CBCT Retrospective Study of the Prevalence of the Anterior Loop of the Mandibular Canal in Yemeni Population

CBCT Retrospective Study of the Prevalence of the Anterior Loop of the Mandibular Canal in Yemeni Population | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article CBCT Retrospective Study of the Prevalence of the Anterior Loop of the Mandibular Canal in Yemeni Population Anas Saeed AL-ZAGHRURI, Mohammed M Al Moaleem, Ammar Ahmed Al-Hiagem, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5506322/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Mandibular canal (MC) is mostly influenced by individual characteristics, such as gender, age, race, and level of alveolar bone loss, and it needs to be assessed prior to various posterior mandibular surgeries. This study aimed to evaluate the MC anatomical patterns and anterior loop (AL) parameters among Yemeni samples via cone‑beam computed tomography (CBCT). Material/Methods: In this CBCT retrospective cross-sectional study, 558 CBCTs were recruited, and the MC patterns and AL parameters were categorized created on sex and age groups. Contributors CBCT images were analyzed, assessed, and measured from the sagittal and panoramic views, and the MC patterns were documented as straight and vertical. In addition, the AL length, diameter, and the distance to buccal cortical plate (BCP) and lingual cortical plate (LCP) and inferior border of the mandible (IBM) in were recorded association with the sex, age groups, and side. The significance level was set at P<0.05. Results: The MC patterns were 64.5%, 32.8%, and 6.9% for the straight and vertical patterns and AL, respectively. The AL had an overall prevalence of 2.7%. The AL length and diameter were 5.1±1.4 and 2.4±0.5 mm, respectively. The distances of the anterior part of the AL were 2.5±0.9, 3.8±1.5, and 8.6±2.0 mm for the BCP, LCP, and IBM, respectively. No significant differences were observed between the MC patterns and all AL parameters (gender, age groups, and side; p > 0.05), except the height between the bottom edge of the inferior alveolar nerve canal and the lower edge of the jawbone (p 0.025). Patient gender had significant effects on all AL height and diameters and parameter mea­surements (p <0.05). Moreover, the AL diameter displayed a significant difference only with the IBM with p 0.001. Conclusions: The overall prevalence of AL was low on both sides, and the AL parameters were higher in males and on the right side. Among MC patterns, the straight pattern was the most prevalent in females, on the right side, and among age groups. Mandibular canal mental foramen anterior loop CBCT gender side Yemeni Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction The mandibular canal (MC) extends on both sides, from the mandibular foramen to the mental foramen (MF), which results in the transport of the inferior alveolar nerve and blood vessels to provide direct innervation and vascular supply to the lower teeth and periodontal tissues on the same side. The MF is crossed by the MC as it moves towards the interforaminal region, where it splits into the mental and incisive canals ( 1 ). As the incisive canal appears in the front, the MC bends upward, backward, and sideways to reach the MF ( 2 ). The position of the MF can be below the mandibular canine to the first molar, although it is usually located under the mandibular second premolar ( 3 – 4 ). Occasionally, the MC can curve further toward the front and then loop back and up to create the anterior loop (AL) of the inferior alveolar nerve ( 5 – 6 ). Although it is a harmless difference, it must be correctly recognized to avoid harming the nerves and blood vessels during various dental procedures, including the placement of dental implants in the area between the mental and mandibular foramen. Given the intricate nature of the loop’s structure, a diagnostic method that enables its clear visualization and accurate measurement must be utilized ( 7 – 9 ). The positioning of the MC is influenced by gender in the areas of the mandibular 2nd premolar and 1st and 2nd second molars in both sides. Males typically display a more coronal course than females in these regions ( 10 – 11 ). In addition, the MC tends to follow a more lingual path in males than in females. However, these gender-based differences were not statistically significant [12–13]. Age was significantly related to the distances between the lower border of the mandible and MC in the molar regions ( 14 ). No difference was identified in the incisive canal distance from the mandibular borders between males and females, and no association was found between age and incisive canal diameter ( 15 ). Various radiological techniques have been employed to accurately evaluate the path of the MC, AL, and MF. Panoramic radiography was previously used for the diagnosis of preoperative conditions or planning implants. However, earlier studies have suggested that the magnification effect of this two-dimensional (2D) form of imaging may lead to inaccuracies in the estimation of true anatomical sizes, which potentially results in either overestimation or underestimation [16]. Moreover, this X-ray method only provides minimal details on the buccolingual location of the canal. Lately, cone-beam computed tomography (CBCT) has become popular in dentistry for its precise distance measurements and potential for 3D analysis, which make it ideal for the examination of intricate mandibular anatomy ( 17 – 19 ). This method is considered the most effective for the evaluation of the anatomy of the AL of the MC and provides a 3D assessment without the issues of magnification, blurriness, and distortion that are present in PR and the only other option for visualizing the loop ( 20 – 21 ). The length and extension of the AL are crucial in the establishment of the safe zone for dental implantation in the interforaminal area. The AL showed a high prevalence in approximately two-thirds of the Sudanese patients who were assessed ( 14 ). Moreover, its occurrence differs within communities, with the percentage of AL ranging from 60.23% and 55.94% (right and left) in the Spanish population ( 10 ) and 48% having a mean length (range) of 0.89 mm ( 21 ); another study revealed a high prevalence (88%); the symmetric occurrence was 76.2%, with a mean length of 4.13 ± 2.04 mm in the Caucasian population ( 22 ). In addition, AL can be visualized in 83.3% of the cases on the right and in 62.5% of the cases on the left side for the Iranian population ( 15 ) and 71% for the Japanese population ( 23 ). On the opposite side, lower prevalence of ALs were documented in 15.2% of the Saudi population ( 24 ). AL was identified in 9.7% of the cases, and its mean length ranged from 1.8 mm to 4.8 mm in Eastern India ( 25 ). Similarly, the occurrence rate of AL pattern stood at 6.9%. The length of AL ranged within 2.4–6.6 mm in a sample of Indian people ( 7 ). Factors, such as site, sex, or age, did not have a statistically significant effect on the AL mesial extension. Slightly fewer than half of the cases demonstrated a mesial extension of less than 2 mm. A previous study indicated that the recommended safe area in front of the MF ranges from 2 to 5 mm when installing implants ( 19 , 21 ). No previous study has assessed the prevalence of MC and nerve patterns or shapes and the related AL parameters among Yemeni population. Therefore, this study aimed to investigate the type of pattern, path, and shape of the MC and related AL parameters. In addition, the MC and AL variations were identified and analyzed in relation to gender, different age groups, and sides in a sample of Yemeni population. The null hypothesis is that no significant differences exist in the MC pattern and AL parameters in relation to gender, age group, and side. Materials and Methods Study design and ethical consideration The present CBCT retrospective cross-sectional survey was directed to assess and measured the prevalence and association among sex, age group, and side of MC patterns and the measurements of AL and its parameters via CBCT scans of patients from the Yemeni population. The present study received ethical approval from the Medical Ethics Committee of the Faculty of Medicine and Health Science, Taiz University (Re no. ECTU2024/12 − 1), and it was conducted in accordance with the Helsinki Declaration. Sample size calculation The CBCT image size was calculated using G*Power software (version 3.1.9.4, University of Dusseldorf). The effect size (d), α, and1-β (power) were 0.5, 0.05, and 0.95, respectively. The calculated sample size was 508, which was divided equally among gender groups to detect a large effect size (0.40) with a 1-β (power) of 0.95, in accordance with previously published studies [6–7,10,24]. An additional 10% of the sample was added to compensate for the clearances of the CBCT assessed, and thus, the final samples comprised 558 CBCT images. Inclusion and exclusion criteria . The inclusion criteria were patients from both sexes, aged 18 years or older, and dentate and edentulous ones. CBCT images were selected based on their suitable diagnostic quality. This study included all CBCT scans for issues related to impacted teeth and orthodontic preparation. The exclusion criteria comprised participants with poor image quality, fractures, artifacts, and pathologies affecting the MF area. Settings for acquiring CBCT images A total of 558 CBCTs obtained from different cities in Yemen (Taiz, Aden, and Sanaa) and collected randomly from archived CBCT were counted and examined. The images of individuals who had a CBCT scan of the premolar and molar areas of their lower jaw were acquired from stored software program data records and analyzed to evaluate the MC patterns and AL parameters. The slice thickness measurements were provided by the system. Every individual had CBCT imaging performed on their MC in a seated position using a Pax-Flex 3D machine (Vatech, Hwaseong, Korea), and under the following parameters: 0.200 *0.200 *0.200 mm 3 field of view, 5 mA, 86 Kvp, and 0.2 voxel size. In brief, the subject was placed on the couch of the laser beam-guided CBCT machine, which and his position was standardized by making the Frankfort plane parallel to the floor. Then, scout imaging was performed to locate the scan area. The area of interest was determined and scanned. The slice thickness (0.3 mm) was used as a factor to multiply this number ( 25 ) as in the following Figures. The Digital Imaging and Communication in Medicine data set files for each subject were reviewed on a personal workstation using simple viewer software from Ez3D-i. Two laptops were used on a 64-bit Windows 10 to process the CBCT images ( 26 ). Data collections A group of final year dental students, who received 2 weeks of training in CBCT analysis, examined the MC patterns and AL parameters of the MC under the supervision of A.S. and A.H., who have 5 years of experience in evaluating CBCT images. The collected data consisted of two parts. The first part was related to the participant characteristics, which comprised gender (male or female), and age group, which was divided into four groups (less than 20, 20–40, 41–60, and more than 60), shape and pattern of the MC (straight, vertical, and AL), and the ALs with their parameters. CBCT Image assessment and measurements Multiplanar reconstructions were made from archived image sequences, and the presence or absence of an AL was recorded. After the identification of AL, the following measurements were carried out on the CBCT images. Previously criteria given ( 27 ) for the assessment of various patterns were followed to classify the MC into straight and vertical patterns and AL using CBCT. Figure 1 presents the shape and definitions of the MC parameters. Figure 2 displays the AL and its parameters, including H 1 , H 2 , and H 3 , along with their characterizations and description and the length and width of AL ( 25 ). Table 1 Different anatomical parameters related to the AL and their definition [7,25] Parameters (abbreviation) Parameters definition Figure number H1 The height from the upper edge of the MF to the lower edge of the mandible in panoramic reconstructed images and sagittal sections. 1 C, 2 H2 The height from the frontmost part of the AL to the lower edge of the mandible in panoramic images and sagittal sections. 1 C, 2 H3 The height between the bottom edge of the inferior alveolar nerve canal to the lower edge of the jawbone. 