the anterior mandibular region.

Objective. The goal of this ultrasound based cross-sectional study was to make use of ultrasound to determine the position of the mental foramen in relation to hard tissue landmarks. Material and methods. One hundred Black and Caucasian subjects were included. An ultrasound transducer was used to locate the mental foramina. Distances to various landmarks were measured and compared. Results. All mental foramina were visualised ultrasonographically. The mean distances to various landmarks from the mental foramen for the entire group on the right and left sides respectively were as follows: a) 22.8 mm (SD 2.04 mm) and 22.8 mm (SD 2.0 mm) to the cusp of the related tooth, b) 13.2 mm (SD 1.6 mm) and 13.2 mm (SD 1.6 mm) to the inferior border of the mandible. The mean position of the mental foramen was found to be 63.4% (SD 1.8%) of the distance from the cusp of the related tooth to the inferior border of the mandible on the right and 63.3% (SD 1.7%) on the left. There were statistically significant differences between race groups and genders, but not between age groups. Conclusion. These results suggest that ultrasound is a sensitive modality to locate the mental foramen. There are minor, statistically significant (but clinically insignificant) differences in the position of the mental foramen with regard to various hard tissue landmarks.

The mental nerve is a sensory nerve that supplies the lower lip, chin, and mandibular labial gingiva. Very few variants of this nerve have been described in the literature. We describe a case in which a patient who was operated for fracture of the mandible, was found to have two mental foramina with three mental nerves. This case report highlights the need for proper radiological evaluation of mental foramina for ideal treatment planning. Clinical implications are discussed.

INTRODUCTION: Ultrasound guided neuro-anaesthesia is a developing field of interest to clinicians from various disciplines. The objective of this proof of concept study was to explore the ability, ease and rapidity of ultrasonography in locating the mental foramen. METHODS: a convenience sample of 100 patients aged 18 years or older, with no known pathology to the mandibular region, that presented to a single urban ED were enrolled. All patients underwent an ultrasound examination on both sides of the face to locate the mental foramina. RESULTS: a total of 100 patients' mental foramina were studied. Mean age was 35.7 years (SD 9.1 years), 50% were black and 25% each were asian and white. The mental foramina were ultrasonographically identified in all (100%) of the subjects in the study group. Although requiring a larger quantity of ultrasound gel, the mental foramina were also visualized in all twelve subjects with facial hair. Three out of the 100 subjects were noted to have accessory mental foramina. The overall mean time taken to locate the first mental foramen in each patient was 16.1 seconds (SD 12.9 seconds). For the first 25 subjects studied, the mean time taken was 34.7 seconds (SD 13.4 seconds), whereas for the next 75 subjects studied, the mean time taken was 9.9 seconds (SD 3.0 seconds). CONCLUSION: bedside ultrasound imaging is a potentially reliable method to identify and locate the mental foramen. With practice and experience, the mental foramen can be more easily identified.

Context: Anatomical literature has described the anterior loop being an extension of the mental nerve which is present anterior to the mental foramen while the caudal loop has been described as the distance between the lower border of the mental foramen and the lowest point of the mandibular canal. The knowledge and identification of the anterior and caudal loop of the mental nerve are important in surgical procedures performed around the mental foramen to avoid inadvertent damage to these vital structures resulting in postoperative complications.Aim: The present study was conducted to determine the incidence and measurement of mental nerve loop in the mandibular arches using cone beam computed tomography (CBCT).Settings and Design: A total of 200 CBCT images were retrieved and inspected for the presence of the mental nerve loop. The length of the anterior loop was measured by counting the number of consecutive contiguous vertical cross sections displaying two round hypodense images. This number was multiplied by the thickness of the slices. The caudal loop was measured as the distance between the lower border of the mental foramen and the lowest point of mandibular canal.Statistical Analysis Used: Shapiro-Wilk test and Mann-Whitney U-test were used. P < 0.05 was considered statistically significant.Results: 57.5% (n = 200 scans) presented with the anterior loop of the mental nerve with a mean length of 0.50 mm and 0.37 mm on the right side and left side, respectively. All the samples of CBCT scans taken were having caudal loop extension with a mean length of 3.53 mm.Conclusion: A considerable number of individuals (57.5%) in the present study presented with the anterior loop of the mental nerve. CBCT was found to be an effective imaging modality for the detection of anterior loop of the mental nerve. [ABSTRACT FROM AUTHOR]

