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Sample records for atrophic posterior mandible

  1. Avoiding osseous grafting in the atrophic posterior mandible for implant-supported fixed partial dentures: a report of 2 cases.

    PubMed

    Flanagan, Dennis

    2011-12-01

    Bone atrophy occurs after tooth extraction in the posterior mandible, placing the mandibular canal and its neural, arterial, and venous contents closer to the osseous facial aspect and the coronal crest. This proximity places the structure in danger of damage when dental implants are surgically placed to support fixed or removable prostheses. Several options are available to treat these areas for implant-supported fixed and removable complete or partial dentures. Osseous grafting and ridge expansion are surgical options that enable acceptance of standard sized dental implants but have serious morbidities. Additionally, vertical osseous augmentation is not predictable at this time. Narrow diameter dental implants can be placed to avoid the mandibular canal, but some bone volume situations preclude this. Very wide and very short (6.5 × 5 mm) dental implants may be placed at an angle in atrophic sites to successfully support fixed partial dentures. An anterior guidance occlusal scheme may be used in maxillary dentate patients or group function in maxillary complete denture patients. A 100 micron occlusal relief in fixed partial dentures in dentate patients may be required to account for natural tooth intrusion and to prevent occlusal overload of the implant-supported partial denture. PMID:20925498

  2. Management of atrophic mandible fractures.

    PubMed

    Madsen, Matthew J; Haug, Richard H; Christensen, Bryan S; Aldridge, Eron

    2009-05-01

    Traumatic facial fractures that were once rarely encountered now present with increasing frequency in the elderly population. Included in this group of fractures are those of the atrophic edentulous mandible. As patients age and become edentulous, atrophy of the mandibular alveolar ridges and adjacent basal bone reduces bony surface area, bone density, and blood supply, making the mandible more brittle and increasing the likelihood of mandibular fracture during a traumatic event. Surgical treatment of these fractures has become more predictable and less morbid. However, because these fractures present so infrequently, many surgeons lack the relevant experience in handling them, and thus find the reduction and fixation of such injuries difficult. A number of techniques have been employed to treat this injury. This article reviews the more common modalities and presents updates on accepted surgical treatments. PMID:19348982

  3. Decision-making algorithm in treatment of the atrophic mandible fractures*

    PubMed Central

    DE FEUDIS, F.; DE BENEDITTIS, M.; ANTONICELLI, V.; VITTORE, P.; CORTELAZZI, R.

    2014-01-01

    Aim Closed treatment of atrophic mandible fractures often results in malunion, pseudoarthrosis and pain. Open reduction and rigid internal fixation (ORIF) is still indicated for displaced atrophic mandible fractures. The Authors report a treatment protocol that allows to gain the best results using reconstruction plates, autologous bone grafting and free fibula flap reconstruction when necessary. Methods Retrospective analysis of 15 patients with atrophic mandible fractures who underwent treatment between 2007 and 2011. 7 cases did not receive any treatment because of their general condition, while the others 8 were surgically managed by external approach. In all cases load-bearing osteosynthesis plates with locking screws were used; in 2 of them contextual bone grafts were performed; in 1 case mandible reconstruction needed harvesting a free fibula flap. Results In 6 out of 8 cases complete functional and morphological restoration were obtained without any major complication. In 1 case suppurative infection and necrosis of the bone graft occurred, which made necessary its removing, leaving in situ only the reconstruction plate. In another case, during the first year after surgical treatment, atrophic mandible resorption occurred from one angle to the other, resulting in loss of the anchoring reconstruction plate. Conclusions ORIF is the gold standard procedure for the of atrophic mandible fractures, because it guarantees best morpho-functional outcomes and predictability. Nevertheless the Authors suggest contextual bone grafting in case of substance loss, or a poor quality bone or for dental implant surgery and free fibula flap in selected cases. PMID:24841687

  4. Unsuccessful Treatment of Atrophic Mandible Fracture by Use of Improper Materials.

    PubMed

    de Moraes Ferreira, Ana Carulina Rezende; Garcia Junior, Idelmo Rangel; Silva, Adalberto Novaes; de Carvalho Reis, Erik Neiva Ribeiro; Pires, Willian Ricardo; Bonardi, João Paulo; Borba, Alexandre Meireles

    2016-06-01

    Fractures of atrophic mandibles are present on the day by day of buccomaxillofacial surgeons. Mandible atrophy occurs due to tooth loss, which over time induces bone resorption leading to a fragile and susceptible to fracture structure. This paper reports the case of a patient victim of face trauma resulting in atrophic mandible fracture with treatment failure through the use of shared load miniplate. Therefore, a new treatment was performed with miniplate of system 2.4 along with bone graft. After 6 months, the patient was rehabilitated with implant-supported prosthesis installation. It is concluded that for successful treatment of atrophic mandible fractures, the use of rigid plates is necessary, allowing an excellent rehabilitation of the stomatognathic system. PMID:27244201

  5. A precise radiographic method to determine the location of the inferior alveolar canal in the posterior edentulous mandible: implications for dental implants. Part 1: Technique.

    PubMed

    Stella, J P; Tharanon, W

    1990-01-01

    In severely atrophic or osteoporotic mandibles, the location of the inferior alveolar nerve may vary considerably, both superoinferiorly and mediolaterally. A clinician's ability to reliably locate this nerve within the mandible would permit the surgical planning of implant placement in the posterior edentulous mandible. Eight edentulous cadaver mandibles were studied. A technique that precisely locates the inferior alveolar nerve within the mandible is described. The technique will aid the surgeon in planning a surgical approach to the posterior mandible with reduced risk of injury to the inferior alveolar nerve. PMID:2391135

  6. Impairment of an atrophic mandible by preparation of the implant cavity: a biomechanical study.

    PubMed

    Steiner, Timm; Torsiglieri, Tobias; Rau, Andrea; Möhlhenrich, Stephan C; Eichhorn, Stefan; Grohmann, Isabella; Deppe, Herbert; Hölzle, Frank; Raith, Stefan

    2016-07-01

    An important complication during insertion of implants in atrophic mandibles is the fracture that can be induced by preparation of the cavity. We designed this study to identify which configuration of cavities in the interforaminal region was the least likely to fracture. An electromechanical testing machine was used to measure breaking loads of specifically-designed synthetic models of atrophic mandibles. The implant cavities correlated with the common clinical patterns. Intact atrophied synthetic mandibles broke at a mean (SD) load of 729.48 (59.94) N (control group). Models with four different configurations of cavities fractured as follows: two short, wide cavities (8 x 4.2mm) at a mean (SD) load of 569.17 (67.7) N; two long, thin cavities (15 x2.8mm) at a load of 563.40 (62.0) N; four short, wide cavities (8 x 4.2mm) at a load of 667.01 (71.89) N; and four long, thin cavities (15 x 2.8mm) at a load of 409.50 (43.61) N. Biomechanical findings showed that there was a greater risk of fracture of atrophic mandibular models in long, thin implant cavities with more preparation sites. Each cavity prepared for an implant increased the risk of fracture in an atrophic mandible. The risk of fracture is greatest with long, thin cavities. PMID:27068851

  7. Reconstruction of an atrophied posterior mandible with the inlay technique and allograft block versus allograft particulate: a case report.

    PubMed

    Checchi, Vittorio; Mazzoni, Annalisa; Breschi, Lorenzo; Felice, Pietro

    2015-01-01

    This case report describes the bilateral reconstruction of a severely atrophic posterior mandible in a 30-year-old woman using allograft block versus particulate grafting in the inlay technique. Three months later, four dental implants were placed and bone core biopsy specimens were taken for histologic evaluation. During implant placement, the grafted sites were stable with good clinical osseointegration. The histologic analysis showed the presence of compact bone revealing areas of demarcation between grafted bone, newly formed bone, and bone-regenerated areas. Allografts might serve as an alternative to autogenous and heterologous grafting in posterior mandible augmentation using the inlay technique. PMID:25738350

  8. Prosthetic management of the atrophic mandible using endosseous implants and overdentures: a six year review.

    PubMed

    Chan, M F; Johnston, C; Howell, R A; Cawood, J I

    1995-11-11

    This paper presents the treatment results and experiences gained from a retrospective study of patients treated with the IMZ osseo-integrated implant system and mandibular overdentures. Patients experiencing problems wearing conventional dentures were assessed by the implant team and 65 cases were treated with 154 endosseous implants placed in the edentulous mandible. Two to four implants were placed in each case and in addition some patients have had augmentation of the mandible with hydroxyapatite. The definitive mandibular prostheses were supported by both implants and the residual ridges. A variety of retention systems were utilised, which included different types of bar and clip, stud attachments, and magnets. The patients have been followed up regularly and evaluated after periods of between one and six years. Six implants have failed over this time resulting in a success rate of over 96%. Most patients expressed a high degree of satisfaction with their new overdentures. There was, however, a considerable burden of maintenance care required for the patient group examined. The findings demonstrate that implant retained overdentures offer a highly effective means of oral rehabilitation for the atrophic mandible, restoring both oral function and facial form. PMID:7495628

  9. Guided Bone Regeneration of an Atrophic Mandible with a Heterologous Bone Block.

    PubMed

    Di Stefano, Danilo Alessio; Greco, Gian Battista; Riboli, Francesco

    2016-03-01

    The aim of this work was to test the effectiveness of using enzymatically deantigenated equine bone block as a scaffold for guided bone regeneration (GBR) during a horizontal augmentation of the lower jaw. A partially edentulous atrophic mandible was augmented using an equine-derived block with an expanded polytetrafluoroethylene membrane. After 8.5 months, two bone core samples were collected at the augmentation site, and implants were placed. A definitive prosthesis delivered 6 months after implant placement provided excellent functional and aesthetic rehabilitation throughout the follow-up period. Histological and histomorphometrical analysis of the biopsies showed newly formed bone to be present and the residual biomaterial was still undergoing remodeling. Comparison of cone beam computed tomography scans taken before augmentation and 26 months later showed maintenance of ridge width and possible corticalization of the vestibular augmented ridge side. The equine-derived bone block placed in accordance with GBR principles provided a successful clinical, radiographic, and histological outcome. PMID:26889354

  10. An unusual case of atrophic mandible fracture in a patient with osteogenesis imperfecta and on oral bisphosphonate therapy: Case report.

    PubMed

    Al-Osaimi, Abdulrahman; Samman, Mahmood; Al-Shakhs, Mohammad; Al-Suhaim, Faisal; Ramalingam, Sundar

    2014-04-01

    Fractures of severely atrophic (height < 10 mm) edentulous mandibles are infrequent and challenging to manage. Factors such as sclerotic bone and decreased vascularity combined with systemic diseases complicate the management of such fractures. Osteogenesis imperfecta (OI) is a heterogeneous group of inherited disorders of type I collagen metabolism. Patients with OI characteristically present with histories of long bone fractures, deformities, blue sclerae, and opalescent dentin. However, fractures of the facial skeleton are rare. Bisphosphonate therapy has been proven to effectively reduce the fracture risk in patients with OI. The purpose of this clinical report is to present an unusual case of spontaneous fracture of the atrophic mandible in a patient with OI. Despite open reduction and internal fixation (ORIF) with miniplate osteosynthesis, the patient developed a second fracture at a screw placement site distal to the first fracture. The patient was successfully treated with ORIF using locking reconstruction plates fixed in the symphyseal and angle regions. Bone healing following ORIF was normal, and no clinical sign of osteonecrosis as a result of bisphosphonate therapy was observed. Patients with OI can present with spontaneous fractures of already weakened mandibles. Although such fractures can be managed with care using established protocols, further research is required to examine the effects of concomitant medication, such as bisphosphonates. PMID:25408599

  11. An unusual case of atrophic mandible fracture in a patient with osteogenesis imperfecta and on oral bisphosphonate therapy: Case report

    PubMed Central

    Al-Osaimi, Abdulrahman; Samman, Mahmood; Al-Shakhs, Mohammad; Al-Suhaim, Faisal; Ramalingam, Sundar

    2014-01-01

    Fractures of severely atrophic (height < 10 mm) edentulous mandibles are infrequent and challenging to manage. Factors such as sclerotic bone and decreased vascularity combined with systemic diseases complicate the management of such fractures. Osteogenesis imperfecta (OI) is a heterogeneous group of inherited disorders of type I collagen metabolism. Patients with OI characteristically present with histories of long bone fractures, deformities, blue sclerae, and opalescent dentin. However, fractures of the facial skeleton are rare. Bisphosphonate therapy has been proven to effectively reduce the fracture risk in patients with OI. The purpose of this clinical report is to present an unusual case of spontaneous fracture of the atrophic mandible in a patient with OI. Despite open reduction and internal fixation (ORIF) with miniplate osteosynthesis, the patient developed a second fracture at a screw placement site distal to the first fracture. The patient was successfully treated with ORIF using locking reconstruction plates fixed in the symphyseal and angle regions. Bone healing following ORIF was normal, and no clinical sign of osteonecrosis as a result of bisphosphonate therapy was observed. Patients with OI can present with spontaneous fractures of already weakened mandibles. Although such fractures can be managed with care using established protocols, further research is required to examine the effects of concomitant medication, such as bisphosphonates. PMID:25408599

  12. Case report of a dilated odontome in the posterior mandible

    PubMed Central

    Almeida, Bruno; Silva, António; Pereira, Miguel; Silva, Mariana; Nunes, Stephanie

    2016-01-01

    Introduction Dens invaginatus (dens in dente) is a developmental malformation resulting from an invagination of enamel organ into the dental papilla, beginning at the crown and sometimes extending into the root before calcification occurs. Dilated odontome is the most extreme form of dens invaginatus and it is extremely rare in the posterior mandible. Presentation of case A 47 years old female patient with occasional episodes of diffuse pain and discomfort in the left posterior mandibular region. The extra-oral examination showed slight facial asymmetry. Panoramic and intra-oral X-rays show an intraosseous circular formation with radiopaque external limits and radiolucent interior. Discussion Computerized tomography scan reveals the bone integrity around the formation, as well as the independence of the neuro-vascular structures of the region. The most likely diagnostic option was dilated odontome. The enucleation procedure was carried out, and the fragments were sent to histopathological examination that revealed a diagnosis consistent with a dilated odontome. Conclusion In this case, the conservative surgical approach after planning was effective and predictable in the treatment of the pathology and patient symptoms without major complications. PMID:26780470

  13. Management of Limited Vertical Bone Height in the Posterior Mandible: Short Dental Implants Versus Nerve Lateralization With Standard Length Implants.

    PubMed

    Dursun, Erhan; Keceli, Huseyin Gencay; Uysal, Serdar; Güngör, Hamiyet; Muhtarogullari, Mehmet; Tözüm, Tolga Fikret

    2016-05-01

    Inferior alveolar nerve lateralization (IANL) and short dental implants (SDI) are 2 viable implant-based treatment approaches in the presence of atrophied posterior mandible. Despite the risks of dysfunction, infection, and pathologic fractures in IANL, it becomes possible to place standard implants. The purpose of this study was to compare SDI and IANL approaches from clinical and radiographic aspects. Fifteen subjects having unilateral atrophic mandibles were allocated to SDI and IANL treatment groups. Following surgical procedures, early postoperative complications, implant survival, and periimplant clinical and radiographic parameters including probing pocket depth, attachment level, keratinized tissue amount, vertical tissue recession, and marginal bone loss were recorded at baseline and 1-year after prosthetic rehabilitation. In both groups, no implant was lost. Except usual postoperative complications, 2 patients had transient paraesthesia after IANL. According to time-dependent evaluation, both groups showed significant increase in probing pocket depth and attachment level at 1-year follow-up compared with baseline (P < 0.05). Except a slight but significant increase in mesial surface of SDI group (P < 0.05), no remarkable time-dependent change was identified in vertical tissue recession. Keratinized tissue amount did not exhibit any inter- or intragroup difference during whole study period. Marginal bone loss did not show any difference between IANL and SDI groups at follow-up. SDI placement or standard length implant placement with IANL can be considered promising alternatives in the treatment of atrophic mandibular posterior regions. However, SDI may be preferred in terms of lower complication risk. PMID:26999693

  14. A two-short-implant-supported molar restoration in atrophic posterior maxilla: A finite element analysis

    PubMed Central

    2016-01-01

    PURPOSE The aim of this study was to investigate the stress distribution of 2-short implants (2SIs) installed in a severely atrophic maxillary molar site. MATERIALS AND METHODS Three different diameters of internal connection implants were modeled: narrow platform (NP), regular platform (RP), and wide platform (WP). The maxillary first molars were restored with one implant or two short implants. Three 2SI models (NP-oblique, NP-vertical, and NP-horizontal) and four single implant models (RP and WP in a centered or cantilevered position) were used. Axial and oblique loadings were applied on the occlusal surface of the crown. The von Mises stress values were measured at the bone-implant, peri-implant bone, and implant/abutment complex. RESULTS The highest stress distribution at the bone-implant interface and the peri-implant bone was noticed in the RP group, and the lowest stress distribution was observed in the 2SI groups. Cantilevered position showed unfavorable stress distribution with axial loading. 2SI types did not affect the stress distribution in oblique loading. The number and installation positions of the implant, rather than the bone level, influenced the stress distribution of 2SIs. The implant/abutment complex of WP presented the highest stress concentration while that of 2SIs showed the lowest stress concentration. CONCLUSION 2SIs may be useful for achieving stable stress distribution on the surrounding bone and implant-abutment complex in the atrophic posterior maxilla. PMID:27555900

  15. Sandwich osteotomy of the atrophic posterior mandible prior to implant placement

    PubMed Central

    Mavriqi, Luan; Baca, Egresa; Demiraj, Ariona

    2015-01-01

    Key Clinical Message The continuing resorption of the alveolar ridge will eventually result in insufficient bone height superior to the IAN, making dental implant placement impossible. The augmentation procedure above the IAN in terms of height provides sufficient bone for implant placement and allows long-term successful restoration of missing teeth with implant-supported prosthesis. PMID:26273452

  16. Sandwich osteotomy of the atrophic posterior mandible prior to implant placement.

    PubMed

    Mavriqi, Luan; Baca, Egresa; Demiraj, Ariona

    2015-07-01

    Key Clinical Message The continuing resorption of the alveolar ridge will eventually result in insufficient bone height superior to the IAN, making dental implant placement impossible. The augmentation procedure above the IAN in terms of height provides sufficient bone for implant placement and allows long-term successful restoration of missing teeth with implant-supported prosthesis. PMID:26273452

  17. Endoscopically-assisted operations in the treatment of odontogenic peripheral osteomyelitis of the posterior mandible.

    PubMed

    Huang, Zixian; Huang, Zhiquan; Zhang, Daming; Hu, Huijun; Liang, Qixiang; Chen, Weiliang

    2016-06-01

    The aim of this study was to evaluate the possibility of using an endoscope in the treatment of five patients with odontogenic peripheral osteomyelitis of the posterior mandible diagnosed between March 2012 and September 2014. After imaging and general preoperative examination, the patients had endoscopically-assisted curettage and sequestrectomy. The data collected included the duration of the operation, complications, and patients' degree of satisfaction. The mean duration of the operation through an intraoral incision, was 46 (range 40-60) minutes. Patients were followed up at 1 week, 3 months, and 6 months, with no signs of recurrence. One patient reported postoperative swelling in the mandibular angle but this settled. The incision was minimal and left no postoperative scar on the face. All the patients recovered free of complications and were satisfied with the results of the operation. Because of the minimally-invasive intraoral incision, endoscopically-assisted treatment of odontogenic peripheral osteomyelitis of the posterior mandible can maintain external facial integrity without surgical scars. PMID:27025231

  18. A precise radiographic method to determine the location of the inferior alveolar canal in the posterior edentulous mandible: implications for dental implants. Part 2: Clinical application.

    PubMed

    Stella, J P; Tharanon, W

    1990-01-01

    An analysis of implant placement in the posterior region of eight edentulous cadaver mandibles was performed. The results demonstrated that the radiographic technique developed can be employed to safely place implants adjacent to the inferior alveolar nerve in the posterior mandible by using radiographic laminography and a specially designed intraoral reference splint. PMID:2391136

  19. Does increasing the number of short implants reduce marginal bone loss in the posterior mandible? A prospective study.

    PubMed

    Tabrizi, Reza; Arabion, Hamidreza; Aliabadi, Ehsan; Hasanzadeh, Farzaneh

    2016-09-01

    Marginal bone loss is a concern in the long-term prognosis of short dental implants. The aim of this prospective cohort study was to evaluate the loss when variable numbers of short implants were used in the posterior mandible. The subjects were allocated into three groups according to the number of short implants. The first group was given two, the second three, and the third four. Each patient had radiographs taken immediately after loading and repeated 36 months later. Twenty- three subjects with 65 implants were entered in the three groups. The mean (SD) marginal bone loss was 0.49 (0.04) mm in the two implant group, 0.41 (0.25) mm in the three implant group, and 0.35 (0.25) mm in the four implant group. There were significant differences in marginal bone loss among the three groups (p=0.001), in that the fewer the number of short implant-supported fixed prostheses in the posterior mandible, the greater the marginal bone loss. When we used more short implants the amount of marginal bone loss decreased. PMID:27131984

  20. A histological study of non-ceramic hydroxyapatite as a bone graft substitute material in the vertical bone augmentation of the posterior mandible using an interpositional inlay technique: A split mouth evaluation.

    PubMed

    Bechara, Karen; Dottore, Alexandre M; Kawakami, Paulo Y; Gehrke, Sergio A; Coelho, Paulo G; Piattelli, Adriano; Iezzi, Giovanna; Shibli, Jamil Awad

    2015-11-01

    The aim of this study was to compare the influence of graft material (non-ceramic hydroxyapatite versus autologous bone) on bone behaviour and perform a resonance frequency analysis of implants placed in augmented sites to evaluate stability. For this study, 11 patients with bilateral edentulous areas in the mandibular posterior region were selected. Alveolar augmentation osteotomies were bilaterally (split mouth design) performed. In one hemiarch, the space generated by the osteotomy was grafted with an interpositional intra-oral autologous bone graft (control group). In the other hemiarch, the space generated by the osteotomy was grafted with an interpositional non-ceramic hydroxyapatite (ncHA) (test group). The groups were randomized. After 6 months of healing, a bone sample was retrieved from each side for histological evaluation using a trephine drill that was 2-mm in internal diameter. The implant stability quotient (ISQ) was measured by the resonance frequency immediately following implant placement at baseline and after 6 months of follow-up. Good incorporation of the graft was observed in both groups; however, in the test group, a residual-grafted material was observed. Bone density and marrow spaces were similar between groups. Correlations between the ISQ values and the histometric variables were not observed (p>0.05). The results of this trial suggest that both intra-oral autologous bone and ncHA may be elected as interpositional grafting materials to vertically augment posterior atrophic mandibles. PMID:26325427

  1. Analysis of the compressive strain below the removable and fixed prosthesis in the posterior mandible using a digital image correlation method.

    PubMed

    Tanasic, Ivan; Milic-Lemic, Aleksandra; Tihacek-Sojic, Ljiljana; Stancic, Ivica; Mitrovic, Nenad

    2012-07-01

    It was the purpose of this study to determine and analyse strains in the bone of posterior mandible below the removable and fixed partial dentures using Digital Image Correlation Method. Dried mandible with shortened dental arch (Kennedy Class 1) was used in the experiment. The mandible model was prepared for accepting two types of restorations for bilaterally missing molars conventional therapy, and removable and fixed partial dentures were manufactured following standard prosthetic protocol. The models with prosthetic restorations placed in situ were subjected to loading of 50-300 N, and photographed using two digital cameras as part of the digital image correlation method equipment. Afterwards, the obtained data for strains within restored mandible during loading ciclus were analysed in the software Aramis and graphically presented. Percentage size of the mandible strains within the line section are from 0.14 to 0.19% for the removable partial denture experimental model and 0-0.14% for the fixed partial denture experimental model. The study has demonstrated that Digital Image Correlation method can be used to measure strain on the mandible surface and replacements during loading and that from biomechanical perspective both therapeutic modalities can be equally useful for the restoration of the mandible with bilaterally distal edentulous spaces. PMID:21918835

  2. Minimally Invasive Transmucosal Insertion and Immediate Provisonalization of One-Piece Implant in Partially Edentulous Posterior Mandible

    PubMed Central

    Rajput, Narpatsingh; K.P., Siyad; G., Rathinavelu; S.C., Chandrasekaran; Mohammed, Jumshad

    2013-01-01

    Although dental implantology had evolved over number of years, many dental surgeons are unaware of the concept of immediate loading with use of titanium one-piece implants that began in the early 1960s. Although long term success have been revealed with the use of two piece implants over the period of years, many obstacles like pain, inflammation and the bacterial migration into the micro-gap of two-piece implants when they are loaded; loosening and even fractures of the internal screws when they are loaded which limits patient acceptance towards dental implants. Immediate loading of one piece implants by using provisional acrylic resin crown with minimally invasive or atraumatic, flapless surgical procedures provides a better soft tissue adhesion and seal to form a healthy collar, avoids a second stage surgical procedure and with higher patient acceptance . One-piece implant also allows a minimally invasive trans-mucosal flapless placement and limits the requirement of hard tissue grafting procedures. With all these conception, the present case report evaluated the clinical performance of a one-piece implant in a partially edentulous posterior mandible. PMID:24179946

  3. Immediate versus conventional loaded single implants in the posterior mandible: a meta-analysis of randomized controlled trials.

    PubMed

    Moraschini, V; Porto Barboza, E

    2016-01-01

    The purpose of this meta-analysis was to compare implant survival, marginal bone loss, and complications between immediate and conventional loading of single implants installed in the posterior mandible. An extensive electronic search was performed of PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials to identify relevant articles published up to January 2015. After the selection process, five studies met the eligibility criteria and were included. The results of the meta-analysis were expressed in terms of the odds ratio (OR) or standardized mean difference (SMD), with a confidence interval (CI) of 95%. Results were pooled according to heterogeneity using the fixed- or random-effects model. There was no statistically significant difference between the two techniques (immediate loading vs. conventional loading) with regard to implant survival (OR 1.71, 95% CI 0.40 to 7.36; P=0.47). There was no statistically significant difference in marginal bone loss (SMD -0.58, 95% CI -1.55 to 0.38; P=0.24). The reported mechanical and biological complications were common to both types of intervention, with the exception of probing depth, which was greater following the immediate loading technique (SMD 0.13, 95% CI -0.19 to 0.44), although this was not statistically significant (P=0.43). PMID:26259980

  4. Mini Implants Supporting Fixed Partial Dentures in the Posterior Mandible: A Retrospective.

    PubMed

    Flanagan, Dennis

    2015-08-01

    Small-diameter, or mini, dental implants have been successfully used to support removable and fixed oral prostheses. These implants impart about twice the per-square-millimeter force on the supporting bone and this should be addressed during treatment planning. In the posterior jaws, bite forces are of a higher magnitude than in the anterior jaws and may induce an overload of the supporting bone and failure of the osseointegration. Thus there should not be occlusal contact in functional excursions that induce off axial loads. The cases presented herein demonstrate that mini dental implants may be used successfully to support fixed partial dentures in mandibular sites in highly selected patients. Attention should be given to the bone density of the site, very slow seating rotation of the implant with intermissions or cooling during insertion, observation of a 4-month healing time, flapless placement, treatment of any existing periodontitis, an insoluble cement, and exclusion of occlusal contact in functional excursions. Importantly, a narrow, rounded occlusal table should be used to minimize off axial loads and an insoluble luting cement should be used to prevent loosening of the crowns due to dissolution of the cement and an overload of the retained implant with any residual cement-retained in the retainer. The implant that supports the cement retained retainer will be subjected to leveraged rotation that may destroy the osseointegration and result in exfoliation of the implant. PMID:24779887

  5. Polynesian mandibles.

    PubMed

    Houghton, P

    1978-10-01

    Adult Polynesian mandibles are predominantly of the rocker form. Polynesian crania have an open cranial base angle, and a rather large upper facial height in the adult. The mandibular growth rotations necessary for normal occlusion to be maintained in the presence of this cranial morphology lead to development of a particularly small gonial angle. There is an increased 'bowing' of the basal component of the bone. Such 'bowing' leads to a sufficiently posterior displacement of the basal component in the gonial region for the development of a distinct angular process (for muscle attachment) to be unnecessary. PMID:721687

  6. A combined superficial inferior epigastric artery flap and vascularized iliac crest flap in the reconstruction of extended composite defects of the posterior mandible and adjacent soft tissue: first clinical results.

    PubMed

    Gaggl, A J; Bürger, H; Chiari, F M

    2011-02-01

    The technique of posterior facial reconstruction using a combination of a superficial inferior epigastric artery (SIEA) flap and a microvascular iliac crest flap (deep circumflex iliac artery (DCIA) flap) is described. 12 cases are reported. The patients had unilateral squamous cell carcinoma of the posterior mandible affecting parts of the soft palate and tonsil region or the posterior cheek. In all patients unilateral neck dissection, resection of the posterior and lateral mandible, was performed. Reconstruction was carried out during primary surgical therapy, followed by postoperative radiotherapy. A flap combination of a SIEA and a DCIA flap was used. There were no problems with pedicle length or anastomoses. There was no flap loss or severe postoperative complications. All patients had good aesthetic and functional results. One patient had distant metastases 2 years postoperatively. All other patients were free of tumour relapse or metastases within 12-58 months of follow up. The SIEA flap and vascularized iliac bone flap combination is useful in reconstructing the posterior face. The iliac bone flap is well suited for posterior mandible reconstruction and the SIEA flap for reconstruction of the soft palate, lateral pharyngeal wall and cheek. Both flaps are harvested from the same donor site. PMID:21075599

  7. Bone dimensions in the posterior mandible: a retrospective radiographic study using cone beam computed tomography. Part 1--analysis of dentate sites.

    PubMed

    Braut, Vedrana; Bornstein, Michael M; Lauber, Roland; Buser, Daniel

    2012-04-01

    This retrospective radiographic study analyzed the dimensions of the alveolar bone in the posterior dentate mandible based on cone beam computed tomography (CBCT) images. A total of 56 CBCT images met the inclusion criteria, resulting in a sample size of 122 cross sections showing posterior mandibular teeth (premolars and molars). The thickness of the buccal and lingual bone walls was measured at two locations: 4 mm apical to the cementoenamel junction (measurement point 1, MP1) and at the middle of the root (measurement point 2, MP2). Further, alveolar bone width was assessed at the level of the most coronal buccal bone detectable (alveolar bone width 1, BW1) and at the superior border of the mandibular canal (alveolar bone width 2, BW2). The vertical distance between the two as well as the presence of a lingual undercut were also analyzed. There was a steady increase in buccal bone wall thickness from the first premolar to the second molar at both MP1 and MP2. BW1 at the level of the premolars was significantly thinner than that for molars. Alveolar bone height was constant for all teeth examined. For the selection of an appropriate postextraction treatment approach, analysis of the alveolar bone dimensions at the tooth to be extracted by means of CBCT can offer valuable information concerning bone volume and morphology at the future implant site. PMID:22292147

  8. Failed Fixation in Atrophic Mandibular Fractures: The Case against Miniplates.

    PubMed

    Madsen, Matthew J; Kushner, George M; Alpert, Brian

    2011-09-01

    Despite advances in the treatment of the fractured atrophic edentulous mandible, treatment continues to be difficult. Patient management is more complicated due to patients often being elderly with more complex medical problems. Rigid internal fixation has greatly improved outcomes with shorter treatment times, yet a consensus has yet to be reached regarding which method yields the most predictable results. Options include using small miniplates to larger reconstruction plates. Although each method has advantages, we present our experience with retreatment of failed miniplate fixation using load-bearing reconstruction plates of fractured atrophic edentulous mandibles. PMID:22942943

  9. Importance of a distal proximal contact on load transfer by implant-supported single adjacent crowns in posterior region of the mandible: a photoelastic study

    PubMed Central

    de AGUIAR JÚNIOR, Fábio Afrânio; TIOSSI, Rodrigo; MACEDO, Ana Paula; de MATTOS, Maria da Gloria Chiarello; RIBEIRO, Ricardo Faria; RODRIGUES, Renata Cristina Silveira

    2013-01-01

    Objective This study aimed to evaluate the importance of a distal proximal contact on the load transfer to the posterior region of the mandible by non-splinted adjacent implant-supported crowns using photoelastic stress analysis. Material and Methods A rectangular model (68x30x15 mm) was made of polymethylmethacrylate resin to simulate half of the mandibular arch. One model was completed with resin replicas representing the first premolar and second molar and with two 3.75 mm dia.x11 mm internal hexagon threaded implants replacing the second premolar and first molar. The other model was manufactured in the same way but without the second molar. Both models were duplicated using photoelastic resin. The roots of the teeth replicas were covered with a layer of polyether impression material to simulate the periodontal ligament. Two different vertical loads were applied to the crowns as follows: 1 - single static point load alternately applied to the crowns replacing the second premolar and first molar (50 N); 2 - simultaneous static point loads applied to both of the crowns replacing the second premolar and first molar (100 N). The resulting isochromatic fringe pattern in the photoelastic model was monitored and photographed. Results All loading conditions studied showed that the presence of the second molar has changed the load transmission and the pattern of stresses. Conclusion Results showed that the presence of a second molar proximal contact can help minimize the stresses around the implants. PMID:24212984

  10. Performance of sintered, porous-surfaced, press-fit implants after 10 years of function in the partially edentulous posterior mandible.

    PubMed

    Deporter, Douglas A; Kermalli, Jaffer; Todescan, Reynaldo; Atenafu, Eshetu

    2012-10-01

    This article updates the results of a prospective clinical trial of press-fit, sintered, porous-surfaced dental implants placed in the posterior mandible of partially edentulous patients. Implants used had overall lengths (including transgingival collar regions) of 7 or 9 mm with designed intrabony lengths (lengths of sintered surface in contact with bone) of 6 or 8 mm. Forty-eight implants were placed in 24 patients, the majority of which replaced molar teeth, and the mean crown-to-root ratio was 1.4. Over 10 years of implant function, 2 patients with 3 implants died and 3 patients with 4 implants were lost to follow-up because of infirmity or relocation. The survival and success rates were both 95.5%. Two implants failed; the mean cumulative crestal bone loss (measured from the implant-abutment interface) for the remaining implants was 1.2 mm. Crestal bone loss was not affected by the crown-to-root ratio, prosthesis design, or whether an implant was the most distal unit in a sextant. However, there was a trend for greater crestal bone loss when implants were opposed by implants rather than by natural teeth. PMID:22754904

  11. Anisotropic elasticity of cortical and cancellous bone in the posterior mandible increases peri-implant stress and strain under oblique loading.

    PubMed

    O'Mahony, A M; Williams, J L; Spencer, P

    2001-12-01

    The aim of this study was to compare implant-bone interface stresses and peri-implant principal strains in anisotropic versus isotropic three-dimensional finite element models of an osseointegrated implant in the posterior mandible. We obtained anisotropic (transversely isotropic) elastic constants for mandibular bone and derived equivalent isotropic constants by averaging over all possible spatial orientations. A finite element model was constructed using ten-node tetrahedral p-elements, providing curved edges where necessary and increasing the accuracy of the results in regions of high stress gradients. Perfect bonding was assumed at the implant-bone interface. An oblique load was applied at the coronal aspect of the crown with 100 N vertical and 20 N bucco-to-lingual components. Implant-bone interface stresses exceeded reported bond strengths and principal strains reached yield strain levels in the cortical crest. Anisotropy increased what were already high levels of stress and strain in the isotropic case by 20 to 30% in the cortical crest. In cancellous bone, anisotropy increased what were relatively low levels of interface stress in the isotropic case by three- to four-fold to exceed bond strength levels. Anisotropy has subtle, yet significant effects on interface stresses and peri-implant strains and careful consideration should be given to its use in finite element studies of dental implants. PMID:11737110

  12. Treatment of atrophic mandibular fractures with the pencilboneplate: report of 2 cases.

    PubMed

    de Oliveira, Henrique do Couto; Pereira-Filho, Valfrido Antonio; Hochuli-Vieira, Eduardo; Gabrielli, Marisa Aparecida Cabrini; Gabrielli, Mario Francisco Real

    2015-03-01

    The incidence of fractures of the atrophic edentulous mandible is still low, even with the increasing life expectancy. The reduced blood supply of the sclerotic bone, the diminished contact area between bone fragments and the patient's systemic condition makes the treatment of those fractures a challenge for any professional. Treatment of atrophic mandibular fractures by means of miniplate osteosynthesis has not been the preferred method of fixation by many authors. Yet, many surgeons have applied this type of fixation for the atrophied jaw sections. This paper reports 2 cases of fractured atrophic mandibles treated with the pencilboneplate, a monocortical 2.0 mm titanium, 8 or 10-hole hardware with reinforcement on its middle portion, highlighting important considerations of its use. The pencilboneplate appears to be a valuable option for the treatment of atrophic mandibular fractures, especially by an intra-oral approach, and warrants further biomechanical and clinical studies. PMID:25838701

  13. Retrospective long-term analysis of bone level changes after horizontal alveolar crest reconstruction with autologous bone grafts harvested from the posterior region of the mandible

    PubMed Central

    2016-01-01

    Purpose The goal of this study was to evaluate the long-term success of horizontal alveolar crest augmentation of the retromolar region of the mandible with particulated bone, as well as factors affecting subsequent peri-implant bone loss. Methods A total of 109 patients (68 female, 41 male) suffering from alveolar ridge deficiencies of the maxilla and mandible were included in this study. All patients were treated with particulated retromolar bone grafts from the mandible prior to the insertion of endosseous dental implants. Mesial and distal peri-implant crestal bone changes were assessed at six time points. Several parameters, including implant survival and the influence of age, gender, localisation of the implant, diameter, covering procedures, and time points of implant placement, were analysed to identify associations with bone level changes using the Mann-Whitney U-test, the Kruskal-Wallis test, and Spearman's rank-order correlation coefficient. Results A total of 164 dental implants were placed in the maxilla (n=97) and in the mandible (n=67). The mean observation period was 105.26±21.58 months after implantation. The overall survival rate was 97.6% after 10 years. Overall, peri-implant bone loss was highest during the first year, but decreased over time. The mean amount of bone loss after 10 years was 2.47 mm mesially and 2.50 mm distally. Bone loss was significantly influenced by implant type and primary stability. Conclusions The use of particulated autologous retromolar bone grafts is a reliable technique for the horizontal reconstruction of local alveolar ridge deficiencies. Our results demonstrate that implants placed in augmented bone demonstrated similar bone level changes compared to implants inserted in non-augmented regions. PMID:27127688

  14. Traumatic bone cyst of mandible.

    PubMed

    Surej Kumar, L K; Kurien, Nikhil; Thaha, Khaleel Ahamed

    2015-06-01

    The traumatic bone cyst, an uncommon lesion of the jaws, belongs to the category of 'pseudocyst' owing to its lack of a lining epithelial membrane. It is an asymptomatic lesion, which is often diagnosed accidentally during routine radiological examination commonly present in the posterior mandible as a unilocular radiolucency with scalloping borders. The exact etiopathogenesis of the lesion is still debated, though the role of trauma is often associated. Here we report a rare case of traumatic bone cyst in the anterior mandible, in a 16-year-old female patient with a previous history of trauma to chin; diagnosed and treated successfully in our surgical unit. The case is discussed in relation to its clinical presentation, etiopathogenesis, diagnosis, management and prognosis. PMID:26028875

  15. Failure of miniplate osteosynthesis for the management of atrophic mandibular fracture.

    PubMed

    Santos, George Soares; de Assis Costa, Marcelo Dias Moreira; de Oliveira Costa, Cecília; Souza, Francisley Avila; Júnior, Idelmo Rangel Garcia; de Melo, Willian Morais

    2013-07-01

    Fractures of the severely atrophic (<10 mm) edentulous mandible are not common, and these fractures with a vertical height of 10 mm or less have long been recognized as being particularly problematic. Although there are advances in the treatment of the atrophic mandibular fracture, the treatment remains controversial. There are some options for treatment planning because of using small miniplates to large reconstruction plates. However, when the fixation method fails, it causes malunion, nonunion, and/or infection, and sometimes it has been associated with large bone defects. The authors describe a clinical report of a failed miniplate fixation for atrophic mandibular fracture management. The authors used a load-bearing reconstruction plate combined with autogenous bone graft from iliac crest for this retreatment. The authors show a follow-up of 6 months, with union of the fracture line and no complication postoperatively. PMID:23851887

  16. Shape analysis of odontocete mandibles: functional and evolutionary implications.

    PubMed

    Barroso, Celia; Cranford, Ted W; Berta, Annalisa

    2012-09-01

    Odontocete mandibles serve multiple functions, including feeding and hearing. We consider that these two major functions have their primary influence in different parts of the mandibles: the anterior feeding component and the posterior sound reception component, though these divisions are not mutually exclusive. One hypothesis is that sound enters the hearing apparatus via the pan bone of the posterior mandibles (Norris, Evolution and Environment,1968, pp 297-324). Another viewpoint, based on finite element models, suggests that sound enters primarily through the gular region and the opening created by the absent medial lamina of the posterior mandibles. This unambiguous link between form and function has catalyzed this study, which uses Geometric Morphometrics to quantify mandibular shape across all major lineages of Odontoceti. The majority of shape variation was found in the anterior (feeding) region: Jaw Flare (45.0%) and Symphysis Elongation (35.5%). Shape differences in the mandibular foramen, within the posterior (sound reception) region, also accounted for a small portion of the total variation (10.9%). The mandibles are an integral component of the sound reception apparatus in toothed whales and the geometry of the mandibular foramen likely plays a role in hearing. Furthermore, model goodness-of-fit tests indicate that mandibular foramina shapes, which appear conserved, evolved under a selective regime, possibly driven by sound reception requirements across Odontoceti. PMID:22806763

  17. Mandible and Tongue Development

    PubMed Central

    Parada, Carolina; Chai, Yang

    2016-01-01

    The tongue and mandible have common origins. They arise simultaneously from the mandibular arch and are coordinated in their development and growth, which is evident from several clinical conditions such as Pierre Robin sequence. Here, we review in detail the molecular networks controlling both mandible and tongue development. We also discuss their mechanical relationship and evolution as well as the potential for stem cell-based therapies for disorders affecting these organs. PMID:26589920

  18. Dermatoscopic findings of atrophic dermatofibrosarcoma protuberans

    PubMed Central

    Akay, Bengu Nisa; Unlu, Ezgi; Erdem, Cengizhan; Heper, Aylin Okcu

    2015-01-01

    Dermatofibrosarcoma protuberans (DFSP) is an uncommon locally aggressive mesenchymal tumor with a high local recurrence rate. Atrophic DFSP is a rare variant of DFSP characterized by a non-protuberant lesion. We report on a 23-year-old female, who presented with an atrophic, asymptomatic macule on the right side of her back 2 cm in diameter. Dermatoscopic examination revealed homogenous pigment network on a purplish erythematous background. The histopathological finding of the incisional biopsy material was consistent with DFSP. To our knowledge, this is the second case of atrophic DFSP discussing the dermatoscopic features of this relatively rare condition. PMID:25692086

  19. Myofibroma of the mandible.

    PubMed

    Shibuya, Yasuyuki; Takeuchi, Junichiro; Sakaguchi, Hiroya; Yokoo, Satoshi; Umeda, Masahiro; Komori, Takahide

    2008-01-01

    This article is reporting a case of myofibroma involving the mandible of a 12-year-old boy. The patient did not have any swelling nor any redness but of partial mental nerve hypoesthesia. A panoramic radiograph demonstrated a globe like radiolucent lesion in the left angle of the mandible that was an increased uptake spot by FDG-PET. Incisional biopsies indicated myofibroma, therefore the tumor was totally resected under general anesthesia. After surgery there was no complication except for a change for the worse of unilateral mental nerve hypoesthesia. At 29 months postoperative, no evidence of recurrence could be found. PMID:19246965

  20. Evaluating evidence for atrophic scarring treatment modalities

    PubMed Central

    McGrouther, Duncan; Chakrabarty, Kaushik

    2014-01-01

    Summary Introduction Atrophic scars cause significant patient morbidity. Whilst there is evidence to guide treatment, there does not appear to be a systematic review to analyse the efficacy of treatment options. Objectives To retrieve all evidence relating to atrophic scar treatment and evaluate using the Clinical Evidence GRADE score in order to allow clinicians to make evidence-based treatment choices. Method Searches were performed in Medline, EMBASE, CINHL and Cochrane to identify all English studies published evaluating treatment of atrophic scars on adults excluding journal letters. Each study was allocated a GRADE score based on type of study, quality, dose response, consistency of results and significance of results. The end score allowed categorisation of evidence into high, moderate, low or very low quality. Results A total of 41 studies were retrieved from searches including randomised controlled trials, observational studies, retrospective analyses and case reports of which 7% were allocated a high-quality score, 10% a moderate score, 7% a low score and 75% a very low score. Treatment modalities included ablative laser therapy, non-ablative laser therapy, autologous fat transfer, dermabrasion, chemical peels, injectables, subcision, tretinoin iontophoresis and combination therapy. Conclusion There is a paucity of good-quality clinical evidence evaluating treatment modalities for atrophic scarring. Evidence supports efficacy of laser, surgery and peel therapy. Further biomolecular research is required to identify targeted treatment options and more randomised controlled trials would make the evidence base for atrophic scar treatment more robust. PMID:25352991

  1. Osteoradionecrosis of the mandible: Pathogenesis

    SciTech Connect

    Bras, J.; de Jonge, H.K.; van Merkesteyn, J.P. )

    1990-07-01

    Although the precise pathogenic mechanisms are not fully understood, osteoradionecrosis of the mandible is caused by radiation-induced cellular injury, ultimately resulting in a chronic, nonhealing wound. This etiology does not explain the strong predisposition of the mandible to radionecrosis relative to the maxilla, and overlooks the contribution of ischemic necrosis due to radiation-induced disturbances in circulation. In this study, irradiated mandibles with and without osteoradionecrosis and nonirradiated mandibles were examined histologically. Our findings show that osteoradionecrosis of the mandible is an ischemic necrosis due to radiation-induced obliteration of the inferior alveolar artery, while revascularization by branches of the facial artery is disturbed by radiation-induced vascular disease and periosteal damage. The most vulnerable part of the mandible is the buccal cortex of the premolar, molar, and retromolar regions.

