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Anterior Loop of the Mandibular Canal—A Source of Possible Complications

Introduction:Recognizing the radiographic position of the mental foramina is not sufficient to avoid complications during dental implant surgery. In many cases, the inferior alveolar nerve extends mesially as an “anterior loop” (AL). The aim of this study was to investigate the prevalence and spatial extension of the AL on computed tomography (CT). Materials and Methods:Thirty-seven human mandibles from an anatomical collection underwent CT analysis. Cross-sectional views and panoramic reconstructions were obtained. Prevalence and length of the AL were investigated. Results:Recognition of the AL on CT was 100%. Prevalence of the AL was 97.3% (n = 36). AL mean length was 2.26 mm (maximum: 7.0 mm). Conclusion:Recognition of the AL on CT scans (100%) is higher compared with data in literature for detection on panoramic radiographs (38.2%). To avoid complications, it is important to detect the AL presence and its mesial extension from the mental foramen. Safety distance of at least 2 mm from the mesial extend of the AL is recommended. Therefore, 3D imaging techniques are advised for loops which courses are not clearly identifiable on panoramic radiographs.