Introduction: Ultrasound guided neuro-anaesthesia is a developing field of interest to clinicians from various disciplines. The objective of this proof of concept study was to explore the ability, ease and rapidity of ultrasonography in locating the mental foramen. Methods: A convenience sample of 100 patients aged 18 years or older, with no known pathology to the mandibular region, that presented to a single urban ED were enrolled. All patients underwent an ultrasound examination on both sides of the face to locate the mental foramina. Results: A total of 100 patients' mental foramina were studied. Mean age was 35.7 years (SD 9.1 years), 50% were black and 25% each were asian and white. The mental foramina were ultrasonographically identified in all (100%) of the subjects in the study group. Although requiring a larger quantity of ultrasound gel, the mental foramina were also visualized in all twelve subjects with facial hair. Three out of the 100 subjects were noted to have accessory mental foramina. The overall mean time taken to locate the first mental foramen in each patient was 16.1 seconds (SD 12.9 seconds). For the first 25 subjects studied, the mean time taken was 34.7 seconds (SD 13.4 seconds), whereas for the next 75 subjects studied, the mean time taken was 9.9 seconds (SD 3.0 seconds). Conclusion: Bedside ultrasound imaging is a potentially reliable method to identify and locate the mental foramen. With practice and experience, the mental foramen can be more easily identified. [ABSTRACT FROM AUTHOR]

The aim of the present paper is to emphasize the importance of the mandibular interforaminal neurovascular bundle with a case and make a warning to dentists and surgeons during oral and maxillofacial surgeries, such as implant replacement, bone harvesting, genioplasty, open reduction of a mandibular fracture, and cyst enucleations at this region. In this paper, we present a 58-year-old male who referred with pain and a tingling sensation on the left lower lip. After radiographical, extraoral and intraoral examinations, findings indicated the lesion to be a cyst which was related with a periapical lesion of the canine tooth and extracted socket of first premolar tooth. After removal of a cyst, the mandibular incisive nerve was documented which was in relation to cyst cavity.

Audience: This innovation is designed for medical students through senior residents. Introduction: Regional anesthesia increases the EM physician’s ability to provide effective pain relief and to complete procedures within the Emergency Department (ED). Studies consistently demonstrate that emergency physicians undertreat pain when performing basic procedures such as suturing lacerations.1,2 Regional anesthesia allows for effective pain relief, while avoiding the risks associated with systemic analgesia/anesthesia or the tissue distortion of local anesthesia.3 Knowledge of the anatomy involved in various nerve blocks is crucial to the development of proper technique and successful performance of this skill. Three dimensional (3-D) model simulation-based mastery of procedural skills has been demonstrated to decrease resident anxiety, improve success rates, and decrease complications during the resident’s transition into the clinical setting.5,6 Similarly, use of a 3-D head and neck model to practice application of facial regional anesthesia is hypothesized to improve provider confidence and competence which will in turn provide an improved patient experience. Objectives: In participating in the educational session associated with this task trainer, the learner will: 1) Identify landmarks for the following nerve blocks: Infraorbital, Supraorbital (V1), Mental, Periauricular 2) Demonstrate the appropriate technique for anesthetic injection for each of these nerve blocks 3) Map the distribution of regional anesthesia expected from each nerve block 4) Apply the indications and contraindications for each regional nerve block Method: This low-fidelity task trainer allows residents and medical students to practice various nerve blocks on the face in order to improve learner confidence and proficiency in performing facial regional anesthesia.

Aim: The aim of this study is to determine the morphological features and morphometrics of mental foramen with reference to surrounding anatomical landmarks in Coastal Andhra population of Andhra Pradesh State. Materials and Methods: Two-hundred and nineteen dry dentate and edentulous mandibles are examined in this study. Out of these 127 were dentate and 92 were edentulous. Various morphological and morphometrical parameters were measured by using digital Vernier caliper, metallic wire and metallic scale on both the right and left sides. Results: In the present study, the distance between most anterior margin of mental foramen and posterior border of ramus of the mandible is [MF-PR], MF-PR is 69.61 ± 6.03 mm on the right side and is 69.17 ± 6. 0 mm on left side in dentate mandible. In edentulous type, MF-PR is 68.39 ±6.4 mm on right side and 68.81 ± 6.55 mm on left side. In the present study, the distance between symphysis menti and most anterior margin of mental foramen [MF-SM] in dentate mandible is 28.24 ± 5.09 mm on right side and is 27.45 ± 3.7 mm on left side. In edentulous mandible (MF-SM) is 28.51 ± 4.5 mm on right side and on left side is 27.99 ± 4.50 mm. Conclusion: Acquiring the knowledge and importance of anatomy of mental foramen is helpful in avoiding neurovascular complications, during regional anesthesia, peri apical surgeries, nerve repositioning and dental implant placement.

Numb chin syndrome (NCS), also known as mental neuropathy, is a sensory neuropathy characterized by numbness involving the distribution of the mental nerve and is an uncommon, but underappreciated neuropathy. The clinical importance lies in its frequent association with malignancies, particularly lymphoma and breast cancer. We report a 30-year-old patient who presented with bilateral numb chin for few days for which no cause was found. Over 3 weeks, he developed systemic symptoms and neck swelling. Investigations revealed low platelet count, raised erythrocyte sedimentation rate, alkaline phosphatase, and lactate dehydrogenase. Biopsy of the swelling and Bone marrow confirmed Burkitt′s lymphoma. Imaging studies confirmed intracranial and hepatic metastasis. Within few days of initiation of therapy, patient succumbed to the disease. Here, we would like to emphasize that all clinicians should be aware of this entity and investigate thoroughly to rule out underlying malignancies as delay in diagnosis leads to the adverse outcome.