  2. Microneedling Therapy for Atrophic Acne Scars

    PubMed Central

    Barakat, Manal; Awad, Sherif; Medhat, Walid; El-Fakahany, Hasan; Farag, Hanna

    2015-01-01

    Objective: Treatment of acne scarring is always a challenge. Microneedling therapy or percutaneous collagen induction is a new addition to the treatment modalities for such scars and has been reported to be simple and effective in atrophic acne scar treatment. The aim of this study is to evaluate the clinical effect and objectively quantify the histological changes of acne scarring in response to skin microneedling. Design: A prospective clinical study. Participants: Ten patients with different types of atrophic acne scars were subjected to three months of skin microneedling treatment (six sessions at two-week intervals). Measurements: Patients were photographed, and skin biopsies were obtained at baseline as well as one and three months from the start of treatment. Histometry for epidermal thickness and quantitative evaluation of total elastin; newly synthesized tropoelastin; collagen types I, III, and VII; and newly synthesized collagen were performed for all biopsies. Results: Compared to the baseline, patients’ evaluations revealed noticeable clinical improvement in atrophic post-acne scars in response to skin microneedling. There was a statistically significant increase (p<0.05) in the mean of collagen types I, III, and VII and newly synthesized collagen, while total elastin was significantly decreased (p<0.05) after the end of treatment. Conclusions: Multiple minimally invasive sessions of skin microneedling are an effective treatment for post-acne atrophic scars as it stimulates the repair processes with the advantage of being a relatively risk-free, in-office procedure with minimal patient recovery time. PMID:26203319

  3. Effective Treatments of Atrophic Acne Scars

    PubMed Central

    Zhou, Bingrong

    2015-01-01

    Atrophic scarring is often an unfortunate and permanent complication of acne vulgaris. It has high prevalence, significant impact on quality of life, and therapeutic challenge for dermatologists. The treatment of atrophic acne scars varies depending on the types of acne scars and the limitations of the treatment modalities in their ability to improve scars. Therefore, many options are available for the treatment of acne scarring, including chemical peeling, dermabrasion, laser treatment, punch techniques, fat transplantation, other tissue augmenting agents, needling, subcision, and combined therapy. Various modalities have been used to treat scars, but limited efficacy and problematic side effects have restricted their application. In order to optimally treat a patient’s scar, we need to consider which treatment offers the most satisfactory result. There are also promising procedures in the future, such as stem cell therapy. In this article, the authors review the different treatment options of atrophic acne scars. This may be useful for selecting the best therapeutic strategy, whether it be single or combined therapy, in the treatment of atrophic acne scars while reducing or avoiding the side effects and complications. PMID:26029333

  4. Actinomycotic Osteomyelitis of Mandible.

    PubMed

    Abbaszadeh, Hamid; Sheibani, Mohammad Sina Arab

    2016-07-01

    Actinomycosis is an infection of filamentous, gram-positive anaerobic bacteria. Actinomycosis of jaw bone is rare and the diagnosis is often difficult. The aim of this patient report is to present an actinomycotic osteomyelitis of mandible in a 30-year-old male patient. The patient presented with a chief complaint of pain and unhealed dental socket after mandibular teeth extractions. Radiographs showed ill-defined radiolucencies and perforation of buccal and lingual cortical plate; several biopsies and different therapy could not improve the lesion because of fault diagnosis and improper treatment. Finally, the authors' histopathological examination revealed granulation tissue surrounded bacterial colonies compatible with actinomycotic colonies. Follow-up examinations showed that the patient was well 6 months after prolonged treatment without any pain and discharge from dental socket. PMID:27391512

  5. Bone remodelling in Neanderthal mandibles from the El Sidrón site (Asturias, Spain)

    PubMed Central

    Martinez-Maza, Cayetana; Rosas, Antonio; García-Vargas, Samuel; Estalrrich, Almudena; de la Rasilla, Marco

    2011-01-01

    Skull morphology results from the bone remodelling mechanism that underlies the specific bone growth dynamics. Histological study of the bone surface from Neanderthal mandible specimens of El Sidrón (Spain) provides information about the distribution of the remodelling fields (bone remodelling patterns or BRP) indicative of the bone growth directions. In comparison with other primate species, BRP shows that Neanderthal mandibles from the El Sidrón (Spain) sample present a specific BRP. The interpretation of this map allows inferences concerning the growth directions that explain specific morphological traits of the Neanderthal mandible, such as its quadrangular shape and the posterior location of the mental foramen. PMID:21307043

  6. ATROPHIC CARDIOMYOCYTE SIGNALING IN HYPERTENSIVE HEART DISEASE

    PubMed Central

    Kamalov, German; Zhao, Wenyuan; Zhao, Tieqiang; Sun, Yao; Ahokas, Robert A.; Marion, Tony N.; Darazi, Fahed Al; Gerling, Ivan C.; Bhattacharya, Syamal K.; Weber, Karl T.

    2013-01-01

    Cardinal pathologic features of hypertensive heart disease (HHD) include not only hypertrophied cardiomyocytes and foci of scattered microscopic scarring, a footprint of prior necrosis, but also small myocytes ensnared by fibrillar collagen where disuse atrophy with protein degradation would be predicted. Whether atrophic signaling is concordant with the appearance of HHD and involves oxidative and endoplasmic reticulum (ER) stress remains unexplored. Herein, we examine these possibilities focusing on the left ventricle (LV) and cardiomyocytes harvested from hypertensive rats receiving 4 wks aldosterone/salt treatment (ALDOST) alone or together with ZnSO4, a nonvasoactive antioxidant, with the potential to attenuate atrophy and optimize hypertrophy. Compared to untreated age-/sex-/strain-matched controls, ALDOST was accompanied by: a) LV hypertrophy with preserved systolic function; b) concordant cardiomyocyte atrophy (<1000 μm2) found at sites bordering on fibrosis where they were re-expressing β-myosin heavy chain; and c) upregulation of ubiquitin ligases, MuRF1 and atrogin-1, and elevated 8-isoprostane and unfolded protein ER response with mRNA upregulation of stress markers. ZnSO4 cotreatment reduced lipid peroxidation, fibrosis and the number of atrophic myocytes, together with a further increase in cell area and width of atrophied and hypertrophied myocytes, and improved systolic function, but did not attenuate elevated blood pressure. We conclude that atrophic signaling, concordant with hypertrophy, occurs in the presence of a reparative fibrosis and induction of oxidative and ER stress at sites of scarring where myocytes are atrophied. ZnSO4 cotreatment in HHD with ALDOST attenuates the number of atrophic myocytes, optimizes size of atrophied and hypertrophied myocytes, and improves systolic function. PMID:24084216

  7. Atrophic cardiomyocyte signaling in hypertensive heart disease.

    PubMed

    Kamalov, German; Zhao, Wenyuan; Zhao, Tieqiang; Sun, Yao; Ahokas, Robert A; Marion, Tony N; Al Darazi, Fahed; Gerling, Ivan C; Bhattacharya, Syamal K; Weber, Karl T

    2013-12-01

    Cardinal pathological features of hypertensive heart disease (HHD) include not only hypertrophied cardiomyocytes and foci of scattered microscopic scarring, a footprint of prior necrosis, but also small myocytes ensnared by fibrillar collagen where disuse atrophy with protein degradation would be predicted. Whether atrophic signaling is concordant with the appearance of HHD and involves oxidative and endoplasmic reticulum (ER) stress remains unexplored. Herein, we examine these possibilities focusing on the left ventricle and cardiomyocytes harvested from hypertensive rats receiving 4 weeks aldosterone/salt treatment (ALDOST) alone or together with ZnSO₄, a nonvasoactive antioxidant, with the potential to attenuate atrophy and optimize hypertrophy. Compared with untreated age-/sex-/strain-matched controls, ALDOST was accompanied by (1) left ventricle hypertrophy with preserved systolic function; (2) concordant cardiomyocyte atrophy (<1000 μm²) found at sites bordering on fibrosis where they were reexpressing β-myosin heavy chain; and (3) upregulation of ubiquitin ligases, muscle RING-finger protein-1 and atrogin-1, and elevated 8-isoprostane and unfolded protein ER response with messenger RNA upregulation of stress markers. ZnSO₄ cotreatment reduced lipid peroxidation, fibrosis, and the number of atrophic myocytes, together with a further increase in cell area and width of atrophied and hypertrophied myocytes, and improved systolic function but did not attenuate elevated blood pressure. We conclude that atrophic signaling, concordant with hypertrophy, occurs in the presence of a reparative fibrosis and induction of oxidative and ER stress at sites of scarring where myocytes are atrophied. ZnSO₄ cotreatment in HHD with ALDOST attenuates the number of atrophic myocytes, optimizes size of atrophied and hypertrophied myocytes, and improves systolic function. PMID:24084216

  8. Scaling of the mandible in squirrels.

    PubMed

    Velhagen, W A; Roth, V L

    1997-05-01

    We compared the shape of the mandible among New World tree squirrels and selected outgroup taxa using linear measurements and areas defined by the median axis and conventional anatomical landmarks. We modified the median axis technique to define novel measurements, which proved complementary to those obtained from conventional landmarks. Allometric analyses showed that the scaling of the mandible among the New World tree squirrels is generally isometric (as has been observed in other groups of mammals), but diverges from isometry in a tendency in smaller animals for the masseteric ridge to be displaced anteriorly, the condylar process and posterior portion of the ascending ramus to be relatively elongated, and the coronoid process to be shortened. Allometric analyses also revealed the ways and extent that outgrowth taxa deviated from the scaling pattern observed for the New World tree squirrels. A flying squirrel (subfamily Pteromyinae), a moderate-sized callosciurine squirrel, and three species of pygmy tree squirrels from Asia and Africa show mandibular proportions very similar to those predicted for New World tree squirrels of corresponding size. Ground squirrels (tribe Marmotini) and successively more distant relatives such as Aplodontia, two myomorph rodents, and a rabbit show greater differences from the New World tree squirrels in their mandibular proportions. Combining the use of median-axis and conventional measurements makes it possible to examine changing relationships between locations of anatomically homologous landmarks and the geometry of the form. PMID:9097464

  9. Fracture properties of the human mandible.

    PubMed

    Unnewehr, M; Homann, C; Schmidt, P F; Sotony, P; Fischer, G; Brinkmann, B; Bajanowski, T; DuChesne, A

    2003-12-01

    A total of seven human mandibles were struck to breaking point under standardised conditions using a pendulum. The cortical deformation for two impact directions was measured with strain gauge strips located at eight defined sites. Fronto-median impacts led to mostly bilateral and always multiple fractures in the posterior area of the bone, especially in the collum and the condyle. The fracture threshold was between 2.5 and 3.1 kN. Lateral impact caused fractures near the impact area as direct fractures of the ipsilateral corpus. Mainly single and double fractures were observed. For lateral impact the fracture threshold was between 0.6 and 0.8 kN. PMID:13680253

  10. EVALUATION OF SIMULATED BONE LESION IN THE HEAD OF THE MANDIBLE BY USING MULTISLICE COMPUTED TOMOGRAPHY

    PubMed Central

    Utumi, Estevam Rubens; Perrella, Andréia; Albuquerque, Marco Antonio Portela; Adde, Carlos Alberto; Rocha, Rodney Garcia; Cavalcanti, Marcelo Gusmão Paraíso

    2009-01-01

    Conventional radiography has shown limitation in acquiring image of the ATM region, thus, computed tomography (CT) scanning has been the best option to the present date for diagnosis, surgical planning and treatment of bone lesions, owing to its specific properties. Objective: The aim of the study was to evaluate images of simulated bone lesions at the head of the mandible by multislice CT. Material and methods: Spherical lesions were made with dental spherical drills (sizes 1, 3, and 6) and were evaluated by using multislice CT (64 rows), by two observers in two different occasions, deploying two protocols: axial, coronal, and sagittal images, and parasagittal images for pole visualization (anterior, lateral, posterior, medial and superior). Acquired images were then compared with those lesions in the dry mandible (gold standard) to evaluate the specificity and sensibility of both protocols. Statistical methods included: Kappa statistics, validity test and chi-square test. Results demonstrated the advantage of associating axial, coronal, and sagittal slices with parasagittal slices for lesion detection at the head of the mandible. Results: There was no statistically significant difference between the types of protocols regarding a particular localization of lesions at the poles. Conclusions: Protocols for the assessment of the head of the mandible were established to improve the visualization of alterations of each of the poles of the mandible's head. The anterior and posterior poles were better visualized in lateral-medial planes while lateral, medial and superior poles were better visualized in the anterior-posterior plane. PMID:19936536

  11. The mandible--an analysis.

    PubMed

    Nayeem, F

    1992-01-01

    In this study, an attempt has been made to examine and analyse the ancient mandibles of people who have died several hundreds of years ago during the second and first millenium B.C. These mandibles have been recovered from the burial mounds in Bahrain (Arabian Gulf) and preserved in the National Museum and the Department of Antiquities in Bahrain. The dental conditions recorded are e.g. attrition, caries, fluorosis, periodontitis or antemortem tooth loss. The results indicate the age, sex, diet, occupation and environmental conditions that existed and even the culture of the people. A comparative study of the ancient mandibles and those of the present generation has been carried out. PMID:1441884

  12. Primary Ewing sarcoma of the coronoid process of mandible.

    PubMed

    Sabir, Husain; Kumbhare, S; Pande, S; Sachdeva, S; Gajbhiye, N

    2016-01-01

    Ewing sarcoma (ES) is a rare, primary malignancy of the bone that occurs mainly in childhood and early adolescence. ES usually occurs in long bones of the axial skeleton. Although uncommon in the jaws, ES at this site is most likely to occur in the posterior mandible. The outcome for patients with localised disease has improved over the decades, due to better combination chemotherapies and better methods of local control. We present the clinicopathologic features and management of a case of ES that developed in the left coronoid process of the mandible of a 31-year-old male. Chemotherapy and, later, a segmental mandibulectomy were used to achieve local control. A fibula-free flap repair was performed with good aesthetic results. This case elucidates the importance of the interdisciplinary approach required for the evaluation and treatment of this aggressive neoplasm. PMID:27514181

  13. An Uncommon Case of Solitary Peripheral Osteoma in the Mandible

    PubMed Central

    Agrawal, Rohit; Agrawal, Shipra; Bhargava, Shitij; Motlani, Mahesh; Agrawal, Rahul

    2015-01-01

    Osteoma is a benign osteogenic lesion which is composed of well differentiated mature compact and/or cancellous bone that proliferates continuously. Its prevalence is 4%. Its pathogenesis is still controversial. Solitary peripheral osteoma of craniofacial region is a rare finding. We report a case of 30-year-old female having solitary peripheral osteoma present on the lingual cortex of the left posterior mandible which was initially asymptomatic but now is causing discomfort while chewing and not associated with Gardner's syndrome. We also laid emphasis on its clinical, differential diagnosis, radiological, surgical, and histopathological features. The aim of this paper is to present an uncommon case of solitary peripheral osteoma in the mandible along with analysis of literature for peripheral osteomas of jaws and to contribute to the knowledge concerning the pathogenesis, differential diagnosis, and management of these lesions. PMID:26788378

  14. An Uncommon Case of Solitary Peripheral Osteoma in the Mandible.

    PubMed

    Agrawal, Rohit; Agrawal, Shipra; Bhargava, Shitij; Motlani, Mahesh; Agrawal, Rahul

    2015-01-01

    Osteoma is a benign osteogenic lesion which is composed of well differentiated mature compact and/or cancellous bone that proliferates continuously. Its prevalence is 4%. Its pathogenesis is still controversial. Solitary peripheral osteoma of craniofacial region is a rare finding. We report a case of 30-year-old female having solitary peripheral osteoma present on the lingual cortex of the left posterior mandible which was initially asymptomatic but now is causing discomfort while chewing and not associated with Gardner's syndrome. We also laid emphasis on its clinical, differential diagnosis, radiological, surgical, and histopathological features. The aim of this paper is to present an uncommon case of solitary peripheral osteoma in the mandible along with analysis of literature for peripheral osteomas of jaws and to contribute to the knowledge concerning the pathogenesis, differential diagnosis, and management of these lesions. PMID:26788378

  15. Elastic properties and apparent density of human edentulous maxilla and mandible

    PubMed Central

    Seong, Wook-Jin; Kim, Uk-Kyu; Swift, James Q.; Heo, Young-Cheul; Hodges, James S.; Ko, Ching-Chang

    2009-01-01

    The aim of this study aim was to determine whether elastic properties and apparent density of bone differ in different anatomical regions of the maxilla and mandible. Additional analyses assessed how elastic properties and apparent density were related. Four pairs of edentulous maxilla and mandibles were retrieved from fresh human cadavers. Bone samples from four anatomical regions (maxillary anterior, maxillary posterior, mandibular anterior, mandibular posterior) were obtained. Elastic modulus (EM) and hardness (H) were measured using the nano-indentation technique. Bone samples containing cortical and trabecular bone were used to measure composite apparent density (cAD) using Archimedes’ principle. Statistical analyses used repeated measures ANOVA and Pearson correlations. Bone physical properties differed between regions of the maxilla and mandible. Generally, mandible had higher physical property measurements than maxilla. EM and H were higher in posterior than in anterior regions; the reverse was true for cAD. Posterior maxillary cAD was significantly lower than that in the three other regions. PMID:19647417

  16. Finite element analysis of dental implant loading on atrophic and non-atrophic cancellous and cortical mandibular bone - a feasibility study.

    PubMed

    Marcián, Petr; Borák, Libor; Valášek, Jiří; Kaiser, Jozef; Florian, Zdeněk; Wolff, Jan

    2014-12-18

    The first aim of this study was to assess displacements and micro-strain induced on different grades of atrophic cortical and trabecular mandibular bone by axially loaded dental implants using finite element analysis (FEA). The second aim was to assess the micro-strain induced by different implant geometries and the levels of bone-to-implant contact (BIC) on the surrounding bone. Six mandibular bone segments demonstrating different grades of mandibular bone atrophy and various bone volume fractions (from 0.149 to 0.471) were imaged using a micro-CT device. The acquired bone STL models and implant (Brånemark, Straumann, Ankylos) were merged into a three-dimensional finite elements structure. The mean displacement value for all implants was 3.1 ±1.2 µm. Displacements were lower in the group with a strong BIC. The results indicated that the maximum strain values of cortical and cancellous bone increased with lower bone density. Strain distribution is the first and foremost dependent on the shape of bone and architecture of cancellous bone. The geometry of the implant, thread patterns, grade of bone atrophy and BIC all affect the displacement and micro-strain on the mandible bone. Preoperative finite element analysis could offer improved predictability in the long-term outlook of dental implant restorations. PMID:25468296

  17. Position of the mandibular foramen in adult male Tanzania mandibles.

    PubMed

    Russa, Afadhali D; Fabian, Flora M

    2014-01-01

    Failure of the inferior alveolar nerve block anesthesia is common in various dental operations. Anatomical variations of the location of the inferior alveolar nerve as it enters the mandibular foramen have been implicated as a main cause of these anesthesia failures. The aim of this work was to determine the location of the mandibular foramen in relation to the occlusal plane at the level of mandibular first molar and second premolar--often used as landmarks during the blocking procedure--and to different landmarks on the ramus of the mandible. The study was performed using mandibles from adult black male Tanzanians aged 30-45 years. Measurements were accomplished using two-digit electronic Vernier calipers. The distances were determined from the center of the mandibular foramen to the different reference points. The mandibular foramen was above the occlusal plane at the M1 and PM2 reference points in all the mandibles studied. It was also located about 20 mm and 12 mm from the anterior and posterior borders of the ramus respectively. There was no significant difference between the left and right side in any of the measurements. These results indicate that during anesthetic or other clinical procedures, the clinician can precisely determine the position of neurovascular bundle of the inferior alveolar nerve above the occlusal plane. PMID:26749676

  18. Implant placement in atrophic alveolar ridges: a simplified technique.

    PubMed

    Fugazzotto, P A

    1998-01-01

    A technique is presented that allows for the predictable and simple placement of implants into ideal restorable positions in severely atrophic, knife-edged ridges. Technical considerations and advantages of this treatment approach are discussed. PMID:9823107

  19. Ontogenetic study of allometric variation in Homo and Pan mandibles.

    PubMed

    Singh, Nandini

    2014-02-01

    Investigating ontogenetic variation and allometry in the mandible can provide valuable insight and aid in addressing questions related to the ontogeny of the skull. Here, patterns of ontogenetic shape change and allometric trajectories were examined in the mandible of 187 sub-adult and adult humans, bonobos, and chimpanzees. Procrustes-based geometric morphometrics was employed to quantify and analyze mandibular form. Thirty three-dimensional landmarks were used to capture the overall morphology of the mandible, and the landmarks were analyzed as a whole and subdivided into separate anterior and posterior units. Principal component analyses in Procrustes shape-space and form-space, and multivariate regressions were used to examine patterns of ontogenetic and allometric shape change. Results suggest that humans are distinct from Pan both in their mandibular morphology, particularly in the anterior-alveolar region, and direction of allometric trajectory. Chimpanzees and bonobos have parallel ontogenetic trajectories, but also show differences in mandibular shape. Species-specific features and adult mandibular shape are established before or by the eruption of the deciduous dentition. This suggests that developmental processes prior to deciduous teeth eruption have a stronger effect establishing taxa-specific phenotypes than later postnatal effects. This additionally implies that divergent trajectories between Pan and Homo do not contribute much to the adult mandibular shape after deciduous teeth eruption. Separate analyses of the anterior-alveolar region and ascending ramus show that these regions are semi-independent in their developmental pattern of shape change and allometry. This implies that allometric variation and ontogenetic shape change in the hominoid mandible is decoupled. PMID:24347386

  20. Custom-Made Computer-Aided-Design/Computer-Aided-Manufacturing Biphasic Calcium-Phosphate Scaffold for Augmentation of an Atrophic Mandibular Anterior Ridge

    PubMed Central

    Mangano, Francesco Guido; van Noort, Ric; Apresyan, Samvel; Piattelli, Adriano; Macchi, Aldo

    2015-01-01

    This report documents the clinical, radiographic, and histologic outcome of a custom-made computer-aided-design/computer-aided-manufactured (CAD/CAM) scaffold used for the alveolar ridge augmentation of a severely atrophic anterior mandible. Computed tomographic (CT) images of an atrophic anterior mandible were acquired and modified into a 3-dimensional (3D) reconstruction model; this was transferred to a CAD program, where a custom-made scaffold was designed. CAM software generated a set of tool-paths for the manufacture of the scaffold on a computer-numerical-control milling machine into the exact shape of the 3D design. A custom-made scaffold was milled from a synthetic micromacroporous biphasic calcium phosphate (BCP) block. The scaffold closely matched the shape of the defect: this helped to reduce the time for the surgery and contributed to good healing. One year later, newly formed and well-integrated bone was clinically available, and two implants (AnyRidge, MegaGen, Gyeongbuk, South Korea) were placed. The histologic samples retrieved from the implant sites revealed compact mature bone undergoing remodelling, marrow spaces, and newly formed trabecular bone surrounded by residual BCP particles. This study demonstrates that custom-made scaffolds can be fabricated by combining CT scans and CAD/CAM techniques. Further studies on a larger sample of patients are needed to confirm these results. PMID:26064701

  1. Custom-Made Computer-Aided-Design/Computer-Aided-Manufacturing Biphasic Calcium-Phosphate Scaffold for Augmentation of an Atrophic Mandibular Anterior Ridge.

    PubMed

    Mangano, Francesco Guido; Zecca, Piero Antonio; van Noort, Ric; Apresyan, Samvel; Iezzi, Giovanna; Piattelli, Adriano; Macchi, Aldo; Mangano, Carlo

    2015-01-01

    This report documents the clinical, radiographic, and histologic outcome of a custom-made computer-aided-design/computer-aided-manufactured (CAD/CAM) scaffold used for the alveolar ridge augmentation of a severely atrophic anterior mandible. Computed tomographic (CT) images of an atrophic anterior mandible were acquired and modified into a 3-dimensional (3D) reconstruction model; this was transferred to a CAD program, where a custom-made scaffold was designed. CAM software generated a set of tool-paths for the manufacture of the scaffold on a computer-numerical-control milling machine into the exact shape of the 3D design. A custom-made scaffold was milled from a synthetic micromacroporous biphasic calcium phosphate (BCP) block. The scaffold closely matched the shape of the defect: this helped to reduce the time for the surgery and contributed to good healing. One year later, newly formed and well-integrated bone was clinically available, and two implants (AnyRidge, MegaGen, Gyeongbuk, South Korea) were placed. The histologic samples retrieved from the implant sites revealed compact mature bone undergoing remodelling, marrow spaces, and newly formed trabecular bone surrounded by residual BCP particles. This study demonstrates that custom-made scaffolds can be fabricated by combining CT scans and CAD/CAM techniques. Further studies on a larger sample of patients are needed to confirm these results. PMID:26064701

  2. Primary leiomyosarcoma of the mandible

    PubMed Central

    Moghadam, Saede Atarbashi; Khodayari, Abbas; Mokhtari, Sepideh

    2014-01-01

    Leiomyosarcoma (LMS) is a malignant soft tissue tumor that exhibits smoothmuscle differentiation. Its occurrence in the oral cavity is exceedingly rare. This article presents a 67-year-old woman with 9-month history of a painful tumoral lesion on the right side of mandible. Tumor was composed of fascicles of spindle-shaped cells with cigar-shaped nuclei and eosinophilic cytoplasm. Immunohistochemistry showed that tumor cells were positive for smooth muscle actin (SMA) and desmin. The findings were consistent with the diagnosis of LMS. PMID:25328319

  3. Cementoblastoma of posterior maxilla involving the maxillary sinus

    PubMed Central

    Dadhich, Anuj S.; Nilesh, Kumar

    2015-01-01

    Cementoblastoma is a rare neoplasm, representing <1% of all odontogenic tumors. It usually occurs in the posterior mandible and is associated with roots of a mandibular first molar or second premolar. This paper presents a rare case of cementoblastoma in the maxillary posterior region involving the maxillary sinus, in a young female patient. The clinical, radiological, and histopathological features of the lesion are discussed along with a review of previously reported cases in the literature. PMID:26389052

  4. Erupted complex odontoma of the posterior maxilla: A rarity

    PubMed Central

    Verma, Sonika; Arul, A. Sri Kennath J.; Arul, A. Sri Sennath J.; Chitra, S.

    2015-01-01

    Complex odontomas, hamartomas of aborted tooth development, mainly occur in posterior part of the mandible and rarely erupt into the oral cavity. The spontaneous eruption may be associated with pain, inflammation of adjacent soft tissues or recurrent infection. The present case of complex odontoma is of particular interest due to its apparent eruption in the maxillary posterior segment, its association with agenesis of the second molar and impacted third molar; with the lesion being completely asymptomatic. PMID:26604611

  5. Erupted complex odontoma of the posterior maxilla: A rarity.

    PubMed

    Verma, Sonika; Arul, A Sri Kennath J; Arul, A Sri Sennath J; Chitra, S

    2015-08-01

    Complex odontomas, hamartomas of aborted tooth development, mainly occur in posterior part of the mandible and rarely erupt into the oral cavity. The spontaneous eruption may be associated with pain, inflammation of adjacent soft tissues or recurrent infection. The present case of complex odontoma is of particular interest due to its apparent eruption in the maxillary posterior segment, its association with agenesis of the second molar and impacted third molar; with the lesion being completely asymptomatic. PMID:26604611

  6. Simultaneous Bimaxillary Surgery and Mandibular Reconstruction With a 3-Dimensional Printed Titanium Implant Fabricated by Electron Beam Melting: A Preliminary Mechanical Testing of the Printed Mandible.

    PubMed

    Lee, Ui-Lyong; Kwon, Jae-Sung; Woo, Su-Heon; Choi, Young-Jun

    2016-07-01

    A woman presented with a long history of mandibular defects posterior to the left lower first premolar caused by inadequate reconstruction after removal of a tumor on the left side of the mandible. In the frontal view, extreme facial asymmetry was apparent. The dental midline of the mandible was deviated 10 mm to the left compared with the dental midline of the maxilla, and all maxillary teeth were inclined to the left owing to dental compensation. There was an 8-mm maxillary occlusal cant relative to the maxillary first molar. Bimaxillary surgery using computer-assisted designed and computer-assisted manufactured devices without an intermediate occlusal splint was performed to align the maxilla and mandible at the correct position, and reconstructive surgery for the mandible using a 3-dimensional printed titanium mandible was concurrently performed. In particular, during the virtual mandible design, 2 abutments that enabled the prosthetic restoration were included in the mandible using a computer-assisted design program. This report describes the successful functional and esthetic reconstruction of the mandible using electron beam melting technology, an alternative technique for reconstruction of mandibles that did not undergo radiation therapy. PMID:27060494

  7. Atrophic vaginitis in breast cancer survivors: a difficult survivorship issue.

    PubMed

    Lester, Joanne; Pahouja, Gaurav; Andersen, Barbara; Lustberg, Maryam

    2015-01-01

    Management of breast cancer includes systematic therapies including chemotherapy and endocrine therapy can lead to a variety of symptoms that can impair the quality of life of many breast cancer survivors. Atrophic vaginitis, caused by decreased levels of circulating estrogen to urinary and vaginal receptors, is commonly experienced by this group. Chemotherapy induced ovarian failure and endocrine therapies including aromatase inhibitors and selective estrogen receptor modulators can trigger the onset of atrophic vaginitis or exacerbate existing symptoms. Symptoms of atrophic vaginitis include vaginal dryness, dyspareunia, and irritation of genital skin, pruritus, burning, vaginal discharge, and soreness. The diagnosis of atrophic vaginitis is confirmed through patient-reported symptoms and gynecological examination of external structures, introitus, and vaginal mucosa. Lifestyle modifications can be helpful but are usually insufficient to significantly improve symptoms. Non-hormonal vaginal therapies may provide additional relief by increasing vaginal moisture and fluid. Systemic estrogen therapy is contraindicated in breast cancer survivors. Continued investigations of various treatments for atrophic vaginitis are necessary. Local estrogen-based therapies, DHEA, testosterone, and pH-balanced gels continue to be evaluated in ongoing studies. Definitive results are needed pertaining to the safety of topical estrogens in breast cancer survivors. PMID:25815692

  8. Atrophic Vaginitis in Breast Cancer Survivors: A Difficult Survivorship Issue

    PubMed Central

    Lester, Joanne; Pahouja, Gaurav; Andersen, Barbara; Lustberg, Maryam

    2015-01-01

    Management of breast cancer includes systematic therapies including chemotherapy and endocrine therapy can lead to a variety of symptoms that can impair the quality of life of many breast cancer survivors. Atrophic vaginitis, caused by decreased levels of circulating estrogen to urinary and vaginal receptors, is commonly experienced by this group. Chemotherapy induced ovarian failure and endocrine therapies including aromatase inhibitors and selective estrogen receptor modulators can trigger the onset of atrophic vaginitis or exacerbate existing symptoms. Symptoms of atrophic vaginitis include vaginal dryness, dyspareunia, and irritation of genital skin, pruritus, burning, vaginal discharge, and soreness. The diagnosis of atrophic vaginitis is confirmed through patient-reported symptoms and gynecological examination of external structures, introitus, and vaginal mucosa. Lifestyle modifications can be helpful but are usually insufficient to significantly improve symptoms. Non-hormonal vaginal therapies may provide additional relief by increasing vaginal moisture and fluid. Systemic estrogen therapy is contraindicated in breast cancer survivors. Continued investigations of various treatments for atrophic vaginitis are necessary. Local estrogen-based therapies, DHEA, testosterone, and pH-balanced gels continue to be evaluated in ongoing studies. Definitive results are needed pertaining to the safety of topical estrogens in breast cancer survivors. PMID:25815692

  9. Mandible shape in hybrid mice.

    PubMed

    Renaud, Sabrina; Alibert, Paul; Auffray, Jean-Christophe

    2009-09-01

    Hybridisation between closely related species is frequently seen as retarding evolutionary divergence and can also promote it by creating novel phenotypes due to new genetic combinations and developmental interactions. We therefore investigated how hybridisation affects the shape of the mouse mandible, a well-known feature in evo-devo studies. Parental groups corresponded to two strains of the European mouse sub-species Mus musculus domesticus and Mus musculus musculus. Parents and hybrids were bred in controlled conditions. The mandibles of F(1) hybrids are mostly intermediate between parental phenotypes as expected for a complex multigenic character. Nevertheless, a transgressive effect as well as an increased phenotypic variance characterise the hybrids. This suggests that hybridisation between the two subspecies could lead to a higher phenotypic variance due to complex interactions among the parental genomes including non-additive genetic effects. The major direction of variance is conserved, however, among hybrids and parent groups. Hybridisation may thus play a role in the production of original transgressive phenotypes occurring following pre-existing patterns of variance. PMID:19504055

  10. Systemic mastocytosis involving the mandible.

    PubMed

    Medina, R; Faecher, R S; Stafford, D S; Zander, D S; Baughman, R A

    1994-07-01

    Systemic mastocytosis is a rare and clinically fascinating disorder that usually involves the skin and hematopoietic tissues. We report a patient with systemic mastocytosis involving the mandible who had no other presenting bone lesions on scintigraphic exam. After noting the radiographic emergence of this osteolytic jaw lesion over a 6-month interval, a biopsy of the lesion was performed, and histologic and electron microscopic studies completed. It is believed that this is the first documented case of mastocytosis to involve an oral-maxillofacial bone. Careful preoperative evaluation and clinical management were conducted to avoid potentially life-threatening complications. A discussion of this condition and strategies for diagnosis and patient management are presented. PMID:8078658

  11. Echinoccocal cyst affecting the mandible.

    PubMed

    Bhola, Nitin; Jadhav, Anendd; Borle, Rajiv; Shukla, Samarth

    2015-01-01

    Echinococcosis is a parasitic infection also called as hydatid disease or hydatidosis. Hydatidosis is a cyclo-zoonotic infection of the larvae form of Echinococcus granulosus (canine tapeworm). The majority of hydatid cysts are seen in the liver (65%) as most of the embryos are trapped within it. Infratemporal region is an unusual site for hydatidosis and has been sparsely reported in the literature. To the best of our knowledge, this is the fourth and perhaps the largest case report of hydatidosis involving the mandible in the literature in right infratemporal region involving the ramus condyle unit in a 35-year-old female with chief complaint of pain on right side of temporomandibular joint area on mastication, and opening and closing of mouth. PMID:26389049

  12. Pediatric non-Helicobacter pylori atrophic gastritis: a case series.

    PubMed

    Pogoriler, Jennifer; Kamin, Daniel; Goldsmith, Jeffrey D

    2015-06-01

    Although autoimmune atrophic gastritis is classically a disease of elderly adults, recent studies have described the disease in younger adults, particularly in those with other autoimmune diseases and iron-deficiency anemia. Atrophic gastritis in pediatrics is a rare and possibly underdiagnosed entity that has been primarily reported as single-case reports. This retrospective study of atrophic gastritis not associated with Helicobacter pylori infection was performed to further expand the knowledge of clinical presentation, pathologic findings, and natural history of this disease in the pediatric population. Twelve patients with a histologic diagnosis of atrophic gastritis were identified, with an age range of 8 months to 18 years. Seven had other autoimmune diseases and/or immunodeficiency. Atrophy was confined to the oxyntic mucosa in 10 patients, with intramucosal inflammation in a diffuse or basal-predominant pattern. Active inflammation was present in 7 patients. Pseudopyloric, intestinal, or squamous/mucinous metaplasia was seen at initial biopsy or on follow-up in 8 patients, and enterochromaffin-like cell hyperplasia was seen in 5. One patient developed an adenocarcinoma during the follow-up period of 10 years. Two false-negative diagnoses were retrospectively identified. In the majority of cases, the possibility of atrophic gastritis was not raised by the submitting physician, and the endoscopic findings were not specific. Therefore, accurate diagnosis requires a high degree of suspicion on the part of the pathologist, and the diagnosis should be considered particularly in patients with a clinical history of other autoimmune diseases or iron-deficiency anemia. PMID:25602795

  13. Effect of clenching on biomechanical response of human mandible and temporomandibular joint to traumatic force analyzed by finite element method

    PubMed Central

    Yamamoto, Kazuhiko; Sugiura, Tsutomu; Kawakami, Masayoshi; Kang, Yu B.; Tsutsumi, Sadami; Kirita, Tadaaki

    2013-01-01

    Purpose: The purpose of the present study was to analyze the effect of clenching on the biomechanical response of human mandible and temporomandibular joint (TMJ) to traumatic force by the finite element (FE) method. Material and Methods: FE models of the mandible and the TMJ in resting and clenching positions were prepared. Distribution and magnitude of von Mises stress were analyzed by applying force as a point load in the symphyseal, canine, body and angle regions of the mandible. In addition, strain energy density (SED) at the articular disc and in posterior connective tissue of TMJ was analyzed. Results: In the resting position, von Mises stress was mainly concentrated at the condylar neck and in the retromolar region of the mandible. In the clenching position, the stress at the condylar neck decreased in all loadings. The stress in the retromolar region similary decreased in the symphyseal, canine and body loading, respectively; however, higher stress was observed in the retromolar region on the loading side in the angle loading. High SED was generated at the articular disc and in posterior connective tissues of TMJ in the resting position. The SED in these tissues decreased in all loadings in the clenching position. Conclusions: Clenching generally reduces stress at the condylar neck and in the retromolar region of the mandible, and strain energy at the articular disc and in posterior connective tissue of TMJ by traumatic forces on the mandible; however, clenching induces greater stress in the retromolar region on the loading side by traumatic force to the angle region. Key words:Mandibular, temporomandibular joint, traumatic force, clenching, finite element analysis. PMID:23524422

  14. The Comprehensive AOCMF Classification System: Mandible Fractures-Level 3 Tutorial

    PubMed Central

    Cornelius, Carl-Peter; Audigé, Laurent; Kunz, Christoph; Rudderman, Randal; Buitrago-Téllez, Carlos H.; Frodel, John; Prein, Joachim

    2014-01-01

    This tutorial outlines the details of the AOCMF image-based classification system for fractures of the mandibular arch (i.e. the non-condylar mandible) at the precision level 3. It is the logical expansion of the fracture allocation to topographic mandibular sites outlined in level 2, and is based on three-dimensional (3D) imaging techniques/computed tomography (CT)/cone beam CT). Level 3 allows an anatomical description of the individual conditions of the mandibular arch such as the preinjury dental state and the degree of alveolar atrophy. Trauma sequelae are then addressed: (1) tooth injuries and periodontal trauma, (2) fracture involvement of the alveolar process, (3) the degree of fracture fragmentation in three categories (none, minor, and major), and (4) the presence of bone loss. The grading of fragmentation needs a 3D evaluation of the fracture area, allowing visualization of the outer and inner mandibular cortices. To document these fracture features beyond topography the alphanumeric codes are supplied with distinctive appendices. This level 3 tutorial is accompanied by a brief survey of the peculiarities of the edentulous atrophic mandible. Illustrations and a few case examples serve as instruction and reference to improve the understanding and application of the presented features. PMID:25489389

  15. Microneedling Therapy in Atrophic Facial Scars: An Objective Assessment

    PubMed Central

    Majid, Imran

    2009-01-01

    Background: Atrophic facial scars are always a challenge to treat, especially the ones that are deep-seated and/or involve much of the face. Microneedling or dermaroller therapy is a new addition to the treatment armamentarium for such scars that offers a simple and reportedly effective management of these scars. Aims: The aim of the present study was to perform an objective evaluation of the efficacy of dermaroller treatment in atrophic facial scars of varying etiology. Materials and Methods: Thirty-seven patients of atrophic facial scarring were offered multiple sittings of microneedling (dermaroller) treatment and their scars were evaluated and graded clinically and by serial photography at the start as well as at two months after the conclusion of the treatment protocol. Any change in the grading of scars after the end of treatment and follow-up period was noted down. The patients were also asked to evaluate the effectiveness of the treatment received on a 1-10 point scale. The efficacy of dermaroller treatment was thus assessed both subjectively by the patients as well as objectively by a single observer. Results: Overall 36 out of the total of 37 patients completed the treatment schedule and were evaluated for its efficacy. Out of these 36 patients, 34 achieved a reduction in the severity of their scarring by one or two grades. More than 80% of patients assessed their treatment as ‘excellent’ on a 10-point scale. No significant adverse effects were noted in any patient. Conclusions: Microneedling therapy seems to be a simple and effective treatment option for the management of atrophic facial scars. PMID:20300368

  16. Combination Therapy in the Management of Atrophic Acne Scars

    PubMed Central

    Garg, Shilpa; Baveja, Sukriti

    2014-01-01

    Background: Atrophic acne scars are difficult to treat. The demand for less invasive but highly effective treatment for scars is growing. Objective: To assess the efficacy of combination therapy using subcision, microneedling and 15% trichloroacetic acid (TCA) peel in the management of atrophic scars. Materials and Methods: Fifty patients with atrophic acne scars were graded using Goodman and Baron Qualitative grading. After subcision, dermaroller and 15% TCA peel were performed alternatively at 2-weeks interval for a total of 6 sessions of each. Grading of acne scar photographs was done pretreatment and 1 month after last procedure. Patients own evaluation of improvement was assessed. Results: Out of 16 patients with Grade 4 scars, 10 (62.5%) patients improved to Grade 2 and 6 (37.5%) patients improved to Grade 3 scars. Out of 22 patients with Grade 3 scars, 5 (22.7%) patients were left with no scars, 2 (9.1%) patients improved to Grade 1and 15 (68.2%) patients improved to Grade 2. All 11 (100%) patients with Grade 2 scars were left with no scars. There was high level of patient satisfaction. Conclusion: This combination has shown good results in treating not only Grade 2 but also severe Grade 4 and 3 scars. PMID:24761094

  17. Enucleation of large keratocystic odontogenic tumor at mandible via unilateral sagittal split osteotomy: a report of three cases

    PubMed Central

    Lee, Hyeong-Geun; Rhee, Seung-Hyun; Noh, Chung-Ah

    2015-01-01

    Keratocystic odontogenic tumor (KCOT) is a common benign tumor of osseous lesions in dental and maxillofacial practice. We describe three cases of large KCOT located in the posterior part of the mandible extending to the angle and ramus region, which were enucleated via sagittal split osteotomy (SSO) of the mandible. There are cases in which a conventional enucleation procedure does not ensure complete excision of the entire lesion without damage to vital structures like the inferior alveolar nerve. In such cases, a SSO approach could be a better choice than conventional methods. The purpose of this article is to describe our experience using unilateral mandibular SSO for removal of a KCOT from the mandible. PMID:26339581

  18. Bilateral Calcifying Cystic Odontogenic Tumour of Mandible: A Rare Case Report and Review of Literature.

    PubMed

    Khandelwal, Pragun; Aditya, Amita; Mhapuskar, Amit

    2015-11-01

    Calcifying cystic odontogenic tumour (CCOT) is a relatively rare lesion of oral and maxillofacial region and forms only 2% of all odontogenic tumours. It was previously known as Calcifying odontogenic cyst and only recently has been classified as a tumour by WHO. The controversy regarding its origin can be owed to its diverse clinical and histopathological presentation and variation in reported malignant potential. It was first reported by Gorlin in 1962 and since then conundrum regarding its true nature has persisted. It is seen in association with other lesions like odontoma, ameloblastoma and ameloblastic fibroma. Both intra-osseous and extra-osseous forms of CCOT have been reported. It commnoly occurs in anterior region with equal preponderance in maxilla and mandible. Here we present a rare case of bilateral CCOT in the posterior mandible of a 16-year-old male patient which was discovered incidentally during a radiographic examination. PMID:26673837

  19. Bilateral Calcifying Cystic Odontogenic Tumour of Mandible: A Rare Case Report and Review of Literature

    PubMed Central

    Khandelwal, Pragun; Mhapuskar, Amit

    2015-01-01

    Calcifying cystic odontogenic tumour (CCOT) is a relatively rare lesion of oral and maxillofacial region and forms only 2% of all odontogenic tumours. It was previously known as Calcifying odontogenic cyst and only recently has been classified as a tumour by WHO. The controversy regarding its origin can be owed to its diverse clinical and histopathological presentation and variation in reported malignant potential. It was first reported by Gorlin in 1962 and since then conundrum regarding its true nature has persisted. It is seen in association with other lesions like odontoma, ameloblastoma and ameloblastic fibroma. Both intra-osseous and extra-osseous forms of CCOT have been reported. It commnoly occurs in anterior region with equal preponderance in maxilla and mandible. Here we present a rare case of bilateral CCOT in the posterior mandible of a 16-year-old male patient which was discovered incidentally during a radiographic examination. PMID:26673837

  20. Eosinophilic Granuloma of the Mandible: Is a Conservative Treatment Sufficient for Local Disease Control?

    PubMed

    Fiorini, Paola; Gallesio, Cesare; Longoni, Valentina; Ramieri, Guglielmo

    2016-05-01

    Eosinophilic granuloma is the most benign and common form of the Langerhans cell histiocytosis, a rare proliferative disease that can affect single or multiple organs. In the quite common head and neck manifestation these lesions can be confused in the beginning, with other bone diseases such as odontogenic cysts, periodontal disease, or malignancies. Treatment varies depending on the size, number, localization of the lesions, and patient's general conditions. The authors describe here a patient of a single lesion of eosinophilic granuloma localized in the posterior mandible region treated with a very conservative surgical approach in a patient with poor socio-economic conditions. The authors performed teeth extractions, an excisional biopsy and open curettage and after a follow-up of 24 months without partial mandible resection and reconstruction time the lesion had healed. The clinical situation confirmed that, in carefully selective patients, a conservative approach could be a useful therapeutic opportunity. PMID:26999697

  1. A Retrospective 3D Radiologic Analysis of 52 Patients with Mandible Fractures.

    PubMed

    Özkan, Heval Selman; Irkoren, Saime; Durum, Yasemin; Karaca, Can

    2016-02-01

    When fractured, mandible angulates. For better preoperative evaluation, movements of fractured mandibular segments should be documented in x-, y-, and z-axes. This article quantitatively evaluates the pattern and degree of the angulation. Fifty-two patients with mandible fractures were involved in this study. After defining a three-dimensional (3D) coordination system consisting of the x-axis (the axis directed from the medial to lateral side of the skull), y-axis (directed from the inferior to superior side), and z-axis (directed from the posterior to anterior side), the degree with which the fractured mandible angulated around each of these axes was measured using 3D graphic software. The tendency of the angulation was compared between the three axes. Frequency of complications, operation times, maxilla mandibular fixation (MMF) need, and epidemiologic data were compared with the angulation results. Angulation around the x-axis was the most frequent with a 55.8% incidence, followed by a substantial margin of angulation around the y-axis with a 21.2% incidence; angulation around the z-axis was rare, with an incidence of 15.4%. Furthermore, the degree of z-axis angulation was minor compared with x- and y-axes angulations. There were statistically increased rate of complications, operation time, and MMF need in patients with more than 10 degrees of angulation in any case. Operation time and complication rates are also increased in patients with internal rotation of the proximal segment. Preoperative evaluation of mandible fracture angulation degree is useful for determining postoperative complication rates, MMF need, and operative challenge. This finding is helpful for effective performance to reposition the fractured mandible. PMID:26862971

  2. 3-Dimensional Physiologic Postural Range of the Mandible: A Computerized-Assisted Technique—A Case Study

    PubMed Central

    2013-01-01

    Previous studies demonstrated that while the mandible assumes its resting position in space, antagonistic muscles should assume minimal muscle activity within a spatial range. This zone of mandibular rest has been mapped using physiologic parameters of muscle activity and incisal spatial kinematics. This case study expands on previous research by monitoring incisal and posterior jaw position and includes lateral pterygoid muscle activity, thus allowing for determining the spatial range including additional relevant coordinates and muscle activity. Four positions were evaluated: a maximum physiologic open position, a maximum physiologic closed position, physiologic rest position, and maximum physiologic protrusion position. Within the physiologic zone of rest formed by these 4 positions, the vertical and anterior borders of the envelope of function may be documented for the incisal and posterior mandible in true 3-dimensional fashion to assist the clinician in determining a physiologic interocclusal freeway space and vertical dimension of occlusion. Advantages and limitations are discussed. PMID:24194764

  3. Chronic atrophic gastritis in association with hair mercury level.

    PubMed

    Xue, Zeyun; Xue, Huiping; Jiang, Jianlan; Lin, Bing; Zeng, Si; Huang, Xiaoyun; An, Jianfu

    2014-11-01

    The objective of this study was to explore hair mercury level in association with chronic atrophic gastritis, a precancerous stage of gastric cancer (GC), and thus provide a brand new angle of view on the timely intervention of precancerous stage of GC. We recruited 149 healthy volunteers as controls and 152 patients suffering from chronic gastritis as cases. The controls denied upper gastrointestinal discomforts, and the cases were diagnosed as chronic superficial gastritis (n=68) or chronic atrophic gastritis (n=84). We utilized Mercury Automated Analyzer (NIC MA-3000) to detect hair mercury level of both healthy controls and cases of chronic gastritis. The statistic of measurement data was expressed as mean ± standard deviation, which was analyzed using Levene variance equality test and t test. Pearson correlation analysis was employed to determine associated factors affecting hair mercury levels, and multiple stepwise regression analysis was performed to deduce regression equations. Statistical significance is considered if p value is less than 0.05. The overall hair mercury level was 0.908949 ± 0.8844490 ng/g [mean ± standard deviation (SD)] in gastritis cases and 0.460198 ± 0.2712187 ng/g (mean±SD) in healthy controls; the former level was significantly higher than the latter one (p=0.000<0.01). The hair mercury level in chronic atrophic gastritis subgroup was 1.155220 ± 0.9470246 ng/g (mean ± SD) and that in chronic superficial gastritis subgroup was 0.604732 ± 0.6942509 ng/g (mean ± SD); the former level was significantly higher than the latter level (p<0.01). The hair mercury level in chronic superficial gastritis cases was significantly higher than that in healthy controls (p<0.05). The hair mercury level in chronic atrophic gastritis cases was significantly higher than that in healthy controls (p<0.01). Stratified analysis indicated that the hair mercury level in healthy controls with eating seafood was significantly higher than that in healthy

  4. Bilateral coronoid hypoplasia and complex odontoma: a rare concurrence of developmental pathology and odontogenic tumour of the mandible.

