The identification of the mental foramen is important for both diagnostic and clinical procedures. The knowledge about its accurate location is significant in reducing complications that may occur during surgical and endodontic treatments involving the mental area. The purpose of this study was to determine the position of mental foramen in relation to the radiographic apex of the mandibular second premolar on panoramic radiographs. Two hundred digital panoramic radiographs were analyzed in this study. Horizontal and vertical position of the mental foramen was determined in relation to the two reference lines which passed through the apex of the mandibular second premolar. The possible positions were: mesial below, mesial intersecting, mesial above, intersecting below, centered, intersecting above, distal below, distal intersecting and distal above. Fifty percent of the panoramic radiographs showed that the mental foramen position was mesial and below the radiographic apex of the second premolar. Mesial and intersecting position was observed in 21% of the radiographs, centered in 13%, intersecting and below in 8%, distal and below in 6%, while 2% of the radiographs showed distal and intersecting position of the mental foramen. No statistically significant differences in the position and the symmetry of the mental foramen were observed in relation to the gender and the side of the mandible. The most common position of the mental foramen was mesial and below the radiographic apex of the mandibular second premolar. For an accurate assessment of the location of the mental foramen, a preoperative radiological study with a panoramic radiograph is necessary.

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