{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T12:47:34Z","timestamp":1770468454620,"version":"3.49.0"},"reference-count":27,"publisher":"American Academy of Implant Dentistry","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>The mandibular interforaminal region has been considered safe for surgical procedures; nevertheless, the risk of injury to neurovascular structures, such as the mental foramen (MF) and its related structures (anterior loop [AL] and lingual foramina [LF]) should not be overlooked. The study aimed to evaluate the relative risk of injury to these structures during surgical procedures in the anterior region of the mandible based on cone-beam computed tomography (CBCT) scans. A retrospective cross-sectional and observational study was performed on 250 CBCTs from adults (18\u201369 years) with dentate jaws. Linear measurements of the MF, AL, and LF were evaluated to estimate the risk of injury to these structures during chin-related surgical procedures. The most frequent distance between the base of the mandible (BM) and MF was 8 mm (30.2%). In addition, 20.4% of the CTs had 6 mm from the vestibular cortical bone to the LF. The commonly found measurement from LF to the apex of the nearest tooth was 7 mm (24.0%); 64.2% of the CTs showed a 2-mm distance between the most distal point of the dental implant site to the most anterior point of the AL. Safety distances for genioplasty techniques (MF to mandible base &gt; 6 mm, 96.6% [CI 95%, 95.0%\u201398.2%]) were observed. Considering the 5-mm cut-off point between the lower limit of a hypothetical bone graft and the chin, 65.4% (CI 95%, 58.9%\u201371.9%) of CTs were within this distance. Regarding the safety margin of 8 mm, 85.6% (CI 95%, 80.8%\u201390.4%) were up to this value. This study found safety margins for genioplasty and chin bone grafting surgical techniques that adopt a 5-mm cut-off point. Further similar studies assessing other surgical methods and employing larger samples from different geographical origins may contribute to this field of investigation.<\/jats:p>","DOI":"10.1563\/aaid-joi-d-22-00199","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T19:51:04Z","timestamp":1717617064000},"page":"254-259","source":"Crossref","is-referenced-by-count":1,"title":["Injury Risk Estimation in Mandible-Related Surgical Procedures: A CBCT Study Based on Vital Interforaminal Anatomical Structures"],"prefix":"10.1563","volume":"50","author":[{"given":"Daniel Almeida Ferreira","family":"Barbosa","sequence":"first","affiliation":[{"name":"Division of Oral and Maxillofacial Radiology, School of Dentistry, Paulo Pican\u00e7o Faculty, Fortaleza, Cear\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00facio Mitsuo","family":"Kurita","sequence":"additional","affiliation":[{"name":"Division of Oral and Maxillofacial Radiology, School of Dentistry, Federal University of Cear\u00e1, Fortaleza, Cear\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulo Goberl\u00e2nio de Barros","family":"Silva","sequence":"additional","affiliation":[{"name":"Division of Oral Pathology, School of Dentistry, University Center Unichristus, Fortaleza, Cear\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra Fragoso","family":"Vieira","sequence":"additional","affiliation":[{"name":"Division of Oral and Maxillofacial Radiology, School of Dentistry, Federal University of Cear\u00e1, Fortaleza, Cear\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renata Cordeiro","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Division of Oral and Maxillofacial Radiology, Radiograf Dental Clinic, Fortaleza, Cear\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alynne Vieira de","family":"Menezes Pimenta","sequence":"additional","affiliation":[{"name":"Division of Oral and Maxillofacial Radiology, School of Dentistry, Federal University of Cear\u00e1, Fortaleza, Cear\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filipe Nobre","family":"Chaves","sequence":"additional","affiliation":[{"name":"Division of Oral Diagnosis, School of Dentistry, Federal University of Cear\u00e1, Campus Sobral, Sobral, Cear\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederico Sampaio","family":"Neves","sequence":"additional","affiliation":[{"name":"Division of Oral Radiology, Federal University of Bahia, Salvador, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Samuel Rodrigues","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Division of Oral and Maxillofacial Surgery, School of Dentistry, Federal University of Cear\u00e1, Campus Sobral, Sobral, Cear\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e1bio Wildson Gurgel","family":"Costa","sequence":"additional","affiliation":[{"name":"Division of Oral and Maxillofacial Radiology, School of Dentistry, Federal University of Cear\u00e1, Fortaleza, Cear\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"434","reference":[{"key":"i1548-1336-50-3-251-b01","series-title":"Clin Oral Implant Res","first-page":"1312","article-title":"New safety margins for chin bone harvesting based on the course of the mandibular incisive canal in CT","volume":"19","author":"Pommer","year":"2008","unstructured":"Pommer\n              B,\n            \n            \n              Tepper\n              G,\n            \n            \n              Gahleitner\n              A,\n            \n            \n              Zechner\n              W,\n            \n            \n              Watzek\n              G.