Morphometric Analysis of the Mental Foramen Using Cone-beam Computed Tomography in the Salem Population

The mental foramen (MF) is a morphological feature in the mandible through which the mental nerve and arteries pass. It is situated between the roots of the lower premolar region or apical to the second premolar. The identification and localization of the MF are essential in various dental and operative procedures, including implant placement, fracture fixation, and orthognathic surgery. Variations in its position, size, and the existence of accessory foramina can impact the course and outcome of operative interventions. The primary aim of this prospective analytical study is to analyze the morphometry of the mental foramen (MF) and the presence, location, and morphology of the accessory mental foramen (AMF) using cone-beam computed tomography (CBCT) in the Salem population. The objectives of the study include evaluation of the size, shape, and position of MF, investigating the presence of any accessory mental foramen (AMF), and determining its location. This prospective descriptive study assessed the mental foramen and the presence and location of an accessory foramen in 60 patients (30 males, 30 females; aged 20–60 years) using a Carestream CS9600 cone beam computed tomography scanner. The mean superior, inferior and mediolateral measurements of the MF were both 2.9 mm. Males exhibited significantly greater MF dimensions than females (p < 0.05). The predominant MF position was on the same plane as the 2nd premolar (P4, 56.7%), followed by between the 1st and 2nd premolars (P3, 35%). The most frequently observed MF shape was test-tube (33.3%), followed by dumbbell (20%) and flask (16.7%). AMFs were present in 31.7% of subjects, predominantly located anterior to the main MF. The vertical height from the MF to the mandibular base was significantly greater in males (p = 0.001). A negative association was observed between age and the perpendicular height from the MF to the crest of the alveolar bone. MF exhibits significant anatomical variability in size, shape, and location, often influenced by sex, underscoring the need for personalized evaluations in treatment planning. Uncommon MF shapes, such as test-tube and dumbbell forms, challenge traditional round/oval depictions, emphasising 3D CBCT imaging over conventional anatomy. In the lower premolar region, the prevalence of AMF (31.7%) was significantly higher than previously reported, confirming the diagnostic value of CBCT and the need for its routine use before invasive dental treatments in mandibular premolar areas.