Differences in Distance between Mandibular Premolars Root Apices and the Mental Foramen by CBCT Imaging according to Sex in Patients Referred to Dental School of Ahvaz Jundishapur University of Medical Science in 2020-2021

Document Type : Original Article


1 Assistant Professor Department of Endodontics, Dental School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 Assistant Professor Department of Oral and Maxillofacial Radiology, Dental School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

3 Dentistry Student, Dental School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.



Background and Objectives Knowing the location of mental foramen during common dental procedures such as local anesthesia, periapical and endodontic surgeries, extraction of impacted teeth and enucleation of cysts and tumors is important. Due to the limitations of available information about this anatomical structure, the aim of this study was to evaluate the relationship between root of mandibular premolar teeth and mental foramen. Subjects and Methods In this retrospective study, CBCT images of 94 patients (47 men and 47 women) who referred to the radiologic department of Ahvaz Jundishapur Dental School in 2020-2021 were recorded and evaluated. Finally, the data were analyzed to evaluate the difference in distance between mandibular premolar teeth root apex and the mental foramen in men and women, using SPSS software version 24 and t- test. Results There was no statistically significant difference for any of the roots of the second right mandibular premolar, first and second left mandibular premolars regarding the distance between the root apex and the mental foramen in men and women. But this distance in the root of the first right mandibular premolar was significantly greater in men than women (p = 0.008). Conclusion This study showed that except for the root of the first right mandibular premolar, there is no significant difference in the distance between the apex of the mandibular premolars to the mental foramen between men and women.


Parnian Alavinezhad [PumMed] [Google Scholar]

 Mohammad Amin Kavoosi [PumMed] [Google Scholar]

Mina Beitsayah [PumMed] [Google Scholar]