    PubMed

    Dar, Mohd Arif; Alaparthi, Ravikiran; Yalamanchili, Samatha; Santosh, Arvind Babu Rajendra

    2015-01-01

    We present a rare case of concurrent bilateral coronoid hypoplasia and complex odontoma in the mandible, with replacement of missing posterior teeth in both sides of the lower jaw. A 20-year-old woman was diagnosed with bilateral occurrence of coronoid hypoplasia and unerupted complex odontoma after radiographic and histopathological examination. The patient was surgically treated with complete removal of the unerupted complex odontoma and prosthetic replacement of the missing teeth. PMID:26464410

  5. On the Variability of the Dmanisi Mandibles

    PubMed Central

    Bermúdez de Castro, José María; Martinón-Torres, María; Sier, Mark Jan; Martín-Francés, Laura

    2014-01-01

    The description of a new skull (D4500) from the Dmanisi site (Republic of Georgia) has reopened the debate about the morphological variability within the genus Homo. The new skull fits with a mandible (D2600) often referred as ‘big’ or ‘enigmatic’ because of its differences with the other Dmanisi mandibles (D211 and D2735). In this report we present a comparative study of the variability of the Dmanisi mandibles under a different perspective, as we focus in morphological aspects related to growth and development. We have followed the notion of modularity and phenotypic integration in order to understand the architectural differences observed within the sample. Our study reveals remarkable shape differences between D2600 and the other two mandibles, that are established early in the ontogeny (during childhood or even before) and that do not depend on size or sexual dimorphism. In addition, D2600 exhibits a mosaic of primitive and derived features regarding the Homo clade, which is absent in D211 and D2735. This mosaic expression is related to the location of the features and can be explained under the concept of modularity. Our study would support the possibility of two different paleodemes represented at the Dmanisi site. This hypothesis has been previously rejected on the basis that all the individuals were constrained in the same stratigraphic and taphonomic settings. However, our revision of the complex Dmanisi stratigraphy suggests that the accumulation could cover an undetermined period of time. Even if “short” in geological terms, the hominin accumulation was not necessarily synchronic. In the same line we discard that the differences between D2600 and the small mandibles are consequence of wear-related dentoalveolar remodeling. In addition, dental wear pattern of D2600 could suggest an adaptation to a different ecological niche than the other Dmanisi individuals. PMID:24586309

  6. Multimodal management of atrophic acne scarring in the aging face.

    PubMed

    O'Daniel, T Gerald

    2011-12-01

    Atrophic facial acne scarring is a widely prevalent condition that can have a negative impact on a patient's quality of life. The appearance of these scars is often worsened by the normal effects of aging. A number of options are available for the treatment of acne scarring, including chemical peeling, dermabrasion, ablative or nonablative laser resurfacing, dermal fillers, and surgical techniques such as subcision or punch excision. Depending on the type and extent of scarring, a multimodal approach is generally necessary to provide satisfactory results. Resurfacing techniques correct surface irregularities, long-lasting dermal fillers address the volume loss resulting from acne, and sub-superficial musculoaponeurotic system (SMAS) face-lift procedures counter the soft tissue laxity and ptosis associated with aging. This article briefly reviews the evolution of individual approaches to treating atrophic acne scarring, followed by case examples illustrating results that can be achieved using a multimodal approach. Representative cases from patients in their 30s, 40s, and 50s are presented. In the author's clinical practice, multimodal approaches incorporating fractionated laser, injectable poly-L: -lactic acid, and sub-SMAS face-lift procedures have achieved optimal aesthetic outcomes, high patient satisfaction, and durability of aesthetic effect over time. PMID:21491169

  7. [A case of basilar impression treated with mandible splitting transoral approach].

    PubMed

    Young-Su, P; Ishikawa, J; Matsumoto, M; Sato, T; Owaki, H

    1997-05-01

    We report a case of basilar impression treated with mandible splitting transoral approach surgery. A 39-year-old man presented a ten-year history of gait disturbance. He had experienced acceleration of his spastic paraparesis for the past few years. Neurological examination on admission demonstrated tetraparesis (MMT4/5), severe hyperreflexia in his arms and legs, severe sensory loss below C2, urinary retention and inability to open his mouth widely. Radiological findings showed the dens and the body of C2 are deeply invaginated to the atlas and the foramen magnum and medulla and upper cervical cord were markedly compressed by this basilar invagination. After carrying out posterior decompression and occipito-cervical fixation, we attempted to remove the invaginated dens and the C2 vertebral body using a conventional transoral approach. But limitation of mouth opening made operative fields narrow. Consequently because of insufficient anterior decompression his neurological deficits could not be alleviated. Employment of mandible splitting procedure brought about a wide operative view so that complete removal of the residual dens and 70% drilling out of the C2 body was made possible. Postoperative complications were negligible. Finally, great alleviation of his deficits was achieved. Mandible splitting procedure is effective for obtaining a wide operative field on the anterior approach to the craniocervical junction. PMID:9145409

  8. Solitary Periosteal Osteoma of the Mandible

    PubMed Central

    Mehta, Reema; Yadav, Archana; Bansal, Shivani P.; Deshpande, Mohan D.

    2014-01-01

    Osteoma of the jaw bones is a rare entity with very few cases reported in the literature. Osteomas are benign, slow-growing osteogenic tumours of the bone commonly encountered in the craniofacial skeleton and characterised by the proliferation of compact or cancellous bone. They can be central, peripheral or extra-skeletal in their location. In the facial region, periosteal osteomas occur more frequently in the paranasal sinuses, but solitary periosteal osteomas of the jaw bones are quite rare. The mandible is more commonly affected than the maxilla, with the sites of predilection being the lingual aspect of the body, the angle and the inferior border. We report a case of a solitary periosteal osteoma on the buccal aspect of the mandible in a 42-year-old woman. PMID:24516749

  9. Mucormycosis of Mandible with Unfavorable Outcome

    PubMed Central

    Oswal, Nitin Prakash; Gadre, Pushkar Kiran; Sathe, Prachee; Gadre, Kiran Shrikrishna

    2012-01-01

    Mucormycosis is a fulminant fungal infection that occurs most often in diabetic and immunocompromised individuals. Our patient, with uncontrolled diabetes mellitus and multiple systemic disorders, developed postextraction mucormycosis of mandible, an extremely rare complication. An initial clinical and radiographic diagnosis of mandibular osteomyelitis was made and the lesion was treated medically and surgically with curettage and saucerisation. The specimen was sent for histopathological evaluation, which showed necrotic area containing broad aseptate fungal hyphae with right angle branching consistent with mucormycosis. The patient succumbed to multipleorgan failure secondary to septicemia. The disease is usually fatal with a poor survival rate; there is still paucity of literature on the definitive management of this disease involving the mandible. This paper emphasizes the need for correction of underlying immunodeficiency and early diagnosis with aggressive multimodality treatment approach to offer the best chance of survival. PMID:22779014

  10. Static balancing behaviour of the mandible.

    PubMed

    Hellmann, Daniel; Brüstle, Fabian; Terebesi, Sophia; Giannakopoulos, Nikolaos N; Eberhard, Lydia; Rammelsberg, Peter; Schindler, Hans J

    2015-12-01

    The objective of this study was to investigate the mechanisms of physiological control of the craniomandibular system during force-controlled biting: in intercuspation, restricted by predetermined anatomic-geometrical conditions [i.e. biting in intercuspation (BIC)]; and on a hydrostatic system [i.e. auto-balanced static equilibrium of the mandible (BAL)], in which the mandible is balanced under unrestricted occlusal conditions. For 20 healthy subjects, the spatial positions of the condyles, the lower molars, and the incisal point were measured, and the electromyographic (EMG) activity of the musculus masseter and musculus temporalis anterior were recorded bilaterally, during force-controlled biting (50, 75, 100 N) on a hydrostatic device. The results were compared with those obtained during BIC. During BAL, the neuromuscular system stabilizes one condyle, so it behaves as a virtual fulcrum, and all available biomechanical degrees of freedom of the opposite side are used to achieve a bilaterally equal vertical distance between the upper and lower dental arches. The variability of the positions of the molars was significantly smaller than for the condyles. The EMG co-contraction ratios calculated for homonymous muscle regions revealed significant differences between BIC and BAL, specifically, greater symmetry during BAL with substantial asymmetry of approximately 25% remaining. In conclusion, the results revealed precise neuromuscular control of the position of the lower dental arch; this information might form the basis for interference-free tracking of the mandible in intercuspation under different conditions. PMID:26446049

  11. [Bodily movement of teeth in atrophic jaw segments].

    PubMed

    Wehrbein, H; Riess, H; Meyer, R; Schneider, B; Diedrich, P

    1990-03-01

    This experimental animal study was conducted to evaluate the extent of bone restructuring after bodily movement of teeth into an area of atrophied alveolar bone. The measured values as well as the radiographic and histologic data indicate that partial or total bone restructuring occurs depending on the rate of tooth movement. In our experiment we observed marked bone formation at an average tooth movement rate of 15 microns/day, whereas no noteworthy bone formation occurred at higher rates of tooth movement (26-40 microns/day). Basically, an improvement in attachment is possible with bodily movement in atrophic alveolar bone. However, it is important to remember the delayed periosteal reaction when planning the mechanics to be applied. PMID:2257823

  12. Immediate rehabilitation of the posterior maxilla with extensive sinus pneumatization with one axial and one trans-sinus tilted implant: a 3-year clinical report and a classification.

    PubMed

    Agliardi, Enrico L; Romeo, Davide; Wenger, Anja; Gastaldi, Giorgio; Gherlone, Enrico

    2015-03-01

    Implant rehabilitation of the posterior maxilla can entail difficulties due to reduced bone quantity and poor bone quality, especially after long-term edentulism. In some patients, multiple surgeries are necessary, which may lead to higher patient morbidity and longer treatment times before a prosthetic rehabilitation can be achieved. This article presents an immediate fixed prosthesis in a posterior atrophic maxilla supported by 1 anterior axial implant and 1 posterior tilted fixture placed with an intrasinus insertion. Additionally, a classification scheme for immediate treatment for the posterior maxilla based on the available residual bone is provided. PMID:25449610

  13. Normal and pathologic CT anatomy of the mandible

    SciTech Connect

    Osborn, A.G.; Hanafee, W.H.; Mancuso, A.A.

    1982-09-01

    The value of computed tomography (CT) in the diagnosis and management of a wide variety of facial lesions has been amply demonstrated. While a number of studies have focused on CT anatomy of the paranasal sinuses, nose, and nasopharynx, none has concentrated on the mandible. Although the mandible is difficult to image because of its complex, curving surfaces and the presence of artifact-producing amalgam fillings or restorations, CT of the mandible can nevertheless be highly informative in selected cases. This pictorial essay depicts normal gross and CT anatomy of the mandible and presents a series of cases that illustrate the utility of CT in examining mandibular lesions.

  14. Histological Features and Biocompatibility of Bone and Soft Tissue Substitutes in the Atrophic Alveolar Ridge Reconstruction.

    PubMed

    Maiorana, Carlo; Beretta, Mario; Rancitelli, Davide; Grossi, Giovanni Battista; Cicciù, Marco; Herford, Alan Scott

    2016-01-01

    The reconstruction of the atrophic alveolar ridges for implant placement is today a common procedure in dentistry daily practice. The surgical reconstruction provides for the optimization of the supporting bone for the implants and a restoration of the amount of keratinized gingiva for esthetic and functional reasons. In the past, tissue regeneration has been performed with autogenous bone and free gingival or connective tissue grafts. Nowadays, bone substitutes and specific collagen matrix allow for a complete restoration of the atrophic ridge without invasive harvesting procedures. A maxillary reconstruction of an atrophic ridge by means of tissue substitutes and its histological features are then presented. PMID:27022489

  15. Histological Features and Biocompatibility of Bone and Soft Tissue Substitutes in the Atrophic Alveolar Ridge Reconstruction

    PubMed Central

    Rancitelli, Davide; Grossi, Giovanni Battista; Herford, Alan Scott

    2016-01-01

    The reconstruction of the atrophic alveolar ridges for implant placement is today a common procedure in dentistry daily practice. The surgical reconstruction provides for the optimization of the supporting bone for the implants and a restoration of the amount of keratinized gingiva for esthetic and functional reasons. In the past, tissue regeneration has been performed with autogenous bone and free gingival or connective tissue grafts. Nowadays, bone substitutes and specific collagen matrix allow for a complete restoration of the atrophic ridge without invasive harvesting procedures. A maxillary reconstruction of an atrophic ridge by means of tissue substitutes and its histological features are then presented. PMID:27022489

  16. [Bone scintigraphy following cryodevitalization of the mandible].

    PubMed

    Döge, H; Eckelt, U; Heber, G; Nelz, P

    1985-01-01

    A tumor of the mandible can be destroyed successfully by cryogenic devitalisation. The revitalisation process was observed in 6 miniature swines by means of nuclear medical bone exploration. The bone metabolism decreased clearly postoperatively, and indeed laterally more than lingually. An increased blood flow and bone metabolism was recognized as an expression of the repair process at the border to the healthy bone after 7 days, later also lingually whereas no reaction was found laterally. The extent of the devitalised bone was 0.5-1.0 cm bigger than the cryosurgical part. PMID:4002765

  17. Tongue Blade Bite Test Predicts Mandible Fractures.

    PubMed

    Neiner, John; Free, Rachael; Caldito, Gloria; Moore-Medlin, Tara; Nathan, Cherie-Ann

    2016-06-01

    The aim of the study is to evaluate the utility of a simple tongue blade bite test in predicting mandible fractures and use this test as an alternative screening tool for further workup. This is a retrospective chart review. An institutional review board approved the retrospective review of patients evaluated by the Department of Otolaryngology at a single institution for facial trauma performed from November 1, 2011, to February 27, 2014. Patients who had a bite test documented were included in the study. CT was performed in all cases and was used as the gold standard to diagnose mandible fractures. Variables analyzed included age, sex, fracture type/location on CT, bite test positivity, and operative intervention. A total of 86 patients met the inclusion criteria and of those 12 were pediatric patients. Majority of the patients were male (80.2%) and adult (86.0%; average age: 34.3 years). Fifty-seven patients had a negative bite test and on CT scans had no mandible fracture. Twenty-three patients had a positive bite test and a CT scan confirmed fracture. The bite test revealed a sensitivity of 88.5% (95% CI: 69.8-97.6%), specificity of 95.0% (95% CI:86.1-99%), positive predictive value [PPV] of 88.5% (95% CI: 69.8-97.6%), and negative predictive value [NPV] of 95.0% (95% CI: 86.1-99.0%). Among pediatric patients, the sensitivity was 100% (95% CI: 29.9-100%), specificity was 88.9% (95% CI: 68.4-100%), PPV was 75.0% (95% CI: 19.4-99.4%), and NPV was 100% (95% CI: 63.1-100%). The tongue blade bite test is a quick inexpensive diagnostic tool for the otolaryngologist with high sensitivity and specificity for predicting mandible fractures. In the pediatric population, where avoidance of unnecessary CT scans is of highest priority, a wider range of data collection should be undertaken to better assess its utility. PMID:27162567

  18. Recurrent Monostotic Fibrous Dysplasia in the Mandible.

    PubMed

    Alves, Nilton; de Oliveira, Reinaldo José; Takehana, Denise; Deana, Naira Figueiredo

    2016-01-01

    Fibrous dysplasia (FD) is a condition in which normal bone marrow is replaced by an abnormal proliferation of new fibrous connective tissue. Female patient, white, 20 years old, attended the dental clinic reporting a slow increase in volume in the right mandible region over the last 5 years. She was examined by imaging: the panoramic X-ray revealed a lesion with the appearance of ground glass while the cone-beam computed tomography showed an extensive lesion in the region of the right hemimandible. The histopathological examination was compatible with fibrous dysplasia. Bone gammagraphy was indicated, plus an endocrinological study to eliminate polyostotic forms, which produced a negative result. Monostotic fibrous dysplasia in the right hemimandible was diagnosed. Conservative surgery was carried out and after 1 year recurrence of the tumour was observed. We may conclude that conservative surgery might not be the best choice for treatment for monostotic fibrous dysplasia in the mandible and that other options must be considered, such as radical surgery or the use of bisphosphonates. In our study, we may also conclude that it is very important to explain to the patient the possibility of recurrence of the lesion and the need for monitoring with periodic imaging studies. PMID:27340572

  19. Recurrent Monostotic Fibrous Dysplasia in the Mandible

    PubMed Central

    de Oliveira, Reinaldo José; Takehana, Denise; Deana, Naira Figueiredo

    2016-01-01

    Fibrous dysplasia (FD) is a condition in which normal bone marrow is replaced by an abnormal proliferation of new fibrous connective tissue. Female patient, white, 20 years old, attended the dental clinic reporting a slow increase in volume in the right mandible region over the last 5 years. She was examined by imaging: the panoramic X-ray revealed a lesion with the appearance of ground glass while the cone-beam computed tomography showed an extensive lesion in the region of the right hemimandible. The histopathological examination was compatible with fibrous dysplasia. Bone gammagraphy was indicated, plus an endocrinological study to eliminate polyostotic forms, which produced a negative result. Monostotic fibrous dysplasia in the right hemimandible was diagnosed. Conservative surgery was carried out and after 1 year recurrence of the tumour was observed. We may conclude that conservative surgery might not be the best choice for treatment for monostotic fibrous dysplasia in the mandible and that other options must be considered, such as radical surgery or the use of bisphosphonates. In our study, we may also conclude that it is very important to explain to the patient the possibility of recurrence of the lesion and the need for monitoring with periodic imaging studies. PMID:27340572

  20. [Cryodevitalization of the mandible. The initial clinical experience].

    PubMed

    Eckelt, U; Lerch, H; Franke, W G

    1990-01-01

    There is given a report about first clinical experiences in the partial cryodevitalization of the mandible. 3 tumor-bearing patients were treated. The resection of the mandible was not necessary. The process of revitalisation was observed by bone scanning. PMID:2150462

  1. Ameloblastic odontoma in the mandible of a llama

    PubMed Central

    Step, Douglas L.; Ritchey, Jerry W.; Drost, William Tod; Bahr, Robert J.

    2003-01-01

    A 4-year-old llama had an aggressive, multiloculated, expansile bone lesion involving the rostral mandible. The mandibular lesion was imaged using radiography and computed tomography. Antemortem diagnosis of an ossifying fibroma was made histologically. Postmortem findings showed the lesion to be limited to the mandible. Final diagnosis was ameloblastic odontoma. PMID:14601679

  2. Comparison of transperitoneal laparoscopic nephrectomy outcomes in atrophic and hydronephrotic kidneys

    PubMed Central

    Gülpınar, Murat Tolga; Akçay, Muzaffer; Sancak, Eyüp Burak; Akbaş, Alpaslan; Tepeler, Abdulkadir; Reşorlu, Berkan; Armağan, Abdullah

    2015-01-01

    Objective To compare the results of transperitoneal laparoscopic nephrectomy in patients with atrophic and hydronephrotic kidneys. Material and methods Clinical data were collected from 35 patients who had undergone laparoscopic nephrectomies for atrophic or hydronephrotic non-functioning kidneys between January 2010 and March 2014. Comparative analysis was carried out between the two groups examining demographic characteristics, imaging modalities, etiology, operative times, port numbers, conversion to open surgery, complications, pre-and post-operative hemoglobin and creatinine values, transfusion rates and length of hospital stays. Results Laparoscopic nephrectomy was performed for atrophic kidneys in 20 (57%) patients and for hydronephrotic kidneys in 15 (42%) patients. In the atrophic group, 3 patients (15%) required transfusion because of bleeding but none of the patients required conversion to open surgery. In the hydronephrotic group one patient (6.6%) required transfusion and conversion to open surgery because of bleeding. Both of the groups were similar in terms of postoperative hospital stay but compared to the atrophic kidneys, hydronephrotic ones were associated with a longer total operative times (90.1 min vs. 73.6 min, p=0.03). Any serious complication (except for bleeding) and mortality were not encountered in both groups. Conclusion Laparoscopic nephrectomy is a safe and effective minimally invasive technique that can be used in atrophic and hydronephrotic non-functioning kidneys. PMID:26623146

  3. The Diagnostic Value of Gastrin-17 Detection in Atrophic Gastritis

    PubMed Central

    Wang, Xu; Ling, Li; Li, Shanshan; Qin, Guiping; Cui, Wei; Li, Xiang; Ni, Hong

    2016-01-01

    Abstract A meta-analysis was performed to assess the diagnostic value of gastrin-17 (G-17) for the early detection of chronic atrophic gastritis (CAG). An extensive literature search was performed, with the aim of selecting publications that reported the accuracy of G-17 in predicting CAG, in the following databases: PubMed, Science Direct, Web of Science, Chinese Biological Medicine, Chinese National Knowledge Infrastructure, Wanfang, and VIP. To assess the diagnostic value of G-17, the following statistics were estimated and described: sensitivity, specificity, diagnostic odds ratios (DOR), summary receiver operating characteristic curves, area under the curve (AUC), and 95% confidence intervals (CIs). Thirteen studies that met the inclusion criteria were included in this meta-analysis, comprising 894 patients and 1950 controls. The pooled sensitivity and specificity of these studies were 0.48 (95% CI: 0.45–0.51) and 0.79 (95% CI: 0.77–0.81), respectively. The DOR was 5.93 (95% CI: 2.93–11.99), and the AUC was 0.82. G-17 may have potential diagnostic value because it has good specificity and a moderate DOR and AUC for CAG. However, more studies are needed to improve the sensitivity of this diagnostic tool in the future. PMID:27149493

  4. Surfactant Protein A Expression in Chronic Rhinosinusitis and Atrophic Rhinitis

    PubMed Central

    El-Anwar, Mohammad Waheed; Hamed, Atef A.; Mohamed, Abd ElRaof Said; Nofal, Ahmad Abdel-Fattah; Mohamed, Maha A.; Abdel-Aziz, Hesham R.

    2015-01-01

    Introduction Surfactant protein A (SP-A) exhibits antimicrobial properties and interacts with a variety of respiratory tract pathogens. Objective The objective of this study was to detect the presence of SP-A and measure its alterations in chronic rhinosinusitis (CRS) and primary atrophic rhinitis (PAR) versus healthy controls. Methods Inferior turbinate and sinus mucosal biopsies were taken from 30 patients with CRS, 30 patients with PAR, and 20 healthy controls. Immunohistochemical staining for SP-A and polymerase chain reaction (PCR) amplification of SP-A messenger RNA were performed on nasal tissue samples. Results Immunostaining localized SP-A to the mucosa and submucosal glands in CRS specimens but failed to localize it in PAR specimens. Quantitative PCR showed a high, statistically significant increase in the SP-A levels of patients with CRS when compared with controls (p < 0.0001) and also demonstrated a significant reduction of SP-A in patients with PAR compared with controls (p < 0.005). Conclusion SP-A is significantly increased in CRS and decreased significantly in PAR and appears to be expressed by respiratory epithelial cells and submucosal glandular elements of the sinonasal mucosa. The potential therapeutic applications of surfactant in the enhancement of mucociliary clearance need to be studied. PMID:25992168

  5. Current therapeutic developments in atrophic age-related macular degeneration.

    PubMed

    Hanus, Jakub; Zhao, Fangkun; Wang, Shusheng

    2016-01-01

    Age-related macular degeneration (AMD), a degenerative disorder of the central retina, is the leading cause of irreversible blindness in the elderly. The underlying mechanism of the advanced form of dry AMD, also named geographic atrophy (GA) or atrophic AMD, remains unclear. Consequently, no cure is available for dry AMD or GA. The only prevention option currently available is the Age-Related Eye Disease Study (AREDS) formulation, which has been demonstrated to slow down the progression of dry AMD. This review summarises recent advances in therapy for dry AMD and GA. Building on the new understanding of the disease and recent technological breakthroughs, numerous ongoing clinical trials have the goal of meeting the need to cure AMD. Therapeutic agents are being developed to target the key features of the disease, including inhibiting the complement pathway and other inflammatory pathways, reducing oxidative stress and protecting retinal pigment epithelial (RPE) cells, inhibiting lipofuscin and visual cycle, regenerating RPE cells from stem cells and restoring choroidal blood flow. Some of these therapeutic options, especially the stem cell-based therapy, hold great promise, which brings great hope for this devastating blinding disease. PMID:26553922

  6. Current Therapeutic Development for Atrophic Age-related Macular Degeneration

    PubMed Central

    Hanus, Jakub; Zhao, Fangkun; Wang, Shusheng

    2016-01-01

    Age-related macular degeneration (AMD), a degenerative disorder of the central retina, is the leading cause of irreversible blindness in the elderly. The underlying mechanism of the advanced form of dry AMD, also named geographic atrophy (GA) or atrophic AMD, remains unclear. Consequently, no cure is available for dry AMD or GA. The only prevention option currently available is the Age Related Eye Disease Study (AREDS) formulation which has been demonstrated to slow down the progression of dry AMD. This review summarizes recent advances in therapy for dry AMD and GA. Building on the new understanding of the disease and recent technological breakthroughs, numerous ongoing clinical trials have the goal of meeting the need to cure AMD. Therapeutic agents are being developed to target the key features of the disease, including inhibiting the complement pathway and other inflammatory pathways, reducing oxidative stress and protecting retinal pigment epithelial (RPE) cells, inhibiting lipofuscin and visual cycle, regenerating RPE cells from stem cells and restoring choroidal blood flow. Some of these therapeutic options, especially the stem-cell based therapy, hold great promise, which brings great hope for this devastating blinding disease. PMID:26553922

  7. Anthropometrics of mental foramen in dry dentate and edentulous mandibles in Coastal Andhra population of Andhra Pradesh State

    PubMed Central

    Moogala, Srinivas; Sanivarapu, Sahitya; Boyapati, Ramanarayana; Devulapalli, Narasimha Swamy; Chakrapani, Swarna; Kolaparthy, Laxmikanth

    2014-01-01

    Aim: The aim of this study is to determine the morphological features and morphometrics of mental foramen with reference to surrounding anatomical landmarks in Coastal Andhra population of Andhra Pradesh State. Materials and Methods: Two-hundred and nineteen dry dentate and edentulous mandibles are examined in this study. Out of these 127 were dentate and 92 were edentulous. Various morphological and morphometrical parameters were measured by using digital Vernier caliper, metallic wire and metallic scale on both the right and left sides. Results: In the present study, the distance between most anterior margin of mental foramen and posterior border of ramus of the mandible is [MF-PR], MF-PR is 69.61 ± 6.03 mm on the right side and is 69.17 ± 6. 0 mm on left side in dentate mandible. In edentulous type, MF-PR is 68.39 ±6.4 mm on right side and 68.81 ± 6.55 mm on left side. In the present study, the distance between symphysis menti and most anterior margin of mental foramen [MF-SM] in dentate mandible is 28.24 ± 5.09 mm on right side and is 27.45 ± 3.7 mm on left side. In edentulous mandible (MF-SM) is 28.51 ± 4.5 mm on right side and on left side is 27.99 ± 4.50 mm. Conclusion: Acquiring the knowledge and importance of anatomy of mental foramen is helpful in avoiding neurovascular complications, during regional anesthesia, peri apical surgeries, nerve repositioning and dental implant placement. PMID:25210267

  8. CBCT Cyst Leasions Diagnosis Imaging Mandible Maxilla

    PubMed Central

    Yuvaraj, A; Prakash, C.A; Parthiban, J; Praveen, B

    2014-01-01

    The bony anatomy and the soft tissue contours of the maxillofacial region, along with the oro dental tissues, is very complex. In earlier times, analog radiographs of the skull, the mandible and the sinuses, along with intraoral films, were the only tools which were available for dentists. The past decade has seen a revolution in dental imaging, with the introduction of Cone beam computed tomography/cone beam volumetric tomography (CBCT/CBVT). In this article, we have discussed the value of CBCT in diagnosis and treatment planning which we observed in four cases of maxillofacial cystic lesions. It proved to be a multifaceted win-win situation for the diagnostician, the patient and the operating surgeon. The 3D imaging led to a precise pre-operative surgical planning, resulting in a surgery that was minimally invasive, minimally morbid and time saving and at the same time, conservative, yet complete. PMID:24959518

  9. Ameloblastic carcinoma of mandible: facts and dilemmas.

    PubMed

    Dutta, Mainak; Kundu, Sohag; Bera, Himel; Barik, Sabyasachi; Ghosh, Bhaskar

    2014-01-01

    Ameloblastic carcinoma is a rare malignant odontogenic tumor and is considered as the malignant counterpart of ameloblastoma with features of both benign and malignant histology. It may arise de novo or from a long-standing ameloblastoma and is locally aggressive with a propensity for metastasis. With limited documentation, little is known about its pathobiogenesis, with no universal guidelines for management. For clinicians, differentiating ameloblastic carcinoma from ameloblastoma and malignant ameloblastoma in a patient presenting with a suspicious jaw tumor is a challenge due to overlapping clinical features, inconclusive cytology/biopsy reports, different management approaches and inadequate follow-up. Proper knowledge of the disease entity and a high index of suspicion are essential. Here we elaborate the dilemmas in diagnosis and management of ameloblastic carcinoma through presentation of a representative case in a 56-year-old man presenting with a tumor in the mandible. PMID:25343557

  10. On the taxonomic affinities of the Dmanisi mandible (Georgia).

    PubMed

    Rosas, A; Bermúdez de Castro, J M

    1998-10-01

    The recent discovery of unexpectedly ancient human remains has fuelled interest about the first dispersion of Homo outside Africa. The Dmanisi mandible is perhaps one of the most interesting findings, as it supposedly represents one of the oldest hominids outside of Africa. Recently, different interpretations have been published about this specimen. Our comparison of the Dmanisi mandible with a large sample of mandibles and teeth has led us to a new interpretation. In our view, the Dmanisi mandible exhibits a unique combination of traits. Some of its features, taken in isolation, may be attributed to morphological extremes within the genus Homo. The architecture of the mandible as well as the morphology and dimensions of incisors, canines, and P3s are clearly primitive. However, dental traits such as the reduction of the talonid in the P4s and a distally decreasing molar series seems to be derived. Some combinations of these traits are found in specimens of Homo ergaster and differ from those generally present in later hominids. Thus, we propose that the Dmanisi mandible might be taxonomically classified as Homo sp. indet. (aff. ergaster). Furthermore, some aspects of the dentition in Dmanisi display close similarities to Asian Homo erectus. If the 1.8-1.6 Myr dating for the Dmanisi mandible is correct, the differentiation of the Asian branch of the genus Homo could be regarded as a very ancient event. PMID:9786330

  11. Posterior partially edentulous jaws, planning a rehabilitation with dental implants

    PubMed Central

    Monteiro, Douglas R; Silva, Emily V F; Pellizzer, Eduardo P; Filho, Osvaldo Magro; Goiato, Marcelo C

    2015-01-01

    AIM: To discuss important characteristics of the use of dental implants in posterior quadrants and the rehabilitation planning. METHODS: An electronic search of English articles was conducted on MEDLINE (PubMed) from 1990 up to the period of March 2014. The key terms were dental implants and posterior jaws, dental implants/treatment planning and posterior maxilla, and dental implants/treatment planning and posterior mandible. No exclusion criteria were used for the initial search. Clinical trials, randomized and non randomized studies, classical and comparative studies, multicenter studies, in vitro and in vivo studies, case reports, longitudinal studies and reviews of the literature were included in this review. RESULTS: One hundred and fifty-two articles met the inclusion criteria of treatment planning of dental implants in posterior jaw and were read in their entirety. The selected articles were categorized with respect to their context on space for restoration, anatomic considerations (bone quantity and density), radiographic techniques, implant selection (number, position, diameter and surface), tilted and pterygoid implants, short implants, occlusal considerations, and success rates of implants placed in the posterior region. The results derived from the review process were described under several different topic headings to give readers a clear overview of the literature. In general, it was observed that the use of dental implants in posterior region requires a careful treatment plan. It is important that the practitioner has knowledge about the theme to evaluate the treatment parameters. CONCLUSION: The use of implants to restore the posterior arch presents many challenges and requires a detailed treatment planning. PMID:25610852

  12. Malignant peripheral nerve sheath tumour (MPNST) of mandible: solving the perplexity.

    PubMed

    Patel, Shilpa; Pathak, Jigna; Dekate, Kamlesh; Mohanty, Neeta

    2015-01-01

    We present an extremely rare case of malignant peripheral nerve sheath tumour (MPNST) in a 30-year-old woman without associated neurofibromatosis 1. The patient presented with an 8 cm×4 cm lesion extending from 46 to the retro molar region involving the ramus of the right mandible associated with regional paraesthesia. Incisional biopsy revealed spindle cells with vesicular nuclei arranged in fascicles leading to a diagnosis of spindle cell lesion. Posterior segmental mandibulectomy was performed under general anaesthesia. On excisional biopsy, a definitive diagnosis of low-grade MPNST was established on the basis of immunohistochemistry. The patient was then lost to follow-up. PMID:25762575

  13. [Posterior capsule opacification].

    PubMed

    Milazzo, S; Grenot, M; Benzerroug, M

    2014-12-01

    Posterior capsule opacification (PCO) is the most common complication after cataract surgery, with an incidence of 30%. It tends to be considered a normal event in the natural history of cataract surgery. Better understanding of its pathophysiology and advancement of intraocular lens material and design along with the improvement of phacoemulsification technique have contributed to decrease the incidence of PCO. Although treatment by Nd: YAG laser posterior capsulotomy is quick and non-invasive, the opening of the posterior capsule may be associated with numerous complications. Prevention remains the best measure for controlling this pathology. PMID:25455552

  14. Automatic segmentation of mandible in panoramic x-ray.

    PubMed

    Abdi, Amir Hossein; Kasaei, Shohreh; Mehdizadeh, Mojdeh

    2015-10-01

    As the panoramic x-ray is the most common extraoral radiography in dentistry, segmentation of its anatomical structures facilitates diagnosis and registration of dental records. This study presents a fast and accurate method for automatic segmentation of mandible in panoramic x-rays. In the proposed four-step algorithm, a superior border is extracted through horizontal integral projections. A modified Canny edge detector accompanied by morphological operators extracts the inferior border of the mandible body. The exterior borders of ramuses are extracted through a contour tracing method based on the average model of mandible. The best-matched template is fetched from the atlas of mandibles to complete the contour of left and right processes. The algorithm was tested on a set of 95 panoramic x-rays. Evaluating the results against manual segmentations of three expert dentists showed that the method is robust. It achieved an average performance of [Formula: see text] in Dice similarity, specificity, and sensitivity. PMID:26587551

  15. 'Skullduggery': Lions Align and Their Mandibles Rock!

    PubMed

    Williams, Vivienne L; Loveridge, Andrew J; Newton, David J; Macdonald, David W

    2015-01-01

    South Africa has legally exported substantial quantities of lion bones to Southeast Asia and China since 2008, apparently as part of the multinational trade substituting bones and body parts of other large cats for those of the tiger in wine and other health tonics. The legal sale of lion bones may mask an illegal trade, the size of which is only partially known. An observed component of the illegal trade is that quantities of skeletons are sometimes declared falsely/fraudulently on CITES export permits. Furthermore, there are emerging concerns that bones from tigers reared in captivity in South Africa and elsewhere are being laundered as lion bones using CITES Appendix II permits. There is therefore a need for tools to monitor the trade in lion body parts and to distinguish between lions and tigers. Our research indicates that it is possible to use skeletons, skulls and cranial sutures to detect misdeclarations in the lion bone trade. It is also possible to use the average mass of a lion skeleton to corroborate the numbers of skeletons declared on CITES permits, relative to the weight of the consolidated consignments stated on the air waybills. When the mass of consolidated consignments of skeletons destined for export was regressed against the number of skeletons in that consignment, there was a strong correlation between the variables (r2 = 0.992) that can be used as a predictor of the accuracy of a declaration on a CITES permit. Additionally, the skulls of lions and tigers differ: two cranial sutures of lions align and their mandibles rock when placed on a flat surface, whereas the cranial sutures of tigers are not aligned and their mandibles rest naturally on two contact points. These two morphological differences between the skulls of tigers and lions are easy to observe at a glance and provide a method for distinguishing between the species if illegal trade in the bones is suspected and the skulls are present. These identifications should ideally be

  16. Skeletal Stability after Bilateral Sagittal Split Advancement and Setback Osteotomy of the Mandible with Miniplate Fixation

    PubMed Central

    Rao, Srinivasan Hanumantha; Selvaraj, Loganathan; Lankupalli, Arathy S.

    2013-01-01

    The purpose of this study was to evaluate intraorally placed mini plates and monocortical screws in terms of postoperative skeletal stability after bilateral sagittal split advancement and setback osteotomy of the mandible. Ten patients were included in this study with five requiring advancement (group I) and five requiring setback of the mandible (group II). Bell and Epker modified surgical technique was followed for all the patients. All the patients underwent pre- and postsurgical orthodontics. Cephalometric radiographs were taken preoperatively, immediate, 3, 6, and 12 months postoperatively. Cephalometric tracings were performed by one individual examiner using a modified burstone analysis. Statistical analysis was performed using the student paired t-test. In advancement patients, SNB (sella, Nasion, B point) angle showed relapse at 12th month postoperative period which was statistically significant (2.4 degrees). No changes were observed in anterior facial height, posterior facial height, Frankfort-mandibular incisor angle (FmiA), and overjet during the follow-up period. In setback patients, posterior facial height (p < 0.05), angles between the lower incisors and mandibular plane and pogonion had a statistically significant change position of 1.4 mm (paired t-test, p = 0.03). The SNB angle, anterior facial height, interincisal angle, and FmiA remained constant (0.8–1.2 degrees) during the follow-up period. In advancement cases, the relapse was seen from the third month postoperative period but in setback cases, the relapse was noted from the sixth month onward and the skeletal relapse in these cases were noticed cephalometrically. PMID:24624252

  17. Osseointegrated implants in microvascular fibula free flap reconstructed mandibles.

    PubMed

    Huryn, J M; Zlotolow, I M; Piro, J D; Lenchewski, E

    1993-11-01

    In the past, prosthodontic rehabilitation of patients who underwent segmental mandibular resection relied on removable prostheses, which were less than ideal. The advent of the microvascular free flap has provided improved appearance and function through reconstruction of the skeletal integrity of the mandible. In select patients osseointegrated implants strategically placed in the reconstructed mandible can be used to restore masticatory function. Patient selection criteria and techniques are discussed. PMID:8254548

  18. Posterior fossa tumor

    MedlinePlus

    ... of the posterior fossa, it can block the flow of spinal fluid and cause increased pressure on the brain and ... the cancer early. A total blockage in the flow of spinal fluid can be life threatening. If tumors are found ...

  19. Posterior Tibial Tendon Dysfunction

    MedlinePlus

    ... when the posterior tibial tendon becomes inflamed or torn. As a result, the tendon may not be ... repetitive use. Once the tendon becomes inflamed or torn, the arch will slowly fall (collapse) over time. ...

  20. Posterior ankle impingement syndrome.

    PubMed

    Maquirriain, Javier

    2005-10-01

    Posterior ankle impingement syndrome is a clinical disorder characterized by posterior ankle pain that occurs in forced plantar flexion. The pain may be acute as a result of trauma or chronic from repetitive stress. Pathology of the os trigonum-talar process is the most common cause of this syndrome, but it also may result from flexor hallucis longus tenosynovitis, ankle osteochondritis, subtalar joint disease, and fracture. Patients usually report chronic or recurrent posterior ankle pain caused or exacerbated by forced plantar flexion or push-off maneuvers, such as may occur during dancing, kicking, or downhill running. Diagnosis of posterior ankle impingement syndrome is based primarily on clinical history and physical examination. Radiography, scintigraphy, computed tomography, and magnetic resonance imaging depict associated bone and soft-tissue abnormalities. Symptoms typically improve with nonsurgical management, but surgery may be required in refractory cases. PMID:16224109

  1. Fetal age estimation using MSCT scans of the mandible.

    PubMed

    Minier, Marie; Dedouit, Fabrice; Maret, Delphine; Vergnault, Marion; Mokrane, Fathima-Zohra; Rousseau, Hervé; Adalian, Pascal; Telmon, Norbert; Rougé, Daniel

    2014-05-01

    The purpose of this study was to examine a documented fetal collection, to carry out morphometric analysis of femoral length and of the mandible, and to develop diagnostic standards for estimating fetal age at death based on multislice computed tomography (MSCT) reconstructions. The sample was composed of 81 fetuses, whose ages were recorded in weeks of amenorrhea (WA) between 20 to 40 WA. The measurements made were femoral length (FL) and six distances and four angles of the mandible. Femoral length was measured in 81 fetuses (39 females and 42 males). Morphometric study of the mandible was carried out in 65 fetuses (31 females and 34 males), as the mandible was missing in 16 fetuses. R software was used for statistical analyses. Coefficient correlation (R(2)) and linear regression formulas were calculated. Intra-observer and inter-observer variabilities were very satisfactory (intra-class correlation coefficient ≥0.95). Our method appears to be reliable and reproducible. Femoral length was most strongly correlated with age (R(2) = 0.9). The measurement of six distances and four mandible angles from four landmark positions showed a correlation similar to the femoral length correlation (R(2) ≥ 0.72). The results of this study agreed with those of the literature. We conclude that the mandible is a reliable indicator for estimating fetal age at death. Moreover, MSCT has been shown to be an innovative and reliable technology for this purpose. PMID:24213737

  2. Phosphorylation of insulin receptor substrate-1 serine 307 correlates with JNK activity in atrophic skeletal muscle

    NASA Technical Reports Server (NTRS)

    Hilder, Thomas L.; Tou, Janet C L.; Grindeland, Richard E.; Wade, Charles E.; Graves, Lee M.

    2003-01-01

    c-Jun NH(2)-terminal kinase (JNK) has been shown to negatively regulate insulin signaling through serine phosphorylation of residue 307 within the insulin receptor substrate-1 (IRS-1) in adipose and liver tissue. Using a rat hindlimb suspension model for muscle disuse atrophy, we found that JNK activity was significantly elevated in atrophic soleus muscle and that IRS-1 was phosphorylated on Ser(307) prior to the degradation of the IRS-1 protein. Moreover, we observed a corresponding reduction in Akt activity, providing biochemical evidence for the development of insulin resistance in atrophic skeletal muscle.

  3. Morphofunctional Compensation of Masseter Muscles in Unilateral Posterior Crossbite Patients

    PubMed Central

    Cutroneo, G.; Vermiglio, G.; Centofanti, A.; Rizzo, G.; Runci, M.; Favaloro, A.; Piancino, M.G.; Bracco, P.; Ramieri, G.; Bianchi, F.; Speciale, F.; Arco, A.; Trimarchi, F.

