Determination of the position of mental foramen and frequency of anterior loop in Saudi population. A retrospective CBCT study.

OBJECTIVES: To determine the position of mental foramen (MF) and frequency of anterior loop (AL) using dental cone beam computed tomography (CBCT). MATERIALS AND METHODS: The study involved the evaluation of 302 CBCT scans (196 males, 106 females). The position of MF was determined with respect to adjacent teeth, nearest root apex of adjacent teeth and mandibular borders. MF position was also assessed based on gender and age. In addition, prevalence of anterior loop was evaluated by categorizing the inferior alveolar canal (IAC) patterns into linear, perpendicular and anterior looping. RESULTS: The study revealed that the most common position of MF was below the apex of 2nd premolar accounting for a total of 52.8% of scans whereas, only 29.6% observed MF between 1st and 2nd premolar (p > 0.05). 38.7% of MF were located at a distance of 1-3 mm from the nearest root apex (2nd premolar), followed by a distance of less than 1 mm in 17.05 of cases. 63.2% of foramen on left side of the mandible were observed below the apex of 2nd premolar in females (p = 0.023). Statistically significant findings were observed with regards to position of MF in different age groups (p < 0.05). The most common IAC pattern observed was linear in nature which accounted for 46.2% of cases followed by perpendicular pattern (38.6%). AL was found only in 15.2% of cases. CONCLUSIONS: Our sample population most commonly exhibited MF below the apex of 2nd premolar with linear IAC pattern. AL was regarded as the least common pattern in Saudi population.

Rectal impalement injury through the pelvis, abdomen and thorax.

Impalement rectal injuries with intraperitoneal organ injuries are rare. It is even rarer for such injuries to result in pelvic, abdominal and thoracic internal injuries. We present the case of a 39-year-old man who was admitted after an assault where a broken broomstick was inserted forcibly into his rectum. Surgery revealed penetration through the rectum, dome of the bladder, mesentery, liver and right lung. The patient survived following management by a multispecialty surgical team. Our literature review identified four similar cases with one fatality only. Prognosis seems to be good in these types of injuries provided there is an early presentation, the penetrating object is left in situ before the operation and, most importantly, there is an organised team approach to deal with the various injuries.