Comparison of the Mandibular Foramen Position Among Different Skeletal Classes Using Panoramic Radiographs

Background: The mandibular foramen has often been considered as the most reliable reference point for several anesthetic and surgical procedures in the maxillofacial region. This study evaluated the position of the mandibular foramen in different skeletal classes. Methods: A total of 90 panoramic and lateral cephalometric images belonging to class I (n = 30), class II (n = 30), and class III (n = 30) patients were used for this study. The position of the mandibular foramen in relation to the anterior and posterior borders of the mandibular ramus, inferior border of the mandible, sigmoid notch and occlusal plane was determined in each panoramic radiograph. Results: The position of the mandibular foramen relative to the occlusal plane and the sigmoid notch significantly differed among the three skeletal groups; however, no significant difference existed among the skeletal classes with regard to the position of the mandibular foramen in relation to the anterior and posterior borders of the ramus and the inferior border of the mandible. Conclusions: The position of the mandibular foramen tends to be lower in skeletal class II patients; therefore, it seems that lower injection heights in these patients could result in better outcomes.