INTRODUCTION: Mandibular foramen is located on the internal surface of the ramus of the mandible. Through this opening mandibular nerve and vessels enter the mandibular canal. As there are no palpable landmarks that allow determining the position of the mandibular foramen precisely, it is helpful to use radiological imaging methods for this purpose. Mainly X-ray techniques are used, especially panoramic radiograph for its accessibility and wide range of diagnostic applications.
Knowledge of the position of the mandibular foramen is essential for the correct and effective performance of the inferior alveolar nerve block, which is one of the most common anaesthesia in dental practice.

AIMS: The purpose of the study was to examine and find possible correlations between sex, age, posterior teeth loss and relative localization of the mandibular foramen.

SUBJECTS AND METHODS: Selected parameters were measured on 50 digital panoramic radiographic images of 50 patients, including 33 males and 17 females, hospitalized in the Maxillofacial Surgery Ward of the Heliodor Swiecicki Clinical Hospital in Poznan.

RESULTS: Localization of the mandibular foramen does not correlate with age, nor the posterior teeth loss and sex has only a slight impact on its vertical location.

CONCLUSIONS:
Since none of the parameters proved to be particularly useful in predicting the location of the mandibular foramen. The operator should administer inferior alveolar nerve anaesthesia in accordance with standard rules.

Mandibular foramen; panoramic radiography; anatomic variation; inferior alveolar nerve block

Bochenek A, Reicher M. Anatomia Człowieka [Human Anatomy], Wydanie V 2006 (tom I, V)

Claeys V, Wackens G: Bifid mandibular canal: literature review and case report,

Dentomaxillofacial Radiology 2005 34, 55–58

Thangavelu K, Kannan R, Senthil Kumar N, Rethish E, Sabitha S, N SayeeGanesh. Significance of localization of mandibular foramen in an inferior alveolar nerve block. J Nat Sci Biol Med. 2012 Jul-Dec; 3(2): 156–160

Okamoto Y, Takasugi Y, Furuya K, Furuya H. Inferior Alveolar Nerve Block by Injection Into the Pterygomandibular Space Anterior to the Mandibular Foramen: Radiographic Study of Local Anesthetic Spread in the Pterygomandibular Space. Anesth Prog. 2000 Winter;47(4):130-3.

AlHindi M, Rashed B, AlOtaibi N. Failure rate of inferior alveolar nerve block among dental students and interns. Saudi Med J. 2016 Jan; 37(1): 84–89

Khoury JN, Mihailidis S, Ghabriel M, Townsend G. Applied anatomy of the pterygomandibular space: improving the success of inferior alveolar nerve blocks. Aust Dent J. 2011 Jun;56(2):112-21

Patil K, Guledgud M V, Bhattacharya P T. Reliability of Panoramic Radiographs in the Localization of Mandibular Foramen. J Clin Diagn Res. 2015 May; 9(5): ZC35–ZC38

Trost O, Salignon V, Cheynel N, Malka G, Trouilloud P. A simple method to locate mandibular foramen preliminary radiological study. Surg Radiol Anat. 2010 Dec;32(10):927-31

Sairam V, Geethamalika MV, Kumar PB, Naresh G, Raju GP. Determination of sexual dimorphism in humans by measurements of mandible on digital panoramic radiograph. Contemp Clin Dent. 2016 Oct-Dec;7(4):434-439.

Jalili MR. The research of mandibular foramen in panorex X-ray. Pak J Biol Sci. 2010 Nov 1;13(21):1062-5.

Nicholson ML. A study of the position of the mandibular foramen in the adult human mandible. Anat Rec. 1985 May;212(1):110-2

Shalini R, RaviVarman C, Manoranjitham R, Veeramuthu M. Morphometric study on mandibular foramen and incidence of accessory mandibular foramen in mandibles of south Indian population and its clinical implications in inferior alveolar nerve block. Anat Cell Biol. 2016 Dec; 49(4): 241–248.

da Fontoura RA, Vasconcellos HA, Campos AE. Morphologic basis for the intraoral vertical ramus osteotomy: anatomic and radiographic localization of the mandibular foramen. J Oral Maxillofac Surg. 2002 Jun;60(6):660-5; discussion 665-6.

Wychowański P, Nieckula P, Panek M , Kalinowski E, Borkowska U, Wojtowicz A. Próba oceny położenia otworu żuchwowego i bródkowego na podstawie analizy cyfrowych zdjęć Pantomograficznych [Trial of Examination of the Mandibular and Mental Foramens Based on the Analysis of Digital Panoramic Photographs] Dent. Med. Probl. 2008, 45, 1, 21-28