Clinical Implications of the Localization and Morphological Variability of the Mental Foramen-A Systematic Review

Background: The mental foramen is a key anatomical structure of the mandible through which the mental nerve and accompanying vessels emerge. Accurate knowledge of its location and morphology is essential for safe dental and surgical procedures in the anterior mandible. Objective: This study was conducted as a systematic review to summarize current evidence on the morphology, localization, and anatomical variants of the mental foramen and their clinical relevance. Methods: The PubMed and Google Scholar databases were searched for studies published between 2015 and 2025 in accordance with current systematic review guidelines. Cone-beam computed tomography (CBCT) studies and anthropological investigations assessing the position, dimensions, and anatomical variants of the mental foramen were included. Results: Thirty-five studies (30 CBCT-based and 5 anthropological) comprising a total of 6240 mandibles or patients were analyzed qualitatively. Considerable variability was observed in the horizontal and vertical position of the mental foramen in relation to mandibular borders and dental landmarks. Anatomical variations included differences in size and shape, the presence of unilateral or bilateral accessory mental foramina, and rare cases of unilateral or bilateral absence of the foramen. Conclusions: The synthesis of recent CBCT and anthropological data across diverse populations highlights clinically relevant patterns of variability. This study identifies key positional patterns and variants of the mental foramen, which can inform clinical planning and help reduce the risk of mental nerve injury.