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      Mental foramen mimicking as periapical pathology - A case report

      case-report

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          Abstract

          The radiographic recognition of any disease requires a thorough knowledge of the radiographic appearance of normal structure. Intelligent diagnosis mandates an appreciation of the wide range of variation in the appearance of normal anatomical structures. The mental foramen is usually the anterior limit of the inferior dental canal that is apparent on radiographs. It opens on the facial aspect of the mandible in the region of the premolars. It can pose diagnostic dilemma radiographically because of its anatomical variation which can mimic as a periapical pathosis. Hereby we are reporting a rare case of superimposed mental foramen over the apex of right mandibular second premolar mimicking as periapical pathology.

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          Most cited references14

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          Mental foramen and mental nerve: changes with age.

          In a study of 525 dry mandibles and dissections in 50 cadavers, the mental foramen (MF) was found: single in 94.67% of the cases and multiple in 5.33%. Its shape was round in 34.48% with an average diameter of 1.68 mm and oval in 65.52% with an average long diameter of 2.37 mm. In 43.66% the MF was located in front of the apex of the root of the second premolar. In children before tooth eruption, the MF is somewhat closer to the alveolar margin; during the eruption period, the MF descends to half way between the margins, and in adults with the teeth preserved, the MF is somewhat closer to the inferior border. With loss of teeth and bone resorption the MF moves upwards closer to the alveolar border. In extreme cases of resorption the MF and the adjacent part of the mandibular canal are open at the alveolar margin. In the dissections the findings were similar. The mental nerve emerged from the MF closer to or at the alveolar border, according to the degree of resorption. In extreme degrees of resorption, the mental nerve and the final part of the inferior alveolar nerve were found directly under the gums. In these cases, the vestibular grooves became very shallow, and the mucosa passed directly from the cheeks over the alveolar ridge. Practical implications of the changes of the MF and mental nerve are discussed.
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            Branching patterns and intraosseous course of the mental nerve.

            The purpose of this study was to clarify the branching patterns of the mental nerve (MN) and intraosseous courses of the MN branches, and to determine the clinical relevance of the various courses of the MN branches.
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              Bilateral mandibular accessory foramina and canals: a case report and review of the literature.

              To present a case of bilateral mandibular accessory canals and foramina observed on CT and review the relevant literature. Based on the literature, accessory canals and foramina are prevalent in the posterior mandible and the area of the symphysis and more frequently on the internal than the external surface of the mandible. Bilateral symmetry is common. Variations exist in size and number. Occurrence may change with age and racial origin. Nerves, neurovascular bundles, arterioles and venules have been found to occupy the accessory canals and foramina. No gender differences have been described. CT has advantages over two-dimensional radiography in identification of anatomical variations in the mandible.
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                Author and article information

                Journal
                JHS
                Journal of Health Sciences
                University of Sarajevo Faculty of Health Studies (Bosnia )
                2232-7576
                1986-8049
                2014
                : 4
                : 2
                : 126-129
                Affiliations
                [1 ]Department of Oral Medicine and Radiology, Century International Institute of Dental Science and Research Centre, Poinachi, Kasaragod – 671541, Kerala, India
                [2 ]School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
                Author notes
                [* ]Corresponding author: Anusha Rangare Lakshman, Department of Oral Medicine and Radiology, Century International Institute of Dental Science and Research Centre, Poinachi, Kasaragod – 671541, Kerala, India E-mail: dr.anusharl@ 123456gmail.com
                Article
                JHS-4-126
                1031c92f-1822-41a4-aadd-d8a32ff25f9d
                Copyright: © Anusha Rangare Lakshman, et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 July 2014
                : 01 September 2014
                Categories
                CASE REPORT

                Nursing,General medicine,Medicine,Molecular medicine,Life sciences
                periapical radiolucency,mental foramen,mandibular premolars

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