Assessment of the prevalence and length of the anterior and caudal loops of the mental nerve as anatomical variants of exiting the mandible at the mental foramen using cone-beam computed tomography: a systematic review and meta-analysis.

[OBJECTIVES] This systematic review aimed to identify the studies that performed cone-beam computed tomography analysis of the prevalence and length of the anterior loop (AL) and caudal loop (CL) of the mental nerve.

[MATERIALS AND METHODS] An electronic database search was performed across PubMed, EMBASE, Web of Science, Scopus, the Cochrane library, and Google Scholar. Original studies reporting the frequency and length of the AL and CL were selected. Qualitative synthesis and meta-analysis were then conducted to assess the prevalence and length of the AL and CL and their associations with age, gender, sides, and dentition status.

[RESULTS] A total of 21 studies were included in this review. The pooled prevalence of the AL (95% confidence interval) of the mental nerve at the patient and side level was 51% (31-71%) and 53% (37-69%) while the mean anterior loop length was 2.08 (1.46-2.70) mm. The pooled prevalence of the CL and mean caudal loop length were 100% and 4.73 (3.44-6.01) mm. No significant associations were found between the prevalence and length of the AL and CL and age, gender, sides, and dentition status.

[CONCLUSIONS] Overall, the pooled prevalence and mean length of AL of the mental nerve varied among different populations while CL seems to be a constant anatomical landmark with a longer CL than AL.

[CLINICAL RELEVANCE] Surgeons performing inter-foraminal oral surgeries like dental implant placement and genioplasty should be aware of the possible distance of the AL and CL to avoid iatrogenic mental nerve injury.