Radiographic localization of mandibular anesthesia landmarks.

The objective of this study was to assess whether bony landmarks used for the standard inferior alveolar nerve block can be used to accurately determine the position of the mandibular foramen and whether panoramic radiographs are appropriate for this purpose. A total of 11 landmarks from 79 panoramic radiographs and 70 corresponding cases of oblique (45-degree) cephalometric radiographs were examined. Ten measurements of the distance from each landmark to the mandibular foramen, as well as 6 ratios from these distances, were calculated from all radiographs. The results showed that the position of the mandibular foramen was highly individualistic and not consistently related to traditional clinical landmarks. Panoramic radiographs were as good as oblique cephalometric radiographs for the locating of the mandibular foramen. No age or gender correlations were found. It was concluded that the mandibular foramen can be localized in panoramic radiographs but that its relation to bony landmarks is highly variable.