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Anatomy was initially developed out of necessity to decrease surgery complications. Over time, anatomists and surgeons have sometimes used different terms for the same anatomical structures, thus resulting in numerous discrepancies in terminology between anatomy and surgery. To avoid any confusion or misunderstanding and to better elucidate the oral anatomy terms, the Federative International Programme for Anatomical Terminology (FIPAT) organized a group of specialists on oral anatomy, Terminologia Oroanatomica (ToA) working group, composed of dentists, anatomy researchers, anatomy educators, oral and maxillofacial surgeons, and oral and maxillofacial radiologists. Within the ToA working group, major anatomical structures in the mandible, such as the mandibular canal, were focused and discussed to determine the most appropriate term, i.e., inferior alveolar canal. Although yet to be approved by the International Federation of Associations of Anatomists (IFAA), this article will preview some changes suggested by the ToA. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to delineate the safety zone concerning the anteriorization of the AL and correlate it with the behavior of the AL, analyzing its feasibility. Methods: Adhering to the Joanna Briggs Institute (JBI) manual guidelines, both the protocol and this review were conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. MeSH terms, combined with free terms, were utilized to search for articles in the following databases: Embase, LILACS, LIVIVO, PubMed/MEDLINE, Scopus, Web of Science, and grey literature. Results: Fifteen articles were select following the eligibility criteria. An average safe zone of 4.75 mm in humans was observed, with a prevalence 60.8% and average anterior length of the AL of 2.09 mm in humans. Conclusion: The AL has varied patterns across different populations, then, it could not be asserted a 100% safe zone. Preoperative analysis of the AL with CBCT is always necessary. While it could be stated that a safe zone should be employed as an inviolable region, stipulated measures of a safe zone should be regarded as an area of greater attention in preoperative planning. [ABSTRACT FROM AUTHOR]

Mental nerve paresthesia is a serious postoperative complication of mandibular third molar extraction. It appears that no study has examined the relationship between the surface morphology of the mandibular third molar roots and the possibility of mental nerve paresthesia following tooth extraction. Therefore, the root morphology of the mandibular third molars was examined according to age using dental cone beam computed tomography (CBCT), and the possibility of mental nerve paresthesia following tooth extraction was evaluated. The study included 1216 patients who had undergone mandibular third molar extractions. The root morphology of 1534 teeth in 791 patients who had CBCT performed before surgery was studied. Factors evaluated were age, complete or incomplete formation of the mandibular third molar roots, periodontal ligament atrophy of the mandibular third molar roots, hypercementosis, and mandibular canal deformation. Mandibular third molar root formation was completed between the ages of 19 and 30 years. Complete formation of the mandibular third molar roots (P = 0.002) and deformation of the mandibular canal (P < 0.001) were identified as risk factors for mental nerve paresthesia. These findings suggest that the risk of mental nerve paresthesia could be reduced if the extraction of third molars is performed prior to complete root formation. [ABSTRACT FROM AUTHOR]

Purpose: Little information is known about the mentalis nerve course from the lower lip approximation margin (free margin) to the upper lip. Likewise, no difference in nerve distribution has been observed between the cutaneous and mucosal parts of the lip. Therefore, this study reexamined mentalis nerve morphology. Methods: For macroscopic observations, three fresh cadavers were dissected (one male and two females; aged 78–93). We also evaluated histological sections obtained from five donated elderly cadavers (two males and three females, aged 82–96 years) and 15 human fetuses (11–40 weeks or crown–rump length 80–372 mm). Immunohistochemical analysis for S100 protein and tyrosine hydroxylase was performed. Results: In both fetuses and adult cadavers, one to three nerve branches ran upward in the submucosal tissue from the mental foramen. Near the free margin of the lip, some branches passed through the orbicularis oris muscle layer toward the lip skin, whereas others followed a reversed J-shaped course along the free margin. Nerve twigs ran in parallel beneath the mucosa, whereas wavy nerve twigs attached to the basal lamina of the lip epidermis. The difference in nerve endings abruptly occurred at the skin–mucosal junction. Tyrosine hydroxylase-positive sympathetic nerve twigs surrounded arteries and formed a branch composed of S100-negative unmyelinated fibers. Conclusion: The lower lip skin was innervated by a perforating branch passing through the orbicularis oris muscle, that was different from the lip mucosa. A sudden change in the nerve ending configuration at the mucocutaneous junction seemed to develop postnatally. [ABSTRACT FROM AUTHOR]