    2016-01-01

    Unilateral posterior crossbite is a widespread, asymmetric malocclusion characterized by an inverse relationship of the upper and lower buccal dental cusps, in the molar and premolar regions, on one side only of the dental arch. Patients with unilateral posterior crossbite exhibit an altered chewing cycles and the crossbite side masseter results to be less active with respect to the contralateral one. Few studies about morphological features of masticatory muscle in malocclusion disorders exist and most of these have been performed on animal models. The aim of the present study was to evaluate morphological and protein expression characteristics of masseter muscles in patients affected by unilateral posterior crossbite, by histological and immunofluorescence techniques. We have used antibody against PAX-7, marker of satellite cells, and against α-, β-, γ-, δ-, ε- and ζ-sarcoglycans which are transmembrane glycoproteins involved in sarcolemma stabilization. By statistical analysis we have evaluated differences in amount of myonucley between contralateral and ipsilateral side. Results have shown: i) altered fibers morphology and atrophy of ipsilateral muscle if compared to the contralateral one; ii) higher number of myonuclei and PAX-7 positive cells in contralateral side than ipsilateral one; iii) higher pattern of fluorescence for all tested sarcoglycans in contralateral side than ipsilateral one. Results show that in unilateral posterior crossbite hypertrophic response of contralateral masseter and atrophic events in ipsilateral masseter take place; by that, in unilateral posterior crossbite malocclusion masticatory muscles modify their morphology depending on the function. That could be relevant in understanding and healing of malocclusion disorders; in fact, the altered balance about structure and function between ipsilateral and contralateral muscles could, long-term, lead and/ or worsen skeletal asymmetries. PMID:27349311

  4. Morphological variation in great ape and modern human mandibles.

    PubMed

    Humphrey, L T; Dean, M C; Stringer, C B

    1999-11-01

    Adult mandibles of 317 modern humans and 91 great apes were selected that showed no pathology. Adult mandibles of Pan troglodytes troglodytes, Pongo pygmaeus pygmaeus and Gorilla gorilla gorilla and from 2 modern human populations (Zulu and Europeans from Spitalfields) were reliably sexed. Thirteen measurements were defined and included mandibular height, length and breadth in representative positions. Univariate statistical techniques and multivariate (principal component analysis and discriminant analysis) statistical techniques were used to investigate interspecific variability and sexual dimorphism in human and great ape mandibles, and intraspecific variability among the modern human mandibles. Analysis of interspecific differences revealed some pairs of variables with a tight linear relationship and others where Homo and the great apes pulled apart from one another due to shape differences. Homo and Pan are least sexually dimorphic in the mandible, Pan less so than Homo sapiens, but both the magnitude of sexual dimorphism and the distribution of sexually dimorphic measurements varied both among and between modern humans and great apes. Intraspecific variation among the 10 populations of modern humans was less than that generally reported in studies of crania (74.3% of mandibles were correctly classified into 1 of 10 populations using discriminant functions based on 13 variables as compared with 93% of crania from 17 populations based on 70 variables in one extensive study of crania). A subrecent European population (Poundbury) emerged as more different from a recent European population (Spitalfields) than other more diverse modern populations were from each other, suggesting considerable morphological plasticity in the mandible through time. This study forms a sound basis on which to explore mandibular variation in Neanderthals, early Homo sapiens and other more ancient fossil hominids. PMID:10634689

  5. Ontogenetic relationships between cranium and mandible in coyotes and hyenas.

    PubMed

    La Croix, Suzanne; Holekamp, Kay E; Shivik, John A; Lundrigan, Barbara L; Zelditch, Miriam Leah

    2011-06-01

    Developing animals must resolve the conflicting demands of survival and growth, ensuring that they can function as infants or juveniles while developing toward their adult form. In the case of the mammalian skull, the cranium and mandible must maintain functional integrity to meet the feeding needs of a juvenile even as the relationship between parts must change to meet the demands imposed on adults. We examine growth and development of the cranium and mandible, using a unique ontogenetic series of known-age coyotes (Canis latrans), analyzing ontogenetic changes in the shapes of each part, and the relationship between them, relative to key life-history events. Both cranial and mandibular development conform to general mammalian patterns, but each also exhibits temporally and spatially localized maturational transformations, yielding a complex relationship between growth and development of each part as well as complex patterns of synchronous growth and asynchronous development between parts. One major difference between cranium and mandible is that the cranium changes dramatically in both size and shape over ontogeny, whereas the mandible undergoes only modest shape change. Cranium and mandible are synchronous in growth, reaching adult size at the same life-history stage; growth and development are synchronous for the cranium but not for the mandible. This synchrony of growth between cranium and mandible, and asynchrony of mandibular development, is also characteristic of a highly specialized carnivore, the spotted hyena (Crocuta crocuta), but coyotes have a much less protracted development, being handicapped relative to adults for a much shorter time. Morphological development does not predict life-history events in these two carnivores, which is contrary to what has been reported for two rodent species. The changes seen in skull shape in successive life-history stages suggest that adult functional demands cannot be satisfied by the morphology characterizing

  6. Bilateral posterior sternoclavicular dislocation.

    PubMed

    Baumann, Matthias; Vogel, Tobias; Weise, Kuno; Muratore, Tim; Trobisch, Per

    2010-07-01

    Posterior sternoclavicular dislocations are a rare injury, representing <5% of all sternoclavicular dislocations and 1 in 1600 shoulder girdle injuries. Proper imaging with computed tomography and prompt diagnosis are essential steps in preventing potentially lethal complications observed in approximately 3% of all posterior sternoclavicular dislocations. Surgical treatment is necessary if closed reduction fails. With the medial clavicular epiphysis being the last to close (between ages 22 and 25), children and adolescents typically present with epiphyseal fractures rather than joint dislocations. If closed reduction fails, open reduction and internal fixation (ORIF) should be considered in fractures, whereas complex reconstructions with tendon graft procedures have been recommended for joint dislocations. This article presents a case of a traumatic bilateral posterior sternoclavicular dislocation due to an epiphyseal fracture in a 15-year-old boy. To our knowledge, this is the first reported case of a bilateral posterior sternoclavicular dislocation. Attempted closed reduction failed with redislocation after 2 days. The patient subsequently required ORIF. This article describes our technique with anterior retraction of the medial clavicle, closure of the posterior periosteum, and ORIF using nonabsorbable sutures. Postoperative shoulder mobilization was started on day 1. At final follow-up, the patient was completely asymptomatic. PMID:20608625

  7. Tibialis Posterior Tendon Entrapment Within Posterior Malleolar Fracture Fragment.

    PubMed

    Fantry, Amanda; Lareau, Craig; Vopat, Bryan; Blankenhorn, Brad

    2016-01-01

    Management of posterior malleolus fractures continues to be controversial, with respect to both need for fixation and fixation methods. Fixation methods include an open posterior approach to the ankle as well as percutaneous reduction and fixation with or without arthroscopy for visualization of the articular surface. Plain radiographs are unreliable in identifying fracture pattern and intraoperative reduction, making arthroscopy a valuable adjunct to posterior malleolus fracture management. In this article, we report a case of tibialis posterior tendon entrapment within a posterior malleolus fracture, as identified by arthroscopy and managed with open reduction. Tibialis posterior tendon entrapment within a posterior malleolus has not been previously reported. Ankle arthroscopy for posterior malleolus fractures provides an opportunity to identify soft-tissue or tendinous entrapment, articular surface reduction, and articular cartilage injuries unlikely to be identified with fluoroscopy alone and should be considered in reduction and fixation of posterior malleolus fractures. PMID:26991573

  8. Increased Expression of Intranuclear Matrix Metalloproteinase 9 in Atrophic Renal Tubules Is Associated with Renal Fibrosis

    PubMed Central

    Tsai, Jen-Pi; Liou, Jia-Hung; Kao, Wei-Tse; Wang, Shao-Chung; Lian, Jong-Da; Chang, Horng-Rong

    2012-01-01

    Background Reduced turnover of extracellular matrix has a role in renal fibrosis. Matrix metalloproteinases (MMPs) is associated with many glomerular diseases, but the histological association of MMPs and human renal fibrosis is unclear. Methods This is a retrospective study. Institutional Review Board approval was obtained for the review of patients’ medical records, data analysis and pathological specimens staining with waiver of informed consents. Specimens of forty-six patients were examined by immunohistochemical stain of MMP-9 in nephrectomized kidneys, and the association of renal expression of MMP-9 and renal fibrosis was determined. MMP-9 expression in individual renal components and fibrosis was graded as high or low based on MMP-9 staining and fibrotic scores. Results Patients with high interstitial fibrosis scores (IFS) and glomerular fibrosis scores (GFS) had significantly higher serum creatinine, lower estimated glomerular filtration rate (eGFR), and were more likely to have chronic kidney disease (CKD) and urothelial cell carcinoma. Univariate analysis showed that IFS and GFS were negatively associated with normal and atrophic tubular cytoplasmic MMP-9 expression and IFS was positively correlated with atrophic tubular nuclear MMP-9 expression. Multivariate stepwise regression indicated that MMP-9 expression in atrophic tubular nuclei (r = 0.4, p = 0.002) was an independent predictor of IFS, and that MMP-9 expression in normal tubular cytoplasm (r = −0.465, p<0.001) was an independent predictor of GFS. Conclusions Interstitial fibrosis correlated with MMP-9 expression in the atrophic tubular nuclei. Our results indicate that renal fibrosis is associated with a decline of MMP-9 expression in the cytoplasm of normal tubular cells and increased expression of MMP-9 in the nuclei of tubular atrophic renal tubules. PMID:23110201

  9. Accuracy of pepsinogens for early diagnosis of atrophic gastritis and gastric cancer in Iranian population

    PubMed Central

    Zoalfaghari, Abbas; Aletaha, Najmeh; Roushan, Nader; Taslimi, Reza; Foroutan, Hossein; Faridnia, Bita

    2014-01-01

    Background: Currently, non-invasive methods for screening atrophic gastritis and gastric cancer are lacking. The purpose of this study was to evaluate the value of serological parameters including serum pepsinogen I (PGI), pepsinogen II (PGII) and pepsinogen I: II ratio for the screening atrophic gastritis and gastric cancer. Methods: The study population consisted of 132 dyspeptic patients who had undergone upper endoscopy with biopsy. Blood samples for ELISA assays of serum PGI, PGII and IgG antibodies against Helicobacter pylori were drawn. Comparison between the two groups was done by Student’s t- test, and Mann Whitney test. Cut-off points were calculated using receiver operating curves (ROC). Results: Mean (±SD) age of the study population was 51.4 (±15.5) years. Values of PGI and PG ratio decreased significantly in the atrophic gastritis as compared with the control group (p<0.05). Values of PG and PG ratio didn’t show any significant difference between the gastric cancer and control group (p>0.05). For patients with atrophic gastritis, the area under the ROC for PGI was 0.639 (95% CI:0.538-0.741, p=0.008) in which the best cut-off value was 40μg/L (sensitivity 90%, specificity 67%, accuracy 69%, negative predictive value 92%, YI : 0.429). The area under the ROC for PG ratio was 0.711 (95% CI: 0.617–0.806, p=0.0001) and the best cut-off value was 8 (sensitivity 71%, specificity 71%, accuracy 71%, negative predictive value 86%,YI : 0.431). Conclusion: It seems that PGI, PGI: PGII ratio is potential biomarkers for screening atrophic gastritis with high sensitivity, specificity, accuracy and negative predictive value. Serology could be used as a screening method for the detection of precancerous states due to its convenience, relative low cost and safety. PMID:25695008

  10. Association of the Extent of Atrophic Gastritis With Specific Dyspeptic Symptoms

    PubMed Central

    Chung, Sook Hee; Lee, Kwang Jae; Kim, Ja Yeon; Im, Seon Gyo; Kim, Eunkyung; Yang, Min Jae; Ryu, Seo Hee

    2015-01-01

    Background/Aims It remains unclear whether atrophic gastritis can affect dyspeptic symptoms. We aimed to investigate whether the extent of atrophic gastritis is associated with specific dyspeptic symptoms. Methods Consecutive adults in a routine health-checkup program were enrolled in the study. The extent of atrophic gastritis was classified into 3 groups based on the Kimura-Takemoto criteria; the gastritis with no or little atrophy (group A: C0), the gastritis with atrophy mainly in the antrum (group B: C1 and C2), and the gastritis with atrophy in the large area of the corpus (group C: C3 and O). Upper gastrointestinal symptoms were categorized into “typical reflux symptoms,” “epigastric pain syndrome (EPS)-related symptoms,” and “postprandial distress syndrome (PDS)-related symptoms.” Results A total of 1827 patients (1009 males, mean age 45.1 years) were included in the analysis. The subgroups of atrophic gastritis were as follows: group A (n = 1218, 66.7%), group B (n = 392, 21.4%), and group C (n = 217, 11.9%). Typical reflux, EPS-related, and PDS-related symptoms were present in 10.5%, 19.8%, and 16.2% of the subjects, respectively. PDS-related and EPS-related symptoms were significantly more prevalent in the group C of male patients and the group B of female patients, respectively, compared with other groups. PDS-related and EPS-related symptoms were independently associated with the group C in males (OR, 2.123; 95% CI, 1.090–4.136) and the group B in females (OR, 2.571; 95% CI, 1.319–5.025), respectively. Conclusions The extent of atrophic gastritis appears to affect the generation of specific dyspeptic symptoms in a gender-dependent manner. PMID:26424039

  11. Osteopetrosis of the mandible masquerading as tubercular osteomyelitis

    PubMed Central

    Sharma, Subramanya S; Saravanan, C; Sathyabama, V; Satish, C

    2013-01-01

    Osteopetrosis is a rare congenital (autosomal type) disorder of the skeletal system. Several variants have been described in the literature with grossly variant prognosis and clinical behaviour. Several reports of intractable osteomyelitis of the jaw bones secondary to osteopetrosis, particularly the mandible, have been published widely. However, there is no published report of the complete mandible sequestrating de novo, in the literature. An overview of this spectrum of sclerotic bone disease, its presentation in the oro-facial region, the diagnostic challenge it poses and the management dilemma it offers to the maxillofacial surgeon is discussed and a protocol for managing this disease effectively is presented. A clinical illustration of the complexities of management of osteopetrosis-induced osteomyelitis of jaw bones is demonstrated with a very rare case in which the entire mandible had sequestrated. PMID:23314447

  12. Morphological Integration of the Modern Human Mandible during Ontogeny

    PubMed Central

    Polanski, Joshua M.

    2011-01-01

    Craniofacial integration is prevalent in anatomical modernity research. Little investigation has been done on mandibular integration. Integration patterns were quantified in a longitudinal modern human sample of mandibles. This integration pattern is one of modularization between the alveolar and muscle attachment regions, but with age-specific differences. The ascending ramus and nonalveolar portions of the corpus remain integrated throughout ontogeny. The alveolar region is dynamic, becoming modularized according to the needs of the mandible at a particular developmental stage. Early in ontogeny, this modularity reflects the need for space for the developing dentition; later, modularity is more reflective of mastication. The overall pattern of modern human mandibular integration follows the integration pattern seen in other mammals, including chimpanzees. Given the differences in craniofacial integration patterns between humans and chimpanzees, but the similarities in mandibular integration, it is likely that the mandible has played the more passive role in hominin skull evolution. PMID:21716741

  13. Geometric properties and comparative biomechanics of Homo floresiensis mandibles.

    PubMed

    Daegling, David J; Patel, Biren A; Jungers, William L

    2014-03-01

    The hypodigm of Homo floresiensis from the cave of Liang Bua on Flores Island in the archipelago of Indonesia includes two mandibles (LB1/2 and LB6/1). The morphology of their symphyses and corpora has been described as sharing similarities with both australopiths and early Homo despite their Late Pleistocene age. Although detailed morphological comparisons of these mandibles with those of modern and fossil hominin taxa have been made, a functional analysis in the context of masticatory biomechanics has yet to be performed. Utilizing data on cortical bone geometry from computed tomography scans, we compare the mechanical attributes of the LB1 and LB6 mandibles with samples of modern Homo, Pan, Pongo, and Gorilla, as well as fossil samples of Paranthropus robustus, Australopithecus africanus and South African early Homo. Structural stiffness measures were derived from the geometric data to provide relative measures of mandibular corpus strength under hypothesized masticatory loading regimes. These mechanical variables were evaluated relative to bone area, mandibular length and estimates of body size to assess their functional affinities and to test the hypothesis that the Liang Bua mandibles can be described as scaled-down variants of either early hominins or modern humans. Relative to modern hominoids, the H. floresiensis material appears to be relatively strong in terms of rigidity in torsion and transverse bending, but is relatively weak under parasagittal bending. Thus, they are 'robust' relative to modern humans (and comparable with australopiths) under some loads but not others. Neither LB1 nor LB6 can be described simply as 'miniaturized' versions of modern human jaws since mandible length is more or less equivalent in Homo sapiens and H. floresiensis. The mechanical attributes of the Liang Bua mandibles are consistent with previous inferences that masticatory loads were reduced relative to australopiths but remained elevated relative to modern Homo. PMID

  14. Juvenile hormone regulates extreme mandible growth in male stag beetles.

    PubMed

    Gotoh, Hiroki; Cornette, Richard; Koshikawa, Shigeyuki; Okada, Yasukazu; Lavine, Laura Corley; Emlen, Douglas J; Miura, Toru

    2011-01-01

    The morphological diversity of insects is one of the most striking phenomena in biology. Evolutionary modifications to the relative sizes of body parts, including the evolution of traits with exaggerated proportions, are responsible for a vast range of body forms. Remarkable examples of an insect trait with exaggerated proportions are the mandibular weapons of stag beetles. Male stag beetles possess extremely enlarged mandibles which they use in combat with rival males over females. As with other sexually selected traits, stag beetle mandibles vary widely in size among males, and this variable growth results from differential larval nutrition. However, the mechanisms responsible for coupling nutrition with growth of stag beetle mandibles (or indeed any insect structure) remain largely unknown. Here, we demonstrate that during the development of male stag beetles (Cyclommatus metallifer), juvenile hormone (JH) titers are correlated with the extreme growth of an exaggerated weapon of sexual selection. We then investigate the putative role of JH in the development of the nutritionally-dependent, phenotypically plastic mandibles, by increasing hemolymph titers of JH with application of the JH analog fenoxycarb during larval and prepupal developmental periods. Increased JH signaling during the early prepupal period increased the proportional size of body parts, and this was especially pronounced in male mandibles, enhancing the exaggerated size of this trait. The direction of this response is consistent with the measured JH titers during this same period. Combined, our results support a role for JH in the nutrition-dependent regulation of extreme mandible growth in this species. In addition, they illuminate mechanisms underlying the evolution of trait proportion, the most salient feature of the evolutionary diversification of the insects. PMID:21731659

  15. Effect of the mandible on mouthguard measurements of head kinematics.

    PubMed

    Kuo, Calvin; Wu, Lyndia C; Hammoor, Brad T; Luck, Jason F; Cutcliffe, Hattie C; Lynall, Robert C; Kait, Jason R; Campbell, Kody R; Mihalik, Jason P; Bass, Cameron R; Camarillo, David B

    2016-06-14

    Wearable sensors are becoming increasingly popular for measuring head motions and detecting head impacts. Many sensors are worn on the skin or in headgear and can suffer from motion artifacts introduced by the compliance of soft tissue or decoupling of headgear from the skull. The instrumented mouthguard is designed to couple directly to the upper dentition, which is made of hard enamel and anchored in a bony socket by stiff ligaments. This gives the mouthguard superior coupling to the skull compared with other systems. However, multiple validation studies have yielded conflicting results with respect to the mouthguard׳s head kinematics measurement accuracy. Here, we demonstrate that imposing different constraints on the mandible (lower jaw) can alter mouthguard kinematic accuracy in dummy headform testing. In addition, post mortem human surrogate tests utilizing the worst-case unconstrained mandible condition yield 40% and 80% normalized root mean square error in angular velocity and angular acceleration respectively. These errors can be modeled using a simple spring-mass system in which the soft mouthguard material near the sensors acts as a spring and the mandible as a mass. However, the mouthguard can be designed to mitigate these disturbances by isolating sensors from mandible loads, improving accuracy to below 15% normalized root mean square error in all kinematic measures. Thus, while current mouthguards would suffer from measurement errors in the worst-case unconstrained mandible condition, future mouthguards should be designed to account for these disturbances and future validation testing should include unconstrained mandibles to ensure proper accuracy. PMID:27155744

  16. Primary Diffuse Large B-cell Lymphoma involving the Mandible.

    PubMed

    Alshahrani, Faleh Ali A; Aljabab, Abdulsalam S; Motabi, Ibraheem Hm; Alrashed, Abdullah; Anil, Sukumaran

    2015-10-01

    Lymphomas of the oral cavity are rare and typically present as intraosseous lesions that are most commonly diffuse large B-cell type. Diffuse large B-cell lymphoma (DLBCL) is an aggressive B-cell lymphoma histologically characterized by diffuse proliferation of large neoplastic B-lymphoid cells with a nuclear size equal to or exceeding normal histiocytic nuclei. A case of DLBCL of the mandible in an 18 years old male patient is presented. This report discusses this rare malignancy, including clinical presentation, histopathologic features, immunologic profile, treatment and prognosis. Though lymphoma of mandible is rare, it must be considered in differential diagnosis of swellings arising in the region. PMID:26581467

  17. Measurement of Mucosal Thickness in Denture-bearing Area of Edentulous Mandible

    PubMed Central

    Dong, Jian; Zhang, Fei-Yu; Wu, Guang-Hui; Zhang, Wei; Yin, Jian

    2015-01-01

    Background: The thickness of the alveolar mucosa influences the probability of the occurrence of denture-induced irritations. Thick denture-supporting tissues offer relief from mucosal tenderness and ulcers; however, the uniformity of the thickness across the entire mandibular alveolar mucosa cannot be accurately determined in edentulous patients. This study aimed to assess the mucosal thickness of the denture-bearing area in the edentulous mandible. Methods: Twenty-seven edentulous patients underwent cone-beam computed tomography scanning, wherein the patients wore a record base to retract soft tissues away from the alveolar mucosa. The measured regions were the central incisor (IC), lateral incisor (IL), canine (Ca), first premolar (P1), second premolar (P2), first molar (M1), and second molar (M2) regions. The thickness was measured in the alveolar ridge crest (T), buccal (B1–B4), and lingual (L1–L4) alveolar ridge mucosa. The average thickness of the mucosa at buccal sides (B) and lingual sides (L) were also assessed. Results: The differences in the mucosal thickness between the left and right sides were not significant. In the Ca–M2 regions, T was the thickest, and L3 was the thinnest of all the measured points in the same regions. L was significantly less than B in posterior regions (P < 0.01). On the other hand, M2 at L4 was thinnest of all the measured regions from Ca to M2 (P < 0.01), and was thicker than IC, IL, P1, and P2 at B2. Conclusions: Since the mucosal thickness of denture-bearing area in the edentulous mandible is not uniform; the tissue surface of the denture base or custom tray should be selectively relieved, which may reduce the risk of denture-induced irritations. PMID:25635429

  18. The Low Mandible Maneuver and Its Resonential Implications for Elite Singers.

    PubMed

    Nair, Angelika; Nair, Garyth; Reishofer, Gernot

    2016-01-01

    Many elite singers appear to frequently drop the posterior mandible while singing to optimize resonance production. This study investigated the physiology of the Low Mandible Maneuver (LMM) through the use of magnetic resonance imaging (MRI), ultrasound (US), and spectrographic analysis. The study of elite singers has been hampered by the paucity of internal imagery. We have attempted to address this problem by using portable US equipment that we could transport to the homes, studios, or dressing rooms of such ranking singers. With the US and acoustic data gathered in fairly brief sessions, we were able to ascertain the resonance gains garnered from the technique's use. The study featured two phases: I--MRI study of the maneuver and its physiological effect on surrounding structures (in collaboration of the Medical University of Graz, Austria) and II--US investigation that studied tongue shape during the maneuver. The LMM has significant ramifications for resonance production by enabling a concomitantly lowered larynx and increased resonance space in the pharyngeal and oral cavities. Measurements of the LMM ranged between 0.7 and 3.1 cm and showed a boost in the first harmonics as well as an enhancement in the singers formant. Its use also has a rather significant effect on the tongue shapes required for all sung phonemes. The advantage of using US for this study was the ability to produce real-time videos of the singer in action and then, through the use of stop action, precisely study both individual phoneme production and phoneme-to-phoneme transitions during the LMM. PMID:26474717

  19. [The cryodevitalization of the mandible in animal experiments].

    PubMed

    Eckelt, U

    1989-01-01

    The mandible of minipigs may be devitalized cryosurgically. With the used cryotechnical method deep temperatures down to -131 degrees C and freezing speeds of 62 degrees C/min can be reached. The bone scintiscanning proved suitable method for establishing the progress of the revitalisation. PMID:2529713

  20. Glandular Odontogenic Cyst of Mandible: A Rare Entity

    PubMed Central

    Mittal, Ankur; Kaur, Gursheen; Sood, Neena

    2015-01-01

    Glandular odontogenic cyst (GOC) is a rare developmental odontogenic cyst. It is a slow growing and asymptomatic swelling, usually affecting middle aged men and has tendency to reoccur. Here, we report a case of GOC in the anterior portion of mandible diagnosed by histopathology. PMID:26813085

  1. The Design of Mechanically Compatible Fasteners for Human Mandible Reconstruction

    NASA Technical Reports Server (NTRS)

    Roberts, Jack C.; Ecker, John A.; Biermann, Paul J.

    1993-01-01

    Mechanically compatible fasteners for use with thin or weakened bone sections in the human mandible are being developed to help reduce large strain discontinuities across the bone/implant interface. Materials being considered for these fasteners are a polyetherertherketone (PEEK) resin with continuous quartz or carbon fiber for the screw. The screws were designed to have a shear strength equivalent to that of compact/trabecular bone and to be used with a conventional nut, nut plate, or an expandable shank/blind nut made of a ceramic filled polymer. Physical and finite element models of the mandible were developed in order to help select the best material fastener design. The models replicate the softer inner core of trabecular bone and the hard outer shell of compact bone. The inner core of the physical model consisted of an expanding foam and the hard outer shell consisted of ceramic particles in an epoxy matrix. This model has some of the cutting and drilling attributes of bone and may be appropriate as an educational tool for surgeons and medical students. The finite element model was exercised to establish boundary conditions consistent with the stress profiles associated with mandible bite forces and muscle loads. Work is continuing to compare stress/strain profiles of a reconstructed mandible with the results from the finite element model. When optimized, these design and fastening techniques may be applicable, not only to other skeletal structures, but to any composite structure.

  2. Reconstruction of the mandible by bone graft and metal prosthesis.

    PubMed

    Kummoona, Raja

    2009-07-01

    This clinical research was carried out in the Maxillofacial Unit, Surgical Specialties Hospital, Medical City, Baghdad, and included 188 patients with mandibular defects. The patients' ages ranged from 4 to 70 years (mean, 37 years); 60 of them were female, and 128 were male. One hundred twenty-six patients represent 67.03% of total cases with benign and locally aggressive tumors and malignant tumors of the mandible and oral cavity. Eighty-four cases (44.68%) of these were benign, 42 cases (22.34%) were malignant tumors, and 62 patients constitute about 32.98% with mandibular defect of posttraumatic missile injuries. Reconstruction of the mandible were done by a variety of techniques ranging from immediate reconstruction of the mandible by chrome-cobalt prosthesis, Kirschner wire, rib graft and bone graft from the iliac crest, and other additional technique of reimplanted condyle, secured with bone graft, and Dacron osteomesh tray carrying cancellous bone harvested from iliac crest. Long-term follow-up ranged between 5 and 10 years.The aim of these study was to share experience and to present an interesting pathology and methods of reconstruction of the mandible by metal prosthesis and bone graft; the management of these cases was a difficult task to be approached in some cases and was a surgical challenge to us. PMID:19521256

  3. Major motor atrophic patterns in the face and neck: CT evaluation

    SciTech Connect

    Harnsberger, H.R.; Dillon, W.P.

    1985-06-01

    Cranial nerve deficits from various pathologic processes of the head and neck may result in characteristic patterns of denervation muscular atrophy. Such atrophic patterns may be clues to the location and extent of the lesion, particularly when cranial nerves are involved early in the course of the disease process. Thirty-six patients with computed tomographic (CT) evidence of muscular atrophy secondary to pathologic conditions involving the motor division of cranial nerves were examined. Five characteristic denervation muscular atrophy patterns seen on CT scans were identified. Recognition of these atrophic patterns can prevent misinterpretation of their CT appearance and direct the CT examination to the course of the compromised cranial nerve from the brainstem to its peripheral innervation.

  4. Severely Atrophic Human Muscle Fibers With Nuclear Misplacement Survive Many Years of Permanent Denervation

    PubMed Central

    Carraro, Ugo; Kern, Helmut

    2016-01-01

    Likewise in rodents, after complete spinal cord injury (SCI) the lower motor neuron (LMN) denervated human muscle fibers lose completely the myofibrillar apparatus and the coil distribution of myonuclei that are relocated in groups (nuclear clumps) in the center of severely atrophic muscle fibers. Up to two years of LMN denervation the muscle fibers with nuclear clumps are very seldom, but in this cohort of patients the severely atrophic muscle fibers are frequent in muscle biopsies harvested three to six years after SCI. Indeed, the percentage increased to 27 ± 9% (p< 0.001), and then abruptly decreased from the 6th year onward, when fibrosis takes over to neurogenic muscle atrophy. Immunohistochemical analyses shown that nuclear misplacements occurred in both fast and slow muscle fibers. In conclusion, human muscle fibers survive permanent denervation much longer than generally accepted and relocation of nuclei is a general behavior in long term denervated muscle fibers. PMID:27478559

  5. Severely Atrophic Human Muscle Fibers With Nuclear Misplacement Survive Many Years of Permanent Denervation.

    PubMed

    Carraro, Ugo; Kern, Helmut

    2016-06-13

    Likewise in rodents, after complete spinal cord injury (SCI) the lower motor neuron (LMN) denervated human muscle fibers lose completely the myofibrillar apparatus and the coil distribution of myonuclei that are relocated in groups (nuclear clumps) in the center of severely atrophic muscle fibers. Up to two years of LMN denervation the muscle fibers with nuclear clumps are very seldom, but in this cohort of patients the severely atrophic muscle fibers are frequent in muscle biopsies harvested three to six years after SCI. Indeed, the percentage increased to 27 ± 9% (p< 0.001), and then abruptly decreased from the 6th year onward, when fibrosis takes over to neurogenic muscle atrophy. Immunohistochemical analyses shown that nuclear misplacements occurred in both fast and slow muscle fibers. In conclusion, human muscle fibers survive permanent denervation much longer than generally accepted and relocation of nuclei is a general behavior in long term denervated muscle fibers. PMID:27478559

  6. An Unusual Presentation of Pseudothrombotic Microangiopathy in a Patient with Autoimmune Atrophic Gastritis

    PubMed Central

    Nasnas, Roy

    2016-01-01

    Introduction. We hereby describe the case of a young female patient who presented with pseudothrombotic microangiopathy, as well as pancytopenia accompanied by autoimmune atrophic gastritis. Case Presentation. A 36-year-old Caucasian woman presented to the emergency department with fatigue and dyspnea on minimal exertion. Physical examination was unremarkable except for pallor and noninjected conjunctiva. Laboratory tests revealed high LDH and low hemoglobin, white blood cells, platelets, and haptoglobin. The peripheral blood smear showed schistocytes suggestive of pseudothrombotic microangiopathy. Low cobalamin level and hyperhomocysteinemia were also detected. Autoimmune atrophic gastritis was confirmed by gastric biopsy and positive anti-intrinsic factor antibodies. Vitamin B12 supplements were given which led to rapid recovery and normalization of blood parameters. Conclusion. This case highlights the importance and serves as a reminder to clinicians to rule out cobalamin deficiency and autoimmune atrophic gastritis in patients presenting with a picture suggestive of thrombotic thrombocytopenic purpura and pancytopenia, which was completely reversible after appropriate replacement therapy without recurring to unnecessary and invasive procedures such as plasma exchange. PMID:27018160

  7. Immediate functional loading of posterior implants placed in partially edentulous patients: a preliminary report on a prospective clinical study.

    PubMed

    Amato, Francesco

    2015-01-01

    The goal of this study was to investigate outcomes of implants placed in the partially edentulous posterior maxilla and mandible and restored with two- to four-unit fixed prostheses that were functionally loaded immediately after implant placement. Forty-nine patients were treated, and 63 fixed prostheses were inserted on 140 implants. After an average of 8.6 months of follow-up, 2 implants failed-a cumulative success rate of 98.6%. These preliminary results support other findings that suggest patients with maxillary and mandibular partial posterior edentulism can confidently be treated with immediately loaded dental implants. PMID:25738344

  8. Posterior Tibial Tendon Transfer.

    PubMed

    Shane, Amber M; Reeves, Christopher L; Cameron, Jordan D; Vazales, Ryan

    2016-01-01

    When performed correctly with the right patient population, a tibialis posterior muscle/tendon transfer is an effective procedure. Many different methods have been established for fixating the tendon, each of which has its' own indications. Passing through the interosseous membrane is the preferred and recommended method and should be used unless this is not possible. Good surgical planning based on patient needs and expectations, along with excellent postoperative care including early range of motion and physical therapy minimizes risk of complications and allows for the optimal outcome to be achieved. PMID:26590722

  9. Posterior Urethral Strictures

    PubMed Central

    Gelman, Joel; Wisenbaugh, Eric S.

    2015-01-01

    Pelvic fracture urethral injuries are typically partial and more often complete disruptions of the most proximal bulbar and distal membranous urethra. Emergency management includes suprapubic tube placement. Subsequent primary realignment to place a urethral catheter remains a controversial topic, but what is not controversial is that when there is the development of a stricture (which is usually obliterative with a distraction defect) after suprapubic tube placement or urethral catheter removal, the standard of care is delayed urethral reconstruction with excision and primary anastomosis. This paper reviews the management of patients who suffer pelvic fracture urethral injuries and the techniques of preoperative urethral imaging and subsequent posterior urethroplasty. PMID:26691883

  10. Posterior Urethral Strictures.

    PubMed

    Gelman, Joel; Wisenbaugh, Eric S

    2015-01-01

    Pelvic fracture urethral injuries are typically partial and more often complete disruptions of the most proximal bulbar and distal membranous urethra. Emergency management includes suprapubic tube placement. Subsequent primary realignment to place a urethral catheter remains a controversial topic, but what is not controversial is that when there is the development of a stricture (which is usually obliterative with a distraction defect) after suprapubic tube placement or urethral catheter removal, the standard of care is delayed urethral reconstruction with excision and primary anastomosis. This paper reviews the management of patients who suffer pelvic fracture urethral injuries and the techniques of preoperative urethral imaging and subsequent posterior urethroplasty. PMID:26691883

  11. Influence of object location in different FOVs on trabecular bone microstructure measurements of human mandible: a cone beam CT study

    PubMed Central

    Parsa, A; Hassan, B; van der Stelt, P; Aartman, I H A; Nambiar, P

    2014-01-01

    The aim of this study was to assess the influence of different object locations in different fields of view (FOVs) of two cone beam CT (CBCT) systems on trabecular bone microstructure measurements of a human mandible. A block of dry human mandible was scanned at five different locations (centre, left, right, anterior and posterior) using five different FOVs of two CBCT systems (NewTom™ 5G; QR Verona, Verona, Italy and Accuitomo 170; Morita, Kyoto, Japan). Image analysis software (CTAn software v. 1.1; SkyScan, Kontich, Belgium) was used to assess the trabecular bone microstructural parameters (thickness, Tb.Th; spacing, Tb.Sp; number, Tb.N; bone volume density, BV/TV). All measurements were taken twice by one trained observer. Tb.Th, Tb.Sp and Tb.N varied significantly across different FOVs in the NewTom 5G (p < 0.001) and the Accuitomo 170 (p < 0.001). For location, a significant difference was observed only when measuring BV/TV (p = 0.03) using the NewTom 5G. The trabecular bone microstructural measurements obtained from CBCT systems are influenced by the size of FOVs. Not all trabecular bone parameters measured using different CBCT systems are affected when varying the object location within the FOVs. PMID:24265395

  12. Posterior Cortical Atrophy

    PubMed Central

    Crutch, Sebastian J; Lehmann, Manja; Schott, Jonathan M; Rabinovici, Gil D; Rossor, Martin N; Fox, Nick C

    2013-01-01

    Posterior cortical atrophy (PCA) is a neurodegenerative syndrome that is characterized by a progressive decline in visuospatial, visuoperceptual, literacy and praxic skills. The progressive neurodegeneration affecting parietal, occipital and occipito-temporal cortices which underlies PCA is attributable to Alzheimer's disease (AD) in the majority of patients. However, alternative underlying aetiologies including Dementia with Lewy Bodies (DLB), corticobasal degeneration (CBD) and prion disease have also been identified, and not all PCA patients have atrophy on clinical imaging. This heterogeneity has led to diagnostic and terminological inconsistencies, caused difficulty comparing studies from different centres, and limited the generalizability of clinical trials and investigations of factors driving phenotypic variability. Significant challenges remain in identifying the factors associated with both the selective vulnerability of posterior cortical regions and the young age of onset seen in PCA. Greater awareness of the syndrome and agreement over the correspondence between syndrome-and disease-level classifications are required in order to improve diagnostic accuracy, research study design and clinical management. PMID:22265212

  13. Solitary Peripheral Osteoma of the Angle of the Mandible

    PubMed Central

    Kshirsagar, Kapil; Bhate, Kalyani; Pawar, Vivek; SanthoshKumar, S. N.; Kheur, Supriya; Dusane, Shrikant

    2015-01-01

    Solitary peripheral osteoma is a benign, slow-growing osteogenic tumor arising from craniofacial bones such as the sinus, temporal, or jaw bones but rarely originating from the mandible. Osteoma consists of compact or cancellous bone that may be of peripheral, central, or extraskeletal type. Peripheral osteoma arises from the periosteum and is commonly a unilateral, pedunculated mushroom-like mass. Solitary peripheral osteomas are characterized by well-defined, rounded, or oval radiopaque mass in the computed tomography. Although multiple osteomas of the jaws are a hallmark of Gardner's syndrome (familial adenomatous polyposis), nonsyndromic cases are typically solitary. Herein, we report a rare case of solitary peripheral osteoma of the angle of the mandible in a 27-year-old female with clinical, radiologic, and histopathologic findings. PMID:26421198

  14. Intramedullary Osteosarcoma of the Mandible: A Clinicoradiologic Perspective

    PubMed Central

    Chittaranjan, Bhogisetty; Tejasvi, ML Avinash; Babu, Bangi Balaji; Geetha, Paramkusam

    2014-01-01

    Osteosarcoma is a non-hematopoietic primary malignant tumor of bone or mesenchymal tissue. Although osteosarcoma is not a common malignant bone tumor, accounting for approximately 20% of sarcomas, tumor of the jaw bone is uncommon, representing only about 4% of osteosarcomas of long bones. We report a case of a 72-year-old female with a swelling on the left side of the mandible and intra-oral swelling on the floor of the mouth. Conventional radiograph and advanced imaging modalities such as computed tomography and magnetic resonance imaging revealed an intramedullary osteosarcoma of the mandible. This report highlights importance of imaging modalities in the diagnosis of malignant tumors of the jaws. PMID:25598996

  15. Odontogenic carcinosarcoma of the mandible: a case report and review

    PubMed Central

    Pae, Sang-Pill; Cho, Hyun-Young; Cho, Hyun-Woo; Seo, Ji-Hoon; Lee, Dong-Hwan; Park, In-Shu

    2015-01-01

    Odontogenic carcinosarcoma is an extremely rare malignant odontogenic tumor with only a few reported cases. It is characterized by a true mixed tumor showing malignant cytology of both epithelial and mesenchymal components. It has been assumed to arise from pre-existing lesions such as ameloblastoma, ameloblastic fibroma, and ameloblastic fibrosarcoma. To date, the reported cases have exhibited considerably aggressive clinical behavior. The case of an odontogenic carcinosarcoma in the mandible of a 61-year-old male is described herein. The tumor destroyed the cortex of the mandible and invaded the adjacent tissues. Treatment was performed by surgical resection and reconstruction. The purposes of this article are to introduce odontogenic carcinosarcoma through this case study, to distinguish it from related diseases and to discuss features of the tumor in the existing literature. PMID:26131431

  16. Augmentation of the rat mandible using guided tissue regeneration.

    PubMed

    Kostopoulos, L; Karring, T

    1994-06-01

    The aim of the present study was to investigate whether it is possible to increase the height of the rat mandible at its inferior border using a bioresorbable membrane adapted to create a secluded space for ingrowth of bone tissue. The experiment was carried out in 18 rats. The mandibular ramus was exposed at both sides. A standardized titanium microimplant was then inserted in the naturally existing curvature at the inferior border of the mandible, serving as a fixed reference and space maker. The mandibular border on one side was covered with a polyhydroxybutyrate bioresorbable membrane, and the contralateral side, serving as control, received no membrane before closure of the wound. The membranes were placed in such a way that a space was created in the curvature between the membrane and the inferior border of the mandible. Macerated jaw specimens representing 6 months of healing demonstrated substantial amounts of bone formation in the curvature of the inferior border of the mandible, resulting in a flattening of the inferior border. Negligible amounts of bone formation had occurred in the control sides. Histological analysis demonstrated that, in 4 of 6 experimental specimens, the space created by the membrane was completely filled with new bone after 6 months of healing, but in some specimens soft tissue seemed to have migrated into the space through ruptures of the membrane or because of poor membrane adaptation at its lateral borders, thereby inhibiting bone formation. Only negligible bone formation had occurred at the control sides.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7918912

  17. Novel posterior fixation keratoprosthesis

    NASA Astrophysics Data System (ADS)

    Lacombe, Emmanuel

    1992-08-01

    The keratoprosthesis is the last solution for corneally blind patients that cannot benefit from corneal transplants. Keratoprostheses that have been designed to be affixed anteriorly usually necessitate multi-step surgical procedures and are continuously subjected to the extrusion forces generated by the positive intraocular pressure; therefore, clinical results in patients prove inconsistent. We proposed a novel keratoprosthesis concept that utilizes posterior corneal fixation which `a priori' minimizes the risk of aqueous leakage and expulsion. This prosthesis is implanted in a single procedure thereby reducing the number of surgical complications normally associated with anterior fixation devices. In addition, its novel design makes this keratoprosthesis implantable in phakic eyes. With an average follow-up of 13 months (range 3 to 25 months), our results on 21 cases are encouraging. Half of the keratoprostheses were implanted in severe burn cases, with the remainder in cases of pseudo- pemphigus. Good visual results and cosmetic appearance were obtained in 14 of 21 eyes.

  18. The Comprehensive AOCMF Classification System: Mandible Fractures- Level 2 Tutorial

    PubMed Central

    Cornelius, Carl-Peter; Audigé, Laurent; Kunz, Christoph; Rudderman, Randal; Buitrago-Téllez, Carlos H.; Frodel, John; Prein, Joachim

    2014-01-01

    This tutorial outlines the details of the AOCMF image-based classification system for fractures of the mandible at the precision level 2 allowing description of their topographical distribution. A short introduction about the anatomy is made. Mandibular fractures are classified by the anatomic regions involved. For this purpose, the mandible is delineated into an array of nine regions identified by letters: the symphysis/parasymphysis region anteriorly, two body regions on each lateral side, combined angle and ascending ramus regions, and finally the condylar and coronoid processes. A precise definition of the demarcation lines between these regions is given for the unambiguous allocation of fractures. Four transition zones allow an accurate topographic assignment if fractures end up in or run across the borders of anatomic regions. These zones are defined between angle/ramus and body, and between body and symphysis/parasymphysis. A fracture is classified as “confined” as long as it is located within a region, in contrast to a fracture being “nonconfined” when it extents to an adjoining region. Illustrations and case examples of mandible fractures are presented to become familiar with the classification procedure in daily routine. PMID:25489388

  19. Biomechanical characteristics of regenerated cortical bone in the canine mandible

    PubMed Central

    Zapata, Uriel; Opperman, Lynne A.; Kontogiorgos, Elias; Elsalanty, Mohammed E.; Dechow, Paul C.

    2010-01-01

    To test the mechanical properties of regenerate cortical bone created using Mandibular Bone Transport (MBT) distraction, five adult male American foxhound dogs underwent unilateral distraction of the mandible with a novel MBT device placed to linearly repair a 30-35 mm bone defect. The animals were sacrificed 12 weeks after the beginning of the consolidation period. Fourteen cylindrical specimens were taken from the inner (lingual) and outer (buccal) plates of the reconstructed mandible and 21 control specimens were removed from the contralateral aspect of the mandible. The mechanical properties of the 35 cylindrical cortical bone specimens were assessed by using a non-destructive pulse ultrasound technique. Results showed that all of the cortical mechanical properties exhibit higher numerical values on the control side than the MBT regenerate side. In addition, both densities and the elastic moduli in the direction of maximum stiffness of the regenerate cortical bone specimens are higher on the lingual side than the buccal side. Interestingly, there is no statistical difference between elastic modulus (E1 and E2) in orthogonal directions throughout the 35 cortical specimens. The data suggest that the regenerate canine cortical bone is not only heterogeneous, but the elastic mechanical properties tend to approximate transverse isotropy at a tissue level as opposed to control cortical bone that is orthotropic. In addition, the elastic mechanical properties are not only higher on the control side but also in the lingual anatomical position, suggesting a stress shielding effect from the presence of the reconstruction plate. PMID:21695796

  20. Complete rehabilitation of the mandible following segmental resection.

    PubMed

    Schrag, Christiaan; Chang, Yang-Ming; Tsai, Chi-Ying; Wei, Fu-Chan

    2006-11-01

    Segmental resection of the mandible leads to significant patient morbidity. Loss of mandibular support to the teeth, tongue and lip causes dysfunctional mastication, swallowing, speech, airway protection and oral competence. Patients also suffer disfigurement following segmental mandibulectomy because the mandible is an important aesthetic landmark. The degrees to which dysfunction and disfigurement occur depend both on the location of the mandibular segment removed and the amount of surrounding soft tissue excised. Between January 1985 and December 2004, 780 fibula osteoseptocutaneous flaps have been used for head and neck reconstruction at the Chang Gung Memorial Hospital, Taiwan. The fibula flap has proven to be the bony flap of choice because it has a lengthy bicortical segment of bone available, a reasonably long vascular pedicle, large diameter vessels, good bone quality, and is easily contoured with multiple osteotomies. The flap can be harvested while ablation is being performed. In addition, a reliable, mobile, thin skin component can always be included to address the soft tissue reconstructive requirements. A chimeric design employing a portion of the soleus muscle can provide further reconstructive options. Ideally complete rehabilitation of the mandible involves placement of titanium osseointegrated implants, which allow dental restoration. Primary placement of implants is preferred in patients without cancer. Selection of candidates to receive osseointegrated implants is paramount. The temporomandibular joint remains a challenge to reconstruct adequately. PMID:17061277

  1. The Comprehensive AOCMF Classification System: Mandible Fractures- Level 2 Tutorial.

    PubMed

    Cornelius, Carl-Peter; Audigé, Laurent; Kunz, Christoph; Rudderman, Randal; Buitrago-Téllez, Carlos H; Frodel, John; Prein, Joachim

    2014-12-01

    This tutorial outlines the details of the AOCMF image-based classification system for fractures of the mandible at the precision level 2 allowing description of their topographical distribution. A short introduction about the anatomy is made. Mandibular fractures are classified by the anatomic regions involved. For this purpose, the mandible is delineated into an array of nine regions identified by letters: the symphysis/parasymphysis region anteriorly, two body regions on each lateral side, combined angle and ascending ramus regions, and finally the condylar and coronoid processes. A precise definition of the demarcation lines between these regions is given for the unambiguous allocation of fractures. Four transition zones allow an accurate topographic assignment if fractures end up in or run across the borders of anatomic regions. These zones are defined between angle/ramus and body, and between body and symphysis/parasymphysis. A fracture is classified as "confined" as long as it is located within a region, in contrast to a fracture being "nonconfined" when it extents to an adjoining region. Illustrations and case examples of mandible fractures are presented to become familiar with the classification procedure in daily routine. PMID:25489388

  2. Mandible protrusion and decrease of TMJ sounds: an electrovibratographic examination.

    PubMed

    Garcia, Alicio Rosalino; Folli, Sérgio; Zuim, Paulo Renato Junqueira; de Sousa, Valdir

    2008-01-01

    This study quantified by, electrovibratography, the amount of mandible protrusion required to decrease significantly temporomandibular joint (TMJ) vibratory energy as an aid in the diagnosis of the recapture of anteriorly displaced disk. Eighteen patients diagnosed as having anterior disk displacement with reduction and TMJ clicking were submitted to electrovibratographic examination at the first appointment and treated with a stabilizing appliance and anterior positioning appliance with 1 to 5 mm protrusion. Vibratory energy was checked in each of these positions. Baseline data were used as control. At the first appointment, the patients had vibrations with more elevated intensities at the middle and late phases of the mouth opening cycle. At only one clinical step, mandible protrusion was obtained with the anterior repositioning appliance, ranging from 1 to 5 mm protusion. At each new position, a new electrovibratographic exam was made. After the 5-mm mandibular projection, only 2 patients presented vibration, with means between 0.6 and 2.8 Hz. Data were analyzed statistically by ANOVA and Tukey's test (alpha=0.05). The outcomes of this study indicate that 3 mm is the minimum amount of mandible protrusion to significantly decrease the TMJ vibratory energy and to recapture the displaced articular disk. PMID:18438565

  3. Tooth wear and dentoalveolar remodeling are key factors of morphological variation in the Dmanisi mandibles

    PubMed Central

    Margvelashvili, Ann; Zollikofer, Christoph P. E.; Lordkipanidze, David; Peltomäki, Timo; Ponce de León, Marcia S.

    2013-01-01

    The Plio-Pleistocene hominin sample from Dmanisi (Georgia), dated to 1.77 million years ago, is unique in offering detailed insights into patterns of morphological variation within a paleodeme of early Homo. Cranial and dentoalveolar morphologies exhibit a high degree of diversity, but the causes of variation are still relatively unexplored. Here we show that wear-related dentoalveolar remodeling is one of the principal mechanisms causing mandibular shape variation in fossil Homo and in modern human hunter–gatherer populations. We identify a consistent pattern of mandibular morphological alteration, suggesting that dental wear and compensatory remodeling mechanisms remained fairly constant throughout the evolution of the genus Homo. With increasing occlusal and interproximal tooth wear, the teeth continue to erupt, the posterior dentition tends to drift in a mesial direction, and the front teeth become more upright. The resulting changes in dentognathic size and shape are substantial and need to be taken into account in comparative taxonomic analyses of isolated hominin mandibles. Our data further show that excessive tooth wear eventually leads to a breakdown of the normal remodeling mechanisms, resulting in dentognathic pathologies, tooth loss, and loss of masticatory function. Complete breakdown of dentognathic homeostasis, however, is unlikely to have limited the life span of early Homo because this effect was likely mediated by the preparation of soft foods. PMID:24101504

  4. Effects of He-Ne laser irradiation on chronic atrophic gastritis in rats

    PubMed Central

    Shao, Xue-Hui; Yang, Yue-Ping; Dai, Jie; Wu, Jing-Fang; Bo, Ai-Hua

    2005-01-01

    AIM: To study the effects of He-Ne laser irradiation on experimental chronic atrophic gastritis (CAG) in rats. METHODS: Sixty-three male adult Wistar rats were randomly divided into five groups including normal control group, model control group and three different dosages He-Ne laser groups. The chronic atrophic gastritis (CAG) model in rats was made by pouring medicine which was a kind of mixed liquor including 2% sodium salicylate and 30% alcohol down the throat for 8 wk to stimulate rat gastric mucosa, combining with irregular fasting and compulsive sporting as pathogenic factors; 3.36, 4.80, and 6.24 J/cm2 doses of He-Ne laser were used, respectively for three different treatment groups, once a day for 20 d. The pH value of diluted gastric acid was determined by acidimeter, the histopathological changes such as the inflammatory degrees in gastric mucosa, the morphology and structure of parietal cells were observed, and the thickness of mucosa was measured by micrometer under optical microscope. RESULTS: In model control group, the secretion of gastric acid was little, pathologic morphological changes in gastric mucosa such as thinner mucous, atrophic glands, notable inflammatory infiltration were found. After 3.36 J/cm2 dose of He-Ne laser treatment for 20 d, the secretion of gastric acid was increased (P < 0.05), the thickness of gastric mucosa was significantly thicker than that in model control group (P < 0.01), the gastric mucosal inflammation cells were decreased (P < 0.05). Morphology, structure and volume of the parietal cells all recuperated or were closed to normal. CONCLUSION: 3.36 J/cm2 dose of He-Ne laser has a significant effect on CAG in rats. PMID:15991302

  5. Fractional CO2 Laser Resurfacing as Monotherapy in the Treatment of Atrophic Facial Acne Scars

    PubMed Central

    Majid, Imran; Imran, Saher

    2014-01-01

    Background: While laser resurfacing remains the most effective treatment option for atrophic acne scars, the high incidence of post-treatment adverse effects limits its use. Fractional laser photothermolysis attempts to overcome these limitations of laser resurfacing by creating microscopic zones of injury to the dermis with skip areas in between. Aim: The aim of the present study is to assess the efficacy and safety of fractional CO2 laser resurfacing in atrophic facial acne scars. Materials and Methods: Sixty patients with moderate to severe atrophic facial acne scars were treated with 3-4 sessions of fractional CO2 laser resurfacing at 6-week intervals. The therapeutic response to treatment was assessed at each follow up visit and then finally 6 months after the last laser session using a quartile grading scale. Response to treatment was labelled as ‘excellent’ if there was >50% improvement in scar appearance and texture of skin on the grading scale while 25-50% response and <25% improvement were labelled as ‘good’ and ‘poor’ response, respectively. The overall satisfaction of the patients and any adverse reactions to the treatment were also noted. Results: Most of the patients showed a combination of different morphological types of acne scars. At the time of final assessment 6 months after the last laser session, an excellent response was observed in 26 patients (43.3%) while 15 (25%) and 19 patients (31.7%) demonstrated a good and poor response respectively. Rolling and superficial boxcar scars responded the best while pitted scars responded the least to fractional laser monotherapy. The commonest reported adverse effect was transient erythema and crusting lasting for an average of 3-4 and 4-6 days, respectively while three patients developed post-inflammatory pigmentation lasting for 8-12 weeks. Conclusions: Fractional laser resurfacing as monotherapy is effective in treating acne scars especially rolling and superficial boxcar scars with minimal

  6. Effect of the additional installation of implants in the posterior region on the prognosis of treatment in the edentulous mandibular jaw.

