CC BY-NC-ND 4.0 · Dental Journal of Advance Studies 2022; 10(03): 138-144
DOI: 10.1055/s-0042-1753491
Original Article

Estimating the Prevalence and Variation in Anterior Loop of Inferior Alveolar Nerve with Cone-Beam Computed Tomography in North Indian Population: An In Vivo Study

Ruchi Sharma
1   Department of Prosthodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
Tarun Kalra
1   Department of Prosthodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
Manjit Kumar
1   Department of Prosthodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
Ajay Bansal
1   Department of Prosthodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
Aaina Dhanda
1   Department of Prosthodontics, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India
› Author Affiliations


Purpose The present in vivo study aimed to estimate the prevalence and variation in anterior loop of inferior alveolar nerve (IAN) in relation to mental foramen to assess the safe zone in anterior part of mandible for implant placement with cone-beam computed tomography (CBCT) in North Indian population.

Materials and Methodology To conduct this study, 70 patients were selected and radiographically evaluated. All CBCT scans were made from Genoray Papaya 3D Plus. CBCTs were evaluated in CDSee software for anterior loop and height measurement anterior to mental foramen. Four parameters of prevalence of loop length and height anterior to mental foramen on right and left side each and four parameters of variation in loop length and height on right and left side each were recorded with the help of descriptive statistical analyses (mean, median, mode, and range) and paired t-test. Level of significance (p) was also calculated.

Result Paired t-test value for comparison on both the right and left sides for loop length of IAN anterior to mental foramen was 0.140 and paired t-test value for loop height was 0.384. The p-values for loop length and height were 0.8891 and 0.7019, respectively.

Conclusion Within the limitation of the study, it was observed that the anterior loop has a wide range of prevalence and variation in terms of loop length and loop height suggesting that it is difficult to get a defined measurement of loop length for a given population and surgical procedures cannot be performed based on the given data for IAN loop anatomy.

Publication History

Article published online:
16 November 2022

© 2022. Bhojia Dental College and Hospital affiliated to Himachal Pradesh University. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Alhassani AA, AlGhamdi AS. Inferior alveolar nerve injury in implant dentistry: diagnosis, causes, prevention, and management. J Oral Implantol 2010; 36 (05) 401-407
  • 2 Dario LJ. Implant placement above a bifurcated mandibular canal: a case report. Implant Dent 2002; 11 (03) 258-261
  • 3 Jalbout Z, Tabourian G. Glossary of Implant Dentistry. Upper Montclair, NJ: International Congress of Oral Implantologists; 2004: 16
  • 4 do Nascimento EH, Dos Anjos Pontual ML, Dos Anjos Pontual A. et al. Assessment of the anterior loop of the mandibular canal: a study using cone-beam computed tomography. Imaging Sci Dent 2016; 46 (02) 69-75
  • 5 Mardinger O, Chaushu G, Arensburg B, Taicher S, Kaffe I. Anterior loop of the mental canal: an anatomical-radiologic study. Implant Dent 2000; 9 (02) 120-125
  • 6 Al-Juboori. Yuen KY, Hua CM. et al. Inferior alveolar nerve location to determine zone of safety for dental implant placement among Malaysian population. J Dent Orofac Surg 2016;1(02): Article 32000108.
  • 7 Kieser J, Kuzmanovic D, Payne A, Dennison J, Herbison P. Patterns of emergence of the human mental nerve. Arch Oral Biol 2002; Oct; 47 (10) 743-747
  • 8 Nortjé CJ, Farman AG, Grotepass FW. Variations in the normal anatomy of the inferior dental (mandibular) canal: a retrospective study of panoramic radiographs from 3612 routine dental patients. Br J Oral Surg 1977–78 15 (01) 55-63
  • 9 Uchida Y, Yamashita Y, Goto M, Hanihara T. Measurement of anterior loop length for the mandibular canal and diameter of the mandibular incisive canal to avoid nerve damage when installing endosseous implants in the interforaminal region. J Oral Maxillofac Surg 2007; 65 (09) 1772-1779
  • 10 Neiva RF, Gapski R, Wang H. Morphometric analysis of implant-related anatomy in Caucasian skulls. J Periodontol 2004; Aug; 75 (08) 1061-1067
  • 11 Apostolakis D, Brown JE. The anterior loop of the inferior alveolar nerve: prevalence, measurement of its length and a recommendation for interforaminal implant installation based on cone beam CT imaging. Clin Oral Implants Res 2012; Sep; 23 (09) 1022-1030
  • 12 Lu CI, Won J, Al-Ardah A, Santana R, Rice D, Lozada J. Assessment of the anterior loop of the mental nerve using cone beam computerized tomography scan. J Oral Implantol 2015; Dec; 41 (06) 632-639
  • 13 Santana RR, Lozada J, Kleinman A, Al-Ardah A, Herford A, Chen JW. Accuracy of cone beam computerized tomography and a three-dimensional stereolithographic model in identifying the anterior loop of the mental nerve: a study on cadavers. J Oral Implantol 2012; 38 (06) 668-676
  • 14 Al-Mahalawy H, Al-Aithan H, Al-Kari B, Al-Jandan B, Shujaat S. Determination of the position of mental foramen and frequency of anterior loop in Saudi population. A retrospective CBCT study. Saudi Dent J 2017; 29 (01) 29-35
  • 15 Juan VL, Grageda E, Gómez Crespo S. Anterior loop of the inferior alveolar nerve: averages and prevalence based on CT scans. J Prosthet Dent 2016; 115 (02) 156-160