Age influence in the location of the mental and mandibular foramen in children: A cone-beam computed tomography-based...

Growth and remodeling of the mandible during childhood results in dynamic changes in the position of key anatomical landmarks. Accurate localization of the mandibular foramen and mental foramen is essential for the successful administration of mandibular anesthesia and to minimize complications during oral and maxillofacial surgical procedures.

This cross-sectional study included 120 patients aged 3-18 years who underwent cone-beam computed tomography (CBCT) for diagnostic purposes. Subjects were divided into three age groups: Group I (3-6 years), Group II (7-12 years), and Group III (13-18 years), with 40 subjects in each group. CBCT images were analyzed to determine the position of the mandibular foramen relative to the occlusal plane, and the vertical and horizontal location of the mental foramen. Variations in the mandibular canal (MC), including bifid canals, were also assessed. Descriptive statistics (mean, standard deviation, and percentages) were calculated. The Chi-square test was used to assess the association between age groups and the position of the mandibular foramen. One-way analysis of variance was applied to compare the continuous variables such as the vertical distance of the mental foramen across age groups. P < 0.05 was considered statistically significant.

The mandibular foramen was predominantly located below the occlusal plane in younger age groups and progressively shifted above the occlusal plane in older age groups, with a statistically significant association ( P < 0.001). The mean vertical distance of the mental foramen increased from 10.76 mm in Group I to 11.59 mm in Group III. A posterior shift in the horizontal position of the mental foramen was observed, from the region of the first premolar in younger subjects to the second premolar region in older subjects. Bifid MCs were identified in 21.66% of cases, most frequently in the 7-12 years age group. No statistically significant differences were observed with respect to gender or side ( P > 0.05).

The position of the mandibular foramen and mental foramen demonstrates significant age-related variation in the pediatric population. The mandibular foramen shows a progressive superior shift relative to the occlusal plane, while the mental foramen exhibits both vertical and posterior positional changes with growth. CBCT serves as a reliable imaging modality for accurate three-dimensional localization of these anatomical landmarks. These findings highlight the importance of age-specific considerations in anesthetic and surgical procedures, particularly in improving the success of inferior alveolar nerve block in children.