{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:12:39Z","timestamp":1789035159780,"version":"build-2803163510"},"reference-count":22,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Severe posterior mandibular atrophy presents anatomical challenges for implant rehabilitation because of reduced residual bone volume and the close relationship between the mental foramen, its anatomical variations, and the surrounding alveolar bone. Among these variations, the anterior loop may further influence the available lingual bone adjacent to the mental foramen. Despite the clinical importance of this region, quantitative three-dimensional anatomical information regarding lingual bone availability remains limited. Therefore, the aim of this retrospective cone-beam computed tomography (CBCT)-based study was to quantitatively evaluate the availability of lingual bone adjacent to the mental foramen in posterior atrophied mandibles and to assess the influence of the anterior loop on these anatomical dimensions, thereby providing quantitative anatomical information about this region. Methods: In a retrospective CBCT-based anatomical study, 110 CBCT scans of adult patients with atrophied mandibles were analyzed using standardized cross-sectional views perpendicular to the dental arch; linear measurements were obtained from the lingual cortical plate to the mesial (Point A), middle (Point B), and distal (Point C) borders of the mental foramen. The presence of the anterior loop was recorded. Descriptive statistics and independent-samples t-tests were performed to compare measurements between loop and no-loop groups (\u03b1 = 0.05). Results: The mean measurements of the lingual bone were 7.22 \u00b1 1.65 mm at Point A, 6.18 \u00b1 1.55 mm at Point B, and 4.82 \u00b1 1.38 mm at Point C, showing a gradual decrease from mesial to distal. An anterior loop was found in 26.4% of the cases. Significantly thinner dimensions of the lingual bone were observed with an anterior loop at all three measurement points (p &lt; 0.01). Conclusions: The present CBCT-based anatomical study measured the amount of lingual bone available adjacent to the mental foramen in posterior atrophied mandibles and observed a significant correlation between the presence of an anterior loop and reduced lingual bone dimensions. These findings add to the knowledge of the anatomy of this area and could serve as the basis for future clinical studies to investigate the potential for a mental foramen bypass concept.<\/jats:p>","DOI":"10.3390\/jcm15187011","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:13:03Z","timestamp":1789031583000},"page":"7011","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["CBCT-Based Anatomical Assessment of Lingual Bone Availability Relevant to the Mental Foramen Bypass Concept in Posterior Atrophied Mandibles"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1981-287X","authenticated-orcid":false,"given":"Abduljaleel","family":"Samad","sequence":"first","affiliation":[{"name":"College of Dentistry, Hawler Medical University, Erbil 44001, Kurdistan Region, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1162-2713","authenticated-orcid":false,"given":"Omed","family":"Shihab","sequence":"additional","affiliation":[{"name":"College of Dentistry, Hawler Medical University, Erbil 44001, Kurdistan Region, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9621-4094","authenticated-orcid":false,"given":"Fedil","family":"Yalda","sequence":"additional","affiliation":[{"name":"College of Dentistry, Hawler Medical University, Erbil 44001, Kurdistan Region, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"given":"Jodal","family":"Ahmed","sequence":"additional","affiliation":[{"name":"College of Dentistry, Hawler Medical University, Erbil 44001, Kurdistan Region, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"software","vocabulary":"credit"}]},{"given":"Azhin","family":"Raza","sequence":"additional","affiliation":[{"name":"Ashti Hospital, Soran Health Directorate, Soran 44008, Kurdistan Region, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101631","DOI":"10.1016\/j.jormas.2023.101631","article-title":"Inferior alveolar nerve repositioning surgical techniques and outcomes: A systematic review","volume":"125","author":"Nicot","year":"2024","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Krzykawska-Krupska, M., Pach, J., Regulski, P., Tomczyk, J., Stru\u017cycka, I., Szopi\u0144ski, K., Osipowicz, K., and Pogorzelska, A. (2026). Clinical Implications of the Localization and Morphological Variability of the Mental Foramen\u2014A Systematic Review. Diagnostics, 16.","DOI":"10.3390\/diagnostics16050779"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1016\/j.joen.2021.08.006","article-title":"Mental Foramen and Anterior Loop Anatomic Characteristics: A Systematic Review and Meta-analysis of Cross-sectional Imaging Studies","volume":"47","author":"Barbosa","year":"2021","journal-title":"J. Endod."},{"key":"ref_4","first-page":"8897275","article-title":"Evaluation of Mental Foramen with Cone Beam Computed Tomography: A Systematic Review of Literature","volume":"2021","author":"Berry","year":"2021","journal-title":"Radiol. Res. Pract."