Evaluation of Mental Foramen Position and Morphology on Panoramic Radiographs

BACKGROUND The mental foramen (MF) is a key anatomical landmark in oral and maxillofacial surgery; its accurate localization is critical for preventing neurovascular complications. This study aimed to radiologically evaluate MF position, morphology, symmetry, and interforaminal distance using panoramic radiographs, with particular emphasis on clinical relevance in surgical planning. MATERIAL AND METHODS This retrospective study included panoramic radiographs of 500 patients from the Department of Oral and Maxillofacial Surgery, Eskişehir Osmangazi University. MF position was classified into 6 categories based on relationship to adjacent teeth. Shape, symmetry, and interforaminal distance were also assessed. Statistical analyses were performed using SPSS software. RESULTS The most common MF position was at the level of the second premolar (position 4, 50.9%), followed by the area between the first and second premolars (position 3, 38.9%). A round shape was the most frequently observed morphology (40%), followed by irregular (34%) and oval (26%) forms. The MF was asymmetrically located in most cases (80.2%). The mean interforaminal distance was 51.95±7.08 mm. No statistically significant differences were observed among age groups (P=0.308); men exhibited significantly greater interforaminal distances than women (P<0.001). CONCLUSIONS Panoramic radiography is susceptible to positioning errors, magnification, and superposition artifacts; careful image acquisition and interpretation are thus essential for accurate evaluation of the MF. Although panoramic radiography can provide useful preliminary information, advanced imaging modalities may be required in complex cases. These findings may assist clinicians in improving surgical safety and reducing mental nerve injury risk during dental procedures.