1 C, 2 Length of AL The distance between H1 and H2 1 C, 2 Diameter of AL The diameter of AL before coming out from the MF 1 C, 2 BCP The distance between the most anterior point of the AL and the Buccal cortical plate (BCP) 3 B LCP The distance between the most anterior point of the AL and the Lingual cortical plate 3 C IBM The distance between the most anterior point of the AL and the Inferior border of the mandible 3 D Figure 3 (A) Reconstructed panoramic image showing the presence of a straight pattern on the left side and anterior loop on the right side (red arrow). Coronal section showing the distance between the most anterior point of the anterior loop and the (B) Buccal cortical plate (BCP) (C) Inferior border of the mandible (IBM) (D) Lingual cortical plate (LCP) Reliability and normality assessments For the assessment of measurement reliability, the intraclass reliability analysis was performed in the present study. The level of agreement between raters was assessed through the application of Cohen’s kappa statistic. The finding indicates a virtually good agreement and meets the values recorded in studies. Statistical significance was set at a P-value of ≤ 0.05. Statistical analysis Statistical analysis was carried out using version 21.0 of the Statistical Package for the Social Sciences (SPSS; IBM, California, USA). Descriptive statistics in the form number and percentage among gender, age groups, side, patterns of MC, and height of the AL were documented. Other AL parameters were documented as mean and standard deviation (± SD). A one-way analysis of variance (ANOVA), Pearson chi-square, independent t-test, and multiple post hoc tests were conducted to assess the association and significance between and within groups. A significance level of ˃0.05 was deemed statistically significant. Result A total of 558 CBCT images (1116 hemimandibles) were analyzed in the current study, with the participants having a mean and ± SD age of 39.1 ± 15.6 years. The participants comprised 232 males (41.6%) and females326 (58.4%). The highest age group was 20–40 years with 292 participants (52), and the lowest was ˃20 years (37 participants; 7.0%) ( Fig. 4 ). The intraclass reliability was high and reached between 0.989–0.994, with a mean 0.992 of indicating a high and strong correlation. The straight mental canal pattern was the highest on both sides, with value of 360 (64.5%) for the right and 355 (63.6%) for the left side. In addition, the vertical pattern was slightly higher on the left side (188; 33.7%) compared with the right (183; 32.8%). The AL of the MC pattern recorded the lowest prevalence on both sides with a value of 15 (2.7%). No significant differences were observed between the sides and patterns of MC (p 0.950; Table 2 ). Table 2 Prevalence of different patterns of mental canal by sides (Chi-squared test) Shapes of MC Right (N = 558) N (%) Left (N = 558) N (%) Total (N = 1116) N (%) p value Straight 360.0 (64.5) 355.0 (63.6) 715.0 (64.1) 0.950 Vertical 183.0 (32.8) 188.0 (33.7) 371.0 (33.2) Anterior loop 15.0 (2.7) 15.0 (2.7) 30.0 (2.7) In terms of the relation between the gender and side, the straight and vertical patterns and AL of the MC were more prevalent among females on both sides. The highest number and percentage were observed in the female group and on the left side for the straight pattern (203; 63.2%), and the vertical pattern was slightly higher on the right side and reached 115 (35.3%). AL exhibited the least pattern among females on both sides. Chi squared test showed no significant differences between the right and left sides, genders, and the pattern of MC, with p 0.326 and 0.226 (Table 3 ). Table 3 Patterns of MC in relation to shape, gender, and side (Chi-squared test) Side Pattern of MC Male (n = 232) N (%) Female (n = 326) N (%) Total (n = 558) N (%) p value Right Straight 157 (67.7) 203 (62.3) 360 (64.5) 0.326 Vertical 68 (29.3) 115 (35.3) 183 (32.8) Anterior loop 7 (3.0) 8 (2.5) 15 (2.7) Left Straight 149 (64.2) 206 (63.2) 355 (63.6) 0.226 Vertical 80 (34.5) 108 (33.1) 188 (33.7) Anterior loop 3 (1.3) 12 (3.7) 15 (2.7) Table 3 presents the pattern of MC shape with the age groups and sides. On the right side, the straight pattern of MC was the highest among the four age groups and directly proportional with age (as age increase, the percentage of the straight MC shape increased). Similarly, a direct proportionality was observed between the percentage of straight MC shape and left side with age groups. Although the vertical shape of the MC was higher on both sides and among younger age groups and decreased with the increase in age, this percentage decreased in the ˂60 age group. AL showed the least patterns among all age groups on both sides. Chi squared test exhibited no significant differences between sides and age groups, with the MC pattern having values of p 0.054 and 0.078, respectively (Table 4 ). Table 4 Patterns of MC in relation to shape, age groups, and side (Chi-squared test) Side Pattern of MC ˃ 20 (N = 37) N (%) 20–40 (N = 292) N (%) 41–60 (N = 171) N (%) ˂ 60 (N = 58) N (%) Total (N = 558) N (%) p value Right Straight 16 (43.2) 182 (62.3) 119 (69.6) 43 (74.1) 360 (64.5) 0.054 Vertical 19 (51.4) 102 (34.9) 48 (28.1) 14 (24.1) 183 (32.8) Anterior loop 2 (5.4) 8 (2.7) 4 (2.3) 1 (1.7) 15 (2.7) Left Straight 18 (48.6) 176 (60.3) 119 (69.6) 42 (72.4) 355 (63.6) 0.078 Vertical 17 (45.9) 106 (36.3) 49 (28.7) 16 (27.6) 188 (33.7) Anterior loop 2 (5.4) 10 (3.4) 3 (1.8) 0 (0.0) 15 (2.7) Regarding the comparison between gender and AL parameters of the evaluated CBCT images, the mean ± SD of heights H1, H2, and H3 were higher in males (13.9 ± 1.1, 11.7 ± 1.3, and 8.4 ± 1.4 mm, respectively). Independent t-test revealed a significant difference between males and females in terms of H1, H2, and H3, with p 0.002, < 0.001, and < 0.001, respectively. The AL lengths (mm) were similar in both genders (5.1 mm), but the mean ± SD of diameter was higher among females, with significant differences observed at p 0.002. The distances of LCP and IBM AL parameters (mm) were higher among males, with the IBM showing significance (p 0.001). Meanwhile, the BCP distance was higher among females 2.6 ± 0.9 and 3.3 ± 0.7 for males, and the independent t- test showed no significant differences (p 0.378, Table 5 ). Table 5 Comparison between mean ± SD of AL parameter and genders (independent t- test). Parameters Males Females Average p values H1 13.9 ± 1.1 11.3 ± 2.3 12.2 ± 2.4 0.002 * H2 11.7 ± 1.3 9.2 ± 1.5 10.1 ± 1.9 < 0.001 * H3 8.4 ± 1.4 6.4 ± 1.2 7.1 ± 1.5 < 0.001 * Length 5.1 ± 1.1 5.1 ± 1.5 5.1 ± 1.4 0.911 Diameter 2.8 ± 0.4 2.2 ± 0.5 2.4 ± 0.5 0.002 * BCP 2.3 ± 0.7 2.6 ± 0.9 2.5 ± 0.9 0.378 LCP 3.9 ± 1.4 3.8 ± 1.7 3.8 ± 1.5 0.938 IBM 10.2 ± 1.4 7.7 ± 1.8 8.6 ± 2.0 0.001 * *Significant In relation to the AL parameters and side of the assessed CBCT images, the mean ± SD of heights H1, H2, and H3 were higher on the right side and reached 12.9 ± 1.9, 10.5 ± 2.0, and 7.4 ± 1.4 mm, respectively. The length and diameter of the AL in mm were slightly higher on the right side, with values of 5.2 ± 1.6 and 2.4 ± 0.4 and 5.0 ± 1.0 and 2.3 ± 0.9 mm the right and left sides, respectively. Likewise, the distances of BCP, LCP, and IBM of the AL parameters (mm) were higher on the right side, with averages of 2.5 ± 0.9, 3.8 ± 1.5, and 8.6 ± 2.0 mm for BCP, LCP, and IBM, respectively. Independent t- test showed no significant differences between the sides and AL parameters (Table 6 ). Table 6 Comparison between mean ± SD of AL parameter measured and sides (independent t- test) AL Parameters Right Left Average p values H1 12.9 ± 1.9 11.4 ± 2.6 12.2 ± 2.4 0.092 H2 10.5 ± 2.0 9.7 ± 1.7 10.1 ± 1.9 0.294 H3 7.4 ± 1.4 6.7 ± 1.7 7.1 ± 1.5 0.237 Length 5.2 ± 1.6 5.0 ± 1.0 5.1 ± 1.4 0.594 Diameter 2.4 ± 0.4 2.3 ± 0.6 2.4 ± 0.5 0.672 BCP 2.5 ± 0.8 2.4 ± 0.9 2.5 ± 0.9 0.831 LCP 4.0 ± 1.4 3.7 ± 1.7 3.8 ± 1.5 0.528 IBM 9.0 ± 2.0 8.1 ± 2.0 8.6 ± 2.0 0.283 Table 7 displays the comparison results between the mean ± SD of all the tested age groups and AL parameters assessed via ANOVA. Among all age groups tested for heights H1, H2, and H3 parameters, the mean ± SD of height (mm) slightly increased with the increase in age, with average values of 12.3 ± 2.4, 10.1 ± 1.9, and 7.1 ± 1.5 mm, respectively. Only height H3 was significantly different among age groups (p 0.025). The length and diameter of AL were changed in the different age groups, with average increases and decreases (mm) of 5.1 ± 1.4 and 2.4 ± 0.5 mm, respectively, but without significant differences (p values of 0.178 and 0.332). Similarly, the distances of BCP, LCP, and IBM parameters (mm) increased and decreased in the different age groups, with average values of 2.5 ± 0.9, 3.8 ± 1.5, and 8.6 ± 2.0 mm for BCP, LCP, and IBM, respectively, and without significant differences (p values of 0.977, 433, and 193; Table 7 ). Table 7 Comparison between mean ± SD of AL parameter measured and age groups (One-way ANOVA test). AL parameters ˃ 20 20–40 41–60 ˂ 60 Average p values H1 11.8 ± 0.8 11.9 ± 2.8 12.5 ± 1.7 15.9 ± NC 12.2 ± 2.4 0.427 H2 8.4 ± 0.8 10.2 ± 1.7 10.3 ± 2.1 13.3 ± NC 10.1 ± 1.9 0.083 H3 6.4 ± 0.7 6.9 ± 1.4 7.5 ± 1.5 11.2 ± NC 7.1 ± 1.5 0.025 * Length 4.1 ± 0.5 5.5 ± 1.6 4.7 ± 0.6 4.3 ± NC 5.1 ± 1.4 0.178 Diameter 2.1 ± 0.5 2.3 ± 0.5 2.7 ± 0.4 2.3 ± NC 2.4 ± 0.5 0.332 BCP 2.6 ± 0.5 2.5 ± 1.0 2.4 ± 0.7 2.3 ± NC 2.5 ± 0.9 0.977 LCP 4.0 ± 1.3 4.2 ± 1.7 3.0 ± 1.2 3.4 ± NC 3.8 ± 1.5 0.433 IBM 7.2 ± 0.7 8.7 ± 2.1 8.5 ± 2.1 11.9 ± NC 8.6 ± 2.0 0.193 *significant NC- not calculated Table 8 shows the Cohen’s kappa statics’ interrater agreements. The highest agreements and correlations were observed for H2 and H3 and AL diameter of 0.75, and medium agreements and correlation were noticed for LCP, AL length, and BCP with 0.59, 0.45, and 0.45, respectively. The only weak interrater agreements were recorded for H1 and IBM parameters (0.32 and 0.31, respectively). All AL parameters showed significant differences with p t H1 38 0.32 1.89 0.100 H2 75 0.72 4.31 0.004 H3 75 0.72 4.31 0.004 Length 50 0.45 2.39 0.048 diameter 75 0.72 4.15 0.004 BCP 50 0.45 2.48 0.042 LCP 63 0.59 3.33 0.013 IBM 38 0.31 2.18 0.066 Discussion The inter-mental space of the mandible is considered safe for implant placement and plays a role in various surgical procedures. Understanding the region’s anatomy is crucial to preventing injuries to the neurovascular bundle. Before performing osteotomy, the foramen position and the potential presence of a loop of the mental nerve near the MF must be considered to prevent any damage to the mental nerve ( 15 ). The diverse patterns of MC, including straight, vertical, and loop patterns, were identified, and measurement of AL parameters among different populations was performed via CBCT for the accurate diagnosis and appropriate choice among different forms of dental treatments ( 28 – 29 ). The present CBCT study assessed the percentage of prevalence of MC patterns and parameters of AL in a sample of Yemeni population and compared the outcomes of these important anatomical structures with those of worldwide studies. The overall AL parameters (height, length, diameter, and distances to buccal and lingual cortical plates and IBM) among sex, age group, and side were slightly consistent with the findings of two studies on Indian population (Giroh et al., 2022 [7]) and marginally parallel with those of Sinha et al. (2019) [25]. However, different results were observed in other national and worldwide research were carried out on Arab population (Al-Mahalawy et al., 2017 (Saudi) [24] and Najm et al., 2017 (Iraqi) [30]), Indian population (Puri et al., 2020 [29; Siddiqui et al., 2018 [31]), Turkish participants (Sahman and Sisman 2016; Eren et al., 2016; Demir et al. 2015 [27,32,33]), Brazilians (do Nascimento et al., 2016; Genú et al., 2014 [34,35]), and a single study in other countries (Apostolakis and Brown 2012 (Greece), Panjnoush et al., 2016 (Iran) [36], Todorovic et al., 2018 (south Africa) [37], and Ngeow et al. 2009 (Malaysia) [38]). The disagreement can be correlated to the different races and systems and procedures of measurements of AL parameters that may play contribute to the total outcomes of the measurements of AL parameters and MC patterns. The prevalence and AL patterns of the mental nerve parameters varied among different populations [39]. According to the results of the present CBCT study, the straight pattern was most prevalent (64.1%), followed by vertical (33.2%) and AL (2.7%) ones. This finding is marginally similar to those verified in the Indian population, with values of 67.1%, 26.0%, and 6.5% for the same parameters ( 7 ), but lower than the prevalence of straight (46.2%), vertical (38.6%), and AL (15.2%), respectively, documented among Saudi population ( 24 ). In the Turkish population, the vertical patten was the most prevalent (44.7%) compared with the straight pattern (33.3%) and AL (21.9%) ( 27 ). However, another research conducted in Turkey showed the AL with a higher prevalence (59.5%), followed by vertical (31.9%) and then straight (8.6%) pattern ( 33 ), which indicates a different outcome compared with those of the current study. The present study showed a low prevalence of AL (2.7%) in the assessed CBCT images. One study on the frequency of AL through the use of CBCT ( 25 ) in Eastern India revealed AL in 97 scans (9.7%) out of 1000 scans. By contrast, another study on an Indian population found a high prevalence of AL (37.3%) ( 31 ), whereas a value of 41.6% was documented among Brazilian population ( 34 ). However, the reported highest percentages of the AL prevalence ranged between 48–86% in surveys carried out in Greece, Iraqi, Iranian, Indian, and South Africa ( 21 , 29 – 30 , 36 – 37 ). This considerable