\n            \n          \n          New safety margins for chin bone harvesting based on the course of the mandibular incisive canal in CT. Clin Oral Implant Res. 2008;19:1312\u20131316."},{"key":"i1548-1336-50-3-251-b02","series-title":"Int J Oral Maxillofac Implant","first-page":"423","article-title":"Imaging aspects of the mandibular incisive canal: a PROSPERO-registered systematic review and meta-analysis of cone beam computed tomography studies","volume":"34","author":"Ferreira-Barbosa","year":"2019","unstructured":"Ferreira-Barbosa\n              DA,\n            \n            \n              Barros\n              ID,\n            \n            \n              Teixeira\n              RC,\n            \n            et al\n          . Imaging aspects of the mandibular incisive canal: a PROSPERO-registered systematic review and meta-analysis of cone beam computed tomography studies. Int J Oral Maxillofac Implant. 2019;34:423\u2013433."},{"key":"i1548-1336-50-3-251-b03","series-title":"J Stomatol Oral Maxillofac Surg","first-page":"282","article-title":"Mini wing osteotomy: a variant of chin wing osteotomy","volume":"121","author":"Cordier","year":"2020","unstructured":"Cordier\n              G,\n            \n            \n              Sigaux\n              N,\n            \n            \n              Carlier\n              A,\n            \n            \n              Ibrahim\n              B,\n            \n            \n              Cresseaux\n              P.\n            \n          \n          Mini wing osteotomy: a variant of chin wing osteotomy. J Stomatol Oral Maxillofac Surg. 2020;121:282\u2013285."},{"key":"i1548-1336-50-3-251-b04","series-title":"Int J Oral Maxillofac Surg","first-page":"1201","article-title":"Chin shield osteotomy\u2014a new genioplasty technique avoiding a deep mento-labial fold in order to increase the labial competence","volume":"38","author":"Triaca","year":"2009","unstructured":"Triaca\n              A,\n            \n            \n              Furrer\n              T,\n            \n            \n              Minoretti\n              R.\n            \n          \n          Chin shield osteotomy\u2014a new genioplasty technique avoiding a deep mento-labial fold in order to increase the labial competence. Int J Oral Maxillofac Surg. 2009;38:1201\u20131205."},{"key":"i1548-1336-50-3-251-b05","series-title":"J. 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J Craniofac Surg. 2014;25:1383\u20131388."},{"key":"i1548-1336-50-3-251-b07","series-title":"J Craniofac Surg","first-page":"1963","article-title":"A new proposal for three dimensional positioning of the chin using a single computer-aided design\/computer-aided manufacturing surgical guide","volume":"29","author":"Costa","year":"2018","unstructured":"Costa\n              PJC,\n            \n            \n              Dem\u00e9trio\n              MS,\n            \n            \n              Nogueira\n              PTBC,\n            \n            \n              Rodrigues\n              LR,\n            \n            \n              J\u00fanior\n              PDR.\n            \n          \n          A new proposal for three dimensional positioning of the chin using a single computer-aided design\/computer-aided manufacturing surgical guide. J Craniofac Surg. 2018;29:1963\u20131964."},{"key":"i1548-1336-50-3-251-b08","series-title":"Int J Period Rest Dent","first-page":"165","article-title":"Autogenous bone harvesting: a chin graft technique for particulate and monocortical bone blocks","volume":"19","author":"Hunt","year":"1999","unstructured":"Hunt\n              DR,\n            \n            \n              Jovanovic\n              SA.\n            \n          \n          Autogenous bone harvesting: a chin graft technique for particulate and monocortical bone blocks. Int J Period Rest Dent. 1999;19:165\u2013173."},{"key":"i1548-1336-50-3-251-b09","series-title":"Int J Oral Maxillofac Implants","first-page":"117","article-title":"The dimensions of the mandibular incisive canal and its spatial relationship to various anatomical landmarks of the mandible: a study using cone beam computed tomography","volume":"28","author":"Apostolakis","year":"2013","unstructured":"Apostolakis\n              D,\n            \n            \n              Brown\n              JE.\n            \n          \n          The dimensions of the mandibular incisive canal and its spatial relationship to various anatomical landmarks of the mandible: a study using cone beam computed tomography. Int J Oral Maxillofac Implants. 2013;28:117\u2013124."},{"key":"i1548-1336-50-3-251-b10","series-title":"J Periodontol","first-page":"1933","article-title":"The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review","volume":"77","author":"Greenstein","year":"2006","unstructured":"Greenstein\n              G,\n            \n            \n              Tarnow\n              D.\n            \n          \n          The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review. J Periodontol. 2006;77:1933\u20131943."