Aim: The mental nerve, the extended part of the inferior alveolar nerve, is often injured during dentoalveolar, orthognathic, or tumor surgery. Numerous therapeutic interventions, including surgery and pharmacotherapy, have been used to enhance the recovery of nerve injuries. Dental pulp stem cells (DPSCs) represent an easily accessible source of adult stem cells that can be isolated from the pulp of extracted teeth. This study evaluated the effect of DPSCs on the regeneration of the mental nerve injury model of rabbits. Methods: In this presented study, DPSCs were cultured and cell characterizations were performed by using flow cytometry and immunostainings. Bilateral mental nerve injury models of rabbits were created. In the control group (n = 10), saline was applied, and in the study group (n = 10), 2 × 106 DPSCs were applied to the repaired nerve areas. After 3 weeks, animals were killed and histological examination was obtained by using Masson's trichrome staining. An unpaired Student's t test was used when comparing the groups. Differences were considered to be statistically significant at P values of less than 0.05. Results: The DPSCs demonstrated a homogeneous population of mesenchymal stromal cells which expressed cluster of differentiation CD44, CD73, CD90, and CD105 and lack of CD34, CD45, and HLA-DR. Our finding clearly demonstrated that a lower number of cross-sectioned axons were founded in the control group (60.18 ± 2.52) compared to the study group (72.96 ± 2.43) (p = 0.00). Conclusions: DPSCs promote mental nerve axonal regeneration. These results suggest that DPSCs provide an important accessible source of adult stem cells for mental nerve regeneration. [ABSTRACT FROM AUTHOR]

Objective: We developed a novel method for thyroidectomy using a single‐incision oral vestibular approach. To assess its advantages and disadvantages, we compared the perioperative parameters of this approach with those of transoral three‐incision thyroidectomy and trans‐areolar thyroidectomy. Methods: In a study of 136 papillary thyroid carcinoma patients (2016–2018), precise thyroidectomy and neck dissection were conducted. Among them, 52 chose single‐incision oral vestibular approach, 33 chose three‐incision variant, and 51 underwent trans‐areolar thyroidectomy. Perioperative aspects of the transoral single‐incision group were compared with those of transoral three‐incision group, and transthoracic group. Results: In the cohort, meticulous tumor level VI lymph node dissection was performed, achieving intended resection extent with one case requiring a switch from transoral to transthoracic approach. No nerve palsy occurred in the transoral group. Thyroidectomy duration varied significantly across groups. Transoral single‐incision had a shorter duration than transoral three‐incision and longer than transthoracic. Minor differences were observed in blood loss and drainage. Perioperative factors like hematoma, infection, hypocalcemia, et al., remained consistent. Notably, no tumor recurrence was observed in this study. Conclusions: This new transoral video‐assisted neck surgery (TOVANS) method for thyroidectomy without gas insufflation approach did not increase the surgical complexity compared with the transoral vestibular three‐incision thyroidectomy and the trans‐areolar thyroidectomy. Level of Evidence: 3 Laryngoscope, 134:2976–2984, 2024 [ABSTRACT FROM AUTHOR]

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: This study aimed to analyse the 3D patterns of the mandibular and mental canals (MDC and MC) referring to the surrounding prominent surgical landmarks such as teeth and mental foramen by cone beam computed tomography (CBCT). Methods: CBCT scans of 354 patients aged 18–67 years with mandibular first premolar to second molar were included and reconstructed 3‐dimensionally (3D) by mimics. The parameters of MDC and MC were measured referring to teeth and mental foramen. Results: From the first premolars to the second molars, the mandibular canals showed a trend of gradually closer to the cementoenamel junction (CEJ) of the adjacent teeth and farther away from the buccal cortical plate. The distance of the MDC with the root apexes (RA) was relatively constant from the first premolar to the first molar, but became much closer to the second molar. About 10.8% of the second molars had MDC‐RA distances of shorter than 2 mm, and 1.34% even had the MDC superior to the RA. Moreover, the Type III of MC presented in 66.0% of the subjects and had a relatively longer length. Besides, the existence of Type I MC may be related to the MDC featuring with close distances to the RA and CEJ of the adjacent teeth. Conclusion: Dentists and surgeons should know the patterns of mandibular and mental canals. A better understanding of the MDC and MC and their relationship to local anatomical landmarks may facilitate the planning of surgeries and alert potential nerve injuries in the operative procedures. [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]

