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An Insight Into a Disappeared Mental Foramen in an Edentulous Old Age Mandible

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An Insight Into a Disappeared Mental Foramen in an Edentulous Old Age Mandible Journal of Critical Reviews ISSN- 2394-5125 Vol 7, Issue 4, 2020 Review Article AN INSIGHT INTO A DISAPPEARED MENTAL FORAMEN IN AN EDENTULOUS OLD AGE MANDIBLE S.P. Jai Prabhu1*, K. Prabhu2 1Research Scholar, Bharath Institute of Higher Education and Research, Chennai. [email protected] 2 Associate Professor, Department of Anatomy, Sree Balaji Medical College and Hospital, Chennai. Received: 25.12.2019 Revised: 28.01.2020 Accepted: 04.02.2020 Abstract In old age the teeth in the alveolar sockets of mandible is lost and is called as edentulous mandible. If the teeth are lost, alveolar bone is resorbed and the mental foramen comes to lie nearer the superior border of the body of the mandible. The objective of this study is to determine the position of mental foramen in an edentulous old age mandible. A total of 50 edentulous old age mandibles were collected from the department of anatomy, RVS dental college and hospital at Coimbatore. The position of mental foramen was observed manually based on the criteria whether the foramen lies close to the alveolar border or on the alveolar ridge. Out of 50 mandibles, 40 mandibles showed the mental foramen lies close to the alveolar border, 9 showed on the alveolar ridge and one mandible showed a unique feature of disappeared mental foramen with exposed mandibular canal. Since the mandibular canal is exposed along the anterior part of the body of the mandible the mental nerve may be covered by the oral mucosa alone. In intraoral procedures, the mental nerve is under high risk of getting impaired since its position lies adjacent to the alveolar crest and hence the knowledge about the position of mental foramen in edentulous mandible is important for Anatomist, Oral Surgeons and Health care professionals. Keywords: Edentulous Old Age Mandible, Alveolar Crest, Mental Foramen, Inferior Border of Mandible. © 2019 by Advance Scientific Research. This is an open-access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) DOI: http://dx.doi.org/10.31838/jcr.07.04.157 INTRODUCTION The largest, most strongest and widely movable part of the skull MATERIALS AND METHODS is the lower jaw which is formed by the mandible. It develops The present study was designed as a descriptive study. A total of from the first pharyngeal arch. It has a horse shoe- shaped body 50 edentulous old age mandibles were collected from the which lodges the teeth, and a pair of rami which project upwards department of anatomy, RVS dental college and hospital at from the posterior ends of the body. The body of the mandible is Coimbatore. The criteria of selection of edentulous old age somewhat U- shaped, and has external and internal surfaces mandibles were no teeth and atrophy of the alveolar border. The separated by upper and lower borders. The upper or superior mandibiles are placed on a plane table covered with asbestos border of the body of mandible is called as alveolar part which sheet. The investigator examined the position of mental foramen contains alveolar sockets for the lower teeth. The alveolar part which lies close to the superior border of the alveolar border and contains 16 alveoli for the roots of the lower teeth. It consists of on the alveolar ridge. The damaged mandibles and bones buccal and lingual plates of bone joined by interdental and inter- involving various pathological conditions were excluded from radicular septa1. the study. The mental foramen lies along the body of the mandible just below the interval between the premolar teeth. Through this RESULTS foramen the mental nerve and vessels emerges out. The mental Out of 50 edentulous old age mandibles, 80% (40/50) of foramen changes its position according to the age changes. At mandibles showed the mental foramen close to the alveolar birth the mental foramen lies closer to the inferior border of the border, 18% (9/50) lies on the alveolar ridge and 2% (1/50) mandible. In adults, it opens midway between the superior and showed a unique feature of disappeared mental foramen with inferior borders because the alveolar and subalveolar parts of exposed mandibular canal (Fig.1). Since the mandibular canal is the bone are equally developed. In old age the teeth fall out and exposed in the anterior part of the body of the mandible, the the alveolar border is absorbed, so that the height of body is mental nerve may be covered by the oral mucosa alone. markedly reduced and the mental foramen lies close to the alveolar border2. The mental nerve is the branch of inferior alveolar nerve3 which MANDIBULAR CANAL (MC) is sensory, originates from the mandibular division of the trigeminal nerve. It arises from the same within the inferior alveolar canal of the mandible. As it exits