    PubMed

    Miyamoto, Youji; Fujisawa, Kenji; Takechi, Masaaki; Momota, Yukihiro; Yuasa, Tetsuya; Tatehara, Seiko; Nagayama, Masaru; Yamauchi, Eiji

    2003-12-01

    The aim of this study was to elucidate the effect of the additional installation of implants in the posterior region on the prognosis of treatment in the edentulous mandibular jaw. Fifteen patients who had received implants (Brånemark system, Nobel Biocare, Gotebörg, Sweden) in the edentulous mandible and completed a 1-year follow-up after the fitting of implant-anchored fixed prostheses were selected. In seven patients (Group A), four or five implants were installed between the mental foramina, and in eight patients (Group P), one or two implants, one on each side, were installed in the posterior regions in addition to the implants between the foramina. All implants of both groups achieved osseointegration. In Group A, there was no implant loss after loading. Six implants were lost in five patients of Group P within 1 year after loading. All of them were located in the posterior region. To elucidate whether or not the failure rate of the implants in the posterior region of Group P after loading was especially high, the failures were also compared with 89 implants, which were installed in the posterior region of the mandibles to support implant-anchored fixed partial prosthesis, during the same period (Group C). The cumulative survival rate of the implants of Group P was 60%, while that of the implants of Group C was 100% (P<0.001). When the survival rates of posterior implants with the same length of the two groups were compared, there were significant differences for the 7- and 10-mm-length implants only. These data demonstrate that the posterior implants in Group P are at greater risk. Deformation of the mandible due to jaw movement was thought to be the most likely cause of the implant loss. Therefore, when such modified treatment is chosen, it should be performed with meticulous attention. PMID:15015949

  7. Gossypiboma mimicking posterior urethral stricture

    PubMed Central

    Kumar, Bindey; Kumar, Prem; Sinha, Sanjay Kumar; Sinha, Neelam; Hasan, Zaheer; Thakur, Vinit Kumar; Anand, Utpal; Priyadarshi, Rajiv Nayan; Mandal, Manish

    2013-01-01

    INTRODUCTION Foreign bodies in the urogenital tract are not uncommon. Hairpins, glass rods, umbilical tapes, ball point pen are described in lower urogenital tract. Retained gauze piece (gossypiboma) in posterior urethra may cause diagnostic dilemma. Symptoms and investigations may mimic stricture of posterior urethra. PRESENTATION OF CASE Two cases of retained gauze pieces in the urethra are described here. The micturating cystourethrogram was suggestive of posterior urethral stricture. DISCUSSION Two cases described here had retained gauze piece as a cause of filling defect and abnormal appearance in the micturating cystourethrogram. Gossypiboma may be a possibility where posterior urethral stricture are seen after previous surgery in paediatric age group. CONCLUSION In the setting of previous urogenital surgery gossypiboma should be kept in the differential diagnosis where posterior urethral stricture are seen in the paediatric age group. PMID:23500749

  8. [Posterior reversible encephalopathy syndrome].

    PubMed

    Fischer, M; Schmutzhard, E

    2016-06-01

    Posterior reversible encephalopathy syndrome refers to a neurological disorder characterized by headache, disorders of consciousness, visual disturbances, epileptic seizures, and subcortical vasogenic edema. About two thirds of patients develop neurological symptoms, which are associated with blood pressure fluctuations. One hypothesis is that hypertensive episodes cause autoregulatory failure, and values above the upper limit of cerebral autoregulation result in a breakthrough followed by hyperperfusion and blood-brain barrier dysfunction. In another hypothesis, endothelial dysfunction triggered by numerous factors including preeclampsia, immunosuppressive agents, chemotherapeutics, sepsis, or autoimmune disorders is thought to be the key pathomechanism. Endo- or exogenic toxic agents including pharmacological substances, cytokines, or bacterial toxins are supposed to trigger endothelial activation and dysfunction resulting in the release of vasoconstrictors, pro-inflammatory mediators, and vascular leakage. Diagnosis is usually based on clinical and neuroimaging findings that frequently show a bilateral, symmetric, and parietooccipital pattern. However, the diagnosis can often only be confirmed during the course of disease after excluding important differential diagnoses. Currently, there is no specific treatment available. Lowering of arterial blood pressure and eliminating the underlying cause usually leads to an improvement of clinical and neuroradiological findings. Admission to a critical care unit is required in about 40 % of patients due to complicating conditions including status epilepticus, cerebral vasoconstriction, ischemia, or intracerebral hemorrhage. Prognosis is favorable; in the majority of patients neurological deficits and imaging findings resolve completely. PMID:27272329

  9. Histopathological Features of Secondary Squamous Cell Carcinoma Around a Dental Implant in the Mandible After Chemoradiotherapy: A Case Report With a Clinicopathological Review.

    PubMed

    Nariai, Yoshiki; Kanno, Takahiro; Sekine, Joji

    2016-05-01

    Oral squamous cell carcinoma (OSCC) around a dental implant is a rare pathologic condition. This report describes a case of recurrent OSCC surrounding a dental implant, histopathologic findings, and a literature review of this condition. A 58-year-old Japanese woman underwent chemoradiotherapy for OSCC in the right lower gingiva, resulting in a complete response. Nine years after primary chemoradiotherapy, a dental implant was placed in her atrophic mandible. Three years later, an OSCC developed around the dental implant in the right lower premolar region. Marginal mandibulectomy was performed. Microscopic examination showed medullary invasion around the implant surface, suggesting that tumor infiltration of the bone was through the interface between the implant and bone. However, no downward invasion through the interface was evident. OSCC can develop around dental implants that are placed for oral rehabilitation after ablative surgery. Staging of OSCC and planning of surgical management should be carried out carefully, because implants placed adjacent to the OSCC can influence tumor invasion. A high degree of vigilance for OSCC is required during follow-up of patients with dental implants who have OSCC risk factors such as premalignant lesions. Detailed evaluation, including biopsy examination, is essential for distinguishing peri-implantitis from OSCC. PMID:26679554

  10. Functional mechanics of beetle mandibles: Honest signaling in a sexually selected system.

    PubMed

    Mills, Maria R; Nemri, Rahmi S; Carlson, Emily A; Wilde, William; Gotoh, Hiroki; Lavine, Laura C; Swanson, Brook O

    2016-01-01

    Male stag beetles possess colossal mandibles, which they wield in combat to obtain access to females. As with many other sexually selected weapons, males with longer mandibles win more fights. However, variation in the functional morphology of these structures, used in male-male combat, is less well understood. In this study, mandible bite force, gape, structural strength, and potential tradeoffs are examined across a wide size range for one species of stag beetle, Cyclommatus metallifer. We found that not only does male mandible size demonstrate steep positive allometry, but the shape, relative bite force, relative gape, and safety factor of the mandibles also change with male size. Allometry in these functionally important mandibular traits suggests that larger males with larger mandibles should be better fighters, and that the mandibles can be considered an honest signal of male fighting ability. However, negative allometry in mandible structural safety factor, wing size, and flight muscle mass suggest significant costs and a possible limit on the size of the mandibles. J. Exp. Zool. 325A:3-12, 2016. © 2015 Wiley Periodicals, Inc. PMID:26350941

  11. Unique zinc mass in mandibles separates drywood termites from other groups of termites

    NASA Astrophysics Data System (ADS)

    Cribb, Bronwen W.; Stewart, Aaron; Huang, Han; Truss, Rowan; Noller, Barry; Rasch, Ronald; Zalucki, Myron P.

    2008-05-01

    Previously, the presence of metals in arthropod mandibles has been linked with harder cuticle, and in termites, a 20% increase in hardness has been found for mandibles containing major quantities of zinc. The current study utilises electron microscopy and energy-dispersive X-ray microanalysis to assess incidence and abundance of metals in all extant subfamilies of the Isoptera. The basal clades contain no zinc and little to no manganese in the cutting edge of the mandible cuticle, suggesting that these states are ancestral for termites. However, experimentation with mandibles in vitro indicates the presence of some elements of the cuticular biochemistry necessary to enable uptake of zinc. The Termopsidae, Serritermitidae, Rhinotermitidae and Termitidae all contain minor quantities of manganese, while trace to minor quantities of zinc occur in all except the Serritermitidae. In contrast, all Kalotermitidae or drywood termites contain major levels of zinc in the mandible edge. Diet and life type are explored as links to metal profiles across the termites. The presence of harder mandibles in the drywood termites may be related to lack of access to free water with which to moisten wood. Scratch tests were applied to a set of mandibles. The coefficient of friction for Cryptotermes primus (Kalotermitidae) mandibles, when compared with species from other subfamilies, indicates that zinc-containing mandibles are likely to be more scratch resistant.

  12. Is Homo heidelbergensis a distinct species? New insight on the Mauer mandible.

    PubMed

    Mounier, Aurélien; Marchal, François; Condemi, Silvana

    2009-03-01

    The discovery of new fossils in Africa, Asia, and Europe, and the recognition of a greater diversity in the middle Pleistocene fossil record, has led to a reconsideration of the species Homo heidelbergensis. This nomen, formulated by Schoetensack in 1908 to describe the Mauer jaw (Germany), was almost forgotten during most of the past century. Numerous fossils have been attributed to it but no consensus has arisen concerning their classification. The holotype anatomical traits are still poorly understood, and numerous fossils with no mandibular remains have been placed in the taxon. Some researchers propose H. heidelbergensis as an Afro-European taxon that is ancestral to both modern humans and Neandertals whereas others think it is a strictly European species that is part of the Neandertal lineage. We focus on the validity of H. heidelbergensis, using the traditional basis of species recognition: anatomical description. We provide a comparative morphological analysis using 47 anatomical traits of 36 Pleistocene fossils from Africa, Asia, and Europe and 35 extant human mandibles. We re-examine the mandibular features of Mauer and discuss the specimen's inclusion in H. heidelbergensis, as well as alternative evolutionary theories. To lend objectivity to specimen grouping, we use multiple correspondence analysis associated with hierarchical classification that creates clusters corresponding to phenetic similarities between jaws. Our phenetic and comparative morphological analyses support the validity of H. heidelbergensis as a taxon. A set of morphological features can be statistically identified for the definition of the species. Some traits can be used to delimit H. heidelbergensis in an evolutionary framework (e.g., foramina mentale posteriorly positioned, horizontal retromolar surface). Those traits are also present on African (e.g., Tighenif) and European (e.g., Sima de los Huesos) specimens that show a close relationship with the Mauer mandible. Therefore, the

  13. Visualization of nasal airflow patterns in a patient affected with atrophic rhinitis using particle image velocimetry

    NASA Astrophysics Data System (ADS)

    Garcia, G. J. M.; Mitchell, G.; Bailie, N.; Thornhill, D.; Watterson, J.; Kimbell, J. S.

    2007-10-01

    The relationship between airflow patterns in the nasal cavity and nasal function is poorly understood. This paper reports an experimental study of the interplay between symptoms and airflow patterns in a patient affected with atrophic rhinitis. This pathology is characterized by mucosal dryness, fetor, progressive atrophy of anatomical structures, a spacious nasal cavity, and a paradoxical sensation of nasal congestion. A physical replica of the patient's nasal geometry was made and particle image velocimetry (PIV) was used to visualize and measure the flow field. The nasal replica was based on computed tomography (CT) scans of the patient and was built in three steps: three-dimensional reconstruction of the CT scans; rapid prototyping of a cast; and sacrificial use of the cast to form a model of the nasal passage in clear silicone. Flow patterns were measured by running a water-glycerol mixture through the replica and evaluating the displacement of particles dispersed in the liquid using PIV. The water-glycerol flow rate used corresponded to an air flow rate representative of a human breathing at rest. The trajectory of the flow observed in the left passage of the nose (more affected by atrophic rhinitis) differed markedly from what is considered normal, and was consistent with patterns of epithelial damage observed in cases of the condition. The data are also useful for validation of computational fluid dynamics predictions.

  14. Clonally Expanding Thymocytes Having Lineage Capability in Gamma-Ray-Induced Mouse Atrophic Thymus

    SciTech Connect

    Yamamoto, Takashi; Morita, Shin-ichi; Go, Rieka; Obata, Miki; Katsuragi, Yoshinori; Fujita, Yukari; Maeda, Yoshitaka; Yokoyama, Minesuke; Aoyagi, Yutaka; Ichikawa, Hitoshi; Mishima, Yukio; Kominami, Ryo

    2010-05-01

    Purpose: To characterize, in the setting of gamma-ray-induced atrophic thymus, probable prelymphoma cells showing clonal growth and changes in signaling, including DNA damage checkpoint. Methods and Materials: A total of 111 and 45 mouse atrophic thymuses at 40 and 80 days, respectively, after gamma-irradiation were analyzed with polymerase chain reaction for D-J rearrangements at the TCRbeta locus, flow cytometry for cell cycle, and Western blotting for the activation of DNA damage checkpoints. Results: Limited D-J rearrangement patterns distinct from normal thymus were detected at high frequencies (43 of 111 for 40-day thymus and 21 of 45 for 80-day thymus). Those clonally expanded thymocytes mostly consisted of CD4{sup +}CD8{sup +} double-positive cells, indicating the retention of lineage capability. They exhibited pausing at a late G1 phase of cell cycle progression but did not show the activation of DNA damage checkpoints such as gammaH2AX, Chk1/2, or p53. Of interest is that 17 of the 52 thymuses showing normal D-J rearrangement patterns at 40 days after irradiation showed allelic loss at the Bcl11b tumor suppressor locus, also indicating clonal expansion. Conclusion: The thymocytes of clonal growth detected resemble human chronic myeloid leukemia in possessing self-renewal and lineage capability, and therefore they can be a candidate of the lymphoma-initiating cells.

  15. Detection and characterization of stomach cancer and atrophic gastritis with fluorescence and Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Li, Xiaozhou; Lin, Junxiu; Jia, Chunde; Wang, Rong

    2003-12-01

    In this paper, we attempt to find a valid method to distinguish gastric cancer and atrophic gastritis. Auto-fluorescence and Raman spectroscopy of laser induced (514.5 nm and 488.0 nm) was measured. The serum spectrum is different between normal and cancer. Average value of diagnosis parameter for normal serum, red shift is less than 12 nm and Raman relative intensity of peak C by 514.5 nm excited is stronger than that of 488.0 nm. To gastric cancer, its red shift of average is bigger than 12 nm and relative intensity of Raman peak C by 514.5 nm excited is weaker than that by 488.0 nm. To atrophic gastritis, the distribution state of Raman peaks is similar with normal serum and auto-fluorescence spectrum's shape is similar to that of gastric cancer. Its average Raman peak red shift is bigger than 12 nm and the relative intensity of peak C by 514.5 excited is stronger than that of by 488.0. We considered it as a criterion and got an accuracy of 85.6% for diagnosis of gastric cancer compared with the result of clinical diagnosis.

  16. Solitary plasmacytoma of the mandible: A rare case report

    PubMed Central

    Sharma, Naresh Kumar; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal

    2015-01-01

    Plasmacytoma is a monoclonal, neoplastic proliferation of plasma cells that usually arises within bone marrow or soft tissue sites. It can involve either a single bone (solitary) or multiple bones. Solitary plasmacytoma has a predisposition for the red marrow-containing axial skeleton and is most frequently seen in the thoracic vertebrae, followed by the ribs, sternum, clavicle, or scapula. Its presence in the jaws is extremely rare. We present a case of a 54-year-old female with a well-defined radiolucency of the body region of the mandible later diagnosed as solitary plasmacytoma. PMID:26668458

  17. [Therapy-resistant aggressive cystic lesion of the mandible].

    PubMed

    Ziegler, C M; Bergstrand, S; Lund, J-A; Viset, T

    2011-10-01

    Several extensive surgical interventions of a cystic lesion in the left mandible were followed by recurrences. The lesion extended from the primary mandibular region into the area of pterygopalatine fossa finally infiltrating the orbital region and the skull base. Histological results could never demonstrate a malignancy with certainty. Due to the patient's poor general condition, the refusal for further surgical inventions and due to the malignoma-like growth pattern radiation treatment was performed. However, this had no effect on tumor progression. PMID:21845481

  18. Primary Xanthoma of the Mandible: Report of a Rare Case.

    PubMed

    Morel, Dominic; Kelsch, Robert D; Nolan, Patrick J

    2016-06-01

    Xanthoma is a lesion most commonly seen in soft tissues such as the skin, subcutis, or tendon sheaths. Xanthoma formation is often associated with primary or secondary hyperlipidemia. Primary bone xanthomas are extremely rare benign bone lesions not associated with hyperlipidemia, histopathologically characterized by histiocytes, abundant lipid containing macrophages (foam cells), and multinucleated giant cells. Cholesterol clefts can be found in the medullary bone. Less than ten cases of xanthoma in the mandible have been reported. We present a rare primary intrabony xanthoma in a normolipidemic patient. PMID:26254177

  19. Malignant Peripheral Nerve Sheath Tumor -A Rare Malignancy in Mandible

    PubMed Central

    Majumdar, Sumit; Kotina, Sreekanth; Uppala, Divya; Kumar, Singam Praveen

    2016-01-01

    Malignant Peripheral Nerve Sheath Tumor (MPNST) is biologically an aggressive tumor that is usually found in the extremities, trunk and infrequently found in the head and neck area particularly in the jaws, arising from the cells allied with nerve sheath. Mandibular MPNST may either arise from a preexisting neurofibroma or develop de novo. Because of the greater variability from case to case in overall appearance both clinically and histologically, a case of MPNST of the mandible in a 25-year-old female patient is reported. The lesion was excised and immunohistological studies (S-100 & Neuron specific enolase) were conducted to confirm the neural origin. PMID:27504425

  20. Osteosarcoma of mandible: Detailed radiographic assessment of a case

    PubMed Central

    Arora, Piyush; Rehman, Farzan; Girish, K. L.; Kalra, Manpreet

    2013-01-01

    Osteosarcoma (OS) is a malignant connective tissue tumor originating from bone and is the most common primary bone malignancy of long bones but seldom arises in jaw bones. Osteosarcoma of jaws is frequently seen arising in the second and third decade as compared to earlier occurrences in other bones and show a slight predilection for body of mandible. It is a highly malignant tumor with varied radiographic features. We present a case with detailed radiographic assessment using intraoral radiograph, computed tomography (CT), 3-D CT, CT angiography techniques and histological evaluation. PMID:24124311

  1. Malignant Peripheral Nerve Sheath Tumor -A Rare Malignancy in Mandible.

    PubMed

    Majumdar, Sumit; Kotina, Sreekanth; Mahesh, Nirujogi; Uppala, Divya; Kumar, Singam Praveen

    2016-06-01

    Malignant Peripheral Nerve Sheath Tumor (MPNST) is biologically an aggressive tumor that is usually found in the extremities, trunk and infrequently found in the head and neck area particularly in the jaws, arising from the cells allied with nerve sheath. Mandibular MPNST may either arise from a preexisting neurofibroma or develop de novo. Because of the greater variability from case to case in overall appearance both clinically and histologically, a case of MPNST of the mandible in a 25-year-old female patient is reported. The lesion was excised and immunohistological studies (S-100 & Neuron specific enolase) were conducted to confirm the neural origin. PMID:27504425

  2. Synergistic role of gaseous ammonia in etiology of Pasteurella multocida-induced atrophic rhinitis in swine.

    PubMed Central

    Hamilton, T D; Roe, J M; Webster, A J

    1996-01-01

    One-week-old Large White piglets were weaned and allocated to 14 experimental groups, each composed of five animals. Each group was housed in a separate Rochester exposure chamber and exposed continuously to gaseous ammonia at either 0, 5, 10, 15, 25, 35, or 50 ppm (two groups per exposure level). One week after ammonia exposure commenced, the pigs from one group at each exposure level were inoculated intranasally with 9 x 10(7) CFU of Pasteurella multocida type D. After a further 4 weeks of exposure, all the pigs were euthanized and the extent of turbinate degeneration was assessed by using a morphometric index (J.T. Done, D. H. Upcott, D. C. Frewin, and C. N. Hebert, Vet. Rec. 114:33-35, 1984) and a subjective scoring system (Ministry of Agriculture, Fisheries and Food, Atrophic Rhinitis: a System of Snout Grading, 1978). Exposure to ammonia at a concentration of 5 ppm or greater resulted in a significant increase in the severity of turbinate atrophy induced by P. multocida compared with that occurring in pigs kept in 0 ppm of ammonia. This effect was maximal at 10 ppm but decreased progressively at concentrations above 25 ppm. Regression analysis revealed a significant relationship between the severity of turbinate degeneration and the number of P. multocida organisms isolated from the nasal epithelium at the end of the experiment (R2 = 0.86). These findings suggest that exposure to ammonia facilitates the growth and/or survival of P. multocida within the upper respiratory tract of the pig, thereby contributing to the severity of the clinical disease atrophic rhinitis. Furthermore, exposure of pigs to ammonia at 10 ppm or greater, in the absence of either P. multocida or Bordetella bronchiseptica, induced a mild but statistically significant degree of turbinate atrophy. The findings of this study demonstrate that exposure to ammonia, at concentrations within the range encountered commonly in commercial piggeries, contributes to the severity of clinical lesions

  3. Spontaneous fractures of the mandible concept & treatment strategy

    PubMed Central

    Marcussen, Mette

    2016-01-01

    Background Spontaneous fractures of the mandible dispose a surgical challenge in comparisons to fractures caused by trauma due to several complicating factors. Additionally: controversies exist concerning the terminology of the field. Material and Methods We conducted a retrospective study of all patients with mandibular fractures, with exclusion of fractures of the coronoid process and the alveolar process, treated at the Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Denmark between February 2003 and February 2013. Data collected from the medical records included sex, age, cause of fracture, site of fracture, and treatment. Results We identified 517 patients with 684 mandible fractures. Twenty-five of these were spontaneous fractures and 659 fractures were of traumatic origin. Condylar fractures rarely occur spontaneously, but constitute the majority of the traumatic fractures. Excluding these fractures from the analysis, we found a non-surgical approach in 14 of 24 (58%) of the spontaneous fractures and 110 of 376 (29%) of the traumatic fractures. This was statistically significant. Conclusions We found a statistical significant difference in favor of non-surgical approach in spontaneous fractures and we discussed the treatment challenges of these fractures. We addressed the terminological controversies regarding pathological fractures, and suggested the term spontaneous fractures denoting a fracture occurring during normal jaw function being either pathological or non-pathological. Key words:Mandibular fractures, spontaneous fractures, pathological fractures, traumatic fractures, treatment. PMID:26636905

  4. Bilateral Radicular Cyst in Mandible: An Unusual Case Report

    PubMed Central

    Bava, Fareed Ahmed; Umar, Dilshad; Bahseer, Bahija; Baroudi, Kusai

    2015-01-01

    A radicular cyst is one of the furthermost everyday odontogenic cysts of the anterior maxilla, not regularly comprehended in youth. They are found mostly at the apices of the tooth (periapical cyst), lateral surface of the roots (lateral radicular cyst) and remains in the jaw after removal of the offending tooth (residual cyst). The radicular cyst has been catalogued as an inflammatory cyst, as an outcome to pulpal necrosis succeeding caries, with a linked periapical inflammatory reaction. They advance sluggishly and asymptomatic lest infected. Because of this they can extent to big dimensions. Many times it is perplexing to segregate radicular cysts from the obligatory pre-existing chronic periapical periodontitis lesions radiographically. Here, we present a rare case with bilateral radicular cyst in relation to first molar of the mandible in a 19-year-old. Orthopantomograph showed a large unilocular radiolucency with a well-defined border in the periapical region of the first molar on the left side extending from the root of the second premolar to the mesial root of the second molar. Correspondingly another well-defined unilocular radiolucency with a well-defined border was seen on the right side of the mandible. Several treatment possibilities are presented for a radicular cyst such as surgical endodontic treatment, extraction of the transgressing tooth, enucleation with primary closure, and marsupialization trailed by enucleation. The patient management comprised surgical enucleation of cystic sac followed by rehabilitation of the same area. PMID:25859111

  5. Improving the minimally invasive approach to mandible angle repair.

    PubMed

    Cole, Patrick; Rottgers, Stephen A; Cameron, Hunter; Hollier, Larry H

    2008-03-01

    Mandible angle fractures can be exceedingly difficult to manage and are associated with the highest complication rate of all mandible fractures. Although technically demanding, minimally invasive plate repair of angle fractures offers minimal morbidity and effective fragment stabilization while providing optimal aesthetic outcome. Although minimally invasive fixation provides attractive results, full mobilization of the operative site is often substantially limited by the inherent nature of local masseteric and deeper tissues. Although access limitations often prompt creation of an additional facial incision, trocar withdrawal into subcutaneous tissue followed by repositioning and deep tissue penetration greatly enhances operative mobility. Although this modification may seem simple, the senior author's experience at several outside institutions demonstrates that surgeons will all-too-often resort to additional facial incisions when access is severely limited. In review of our 5-year experience with minimally invasive angle repair, this straightforward innovation significantly decreased operative challenge, improved instrument range-of-motion, and eased the steep learning curve of these often-difficult procedures. PMID:18362737

  6. Compact bone distribution and biomechanics of early hominid mandibles.

    PubMed

    Daegling, D J; Grine, F E

    1991-11-01

    This investigation explores the effects of compact bone distribution on the biomechanical properties of the postcanine mandibular corpus of the fossil hominid taxa Australopithecus africanus and Paranthropus robustus. The mandibles of extant great apes, modern humans, and the fossil hominids are examined by computed tomography (CT), and compact bone contours are used to calculate cross-sectional biomechanical properties (cortical area, second moments of area, and Bredt's formula for torsional strength). The relative amount of compact bone is comparable in the modern and fossil mandibles, but the mechanical properties of A. africanus and P. robustus jaws are distinct in terms of the ratio of minimum to maximum second moments of area. This difference most likely represents a structural response to elevated torsional moments in the fossil hominids. Although the relative amount of compact bone in cross-section does not differ significantly between taxa by statistical criteria, A. africanus utilizes less cortical bone than P. robustus in the same manner in which Pongo is separated from the condition in other extant large-bodied hominoids. It has been suggested that the phenomenon of mandibular "robusticity" (expressed as an index of corpus breadth/corpus height) may be an effect of postcanine megadontia and/or reduced canine size in the australopithecines. Results presented here, however, indicate that it is unlikely that either factor adequately accounts for mandibular size and shape variation in early hominids. PMID:1746641

  7. Bilateral radicular cyst in mandible: an unusual case report.

    PubMed

    Bava, Fareed Ahmed; Umar, Dilshad; Bahseer, Bahija; Baroudi, Kusai

    2015-02-01

    A radicular cyst is one of the furthermost everyday odontogenic cysts of the anterior maxilla, not regularly comprehended in youth. They are found mostly at the apices of the tooth (periapical cyst), lateral surface of the roots (lateral radicular cyst) and remains in the jaw after removal of the offending tooth (residual cyst). The radicular cyst has been catalogued as an inflammatory cyst, as an outcome to pulpal necrosis succeeding caries, with a linked periapical inflammatory reaction. They advance sluggishly and asymptomatic lest infected. Because of this they can extent to big dimensions. Many times it is perplexing to segregate radicular cysts from the obligatory pre-existing chronic periapical periodontitis lesions radiographically. Here, we present a rare case with bilateral radicular cyst in relation to first molar of the mandible in a 19-year-old. Orthopantomograph showed a large unilocular radiolucency with a well-defined border in the periapical region of the first molar on the left side extending from the root of the second premolar to the mesial root of the second molar. Correspondingly another well-defined unilocular radiolucency with a well-defined border was seen on the right side of the mandible. Several treatment possibilities are presented for a radicular cyst such as surgical endodontic treatment, extraction of the transgressing tooth, enucleation with primary closure, and marsupialization trailed by enucleation. The patient management comprised surgical enucleation of cystic sac followed by rehabilitation of the same area. PMID:25859111

  8. Biomechanical behavior of restored and unrestored mandible with shortened dental arch under vertical loading condition.

    PubMed

    Tanasić, Ivan; Tihaček-Šojić, Ljiljana; Milić-Lemić, Aleksandra

    2012-01-01

    The aim of this in vitro study was to investigate the strain distribution of the compressed mandible bone under the applied restoration- removable partial denture and to compare with the same but unrestored mandible under vertical (occlusal) load and to find out whether removable partial denture-restored or unrestored mandible causes greater strain effect on supporting tissue. Four mandible models were tested during loading for the purpose of strain measuring. Digital image correlation system (GOM - German Optical Measuring, Braunschweig, Germany), used for measuring strain consists of two digital cameras and software ARAMIS (6.2.0, Braunschweig, Germany). Remaining teeth suffer from greater strain in the mandible model without removable partial denture (7.5-10%). On the contrary, mandible with removable partial denture shows the maximum strain below the denture saddle (3.5%). However, it can be noticed that the marginal bone of the second lower praemolar in both experimental models is deformed whether the mandible model has (2.8%) or has not (10%) replacement. Within the limitations of this study the higher strain is observed in mandible model without replacement and the strain is limited locally, in the bone region that surrounds remaining teeth and mental foramen. PMID:23394230

  9. Solitary central osteoma of mandible in a geriatric patient: Report and review

    PubMed Central

    Bhujbal, Ravi B.; Nayak, Ajay G.

    2016-01-01

    Solitary central osteomas of jaw are extremely rare lesions with only few previously documented cases. This paper reports a case of large solitary central osteoma involving mandible symphysis- parasymphysis region in an elderly female patient. A brief review of similar cases reported in the literature is also provided in this paper. Key words:Osteomas, osteogenic,bone, tumor, jaw, mandible. PMID:27034765

  10. New data evaluation procedure including advanced background subtraction for radiography using the example of insect mandibles

    NASA Astrophysics Data System (ADS)

    Mangold, Stefan; van de Kamp, Thomas; Steininger, Ralph

    2016-05-01

    The usefulness of full field transmission spectroscopy is shown using the example of mandible of the stick insect Peruphasma schultei. An advanced data evaluation tool chain with an energy drift correction and highly reproducible automatic background correction is presented. The results show significant difference between the top and the bottom of the mandible of an adult stick insect.

  11. Analysis of arch-like bones: The rodent mandible as a case study.

    PubMed

    Vassallo, Aldo Iván

    2016-07-01

    Bone strength is determined by the mechanical properties of bone material, and the size and shape of the whole bone, i.e., its architecture. The mandible of vertebrates has been traditionally regarded as a beam oriented in relation to main masticatory loads, i.e., the longer dimension of its cross-section being parallel to the load. Rodents follow this pattern but, in addition, their mandible possesses an intriguing arch-like shape that is apparent when seen in the lateral view. Little attention was given to the structural capacity of this trait. The advantage of an arch is that it can withstand a greater load than a horizontal beam. The objective of this study was to model the rodent mandible like an arch to evaluate its structural strength. The bending moment in an arch-like mandible was 15-25% lower with respect to a beam-like mandible. Further, bending varies with mandible "slenderness" and incisor procumbency, a functionally relevant rodent trait. In the rodent Ctenomys talarum (Caviomorpha; Ctenomyidae), bone stress was substantially reduced when the mandible was modeled as an arch-like structure as compared with a beam-like structure, and safety factors were 15-34% higher. The shape of rodents' mandible might confer a functional advantage to high and repeatedly applied loads resulting from a unique feeding mode: gnawing. J. Morphol. 277:879-887, 2016. © 2016 Wiley Periodicals, Inc. PMID:27059294

  12. Radiometric dating of quaternary deposits and the hominid mandible of lake banyolas, Spain

    USGS Publications Warehouse

    Julia, R.; Bischoff, J.L.

    1991-01-01

    We report results of U-series analyses of the travertine matrix surrounding the Banyolas mandible that indicate an age of 45??4 ka bp. The mandible, an archaic hominid fossil generally deemed of mid-Pleistocene age, was recovered from a travertine matrix in 1887. Similar analyses on 21 travertine samples from quarries near the discovery site yield coherent U-series dates in correct stratigraphic order, ranging from 44 ka bp to 117 ka bp. Isotopic composition of these samples and the mandible matrix show no evidence of open system behaviour. Coherent isotopic results from adjacent quarries support the validity of the date on the mandible travertine, and we conclude the mandible is much younger than previously believed. ?? 1991.

  13. Onset of mandible and tibia osteoradionecrosis – a comparative pilot study in the rat

    PubMed Central

    Damek-Poprawa, Monika; Both, Stefan; Wright, Alexander C.; Maity, Amit; Akintoye, Sunday O.

    2012-01-01

    Objectives Osteoradionecrosis (ORN) is common in the jaws following radiotherapy. We hypothesized that mandible is more susceptible to ORN than tibia based on site-disparity in hypoxic-hypocellular-hypovascular tissue breakdown. Study Design Twelve rats received 50 Gy irradiation to mandible or tibia; 4 of 12 rats further received minor surgical trauma to the irradiated sites. Structural and cellular skeletal changes were assessed with computer tomography, histology and immunostaining. Results Mandible developed ORN with 70% mean bone loss 10 weeks post-irradiation (p < 0.05) while tibia was structurally and radiological intact for 20 weeks post-irradiation. Hypocellularity, hypoxia and oxidative stress were higher in irradiated mandible (p < 0.001) than tibia (p < 0.01) but vascular damage was similar at both skeletal sites. Combined effects of radiation and minor trauma promoted mandibular alveolar bone loss and tibial fracture Conclusion ORN has a more rapid onset in mandible relative to tibia in the rat PMID:23254371

  14. Loss of interleukin-21 leads to atrophic germinal centers in multicentric Castleman's disease.

    PubMed

    Yajima, Hidetaka; Yamamoto, Motohisa; Shimizu, Yui; Sakurai, Nodoka; Suzuki, Chisako; Naishiro, Yasuyoshi; Imai, Kohzoh; Shinomura, Yasuhisa; Takahashi, Hiroki

    2016-01-01

    Both multicentric Castleman's disease (MCD) and immunoglobulin (Ig)G4-related disease (IgG4-RD) are systemic diseases, presenting with hypergammaglobulinemia and elevated serum levels of IgG4. However, with regard to histopathological findings, MCD shows atrophic germinal centers. On the other hand, expanded germinal centers are detected in IgG4-RD. We extracted germinal centers from specimens of each disorder by microdissection and analyzed the expression of mRNAs by real-time polymerase chain reaction to clarify the mechanisms underlying atrophied germinal centers in MCD. This analysis disclosed loss of interleukin (IL)-21 and B cell lymphoma (Bcl)-6 in the germinal centers of MCD. Loss of IL-21 is considered to be involved in the disappearance of Bcl-6 and leads to atrophied germinal centers in MCD. PMID:26377996

  15. Atrophic nerve fibers in regions of reduced MIBG uptake in doxorubicin cardiomyopathy

    SciTech Connect

    Takano, Hajime; Ozawa Hideyuki; Kobayashi, Isao

    1995-11-01

    A myocardial MIBG-SPECT examination was conducted 2 wk after doxorubicin chemotherapy on a 52-yr-old woman without cardiac symptoms. Despite normal {sup 201}Tl scintigraphy, reduced MIBG uptake was detected in the apical anterior, inferior and lateral segments of the left ventricle. The patient died of congestive heart failure due to doxorubicin-induced cardiomyopathy 10 mo later. At necropsy, the left ventricle was markedly dilated and the apical anterior, inferior and lateral walls were thin, stiff and whitish. Nerve fibers in the apical inferior wall were atrophic and markedly fibrotic where MIBG uptake was most reduced. Nerve fibers in the septum were normal where MIBG uptake had remained normal. The histologic findings correspond with the findings on the MIBG image. MIBG imaging may detect cardiac sympathetic denervation in doxorubicin-induced cardiomyopathy before cardiac symptoms are manifest and cardiac function deteriorates. 5 refs., 2 figs.

  16. The Opa1-Dependent Mitochondrial Cristae Remodeling Pathway Controls Atrophic, Apoptotic, and Ischemic Tissue Damage

    PubMed Central

    Varanita, Tatiana; Soriano, Maria Eugenia; Romanello, Vanina; Zaglia, Tania; Quintana-Cabrera, Rubén; Semenzato, Martina; Menabò, Roberta; Costa, Veronica; Civiletto, Gabriele; Pesce, Paola; Viscomi, Carlo; Zeviani, Massimo; Di Lisa, Fabio; Mongillo, Marco; Sandri, Marco; Scorrano, Luca

    2015-01-01

    Summary Mitochondrial morphological and ultrastructural changes occur during apoptosis and autophagy, but whether they are relevant in vivo for tissue response to damage is unclear. Here we investigate the role of the optic atrophy 1 (OPA1)-dependent cristae remodeling pathway in vivo and provide evidence that it regulates the response of multiple tissues to apoptotic, necrotic, and atrophic stimuli. Genetic inhibition of the cristae remodeling pathway in vivo does not affect development, but protects mice from denervation-induced muscular atrophy, ischemic heart and brain damage, as well as hepatocellular apoptosis. Mechanistically, OPA1-dependent mitochondrial cristae stabilization increases mitochondrial respiratory efficiency and blunts mitochondrial dysfunction, cytochrome c release, and reactive oxygen species production. Our results indicate that the OPA1-dependent cristae remodeling pathway is a fundamental, targetable determinant of tissue damage in vivo. PMID:26039448

  17. Comparison of different laser systems in the treatment of hypertrophic and atrophic scars and keloids

    NASA Astrophysics Data System (ADS)

    Scharschmidt, D.; Algermissen, Bernd; Willms-Jones, J.-C.; Philipp, Carsten M.; Berlien, Hans-Peter

    1997-12-01

    Different laser systems and techniques are used for the treatment of hypertrophic scars, keloids and acne scars. Significant criteria in selecting a suitable laser system are the scar's vascularization, age and diameter. Flashlamp- pumped dye-lasers, CO2-lasers with scanner, Argon and Nd:YAG-lasers are used. Telangiectatic scars respond well to argon lasers, erythematous scars and keloids to dye-laser treatment. Using interstitial Nd:YAG-laser vaporization, scars with a cross-section over 1 cm can generally be reduced. For the treatment of atrophic and acne scars good cosmetic results are achieved with a CO2-laser/scanner system, which allows a precise ablation of the upper dermis with low risk of side-effects.

  18. Factors Modulating Recovery Rate after Intermittent Tetanic Fatigue in Atrophic Soleus

    NASA Astrophysics Data System (ADS)

    Li, Hui; Jiao, Bo; Yu, Zhibin

    2008-06-01

    To specify the factors modulating the recovery rate after intermittent tetanic fatigue in soleus, and to seek the reasons for the decrease of recovery rate in atrophic soleus, we observed the recovery time course of different types of fatigue in isolated muscle strips. A 10 % or 50 % decrease in maximal contraction tension of tetani was defined respectively as slight or moderate fatigue. Tetanic tension recovery rates after short-term and long-term of slight or moderate fatigue were observed, some pharmacological intervention were also used. The results showed that slight fatigue only induced an inhibition to myofibril, while moderate fatigue induced an inhibition in myofibril and sarcoplasmic reticulum Ca2+ release channels. There were significant decreases in all of the fatigue groups in one-week tail-suspended rats. These suggest that both slight and moderate fatigue inhibit the myofibrils and the sarcoplasmic reticulum Ca2+ release channels in one-week unloaded soleus.

  19. Mesenchymal stem cell implantation in atrophic nonunion of the long bones

    PubMed Central

    Phedy, P.; Kholinne, E.; Djaja, Y. P.; Kusnadi, Y.; Merlina, M.; Yulisa, N. D.

    2016-01-01

    Objectives To explore the therapeutic potential of combining bone marrow-derived mesenchymal stem cells (BM-MSCs) and hydroxyapatite (HA) granules to treat nonunion of the long bone. Methods Ten patients with an atrophic nonunion of a long bone fracture were selectively divided into two groups. Five subjects in the treatment group were treated with the combination of 15 million autologous BM-MSCs, 5g/cm3 (HA) granules and internal fixation. Control subjects were treated with iliac crest autograft, 5g/cm3 HA granules and internal fixation. The outcomes measured were post-operative pain (visual analogue scale), level of functionality (LEFS and DASH), and radiograph assessment. Results Post-operative pain evaluation showed no significant differences between the two groups. The treatment group demonstrated faster initial radiographic and functional improvements. Statistically significant differences in functional scores were present during the first (p = 0.002), second (p = 0.005) and third (p = 0.01) month. Both groups achieved similar outcomes by the end of one-year follow-up. No immunologic or neoplastic side effects were reported. Conclusions All cases of nonunion of a long bone presented in this study were successfully treated using autologous BM-MSCs. The combination of autologous BM-MSCs and HA granules is a safe method for treating nonunion. Patients treated with BM-MSCs had faster initial radiographic and functional improvements. By the end of 12 months, both groups had similar outcomes. Cite this article: H.D. Ismail, P. Phedy, E. Kholinne, Y. P. Djaja, Y. Kusnadi, M. Merlina, N. D. Yulisa. Mesenchymal stem cell implantation in atrophic nonunion of the long bones: A translational study. Bone Joint Res 2016;5:287–293. DOI: 10.1302/2046-3758.57.2000587. PMID:27412657

  20. Time Course of Atrophic Remodeling: Effects of Exercise on Cardiac Morpology and Function

    NASA Technical Reports Server (NTRS)

    Scott, J. M.; Martin, D.; Caine, T.; Matz, T.; Ploutz-Snyder, L. L.

    2014-01-01

    Early and consistent evaluation of cardiac morphology and function throughout an atrophic stimulus is critically important for the design and optimization of interventions. Exercise training is one intervention that has been shown to confer favorable improvements in LV mass and function during unloading. However, the format and intensity of exercise required to induce optimal cardiac improvements has not been investigated. PURPOSE: This randomized, controlled trial was designed to 1) comprehensively characterize the time course of unloading-induced morpho-functional remodeling, and 2) examine the effects of high intensity exercise training on cardiac structural and functional parameters during unloading. METHODS: Twenty six subjects completed 70 days of head down tilt bed rest (HDBR): 17 were randomized to exercise training (ExBR) and 9 remained sedentary. Exercise consisted of integrated high intensity, continuous, and resistance exercise. We assessed cardiac morphology (left ventricular mass; LVM) and function (speckle-tracking assessment of longitudinal, radial, and circumferential strain and twist) before (BR-2), during (BR7,21,31,70), and following (BR+0, +3) HDBR. Cardiorespiratory fitness (VO2max) was evaluated before (BR- 3), during (BR4,25,46,68) and following (BR+0) HDBR. RESULTS: Sedentary HDBR resulted in a progressive decline in LVM, longitudinal, radial, and circumferential strain, and an increase in twist. ExBR mitigated decreases in LVM and function. Change in twist was significantly related to change in VO2max (R=0.68, p<0.01). CONCLUSIONS: Alterations in cardiac morphology and function begin early during unloading. High-intensity exercise attenuates atrophic morphological and functional remodeling.