Paresthesia is a potential consequence of unsuccessful root canal treatment. Persistent infection resulting in apical periodontitis may enlarge sufficiently to involve the mental neurovascular bundle. The case presented in this report was referred for endodontic evaluation with a chief complaint of discomfort on mastication and persistent numbness of the lower left lip. Clinical and radiographic evaluation revealed incomplete primary endodontic treatment of the left mandibular second premolar with complex internal anatomy. The untreated root canal system resulted in the progression of apical periodontitis involving the left mental neurovascular bundle as confirmed by cone-beam computed tomography imaging. Nonsurgical root canal retreatment was performed over 2 visits. At the 3-year follow-up visit, the paresthesia had resolved with return of normal sensation. Nonsurgical endodontic retreatment may be sufficient to allow healing of large periapical lesions and resolve complications including paresthesia without the need for surgical intervention. [ABSTRACT FROM AUTHOR]

Injuries to the mental nerve are not an uncommon complication in maxillofacial surgeries. Manipulation close to the mental nerve poses a great risk of nerve injury from drills, bone cutting and trimming burs, and oscillating/reciprocating saws. Nerve injuries can be painful and affect the patient's quality of life. The accompanying complication of the nerve injury depends on the severity of the damage inflicted and can range from transient hypoesthesia to neuropathic pain or trigeminal neuralgia. It is considered that direct injury to the nerve may lead to permanent damage and more severe postoperative clinical symptoms than indirect injuries caused by nerve stretching or during endosteal implant fixation. This technical note describes a technique for shielding the mental nerve and protecting it from rotary drill injury during mandibular inferior border recontouring, orthognathic surgeries, and mandibular body fracture fixation. [ABSTRACT FROM AUTHOR]

Copyright of Agri: Journal of the Turkish Society of Algology / Türk Algoloji (Ağrı) Derneği'nin Yayın Organıdır is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Copyright of Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopadie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Objectives: This systematic review aimed to identify the studies that performed cone-beam computed tomography analysis of the prevalence and length of the anterior loop (AL) and caudal loop (CL) of the mental nerve. Materials and methods: An electronic database search was performed across PubMed, EMBASE, Web of Science, Scopus, the Cochrane library, and Google Scholar. Original studies reporting the frequency and length of the AL and CL were selected. Qualitative synthesis and meta-analysis were then conducted to assess the prevalence and length of the AL and CL and their associations with age, gender, sides, and dentition status. Results: A total of 21 studies were included in this review. The pooled prevalence of the AL (95% confidence interval) of the mental nerve at the patient and side level was 51% (31–71%) and 53% (37–69%) while the mean anterior loop length was 2.08 (1.46–2.70) mm. The pooled prevalence of the CL and mean caudal loop length were 100% and 4.73 (3.44–6.01) mm. No significant associations were found between the prevalence and length of the AL and CL and age, gender, sides, and dentition status. Conclusions: Overall, the pooled prevalence and mean length of AL of the mental nerve varied among different populations while CL seems to be a constant anatomical landmark with a longer CL than AL. Clinical relevance: Surgeons performing inter-foraminal oral surgeries like dental implant placement and genioplasty should be aware of the possible distance of the AL and CL to avoid iatrogenic mental nerve injury. [ABSTRACT FROM AUTHOR]