diffrences can be associated and related to interindividual anatomical variability linked with gender, age, and race and the application of vaopis measurement techniques. The prevalence of MC patterns varied among different genders and sides of populations [39]. According to the current study results, no significant difference was observed between gender and side. By contrast, the straight pattern was more prevalence and common in females, however the vertical pattern and AL were more amongst males. The spreading of patterns of MC was highly significant between the studied male and female participants ( 7 ). The varied observations detected in various studies can be due to the ethnic variances and genetic structure among genders. In this study, the results on age parameter showed no significant differences and were uncorrelated with the prevalence of various patterns of MC. Similar findings were documented earlier in a Thai population ( 8 ). However, other previous results have assumed that age was significant with the prevalence of AL ( 31 ); another study demonstrated a high prevalence of AL among older age groups ( 25 ). Another relevant factor can be the grade of cortication because of its relation to canal visibility. Well cortication may lead to enhanced perceptibility and visualization of the canal ( 34 ). The grade of resorption of the mandible decrees the visualization of the canal during CBCT analysis. The visibility of ALs condensed with increase in the age of participants. An obvious increase in resorption and the enlargement of marrow space were observed with aging, and disordered trabeculae were often observed, and they affected the identification of the AL ( 38 ). According to the present results, no significant differences were observed between gender and AL prevalence. This finding is parallel to those observed in a Brazilin population ( 35 ). By contrast, among Turkish, Iraqi, and Easten Indian populations, significant differences were documented between gender and AL prevalence ( 7 , 30 , 32 ), German ( 40 ) and South Africa populations ( 37 ). However, the present study revealed that AL was more prevalent in females than males, which coincides with findings of previous studies on Brazilian and Turkish populations ( 32 , 35 ). Other works conducted in different countries revealed a higher AL incidence in males than in females ( 7 , 25 , 30 , 31 , 37 ). The varied notes found in different literatures can be due to ethnic differences and genetic constitution among the populations. In the present CBCT study, the percentages of AL were the same on the right and left sides, which is in difference to those of various studies conducted among populations from Turkey and Iraq ( 30 , 35 ), where AL was more commonly observed on the left side. However, Giroh et al. (2022) documented that AL was higher on the right side among Indians [7]. The height of the AL to the lower border of mandible from three different points (H1, H2, and H3) is an important anatomical structure; iatrogenic injury should be avoided in different surgical areas on both sides of the mandible ( 25 ). The average distances of AL parameters showed a significant difference between genders (Table 0000), with values of 12.15 ± 2.25, 10.1 ± 1.85, and 7.05 ± 1.55 mm for H1, H2, and H3, respectively. Meanwhile, among the different assessed age groups, only H3 displayed a significant difference with the side (Table 000). A single study revealed no significant differences in the H1, H2, and H3 among males and females, side, and age ( 25 ). The length of AL amongst the most anterior part of the loop and MF represents the distance of MC mesial to MF ( 25 , 29 , 35 ). In the current CBCT study, the length of AL was greater in males than females but without a significant difference. This result coincides with the findings of studies conducted on Brazilians, Turkish, and Japanese ( 23 , 32 , 35 ). By contrast, the length of AL was significantly different and higher in males than females ( 7 , 30 , 34 ). Such differences may be explained by size of the males’ mandible arch, which is larger than that of females. Furthermore, the present study revealed that the length of AL was not significant with side, similar to the findings of earlier studies (7,2329,32,34–35). Our result showed no significance with age ( 23 , 32 , 34 ). The longest AL verified in this CBCT analysis study was 10.3 mm, and the mean length of the AL was 5.1 ± 1.4 mm, which is slightly longer than that recorded by previous studies on Indian populations (mean of length of the AL 3.31 and 1.07 ± 1.42 mm ( 7 , 29 ) and 3.25 ± 0.77 in Eastern India ( 25 )). In addition, the documented length of AL among Yemenis participants was higher than that recognized among Brazilin and Turkish populations (3.14 ± 1.25 and 2.9 ± 3.3 mm, respectively) ( 32 , 35 ). Despite being clinically related to a certain level, this length was nearly similar with the maximum length (11 mm) reported for a sample assessed from a Caucasian subpopulation ( 22 ). This finding may be attributed to individual characteristics such as gender, age, race, the method of assessment, and the level of alveolar bone loss. The diameter and length of the AL before emerging from the MF should be carefully considered and quantified during different dental steps to minimize postsurgical complications ( 25 , 39 ). In this CBCT study, the AL diameter was 2.4 ± 0.5 mm, which is significantly higher in males than in females and but not significantly different with age and side. This result is in disagreement with the AL diameter observed among Indian contributors (3 ± 0.67 mm); however, the results showed no significant difference between genders, side, and age ( 25 ). The measurement of distance between the most anterior point of the AL and its parameters (BCP, LCP, and IBM) is important during surgery near the MC foremen ( 7 , 30 ). In this study which used CBCT, BCP and LCP were not significantly different in males and female; only IBM was significantly greater in males than females, which is in agreement with the finding of Giroh et al. (2022), whose measured the distances of the same AL parameters among Indians ( 7 ). However, the same parameters were significantly higher in males among Iraqis ( 30 ). On the contrary, no significant differences were noted among AL parameters (BCP, LCP, and IBM), and no significant difference was observed in Turkish males and females ( 32 ). However, all the studies exhibited higher values in males than females ( 7 , 30 , 32 ). Such differences may be explained by the of males’ mandible’s larger volume, increased height, and wider buccolingual width ( 33 ). Furthermore, the BCP, LCP, and IBM were not significantly different with side and age. These results are in parallel with those of study conducted among Turkish ( 32 ) and in contrast with those of research that involved Indian and Iraqis ( 7 , 30 ), which revealed the significance of those parameters and the jaw site. The race-related physique can be an important influencing factor, and the number of CBCT was included in different studies. Dental practitioners of various specialty accomplishment inter-foraminal oral operations, such as dental implant drilling and genioplasty, should be alert of the AL parameters to prevent iatrogenic mental nerve injury [39]. In present study, the recorded mean ± SD distance between the AL and other parameters were 2.5 ± 0.9, 3.8 ± 1.5, and 3.8 ± 1.5 mm (BCP, LCP, and IBM, respectively). Similar distances were documented among samples from Turkey ( 32 ) for the three parameters, and only BCP and IBM were marginally near the values recorded in this study; however, considerably higher mean ± SD were recorded for the LCP, with values of 2.24, 4.24, and 8.63 mm for BCP, IBM, and LCP, respectively, among Indian samples ( 7 ). By contrast, a study conducted among Iraqi patients recorded a lower average distance of AL to BCP (2.5 ± 0.9/1.06 ± 0.3 mm) and higher AL to LCP and IBM (3.8 ± 1.5/4.25 ± 0.4/3.8 ± 1.5 and 3.8 ± 1.5/7.69 ± 0.9 mm respectively) ( 30 ). This finding was observed possibly because race-related physique can be an vital influencing aspect. The present study provided information on the frequency of different patterns of MC and AL parameters (height, length, diameter, and distances to buccal and lingual cortical plates and IBM), including gender, different age groups, and side used. The findings compared with the results supported by the utilizing of 3D measurement and assessment. Anatomical point measurement was critical in avoiding challenges earlier to the most dental procedures near the MF, such as apicoectomy, impacted teeth removal, immediate implant placement, pathology removal, and orthognathic surgery and related procedures. The present CBCT analysis study was limited to three cities of Yemen and did not focus on associated structures of the mental canals. In practical terms, we highlight the status of evaluating each case individually and not relying on specific measurements for determining a safety distance. Conclusion The following conclusions can be drawn from the present CBCT study: The most prevalent MC pattern was straight, followed by a vertical pattern and AL. Patient age, sex, and side had no significant effects on the prevalence of various patterns of MC (straight, vertical, and loop). AL measurement showed no significance with age and side except the height between the bottom edge of the inferior alveolar nerve canal to the lower edge of the mandible. Patient sex exhibited significant effects on all AL measurements (height and diameters of AL and distance from the most anterior part of AL to IBM) and non-significance with the length of AL and most anterior part of the AL to the lingual and buccal plates. Clinically, dental specialist and practitioners must study parameters, such as age, sex, and status of AL among Yemeni patients, during different dental procedures. Declarations Author Contribution Study Design AData Collection BStatistical Analysis CData Interpretation DManuscript Preparation Ereviewed the manuscript FAnas Saeed AL-Zaghruri A,B,D,EMohammed M Al Moaleem A,B,C,EAmmar Ahmed Al-Hiagem B D,FNashwan abduljabbar Noman B,FBaleegh Abdulraoof Al-kadasi D,FKhaled Ahmed Abdulkareem B,DAmjad fahedAL-Magraby B,DElyas Ahmed AL-romema B,DSara Muneer Abdullah B,DNada Abdo Hamood B,D References Jacobs R, Lambrichts I, Liang X, Martens W, Mraiwa N, Adriaensens P, Gelan J. Neurovascularization of the anterior jaw bones revisited using high-resolution magnetic resonance imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 May;103(5):683-93. doi: 10.1016/j.tripleo.2006.11.014. Jeon YH, Lee CK, Kim HJ, Chung JH, Kim HJ, Yu SK. 3-dimensional reconstruction of mandibular canal at the interforaminal region using micro-computed tomography in Korean. J Adv Prosthodont. 2017 Dec;9(6):470-475. doi: 10.4047/jap.2017.9.6.470. 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Puri A, Verma P, Mahajan P, Bansal A, Kohli S, Faraz SA. CBCT Evaluation of the Vital Mandibular Interforaminal Anatomical Structures. Ann Maxillofac Surg. 2020 Jan-Jun;10(1):149-157. doi: 10.4103/ams.ams_144_19. Najm AA, Al-Sudani RJ, Mahdi AS. Radiographical evaluation of anterior mental loop presence, position and length in Iraqi sample using cone beam computed tomography. Inte J Scie Research. 2017; 6(3): 920-7. DOI:10.21275/ART20171557 Siddiqui Z, Rai S, Ranjan V. Efficacy and evaluation of cone beam computed tomography in determining the prevalence and length of anterior loop of inferior alveolar nerve in North Indian population. J Indian Academy Oral Medicine Radiology. 2018; 30(1): 32-37. DOI: 10.4103/jiaomr.jiaomr_121_17 Eren HK, Orhan N, Bagis R, Nalcaci M, Hincal E. Cone beam computed tomography evaluation of mandibular canal anterior loop morphology and volume in a group of Turkish patients. Biotechnology Biotechnological Equipment. 2016; 30(2): 346-353. https://doi.org/10.1080/13102818.2015.1127181 Demir A, Izgi E, Pekiner PN. Anterior loop of the mental foramen in a Turkish subpopulation with dentate patients: a cone beam computed tomography study. J Marmara Univ Inst Health Sci. 2015; 5(4): 231-38. DOI: 10.5455/musbed.20150715121209 do Nascimento EH, Dos Anjos Pontual ML, Dos Anjos Pontual A, da Cruz Perez DE, Figueiroa JN, Frazão MA, Ramos-Perez FM. Assessment of the anterior loop of the mandibular canal: A study using cone-beam computed tomography. Imaging Sci Dent. 2016 Jun;46(2):69-75. doi: 10.5624/isd.2016.46.2.69. Genú PRR, Vasconcellos BP, Oliveira BCG, Vasconcelos D, Delgado C. Analysis of anatomical landmarks of the mandibular interforaminal region using CBCT in a Brazilian population. Braz. J. Oral Sci.. 2014; 13 (4): 303-307. https://doi.org/10.1590/1677-3225v13n4a12 Panjnoush M, Rabiee ZS, Kheirandish Y. Assessment of Location and Anatomical Characteristics of Mental Foramen, Anterior Loop and Mandibular Incisive Canal Using Cone Beam Computed Tomography. J Dent (Tehran). 