},{"key":"i1548-1336-50-3-251-b11","series-title":"Int J Oral Maxillofac Surg","first-page":"961","article-title":"Floor of mouth haemorrhage and life-threatening airway obstruction during immediate implant placement in the anterior mandible","volume":"35","author":"Woo","year":"2006","unstructured":"Woo\n              BM,\n            \n            \n              Al-Bustani\n              S,\n            \n            \n              Ueeck\n              BA.\n            \n          \n          Floor of mouth haemorrhage and life-threatening airway obstruction during immediate implant placement in the anterior mandible. Int J Oral Maxillofac Surg. 2006;35:961\u2013964."},{"key":"i1548-1336-50-3-251-b12","series-title":"Oral Maxillofac Surg","first-page":"223","article-title":"Hematoma of the floor of the mouth and airway obstruction during mandibular dental implant placement: a case report","volume":"12","author":"Del Castillo-Pardo de Vera","year":"2008","unstructured":"Del Castillo-Pardo de Vera\n              JL,\n            \n            \n              L\u00f3pez-Arcas Calleja\n              JM,\n            \n            \n              Burgue\u00f1o-Garc\u00eda\n              M.\n            \n          \n          Hematoma of the floor of the mouth and airway obstruction during mandibular dental implant placement: a case report. Oral Maxillofac Surg. 2008;12:223\u2013226."},{"key":"i1548-1336-50-3-251-b13","series-title":"J Oral Maxillofac Surg","first-page":"1408","article-title":"The incidence of altered sensation of the mental nerve after mandibular implant placement","volume":"57","author":"Bartling","year":"1999","unstructured":"Bartling\n              R,\n            \n            \n              Freeman\n              K,\n            \n            \n              Kraut\n              RA.\n            \n          \n          The incidence of altered sensation of the mental nerve after mandibular implant placement. J Oral Maxillofac Surg. 1999;57:1408\u20131412."},{"key":"i1548-1336-50-3-251-b14","series-title":"J Prosthet Dent","first-page":"443","article-title":"Altered sensation associated with implants in the anterior mandible: a prospective study","volume":"83","author":"Walton","year":"2000","unstructured":"Walton\n              JN.\n            \n          \n          Altered sensation associated with implants in the anterior mandible: a prospective study. J Prosthet Dent. 2000;83:443\u2013449."},{"key":"i1548-1336-50-3-251-b15","series-title":"J Clin Epidemiol","first-page":"344","article-title":"The strengthening the reporting of observational studies in epidemiology (strobe) statement: guidelines for reporting observational studies","volume":"61","author":"Von Elm","year":"2008","unstructured":"Von Elm\n              E,\n            \n            \n              Altman\n              DG,\n            \n            \n              Egger\n              M,\n            \n            \n              Pocock\n              SJ,\n            \n            \n              G\u00f8tzsche\n              PC,\n            \n            \n              Vandenbroucke\n              JP;\n            \n            STROBE Initiative\n          . The strengthening the reporting of observational studies in epidemiology (strobe) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61:344\u2013349."},{"key":"i1548-1336-50-3-251-b16","series-title":"Anais da Academia Brasileira de Cie\u0302ncias","first-page":"2865","article-title":"Accuracy of linear measurements performed with two imaging software in cone-beam computed tomography scans of dry human mandibles","volume":"89","author":"Silva","year":"2017","unstructured":"Silva\n              AALS,\n            \n            \n              Franco\n              A,\n            \n            \n              Fernandes\n              A,\n            \n            \n              Costa\n              C,\n            \n            \n              Barbosa\n              JS,\n            \n            \n              Westphalen\n              FH.\n            \n          \n          Accuracy of linear measurements performed with two imaging software in cone-beam computed tomography scans of dry human mandibles. Anais da Academia Brasileira de Cie\u0302ncias. 2017;89:2865\u20132873."},{"key":"i1548-1336-50-3-251-b17","series-title":"J Craniofac Surg","first-page":"2227","article-title":"Morphometric and morphologic evaluation of the mental foramen in relation to age and sex: an anatomic cone beam computed tomography study","volume":"25","author":"\u00c7a\u011flayan","year":"2014","unstructured":"\u00c7a\u011flayan\n              F,\n            \n            \n              S\u00fcmb\u00fcll\u00fc\n              MA,\n            \n            \n              Akg\u00fcl\n              HM,\n            \n            \n              Altun\n              O.\n            \n          \n          Morphometric and morphologic evaluation of the mental foramen in relation to age and sex: an anatomic cone beam computed tomography study. J Craniofac Surg. 2014;25:2227\u20132730."},{"key":"i1548-1336-50-3-251-b18","series-title":"J Endod","first-page":"1522","article-title":"Location and dimensions of the mental foramen: a radiographic analysis by using cone-beam computed tomography","volume":"39","author":"Von Arx","year":"2013","unstructured":"Von Arx\n              T,\n            \n            \n              Friedli\n              M,\n            \n            \n              Sendi\n              P,\n            \n            \n              Lozanoff\n              S,\n            \n            \n              Bornstein\n              MM.