Mandibular foramen location and its implication to the inferior alveolar nerve block: A retrospective study

Aim: This study was carried out to identify differences in the parameters for locating mandibular foramen (MF) in the central Indian population and the recommended guidelines for the administration of inferior alveolar nerve block (IAN) as mentioned in the dental literature. Methods: Eighty high-resolution full volumes cone-beam computed tomography (CBCT) scans were randomly selected from the radiology database and the scans were rendered, viewed, and measured using the on-demand volumetric imaging software (Anatomage, San Jose, CA). The parameters used in locating the MF/IAN complex were the horizontal distance from the mandibular notch to the midpoint of MF (H); vertical distance from the level of the mandibular occlusal plane to the center of MF (V) and the angle from the contralateral premolar contact area to the MF. Results: Paired t-test was applied. The mean horizontal distance from the mandibular notch to MF was 22.36 ± 2.60 mm in males and 21.05 ± 3.57 mm in females. The mean vertical distance to the occlusal plane was 10.23 ± 4.57 mm in males and 7.42 ± 4.96 mm in females, with a significant difference between the genders (P < 0.05). The mean value for the angulation for the occlusal plane was 39.28° ±5.23° and 37.35° ±3.72° in males and females, respectively. Conclusion: Ethnicity and gender influence the location of the MF/IAN complex. The utilization of long needles, orienting the syringe barrel at an angulation slightly <45° and approximately 10 mm above the mandibular occlusal plane can aid in successfully administering the IAN block.