2016 Mar;13(2):126-132. PMID: 27928241; PMCID: PMC5139930. Todorovic VS, Postma TC, van Zyl AW. Assessment of the anterior loop of the inferior alveolar nerve using reformatted computed tomography: a retrospective study. Br J Oral Maxillofac Surg. 2018 Apr;56(3):186-191. doi: 10.1016/j.bjoms.2018.01.007. Ngeow WC, Dionysius DD, Ishak H, Nambiar P. A radiographic study on the visualization of the anterior loop in dentate subjects of different age groups. J Oral Sci. 2009 Jun;51(2):231-7. doi: 10.2334/josnusd.51.231. Hui L, Hung KF, Bornstein MM, Leung YY. 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. Clin Oral Investig. 2022 Nov;26(11):6423-6441. doi: 10.1007/s00784-022-04656-x. Ritter L, Neugebauer J, Mischkowski RA, Dreiseidler T, Rothamel D, Richter U, Zinser MJ, Zoller JE. Evaluation of the course of the inferior alveolar nerve in the mental foramen by cone beam computed tomography. Int J Oral Maxillofac Implants. 2012 Sep-Oct;27(5):1014-21. PMID: 23057013. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5506322","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":381640150,"identity":"f5aeb448-415c-4f6b-861c-9de806494666","order_by":0,"name":"Anas Saeed 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University","correspondingAuthor":false,"prefix":"","firstName":"Sara","middleName":"Muneer","lastName":"Abdullah","suffix":""},{"id":381640159,"identity":"354c79c1-41c3-4304-b833-a9968e885de0","order_by":9,"name":"Nada Abdo Hamood Farhan","email":"","orcid":"","institution":"Al-Hikmah University","correspondingAuthor":false,"prefix":"","firstName":"Nada","middleName":"Abdo Hamood","lastName":"Farhan","suffix":""}],"badges":[],"createdAt":"2024-11-22 17:53:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5506322/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5506322/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":69831870,"identity":"c52f3f86-ccd4-4136-9227-4427fd10ec57","added_by":"auto","created_at":"2024-11-25 15:39:30","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":153488,"visible":true,"origin":"","legend":"\u003cp\u003eImages of a right side of a female 19-years old, showing different patterns of Mandibular Canal which (A) straight (B) vertical (C) Anterior loop with its parameters.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5506322/v1/f50bcf3837afec3619f257b0.png"},{"id":69831871,"identity":"fce4c567-f378-40b6-9412-41bbb31377d8","added_by":"auto","created_at":"2024-11-25 15:39:31","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":199499,"visible":true,"origin":"","legend":"\u003cp\u003eSchematic representation of different measurements of anterior loop parameters from the right side of the mandibulae\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5506322/v1/89612091fd795c8d1fb9d84a.png"},{"id":69831875,"identity":"cef71443-b071-4ef9-9be7-af7686228ac5","added_by":"auto","created_at":"2024-11-25 15:39:31","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":175400,"visible":true,"origin":"","legend":"\u003cp\u003e(A) Reconstructed panoramic image showing the presence of a straight pattern on the left side and anterior loop on the right side (red arrow). Coronal section showing the distance between the most anterior point of the anterior loop and the (B) Buccal cortical plate (BCP) (C) Inferior border of the mandible (IBM) (D) Lingual cortical plate (LCP)\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-5506322/v1/24625ea601a9401f66b44f80.png"},{"id":69831869,"identity":"9929f3b6-8665-4c30-b156-6c4ef8c5de9b","added_by":"auto","created_at":"2024-11-25 15:39:30","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":19579,"visible":true,"origin":"","legend":"\u003cp\u003eParticipant characteristics\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-5506322/v1/69c0795a411e137a1dd093e7.png"},{"id":69834749,"identity":"b5bab8e2-a2c2-41dd-b275-cbb9ebc75401","added_by":"auto","created_at":"2024-11-25 16:07:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1471624,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5506322/v1/fc4e4923-2271-43d7-9fb0-91dc10e8b2c0.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"CBCT Retrospective Study of the Prevalence of the Anterior Loop of the Mandibular Canal in Yemeni Population","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe mandibular canal (MC) extends on both sides, from the mandibular foramen to the mental foramen (MF), which results in the transport of the inferior alveolar nerve and blood vessels to provide direct innervation and vascular supply to the lower teeth and periodontal tissues on the same side. The MF is crossed by the MC as it moves towards the interforaminal region, where it splits into the mental and incisive canals (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). As the incisive canal appears in the front, the MC bends upward, backward, and sideways to reach the MF (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). The position of the MF can be below the mandibular canine to the first molar, although it is usually located under the mandibular second premolar (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Occasionally, the MC can curve further toward the front and then loop back and up to create the anterior loop (AL) of the inferior alveolar nerve (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAlthough it is a harmless difference, it must be correctly recognized to avoid harming the nerves and blood vessels during various dental procedures, including the placement of dental implants in the area between the mental and mandibular foramen. Given the intricate nature of the loop\u0026rsquo;s structure, a diagnostic method that enables its clear visualization and accurate measurement must be utilized (\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe positioning of the MC is influenced by gender in the areas of the mandibular 2nd premolar and 1st and 2nd second molars in both sides. Males typically display a more coronal course than females in these regions (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). In addition, the MC tends to follow a more lingual path in males than in females. However, these gender-based differences were not statistically significant [12\u0026ndash;13]. Age was significantly related to the distances between the lower border of the mandible and MC in the molar regions (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). No difference was identified in the incisive canal distance from the mandibular borders between males and females, and no association was found between age and incisive canal diameter (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eVarious radiological techniques have been employed to accurately evaluate the path of the MC, AL, and MF. Panoramic radiography was previously used for the diagnosis of preoperative conditions or planning implants. However, earlier studies have suggested that the magnification effect of this two-dimensional (2D) form of imaging may lead to inaccuracies in the estimation of true anatomical sizes, which potentially results in either overestimation or underestimation [16]. Moreover, this X-ray method only provides minimal details on the buccolingual location of the canal. Lately, cone-beam computed tomography (CBCT) has become popular in dentistry for its precise distance measurements and potential for 3D analysis, which make it ideal for the examination of intricate mandibular anatomy (\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). This method is considered the most effective for the evaluation of the anatomy of the AL of the MC and provides a 3D assessment without the issues of magnification, blurriness, and distortion that are present in PR and the only other option for visualizing the loop (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe length and extension of the AL are crucial in the establishment of the safe zone for dental implantation in the interforaminal area. The AL showed a high prevalence in approximately two-thirds of the Sudanese patients who were assessed (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Moreover, its occurrence differs within communities, with the percentage of AL ranging from 60.23% and 55.94% (right and left) in the Spanish population (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) and 48% having a mean length (range) of 0.89 mm (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e); another study revealed a high prevalence (88%); the symmetric occurrence was 76.2%, with a mean length of 4.13\u0026thinsp;\u0026plusmn;\u0026thinsp;2.04 mm in the Caucasian population (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn addition, AL can be visualized in 83.3% of the cases on the right and in 62.5% of the cases on the left side for the Iranian population (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e) and 71% for the Japanese population (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). On the opposite side, lower prevalence of ALs were documented in 15.2% of the Saudi population (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). AL was identified in 9.7% of the cases, and its mean length ranged from 1.8 mm to 4.8 mm in Eastern India (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Similarly, the occurrence rate of AL pattern stood at 6.9%. The length of AL ranged within 2.4\u0026ndash;6.6 mm in a sample of Indian people (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Factors, such as site, sex, or age, did not have a statistically significant effect on the AL mesial extension. Slightly fewer than half of the cases demonstrated a mesial extension of less than 2 mm. A previous study indicated that the recommended safe area in front of the MF ranges from 2 to 5 mm when installing implants (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNo previous study has assessed the prevalence of MC and nerve patterns or shapes and the related AL parameters among Yemeni population. Therefore, this study aimed to investigate the type of pattern, path, and shape of the MC and related AL parameters. In addition, the MC and AL variations were identified and analyzed in relation to gender, different age groups, and sides in a sample of Yemeni population. The null hypothesis is that no significant differences exist in the MC pattern and AL parameters in relation to gender, age group, and side.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and ethical consideration\u003c/h2\u003e \u003cp\u003eThe present CBCT retrospective cross-sectional survey was directed to assess and measured the prevalence and association among sex, age group, and side of MC patterns and the measurements of AL and its parameters via CBCT scans of patients from the Yemeni population. The present study received ethical approval from the Medical Ethics Committee of the Faculty of Medicine and Health Science, Taiz University (Re no. ECTU2024/12\u0026thinsp;\u0026minus;\u0026thinsp;1), and it was conducted in accordance with the Helsinki Declaration.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSample size calculation\u003c/h3\u003e\n\u003cp\u003eThe CBCT image size was calculated using G*Power software (version 3.1.9.4, University of Dusseldorf). The effect size (d), α, and1-β (power) were 0.5, 0.05, and 0.95, respectively. The calculated sample size was 508, which was divided equally among gender groups to detect a large effect size (0.40) with a 1-β (power) of 0.95, in accordance with previously published studies [6\u0026ndash;7,10,24]. An additional 10% of the sample was added to compensate for the clearances of the CBCT assessed, and thus, the final samples comprised 558 CBCT images.\u003c/p\u003e \u003cp\u003e \u003cb\u003eInclusion and exclusion criteria\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eThe inclusion criteria were patients from both sexes, aged 18 years or older, and dentate and edentulous ones. CBCT images were selected based on their suitable diagnostic quality. This study included all CBCT scans for issues related to impacted teeth and orthodontic preparation. The exclusion criteria comprised participants with poor image quality, fractures, artifacts, and pathologies affecting the MF area.\u003c/p\u003e\n\u003ch3\u003eSettings for acquiring CBCT images\u003c/h3\u003e\n\u003cp\u003eA total of 558 CBCTs obtained from different cities in Yemen (Taiz, Aden, and Sanaa) and collected randomly from archived CBCT were counted and examined. The images of individuals who had a CBCT scan of the premolar and molar areas of their lower jaw were acquired from stored software program data records and analyzed to evaluate the MC patterns and AL parameters.\u003c/p\u003e \u003cp\u003eThe slice thickness measurements were provided by the system. Every individual had CBCT imaging performed on their MC in a seated position using a Pax-Flex 3D machine (Vatech, Hwaseong, Korea), and under the following parameters: 0.200 *0.200 *0.200 mm\u003csup\u003e3\u003c/sup\u003e field of view, 5 mA, 86 Kvp, and 0.2 voxel size. In brief, the subject was placed on the couch of the laser beam-guided CBCT machine, which and his position was standardized by making the Frankfort plane parallel to the floor. Then, scout imaging was performed to locate the scan area. The area of interest was determined and scanned. The slice thickness (0.3 mm) was used as a factor to multiply this number (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) as in the following Figures.