},{"key":"ref_5","first-page":"4571895","article-title":"Morphometric analysis of the mental foramen using cone-beam computed tomography","volume":"2018","year":"2018","journal-title":"Int. J. Dent."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"63","DOI":"10.11648\/j.ijmi.20140203.14","article-title":"The importance of the mental foramen location detection by using different radiographic techniques: A mini review","volume":"2","author":"Jasim","year":"2014","journal-title":"Int. J. Med. Imaging"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1080\/00016357.2017.1387813","article-title":"3D CBCT morphometric assessment of the mental foramen in an Arabic population and global comparison","volume":"76","author":"Alam","year":"2018","journal-title":"Acta Odontol. Scand."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Ahmed, A.A., Ahmed, R.M., Jamleh, A., and Spagnuolo, G. (2021). Morphometric Analysis of the Mandibular Canal, Anterior Loop, and Mental Foramen: A Cone-Beam Computed Tomography Evaluation. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18073365"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1007\/s00276-018-2039-8","article-title":"Available bone morphology and neural structures in the mandibular interforaminal region: A 3D CBCT analysis","volume":"40","year":"2018","journal-title":"Surg. Radiol. Anat."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.ijom.2019.03.165","article-title":"Inferior alveolar nerve lateralization\/transposition technique evaluation; a 10 year experience","volume":"48","author":"Brosh","year":"2019","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/sj.bdj.2019.49","article-title":"Current practice in the use of cone beam computed tomography: A survey of UK dental practices","volume":"226","author":"Holroyd","year":"2019","journal-title":"Br. Dent. J."},{"key":"ref_12","unstructured":"Misch, C.E. (2008). Contemporary Implant Dentistry, Mosby Elsevier. [3rd ed.]."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1902\/jop.2006.060197","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","journal-title":"J. Periodontol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.ijom.2011.11.002","article-title":"Managing iatrogenic trigeminal nerve injury: A case series and review","volume":"40","author":"Renton","year":"2012","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2130","DOI":"10.1016\/j.joms.2008.06.021","article-title":"Comparison between digital panoramic radiography and cone-beam computed tomography for the identification of the mandibular canal as part of presurgical dental implant assessment","volume":"66","author":"Angelopoulos","year":"2008","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1111\/j.1600-0501.2011.02261.x","article-title":"The anterior loop of the inferior alveolar nerve: Prevalence, measurement of its length and a recommendation for interforaminal implant installation based on cone beam CT imaging","volume":"23","author":"Apostolakis","year":"2012","journal-title":"Clin. Oral Implants Res."},{"key":"ref_17","first-page":"387","article-title":"Assessment of variations of the mandibular canal using cone beam computed tomography","volume":"16","author":"Souza","year":"2011","journal-title":"Clin. Oral Investig."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1034\/j.1600-0501.2003.00869.x","article-title":"Anterior loop of the mental nerve: A morphological and radiographic study","volume":"14","author":"Kuzmanovic","year":"2003","journal-title":"Clin. Oral Implants Res."},{"key":"ref_19","first-page":"e216","article-title":"Prevalence, length, and patterns of Anterior Loop among the South Indian population: A comparative study between Panoramic Radiography and Cone Beam Computed Tomography","volume":"8","year":"2023","journal-title":"Porto Biomed. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/prd.12051","article-title":"Dental Cone Beam Computed Tomography: Justification for Use in Planning Oral Implant Placement","volume":"66","author":"Jacobs","year":"2014","journal-title":"Periodontology 2000"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1038\/sj.bdj.4807427","article-title":"Alveolar ridge resorption and mandibular atrophy. A review of the role of local and systemic factors","volume":"170","author":"Devlin","year":"1991","journal-title":"Br. Dent. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.sdentj.2018.12.006","article-title":"Mandibular residual ridge height in relation to age, gender and duration of edentulism in a Saudi population: A clinical and radiographic study","volume":"31","author":"AlSheikh","year":"2019","journal-title":"Saudi Dent. J."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7011\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:44:51Z","timestamp":1789033491000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/18\/7011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":22,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15187011"],"URL":"https:\/\/doi.org\/10.3390\/jcm15187011","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]}}}