  1. Effect of decompression on cystic lesions of the mandible: 3-dimensional volumetric analysis.

    PubMed

    Song, I S; Park, H S; Seo, B M; Lee, J H; Kim, M J

    2015-11-01

    Decompression is effective in reducing both the size of cystic lesions on jaws and the associated morbidity of resection. However, quantitative measurement of reduced volume after decompression among different cystic diseases has not been fully investigated. We have retrospectively investigated the difference in reduction in volume among keratocystic odontogenic tumours (n=17), unicystic ameloblastomas (n=10), and dentigerous cysts (n=10) of the posterior mandible using 3-dimensional computed tomography (CT). Various other influential factors such as age, sex, the presence of impacted teeth, and the number of drains were also recorded. There was no significant difference in the speed of shrinkage among the 3 groups, but there was a significant correlation (p<0.01) between the initial detected volume of the lesion and the absolute speed of shrinkage in each type of cyst. Initial volume was also significantly associated (p<0.01) with reduction of total volume in each type of cyst. Age may correlate negatively with the rate of reduction in dentigerous cysts, which means that the older the patient is, the less the reduction. Treatment seemed to last longer as the speed of shrinkage lessened in the keratocystic tumours and dentigerous cysts (p<0.05) as multiple regression has shown. The relative speed of shrinkage of unicystic ameloblastomas seemed to be slower when an impacted tooth was involved in the lesion (p=0.019). However, the sample size was too small to make any definite statistical statement. These results suggest that the rate of reduction of volume was related to the original size of the lesion. Despite the need for a second operation and longer duration of treatment compared with excision alone, decompression is a valuable way of reducing the size of large cystic lesions, with low morbidity and recurrence rate. There was no difference in the rate of reduction according to the underlying histopathological picture. PMID:26212420

  2. Isolated Posterior Fossa Involvement in Posterior Reversible Encephalopathy Syndrome

    PubMed Central

    Shimizu, Yukie; Tha, Khin Khin; Iguchi, Akihiro; Cho, Yuko; Yoshida, Atsushi; Fujima, Noriyuki; Tsukahara, Akiko; Shirato, Hiroki; Terae, Satoshi

    2013-01-01

    Summary Posterior reversible encephalopathy syndrome (PRES) is characterized by reversible vasogenic edema affecting the subcortical white matter of bilateral occipital and parietal lobes. We describe a case of isolated posterior fossa involvement of PRES which occurred during remission induction chemotherapy for T-cell acute lymphoblastic leukemia. Both the brainstem and cerebellum were extensively involved, but the supratentorial structures were completely spared. The follow-up magnetic resonance images revealed reversibility of most lesions. The knowledge of atypical radiological features of PRES is essential for prompt diagnosis. PMID:24199811

  3. Application of Crestal Anesthesia for Treatment of Class I Caries in Posterior Mandibular Teeth

    PubMed Central

    Taheri Talesh, Koroush; Solahaye Kahnamouii, Shiva

    2011-01-01

    Background and aims Current infiltration techniques for achieving anesthesia in dental procedures are not applicable in posterior mandibular region because of its dense cortical bone. The aim of this study was to evaluate the efficacy of a specific infiltration anesthesia in posterior mandibular teeth instead of inferior alveolar nerve block for restorative procedures. Materials and methods Crestal anesthesia (CA) was assessed both clinically and by computed tomography scan for its efficacy and side effects. A combination of an opaque material (Ultravist) and 2% lidocaine was used to trace the anesthetic solution. The combination was primarily injected in the gingival tissue of rabbit and was followed-up regularly for two weeks to assess any possible injury. After confirming its safety, a combination of these materials was injected to volunteers to assess efficacy and diffusion route. A total of 154 patients (77 female, 77 male) with matched bilateral posterior teeth in mandible were selected randomly and an IANB and CA were performed randomly and separately in different sessions for the contra lateral teeth. The onset of anesthesia, anesthesia duration, pain, blood pressure, pulse rate, and consumed volume of anesthetic solution was recorded for each technique. Data were analyzed using paired t-test. Results There were no significant differences in clinical attachment loss, pocket depth, bone level, plaque index, and free gingival margin between the two flaps (p>0.05). Conclusion CA could be considered as a reliable and safe primary injection in posterior mandibular teeth for restorative treatments. PMID:23019502

  4. Decompression for management of keratocystic odontogenic tumor in the mandible.

    PubMed

    Morais de Melo, Willian; Pereira-Santos, Darklilson; Sonoda, Celso Koogi; Hochuli-Vieira, Eduardo

    2012-11-01

    Keratocystic odontogenic tumor (KCOT) is a benign intraosseous neoplasm of odontogenic origin with high recurrence rate. To date, various conservative or aggressive management strategies have been suggested as a method of treatment. Decompression is a conservative method that has been used in the treatment of large odontogenic cysts. The present paper reports a case of KCOT located in the mandible and discusses the importance of its management using conservative methods. The authors present a case of a 38-year-old patient with a KCOT located in the right mandibular angle and ascending ramus, which was treated by decompression followed by enucleation and curettage. The lesion did not recur during a follow-up period of 3 years after surgery. Preserving important structures of the bone and soft tissue decompression is a method with low morbidity. In addition, according to the literature, decompression has a success rate at least as high as the one of most aggressive treatments. PMID:23172507

  5. Eosinophilic granuloma of the mandible: a diagnostic dilemma

    PubMed Central

    Sherwani, Rana K; Akhtar, Kafil; Qadri, Shagufta; Ray, Prasenjit Sen

    2014-01-01

    Eosinophilic granuloma (EG) is a rare histiocytic disorder resulting from clonal proliferation of Langerhans cells. It accounts for less than 1% of all osseous neoplasms and has a predilection for involving the axial skeleton. Although suspicion of the disease may arise from clinical features and radiographic demonstration of destructive bone lesions, it is still difficult to make a correct diagnosis without proper pathological evaluation. This is more evident when common differentials mimicking EG, both clinically and radiologically, need to be ruled out. This report describes a case of unifocal EG of the mandible occurring in a 4-year-old boy whose initial presentation led to confusion between osteomyelitis, primary bone tumour and lymphoma. A final diagnosis of EG was established after histopathological examination of the biopsy specimen. PMID:24700031

  6. Odontometric systematic assessment of the Swartkrans SK 15 mandible.

    PubMed

    Curnoe, D

    2006-01-01

    This study reports a comparison of molar crown and cusp size and shape in the Swartkrans early Homo mandible SK 15 with relevant Plio-Pleistocene taxa. Univariate and multivariate methods are employed to consider the morphological affinities of this specimen and to assess its taxonomy. The case exists for classifying SK 15 in Homo habilis with 11 features aligning it with this species. The results of multivariate studies are consistent with this hypothesis. Moreover, SK 15 lacks a number of important features that characterise the mandibular molars of Homo sapiens erectus. Considerable evidence for parallelism in the dental morphology of SK 15 and H. habilis with A. robustus is discussed. Fossil evidence for the presence of H. sapiens erectus during the Plio-Pleistocene of South Africa presently seems to be lacking. Archaeological interpretations should take greater account of this gap in the fossil record. PMID:16889778

  7. Chronic Suppurative Osteomyelitis of Mandible: A Case Report

    PubMed Central

    Mehra, Hemant; Gupta, Sumit; Gupta, Hemant; Sinha, V.; Singh, Jasmeet

    2013-01-01

    Osteomyelitis is an inflammatory disease of the bone that usually begins as an infection of the medullary cavity, rapidly involves the haversian system, and quickly extends to the periosteum of the area. It develops in the jaws after a chronic odontogenic infection or for a variety of other reasons such as trauma, inadequate treatment of fracture, or irradiation to the mandible. When antimicrobial agents or drainage prove unsuccessful, acute osteomyelitis may become chronic. Conventional radiography, culture, bone biopsy, radioisotope bone scan, laser Doppler flowmetry, computed tomography, and magnetic resonance imaging are used for its diagnosis. We present a case of chronic suppurative osteomyelitis associated with a draining extraoral sinus, which was successfully treated with surgical debridement and stabilization with a 10-hole reconstruction plate and bicortical screws using AO principles. PMID:24436759

  8. Parathyroid adenoma presenting as a brown tumour of the mandible.

    PubMed

    Amin, Kavit; Fu, Bertram; Barbaccia, Carmelo

    2012-01-01

    Background. Parathyroid adenoma is the commonest cause of primary hypercalcaemia and usually presents with symptoms/signs of hypercalcaemia. This paper highlights an unusual presentation. Case Report. A 27-year-old female presented with a painful left mandibular swelling, suspicious of neoplasia. A computed tomography (CT) guided biopsy was performed. Based on the histology result, serum calcium was carried out, confirming hypercalcaemia. A left inferior parathyroid adenoma was subsequently removed. CT mandible showed extensive erosive lesions at the left 2nd/3rd inferior molar roots with protrusion to adjacent soft tissues. USS revealed a hypoechoic lesion on the left inferior parathyroid gland. Sestamibi scan showed a focus of MIBI uptake and retention at the inferior aspect of the left thyroid lobe. Conclusion. This case highlights the importance of a thorough history and examination. Clinicians should always bear in mind atypical presentations of parathyroid adenomas, with the need to exclude this differential in the presence of hypercalcaemia. PMID:23251179

  9. Benign cementoblastoma of the anterior mandible: an unusual case report

    PubMed Central

    Karöz, Tuğçe Berre; Sumer, Mahmut; Açıkgöz, Aydan; Süllü, Yurdanur

    2016-01-01

    A benign cementoblastoma, which is another name for a true cementoma, is a rare neoplasm that develops from odontogenic ectomesenchyme. It is characterized by a mineralized mass attached to the apex of the root produced by neoplastic cementoblasts. More than 75% of cases arise in the mandible, with 90% of them manifesting in the molar and premolar regions. This neoplasm occurs most commonly in children and young adults, with males being affected slightly more than females. Radiographically, the tumor is observed as a well-defined radiopaque mass that is fused to a tooth root and is surrounded by a radiolucent rim. The treatment of benign cementoblastoma consists of removal of the lesion and extraction of the affected tooth. This report presents an unusual case of benign cementoblastoma in a 31-year-old female, presenting as a densely mineralized mass seen at the apex of the impacted right mandibular canine tooth on radiographs. PMID:27595092

  10. Benign cementoblastoma of the anterior mandible: an unusual case report.

    PubMed

    Çalışkan, Armağan; Karöz, Tuğçe Berre; Sumer, Mahmut; Açıkgöz, Aydan; Süllü, Yurdanur

    2016-08-01

    A benign cementoblastoma, which is another name for a true cementoma, is a rare neoplasm that develops from odontogenic ectomesenchyme. It is characterized by a mineralized mass attached to the apex of the root produced by neoplastic cementoblasts. More than 75% of cases arise in the mandible, with 90% of them manifesting in the molar and premolar regions. This neoplasm occurs most commonly in children and young adults, with males being affected slightly more than females. Radiographically, the tumor is observed as a well-defined radiopaque mass that is fused to a tooth root and is surrounded by a radiolucent rim. The treatment of benign cementoblastoma consists of removal of the lesion and extraction of the affected tooth. This report presents an unusual case of benign cementoblastoma in a 31-year-old female, presenting as a densely mineralized mass seen at the apex of the impacted right mandibular canine tooth on radiographs. PMID:27595092

  11. Posterior polar cataract: A review

    PubMed Central

    Kalantan, Hatem

    2011-01-01

    Posterior polar cataract is a rare form of congenital cataract. It is usually inherited as an autosomal dominant disease, yet it can be sporadic. Five genes have been attributed to the formation of this disease. It is highly associated with complications during surgery, such as posterior capsule rupture and nucleus drop. The reason for this high complication rate is the strong adherence of the opacity to the weak posterior capsule. Different surgical strategies were described for the handling of this challenging entity, most of which emphasized the need for gentle maneuvering in dealing with these cases. It has a unique clinical appearance that should not be missed in order to anticipate, avoid, and minimize the impact of the complications associated with it. PMID:23960967

  12. Rethinking "posterior" tongue-tie.

    PubMed

    Douglas, Pamela Sylvia

    2013-12-01

    Currently, many clinicians who help with breastfeeding problems are diagnosing "posterior" tongue-tie in infants and performing or referring for frenotomy. In this "Speaking Out" article, I argue that the diagnosis of "posterior" tongue-tie has successfully raised awareness of the importance of impaired tongue function in breastfeeding difficulty. However, the diagnosis of "posterior" tongue-tie also applies a reductionist, medicalized theoretical frame to the complex problem of impaired tongue function, risking unintended outcomes. Impaired tongue function arises out of multiple interacting and co-evolving factors, including the interplay between social behaviors concerning breastfeeding and mother-infant biology. Consideration of theoretical frames is vital if we are to build an evidence base through efficient use of the scarce resources available for clinical breastfeeding research and minimize unintended outcomes. PMID:24143939

  13. Semireal Time Monitoring Of The Functional Movements Of The Mandible

    NASA Astrophysics Data System (ADS)

    Isaacson, Robert J.; Baumrind, Sheldon; Curry, Sean; Molthen, Robert A.

    1983-07-01

    Many branches of dental practice would benefit from the availability of a relatively accurate, precise, and efficient method for monitoring the movements of the human mandible during function. Mechanical analog systems have been utilized in the past but these are difficult to quantify, have limited accuracy due to frictional resistance of the components, and contain information only on the borders of the envelopes of possible movement of the landmarks measured (rather than on the functional paths of the landmarks which lie within their envelopes). Those electronic solutions which have been attempted thus far have been prohibitively expensive and time consuming for clinical use, have had lag times between data acquisition and display, or have involved such restrictions of freedom of motion as to render ambiguous the meaning of the data obtained. We report work aimed at developing a relatively non-restrictive semi-real time acoustical system for monitoring the functional movement of the mandible relative to the rest of the head. A set of three sparking devices is mounted to the mandibular component of a light, relatively non-constraining extra-oral harness and another set of three sparkers is attached to the harness' cranial or skull component. The sparkers are fired sequentially by a multiplexer and the sound associated with each firing is recorded by an array of three or more microphones. Computations based on the known speed of sound are used to evaluate the distances between the sparkers and the microphones. These data can then be transformed by computer to provide numeric or graphic information on the movement of selected mandibular landmarks with respect to the skull. Total elapsed time between the firing of the sparkers and the display of graphic information need not exceed 30-60 seconds using even a relatively modest modern computer.

  14. Mechanical testing of recombinant human bone morphogenetic protein-7 regenerated bone in sheep mandibles.

    PubMed

    Kontaxis, A; Abu-Serriah, M; Ayoub, A F; Barbenel, J C

    2004-01-01

    A new method was developed in this study for testing excised sheep mandibles as a cantilever. The method was used to determine the strength and stiffness of sheep hemi-mandibles including a 35 mm defect bridged by regenerated bone. Recombinant human bone morphogenetic protein-7 (rhBMP-7) in a bovine collagen type-I carrier was used for the bone regeneration. Initial tests on ten intact sheep mandibles confirmed that the strength, stiffness and area beneath the load-deformation curves of the right and left hemi-mandibles were not significantly different, confirming the validity of using the contra-lateral hemi-mandible as a control side. Complete bone regeneration occurred in six hemi-mandibles treated with rhBMP, but the quality and mechanical properties of the bone were very variable. The new bone in three samples contained fibrous tissue and was weaker and less stiff than the contra-lateral side (strength, 10-20 per cent; stiffness, 6-15 per cent). The other half had better-quality bone and was significantly stiffer and stronger (p < 0.05), with strength 45-63 per cent and stiffness 35-46 per cent of the contra-lateral side. Hemi-mandibles treated with collagen alone had no regenerated bone bridge suggesting that 35 mm is a critical-size bone defect. PMID:15648662

  15. Lights and shadows of bone augmentation in severe resorbed mandible in combination with implant dentistry.

    PubMed

    Baj, A; Sollazzo, V; Lauritano, D; Candotto, V; Mancini, G E; Gianni, A B

    2016-01-01

    Edentulous mandible frequently undergoes severe bone atrophy with problems of prosthetic instability. Instability of the lower denture may cause difficulties with eating and speech, ulcerations of the oral mucosa for lower denture trauma, loss of facial vertical dimension. These problems may be solved by bone augmentation of severe resorption of edentulous mandible. The aim of this short review is to describe surgical techniques for bone augmentation of the severe resorption of edentulous mandible. In this paper, we define a severe resorption of edentulous mandible as a mandibular height in the symphyseal area of 12 mm or less as measured on a standardized lateral cephalogram. Bone grafts and distraction osteogenesis have allowed improving implantology from an experimental to a consolidate dental procedure. It is currently a valuable treatment modality in the prosthetic treatment of severe resorption of edentulous mandible. Numerous techniques have been developed for the rehabilitation of edentulous mandible with fixed or removable mandibular dentures. Today, the options for the restoration of the severe resorption of edentulous mandible with implants can be categorized as follows: insertion of short and narrow implants and a fixed or removable prosthesis; augmentation of the bone with the use of distraction osteogenesis or grafting procedures in combination with the insertion of dental implants loaded with fixed or removable prosthesis; placement of a transosteal dental implants supporting a denture. PMID:27469566

  16. Insect mandibles--comparative mechanical properties and links with metal incorporation.

    PubMed

    Cribb, Bronwen W; Stewart, Aaron; Huang, Han; Truss, Rowan; Noller, Barry; Rasch, Ronald; Zalucki, Myron P

    2008-01-01

    A number of arthropod taxa contain metals in their mandibles (jaws), such as zinc, manganese, iron, and calcium. The occurrence of zinc and its co-located halogen chlorine have been studied in relation to the mechanical properties and shown to be linked in a direct fashion with increasing concentration. Hardness along with elastic modulus (stiffness) has also been linked to zinc and halogen concentration in some marine polychaete worms. The metal appears to be incorporated within the biological matrix, possibly bonding with proteins. However, the comparative advantage of metal inclusion has not been tested. It is possible that without metals, alternative mechanisms are used to achieve hardness of equal value in similar 'tools' such as mandibles. This question has direct bearing on the significance of metal hardening. In the present article, we compare across mandibles from six termite species, including samples with major zinc concentration, minor manganese, and no metals. Nanoindentation, electron microscopy, and electron microanalysis are used to assess metal concentration, form, and mechanical properties. The data demonstrate that termite mandibles lacking metals when fully developed have lower values for hardness and elastic modulus. Zinc is linked to a relative 20% increase in hardness when compared with mandibles devoid of metals. The similar transition metal, manganese, found in minor concentrations, is not linked to any significant increase in these mechanical properties. This raises the question of the function of manganese, which is as commonly found in insect mandibles as zinc and often located in the same mandibles. PMID:17646951

  17. [General partial resection of the mandible in para-osteal cancers of the mouth and oropharynx].

    PubMed

    Weidenbecher, M; Pesch, H J

    1982-12-01

    The mandibles of 24 patients with a squamous cell carcinoma of the floor of the mouth or the tongue or the tonsils (all were T2N1b and T3N1b), were histologically examined. It could histologically be shown, that the bone will be destroyed by 2 modalities: 1. Atrophy of the mandible, caused by the pressure of the tumor, leaving the periosteum intact 2. Infiltration of the tumor into the bone. Tumor cells could not be found in the lymphatic system of the periosteum. Since the periosteum is a barrier against tumor growth, the indicator for the resection of the mandible was made after shaved off the periosteum. Resulting from our findings we propose the following concept: 1. If the tumor reaches the mandible (distance tumor to bone = 0 mm) or is fixed to the periosteum and the compacta shows no errosion, after shaving off the periosteum, the mandible can be preserved. 2. If the tumor grows through the periosteum, a marginal resection of the mandible is necessary. 3. If the bone shows errosion, a partial resection of the anterior part of the mandible or a hemimandibulectomy is indicated. PMID:7161159

  18. In vivo bone strain and finite element modeling of the mandible of Alligator mississippiensis

    PubMed Central

    Porro, Laura B; Metzger, Keith A; Iriarte-Diaz, Jose; Ross, Callum F

    2013-01-01

    Forces experienced during feeding are thought to strongly influence the morphology of the vertebrate mandible; in vivo strain data are the most direct evidence for deformation of the mandible induced by these loading regimes. Although many studies have documented bone strains in the mammalian mandible, no information is available on strain magnitudes, orientations or patterns in the sauropsid lower jaw during feeding. Furthermore, strain gage experiments record the mechanical response of bone at a few locations, not across the entire mandible. In this paper, we present bone strain data recorded at various sites on the lower jaw of Alligator mississippiensis during in vivo feeding experiments. These data are used to understand how changes in loading regime associated with changes in bite location are related to changes in strain regime on the working and balancing sides of the mandible. Our results suggest that the working side mandible is bent dorsoventrally and twisted about its long-axis during biting, and the balancing side experiences primarily dorsoventral bending. Strain orientations are more variable on the working side than on the balancing side with changes in bite point and between experiments; the balancing side exhibits higher strain magnitudes. In the second part of this paper, we use principal strain orientations and magnitudes recorded in vivo to evaluate a finite element model of the alligator mandible. Our comparison demonstrates that strain orientations and mandibular deformation predicted by the model closely match in vivo results; however, absolute strain magnitudes are lower in the finite element model. PMID:23855772

  19. Occurrence of neanderthal features in mandibles from the Atapuerca-SH site.

    PubMed

    Rosas, A

    2001-01-01

    Analysis of variation and distribution of evolutionary novelties is meaningful in understanding evolutionary processes. The mandible, as a morphological complex, comprises a large number of derived Neanderthal features. The present study investigates whether the features usually considered as European lineage apomorphies evolved independently; the occurrence of these features is studied in the mandibles from the Sima de los Huesos (SH) site (Atapuerca, Spain). For comparative purposes, a large sample of Neanderthal mandibles as well as older fossil Homo specimens have been used for the study. Chi-square tests were employed to test for independence. The SH mandibles present a set of features that clearly show the basic architecture of the Neanderthal mandible. A highly significant association is detected in the variation of the position of the mental foramen, the lateral prominence, and the anterior marginal tubercle, as well as in the development of retromolar space. However, a much weaker association is detected in the features of the internal aspect of the mandible, with a few exceptions. Features of the external aspect of the mandible occur chronologically earlier than those observed in the internal aspect. The hypothesis that two distinct and consecutive morphological processes have driven the emergence of the European lineage throughout the Middle Pleistocene is proposed. A first transformation affects the mandible by means of backwards displacement of the structures located at the external aspect, as well as the position of the condyle. A second process would modify the features of the internal aspect of the mandible, in which the relief of the masseteric and pterygoid fossae are affected, in association with a spatial rearrangement of the corpus and ramus. Analyzed individually, some of the considered features may be questioned as Neanderthal apomorphies (Trinkaus,1993; Franciscus and Trinkaus, 995); however, the joint occurrence of many of them suggests

  20. A strategy for removal of foreign body in mandible with navigation system.

    PubMed

    Li, P; Li, Z; Tian, W; Tang, W

    2015-07-01

    Navigation surgery in the mandible has rarely been reported because of the complexities of navigating a mobile structure. In this article, we present a simple and novel strategy for removal of a foreign body in the mandible using a navigation system. A female diagnosed with a foreign body in the left mandible underwent navigation surgery using a BrainLAB system. We used a special open splint fabricated with acrylic resin to successfully perform the mandibular navigation. This strategy may be appropriate for many types of mandibular navigation surgery. PMID:25744644

  1. Fibre Bragg grating sensing and finite element analysis of the biomechanics of the mandible

    NASA Astrophysics Data System (ADS)

    Silva, J. C. C.; Ramos, A.; Carvalho, L.; Nogueira, R. N.; Ballu, A.; Mesnard, M.; Pinto, J. L.; Kalinowski, Hypolito J.; Simoes, J. A.

    2005-05-01

    This paper describes the application of fibre Bragg grating (FBG) sensors to measure strains at the outer surface of a mandible. The strains were correlated to identical ones obtained with a numerical finite element model. For this purpose, a synthetic mandible was used and 4 Bragg sensors were glued to the mandible. Strain patterns were assessed for different load configurations which included the forces of the masseter and temporal muscles and occlusion loads on different tooth (incisor, canine and molar). Overall the strains obtained using different measuring methods were identical, namely for the case of symmetric loading. When loading was non-symmetric, strain differences were observed at one sensor.

  2. Metastasis of lung adenocarcinoma to the mandible: Report of a case

    PubMed Central

    Misir, Ahmet Ferhat; Mercan, Uğur; Günhan, Ömer

    2013-01-01

    Adenocarcinoma of the lung that metastasizes to the mandible is uncommon. There are only a few cases described in the English-language literature regarding metastasis to mandible from adenocarcinoma of the lung. This article shows a metastasis from adenocarcinoma of the lung affecting the mandible of a 55-year-old male patient where the metastatic lesion was detected before primary tumor. This article emphasizes the importance of detailed dentoalveolar examination and early diagnosis for finding the primary focus of metastatic lesions. PMID:24250088

  3. A radiological approach to benign and malignant lesions of the mandible.

    PubMed

    Harmon, M; Arrigan, M; Toner, M; O'Keeffe, S A

    2015-04-01

    There is a wide range of pathological conditions that affect the mandible. Although some lesions demonstrate characteristic imaging features, many of the pathological processes encountered in the mandible often exhibit similar imaging appearances resulting in uncertainty for the reporting radiologist. Many mandibular lesions remain impossible to distinguish without histological analysis. Therefore, this review aims to reassure the radiologist that although imaging findings may not always lead to a specific diagnosis, they narrow the differential diagnosis and guide further work-up. In this regard, we aim to provide a clinically useful framework and approach for radiologists to use when they encounter lesions within the mandible. PMID:25559378

  4. [Developing a finite element model of human head with true anatomic structure mandible].

    PubMed

    Ma, Chunsheng; Zhang, Haizhong; Du, Huiliang; Huang, Shilin; Zhang, Jinhuan

    2005-02-01

    A finite element model of human mandible is developed from CT scan images by the technologies of three-dimensional reconstruction, image processing and meshing. The mandible model is connected to one modified head model of Hybrid III dummy with joint according to the anatomic structure and mechanical characteristics of the temporomandibular joint. Then a finite element model of the human head with the true anatomic structure mandible is developed. This model has been validated with the cadaver test results. It can be used in researches on the mechanism of craniofacial blunt-impact injury and on the assessment of injury severity. PMID:15762115

  5. Study of mandible reconstruction using a fibula flap with application of additive manufacturing technology

    PubMed Central

    2014-01-01

    Background This study aimed to establish surgical guiding techniques for completing mandible lesion resection and reconstruction of the mandible defect area with fibula sections in one surgery by applying additive manufacturing technology, which can reduce the surgical duration and enhance the surgical accuracy and success rate. Methods A computer assisted mandible reconstruction planning (CAMRP) program was used to calculate the optimal cutting length and number of fibula pieces and design the fixtures for mandible cutting, registration, and arrangement of the fibula segments. The mandible cutting and registering fixtures were then generated using an additive manufacturing system. The CAMRP calculated the optimal fibula cutting length and number of segments based on the location and length of the defective portion of the mandible. The mandible cutting jig was generated according to the boundary surface of the lesion resection on the mandible STL model. The fibular cutting fixture was based on the length of each segment, and the registered fixture was used to quickly arrange the fibula pieces into the shape of the defect area. In this study, the mandibular lesion was reconstructed using registered fibular sections in one step, and the method is very easy to perform. Results and conclusion The application of additive manufacturing technology provided customized models and the cutting fixtures and registered fixtures, which can improve the efficiency of clinical application. This study showed that the cutting fixture helped to rapidly complete lesion resection and fibula cutting, and the registered fixture enabled arrangement of the fibula pieces and allowed completion of the mandible reconstruction in a timely manner. Our method can overcome the disadvantages of traditional surgery, which requires a long and different course of treatment and is liable to cause error. With the help of optimal cutting planning by the CAMRP and the 3D printed mandible resection jig and

  6. A new find of a Middle Pleistocene mandible from Bilzingsleben, Germany

    NASA Astrophysics Data System (ADS)

    Vlcek, E.; Mania, D.; Mania, U.

    The Middle Pleistocene site at Bilzingsleben is being excavated by the Forschungsstelle Bilzingsleben, FSU Jena. It is a living floor with structures of settlement and a great number of Lower Palaeolithic cultural remains. So far, 28 human skull fragments have been discovered, which can be reconstructed into two individual skulls. Recently, the right mandible has also been discovered (Bilzingsleben E7). Morphological comparisons indicate that there is a great similarity to the mandibles of HI and BI of Sinanthropus. A strong likeness to Arago II and XIII was also discovered. There are various different archaic features which assign the Bilzingsleben mandible and the two skulls to the advanced Homo erectus.

  7. Correction of dental Class III with posterior open bite by simple biomechanics using an anterior C-tube miniplate

    PubMed Central

    Ahn, Hyo-Won; Chung, Kyu-Rhim; Kang, Suk-Man; Lin, Lu; Nelson, Gerald

    2012-01-01

    In the correction of dental Class III molar relationship in skeletal Class II patients, uprighting of the mandibular posterior segments without opening the mandible is an important treatment objective. In the case reported herein, a C-tube miniplate fixed to the lower labial symphysis and connected with a nickel-titanium reverse-curved archwire provided effective uprighting of the lower molars, without the need of orthodontic appliances on the mandibular anteriors. Using this approach, an appropriate magnitude of force is exerted on the molars while avoiding any negative effect on the mandibular anteriors. PMID:23173121

  8. Contributory and Exacerbating Roles of Gaseous Ammonia and Organic Dust in the Etiology of Atrophic Rhinitis

    PubMed Central

    Hamilton, T. D. C.; Roe, J. M.; Hayes, C. M.; Jones, P.; Pearson, G. R.; Webster, A. J. F.

    1999-01-01

    Pigs reared commercially indoors are exposed to air heavily contaminated with particulate and gaseous pollutants. Epidemiological surveys have shown an association between the levels of these pollutants and the severity of lesions associated with the upper respiratory tract disease of swine atrophic rhinitis. This study investigated the role of aerial pollutants in the etiology of atrophic rhinitis induced by Pasteurella multocida. Forty, 1-week-old Large White piglets were weaned and divided into eight groups designated A to H. The groups were housed in Rochester exposure chambers and continuously exposed to the following pollutants: ovalbumin (groups A and B), ammonia (groups C and D), ovalbumin plus ammonia (groups E and F), and unpolluted air (groups G and H). The concentrations of pollutants used were 20 mg m−3 total mass and 5 mg m−3 respirable mass for ovalbumin dust and 50 ppm for ammonia. One week after exposure commenced, the pigs in groups A, C, E, and G were infected with P. multocida type D by intranasal inoculation. After 4 weeks of exposure to pollutants, the pigs were killed and the extent of turbinate atrophy was assessed with a morphometric index (MI). Control pigs kept in clean air and not inoculated with P. multocida (group H) had normal turbinate morphology with a mean MI of 41.12% (standard deviation [SD], ± 1.59%). In contrast, exposure to pollutants in the absence of P. multocida (groups B, D, and F) induced mild turbinate atrophy with mean MIs of 49.65% (SD, ±1.96%), 51.04% (SD, ±2.06%), and 49.88% (SD, ±3.51%), respectively. A similar level of atrophy was also evoked by inoculation with P. multocida in the absence of pollutants (group G), giving a mean MI of 50.77% (SD, ±2.07%). However, when P. multocida inoculation was combined with pollutant exposure (groups A, C, and E) moderate to severe turbinate atrophy occurred with mean MIs of 64.93% (SD, ±4.64%), 59.18% (SD, ±2.79%), and 73.30% (SD, ±3.19%), respectively. The severity

  9. Posterior Tibial Tendon Dysfunction (PTTD)

    MedlinePlus

    ... ACFAS | Información en Español Advanced Search Home » Foot & Ankle Conditions » Posterior Tibial Tendon Dysfunction (PTTD) Text Size ... the arch, and an inward rolling of the ankle. As the condition progresses, the symptoms will change. ...

  10. Stereolithography for Posterior Fossa Cranioplasty

    PubMed Central

    Agner, Celso; Dujovny, Manuel; Evenhouse, Raymond; Charbel, Fady T.; Sadler, Lewis

    1998-01-01

    Posterior fossa cranioplasty has been suggested for improvement of neurological symptoms following craniectomy. However, there is no particular recommendation in the literature about techniques for prosthesis manufacture and implantation. We report our experience using rapid prototyping technology and stereolithography for pre-surgical implant design and production of cranioplasties. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5 PMID:17171056

  11. Efficacy of fractional CO2 laser in treatment of atrophic scar of cutaneous leishmaniasis.

    PubMed

    Banihashemi, Mahnaz; Nahidi, Yalda; Maleki, Masoud; Esmaily, Habibollah; Moghimi, Hamid Reza

    2016-05-01

    Cutaneous leishmaniasis is an endemic disease in Iran. Unfortunately, it can lead to unsightly atrophic scars with limited treatment options. Fractional CO2 laser is accepted for treatment of atrophic acne scars and recently has been used to treat cutaneous leishmaniasis, so we planned to use fractional CO2 laser on leishmaniasis scar. We conducted this study on 60 leishmaniasis scars on the face of 40 patients. The lesions were treated by a fractional CO2 laser with beam size of 120 μm, with energy of 50-90 mJ, and 50-100 spots/cm(2) density with two passes in three monthly sessions. Evaluation was done in the first and second months after the first treatment and 3 and 6 months after the last treatment. Digital photography was performed at each visit. Assessment of improvement rate by patient and physician was rated separately as follows: no improvement (0 %), mild (<25 %), moderate (25-50 %), good (51-75 %), and excellent (76-100 %). Based on patients' opinion, in the first and second follow-up, 48.3 and 90 % of them reported moderate to excellent healing, respectively (p < 0.001). In 3 and 6 months follow-up after the end of the experiment, most of the patients (88.3 and 95 %, respectively) reported moderate to excellent healing of scars. Based on two observers' opinion, healing in the first follow-up in most of the patients (65 %) was mild to moderate and 33 % were reported as having no healing. In the second follow-up, only 5 % of the patients were reported with no healing and 60 % were reported as having moderate healing (p < 0.001). In 3 and 6 months follow-up, most of the patients (95 and 96.6 %) were reported as having moderate to excellent healing (p = <0.001). Our results underlined the high efficacy of fractional CO2 laser for leishmaniasis scar. No significant adverse effects were noted. PMID:26984344

  12. [The application of helium-neon laser radiation for the combined treatment of the patients with atrophic rhinitis].

    PubMed

    Sharipov, R A; Sharipova, E R

    2012-01-01

    The objective of the present study was to improve the efficacy of the treatment of the patients presenting with atrophic rhinitis (ozena) of the upper respiratory tract by the application of helium-neon laser radiation. A total of 120 patients aged from 15 to 53 years were treated based at the Department of Otorhinolaryngology, G.G. Kuvatov Republican Clinical Hospital, Ufa. All these patients underwent routine clinical, roentgenological, microbiological, and rheographic examination. The method for the treatment of atrophic rhinitis is described; it includes the application of helium-neon laser radiation in combination with the administration of the purified preparation of liquid polyvalent Klebsiella bacteriophage. The positive results of the treatment by the proposed method were documented in 90% of the patients. PMID:23268248

  13. Clinical studies of the treatment of facial atrophic acne scars and acne with a bipolar fractional radiofrequency system.

    PubMed

    Kaminaka, Chikako; Uede, Mikiko; Matsunaka, Hiroshi; Furukawa, Fukumi; Yamamoto, Yuki

    2015-06-01

    Few clinical studies have examined the utility of bipolar fractional radiofrequency (FRF) therapy as a treatment for atrophic acne scars and active acne in people with darker skin. This study was designed to compare the safety and efficacy of bipolar FRF therapy as a treatment for atrophic acne scars and acne vulgaris. Twenty-three Japanese patients with atrophic acne scars and mild to severe acne on both cheeks were treated with a bipolar FRF system (eMatrix; Syneron, Yokneam Illit, Israel). Five treatment sessions were carried out at 1-month intervals, and the patients were followed up for 3 months after the final treatment. Assessments of scar severity and the number of acne lesions and 3-D in vivo imaging analysis were performed. Evaluations of the treatment outcomes and their effects on the patients' quality of life (QOL) were also carried out. We demonstrated that the improvement in scar volume was marked in the patients with mild scars and was at least moderate in 23 (57.5%) of the treated areas. With regard to the number of acne lesions, the treated areas exhibited significantly fewer lesions compared with the baseline at each time point (P < 0.05). The patients' assessments of the treatment outcomes and their QOL indicated that both had improved significantly by the end of the study. Furthermore, significant reductions in the patients' sebum levels, skin roughness and scar depth were observed. Bipolar FRF treatment significantly improved the atrophic acne scars and acne of Japanese patients and had minimal side-effects. PMID:25855397

  14. Chronic Sclerosing Osteomyelitis of the Mandible Treated with Hemimandibulectomy and Fibular Free Flap Reconstruction

    PubMed Central

    Singh, Shubhi; Bullock, Martin; Rigby, M.H.; Taylor, S. Mark; Trites, Jonathan R.B.; Hart, Robert D.

    2015-01-01

    Summary: Primary chronic osteomyelitis of the mandible is a rare condition that presents with a long-standing chronic facial swelling over the mandible, pain with mastication, and trismus. With no clinically appreciated acute phase, the aetiology often remains unknown. Many patients achieve adequate symptom control with broad-spectrum antibiotics, hyperbaric oxygen therapy and surgical debridement, or decortication of bone sequestration. However, because of the rarity of primary chronic osteomyelitis and the extensive involvement of the mandible that can result, we present a case of a 32-year-old woman with chronic disease of the left mandible requiring a left hemimandibulectomy and fibular free flap reconstruction. Few such cases have been reported in the literature, which require such extensive resection and reconstruction to control long-standing symptoms. PMID:26894005

  15. Osseointegrated implants: a potential route of entry for squamous cell carcinoma of the mandible.

    PubMed

    Schache, Andrew; Thavaraj, Selvam; Kalavrezos, Nicholas

    2008-07-01

    Documented cases of oral squamous cell carcinoma in relation to osseointegrated implants are rare. We present the first case with evidence to suggest that implants provide a route of entry for squamous cell carcinoma to the mandible. PMID:18063453

  16. Scanning electron microscopy analysis of experimental bone hacking trauma of the mandible.

    PubMed

    Alunni-Perret, Véronique; Borg, Cybèle; Laugier, Jean-Pierre; Bertrand, Marie-France; Staccini, Pascal; Bolla, Marc; Quatrehomme, Gérald; Muller-Bolla, Michèle

    2010-12-01

    The authors report on a macroscopic and microscopic study of human mandible bone lesions achieved by a single-blade knife and a hatchet. The aim of this work was to complete the previous data (scanning electron microscopy analysis of bone lesions made by a single-blade knife and a hatchet, on human femurs) and to compare the lesions of the femur with those of the mandible. The results indicate that the mandible is a more fragile bone, but the features observed on the mandible are quite similar to those previously observed on the femur. This work spells out the main scanning electron microscopy characteristics of sharp (bone cutting) and blunt (exerting a pressure on the bone) mechanisms on human bone. Weapon characteristics serve to explain all of these features. PMID:20890172

  17. Molecular Genotyping of Anisakis Larvae in Middle Eastern Japan and Endoscopic Evidence for Preferential Penetration of Normal over Atrophic Mucosa

    PubMed Central

    Arai, Toshio; Akao, Nobuaki; Seki, Takenori; Kumagai, Takashi; Ishikawa, Hirofumi; Ohta, Nobuo; Hirata, Nobuto; Nakaji, So; Yamauchi, Kenji; Hirai, Mitsuru; Shiratori, Toshiyasu; Kobayashi, Masayoshi; Fujii, Hiroyuki; Ishii, Eiji; Naito, Mikio; Saitoh, Shin-ichi; Yamaguchi, Toshikazu; Shibata, Nobumitsu; Shimo, Masamune; Tokiwa, Toshihiro

    2014-01-01

    Background Anisakiasis is a parasitic disease caused primarily by Anisakis spp. larvae in Asia and in Western countries. The aim of this study was to investigate the genotype of Anisakis larvae endoscopically removed from Middle Eastern Japanese patients and to determine whether mucosal atrophy affects the risk of penetration in gastric anisakiasis. Methods In this study, 57 larvae collected from 44 patients with anisakiasis (42 gastric and 2 colonic anisakiasis) were analyzed retrospectively. Genotyping was confirmed by restriction fragment length polymorphism (RFLP) analysis of ITS regions and by sequencing the mitochondrial small subunit (SSU) region. In the cases of gastric anisakiasis, correlation analyses were conducted between the frequency of larval penetration in normal/atrophic area and the manifestation of clinical symptoms. Results Nearly all larvae were A. simplex seusu stricto (s.s.) (99%), and one larva displayed a hybrid genotype. The A. simplex larvae penetrated normal mucosa more frequently than atrophic area (p = 0.005). Finally, patients with normal mucosa infection were more likely to exhibit clinical symptoms than those with atrophic mucosa infection (odds ratio, 6.96; 95% confidence interval, 1.52–31.8). Conclusions In Japan, A. simplex s.s. is the main etiological agent of human anisakiasis and tends to penetrate normal gastric mucosa. Careful endoscopic examination of normal gastric mucosa, particularly in the greater curvature of the stomach will improve the detection of Anisakis larvae. PMID:24586583

  18. Artificial neural networks in the recognition of the presence of thyroid disease in patients with atrophic body gastritis

    PubMed Central

    Lahner, Edith; Intraligi, Marco; Buscema, Massimo; Centanni, Marco; Vannella, Lucy; Grossi, Enzo; Annibale, Bruno

    2008-01-01

    AIM: To investigate the role of artificial neural networks in predicting the presence of thyroid disease in atrophic body gastritis patients. METHODS: A dataset of 29 input variables of 253 atrophic body gastritis patients was applied to artificial neural networks (ANNs) using a data optimisation procedure (standard ANNs, T&T-IS protocol, TWIST protocol). The target variable was the presence of thyroid disease. RESULTS: Standard ANNs obtained a mean accuracy of 64.4% with a sensitivity of 69% and a specificity of 59.8% in recognizing atrophic body gastritis patients with thyroid disease. The optimization procedures (T&T-IS and TWIST protocol) improved the performance of the recognition task yielding a mean accuracy, sensitivity and specificity of 74.7% and 75.8%, 78.8% and 81.8%, and 70.5% and 69.9%, respectively. The increase of sensitivity of the TWIST protocol was statistically significant compared to T&T-IS. CONCLUSION: This study suggests that artificial neural networks may be taken into consideration as a potential clinical decision-support tool for identifying ABG patients at risk for harbouring an unknown thyroid disease and thus requiring diagnostic work-up of their thyroid status. PMID:18203288

  19. ‘Skullduggery’: Lions Align and Their Mandibles Rock!

    PubMed Central

    Williams, Vivienne L.; Loveridge, Andrew J.; Newton, David J.; Macdonald, David W.

    2015-01-01

    South Africa has legally exported substantial quantities of lion bones to Southeast Asia and China since 2008, apparently as part of the multinational trade substituting bones and body parts of other large cats for those of the tiger in wine and other health tonics. The legal sale of lion bones may mask an illegal trade, the size of which is only partially known. An observed component of the illegal trade is that quantities of skeletons are sometimes declared falsely/fraudulently on CITES export permits. Furthermore, there are emerging concerns that bones from tigers reared in captivity in South Africa and elsewhere are being laundered as lion bones using CITES Appendix II permits. There is therefore a need for tools to monitor the trade in lion body parts and to distinguish between lions and tigers. Our research indicates that it is possible to use skeletons, skulls and cranial sutures to detect misdeclarations in the lion bone trade. It is also possible to use the average mass of a lion skeleton to corroborate the numbers of skeletons declared on CITES permits, relative to the weight of the consolidated consignments stated on the air waybills. When the mass of consolidated consignments of skeletons destined for export was regressed against the number of skeletons in that consignment, there was a strong correlation between the variables (r2 = 0.992) that can be used as a predictor of the accuracy of a declaration on a CITES permit. Additionally, the skulls of lions and tigers differ: two cranial sutures of lions align and their mandibles rock when placed on a flat surface, whereas the cranial sutures of tigers are not aligned and their mandibles rest naturally on two contact points. These two morphological differences between the skulls of tigers and lions are easy to observe at a glance and provide a method for distinguishing between the species if illegal trade in the bones is suspected and the skulls are present. These identifications should ideally be

  20. Impaired Translocation of GLUT4 Results in Insulin Resistance of Atrophic Soleus Muscle

    PubMed Central

    Xu, Peng-Tao; Song, Zhen; Zhang, Wen-Cheng; Jiao, Bo; Yu, Zhi-Bin

    2015-01-01

    Whether or not the atrophic skeletal muscle induces insulin resistance and its mechanisms are not resolved now. The antigravity soleus muscle showed a progressive atrophy in 1-week, 2-week, and 4-week tail-suspended rats. Hyperinsulinemic-euglycemic clamp showed that the steady-state glucose infusion rate was lower in 4-week tail-suspended rats than that in the control rats. The glucose uptake rates under insulin- or contraction-stimulation were significantly decreased in 4-week unloaded soleus muscle. The key protein expressions of IRS-1, PI3K, and Akt on the insulin-dependent pathway and of AMPK, ERK, and p38 on the insulin-independent pathway were unchanged in unloaded soleus muscle. The unchanged phosphorylation of Akt and p38 suggested that the activity of two signal pathways was not altered in unloaded soleus muscle. The AS160 and GLUT4 expression on the common downstream pathway also was not changed in unloaded soleus muscle. But the GLUT4 translocation to sarcolemma was inhibited during insulin stimulation in unloaded soleus muscle. The above results suggest that hindlimb unloading in tail-suspended rat induces atrophy in antigravity soleus muscle. The impaired GLUT4 translocation to sarcolemma under insulin stimulation may mediate insulin resistance in unloaded soleus muscle and further affect the insulin sensitivity of whole body in tail-suspended rats. PMID:25713812

  1. Impaired translocation of GLUT4 results in insulin resistance of atrophic soleus muscle.

    PubMed

    Xu, Peng-Tao; Song, Zhen; Zhang, Wen-Cheng; Jiao, Bo; Yu, Zhi-Bin

    2015-01-01

    Whether or not the atrophic skeletal muscle induces insulin resistance and its mechanisms are not resolved now. The antigravity soleus muscle showed a progressive atrophy in 1-week, 2-week, and 4-week tail-suspended rats. Hyperinsulinemic-euglycemic clamp showed that the steady-state glucose infusion rate was lower in 4-week tail-suspended rats than that in the control rats. The glucose uptake rates under insulin- or contraction-stimulation were significantly decreased in 4-week unloaded soleus muscle. The key protein expressions of IRS-1, PI3K, and Akt on the insulin-dependent pathway and of AMPK, ERK, and p38 on the insulin-independent pathway were unchanged in unloaded soleus muscle. The unchanged phosphorylation of Akt and p38 suggested that the activity of two signal pathways was not altered in unloaded soleus muscle. The AS160 and GLUT4 expression on the common downstream pathway also was not changed in unloaded soleus muscle. But the GLUT4 translocation to sarcolemma was inhibited during insulin stimulation in unloaded soleus muscle. The above results suggest that hindlimb unloading in tail-suspended rat induces atrophy in antigravity soleus muscle. The impaired GLUT4 translocation to sarcolemma under insulin stimulation may mediate insulin resistance in unloaded soleus muscle and further affect the insulin sensitivity of whole body in tail-suspended rats. PMID:25713812

  2. Effects of low dose estrogen therapy on the vaginal microbiomes of women with atrophic vaginitis

    PubMed Central

    Shen, Jian; Song, Ning; Williams, Christopher J.; Brown, Celeste J.; Yan, Zheng; Xu, Chen; Forney, Larry J.

    2016-01-01

    Atrophic vaginitis (AV) is common in postmenopausal women, but its causes are not well understood. The symptoms, which include vaginal itching, burning, dryness, irritation, and dyspareunia, can usually be alleviated by low doses of estrogen given orally or locally. Regrettably, the composition of vaginal bacterial communities in women with AV have not been fully characterized and little is known as to how these communities change over time in response to hormonal therapy. In the present intervention study we determined the response of vaginal bacterial communities in postmenopausal women with AV to low-dose estrogen therapy. The changes in community composition in response to hormonal therapy were rapid and typified by significant increases in the relative abundance of Lactobacillus spp. that were mirrored by a decreased relative abundance of Gardnerella. These changes were paralleled by a significant four-fold increase in serum estradiol levels and decreased vaginal pH, as well as nearly a two-fold increase in the Vaginal Maturation Index (VMI). The results suggest that after menopause a vaginal microbiota dominated by species of Lactobacillus may have a beneficial role in the maintenance of health and these findings that could lead to new strategies to protect postmenopausal women from AV. PMID:27103314

  3. Microscopic and ultrastructural modifications of postmenopausal atrophic vaginal mucosa after fractional carbon dioxide laser treatment.