\u003c/p\u003e \u003cp\u003eThe Digital Imaging and Communication in Medicine data set files for each subject were reviewed on a personal workstation using simple viewer software from Ez3D-i. Two laptops were used on a 64-bit Windows 10 to process the CBCT images (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eData collections\u003c/h3\u003e\n\u003cp\u003eA group of final year dental students, who received 2 weeks of training in CBCT analysis, examined the MC patterns and AL parameters of the MC under the supervision of A.S. and A.H., who have 5 years of experience in evaluating CBCT images. The collected data consisted of two parts. The first part was related to the participant characteristics, which comprised gender (male or female), and age group, which was divided into four groups (less than 20, 20\u0026ndash;40, 41\u0026ndash;60, and more than 60), shape and pattern of the MC (straight, vertical, and AL), and the ALs with their parameters.\u003c/p\u003e\n\u003ch3\u003eCBCT Image assessment and measurements\u003c/h3\u003e\n\u003cp\u003eMultiplanar reconstructions were made from archived image sequences, and the presence or absence of an AL was recorded. After the identification of AL, the following measurements were carried out on the CBCT images. Previously criteria given (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e) for the assessment of various patterns were followed to classify the MC into straight and vertical patterns and AL using CBCT. Figure\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the shape and definitions of the MC parameters. Figure\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e displays the AL and its parameters, including H\u003csub\u003e1\u003c/sub\u003e, H\u003csub\u003e2\u003c/sub\u003e, and H\u003csub\u003e3\u003c/sub\u003e, along with their characterizations and description and the length and width of AL (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDifferent anatomical parameters related to the AL and their definition [7,25]\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParameters (abbreviation)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParameters definition\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFigure number\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe height from the upper edge of the MF to the lower edge of the mandible in panoramic reconstructed images and sagittal sections.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 C, 2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe height from the frontmost part of the AL to the lower edge of the mandible in panoramic images and sagittal sections.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 C, 2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe height between the bottom edge of the inferior alveolar nerve canal to the lower edge of the jawbone.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 C, 2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLength of AL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe distance between H1 and H2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 C, 2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiameter of AL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe diameter of AL before coming out from the MF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 C, 2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBCP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe distance between the most anterior point of the AL and the Buccal cortical plate (BCP)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 B\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLCP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe distance between the most anterior point of the AL and the Lingual cortical plate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 C\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIBM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe distance between the most anterior point of the AL and the Inferior border of the mandible\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 D\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e (A) Reconstructed panoramic image showing the presence of a straight pattern on the left side and anterior loop on the right side (red arrow). Coronal section showing the distance between the most anterior point of the anterior loop and the (B) Buccal cortical plate (BCP) (C) Inferior border of the mandible (IBM) (D) Lingual cortical plate (LCP)\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eReliability and normality assessments\u003c/h2\u003e \u003cp\u003eFor the assessment of measurement reliability, the intraclass reliability analysis was performed in the present study. The level of agreement between raters was assessed through the application of Cohen\u0026rsquo;s kappa statistic. The finding indicates a virtually good agreement and meets the values recorded in studies. Statistical significance was set at a P-value of \u0026le;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eStatistical analysis was carried out using version 21.0 of the Statistical Package for the Social Sciences (SPSS; IBM, California, USA). Descriptive statistics in the form number and percentage among gender, age groups, side, patterns of MC, and height of the AL were documented. Other AL parameters were documented as mean and standard deviation (\u0026plusmn;\u0026thinsp;SD). A one-way analysis of variance (ANOVA), Pearson chi-square, independent t-test, and multiple post hoc tests were conducted to assess the association and significance between and within groups. A significance level of ˃0.05 was deemed statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Result","content":"\u003cp\u003eA total of 558 CBCT images (1116 hemimandibles) were analyzed in the current study, with the participants having a mean and \u0026plusmn;\u0026thinsp;SD age of 39.1\u0026thinsp;\u0026plusmn;\u0026thinsp;15.6 years. The participants comprised 232 males (41.6%) and females326 (58.4%). The highest age group was 20\u0026ndash;40 years with 292 participants (52), and the lowest was ˃20 years (37 participants; 7.0%) \u003cb\u003e(\u003c/b\u003eFig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e The intraclass reliability was high and reached between 0.989\u0026ndash;0.994, with a mean 0.992 of indicating a high and strong correlation.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe straight mental canal pattern was the highest on both sides, with value of 360 (64.5%) for the right and 355 (63.6%) for the left side. In addition, the vertical pattern was slightly higher on the left side (188; 33.7%) compared with the right (183; 32.8%). The AL of the MC pattern recorded the lowest prevalence on both sides with a value of 15 (2.7%). No significant differences were observed between the sides and patterns of MC (p 0.950; Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePrevalence of different patterns of mental canal by sides (Chi-squared test)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eShapes of MC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRight (N\u0026thinsp;=\u0026thinsp;558)\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLeft (N\u0026thinsp;=\u0026thinsp;558)\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal (N\u0026thinsp;=\u0026thinsp;1116)\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStraight\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e360.0 (64.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e355.0 (63.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e715.0 (64.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.950\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVertical\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e183.0 (32.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e188.0 (33.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e371.0 (33.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAnterior loop\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15.0 (2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.0 (2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.0 (2.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn terms of the relation between the gender and side, the straight and vertical patterns and AL of the MC were more prevalent among females on both sides. The highest number and percentage were observed in the female group and on the left side for the straight pattern (203; 63.2%), and the vertical pattern was slightly higher on the right side and reached 115 (35.3%). AL exhibited the least pattern among females on both sides. Chi squared test showed no significant differences between the right and left sides, genders, and the pattern of MC, with p 0.326 and 0.226 (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePatterns of MC in relation to shape, gender, and side (Chi-squared test)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSide\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePattern of MC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMale (n\u0026thinsp;=\u0026thinsp;232)\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale (n\u0026thinsp;=\u0026thinsp;326)\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;558)\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eRight\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStraight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e157 (67.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e203 (62.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e360 (64.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.326\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVertical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68 (29.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e115 (35.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e183 (32.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eAnterior loop\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8 (2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15 (2.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eLeft\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStraight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e149 (64.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e206 (63.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e355 (63.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.226\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVertical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e80 (34.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e108 (33.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e188 (33.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eAnterior loop\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12 (3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15 (2.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the pattern of MC shape with the age groups and sides. On the right side, the straight pattern of MC was the highest among the four age groups and directly proportional with age (as age increase, the percentage of the straight MC shape increased). Similarly, a direct proportionality was observed between the percentage of straight MC shape and left side with age groups. Although the vertical shape of the MC was higher on both sides and among younger age groups and decreased with the increase in age, this percentage decreased in the ˂60 age group. AL showed the least patterns among all age groups on both sides. Chi squared test exhibited no significant differences between sides and age groups, with the MC pattern having values of p 0.054 and 0.078, respectively (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePatterns of MC in relation to shape, age groups, and side (Chi-squared test)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSide\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePattern of MC\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e˃ 20 (N\u0026thinsp;=\u0026thinsp;37)\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20\u0026ndash;40 (N\u0026thinsp;=\u0026thinsp;292)\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41\u0026ndash;60 (N\u0026thinsp;=\u0026thinsp;171)\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e˂ 60 (N\u0026thinsp;=\u0026thinsp;58)\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTotal (N\u0026thinsp;=\u0026thinsp;558)\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eRight\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStraight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16 (43.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e182 (62.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e119 (69.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e43 (74.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e360 (64.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.054\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVertical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (51.