Purpose: Evaluating the effect of ABS (Ankaferd Blood Stopper®), Tranexamic Acid (Transamin®) and Thrombin-Containing Hemostatic Matrix (Floseal®) on the mental nerve of rats by using histopathologic and immunohistochemical analyses. Materials and methods: 40 Wistar Albino rats were used. Rats were randomly selected into 4 groups as Control (G1), ABS (G2), Tranexamic Acid (G3) and Thrombin-Containing Hemostatic Matrix (G4). In the control group G1, the left mental nerve was exposed and 0.3 ml of sterile saline was applied for 5 min, then closed with suture. In the other three groups, the left mental nerve was exposed and 0.3 ml ABS, Tranexamic Acid and Floseal was applied to groups, respectively. After 5 min, wounds were closed with suture. Immunohistochemical and histopathologic examinations were performed on mental nerves after 28 days. Results: The total histopathologic and immunohistochemical semiquantitative scores were significantly higher in ABS (G2) compared to Control (G1), Tranexamic Acid (G3) and Thrombin-Containing Hemostatic Matrix (G4) (P < 0.05). Myelin thickness were significantly lower in G2 compared to G1, G2 and G3 (P < 0.05). G3 has the most reliable results compared to G2 and G4 (P < 0.05). Conclusion: The study results suggest that ABS has neurotoxic effects and should not be used close to the nerve, and thrombin-containing hemostatic matrix should be used carefully. Tranexamic acid, on the other hand, was found to be the most reliable hemostatic agent for use in close proximity to neural tissues. Further studies are required to determine the efficacy of the hemostatic agents on peripheral nerve degeneration. [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: 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, 60 bones were studied in 2 years duration. The study was carried out in the Department of Anatomy Tertiary Care Teaching Hospital over a period of 1 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: The present study showed that the position of mental foramen from symphysis menti and posterior border of ramus of mandible was more from right side than left side and found to be insignificant while position of mental foramen from inferior border of body of mandible was more from left side than right side and found to be insignificant for right side while significant for left side. The shape of mental foramen from right side was found to be (Oval shape-68.33% and round shape - 31.66%) while for left side was found to be (Oval shape-71.66% and round shape - 28.33%). 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]

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.

Lower lip hypoesthesia is the most common complication following osseous genioplasty. Concentrated growth factor (CGF) has recently been shown to improve neural regeneration. The aim of this study was to evaluate the effect of concentrated growth factor on neurosensory recovery after osseous genioplasty. Patients who underwent osseous genioplasty between June 2017 and February 2020 were enrolled. CGF was applied to the mental nerve on one side. The treatment side was randomized, and the other side was considered as the control. Lower lip hypoesthesia was assessed preoperatively and postoperatively (1 week, 1, 3, 6, and 9 months) using the two-point discrimination test and a 10-point visual analogue scale (self-reported paresthesia). The assessor was blinded. Twenty-six female patients completed the study. At 1 and 3 months, both the mean two-point discrimination value and mean visual analogue scale score were significantly lower in the CGF group than in the control group (P < 0.001). At 3 months, the percentage of patients with lower lip hypoesthesia in the CGF group was significantly lower than that in the control group (P < 0.001). Both groups showed resolution of lower lip hypoesthesia at 6 months. Concentrated growth factor may accelerate the recovery of long-standing sensory nerve impairment following mental osteotomy. [ABSTRACT FROM AUTHOR]

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.

This prospective study aimed to evaluate neurosensory disturbance and quality of life in patients who underwent mandibular resection for benign tumors and whose inferior alveolar nerve (IAN) was either preserved or sacrificed. Mandibular resection was indicated owing to the presence of osteoradionecrosis in 25 patients and ameloblastoma in 15 patients. Resection was unilateral in 24 patients and bilateral in 16 patients. The authors assessed the inferior alveolar nerve's sensory dysfunction by measuring the electroexcitability of skin receptors using an electro-odontometer. Study participants' quality of life was estimated with the oral health impact profile (OHIP)-14 and short-form (SF)-36 questionnaire. All the patients in whom the inferior alveolar nerve was sacrificed experienced persistent numbness in the area of innervation with mental nerve on the affected side. The average pain threshold reached preoperative levels (point 1–22.7 ± 2.5, p-value =.025; point 2–25.8 ± 2.7, p-value =.023) 6 months after the operation in patients in whom the IAN was preserved (point 1–23.7 ± 2.3, p-value =.022; point 2–25.4 ± 2.8, p-value =.025). The results of the OHIP-14 and SF-36 showed that patients with preserved IANs had a significantly better quality of life than the patients in whom the IAN was sacrificed. The results of OHIP-14 twelve months after the operation in unilateral resection: control group - 16.0 ± 1.6, p-value =.029; study group - 8.0 ± 0.8, p-value =.029, and in bilateral resection: control group - 26.0 ± 3.2, p-value =.044; study group - 9.0 ± 0.7, p-value =.027. The possibility of sparing the inferior alveolar nerve should not be ignored when planning mandibular resection and reconstruction. [ABSTRACT FROM AUTHOR]

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.

