Prevalence of Anterior Loop Assessment by Digital Panoramic Radiography

Adithya KNV¹*, Vaka Sravani² and Sannidhya John Thapa³

¹MD Medicine, Consultant Physician, Panimalar Medical College Hospital and Research Institute, India
²MDS, Oral Radiologist, Consultant at Kartik Hospital, Chennai, India
³3^rd Year MBBS Student at Panimalar Medical College Hospital and Research Institute, India

*Corresponding Author: Adithya KNV, MD Medicine, Consultant Physician, Panimalar Medical College Hospital and Research Institute, India.

Received: August 25, 2025; Published: September 18, 2025

Abstract

Anterior loop is defined as mental neurovascular bundle which crosses anterior to the mental foramen and then doubles back to exit the mental foramen and it is important to determine the placement of implants in the mandibular premolar region. This study was taken to assess the prevalence of anterior loop and emergence pattern by digital panoramic radiographs.

Materials and Methods: A total of random sample of 368 panoramic radiographs of subjects selected randomly coming for dental treatment with advised OPG of 3 different age groups were taken with using machine specifications. Intra examiner reliability was assessed by kappa‑statistics and percentages of observations were obtained to find out association of age and gender.

Results: This study includes 197 males (53.5%) and 171 females(46.5%) of age group of 20yrs to above 60 years of age. 20.9% of the subjects shown bilateral loop prevalence followed by right side(15.2%) and the most commonly observed pattern was the straight pattern of the total radiographs.

Conclusion: Anterior loop was visible in 77 (20.9%) dental panoramic radiographs bilaterally, (15.2%) right side only. Panoramic radiography is not sufficient for pre surgical implant planning in the mental region and may need to be supplemented with other modalities such as CT and CBCT for better visualization of the area.

 Keywords: Mental Nerve (MN); Mental Foramen (MF)

References

1. Arzu Demir., et al. “Anterior Loop of the Mental foramen in a Turkish Subpopulation with Dentate Patients: a Cone Beam Computed Tomography Study”. MUSBED 4 (2015): 231-238.
2. Sun-Kyoung Yu., et al. “Morphological assessment of the anterior loop of the mandibular canal in Koreans”. Anatomy and Cell Biology 48 (2015): 75-80.
3. Couto F., et al. “Accuracy in the diagnosis of the position of the mental nerve loop. A comparative study between panoramic radiography and cone beam computed tomography”. International Journal of Morphology 1 (2015): 327-332.
4. Juodzbalys G., et al. “Anatomy of Mandibular Vital Structures. Part II: Mandibular Incisive Canal, Mental Foramen and Associated Neurovascular Bundles in Relation with Dental Implantology”. Journal of Oral & Maxillofacial Research: JOMR 1 (2010): | e3 | 1-10.
5. Ngeow WC., et al. “A radiographic study on the visualization of anterior loop in dentate subjects of different age groups”. Journal of Oral Science2 (2009): 231‑237.
6. Solar P., et al. “A classification of the intraosseous paths of the mental nerve”. The International Journal of Oral & Maxillofacial Implants 9 (1994): 339‑3
7. Hu KS., et al. “Branching patterns and intraosseous course of the mental nerve”. Journal of Oral and Maxillofacial Surery 65 (2007): 2288‑22
8. Von Wowern N and Stoltze K. “Pattern of age related bone loss in mandibles”. Scandinavian Journal of Dental Research 88 (1980): 134-146.
9. Kingsmill VJ and Boyde A. “Variation in the apparent density of human mandibular bone with age and dental status”. Journal of Anatomy2 (1998): 233-244.
10. Asha R., et al. “Detection of anterior loop and other patterns of entry of mental nerve into the mental foramen: A radiographic study in panoramic images”. Journal of Dental Implantation 1 (2013): 21-25.
11. Kuzmanovic DV., et al. “Anterior loop of the mental nerve: A morphological and radiographic study”. Clinical Oral Implants Research 14 (2003): 464-71.
12. Dharmar S. “Locating the mandibular canal in panoramic radiographs”. The International Journal of Oral and Maxillofacial Implants 12 (1997): 113-117.
13. Jacobs R., et al. “Appearance, location, course, and morphology of the mandibular incisive canal: An assessment on spiral CT scan”. Dentomaxillofacial Radiology 31 (2002): 322‑32
14. Scarfe WC and Farman AG. “What is Cone-Beam CT and How Does it Work?” Dental Clinics of North America 4 (2008): 707-730.

Citation

Citation: Adithya KNV., et al. “Prevalence of Anterior Loop Assessment by Digital Panoramic Radiography”.Acta Scientific Medical Sciences 9.10 (2025): 57-62.

Copyright

Copyright: © 2025 Adithya KNV., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.