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e102 (34.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e48 (28.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e14 (24.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e183 (32.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eAnterior loop\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8 (2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4 (2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1 (1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e15 (2.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eLeft\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStraight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18 (48.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e176 (60.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e119 (69.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e42 (72.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e355 (63.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e0.078\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVertical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17 (45.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e106 (36.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e49 (28.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e16 (27.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e188 (33.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eAnterior loop\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (3.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3 (1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e15 (2.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eRegarding the comparison between gender and AL parameters of the evaluated CBCT images, the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD of heights H1, H2, and H3 were higher in males (13.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1, 11.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3, and 8.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4 mm, respectively). Independent t-test revealed a significant difference between males and females in terms of H1, H2, and H3, with p 0.002, \u0026lt;\u0026thinsp;0.001, and \u0026lt;\u0026thinsp;0.001, respectively. The AL lengths (mm) were similar in both genders (5.1 mm), but the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD of diameter was higher among females, with significant differences observed at p 0.002. The distances of LCP and IBM AL parameters (mm) were higher among males, with the IBM showing significance (p 0.001). Meanwhile, the BCP distance was higher among females 2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9 and 3.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7 for males, and the independent t- test showed no significant differences (p 0.378, Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison between mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD of AL parameter and genders (independent t- test).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParameters\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAverage\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep values\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eH1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e13.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e11.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e12.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eH2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e11.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e9.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e10.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eH3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e8.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e7.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLength\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e5.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e5.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e5.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.911\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDiameter\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e2.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBCP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e2.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.378\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLCP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e3.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.938\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIBM\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e10.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e7.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e8.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e*Significant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn relation to the AL parameters and side of the assessed CBCT images, the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD of heights H1, H2, and H3 were higher on the right side and reached 12.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9, 10.5\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0, and 7.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4 mm, respectively. The length and diameter of the AL in mm were slightly higher on the right side, with values of 5.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.6 and 2.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4 and 5.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0 and 2.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9 mm the right and left sides, respectively. Likewise, the distances of BCP, LCP, and IBM of the AL parameters (mm) were higher on the right side, with averages of 2.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9, 3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5, and 8.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0 mm for BCP, LCP, and IBM, respectively. Independent t- test showed no significant differences between the sides and AL parameters (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison between mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD of AL parameter measured and sides (independent t- test)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAL Parameters\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRight\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAverage\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep values\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eH1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e12.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e11.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e12.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.092\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eH2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e10.5\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e9.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e10.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.294\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eH3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e7.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e7.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.237\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLength\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e5.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e5.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e5.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.594\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDiameter\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e2.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.672\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBCP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e2.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.831\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLCP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e4.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e3.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.528\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIBM\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e9.0\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e8.1\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e8.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.283\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e displays the comparison results between the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD of all the tested age groups and AL parameters assessed via ANOVA. Among all age groups tested for heights H1, H2, and H3 parameters, the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD of height (mm) slightly increased with the increase in age, with average values of 12.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4, 10.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9, and 7.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5 mm, respectively. Only height H3 was significantly different among age groups (p 0.025).\u003c/p\u003e \u003cp\u003eThe length and diameter of AL were changed in the different age groups, with average increases and decreases (mm) of 5.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4 and 2.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5 mm, respectively, but without significant differences (p values of 0.178 and 0.332). Similarly, the distances of BCP, LCP, and IBM parameters (mm) increased and decreased in the different age groups, with average values of 2.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9, 3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5, and 8.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0 mm for BCP, LCP, and IBM, respectively, and without significant differences (p values of 0.977, 433, and 193; Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison between mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD of AL parameter measured and age groups (One-way ANOVA test).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAL parameters\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e˃ 20\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u0026ndash;40\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41\u0026ndash;60\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e˂ 60\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAverage\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep values\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e11.8\u0026thinsp;\u0026plusmn;\u0026thinsp;0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e11.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e12.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.9\u0026thinsp;\u0026plusmn;\u0026thinsp;NC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e12.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.427\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e8.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e10.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e10.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.3\u0026thinsp;\u0026plusmn;\u0026thinsp;NC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e10.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eH3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e6.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e7.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.2\u0026thinsp;\u0026plusmn;\u0026thinsp;NC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e7.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.025\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLength\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e4.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e5.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e4.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.3\u0026thinsp;\u0026plusmn;\u0026thinsp;NC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e5.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.178\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiameter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.1\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.3\u0026thinsp;\u0026plusmn;\u0026thinsp;NC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e2.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.332\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBCP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e2.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e2.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.3\u0026thinsp;\u0026plusmn;\u0026thinsp;NC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e2.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.977\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLCP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e4.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e4.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e3.