    PubMed

    Zerbinati, Nicola; Serati, Maurizio; Origoni, Massimo; Candiani, Massimo; Iannitti, Tommaso; Salvatore, Stefano; Marotta, Francesco; Calligaro, Alberto

    2015-01-01

    Vaginal atrophy occurring during menopause is closely related to the dramatic decrease in ovarian estrogens due to the loss of follicular activity. Particularly, significant changes occur in the structure of the vaginal mucosa, with consequent impairment of many physiological functions. In this study, carried out on bioptic vaginal mucosa samples from postmenopausal, nonestrogenized women, we present microscopic and ultrastructural modifications of vaginal mucosa following fractional carbon dioxide (CO2) laser treatment. We observed the restoration of the vaginal thick squamous stratified epithelium with a significant storage of glycogen in the epithelial cells and a high degree of glycogen-rich shedding cells at the epithelial surface. Moreover, in the connective tissue constituting the lamina propria, active fibroblasts synthesized new components of the extracellular matrix including collagen and ground substance (extrafibrillar matrix) molecules. Differently from atrophic mucosa, newly-formed papillae of connective tissue indented in the epithelium and typical blood capillaries penetrating inside the papillae, were also observed. Our morphological findings support the effectiveness of fractional CO2 laser application for the restoration of vaginal mucosa structure and related physiological trophism. These findings clearly coupled with striking clinical relief from symptoms suffered by the patients before treatment. PMID:25410301

  4. The Diagnostic Value of Gastrin-17 Detection in Atrophic Gastritis: A Meta-Analysis.

    PubMed

    Wang, Xu; Ling, Li; Li, Shanshan; Qin, Guiping; Cui, Wei; Li, Xiang; Ni, Hong

    2016-05-01

    A meta-analysis was performed to assess the diagnostic value of gastrin-17 (G-17) for the early detection of chronic atrophic gastritis (CAG).An extensive literature search was performed, with the aim of selecting publications that reported the accuracy of G-17 in predicting CAG, in the following databases: PubMed, Science Direct, Web of Science, Chinese Biological Medicine, Chinese National Knowledge Infrastructure, Wanfang, and VIP. To assess the diagnostic value of G-17, the following statistics were estimated and described: sensitivity, specificity, diagnostic odds ratios (DOR), summary receiver operating characteristic curves, area under the curve (AUC), and 95% confidence intervals (CIs).Thirteen studies that met the inclusion criteria were included in this meta-analysis, comprising 894 patients and 1950 controls. The pooled sensitivity and specificity of these studies were 0.48 (95% CI: 0.45-0.51) and 0.79 (95% CI: 0.77-0.81), respectively. The DOR was 5.93 (95% CI: 2.93-11.99), and the AUC was 0.82.G-17 may have potential diagnostic value because it has good specificity and a moderate DOR and AUC for CAG. However, more studies are needed to improve the sensitivity of this diagnostic tool in the future. PMID:27149493

  5. A polysaccharide from cultured mycelium of Hericium erinaceus and its anti-chronic atrophic gastritis activity.

    PubMed

    Wang, Mingxing; Gao, Yang; Xu, Duoduo; Gao, Qipin

    2015-11-01

    A polysaccharide named EP-1 was found by screening cultured mycelium of Hericium erinaceus, which was extracted and subjected to precipitation with ethanol, hollow-fiber ultrafiltration and ion-exchange chromatography. The polysaccharide has a molecular weight of approximately 3100Da and is composed of glucose, mannose and galactose, thus being a heteroglycan. EP-1 has a backbone of α-d-Glc(1→3) and β-d-Glc(1→3). The β-d-Glc(1→3) and α-d-Gal-(1→3) were regarded as branches attached to the C-4 position. The α-d-Man was regarded as a terminal residue. The anti-CAG activity was evaluated in experimental systems using a cell model for identification. The polysaccharide significantly inhibited the growth of MC cells obtained from human gastric mucosa epithelium (GES-1) cells transformed by MNNG, which were used as a chronic atrophic gastritis cell model. It also interfered with the MC cells by inducing cell cycle arrest. Thus, EP-1 shows potential for the development of new functional foods and drugs. PMID:26314904

  6. Rationale in diagnosis and screening of atrophic gastritis with stomach-specific plasma biomarkers

    PubMed Central

    Agréus, Lars; Kuipers, Ernst J; Kupcinskas, Limas; Malfertheiner, Peter; Di Mario, Francesco; Leja, Marcis; Mahachai, Varocha; Yaron, Niv; Van Oijen, Martijn; Perez, Guillermo Perez; Rugge, Massimo; Ronkainen, Jukka; Salaspuro, Mikko; Sipponen, Pentti; Sugano, Kentaro; Sung, Joseph

    2012-01-01

    Background and aims Atrophic gastritis (AG) results most often from Helicobacter pylori (H. pylori) infection. AG is the most important single risk condition for gastric cancer that often leads to an acid-free or hypochlorhydric stomach. In the present paper, we suggest a rationale for noninvasive screening of AG with stomach-specific biomarkers. Methods The paper summarizes a set of data on application of the biomarkers and describes how the test results could be interpreted in practice. Results In AG of the gastric corpus and fundus, the plasma levels of pepsinogen I and/or the pepsinogen I/pepsinogen II ratio are always low. The fasting level of gastrin-17 is high in AG limited to the corpus and fundus, but low or non-elevated if the AG occurs in both antrum and corpus. A low fasting level of G-17 is a sign of antral AG or indicates high intragastric acidity. Differentiation between antral AG and high intragastric acidity can be done by assaying the plasma G-17 before and after protein stimulation, or before and after administration of the proton pump inhibitors (PPI). Amidated G-17 will rise if the antral mucosa is normal in structure. H. pylori antibodies are a reliable indicator of helicobacter infection, even in patients with AG and hypochlorhydria. Conclusions Stomach-specific biomarkers provide information about the stomach health and about the function of stomach mucosa and are a noninvasive tool for diagnosis and screening of AG and acid-free stomach. PMID:22242613

  7. The FSHD Atrophic Myotube Phenotype Is Caused by DUX4 Expression

    PubMed Central

    Vanderplanck, Céline; Ansseau, Eugénie; Charron, Sébastien; Stricwant, Nadia; Tassin, Alexandra; Laoudj-Chenivesse, Dalila; Wilton, Steve D.

    2011-01-01

    Background Facioscapulohumeral muscular dystrophy (FSHD) is linked to deletions in 4q35 within the D4Z4 repeat array in which we identified the double homeobox 4 (DUX4) gene. We found stable DUX4 mRNAs only derived from the most distal D4Z4 unit and unexpectedly extended to the flanking pLAM region that provided an intron and a polyadenylation signal. DUX4 encodes a transcription factor expressed in FSHD but not control primary myoblasts or muscle biopsies. The DUX4 protein initiates a large transcription deregulation cascade leading to muscle atrophy and oxidative stress, which are FSHD key features. Methodology/Principal Findings We now show that transfection of myoblasts with a DUX4 expression vector leads to atrophic myotube formation associated with the induction of E3 ubiquitin ligases (MuRF1 and Atrogin1/MAFbx) typical of muscle atrophy. DUX4 induces expression of downstream targets deregulated in FSHD such as mu-crystallin and TP53. We developed specific siRNAs and antisense oligonucleotides (AOs) targeting the DUX4 mRNA. Addition of these antisense agents to primary FSHD myoblast cultures suppressed DUX4 protein expression and affected expression of the above-mentioned markers. Conclusions/Significance These results constitute a proof of concept for the development of therapeutic approaches for FSHD targeting DUX4 expression. PMID:22053214

  8. Are atrophic long-bone nonunions associated with low-grade infections?

    PubMed Central

    Dapunt, Ulrike; Spranger, Ole; Gantz, Simone; Burckhardt, Irene; Zimmermann, Stefan; Schmidmaier, Gerhard; Moghaddam, Arash

    2015-01-01

    Impaired fracture healing, especially when associated with bacterial infection, is a severe complication following long-bone fractures and requires special treatment. Because standard diagnostic techniques might provide falsely negative results, we evaluated the sonication method for detection of bacteria on implants of patients with fracture nonunions. A total of 49 patients with a nonunion (group NU) and, for comparison, 45 patients who had undergone routine removal of osteosynthetic material (group OM), were included in the study. Five different diagnostic methods (culture of tissue samples, culture of intraoperative swabs, histopathology of tissue samples, culture of sonication fluid, and 16S ribosomal DNA polymerase chain reaction of sonication fluid) were compared and related to clinical data. Among the diagnostic tests, culture of sonication fluid demonstrated by far the highest detection rate of bacteria (57%) in group NU, and rather unexpectedly 40% in group OM. Culture of sonication samples also revealed a broad spectrum of bacteria, in particular Propionibacterium spp. In conclusion, our results indicate that more bacteria can be detected on implants of patients with atrophic nonunions of long-bone fractures by means of the sonication procedure, which provides a valuable additional diagnostic tool to decide on a surgical procedure (eg, two-step procedure) and to further specify antimicrobial therapy. PMID:26719698

  9. Fixation of a severely resorbed mandible for complete arch screw-retained rehabilitation: A clinical report.

    PubMed

    Fabris, Vinicius; Bacchi, Atais

    2016-05-01

    Severely resorbed mandibles with placed endosteal dental implants can fracture. Therefore, techniques to reduce the risk or minimize the consequences of these fractures are needed. This clinical report presents a technique for placing a titanium plate in a severely resorbed mandible subjected to complete-arch implant therapy. The titanium plate is placed in the same surgical procedure as the implants, allowing immediate implant loading. This technique provides safe implant-supported treatment for patients with severe mandibular resorption. PMID:26775245

  10. Disparate osteogenic response of mandible and iliac crest bone marrow stromal cells to pamidronate

    PubMed Central

    Stefanik, D.; Sarin, J.; Lam, T.; Levin, L.; Leboy, PS; Akintoye, SO.

    2010-01-01

    OBJECTIVE Long-term administration of intravenous bisphosphonates like pamidronate is associated with jaw osteonecrosis but axial and appendicular bones are unaffected. Pathogenesis of bisphosphonate-associated jaw osteonecrosis may relate to skeletal-site specific effects of bisphosphonates on osteogenic differentiation of bone marrow stromal cells (BMSCs) of orofacial and axial/appendicular bones. This study evaluated and compared skeletal site-specific osteogenic response of mandible (orofacial bone) and iliac crest (axial bone) human BMSCs to pamidronate. MATERIALS AND METHODS Mandible and iliac crest BMSCs from six normal healthy volunteers were established in culture and tested with pamidronate to evaluate and compare cell survival, osteogenic marker alkaline phosphatase, osteoclast differentiation in co-cultures with CD34+ hematopoietic stem cells, gene expression of receptor activator of NFκB ligand (RANKL) and osteoprotegerin, and in vivo bone regeneration. BRESULTS Mandible BMSCs were more susceptible to pamidronate than iliac crest BMSCs based on decreased cell survival, lower alkaline phosphatase production and structurally less organized in vivo bone regeneration. Pamidronate promoted higher RANKL gene expression and osteoclast recruitment by mandible BMSCs. CONCLUSION Mandible and iliac crest BMSC survival and osteogenic differentiation are disparately affected by pamidronate to favor dysregulated mandible bone homeostasis. PMID:18938273

  11. The effects of the spring-loaded posterior bite-block on the maxillo-facial morphology.

    PubMed

    Işcan, H N; Akkaya, S; Koralp, E

    1992-02-01

    The purpose of this study was to determine the effects of the spring-loaded bilateral posterior occlusal bite-block on the maxillo-facial morphology, with emphasis on the response of the facial structures to the progressively increased vertical dimension. Our sample consisted of two groups: eleven open-bite subjects having a mean age of 10.30 years, treated with spring-loaded posterior bite-blocks over a mean period of 0.49 +/- 0.08 years (6 months); and twelve open bite subjects with a mean age of 9.84 years, treated by means of passive posterior bite-block and vertical chin-cap for a mean period of 0.67 +/- 0.03 years (8 months). The average daily use of the appliances was 16 hours. The study was carried out on lateral head films taken prior to and after treatment, which was concluded when an overbite of 1-1.5 mm was achieved. The results did not reflect any statistically significant difference between the groups when considering the changes in the horizontal growth pattern of the mandible, the decrease of the lower and the total anterior facial heights, or the overbite achieved by the two types of posterior bite-blocks. The artificial increase of the vertical dimension contributed to a statistically significant increase in the ramal inclination in both groups, though greater in the spring-loaded posterior bite-block group. PMID:1563475

  12. Posterior cruciate ligament of the knee (image)

    MedlinePlus

    The posterior cruciate ligament (PCL) is a powerful ligament extending from the top-rear surface of the tibia to the bottom-front surface of the femur. The ligament prevents the knee joint from posterior instability.

  13. Bilateral posterior cerebral artery infarction.

    PubMed

    Ryan, Davinia; Murphy, Sinead M; Hennessey, Michael J

    2010-01-01

    We report the case of a 70-year-old man who presented with short-term memory impairment and a homonymous left inferior quadrantanopia secondary to simultaneous bilateral posterior cerebral artery (PCA) territory infarction. As in more than a quarter of cases of PCA infarction, no aetiological cause was identified. Unlike the transient nature of symptoms in some cases following unilateral infarction, his deficits persisted on 2-month follow-up. PMID:22798298

  14. Role of Articular Disc in Condylar Regeneration of the Mandible

    PubMed Central

    Hayashi, Hidetaka; Fujita, Tadashi; ShIrakura, Maya; Tsuka, Yuji; Fujii, Eri; Terao, Akiko; Tanimoto, Kotaro

    2014-01-01

    The articular disc in the temporomandibular joint plays an important role in mandibular growth. Functional appliances induce regeneration of the condyle even after condylectomy. The aim of this study was to examine the role of the articular disc in regeneration of the condyle after unilateral condylectomy with use of a functional appliance in growing rats. Fifty growing rats were subjected to unilateral condylectomy and then half of them underwent discectomy. The functional appliance was applied to half of the rats in each group to induce regeneration of the condyle. Four and eight weeks later, morphometric and histologic analyses of the mandible were performed. Regeneration of the condyle was demonstrated in the two condylectomy groups. In the condylectomy+appliance group, the shape and cartilage of the condyle were equivalent to a normal condyle. However, regeneration of the condyle was not observed in the two discectomy groups even with the use of the functional appliance. The articular disc appears to be crucial in the regeneration of a damaged condyle, suggesting that defects or damage to the articular disc may influence mandibular growth and regeneration or repair of the condyle. PMID:25030880

  15. Mandible, maxilla and cervical spine--a functional unit?

    PubMed

    Kubein-Meesenburg, D; Thieme, K M; Weber, S; Fanghanel, J; Dumont, C; Spassov, A; Hahn, W; Ihlow, D; Nagerl, H

    2008-11-01

    The motion patterns of mandibular points were recorded in vivo in closed, free movements of the mandible parallel to the sagittal-vertical plane. The points ran along loops which were valued by their area and length. All points whose loops included the same area under regarding the sense of circulation formed a straight line. Lines belonging to different areas were parallel. When the absolute areas of the oops were plotted for particular points a hollow depression with two minima resulted. The point that showed the lowest minimum in the depression corresponded to the position of the neuromuscular mandibular axis of rotation. The points running along equal loop lengths formed elliptical lines with a minimum below the condyle. The lines of constant loop area and loop length were overlaid with lateral radiographs, to match the patterns of motion with anatomical structures. The mandibular axis of rotation lay mostly cranial anterior of the condyle whereas the point with the shortest path lay mainly below this axis point, inside the bony structures. The row of teeth in the maxilla was found to be located below the line of minimal loop lengths. The cervical spine was arranged along the depression of the minimal absolute areas. PMID:19075327

  16. Giant aneurysmal bone cyst of the mandible with unusual presentation.

    PubMed

    Capote-Moreno, Ana; Acero, Julio; García-Recuero, Ignacio; Ruiz, Julián; Serrano, Rosario; de Paz, Víctor

    2009-03-01

    Aneurysmal bone cysts are rare benign lesions of bone tissue, infrequent in craneofacial skeleton with regard to other structures like long bones or the spine. They are composed of sinusoidal and vascular spaces blood-filled and surrounded by fibrous tissue septa. We present a case of a 29-year-old Caucasian male with a big swelling in the left mandible associated to pain and rapid growth. He referred previous extraction of the left inferior third molar. On the X-ray study, an expansive multilocular and high vascularized bony lesion within the mandibular angle was observed. It produced expansion and destruction of lingual and buccal cortex. An incisional biopsy was performed showing a fibrous tissue with blood-filled spaces lesion suggestive of an aneurysmal bone cyst. After selective embolization of the tumour, surgical resection was done with curettage and immediate reconstruction of the defect with an anterior iliac crest graft. Aneurysmal bone cysts are non-neoplastic but locally aggressive tumours with occasional rapid growth that may be differentiated from other multilocular process like ameloblastoma, ossifying fibroma, epithelial cyst, giant cell granuloma and sarcomas. Treatment of choice consists on conservative surgical excision of the mass with curettage or enucleation. When resection creates a big defect, primary surgical reconstruction is recommended. PMID:19242394

  17. Leiomyosarcoma in the mandible: A rare case report.

    PubMed

    Lewandowski, Bogumił; Brodowski, Robert; Pakla, Paweł; Stopyra, Wojciech; Gawron, Iwona

    2016-07-01

    Leiomyosarcoma (LMS) is a malignancy which very rarely occurs in maxillofacial location, and the course of the disease is not very characteristic.In this case report, we present a 58-year-old female patient with a painless tumor of the left angle of the mandible causing slight asymmetry of the face. She also reported that she observed deterioration in fitting of the lower denture in the oral cavity for several months, which she had used successfully for 5 years.On the basis of clinical tests, histopatological examination, and imaging (CT, MRI, ultrasound, pantomography), the patient was diagnosed with primary malignant leiomyosarcoma (LMS) of the mandibular corpus and ramus on the left side. The patient received combined surgical and oncological treatment. The first stage was a surgery, and then adjuvant radiotherapy was applied on the site of the resected tumor-a total dose of 60 Gy in 35 fractions. The patient's postoperative course was uneventful. She also underwent adjuvant therapy well. In the period of 3-year follow-up, no signs of recurrence were observed.The findings may extend our knowledge and experiences in the treatment of leiomvosarcoma in the craniofacial area. PMID:27399080

  18. Moving the mandible in orthognathic surgery - A multicenter analysis.

    PubMed

    Thiele, Oliver C; Kreppel, Matthias; Bittermann, Gido; Bonitz, Lars; Desmedt, Maria; Dittes, Carsten; Dörre, Annegret; Dunsche, Anton; Eckert, Alexander W; Ehrenfeld, Michael; Fleiner, Bernd; Frerich, Bernhard; Gaggl, Alexander; Gerressen, Marcus; Gmelin, Leonore; Hammacher, Andreas; Haßfeld, Stefan; Heiland, Max; Hemprich, Alexander; Hidding, Johannes; Hölzle, Frank; Howaldt, Hans-Peter; Iizuka, Tateyuki; Kater, Wolfgang; Klein, Cornelius; Klein, Martin; Köhnke, Robert H; Kolk, Andreas; Kübler, Alexander C; Kübler, Norbert R; Kunkel, Martin; Kuttenberger, Johannes J; Kreusch, Thomas; Landes, Constantin; Lehner, Bernhard; Mischkowski, Robert A; Mokros, Steffen; Neff, Andreas; Nkenke, Emeka; Palm, Frank; Paulus, Gerhard W; Piesold, Jörn U; Rasse, Michael; Rodemer, Herbert; Rothamel, Daniel; Rustemeyer, Jan; Sader, Robert; Scheer, Martin; Scheffler, Birgit; Schippers, Christian; Schliephake, Henning; Schmelzeisen, Rainer; Schramm, Alexander; Spitzer, Wolfgang J; Stoll, Christian; Terheyden, Hendrik; Weingart, Dieter; Wiltfang, Jörg; Wolff, Klaus D; Ziegler, Christoph M; Zöller, Joachim E

    2016-05-01

    Orthognathic surgery has always been a classical focus of maxillofacial surgery. Since more than 100 years, various surgical techniques for mandibular repositioning have been developed and clinically tested. Since the establishment of plate and screw osteosynthesis, orthognathic surgery became more stable and safe. Nowadays, different surgical methods for mobilising the mandible are existing. This international multicenter analysis (n = 51 hospitals) is providing first evidence based data for the current use of different surgical methods. The dominating techniques were Obwegeser/dal Pont (61%) followed by Hunsuck/Epker (37%) and Perthes/Schlössmann (29%). The main osteosynthesis materials were plates (82%), bicortical screws (23.5%), or a combination of both (5.9%). 47% of all centers reported to use several surgical methods at the same time, depending on the anatomical problem and the surgeon's preference. This shows that different surgical methods seem to work as comparable, safe, and reliable procedures in everydays clinical practise. On this basis, further prospective studies could evaluate possible advantages for our patients. PMID:27017103

  19. Spinal hemianesthesia: Unilateral and posterior

    PubMed Central

    Imbelloni, Luiz Eduardo

    2014-01-01

    The injection of a non-isobaric local anesthetic should induce a unilateral spinal anesthesia in patients in a lateral decubitus position. The posterior spinal hemianesthesia only be obtained with hypobaric solutions injected in the jackknife position. The most important factors to be considered when performing a spinal hemianesthesia are: type and gauge of the needle, density of the local anesthetic relative to the CSF, position of the patient, speed of administration of the solution, time of stay in position, and dose/concentration/volume of the anesthetic solution. The distance between the spinal roots on the right-left sides and anterior-posterior is, approximately, 10-15 mm. This distance allows performing unilateral spinal anesthesia or posterior spinal anesthesia. The great advantage of obtaining spinal hemianesthesia is the reduction of cardiovascular changes. Likewise, both the dorsal and unilateral sensory block predominates in relation to the motor block. Because of the numerous advantages of producing spinal hemianesthesia, anesthesiologists should apply this technique more often. This review considers the factors which are relevant, plausible and proven to obtain spinal hemianesthesia. PMID:25886320

  20. The effect of mandibular buccal tilting on the accuracy of posterior mandibular spiral tomographic images: An in vitro study

    PubMed Central

    Sheikhi, Mahnaz; Maleki, Vida

    2011-01-01

    Background: Accurate measurement of the height and buccolingual thickness of available bone has a significant role in dental implantology. The shadow of ramus on the mandibular second molar region disturbs the sharpness of conventional tomographic images. The aim of this study was to evaluate the effect of transferring the shadow of ramus from the center of the focal plane, by changing the position of mandible, on the sharpness of the posterior mandibular region. Materials and Methods: In this experimental study, we used 10 dry human mandibles. Three metal balls were mounted on the midline and mandibular second molar regions bilaterally. Standard panoramic and tomographic images were taken. Then, the mandible was tilted buccaly for 8° – compensating the normal lingual inclination of the mandibular ridge and teeth on this region – and tomographic images were taken again. The height and thickness of bone were measured on the images and then compared with the real amounts measured directly on mandibles. Also, the sharpness of mandibular canals was compared between the two tomographic methods. Findings were analyzed with repeated measured ANOVA test (P<0.05). Results: The height of mandibular bone, on the images of the tilted tomography technique was more accurate compared to standard (P<0.001), but standard tomography had more accuracy in estimating the buccolingual thickness at the half-height point. Regarding the sharpness of mandibular canals, we found no significant differences between two tomographic methods. Conclusion: Buccal tilting is recommended when measuring the bone height is more important, but routine standard tomography is preferred when the thickness is requested. PMID:23372586

  1. Antero-posterior lingual sliding retraction system for orthodontic correction of hyperdivergent Class II protrusion

    PubMed Central

    2014-01-01

    Background This report introduces a lingual bonded retraction system (Kinematics of Lingual Bar on Non-Paralleling Technique, KILBON) for efficient sliding mechanics combined with vertical control of the anterior and posterior teeth, which is suitable for Class II hyperdivergent patients. Methods Design and biomechanics of the KILBON System were described. Two adults with hyperdivergent class II malocclusion were treated with the KILBON system and temporary skeletal anchorage devices (TSADs) on the palate. The first patient was treated with conventional KILBON system on the upper arch and detailed with lingual appliances. The second patient showed the modified design of the KILBON when applied to a low palatal vault. Results A large amount of intrusion and retraction of the anterior teeth and simultaneous intrusion of the posterior segment were achieved in short treatment time. Concomitant counterclockwise rotation of the mandible improved the esthetic profile. Periodontal support without dehiscence or bone loss was confirmed on anterior region in spite of large amount of retraction. Conclusions This report presented a lingual retraction system that provides simple and effective vertical and sagittal control of both anterior and posterior teeth. The biomechanics are dependable for correcting a dentoalveolar protrusion in a patient with Class II hyperdivergent skeletal pattern. PMID:24897979

  2. A strong association between thyrotropin receptor-blocking antibody-positive atrophic autoimmune thyroiditis and HLA-DR8 and HLA-DQB1 0302 in Koreans

    SciTech Connect

    Cho, Bo Youn; Chung, Jae Hoon; Lee, Hong Kyu; Koh, Chang-Soon; Lee, Jung-Bin ); Shong, Young Kee ); Han, Hoon ); Chang, Youn Bok )

    1993-09-01

    The authors investigated whether the associations between HLA alleles of patients with autoimmune hypothyroidism varied according to the presence or absence of TSH receptor-blocking antibody (TRBab). They analyzed the HLA-A, -B, -C, and -DR antigens by serotyping and the DQA1 and DQB1 genes using both enzymatic DNA amplification and sequence-specific oligonucleotide hybridizations. The patient population consisted of 47 Korean patients with atrophic autoimmune thyroiditis and 62 patients with goitrous autoimmune thyroiditis. The antigen frequency of HLA-DR8 was significantly increased in 23 atrophic autoimmune thyroiditis patients that were positive for TSH binding inhibitor immunoglobulin (TBII) compared to 136 controls [52% vs. 16%; x[sup 2] = 13.1; Pc (corrected P value) = 0.003]. This relative risk was 5.7; the etiological fraction was 0.43. HLA-DQB1*0302 was also increased in patients with TBII-positive atrophic autoimmune thyroiditis (24% vs. 7%; x[sup 2] = 11.2; Pc = 0.012; relative risk = 4.4; etiological fraction = 0.19). No specific DR antigens or DQB1 alleles were increased in either TBII-negative atrophic autoimmune thyroidities or goitrous autoimmune thyroiditis. A significant decrease in the frequency of HLA-DR6 antigen was observed in both TBII-positive atrophic antoimmune thyroiditis (0% vs. 32%; x[sup 2] = 8.4; Pc = 0.03) and goitrous autoimmune thyroiditis (0% vs. 32%; x[sup 2] = 23.2; Pc < 0.001) patients. The frequency of the HLC-Cwl antigen was significantly increased in all patient groups. The authors conclude that TRBab-positive atrophic autoimmune thyroiditis is immunogenetically different from both goitrous autoimmune thyroiditis and TRBab-negative atrophic autoimmune thyroiditis. It is possible that HLA-DR8 and/or DQB1*0302 may be related to the susceptibility genes involved in the production of TRBab in Koreans. 32 refs., 5 tabs.

  3. Risk factors for atrophic chronic gastritis in a European population: results of the Eurohepygast study

    PubMed Central

    2002-01-01

    Background and aims: The development of atrophic chronic gastritis (ACG) is multifactorial, involving environment as well as host responses to Helicobacter pylori infection. The aim of this study was to determine factors involved in ACG in a European dyspeptic population. Methods: Data concerning sociodemographics, social behaviour, biological aspects, diet, and virulence factors of H pylori strains were collected in a cross sectional study from 19 European centres in 14 countries. Dyspeptic H pylori positive patients with ACG or non-ACG (NACG) at histology were included. Anti-CagA antibodies were evaluated by two immunoblot tests and anti-VacA antibodies by one. Logistic regression models were constructed, and estimated odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated from the coefficients. Results: Of the 451 patients included in the study, 267 were analysed: 202 had NACG and 65 ACG. Mean age was 44.4 years and 63% were women. Risk factors for atrophy identified by multivariate analysis were: age over 60 years (OR 4.14, 95% CI 1.79–9.58), coffee consumption (OR 2.35, 95% CI 1.07–5.16), sedative consumption (OR 2.17, 95% CI 1.04–4.52), and harbouring anti-CagA and anti-VacA antibodies simultaneously (OR 3.09, 95% CI 1.26–7.56), while the odds were significantly reduced for those with an anxiety score of 6 or more (OR 0.45, 95% CI 0.21–0.99). Conclusion: The simultaneous presence of anti-CagA and anti-VacA antibodies enhanced the risk of ACG in European dyspeptic patients. Failure to discern diet and family history as risk factors for ACG may suggest that diet is homogeneous in Europe and that most of the risk factors for ACG identified so far are identical to risk factors for H pylori infection. PMID:12010878

  4. The complete genome sequence of a chronic atrophic gastritis Helicobacter pylori strain: Evolution during disease progression

    PubMed Central

    Oh, Jung D.; Kling-Bäckhed, Helene; Giannakis, Marios; Xu, Jian; Fulton, Robert S.; Fulton, Lucinda A.; Cordum, Holland S.; Wang, Chunyan; Elliott, Glendoria; Edwards, Jennifer; Mardis, Elaine R.; Engstrand, Lars G.; Gordon, Jeffrey I.

    2006-01-01

    Helicobacter pylori produces acute superficial gastritis in nearly all of its human hosts. However, a subset of individuals develops chronic atrophic gastritis (ChAG), a condition characterized in part by diminished numbers of acid-producing parietal cells and increased risk for development of gastric adenocarcinoma. Previously, we used a gnotobiotic transgenic mouse model with an engineered ablation of parietal cells to show that loss of parietal cells provides an opportunity for a H. pylori isolate from a patient with ChAG (HPAG1) to bind to, enter, and persist within gastric stem cells. This finding raises the question of how ChAG influences H. pylori genome evolution, physiology, and tumorigenesis. Here we describe the 1,596,366-bp HPAG1 genome. Custom HPAG1 Affymetrix GeneChips, representing 99.6% of its predicted ORFs, were used for whole-genome genotyping of additional H. pylori ChAG isolates obtained from Swedish patients enrolled in a case-control study of gastric cancer, as well as ChAG- and cancer-associated isolates from an individual who progressed from ChAG to gastric adenocarcinoma. The results reveal a shared gene signature among ChAG strains, as well as genes that may have been lost or gained during progression to adenocarcinoma. Whole-genome transcriptional profiling of HPAG1’s response to acid during in vitro growth indicates that genes encoding components of metal uptake and utilization pathways, outer membrane proteins, and virulence factors are among those associated with H. pylori’s adaptation to ChAG. PMID:16788065

  5. Accuracy of GastroPanel for the diagnosis of atrophic gastritis

    PubMed Central

    Forné, Montserrat; Barrio, Jesus; De la Coba, Cristobal; González, Begoña; Rivera, Robin; Esteve, Maria; Fernandez-Bañares, Fernando; Madrigal, Beatriz; Gras-Miralles, Beatriz; Perez-Aisa, Angeles; Viver-Pi-Sunyer, Jose M.; Bory, Felipe; Rosinach, Merce; Loras, Carmen; Esteban, Carlos; Santolaria, Santos; Gomollon, Fernando; Valle, Julio; Gisbert, Javier P.

    2014-01-01

    Background It has been suggested that GastroPanel might be a useful tool for the diagnosis of chronic atrophic gastritis (CAG) measuring four biomarkers in blood: basal gastrin-17 (G17), pepsinogen I and II (PGI and PGII), and Helicobacter pylori antibodies. Aim To determine the accuracy of GastroPanel for the diagnosis of CAG. Methods This was a prospective, blinded, multicenter study that included dyspeptic patients. G17, PGI, and PGII were determined by enzyme immunoassays. Three antrum and two corpus biopsies were obtained for standard histological analysis and rapid urease test. Biopsies were analyzed by a single blinded expert pathologist. Results Ninety-one patients were included (77% women, mean age 44 years, 51% H. pylori positive, 17% with CAG). G17 was reduced in patients with antrum CAG (5.4 vs. 13.4 pmol/l; P<0.01) and increased in patients with corpus CAG (11 vs. 24 pmol/l; P<0.05), but its accuracy was only acceptable in the case of corpus localization [area under the receiver operating characteristic curve (AUC), 74%]; PGII difference was almost statistically significant only when testing for corpus atrophy (33 vs. 21 μg/l; P=0.05; AUC=72%). The PGI and PGI/PGII ratio showed no significant differences (AUCs were all unacceptably low). Helicobacter pylori antibody levels were higher in H. pylori-infected patients (251 vs. 109 EIU, P=0.01; AUC=70). The accuracy of GastroPanel for the diagnosis of CAG was as follows: sensitivity 50%; specificity 80%; positive 25% and negative 92% predictive values; and positive 2.4 and negative 0.6 likelihood ratios. Conclusion GastroPanel is not accurate enough for the diagnosis of CAG; thus, its systematic use in clinical practice cannot be recommended. PMID:25014624

  6. Investigation of the influence of mallet and chisel techniques on the lingual fracture line and comparison with the use of splitter and separators during sagittal split osteotomy in cadaveric pig mandibles.

    PubMed

    Verweij, Jop P; Mensink, Gertjan; Houppermans, Pascal N W J; Frank, Michael D; van Merkesteyn, J P Richard

    2015-04-01

    In bilateral sagittal split osteotomy the proximal and distal segments of the mandible are traditionally separated using chisels. Modern modifications include prying and spreading the segments with splitters. This study investigates the lingual fracture patterns and status of the nerve after sagittal split osteotomy (SSO) using the traditional chisel technique and compares these results with earlier studies using the splitter technique. Lingual fractures after SSO in cadaveric pig mandibles were analysed using a lingual split scale and split scoring system. Iatrogenic damage to the inferior alveolar nerve was assessed. Fractures started through the caudal cortex more frequently in the chisel group. This group showed more posterior lingual fractures, although this difference was not statistically significant. Nerve damage was present in three cases in the chisel group, but was not observed in the splitter group. A trend was apparent, that SSO using the chisel technique instead of the splitter technique resulted in more posterior lingual fracture lines, although this difference was not statistically significant. Both techniques resulted in reliable lingual fracture patterns. Splitting without chisels could prevent nerve damage, therefore we propose a spreading and prying technique with splitter and separators. However, caution should be exercised when extrapolating these results to the clinic. PMID:25697050

  7. Management of subcondylar mandible fractures in the adult patient.

    PubMed

    Hackenberg, Berit; Lee, Cameron; Caterson, E J

    2014-01-01

    The treatment of subcondylar mandible fractures is a topic of debate and can be variable even though these fractures are commonly seen. Historically, the treatment algorithm was between open reduction and closed treatment. Now, recent technical advances regarding the use of the endoscope in the field of craniofacial surgery provide additional treatment options. This article aimed to evaluate 3 current management strategies: closed reduction with maxillomandibular fixation, open reduction with internal fixation, and endoscopic-assisted reduction with internal fixation. We present our rationale for surgical decision making and attempt to develop an algorithmic approach to subcondylar fractures. Ankylosis of the temporomandibular joint is a feared complication in these fractures that can lead to the decision to apply maxillomandibular fixation for potentially too short of a period. It is the condylar head fractures within the joint's capsule that contain the hemarthrosis that are often responsible for ankylosis. Subcondylar fractures are, by definition, below the attachment of the joint capsule and in general are devoid of ankylosis. Therefore, maxillomandibular fixation is recommended to be applied for a period of 4 to 6 weeks in most cases. Open reduction with internal fixation can increase the risk for facial nerve damage during the operative approach. However, open reduction is often necessary in fracture patterns with a high degree of displacement. In these cases, facial nerve monitoring can successfully mitigate risks to allow safe exposure for open reduction with internal fixation of subcondylar fractures. Endoscopic-assisted reduction with internal fixation combines the benefits of both techniques while minimizing their associated risks. Nevertheless, reduction can be difficult especially when there is significant medial displacement of the proximal fracture fragment. In our experience, the endoscopic option is optimal for mildly displaced fractures and for

  8. How does the mandible grow after early high condylectomy?

    PubMed

    Di Blasio, Chiara; Di Blasio, Alberto; Pedrazzi, Giuseppe; Anghinoni, Marilena; Sesenna, Enrico

    2015-05-01

    The early high condylectomy (HC), removing the overgrowing area of the condyle, may be indicated for condylar hyperplasia. However, in young patients, when the HC removes the pathological overgrowing tissue the contralateral condyle is still growing. May this surgical procedure, in these growing patients, stop the operated side growth creating the conditions for an opposite asymmetry? Authors investigate the way the operated mandible develops after the early HC, both as a symmetry percentage and in an absolute value related to the unaffected side. A sample of 8 consecutive growing patients, 1 male and 7 females, referred to the Maxillofacial Surgery Department of Parma University for HC were investigated. Patients were longitudinally studied with 3 orthopantomographies at: T0 (diagnosis: mean age, 13 years; range, 11 years 2 months to 13 years 8 months), T1 (after surgery: mean age, 15; range, 13-18 years) and T2 (follow-up: mean age, 18 years; range, 17-20 years). The x-ray is used to study the condyle, ramus, and total vertical structures length by Mattila tracing method. The data were analyzed by the Student t test and Wilcoxon matched pairs test; P value was set at 0.5. The operated side was overcorrected by HC and; during the investigated period, its growth decreased from T0 to T1 and restarted from T1 to T2. The whole T0-T2 growth of the operated side was not statistically different from the one of the healthy side (P < 0.05). These results suggest that the operated side growth may continue in a more normal way after condylectomy. PMID:25974787

  9. Isolated posterior cruciate ligament calcification.

    PubMed

    Koukoulias, Nikolaos E; Papastergiou, Stergios G

    2011-01-01

    The authors present a case of calcified posterior cruciate ligament (PCL). A 61-year-old female presented in our department reporting 12 months history of knee pain that was getting worse during the night. The patient was under medication for epileptic seizure, osteoporosis and hyperthyroidism. X-rays demonstrated calcification of the PCL. CT and MRI excluded any other intra-articular and extra-articular pathology. Arthroscopic debridement of the calcium deposits was performed and the symptoms resolved immediately, while the postoperative x-rays were normal. Histological examination confirmed the calcium nature of the lesion. Two years postoperatively the patient remains asymptomatic. PMID:22669889

  10. Isolated posterior cruciate ligament calcification

    PubMed Central

    Koukoulias, Nikolaos E; Papastergiou, Stergios G

    2011-01-01

    The authors present a case of calcified posterior cruciate ligament (PCL). A 61-year-old female presented in our department reporting 12 months history of knee pain that was getting worse during the night. The patient was under medication for epileptic seizure, osteoporosis and hyperthyroidism. X-rays demonstrated calcification of the PCL. CT and MRI excluded any other intra-articular and extra-articular pathology. Arthroscopic debridement of the calcium deposits was performed and the symptoms resolved immediately, while the postoperative x-rays were normal. Histological examination confirmed the calcium nature of the lesion. Two years postoperatively the patient remains asymptomatic. PMID:22669889

  11. Posterior ankyloglossia: a case report.

    PubMed

    Chu, Michael W; Bloom, David C

    2009-06-01

    Ankyloglossia, or tongue-tie, refers to an abnormally short lingual frenulum. Ankyloglossia is a recognized but poorly defined condition and has been reported to cause feeding difficulties, dysarthria, dyspnea, and social or mechanical problems. In infants, the most concerning symptoms are feeding difficulties and inability to breastfeed. While a recent trend toward breastfeeding has brought frenulectomy back into favor, the literature regarding treatment remains inconclusive. We report a case of posterior ankyloglossia with anterior mucosal hooding and a simple, safe, and effective way to treat it to improve breastfeeding. PMID:19303646

  12. Cap’n’collar differentiates the mandible from the maxilla in the beetle Tribolium castaneum

    PubMed Central

    2012-01-01

    Background The biting mandible of the arthropods is thought to have evolved in the ancestor of the insects, crustaceans and myriapods: the Mandibulata. A unique origin suggests a common set of developmental genes will be required to pattern the mandible in different arthropods. To date we have functional studies on patterning of the mandibular segment of Drosophila melanogaster showing in particular the effects of the gene cap’n’collar (cnc), however, the dipteran head is far from representative of insects or of more distantly related mandibulates; Drosophila does not even possess a mandibular appendage. To study the development of a more representative insect mandible, we chose the red flour beetle Tribolium castaneum and investigated the function of the Tribolium orthologs of cap’n’collar (Tc-cnc) and the Hox gene Deformed (Tc-Dfd). In order to determine the function of Tc-cnc and Tc-Dfd, transcripts were knocked down by maternal RNA interference (RNAi). The effects of gene knockdown were examined in the developing embryos and larvae. The effect of Tc-cnc and Tc-Dfd knockdown on the expression of other genes was determined by using in situ hybridization on Tribolium embryos. Results Our analyses show that Tc-cnc is required for specification of the identity of the mandibular segment of Tribolium and differentiates the mandible from maxillary identity. Loss of Tc-cnc function results in a transformation of the mandible to maxillary identity as well as deletion of the labrum. Tc-Dfd and the Tribolium homolog of proboscipedia (Tc-mxp = maxillopedia), Hox genes that are required to pattern the maxillary appendage, are expressed in a maxilla-like manner in the transformed mandible. Tribolium homologs of paired (Tc-prd) and Distal-less (Tc-Dll) that are expressed in the endites and telopodites of embryonic appendages are also expressed in a maxilla-like manner in the transformed mandible. We also show that Tc-Dfd is required to activate the collar of Tc

  13. Fast and Powerful: Biomechanics and Bite Forces of the Mandibles in the American Cockroach Periplaneta americana

    PubMed Central

    Weihmann, Tom; Reinhardt, Lars; Weißing, Kevin; Siebert, Tobias; Wipfler, Benjamin

    2015-01-01

    Knowing the functionality and capabilities of masticatory apparatuses is essential for the ecological classification of jawed organisms. Nevertheless insects, especially with their outstanding high species number providing an overwhelming morphological diversity, are notoriously underexplored with respect to maximum bite forces and their dependency on the mandible opening angles. Aiming for a general understanding of insect biting, we examined the generalist feeding cockroach Periplaneta americana, characterized by its primitive chewing mouth parts. We measured active isometric bite forces and passive forces caused by joint resistance over the entire mandibular range with a custom-built 2D force transducer. The opening angle of the mandibles was quantified by using a video system. With respect to the effective mechanical advantage of the mandibles and the cross-section areas, we calculated the forces exerted by the mandible closer muscles and the corresponding muscle stress values. Comparisons with the scarce data available revealed close similarities of the cockroaches’ mandible closer stress values (58 N/cm2) to that of smaller specialist carnivorous ground beetles, but strikingly higher values than in larger stag beetles. In contrast to available datasets our results imply the activity of faster and slower muscle fibres, with the latter becoming active only when the animals chew on tough material which requires repetitive, hard biting. Under such circumstances the coactivity of fast and slow fibres provides a force boost which is not available during short-term activities, since long latencies prevent a specific effective employment of the slow fibres in this case. PMID:26559671

  14. Mandible-first sequence in bimaxillary orthognathic surgery: a systematic review.

    PubMed

    Borba, A M; Borges, A H; Cé, P S; Venturi, B A; Naclério-Homem, M G; Miloro, M

    2016-04-01

    The sequencing of bimaxillary orthognathic surgery remains controversial, although the traditional maxilla-first approach is performed routinely. The goal of this study was to present a systematic review of the mandible-first sequence in bimaxillary orthognathic surgery, to provide data that may assist in the decision as to which jaw should undergo osteotomy first in bimaxillary orthognathic surgery cases. A literature search was conducted for articles published in the English language, reporting the use of the altered sequence for bimaxillary orthognathic surgery (mandible-first), using the following descriptors: 'orthognathic' and 'double-jaw', 'orthognathic' and 'two-jaw', 'orthognathic' and 'mandible-first', 'orthognathic' and 'bimaxillary'. Eight hundred eighty-seven abstracts were initially identified and were evaluated for inclusion according to the proposed inclusion criteria. After evaluation of these abstracts and relevant references, six publications met the criteria for consideration. Performing mandible-first surgery in bimaxillary orthognathic cases dates back to the 1970s; however the decision regarding the jaw to be operated on first seems to rely on accurate preoperative planning based upon the surgeon's experience and preference. While there appear to be significant theoretical advantages to support the use of the altered orthognathic sequence (mandible-first), future prospective studies on its reliability, accuracy, and short- and long-term outcomes are required. PMID:26603195

  15. Failure location prediction by finite element analysis for an additive manufactured mandible implant.

    PubMed

    Huo, Jinxing; Dérand, Per; Rännar, Lars-Erik; Hirsch, Jan-Michaél; Gamstedt, E Kristofer

    2015-09-01

    In order to reconstruct a patient with a bone defect in the mandible, a porous scaffold attached to a plate, both in a titanium alloy, was designed and manufactured using additive manufacturing. Regrettably, the implant fractured in vivo several months after surgery. The aim of this study was to investigate the failure of the implant and show a way of predicting the mechanical properties of the implant before surgery. All computed tomography data of the patient were preprocessed to remove metallic artefacts with metal deletion technique before mandible geometry reconstruction. The three-dimensional geometry of the patient's mandible was also reconstructed, and the implant was fixed to the bone model with screws in Mimics medical imaging software. A finite element model was established from the assembly of the mandible and the implant to study stresses developed during mastication. The stress distribution in the load-bearing plate was computed, and the location of main stress concentration in the plate was determined. Comparison between the fracture region and the location of the stress concentration shows that finite element analysis could serve as a tool for optimizing the design of mandible implants. PMID:26227805

  16. Regional, ontogenetic, and sex-related variations in elastic properties of cortical bone in baboon mandibles

    PubMed Central

    Wang, Qian; Ashley, Dennis W.; Dechow, Paul C.

    2010-01-01

    Understanding the mechanical features of cortical bone and their changes with growth and adaptation to function plays an important role in our ability to interpret the morphology and evolution of craniofacial skeletons. We assessed the elastic properties of cortical bone of juvenile and adult baboon mandibles using ultrasonic techniques. Results showed that, overall, cortical bone from baboon mandibles could be modeled as an orthotropic elastic solid. There were significant differences in the directions of maximum stiffness, thickness, density, and elastic stiffness among different functional areas, indicating regional adaptations. After maturity, the cortical bone becomes thicker, denser, and stiffer, but less anisotropic. There were differences in elastic properties of the corpus and ramus between male and female mandibles which are not observed in human mandibles. There were correlations between cortical thicknesses and densities, between bone elastic properties and microstructural configuration, and between the directions of maximum stiffness and bone anatomical axes in some areas. The relationships between bone extrinsic and intrinsic properties bring us insights into the integration of form and function in craniofacial skeletons and suggest that we need to consider both macroscopic form, microstructural variation, and the material properties of bone matrix when studying the functional properties and adaptive nature of the craniofacial skeleton in primates. The differences between baboon and human mandibles is at variance to the pattern of differences in crania, suggesting differences in bone adaption to varying skeletal geometries and loading regimes at both phylogenetic and ontogenetic levels. PMID:19927280

  17. Comparison between all-on-four and all-on-six treatment concepts and framework material on stress distribution in atrophic maxilla: A prototyping guided 3D-FEA study.

    PubMed

    Bhering, Cláudia Lopes Brilhante; Mesquita, Marcelo Ferraz; Kemmoku, Daniel Takanori; Noritomi, Pedro Yoshito; Consani, Rafael Leonardo Xediek; Barão, Valentim Adelino Ricardo

    2016-12-01

    We evaluated two treatment concepts for the rehabilitation of moderate atrophic maxilla with dental implants (all-on-four and all-on-six) and the effect of framework material on the stress distribution of implant-support system. A three-dimensional finite element model based on a prototype was built to simulate an entirely edentulous maxilla with moderate sinus pneumatization that was rehabilitated with a full-arch fixed dental prosthesis. Four standard implants were positioned according to the all-on-four concept and four standard implants and two short implants were placed according to the all-on-six concept. Three framework materials were evaluated: cobalt-chrome (CoCr), titanium (Ti) and zirconia (Zr), totalizing six groups. A unilateral oblique force of 150N was applied to the posterior teeth. The von Mises (σVM), maximum (σmax) and minimum (σmin) principal stress and displacements were obtained. All-on-six showed smaller σmin, σVM and σmax values on the cortical bone, implants and trabecular bone, respectively. All-on-four exhibited higher displacement levels. Ti presented the highest stress values on the cortical bone, implants, abutments, prosthetic screws and displacement levels. In conclusion, the all-on-six approach and framework stiffer materials showed the most favorable biomechanical behavior. However, the stress values did not exceed the bone resistance limits for both treatment concepts. PMID:27612765

  18. Computer-aided diagnostic method for classification of Alzheimer's disease with atrophic image features on MR images

    NASA Astrophysics Data System (ADS)

    Arimura, Hidetaka; Yoshiura, Takashi; Kumazawa, Seiji; Tanaka, Kazuhiro; Koga, Hiroshi; Mihara, Futoshi; Honda, Hiroshi; Sakai, Shuji; Toyofuku, Fukai; Higashida, Yoshiharu

    2008-03-01

    Our goal for this study was to attempt to develop a computer-aided diagnostic (CAD) method for classification of Alzheimer's disease (AD) with atrophic image features derived from specific anatomical regions in three-dimensional (3-D) T1-weighted magnetic resonance (MR) images. Specific regions related to the cerebral atrophy of AD were white matter and gray matter regions, and CSF regions in this study. Cerebral cortical gray matter regions were determined by extracting a brain and white matter regions based on a level set based method, whose speed function depended on gradient vectors in an original image and pixel values in grown regions. The CSF regions in cerebral sulci and lateral ventricles were extracted by wrapping the brain tightly with a zero level set determined from a level set function. Volumes of the specific regions and the cortical thickness were determined as atrophic image features. Average cortical thickness was calculated in 32 subregions, which were obtained by dividing each brain region. Finally, AD patients were classified by using a support vector machine, which was trained by the image features of AD and non-AD cases. We applied our CAD method to MR images of whole brains obtained from 29 clinically diagnosed AD cases and 25 non-AD cases. As a result, the area under a receiver operating characteristic (ROC) curve obtained by our computerized method was 0.901 based on a leave-one-out test in identification of AD cases among 54 cases including 8 AD patients at early stages. The accuracy for discrimination between 29 AD patients and 25 non-AD subjects was 0.840, which was determined at the point where the sensitivity was the same as the specificity on the ROC curve. This result showed that our CAD method based on atrophic image features may be promising for detecting AD patients by using 3-D MR images.