[1] Renton T, Yilmaz Z. Profiling of patients presenting with posttraumatic neuropathy of the trigeminal nerve. Journal of orofacial pain. 2011 Sep 1;25(4):333. [PMID]
[2] Caissie R, Goulet J, Fortin M, Morielli D. Iatrogenic paresthesia in the third division of the trigeminal nerve: 12 years of clinical experience. J Can Dent Assoc. 2005 Mar 1;71(3):185-90. [PMID]
[3] Renton T. Prevention of iatrogenic inferior alveolar nerve injuries in relation to dental procedures. Dental update. 2010 Jul 2;37(6):350-63. [10.12968/denu.2010.37.6.350 ] [PMID]
[4] Greenstein G, Tarnow D. The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review. Journal of periodontology. 2006 Dec;77(12):1933-43. [10.1902/jop.2006.060197 ] [PMID]
[5] Guo JL, Su L, Zhao JL, Yang L, Lv DL, Li YQ, Cheng FB. Location of mental foramen based on soft-and hard-tissue landmarks in a Chinese population. Journal of Craniofacial Surgery. 2009 Nov 1;20(6):2235-7. [10.1097/SCS.0b013e3181bf85f4 ] [PMID]
[6] Haghanifar S, Rokouei M. Radiographic evaluation of the mental foramen in a selected Iranian population. Indian Journal of dental research. 2009 Apr 1;20(2):150-2. [10.4103/ 0970-9290.52886 ] [PMID]
[7] Ilayperuma I, Nanayakkara G, Palahepitiya N. Morphometric analysis of the mental foramen in adult Sri Lankan mandibles. Int J Morphol. 2009 Dec 1;27(4):1019-24. [Link]
[8] Singh R, Srivastav AK. Study of position, shape, size and incidence of mental foramen and accessory mental foramen in Indian adult human skulls. Int J Morphol. 2010 Dec;28(4):1141-6. [Link]
[9] Guedes O, Rabelo LE, Porto OC, Alencar AH, Estrela C. Avaliação radiográfica da posição e forma do forame mentual em uma subpopulação Brasileira. Revista Odontológica do Brasil Central. 2011 Sep 1;20(53). [Link]
[10] .Sankar DK, Bhanu SP, Susan PJ. Morphometrical and morphological study of mental foramen in dry dentulous mandibles of South Andhra population of India. Indian Journal of Dental Research. 2011 Jul 1;22(4):542-6. [10.4103/0970-9290.90290 ] [PMID]
[11] Koppe T. Summary of: A comparative anthropometric study of the position of the mental foramen in three populations. British Dental Journal. 2012 Feb 25;212(4):188-9. [10.1038/ sj.bdj.2012.160 ] [PMID]
[12] Pyun JH, Lim YJ, Kim MJ, Ahn SJ, Kim J. Position of the mental foramen on panoramic radiographs and its relation to the horizontal course of the mandibular canal: a computed tomographic analysis. Clinical oral implants research. 2013 Aug;24(8):890-5. [10.1111/j.1600-0501.2011.02400.x ] [PMID]
[13] Nehammer C, Chong BS, Rattan R. Endodontics. Clinical Risk. 2004 Mar 1;10(2):45-8. [Link]
[14] Bjørndal L, Reit C. Endodontic malpractice claims in Denmark 1995–2004. International endodontic journal. 2008 Dec;41(12):1059-65. [10.1111/j.1365-2591.2008.01455.x ] [PMID]
[15] Givol N, Rosen E, Taicher S, Tsesis I. Risk management in endodontics. Journal of endodontics. 2010 Jun 1;36(6):982-4. [10.1016/j.joen.2010.03.030 ] [PMID]
[16] Givol N, Rosen E, Bjørndal L, Taschieri S, Ofec R, Tsesis I. Medico-legal aspects of altered sensation following endodontic treatment: a retrospective case series. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2011 Jul 1;112(1):126-31. [10.1016/j.tripleo. 2011.01.007 ] [PMID]
[17] Ahonen M, Tjäderhane L. Endodontic-related paresthesia: a case report and literature review. Journal of endodontics. 2011 Oct 1;37(10):1460-4. [10.1016/j.joen.2011.06.016 ] [PMID]
[18] Gambarini G, Plotino G, Grande NM, Testarelli L, Prencipe M, Messineo D, Fratini L, D’ambrosio F. Differential diagnosis of endodonticā€related inferior alveolar nerve paraesthesia with cone beam computed tomography: a case report. International endodontic journal. 2011 Feb;44(2):176-81. [10.1111/j.1365-2591.2010.01816.x ] [PMID]
[19] Renton T. Minimising and managing nerve injuries in dental surgical procedures. Faculty Dental Journal. 2011 Oct;2(4):164-71. [10.1038/sj.bdj.2013.993 ] [PMID]
[20] .Chong BS, Quinn A, Pawar RR, Makdissi J, Sidhu SK. The anatomical relationship between the roots of mandibular second molars and the inferior alveolar nerve. International endodontic journal. 2015 Jun;48(6):549-55. [10.1111/iej. 12348 ] [PMID]
[21] Gluskin AH. Mishaps and serious complications in endodontic obturation. Endodontic topics. 2005 Nov;12(1):52-70. [Link]
[22] Council GD. Standards for the dental team. London: GDC. 2013 Sep. [Link]
[23] Aminoshariae A, Su A, Kulild JC. Determination of the location of the mental foramen: a critical review. Journal of endodontics. 2014 Apr 1;40(4):471-5. [10.1016/j.joen.2013. 12.009 ] [PMID]
[24] Patel S, Dawood A, Whaites E, Pitt Ford T. New dimensions in endodontic imaging: part 1. Conventional and alternative radiographic systems. International endodontic journal. 2009 Jun;42(6):447-62. [10.1111/j.1365-2591.2008.01530.x ] [PMID]
[25] Currie CC, Meechan JG, Whitworth JM, Carr A, Corbett IP. Determination of the mental foramen position in dental radiographs in 18–30 year olds. Dentomaxillofacial Radiology. 2016 Jan;45(1):20150195. [10.1259/dmfr.20150195 ] [PMID]
[26] Ludlow JB, Laster WS, See M, Bailey LT, Hershey HG. Accuracy of measurements of mandibular anatomy in cone beam computed tomography images. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2007 Apr 1;103(4):534-42. [10.1016/j.tripleo.2006.04.008 ] [PMID]
[27] Chong BS, Gohil K, Pawar R, Makdissi J. Anatomical relationship between mental foramen, mandibular teeth and risk of nerve injury with endodontic treatment. Clinical oral investigations. 2017 Jan;21:381-7 [10.1007/s00784-016-1801-8 ] [PMID]
[28] Dos Santos Oliveira R, Rodrigues Coutinho M, Kühl Panzarella F. Morphometric analysis of the mental foramen using cone-beam computed tomography. International journal of dentistry. 2018 Mar 26;2018. [10.1155/2018/4571895 ] [PMID]
[29] SHadmehr E, Doosti P, Hekmatian E, Hasheminia SM. Evaluation of the distance between the Root Apices of Mandibular First and Second Premolars and First Molars and the Mental Foramen using Conebeam Computed Tomography. [Link]
Alavinezhad P, et al. Mandibular Premolars Roots to Mental Foramen in Male and Female CBCT Images. JSMJ. 2024; 22(4):412-424
Journal of Medical Sciences
September & October 2024. Vol 22. No 4
[30] Kabak SL, Zhuravleva NV, Melnichenko YM, Alex N. Topography of mental foramen in a selected Belarusian population according to cone beam computed tomography. Imaging in Medicine. 2017;9(3):49-58. [Link]
[31] Sheth K, Banga KS, Pawar AM, Gutmann JL, Kim HC. Shape and anatomical relationship of the mental foramen to the mandibular premolars in an Indian sub-population: a retrospective CBCT analysis. Restorative Dentistry & Endodontics. 2022 Feb;47(1). [10.5395/rde.2022.47.e1 ] [PMID]
[32] Adiguzel O, Cangul S, Adiguzel A, Erpacal B, Akkus Z. The proximity of mental foramen to mandibular first premolar teeth: Cone beam computed tomography analysis in Turkish population. Balkan Journal of Dental Medicine. 2021;25(1):29-33. [Link]
[33] Aldosimani MA, Aljarbou FA, Althumairy RI, Alhezam AA, Aldawsari AI. Analysis of mandibular premolar root position in relation to adjacent cortical plates and mental foramen using cone beam computed tomography in the Saudi population. Saudi Medical Journal. 2019 Mar;40(3):298. [10.15537/smj. 2019.3.23597] [PMID]
[34] Zhang L, Zheng Q, Zhou X, Lu Y, Huang D. Anatomic relationship between Mental Foramen and Peripheral Structures observed by one-Beam Computed Tomography. Anat Physiol. 2015; 5(182):2161-0940. [Link]