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.4\u0026thinsp;\u0026plusmn;\u0026thinsp;NC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.433\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIBM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e7.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e8.7\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e8.5\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.9\u0026thinsp;\u0026plusmn;\u0026thinsp;NC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c6\"\u003e \u003cp\u003e8.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.193\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e*significant NC- not calculated\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e shows the Cohen\u0026rsquo;s kappa statics\u0026rsquo; interrater agreements. The highest agreements and correlations were observed for H2 and H3 and AL diameter of 0.75, and medium agreements and correlation were noticed for LCP, AL length, and BCP with 0.59, 0.45, and 0.45, respectively. The only weak interrater agreements were recorded for H1 and IBM parameters (0.32 and 0.31, respectively). All AL parameters showed significant differences with p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 except for H1 and IBM, with p values of 0.100 and 0.066, respectively.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCohen's kappa-statistic measure of interrater agreement of AL parameters\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLA Parmeter\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgreement %\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eKappa\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u0026thinsp;\u0026gt;\u0026thinsp;t\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eH1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eH2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eH3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLength\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.048\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ediameter\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBCP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.042\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLCP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIBM\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.066\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe inter-mental space of the mandible is considered safe for implant placement and plays a role in various surgical procedures. Understanding the region\u0026rsquo;s anatomy is crucial to preventing injuries to the neurovascular bundle. Before performing osteotomy, the foramen position and the potential presence of a loop of the mental nerve near the MF must be considered to prevent any damage to the mental nerve (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). The diverse patterns of MC, including straight, vertical, and loop patterns, were identified, and measurement of AL parameters among different populations was performed via CBCT for the accurate diagnosis and appropriate choice among different forms of dental treatments (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe present CBCT study assessed the percentage of prevalence of MC patterns and parameters of AL in a sample of Yemeni population and compared the outcomes of these important anatomical structures with those of worldwide studies. The overall AL parameters (height, length, diameter, and distances to buccal and lingual cortical plates and IBM) among sex, age group, and side were slightly consistent with the findings of two studies on Indian population (Giroh et al., 2022 [7]) and marginally parallel with those of Sinha et al. (2019) [25]. However, different results were observed in other national and worldwide research were carried out on Arab population (Al-Mahalawy et al., 2017 (Saudi) [24] and Najm et al., 2017 (Iraqi) [30]), Indian population (Puri et al., 2020 [29; Siddiqui et al., 2018 [31]), Turkish participants (Sahman and Sisman 2016; Eren et al., 2016; Demir et al. 2015 [27,32,33]), Brazilians (do Nascimento et al., 2016; Gen\u0026uacute; et al., 2014 [34,35]), and a single study in other countries (Apostolakis and Brown 2012 (Greece), Panjnoush et al., 2016 (Iran) [36], Todorovic et al., 2018 (south Africa) [37], and Ngeow et al. 2009 (Malaysia) [38]). The disagreement can be correlated to the different races and systems and procedures of measurements of AL parameters that may play contribute to the total outcomes of the measurements of AL parameters and MC patterns.\u003c/p\u003e \u003cp\u003eThe prevalence and AL patterns of the mental nerve parameters varied among different populations [39]. According to the results of the present CBCT study, the straight pattern was most prevalent (64.1%), followed by vertical (33.2%) and AL (2.7%) ones. This finding is marginally similar to those verified in the Indian population, with values of 67.1%, 26.0%, and 6.5% for the same parameters (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), but lower than the prevalence of straight (46.2%), vertical (38.6%), and AL (15.2%), respectively, documented among Saudi population (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). In the Turkish population, the vertical patten was the most prevalent (44.7%) compared with the straight pattern (33.3%) and AL (21.9%) (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). However, another research conducted in Turkey showed the AL with a higher prevalence (59.5%), followed by vertical (31.9%) and then straight (8.6%) pattern (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e), which indicates a different outcome compared with those of the current study.\u003c/p\u003e \u003cp\u003eThe present study showed a low prevalence of AL (2.7%) in the assessed CBCT images. One study on the frequency of AL through the use of CBCT (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) in Eastern India revealed AL in 97 scans (9.7%) out of 1000 scans. By contrast, another study on an Indian population found a high prevalence of AL (37.3%) (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e), whereas a value of 41.6% was documented among Brazilian population (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). However, the reported highest percentages of the AL prevalence ranged between 48\u0026ndash;86% in surveys carried out in Greece, Iraqi, Iranian, Indian, and South Africa (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). This considerable diffrences can be associated and related to interindividual anatomical variability linked with gender, age, and race and the application of vaopis measurement techniques.\u003c/p\u003e \u003cp\u003eThe prevalence of MC patterns varied among different genders and sides of populations [39]. According to the current study results, no significant difference was observed between gender and side. By contrast, the straight pattern was more prevalence and common in females, however the vertical pattern and AL were more amongst males. The spreading of patterns of MC was highly significant between the studied male and female participants (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). The varied observations detected in various studies can be due to the ethnic variances and genetic structure among genders.\u003c/p\u003e \u003cp\u003eIn this study, the results on age parameter showed no significant differences and were uncorrelated with the prevalence of various patterns of MC. Similar findings were documented earlier in a Thai population (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). However, other previous results have assumed that age was significant with the prevalence of AL (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e); another study demonstrated a high prevalence of AL among older age groups (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Another relevant factor can be the grade of cortication because of its relation to canal visibility. Well cortication may lead to enhanced perceptibility and visualization of the canal (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). The grade of resorption of the mandible decrees the visualization of the canal during CBCT analysis. The visibility of ALs condensed with increase in the age of participants. An obvious increase in resorption and the enlargement of marrow space were observed with aging, and disordered trabeculae were often observed, and they affected the identification of the AL (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAccording to the present results, no significant differences were observed between gender and AL prevalence. This finding is parallel to those observed in a Brazilin population (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). By contrast, among Turkish, Iraqi, and Easten Indian populations, significant differences were documented between gender and AL prevalence (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e), German (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e) and South Africa populations (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). However, the present study revealed that AL was more prevalent in females than males, which coincides with findings of previous studies on Brazilian and Turkish populations (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Other works conducted in different countries revealed a higher AL incidence in males than in females (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). The varied notes found in different literatures can be due to ethnic differences and genetic constitution among the populations.\u003c/p\u003e \u003cp\u003eIn the present CBCT study, the percentages of AL were the same on the right and left sides, which is in difference to those of various studies conducted among populations from Turkey and Iraq (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e), where AL was more commonly observed on the left side. However, Giroh et al. (2022) documented that AL was higher on the right side among Indians [7].\u003c/p\u003e \u003cp\u003eThe height of the AL to the lower border of mandible from three different points (H1, H2, and H3) is an important anatomical structure; iatrogenic injury should be avoided in different surgical areas on both sides of the mandible (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). The average distances of AL parameters showed a significant difference between genders (Table\u0026nbsp;0000), with values of 12.15\u0026thinsp;\u0026plusmn;\u0026thinsp;2.25, 10.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.85, and 7.05\u0026thinsp;\u0026plusmn;\u0026thinsp;1.55 mm for H1, H2, and H3, respectively. Meanwhile, among the different assessed age groups, only H3 displayed a significant difference with the side (Table\u0026nbsp;000). A single study revealed no significant differences in the H1, H2, and H3 among males and females, side, and age (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe length of AL amongst the most anterior part of the loop and MF represents the distance of MC mesial to MF (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). In the current CBCT study, the length of AL was greater in males than females but without a significant difference. This result coincides with the findings of studies conducted on Brazilians, Turkish, and Japanese (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). By contrast, the length of AL was significantly different and higher in males than females (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). Such differences may be explained by size of the males\u0026rsquo; mandible arch, which is larger than that of females. Furthermore, the present study revealed that the length of AL was not significant with side, similar to the findings of earlier studies (7,2329,32,34\u0026ndash;35). Our result showed no significance with age (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe longest AL verified in this CBCT analysis study was 10.3 mm, and the mean length of the AL was 5.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4 mm, which is slightly longer than that recorded by previous studies on Indian populations (mean of length of the AL 3.31 and 1.07\u0026thinsp;\u0026plusmn;\u0026thinsp;1.42 mm (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e) and 3.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77 in Eastern India (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e)). In addition, the documented length of AL among Yemenis participants was higher than that recognized among Brazilin and Turkish populations (3.14\u0026thinsp;\u0026plusmn;\u0026thinsp;1.25 and 2.9\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3 mm, respectively) (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Despite being clinically related to a certain level, this length was nearly similar with the maximum length (11 mm) reported for a sample assessed from a Caucasian subpopulation (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). This finding may be attributed to individual characteristics such as gender, age, race, the method of assessment, and the level of alveolar bone loss.