Objective: This study was designed to provide important clinical signs for tracking nerves in the mandible during regional anesthesia in Gurcu goats. Materials and methods: The study was conducted on the mandible bones of ten adult Gurcu goats of both sex (five male and five female). The mandible bone samples of naturally dead Gurcu goat were collected from Kafkas University veterinary faculty education, research, and application farm and processed as per the standard maceration technique. Altogether, 16 measurements were taken in the mandible bones of Gurcu goats by using a digital caliper and the results were expressed as mean and standard deviation. Results: The obtained parameters from the present study can be useful for an extraoral and intraoral approach for nerve block of mental and mandibular nerve in the mandibular regions of Gurcu goat. According to results the mandibular length and height were 158.86±10.37 mm, 89.38±5.81 mm, in females and 198.93±3.85 mm, 114.5±7.29 mm, in males of Gurcu goats, respectively. The distance between the first inferior incisor tooth and mental foramen and to the first premolar tooth was 19.72±2.3, 19.26±0.44 mm in females, and 29.41±6.10, 21.83±1.02 mm, in males, respectively. The present study revealed that all the obtained parameters related to regional anesthesia showed a significant statistical difference (p<0.01**) between the males and females of Gurcu goat. Conclusion: It can be concluded from the present study that the various applied parameters of the present study are thought to assist clinicians in the administration of regional anesthesia in the lower jaw area (mandibular region) of the Gurcu goat. [ABSTRACT FROM AUTHOR]

Abstract Introduction Methods Results Conclusions Mental nerve stimulation is recognised as a treatment option for neuropathic facial pain. Historically however, lead migration across the mobile temporomandibular joint has prevented this procedures utility.We describe a new method of insertion and anchoring of a mental nerve stimulator for the management of refractory neuropathic pain in the distribution of the mental nerve. We anchored the stimulator lead to the mandibular body.Significant analgesic effect was achieved and no lead migration had occurred at 1 year post-operatively.This report describes in detail the procedure of mental nerve stimulator insertion, with a novel technique of mandibular anchoring of the lead. [ABSTRACT FROM AUTHOR]

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.

Endodontic microsurgery encompasses the use of microscopy, specialized instruments, and advanced imaging with cone-beam computed tomographic (CBCT) imaging. This treatment modality results in high clinical success rates and facilitates the enucleation of osteolytic lesions, the resection of apical root canal complexities harboring persistent bacterial biofilms, and the evaluation of possible root defects and fractures. However, there is the risk of injury to important anatomic structures, particularly when treating posterior teeth. Neurovascular bundles are among these structures at risk for injury. Fortunately, high-resolution CBCT scans can be used to detect these structures that are known to have a high anatomic variability. In addition, CBCT information can be combined with high-resolution intraoral scans to plan, design, and fabricate surgical guides to be used in a targeted endodontic microsurgery (TEMS) approach. We report 3 cases with previous endodontic treatment having persistent apical periodontitis that were treated with TEMS to avoid damage to the neurovascular bundles at risk of injury. In the first case, the palatal root of tooth #14 was adjacent to the greater palatine artery. In the second case, the mental nerve exited through 2 separate foramina close to the predictive osteotomy site for the mesial root of tooth #19. In the third case, the posterior superior alveolar artery was in close proximity to the mesiobuccal root of tooth #14. Collectively, these cases illustrate the diagnostic value of CBCT imaging for detecting neurovascular bundles and the use of TEMS to mitigate the risk of injury to these important structures. Thus, the combination of CBCT imaging and TEMS can potentially minimize the risk of intraoperative complications and postoperative sequelae while increasing the predictability of endodontic microsurgeries in complex cases. [ABSTRACT FROM AUTHOR]

Introduction: Sensory disturbances of the inferior alveolar and mental nerves are often associated to endodontic-related causes. For their diagnosis and management, a precise history and imaging of the area are required. The aim of this article is to present two cases of successfully treated endodonticrelated mental nerve paraesthesia, in which cone beam computed tomography (CBCT) images aided the precise diagnosis and decision-making for the treatment plan. Case report: In this report, two cases of endodontic-related mental nerve paraesthesia are described. Cone beam computed tomography (CBCT) images supplemented the information obtained from the conventional radiographs and offered superior diagnostic accuracy. In both cases, a non-surgical management of the neurosensory disturbances was decided, including the non-surgical retreatment of a failed root canal treatment and monitoring of the patient in the first case and pharmaceutical coverage and monitoring in the second one. Conclusion: The use of CBCT in cases of endodontic-related neurosensory disturbances is a proven adjunct to the two-dimensional imaging, enabling a more predictable management. [ABSTRACT FROM AUTHOR]

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.)