\n            \n          \n          Location and dimensions of the mental foramen: a radiographic analysis by using cone-beam computed tomography. 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Dent Res J. 2012;9:45\u201351."},{"key":"i1548-1336-50-3-251-b21","series-title":"J Oral Maxillofac Surg","first-page":"1431","article-title":"In Vivo tooth-supported implant surgical guides fabricated with desktop stereolithographic printers: fully guided surgery is more accurate than partially guided surgery","volume":"7","author":"Bencharit","year":"2018","unstructured":"Bencharit\n              S,\n            \n            \n              Staffen\n              A,\n            \n            \n              Yeung\n              M,\n            \n            \n              Whitley\n              D,\n            \n            \n              Laskin\n              DM,\n            \n            \n              Deeb\n              GR.\n            \n          \n          In Vivo tooth-supported implant surgical guides fabricated with desktop stereolithographic printers: fully guided surgery is more accurate than partially guided surgery. J Oral Maxillofac Surg. 2018;7:1431\u20131439."},{"key":"i1548-1336-50-3-251-b22","series-title":"Surg Radiol Anat","first-page":"1133","article-title":"Assessment of morphological and anatomical characteristics of mental foramen using cone beam computed tomography","volume":"40","author":"Goyushov","year":"2018","unstructured":"Goyushov\n              S,\n            \n            \n              T\u00f6z\u00fcm\n              MD,\n            \n            \n              T\u00f6z\u00fcm\n              TF.\n            \n          \n          Assessment of morphological and anatomical characteristics of mental foramen using cone beam computed tomography. Surg Radiol Anat. 2018;40:1133\u20131139."},{"key":"i1548-1336-50-3-251-b23","series-title":"Am J Orthod","first-page":"382","article-title":"The analysis of errors in orthodontic measurements","volume":"83","author":"Houston","year":"1983","unstructured":"Houston\n              WJ.\n            \n          \n          The analysis of errors in orthodontic measurements. 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Int J Oral Maxillofac Implants. 2005;20:533\u2013539."},{"key":"i1548-1336-50-3-251-b25","series-title":"Oral Maxillofac Surg Clin North Am","first-page":"209","article-title":"Bone grafting the mandible","volume":"23","author":"Louis","year":"2010","unstructured":"Louis\n              PJ.\n            \n          \n          Bone grafting the mandible. Oral Maxillofac Surg Clin North Am. 2010;23:209\u2013227."},{"key":"i1548-1336-50-3-251-b26","series-title":"Clin Implant Dent Relat Res","first-page":"149","article-title":"Morbidity after chin bone harvesting \u2013 a retrospective long-term follow-up study","volume":"11","author":"Weibull","year":"2009","unstructured":"Weibull\n              L,\n            \n            \n              Widmark\n              G,\n            \n            \n              Ivanoff\n              CJ,\n            \n            \n              Borg\n              E,\n            \n            \n              Rasmusson\n              L.\n            \n          \n          Morbidity after chin bone harvesting \u2013 a retrospective long-term follow-up study. Clin Implant Dent Relat Res. 2009;11:149\u2013157."},{"key":"i1548-1336-50-3-251-b27","series-title":"Implant Dent","first-page":"21","article-title":"Augmentation of the anterior maxilla with intraoral onlay grafts for implant placement","volume":"21","author":"Greenberg","year":"2012","unstructured":"Greenberg\n              JA,\n            \n            \n              Wiltz\n              MJ,\n            \n            \n              Kraut\n              RA.\n            \n          \n          Augmentation of the anterior maxilla with intraoral onlay grafts for implant placement. Implant Dent. 2012; 21:21\u201324."}],"container-title":["Journal of Oral Implantology"],"original-title":[],"link":[{"URL":"https:\/\/joi.kglmeridian.com\/view\/journals\/orim\/50\/3\/article-p254.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/joi\/article-pdf\/50\/3\/254\/3382843\/i1548-1336-50-3-254.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/joi.kglmeridian.com\/downloadpdf\/journals\/orim\/50\/3\/article-p254.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/joi.kglmeridian.com\/downloadpdf\/journals\/orim\/50\/3\/article-p254.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:21:00Z","timestamp":1752193260000},"score":1,"resource":{"primary":{"URL":"https:\/\/joi.kglmeridian.com\/view\/journals\/orim\/50\/3\/article-p254.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6]]},"references-count":27,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.1563\/aaid-joi-d-22-00199","relation":{},"ISSN":["1548-1336","0160-6972"],"issn-type":[{"value":"1548-1336","type":"electronic"},{"value":"0160-6972","type":"print"}],"subject":[],"published":{"date-parts":[[2024,6]]}}}