\u003c/p\u003e \u003cp\u003eThe diameter and length of the AL before emerging from the MF should be carefully considered and quantified during different dental steps to minimize postsurgical complications (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). In this CBCT study, the AL diameter was 2.4\u0026thinsp;\u0026plusmn;\u0026thinsp;0.5 mm, which is significantly higher in males than in females and but not significantly different with age and side. This result is in disagreement with the AL diameter observed among Indian contributors (3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.67 mm); however, the results showed no significant difference between genders, side, and age (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe measurement of distance between the most anterior point of the AL and its parameters (BCP, LCP, and IBM) is important during surgery near the MC foremen (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). In this study which used CBCT, BCP and LCP were not significantly different in males and female; only IBM was significantly greater in males than females, which is in agreement with the finding of Giroh et al. (2022), whose measured the distances of the same AL parameters among Indians (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). However, the same parameters were significantly higher in males among Iraqis (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOn the contrary, no significant differences were noted among AL parameters (BCP, LCP, and IBM), and no significant difference was observed in Turkish males and females (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). However, all the studies exhibited higher values in males than females (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Such differences may be explained by the of males\u0026rsquo; mandible\u0026rsquo;s larger volume, increased height, and wider buccolingual width (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). Furthermore, the BCP, LCP, and IBM were not significantly different with side and age. These results are in parallel with those of study conducted among Turkish (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e) and in contrast with those of research that involved Indian and Iraqis (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e), which revealed the significance of those parameters and the jaw site. The race-related physique can be an important influencing factor, and the number of CBCT was included in different studies.\u003c/p\u003e \u003cp\u003eDental practitioners of various specialty accomplishment inter-foraminal oral operations, such as dental implant drilling and genioplasty, should be alert of the AL parameters to prevent iatrogenic mental nerve injury [39]. In present study, the recorded mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD distance between the AL and other parameters were 2.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9, 3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5, and 3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5 mm (BCP, LCP, and IBM, respectively). Similar distances were documented among samples from Turkey (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e) for the three parameters, and only BCP and IBM were marginally near the values recorded in this study; however, considerably higher mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD were recorded for the LCP, with values of 2.24, 4.24, and 8.63 mm for BCP, IBM, and LCP, respectively, among Indian samples (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). By contrast, a study conducted among Iraqi patients recorded a lower average distance of AL to BCP (2.5\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9/1.06\u0026thinsp;\u0026plusmn;\u0026thinsp;0.3 mm) and higher AL to LCP and IBM (3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5/4.25\u0026thinsp;\u0026plusmn;\u0026thinsp;0.4/3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5 and 3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5/7.69\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9 mm respectively) (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). This finding was observed possibly because race-related physique can be an vital influencing aspect.\u003c/p\u003e \u003cp\u003eThe present study provided information on the frequency of different patterns of MC and AL parameters (height, length, diameter, and distances to buccal and lingual cortical plates and IBM), including gender, different age groups, and side used. The findings compared with the results supported by the utilizing of 3D measurement and assessment. Anatomical point measurement was critical in avoiding challenges earlier to the most dental procedures near the MF, such as apicoectomy, impacted teeth removal, immediate implant placement, pathology removal, and orthognathic surgery and related procedures.\u003c/p\u003e \u003cp\u003eThe present CBCT analysis study was limited to three cities of Yemen and did not focus on associated structures of the mental canals. In practical terms, we highlight the status of evaluating each case individually and not relying on specific measurements for determining a safety distance.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe following conclusions can be drawn from the present CBCT study:\u003c/p\u003e \u003cp\u003eThe most prevalent MC pattern was straight, followed by a vertical pattern and AL. Patient age, sex, and side had no significant effects on the prevalence of various patterns of MC (straight, vertical, and loop).\u003c/p\u003e \u003cp\u003eAL measurement showed no significance with age and side except the height between the bottom edge of the inferior alveolar nerve canal to the lower edge of the mandible.\u003c/p\u003e \u003cp\u003ePatient sex exhibited significant effects on all AL measurements (height and diameters of AL and distance from the most anterior part of AL to IBM) and non-significance with the length of AL and most anterior part of the AL to the lingual and buccal plates.\u003c/p\u003e \u003cp\u003eClinically, dental specialist and practitioners must study parameters, such as age, sex, and status of AL among Yemeni patients, during different dental procedures.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eStudy Design AData Collection BStatistical Analysis CData Interpretation DManuscript Preparation Ereviewed the manuscript FAnas Saeed AL-Zaghruri A,B,D,EMohammed M Al Moaleem A,B,C,EAmmar Ahmed Al-Hiagem B D,FNashwan abduljabbar Noman B,FBaleegh Abdulraoof Al-kadasi D,FKhaled Ahmed Abdulkareem B,DAmjad fahedAL-Magraby B,DElyas Ahmed AL-romema B,DSara Muneer Abdullah B,DNada Abdo Hamood B,D\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eJacobs R, Lambrichts I, Liang X, Martens W, Mraiwa N, Adriaensens P, Gelan J. 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Inte J Scie Research. 2017; 6(3): 920-7. DOI:10.21275/ART20171557\u003c/li\u003e\n\u003cli\u003eSiddiqui Z, Rai S, Ranjan V. Efficacy and evaluation of cone beam computed tomography in determining the prevalence and length of anterior loop of inferior alveolar nerve in North Indian population. J Indian Academy Oral Medicine Radiology. 2018; 30(1): 32-37. DOI: 10.4103/jiaomr.jiaomr_121_17\u003c/li\u003e\n\u003cli\u003eEren HK, Orhan N, Bagis R, Nalcaci M, Hincal E. Cone beam computed tomography evaluation of mandibular canal anterior loop morphology and volume in a group of Turkish patients. Biotechnology Biotechnological Equipment. 2016; 30(2): 346-353. https://doi.org/10.1080/13102818.2015.1127181\u003c/li\u003e\n\u003cli\u003eDemir A, Izgi E, Pekiner PN. Anterior loop of the mental foramen in a Turkish subpopulation with dentate patients: a cone beam computed tomography study. J Marmara Univ Inst Health Sci. 2015; 5(4): 231-38. DOI: 10.5455/musbed.20150715121209\u003c/li\u003e\n\u003cli\u003edo Nascimento EH, Dos Anjos Pontual ML, Dos Anjos Pontual A, da Cruz Perez DE, Figueiroa JN, Fraz\u0026atilde;o MA, Ramos-Perez FM. Assessment of the anterior loop of the mandibular canal: A study using cone-beam computed tomography. Imaging Sci Dent. 2016 Jun;46(2):69-75. doi: 10.5624/isd.2016.46.2.69.\u003c/li\u003e\n\u003cli\u003eGen\u0026uacute; PRR, Vasconcellos BP, Oliveira BCG, Vasconcelos D, Delgado C. Analysis of anatomical landmarks of the mandibular interforaminal region using CBCT in a Brazilian population. Braz. J. Oral Sci.. 2014; 13 (4): 303-307. https://doi.org/10.1590/1677-3225v13n4a12\u003c/li\u003e\n\u003cli\u003ePanjnoush M, Rabiee ZS, Kheirandish Y. Assessment of Location and Anatomical Characteristics of Mental Foramen, Anterior Loop and Mandibular Incisive Canal Using Cone Beam Computed Tomography. J Dent (Tehran). 2016 Mar;13(2):126-132. PMID: 27928241; PMCID: PMC5139930.\u003c/li\u003e\n\u003cli\u003eTodorovic VS, Postma TC, van Zyl AW. Assessment of the anterior loop of the inferior alveolar nerve using reformatted computed tomography: a retrospective study. Br J Oral Maxillofac Surg. 2018 Apr;56(3):186-191. doi: 10.1016/j.bjoms.2018.01.007. \u003c/li\u003e\n\u003cli\u003eNgeow WC, Dionysius DD, Ishak H, Nambiar P. A radiographic study on the visualization of the anterior loop in dentate subjects of different age groups. J Oral Sci. 2009 Jun;51(2):231-7. doi: 10.2334/josnusd.51.231.\u003c/li\u003e\n\u003cli\u003eHui L, Hung KF, Bornstein MM, Leung YY. 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. Clin Oral Investig. 2022 Nov;26(11):6423-6441. doi: 10.1007/s00784-022-04656-x. \u003c/li\u003e\n\u003cli\u003eRitter L, Neugebauer J, Mischkowski RA, Dreiseidler T, Rothamel D, Richter U, Zinser MJ, Zoller JE. Evaluation of the course of the inferior alveolar nerve in the mental foramen by cone beam computed tomography. Int J Oral Maxillofac Implants. 2012 Sep-Oct;27(5):1014-21. PMID: 23057013.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Mandibular canal, mental foramen, anterior loop, CBCT, gender, side, Yemeni ","lastPublishedDoi":"10.21203/rs.3.rs-5506322/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5506322/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Mandibular canal (MC) is mostly influenced by individual characteristics, such as gender, age, race, and level of alveolar bone loss, and it needs to be assessed prior to various posterior mandibular surgeries. This study aimed to evaluate the MC anatomical patterns and anterior loop (AL) parameters among Yemeni samples via cone‑beam computed tomography (CBCT).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterial/Methods: \u003c/strong\u003eIn this CBCT retrospective cross-sectional study, 558 CBCTs were recruited, and the MC patterns and AL parameters were categorized created on sex and age groups. Contributors CBCT images were analyzed, assessed, and measured from the sagittal and panoramic views, and the MC patterns were documented as straight and vertical. In addition, the AL length, diameter, and the distance to buccal cortical plate (BCP) and lingual cortical plate (LCP) and inferior border of the mandible (IBM) in were recorded association with the sex, age groups, and side. The significance level was set at P\u0026lt;0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe MC patterns were\u003cstrong\u003e \u003c/strong\u003e64.5%, 32.8%, and 6.9% for the straight and vertical patterns and AL, respectively. The AL had an overall prevalence of 2.7%. The AL length and diameter were 5.1±1.4 and 2.4±0.5 mm, respectively. The distances of the anterior part of the AL were 2.5±0.9, 3.8±1.5, and 8.6±2.0 mm for the BCP, LCP, and IBM, respectively. No significant differences were observed between the MC patterns and all AL parameters (gender, age groups, and side; p \u0026gt; 0.05), except the height between the bottom edge of the inferior alveolar nerve canal and the lower edge of the jawbone (p 0.025). Patient gender had significant effects on all AL height and diameters and parameter mea­surements (p \u0026lt;0.05). Moreover, the AL diameter displayed a significant difference only with the IBM with p 0.001.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e The overall prevalence of AL was low on both sides, and the AL parameters were higher in males and on the right side. Among MC patterns, the straight pattern was the most prevalent in females, on the right side, and among age groups.\u003c/p\u003e","manuscriptTitle":"CBCT Retrospective Study of the Prevalence of the Anterior Loop of the Mandibular Canal in Yemeni Population","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-25 15:39:16","doi":"10.21203/rs.3.rs-5506322/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"91985e6f-b539-4069-83b7-90c5cd938f29","owner":[],"postedDate":"November 25th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-11-25T15:39:26+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-25 15:39:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5506322","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5506322","identity":"rs-5506322","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}