from the mental foramen, it divides into three branches the mental branch, labial branch, and gingival branch, which supply the chin, lower lip and gingiva, respectively. In the present study the position of mental foramen in an edentulous old age mandibles were examined and studied. MC Fig. 1: Exposed mandibular canal (MC) in an edentulous old age mandible Journal of critical reviews 840 AN INSIGHT INTO A DISAPPEARED MENTAL FORAMEN IN AN EDENTULOUS OLD AGE MANDIBLE of the literature. Oral maxilla fac surg. 2015; 19(2): 177- DISCUSSION 181. Mandible for1ms the contour of the lower face. In old age the 5. Amorim MM, Prado FB, Borini CB, et al. The mental foramen contour of the face is lost, one of the reason for it is mandible position in dentate and edentulous brazilian’s mandible. Int where resorption of alveolar bone occurs due to loss of teeth and j morphol. 2008; 26(4):981-987. their periodontal membranes4. The resorbed alveolar ridge 6. Tavana, A.Heart failure and oral bacteria: How could be reduces the height of the body of the mandible which changes the prevented(2010) Journal of Cardiovascular Disease position of mental foramen to lie near the superior border of the Research, 1 (3), p. 161. alveolar bone. Initial phase of the bone resorption takes place on DOI: 10.4103/0975-3583.70924 the alveolar crest, while the inferior border of the mandible 7. Greenstein G, Tarnow D. The mental foramen and nerve: remains unchanged. The resorption process is rapid till the first clinical and anatomical factors related to dental implant year after teeth loss and after the second year the resorption of placement: a literature review. J periodontal. 2006; bone gradually gets stabilized. This resorption process is more 77(12):1933-1943. rapid in the labial and buccal parts of the alveolar crest and is 8. Grisar K, Sinha D, Schoenaers J, et al. Retrospective analysis particularly quick and faster in mandible when compared to of dental implants placed between 2012 and 2014: resorption in maxilla5. In the present study the mental foramen indications, risk factors, and early survival. Int j oral position was close to alveolar border in 80% and on the alveolar maxillofac implants. 2017; 32(3):649-654. ridge in 18% of the edentulous old age mandibles which 9. Chavda HV, Patel CN, Anand IS. "Biopharmaceutics corroborates with the study of Charalampakis.A 6 . The rare Classification System." Systematic Reviews in Pharmacy 1.1 feature found in the present study was absence of mental (2010), 62-69. Print. doi:10.4103/0975-8453.59514 foramen with the exposed mandibular canal where the nerve 10. Ulm CW, Solar P, Blahout R, et al. Location of the may be covered by oral mucosa alone. The exposed canal was mandibular canal within the atrophic mandible. Br J Oral observed in the anterior part of the body of the mandible, the Maxillofac Surg. 1993; 31(6): 370-375. mental nerve and its branches may be compressed while 11. Madhumita srivastava, Gaurav vishal, Sanjoy chowdhury masticatory movement of the jaw. Thus it may end up in and Pramod kumar biswal. Mental nerve: an unpredictable permanent or transitory sensitive, tactile and thermal changes7. course and its clinical implication. Journal of universal Depending on the quantity of pressure exerted on the mental surgery. 2018; 6(3): 18. nerve, the injury to the could be categorized as neurapraxia or as 12. Jagadeesh. D, Patil. RA, Kattimani.PT. Clinical evaluation of axonotmesis8. Lower lip numbness is a common symptom that mandibular ridge height in relation to aging and length of occurs due to damage, injury or irritation of the mental nerve. It edentulism. J dental med scien. 2013; 3(4): 44-47. usually causes unilateral loss of sensitivity of the lower lip and gums, numbness, a tingling sensation, and dryness of the affected mucosa. It is often preceded by intense pain and burning sensation in the affected area9. Prosthetic rehabilitation treatment with osseointegrated implants has increased in recent scenario. It makes the quality of life of the patients to improve and with that restoring self-dignity and social recognition. It also will restore the normal function, masticatory and the normal anatomy of the mouth. There are several factors which the clinicians take as criteria before they choose the most suitable prosthesis10. The area situated between mental foramen and the symphysis menti is commonly the choice by oral surgeons and prosthodontist to install the implants that retain the complete fixed denture in the mandibular arch11. One of the genuine reasons to choose the anterior part is because of the fact that human mandible has a complex and bio-mechanical behavior when it is subjected to the various functions performed by it. In addition to it the implants need to be fastened so that it forms a rigid bar and at the same time it should not extend to the posterior region where it is full of important structures12.
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