Objectives: This retrospective cross-sectional study aimed to determine the localization of the mental foramen in a Saudi population using panoramic radiographs, identify the most common vertical and horizontal positions, assess bilateral symmetry, and analyze variations based on age and gender.
Methods: Digital panoramic radiographs of 504 patients, aged 18-58 years, were analyzed. The variables assessed included age group, gender, vertical position (Zones A, B, and C), horizontal position (Zones 1-6), and symmetry (present/absent) of the mental foramen location bilaterally. The mental foramen location was determined using standardized vertical and horizontal zones, and data were recorded on specialized sheets. Descriptive statistics, Pearson's chi-square test, and intra-examiner reliability were performed.
Results: The sample consisted of 250 (49.6%) females and 254 (50.4%) males. Vertically, Zone B coinciding with premolar apices was the most frequent position bilaterally, with 317 (62.9%) on the right side and 321 (63.7%) on the left side. Horizontally, Zone 4 between the first and second premolars was predominant, with 332 (65.9%) on the right side and 345 (68.5%) on the left side. High bilateral symmetry in the location was observed in 441 (87.5%) cases. Statistically significant differences were found in mental foramen localization based on gender (p < 0.05). No significant association was found between age and vertical position, although a tendency for more anterior horizontal positioning in older individuals was noted (p > 0.05).
Conclusion: Within the limitations of this panoramic assessment, the mental foramen was located most often inferior to premolar apices vertically and between the first and second premolars horizontally, with a high degree of bilateral symmetry. Gender had a significant impact on mental foramen position, while age showed a non-significant trend toward anterior horizontal localization. These findings guide dental procedures in the premolar region to avoid neurovascular damage.
Keywords: anatomy; localization; mandible; mental foramen; panoramic radiograph.
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