  19. Longevity of Posterior Composite Restorations

    PubMed Central

    Opdam, N.J.M.; van de Sande, F.H.; Bronkhorst, E.; Cenci, M.S.; Bottenberg, P.; Pallesen, U.; Gaengler, P.; Lindberg, A.; Huysmans, M.C.D.N.J.M.; van Dijken, J.W.

    2014-01-01

    The aim of this meta-analysis, based on individual participant data from several studies, was to investigate the influence of patient-, materials-, and tooth-related variables on the survival of posterior resin composite restorations. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a search resulting in 12 longitudinal studies of direct posterior resin composite restorations with at least 5 years’ follow-up. Original datasets were still available, including placement/failure/censoring of restorations, restored surfaces, materials used, reasons for clinical failure, and caries-risk status. A database including all restorations was constructed, and a multivariate Cox regression method was used to analyze variables of interest [patient (age; gender; caries-risk status), jaw (upper; lower), number of restored surfaces, resin composite and adhesive materials, and use of glass-ionomer cement as base/liner (present or absent)]. The hazard ratios with respective 95% confidence intervals were determined, and annual failure rates were calculated for subgroups. Of all restorations, 2,816 (2,585 Class II and 231 Class I) were included in the analysis, of which 569 failed during the observation period. Main reasons for failure were caries and fracture. The regression analyses showed a significantly higher risk of failure for restorations in high-caries-risk individuals and those with a higher number of restored surfaces. PMID:25048250

  20. Huge interparietal posterior fontanel meningohydroencephalocele

    PubMed Central

    Dos Santos, Manuel Filipe Dias; de Santa Barbara, Rita de Cassia

    2015-01-01

    Congenital encephalocele is a neural tube defect characterized by a sac-like protrusion of the brain, meninges, and other intracranial structures through the skull, which is caused by an embryonic development abnormality. The most common location is at the occipital bone, and its incidence varies according to different world regions. We report a case of an 1-month and 7-day-old male child with a huge interparietal-posterior fontanel meningohydroencephalocele, a rare occurrence. Physical examination and volumetric computed tomography were diagnostic. The encephalocele was surgically resected. Intradural and extradural approaches were performed; the bone defect was not primarily closed. Two days after surgery, the patient developed hydrocephaly requiring ventriculoperitoneal shunting. The surgical treatment of the meningohydroencephalocele of the interparietal-posterior fontanel may be accompanied by technical challenges and followed by complications due to the presence of large blood vessels under the overlying skin. In these cases, huge sacs herniate through large bone defects including meninges, brain, and blood vessels. The latter present communication with the superior sagittal sinus and ventricular system. A favorable surgical outcome generally follows an accurate strategy taking into account individual features of the lesion. PMID:26484324

  1. Narrow-implant-retained overdenture in an atrophic mandibular ridge: a case report with 6-year follow-up.

    PubMed

    Araujo, Carlos Roberto Garcia; Martins-Junior, Paulo Antonio; Araujo, Roberto Carlos de; Sa, Marcos Augusto de; Wassall, Thomaz; Ferreira, Anderson Jose

    2015-01-01

    When atrophic jaws compromise oral rehabilitation with conventional implants, narrow-diameter implants can be used. This case report describes treatment of an edentulous 75-year-old diabetic woman with a severely resorbed mandibular ridge. Her mandibular dentition was restored with an overdenture supported by 3 narrow implants and 1 mini implant. Her maxillary dentition was restored with a conventional complete denture. A 6-year clinical and radiographic follow-up confirmed that the narrow implants had provided effective stability for the overdenture, providing improvements in phonetics and masticatory ability at a low cost. PMID:26545281

  2. Association of nucleotide excision repair pathway gene polymorphisms with gastric cancer and atrophic gastritis risks

    PubMed Central

    Liu, Jingwei; Sun, Liping; Xu, Qian; Tu, Huakang; He, Caiyun; Xing, Chengzhong; Yuan, Yuan

    2016-01-01

    Polymorphisms of NER genes could change NER ability, thereby altering individual susceptibility to GC. We systematically analyzed 39 SNPs of 8 key genes of NER pathway in 2686 subjects including 898 gastric cancer (GC), 851 atrophic gastritis (AG) and 937 controls (CON) in northern Chinese. SNP genotyping were performed using Sequenom MassARRAY platform. The results demonstrated that DDB2 rs830083 GG genotype was significantly associated with increased GC risk compared with wildtype CC (OR=2.32, P = 6.62 × 10−9); XPC rs2607775 CG genotype conferred a 1.73 increased odds of GC risk than non-cancer subjects compared with wild-type CC (OR=1.73, P= 3.04 × 10−4). The combined detection of these two polymorphisms demonstrated even higher GC risk (OR=3.05). Haplotype analysis suggested that DDB2 rs2029298-rs326222-rs3781619-rs830083 GTAG haplotype was significantly associated with disease risk in each step of CON→AG→GC development (AG vs. CON: OR=2.88, P= 7.51 × 10−7; GC vs. AG: OR=2.90, P=5.68 × 10−15; GC vs. CON: OR=8.42, P=2.22 × 10−15); DDB2 GTAC haplotype was associated with reduced risk of GC compared with CON (OR=0.63, P= 8.31 × 10−12). XPC rs1870134-rs2228000- rs2228001-rs2470352-rs2607775 GCAAG haplotype conferred increased risk of GC compared with AG (OR=1.88, P= 6.98 × 10−4). XPA rs2808668 and drinking, DDB2 rs326222, rs3781619, rs830083 and smoking demonstrated significant interactions in AG; XPC rs2607775 had significant interaction with smoking in GC. In conclusion, NER pathway polymorphisms especially in “damage incision” step were significantly associated with GC risk and had interactions with environment factors. The detection of NER pathway polymorphisms such as DDB2 and XPC might be applied in the prediction of GC risk and personalized prevention in the future. NOVELTY & IMPACT STATEMENTS NER pathway polymorphisms especially in “damage incision” step were significantly associated with GC risk and had interactions with

  3. Association of nucleotide excision repair pathway gene polymorphisms with gastric cancer and atrophic gastritis risks.

    PubMed

    Liu, Jingwei; Sun, Liping; Xu, Qian; Tu, Huakang; He, Caiyun; Xing, Chengzhong; Yuan, Yuan

    2016-02-01

    Polymorphisms of NER genes could change NER ability, thereby altering individual susceptibility to GC. We systematically analyzed 39 SNPs of 8 key genes of NER pathway in 2686 subjects including 898 gastric cancer (GC), 851 atrophic gastritis (AG) and 937 controls (CON) in northern Chinese. SNP genotyping were performed using Sequenom MassARRAY platform. The results demonstrated that DDB2 rs830083 GG genotype was significantly associated with increased GC risk compared with wild-type CC (OR=2.32, P= 6.62 × 10-9); XPC rs2607775 CG genotype conferred a 1.73 increased odds of GC risk than non-cancer subjects compared with wild-type CC (OR=1.73, P= 3.04 × 10-4). The combined detection of these two polymorphisms demonstrated even higher GC risk (OR=3.05). Haplotype analysis suggested that DDB2 rs2029298-rs326222-rs3781619-rs830083 GTAG haplotype was significantly associated with disease risk in each step of CON→AG→GC development (AG vs. CON: OR=2.88, P= 7.51 × 10-7; GC vs. AG: OR=2.90, P=5.68 × 10-15; GC vs. CON: OR=8.42, P=2.22 × 10-15); DDB2 GTAC haplotype was associated with reduced risk of GC compared with CON (OR=0.63, P= 8.31 × 10-12). XPC rs1870134-rs2228000-rs2228001-rs2470352-rs2607775 GCAAG haplotype conferred increased risk of GC compared with AG (OR=1.88, P= 6.98 × 10-4). XPA rs2808668 and drinking, DDB2 rs326222, rs3781619, rs830083 and smoking demonstrated significant interactions in AG; XPC rs2607775 had significant interaction with smoking in GC. In conclusion, NER pathway polymorphisms especially in "damage incision" step were significantly associated with GC risk and had interactions with environment factors. The detection of NER pathway polymorphisms such as DDB2 and XPC might be applied in the prediction of GC risk and personalized prevention in the future. NER pathway polymorphisms especially in "damage incision" step were significantly associated with GC risk and had interactions with environment factors, which might be applied in the

  4. Central cavernous hemangioma of mandible: Case report and review of literature

    PubMed Central

    Dhiman, Neeraj Kumar; Jaiswara, Chandresh; Kumar, Naresh; Patne, Shashikant C. U.; Pandey, Arun; Verma, Vishal

    2015-01-01

    Intraosseous hemangiomas are one of the rarest lesion of jaw bones (0.5–1%) occurring most commonly in vertebral column, skull bone, and rarely in mandible. Mainly occurs in the second decade of life with female: male predilection (2:1). Origin of hemangiomas is still debatable. World Health Organization considers it as a true benign neoplasm of vascular origin, and many authors believe it to be a hamartoma. It is very difficult to diagnose due to variable clinical and radiological features. A biopsy is not done on a routine basis due to a higher risk of hemorrhage. Management is very difficult because of massive vascular network in that region. Here, we are presenting a case report of a 14-year-old boy with intraosseous hemangioma of right body of mandible, which was treated with en bloc surgical resection of mandible and followed by reconstruction. PMID:27390499

  5. A Novel Objective Method of Estimating the Age of Mandibles from African Elephants (Loxodonta africana Africana)

    PubMed Central

    Stansfield, Fiona J.

    2015-01-01

    The importance of assigning an accurate estimate of age and sex to elephant carcasses found in the wild has increased in recent years with the escalation in levels of poaching throughout Africa. Irregularities identified in current ageing techniques prompted the development of a new method to describe molar progression throughout life. Elephant mandibles (n = 323) were studied and a point near the distal dental alveolus was identified as being most useful in ranking each jaw according to molar progression. These ‘Age Reference Lines’ were then associated with an age scale based on previous studies and Zimbabwean mandibles of known age. The new ranking produced a single age scale that proved useful for both male and female mandibles up to the maximum lifespan age of 70–75 years. Methods to aid in molar identification and the sexing of found jaws were also identified. PMID:25970428

  6. A Novel Objective Method of Estimating the Age of Mandibles from African Elephants (Loxodonta africana Africana).

    PubMed

    Stansfield, Fiona J

    2015-01-01

    The importance of assigning an accurate estimate of age and sex to elephant carcasses found in the wild has increased in recent years with the escalation in levels of poaching throughout Africa. Irregularities identified in current ageing techniques prompted the development of a new method to describe molar progression throughout life. Elephant mandibles (n = 323) were studied and a point near the distal dental alveolus was identified as being most useful in ranking each jaw according to molar progression. These 'Age Reference Lines' were then associated with an age scale based on previous studies and Zimbabwean mandibles of known age. The new ranking produced a single age scale that proved useful for both male and female mandibles up to the maximum lifespan age of 70-75 years. Methods to aid in molar identification and the sexing of found jaws were also identified. PMID:25970428

  7. Successful treatment of osteonecrosis-induced fractured mandible with teriparatide therapy: A case report

    PubMed Central

    Yao, Mayumi; Shimo, Tsuyoshi; Ono, Yuko; Obata, Kyoichi; Yoshioka, Norie; Sasaki, Akira

    2016-01-01

    Introduction The management of medication-related osteonecrosis of the jaw (MRONJ) is controversial. To date, there is no established treatment for cases of advanced stage 3 MRONJ osteoporosis in elderly patients. Presentation An 87-year-old osteoporotic woman with osteonecrosis-induced left mandible fracture related to minodronate therapy was referred to us for treatment. She had a vertebral compression fracture concurrently and had started subcutaneous injection of teriparatide. After 18 months of treatment with teriparatide the pathological mandible fracture was healed and functional recovery of the occlusion was obtained by complete dentures. Discussion Teriparatide may have a powerful anabolic effect on bone, and promote bone regeneration against pathologic mandible fracture induced by MRONJ. Conclusion Based upon these findings, teriparatide might be beneficial for advanced stage 3 MRONJ osteoporosis in elderly patients. PMID:26947555

  8. Enamel-like apatite crown covering amorphous mineral in a crayfish mandible.

    PubMed

    Bentov, Shmuel; Zaslansky, Paul; Al-Sawalmih, Ali; Masic, Admir; Fratzl, Peter; Sagi, Amir; Berman, Amir; Aichmayer, Barbara

    2012-01-01

    Carbonated hydroxyapatite is the mineral found in vertebrate bones and teeth, whereas invertebrates utilize calcium carbonate in their mineralized organs. In particular, stable amorphous calcium carbonate is found in many crustaceans. Here we report on an unusual, crystalline enamel-like apatite layer found in the mandibles of the arthropod Cherax quadricarinatus (freshwater crayfish). Despite their very different thermodynamic stabilities, amorphous calcium carbonate, amorphous calcium phosphate, calcite and fluorapatite coexist in well-defined functional layers in close proximity within the mandible. The softer amorphous minerals are found primarily in the bulk of the mandible whereas apatite, the harder and less soluble mineral, forms a wear-resistant, enamel-like coating of the molar tooth. Our findings suggest a unique case of convergent evolution, where similar functional challenges of mastication led to independent developments of structurally and mechanically similar, apatite-based layers in the teeth of genetically remote phyla: vertebrates and crustaceans. PMID:22588301

  9. Epstein-barr virus-associated lymphoepithelioma-like carcinoma of mandible.

    PubMed

    Shet, Tanuja; Arora, Brijesh; Laskar, Siddhartha; Basak, Rajan; Kane, Shubhada; Kurkure, Purna

    2009-01-01

    We describe the first case of an lymphoepithelioma-like carcinoma (LEC) of the mandible with a view to discuss probable histogenesis from salivary gland inclusions in the mandible, effective therapy, the unusual pattern of nodal metastases, and association with the Epstein-Barr virus. An 11-year-old boy presented with a lytic lesion in the left mandible and bilateral neck node enlargement. Histologically, the biopsied metastatic neck nodes showed sinusoids distended with histiocytes and single large atypical cells that mimicked Hodgkin lymphoma. The mandibular tumor on biopsy showed morphology similar to an undifferentiated carcinoma or LEC of nasopharynx with nuclear Epstein-Barr virus-associated in situ hybridization signals. The patient received ifosfamide, cisplatin, and etoposide chemotherapy followed by a hemimandibulectomy, which did not reveal any residual tumor. Postoperative radiotherapy was completed, and 3 years later the patient is alive and free of disease. PMID:18457481

  10. Enamel-like apatite crown covering amorphous mineral in a crayfish mandible

    PubMed Central

    Bentov, Shmuel; Zaslansky, Paul; Al-Sawalmih, Ali; Masic, Admir; Fratzl, Peter; Sagi, Amir; Berman, Amir; Aichmayer, Barbara

    2012-01-01

    Carbonated hydroxyapatite is the mineral found in vertebrate bones and teeth, whereas invertebrates utilize calcium carbonate in their mineralized organs. In particular, stable amorphous calcium carbonate is found in many crustaceans. Here we report on an unusual, crystalline enamel-like apatite layer found in the mandibles of the arthropod Cherax quadricarinatus (freshwater crayfish). Despite their very different thermodynamic stabilities, amorphous calcium carbonate, amorphous calcium phosphate, calcite and fluorapatite coexist in well-defined functional layers in close proximity within the mandible. The softer amorphous minerals are found primarily in the bulk of the mandible whereas apatite, the harder and less soluble mineral, forms a wear-resistant, enamel-like coating of the molar tooth. Our findings suggest a unique case of convergent evolution, where similar functional challenges of mastication led to independent developments of structurally and mechanically similar, apatite-based layers in the teeth of genetically remote phyla: vertebrates and crustaceans. PMID:22588301

  11. Osteopetrosis Complicated by Osteomyelitis of the Maxilla and Mandible: Light and Electron Microscopic Findings

    PubMed Central

    Ribeiro, Michel Campos; Sverzut, Cassio Edvard; Bonucci, Ermanno; Nanci, Antonio; de Oliveira, Paulo Tambasco

    2009-01-01

    This report presents a case of osteopetrosis in a 25-year-old male, which was complicated by the development of osteomyelitis in the maxilla and mandible following traumatic injury and tooth extractions. The osteomyelitis in the mandible was refractory to marginal resection and antibiotic therapy. Partial resection with mandible reconstruction was then carried out. Light and backscattered electron scanning microscopy revealed sclerosis of spongy bone and variations in mineral density of the bone matrix. There was also a prominent periosteal bone formation in regions affected by osteomyelitis. An 18-month follow-up showed absence of active infections in the face and oral structures, with a focal area of bone exposure in the right parasymphysis. However, development of anemia and bone marrow deficiency will likely affect prognosis. The importance of preventive oral health care and dental/periodontal managements in osteopetrosis is emphasized. PMID:20596853

  12. Swellings of the angle of the mandible in 32 horses (1997-2011).

    PubMed

    Dixon, P M; Loh, N; Barakzai, S Z

    2014-01-01

    Disorders of the horizontal ramus (body) of the equine mandible are well reported, but there is minimal documentation of disorders of the angle of mandible. A retrospective examination of the records of Edinburgh University Equine Hospital (1997-2011) showed that 32 horses were referred due to swellings of the angle of the mandible. The aetiology of these swellings was identified in just 13/32 cases (41%) including fractures (n=2), traumatic, localised periosteal/cortical lesions (n=4), traumatic soft tissue lesions (n=2), neoplasia (n=3), and inflammation of the adjacent salivary gland (n=1) and masseter muscle (n=1). The remaining 19 (59%) cases without a definitive diagnosis showed two patterns of lesions. Twelve cases had localised periosteal/cortical lesions of the ventral aspect of the angle of mandible that were most likely traumatic in origin. The remaining seven undiagnosed cases without mandibular bony changes all had sinus tracts/chronic soft tissue infections on the medial aspect of the angle of the mandible which were believed to be caused by a draining retro-pharyngeal lesion in five cases. Surgical excision of abnormal soft tissues (if present) and bone curettage was the most successful treatment. It was concluded that the aetiology of swellings of the angle of the equine mandible are often obscure; most appear to be traumatic in origin, yet horses seldom develop gross fractures at this site due to the support of the dense surrounding musculo-tendinous structures. A smaller proportion are caused by draining retropharyngeal lesions that respond poorly to medical therapy, but respond well to surgical treatment. PMID:24290988

  13. A new early Pleistocene hominin mandible from Atapuerca-TD6, Spain.

    PubMed

    Bermúdez de Castro, José María; Pérez-González, Alfredo; Martinón-Torres, María; Gómez-Robles, Aida; Rosell, Jordi; Prado, Leyre; Sarmiento, Susana; Carbonell, Eudald

    2008-10-01

    We present the description of a new mandibular specimen, ATD6-113, recovered in 2006 from the TD6 level of the Gran Dolina cave site in Sierra de Atapuerca, northern Spain. A detailed study of the lithostratigraphy of the top sequence of this level, the section from where all human remains have been recovered so far, is also presented. We have observed that the hominin stratum, previously defined as Aurora Stratum, represents a condensed deposit of at least six layers, which could not be distinguished in the test pit made in 1994-95. Therefore, the human fossil remains were probably deposited during a discrete and undetermined time period. The new mandibular fragment exhibits a very similar morphology to that of the most complete specimen, ATD6-96, which was recovered in 2003 from a different layer. This suggests that both specimens represent the same biological population. The two mandibles, as well as the small mandibular fragment ATD6-5 (which constitutes part of the holotype of Homo antecessor), present a morphological pattern clearly derived with regard to that of the African early Homo specimens usually included in H. habilis and H. rudolfensis, the mandibles D211 and D2735 from Dmanisi, and most of the early Pleistocene mandibles from Sangiran. The TD6 mandibles also exhibit some derived features with regard to the African early Pleistocene specimens included in H. ergaster (or African H. erectus). Thus, the TD6 hominins seem to represent a lineage different from other African and Asian lineages, although some (metric in particular) similarities with Chinese middle Pleistocene mandibles are noted. Interestingly, none of the apomorphic mandibular features of the European middle and early late Pleistocene hominins are present in the TD6 mandibles. PMID:18657300

  14. Minimally invasive posterior hamstring harvest.

    PubMed

    Wilson, Trent J; Lubowitz, James H

    2013-01-01

    Autogenous hamstring harvesting for knee ligament reconstruction is a well-established standard. Minimally invasive posterior hamstring harvest is a simple, efficient, reproducible technique for harvest of the semitendinosus or gracilis tendon or both medial hamstring tendons. A 2- to 3-cm longitudinal incision from the popliteal crease proximally, in line with the semitendinosus tendon, is sufficient. The deep fascia is bluntly penetrated, and the tendon or tendons are identified. Adhesions are dissected. Then, an open tendon stripper is used to release the tendon or tendons proximally; a closed, sharp tendon stripper is used to release the tendon or tendons from the pes. Layered, absorbable skin closure is performed, and the skin is covered with a skin sealant, bolster dressing, and plastic adhesive bandage for 2 weeks. PMID:24266003

  15. Primary Burkitt lymphoma in the posterior mediastinum.

    PubMed

    Chaari, Zied; Charfi, Slim; Hentati, Abdessalem; Ayadi, Ines; Abid, Hanene; Frikha, Imed

    2015-11-01

    A 13-year-old boy was admitted to our hospital with complaints of posterior chest pain and dyspnea. Computed tomography and magnetic resonance imaging of the chest revealed a mass in the posterior mediastinum, extending from T8 to T11 with intraspinal involvement. A percutaneous core needle biopsy confirmed the diagnosis of Burkitt lymphoma. He was treated according to the Lymphoma Malignancy B protocol 2001 arm C3, but he presented with liver and brain relapses and died 7.5 months after admission. Although lymphoma is rarely localized in the posterior mediastinum, it should be considered in the differential diagnosis of posterior mediastinal masses in children. PMID:26038605

  16. Secondary Metastasis to the Mandible From Breast Carcinoma -A Rare Case Report.

    PubMed

    Thorawat, Amit; Naikmasur, Venkatesh G; Patil, Preeti; Perumal, Priya

    2015-07-01

    Regardless of the rare occurrence of metastatic lesions to the jaw, it should be taken into consideration in the individuals with a history of malignancy. Early detection requires accurate examination, and microscopic evaluation is essential. In this paper we report a case of breast carcinoma to the mandible as female breast cancer is the most frequent metastatic lesion to the mandible and its metastasis is well documented. The patient's medical history revealed that she had undergone mastectomy on the left breast three years ago. As this condition is infrequently described, documentation of new cases will augment the existing knowledge. PMID:26393225

  17. Cemento-ossifying fibroma of mandible: An unusual case report and review of literature

    PubMed Central

    Mohapatra, Mounabati; Banushree, CS; Nagarajan, K; Pati, Debashish

    2015-01-01

    The term ossifying fibroma (OF) has recently been included under fibro-osseous lesions. Cemento-OF (COF) is a benign neoplasm that arises from the periodontal membrane which contains multipotential cells that are capable of forming cementum, lamellar bone and fibrous tissue. These tumors occur in the third and fourth decades of life with a predilection for women. The mandible is more commonly involved than the maxilla. This lesion has caused considerable controversy regarding the use of terminology, origin and diagnostic criteria. This article describes an unusual case of COF presenting as unilocular lytic lesion of mandible in a 38-year-old male patient with review of literature. PMID:26980975

  18. Multi Vesicular Osseous Hydatid Disease of the Mandible- A Case Report

    PubMed Central

    Shahoon, H; Esmaeili, M; Mobedi, I; Nematollahi, M

    2010-01-01

    Hydatid disease is a common and major public health issue caused by parasite Echinococcus granulosus. The highest prevalence of the parasite can be found in different parts of world like Africa, Australia, and South America. This infection can occurs in almost any part of the body. Here we present clinical, radiological, histological features and treatment of a multi vesicular osseous hydatid disease of the mandible in an Afghan 5 year old boy with a firm swelling in the right side of mandible. PMID:22347236

  19. The use of a new locking 90° blade plate in the treatment of atrophic proximal humerus nonunions

    PubMed Central

    Allende, Bartolome T.

    2008-01-01

    This level IV case series study prospectively evaluated patients with atrophic proximal humerus nonunions stabilised with a locking 90° blade plate. All patients were women with an average age of 69 years (range 56–78). Time from trauma to nonunion treatment averaged 23 months. Five patients had had previous surgical treatments. Two patients had a history of infection and one patient with active infection was reconstructed in two stages. Follow-up averaged 22 months (range 18–36); union was achieved in all seven cases after an average of 5.85 months. The DASH score at the last follow-up averaged 25 points and Constant score averaged 72.7 points. No patient required additional procedures. At the last follow-up all patients were free of infection, and there were no cases of avascular necrosis. The results with locked 90° blade plates in atrophic nonunions of the proximal humerus in adults were favourable in this series. PMID:18974986

  20. Inlay osteotome sinus floor elevation with concentrated growth factor application and simultaneous short implant placement in severely atrophic maxilla.

    PubMed

    Chen, Yonghui; Cai, Zhiyu; Zheng, Dingguo; Lin, Pei; Cai, Yahua; Hong, Shuxin; Lai, Yiwei; Wu, Dong

    2016-01-01

    Sinus floor elevation with simultaneous implant placement in severely atrophic maxilla is challenging. The aim of this retrospective study was to evaluate the short-term performance of modified osteotome sinus floor elevation (OSFE) with concentrated growth factor (CGF) application and concurrent placement of a short implant in cases with residual bone height (RBH) of 2-4 mm. Twenty-five short implants were installed in 16 patients with mean RBH of 3.23 mm using modified OSFE with CGFs from January 2012 to April 2014. Postoperatively, the implants were clinically evaluated, and vertical bone gain (VBG) was measured using cone beam computed tomography. The mean duration of follow-up was 19.88 months (12-32 months). All the implants were stable with an overall survival rate of 100%. The mean VBG immediately after surgery was 9.21 mm. Six months later, significant reduction of alveolar bone height (2.90 ± 0.22 mm) was found (P < 0.05). During the second 6-month period, further alveolar bone resorption (0.14 ± 0.11 mm) was noted but without significance (P > 0.05). Within the limits of this study, modified OSFE with CGF application and simultaneous short implant placement could yield predictable clinical results for severely atrophic maxilla with RBH of 2-4 mm. PMID:27250556

  1. An atrophic, telangiectatic patch at the distal border of the tongue: a mucous membrane manifestation of xeroderma pigmentosum.

    PubMed

    Bologna, Sheyla Batista; Harumi Nakajima Teshima, Tathyane; Lourenço, Silvia Vanessa; Nico, Marcello Menta Simonsen

    2014-01-01

    Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder characterized by clinical and cellular sensitivity, pigmentary changes, and early development of malignancies in sun-exposed mucocutaneous and ocular structures due to a defective ability to repair intracellular DNA damage. Individuals with XP also have a greater frequency of oral cancer, particularly squamous cell carcinoma of the anterior third of the tongue. The current study reports four cases of XP that exhibited a characteristic crescent-shaped, atrophic, telangiectatic area on the distal border of the tongue and correlates this lesion with the development of tumors at this site during follow-up. The tongue lesion was photographed and biopsied in the four patients. During routine follow-up visits, new biopsies were performed if additional tongue lesions were observed. The studied lesions were similar in the four patients. During follow-up, squamous cell carcinoma developed in one patient and pyogenic granuloma developed in three patients and was relapsing in one. The lesion remained stable in one patient during the study. The atrophic and telangiectatic patches probably occur because of chronic sun damage to the exposed portion of the tongue, and this area has a high predisposition for the development of benign and malignant tumors. PMID:24456184

  2. Effects of epidermal growth factor on atrophic enteritis in piglets induced by experimental porcine epidemic diarrhoea virus.

    PubMed

    Jung, Kwonil; Kang, Bo-Kyu; Kim, Jeom-Yong; Shin, Kyoung-Sun; Lee, Chul-Seung; Song, Dae-Sub

    2008-08-01

    Epidermal growth factor (EGF) promotes gastrointestinal mucosal recovery by stimulating the mitogenic activity of intestinal crypt epithelial cells. The aim of this study was to determine the effects of EGF on atrophic enteritis induced in piglets by experimental infection with porcine epidemic diarrhoea virus (PEDV) strain Dr13. Two groups of 12 conventional, colostrum-deprived, 1-day-old, large White-Duroc cross breed piglets were inoculated orally with PEDV (3 x 10(5) 50% tissue culture infective doses), with or without EGF (10 microg/kg/day, intraperitoneally once daily for 4 days after infection) and compared to 12 uninfected, untreated control piglets. PEDV+EGF piglets had less severe clinical signs than PEDV only piglets at 48 and 60 h post-infection (hpi). Histologically, the ratio of villous height:crypt depth of PEDV+EGF piglets was significantly higher than PEDV only piglets at 36 and 48 hpi. Immunohistochemistry for Ki67 demonstrated increased proliferation in intestinal crypt epithelial cells of PEDV+EGF piglets compared to PEDV only piglets at 36, 48 and 60 hpi. EGF stimulates proliferation of intestinal crypt epithelial cells and promotes recovery from atrophic enteritis in PEDV-infected piglets. PMID:17574457

  3. Inlay osteotome sinus floor elevation with concentrated growth factor application and simultaneous short implant placement in severely atrophic maxilla

    PubMed Central

    Chen, Yonghui; Cai, Zhiyu; Zheng, Dingguo; Lin, Pei; Cai, Yahua; Hong, Shuxin; Lai, Yiwei; Wu, Dong

    2016-01-01

    Sinus floor elevation with simultaneous implant placement in severely atrophic maxilla is challenging. The aim of this retrospective study was to evaluate the short-term performance of modified osteotome sinus floor elevation (OSFE) with concentrated growth factor (CGF) application and concurrent placement of a short implant in cases with residual bone height (RBH) of 2–4 mm. Twenty-five short implants were installed in 16 patients with mean RBH of 3.23 mm using modified OSFE with CGFs from January 2012 to April 2014. Postoperatively, the implants were clinically evaluated, and vertical bone gain (VBG) was measured using cone beam computed tomography. The mean duration of follow-up was 19.88 months (12–32 months). All the implants were stable with an overall survival rate of 100%. The mean VBG immediately after surgery was 9.21 mm. Six months later, significant reduction of alveolar bone height (2.90 ± 0.22 mm) was found (P < 0.05). During the second 6-month period, further alveolar bone resorption (0.14 ± 0.11 mm) was noted but without significance (P > 0.05). Within the limits of this study, modified OSFE with CGF application and simultaneous short implant placement could yield predictable clinical results for severely atrophic maxilla with RBH of 2–4 mm. PMID:27250556

  4. Tetanic contraction induces enhancement of fatigability and sarcomeric damage in atrophic skeletal muscle and its underlying molecular mechanisms.

    PubMed

    Yu, Zhi-Bin

    2013-11-01

    Muscle unloading due to long-term exposure of weightlessness or simulated weightlessness causes atrophy, loss of functional capacity, impaired locomotor coordination, and decreased resistance to fatigue in the antigravity muscles of the lower limbs. Besides reducing astronauts' mobility in space and on returning to a gravity environment, the molecular mechanisms for the adaptation of skeletal muscle to unloading also play an important medical role in conditions such as disuse and paralysis. The tail-suspended rat model was used to simulate the effects of weightlessness on skeletal muscles and to induce muscle unloading in the rat hindlimb. Our series studies have shown that the maximum of twitch tension and the twitch duration decreased significantly in the atrophic soleus muscles, the maximal tension of high-frequency tetanic contraction was significantly reduced in 2-week unloaded soleus muscles, however, the fatigability of high-frequency tetanic contraction increased after one week of unloading. The maximal isometric tension of intermittent tetanic contraction at optimal stimulating frequency did not alter in 1- and 2-week unloaded soleus, but significantly decreased in 4-week unloaded soleus. The 1-week unloaded soleus, but not extensor digitorum longus (EDL), was more susceptible to fatigue during intermittent tetanic contraction than the synchronous controls. The changes in K+ channel characteristics may increase the fatigability during high-frequency tetanic contraction in atrophic soleus muscles. High fatigability of intermittent tetanic contraction may be involved in enhanced activity of sarcoplasmic reticulum Ca(2+)-ATPase (SERCA) and switching from slow to fast isoform of myosin heavy chain, tropomyosin, troponin I and T subunit in atrophic soleus muscles. Unloaded soleus muscle also showed a decreased protein level of neuronal nitric oxide synthase (nNOS), and the reduction in nNOS-derived NO increased frequency of calcium sparks and elevated

  5. Class II Division 1 in New Dimension: Role of Posterior Transverse Interarch Discrepancy in Class II Division 1 Malocclusion During the Mixed Dentition Period

    PubMed Central

    Garg, Deepanshu; Mahajan, Neeraj; Bansal, Samriti; Sawhney, Anshul; Kaur, Jasvir; Tripathi, Shashank; Malaviya, Neha

    2015-01-01

    Introduction Posterior transverse discrepancy as seen in some cases of Class II Division 1 malocclusion in mixed dentition period can be related to typical skeletofacial characteristics. These features when studied early in the mixed dentition period give a clear view of the desired appropriate treatment plan in a particular case. Aim The purpose of this study was to establish a simple method to determine the posterior (intermolar) transverse discrepancy and craniofacial skeletal features between the dental arches during the mixed dentition in a sample of Class II Division 1 patients to provide diagnostic and therapeutic guidance in the early approach. Materials and Methods A sample of 60 Class II Division 1 patients in mixed dention that were divided into 30 Class II Division 1 patients with posterior transverse interarch discrepancy {Class II (I) PTID group} and 30 Class II Division 1 patients without posterior transverse interarch discrepancy {Class II (I) NPTID group}. Thirty Class I subjects in mixed dentition were included as control. Results The skeletal features of the Class II group without PTID are those of the skeletal Class II associated with ‘anatomic’ mandibular retrusion (due to a micrognathic mandible) and those of the Class II group with PTID as skeletal Class II associated with only a ‘functional’ mandibular retrusion (due to a posteriorly displaced mandible of normal size). Conclusion This study confirmed the role of occlusion in the control of maxillomandibular skeletal relationships.The treatment strategies could be planned on the basis of the transverse component of Class II Division 1 groups in the mixed dentition period. PMID:26417555

  6. Reverse engineering of mandible and prosthetic framework: Effect of titanium implants in conjunction with titanium milled full arch bridge prostheses on the biomechanics of the mandible.

    PubMed

    De Santis, Roberto; Gloria, Antonio; Russo, Teresa; D'Amora, Ugo; Varriale, Angelo; Veltri, Mario; Balleri, Piero; Mollica, Francesco; Riccitiello, Francesco; Ambrosio, Luigi

    2014-12-18

    This study aimed at investigating the effects of titanium implants and different configurations of full-arch prostheses on the biomechanics of edentulous mandibles. Reverse engineered, composite, anisotropic, edentulous mandibles made of a poly(methylmethacrylate) core and a glass fibre reinforced outer shell were rapid prototyped and instrumented with strain gauges. Brånemark implants RP platforms in conjunction with titanium Procera one-piece or two-piece bridges were used to simulate oral rehabilitations. A lateral load through the gonion regions was used to test the biomechanical effects of the rehabilitations. In addition, strains due to misfit of the one-piece titanium bridge were compared to those produced by one-piece cast gold bridges. Milled titanium bridges had a better fit than cast gold bridges. The stress distribution in mandibular bone rehabilitated with a one-piece bridge was more perturbed than that observed with a two-piece bridge. In particular the former induced a stress concentration and stress shielding in the molar and symphysis regions, while for the latter design these stresses were strongly reduced. In conclusion, prosthetic frameworks changed the biomechanics of the mandible as a result of both their design and manufacturing technology. PMID:25468297

  7. Mandibular fracture after endosseous implant placement in conjunction with inferior alveolar nerve transposition: a patient treatment report.

    PubMed

    Kan, J Y; Lozada, J L; Boyne, P J; Goodacre, C J; Rungcharassaeng, K

    1997-01-01

    A patient with a severely atrophic right posterior mandible had three endosseous implants placed in conjunction with transposition of the inferior alveolar nerve. Three weeks following implant placement surgery, the patient experienced a spontaneous fracture of the mandible involving the two anterior implants. The two implants were removed, and the fracture was treated with open reduction and fixation with titanium mesh. The fracture healed, and the posterior implant integrated. This report suggests that the buccolingual and superior-inferior position of the mandibular canal can increase the possibility of mandibular fracture by increasing the size of the buccal cortical plate that is removed to expose the nerve during surgery. PMID:9337027

  8. Pseudoaneurysm of the Posterior Tibial Artery After Posterior Tibial Tendon Transfer.

    PubMed

    Elabdi, Monsef; Roukhsi, Redouane; Tijani, Youssef; Chtata, Hassan; Jaafar, Abdeloihab

    2016-01-01

    Pseudoaneurysm of the posterior tibial artery is an uncommon condition that, left untreated, can lead to hemorrhage, thrombosis, or emboli. We present the case of a 54-year-old male who developed pseudoaneurysm of the posterior tibial artery 4 months after undergoing tibialis posterior tendon transfer for management of peroneal nerve palsy, which had developed as a complication of hip arthroplasty. PMID:26972754

  9. Posterior Cervical Foraminotomy: Indications, Technique, and Outcomes.

    PubMed

    Dodwad, Shah-Jahan M; Dodwad, Shah-Nawaz M; Prasarn, Mark L; Savage, Jason W; Patel, Alpesh A; Hsu, Wellington K

    2016-06-01

    Cervical radiculopathy presents with upper extremity pain, decreased sensation, and decreased strength caused by irritation of specific nerve root(s). After failure of conservative management, surgical options include anterior cervical decompression and fusion, disk arthroplasty, and posterior cervical foraminotomy. In this review, we discuss indications, techniques, and outcomes of posterior cervical laminoforaminotomy. PMID:27187617

  10. Consistently inconsistent, the posterior vaginal wall.

    PubMed

    Hale, Douglass S; Fenner, Dee

    2016-03-01

    Posterior vaginal wall prolapse is one of the most common prolapses encountered by gynecological surgeons. What appears to be a straightforward condition to diagnose and treat surgically for physicians has proven to be frustratingly unpredictable with regard to symptom relief for patients. Functional disorders such as dyssynergic defecation and constipation are often attributed to posterior vaginal wall prolapse. Little scientific evidence supports this assumption, emphasizing that structure and function are not synonymous when treating posterior vaginal wall prolapse. Rectoceles, enteroceles, sigmoidoceles, peritoneoceles, rectal and intraanal intussusception, rectal prolapse, and descending perineal syndrome are all conditions that have an impact on the posterior vaginal wall. All too often these different anatomic conditions are treated with the same surgical approach, addressing a posterior vaginal wall bulge with a traditional posterior colporrhaphy. Studies that examine the correlation between stage of posterior wall prolapse and patient symptoms have failed to reliably do so. Surgical outcomes measured by prolapse staging appear successful, yet patient expectations are often not met. As increasing attention is being placed on patient satisfaction outcomes concerning surgical treatments, this fact will need to be addressed. Surgeons will have to clearly communicate what can and what cannot be expected with surgical repair of posterior vaginal wall prolapse. PMID:26348375

  11. Preliminary observations on the mandibles of palaemonoid shrimp (Crustacea: Decapoda: Caridea: Palaemonoidea).

    PubMed

    Ashelby, Christopher W; De Grave, Sammy; Johnson, Magnus L

    2015-01-01

    The mandibles of caridean shrimps have been widely studied in the taxonomy and functional biology of the group. Within the Palaemonoidea the mandibles reach a high level of structural diversity reflecting the diverse lifestyles within the superfamily. However, the majority of studies have been restricted to light microscopy, with the ultrastructure at finer levels poorly known. This study investigates the mandible of nine species belonging to six of the recognised families of the Palaemonoidea using SEM and analyses the results in a phylogenetic and dietary framework. The results of the study indicate that little phylogenetic information is conveyed by the structure of the mandible, but that its form is influenced by primary food sources of each species. With the exception of Anchistioides antiguensis, all species examined possessed cuticular structures at the distal end of the pars molaris (molar process). Five types of cuticular structures are recognised herein, each with a unique form, but variable in number, placement and arrangement. Each type is presumed to have a different function which is likewise related to diet. PMID:25825676

  12. Multidrug-resistant viridans streptococcus (MDRVS) osteomyelitis of the mandible successfully treated with moxifloxacin.

    PubMed

    Ang, Jocelyn Y; Asmar, Basim I

    2008-05-01

    Multidrug-resistant viridans group streptococcus (MDRVS) strains have emerged as important pathogens. Treatment of MDRVS infections is problematic. The use of fluoroquinolones for treatment of MDRVS osteomyelitis has not been established. We present the first case of MDRVS osteomyelitis of the mandible successfully treated with sequential intravenous then oral moxifloxacin, and review the literature on the subject. PMID:18414152

  13. Genetic architecture of mandible shape in mice: effects of quantitative trait loci analyzed by geometric morphometrics.

    PubMed Central

    Klingenberg, C P; Leamy, L J; Routman, E J; Cheverud, J M

    2001-01-01

    This study introduces a new multivariate approach for analyzing the effects of quantitative trait loci (QTL) on shape and demonstrates this method for the mouse mandible. We quantified size and shape with the methods of geometric morphometrics, based on Procrustes superimposition of five morphological landmarks recorded on each mandible. Interval mapping for F(2) mice originating from an intercross of the LG/J and SM/J inbred strains revealed 12 QTL for size, 25 QTL for shape, and 5 QTL for left-right asymmetry. Multivariate ordination of QTL effects by principal component analysis identified two recurrent features of shape variation, which involved the positions of the coronoid and angular processes relative to each other and to the rest of the mandible. These patterns are reminiscent of the knockout phenotypes of a number of genes involved in mandible development, although only a few of these are possible candidates for QTL in our study. The variation of shape effects among the QTL showed no evidence of clustering into distinct groups, as would be expected from theories of morphological integration. Further, for most QTL, additive and dominance effects on shape were markedly different, implying overdominance for specific features of shape. We conclude that geometric morphometrics offers a promising new approach to address problems at the interface of evolutionary and developmental genetics. PMID:11156997

  14. Fracture of mandible during yawning in a patient with osteogenesis imperfecta

    PubMed Central

    Ram, Hari; Shadab, Mohammad; Vardaan, Ajay; Aga, Pallavi

    2014-01-01

    Osteogenesis imperfecta is a genetic disorder characterised by fragility and multiple fractures of bones. Clinical signs and symptoms vary depending on the type of disease. Fractures of facial bones are rare compared with load-bearing long bones. We report a case of fracture of the mandible during yawning which was managed by open reduction and internal fixation. PMID:25103485

  15. Preliminary observations on the mandibles of palaemonoid shrimp (Crustacea: Decapoda: Caridea: Palaemonoidea)

    PubMed Central

    De Grave, Sammy; Johnson, Magnus L.

    2015-01-01

    The mandibles of caridean shrimps have been widely studied in the taxonomy and functional biology of the group. Within the Palaemonoidea the mandibles reach a high level of structural diversity reflecting the diverse lifestyles within the superfamily. However, the majority of studies have been restricted to light microscopy, with the ultrastructure at finer levels poorly known. This study investigates the mandible of nine species belonging to six of the recognised families of the Palaemonoidea using SEM and analyses the results in a phylogenetic and dietary framework. The results of the study indicate that little phylogenetic information is conveyed by the structure of the mandible, but that its form is influenced by primary food sources of each species. With the exception of Anchistioides antiguensis, all species examined possessed cuticular structures at the distal end of the pars molaris (molar process). Five types of cuticular structures are recognised herein, each with a unique form, but variable in number, placement and arrangement. Each type is presumed to have a different function which is likewise related to diet. PMID:25825676

  16. Cineradiographic Examination of Articulatory Movement of Pseudo-Tongue, Hyoid, and Mandible in Congenital Aglossia

    ERIC Educational Resources Information Center

    McMicken, Betty; Vento-Wilson, Margaret; Von Berg, Shelley; Rogers, Kelly

    2014-01-01

    This research examined cineradiographic films (CRF) of articulatory movements in a person with congenital aglossia (PWCA) during speech production of four phrases. Pearson correlations and a multiple regression model investigated co-variation of independent variables, positions of mandible and hyoid; and pseudo-tongue-dependent variables,…

  17. The influence of simvastatin in rats mandible and femur bone mass under Freund's adjuvant arthritis.

    PubMed

    Seferos, Nikos; Pantopoulou, Alkistis; Kotsiou, Antonia; Rallis, Georgios; Tesseromatis, Christine

    2012-01-01

    OBJECTIVES. Complete Freund's Adjuvant (CFA)-induced arthritis in rats has been used widely as a model of rodent arthropathy and polyarthritis followed by osteoporosis, decreased bone formation and increased bone formation. Osteoporosis is characterized by rapid reduce of bone mass affecting more than 100 million people worldwide. Periodontitis a chronic inflammatory, of multifactorian origin disease has been associated with general osteoporosis. Protective bone-specific anabolic and antiresorptive effects of HMG-CoA reductase inhibitors have also been evaluated in normal and osteoporotic bone. AIM. The aim of the study was to investigate mandible and femur bone density in Freund's adjuvant induced arthritis rats under the influence of simvastatin. METHODS. Three groups (A, B, C) of 7 Wistar male rats each aged 3 months, (292±48.38 g) were used. A control. Group B and C subjected experimental arthritis via complete Freund's adjuvant injected in right paw. Group C was treated with simvastatin 0.5 mg/kg/daily po 14 days. Femur, mandible were isolated and sizes parameters, biochemical serum findings and BMD were estimated. RESULTS. CFA established by paw diameter, adrenals and spleen weight increase and thymus weight decrease, while biochemical serum findings were also affected. Reduced femur, mandible weight and general bone mass parameters BMD evaluated via DEXA occurred and restored under simvastatin treatment. CONCLUSIONS. CFA induced mandible and femur injuries are repaired by ssimvatatin treatment that could be therapeutically useful. PMID:23037783

  18. Protuberance or fossa on the lateral surface of the mandible in primates.

    PubMed

    Kondo, Shintaro; Naitoh, Munetaka; Matsuno, Masanobu; Kanazawa, Eisaku; Takai, Masanaru

    2016-01-01

    In order to clarify the morphological characteristics and function of the protuberance and/or fossa on the lateral surface of the mandible, we examined 778 mandibles of 9 genera, 19 species of non-human primates. Both protuberance and fossa were found in Macaca, Chlorocebus, and Cercocebus at frequencies ranging from 0% to 60%. The protuberance was composed of compact bone and was similar to the mandibular torus in humans. A well-developed protuberance extended from the fourth premolar to third molar region, and was situated at the central part of the mandibular body, or continued on the oblique line. Sometimes the protuberance localized on the mandibular base. A deep and large fossa was found in all individuals of Papio, Theropithecus, and Mandrillus, and the bone width was thin in the center of the fossa. The fossa extended from the third premolar to the second molar region, and the deepest area was the first molar region. In Macaca, Chlorocebus, and Cercocebus, the curvature of the external table of the mandible created a fossa. In Colobus, and Hylobates, the external surface of the mandible looked concave because of the thickened mandibular base. These concavo-convex structures have some biological functions and represent an adaptive change for mastication. PMID:25817174

  19. A rare case of angiofibroma of the mandible: A case report

    PubMed Central

    Ul Khaliq, Mohammed Israr; Shah, Ajaz A.; Dar, Nahida

    2016-01-01

    Angiofibroma is a rare, highly vascular nonencapsulated tumor, which is locally invasive. A rare case of angiofibroma of the mandible in a 16-year-old female patient is reported here. The lesion was excised along with surgical removal of right mandibular third molar tooth. Patient was followed up for 1 year without any recurrence. PMID:27195217

  20. Does 3D Phenotyping Yield Substantial Insights in the Genetics of the Mouse Mandible Shape?

    PubMed Central

    Navarro, Nicolas; Maga, A. Murat

    2016-01-01

    We describe the application of high-resolution 3D microcomputed tomography, together with 3D landmarks and geometric morphometrics, to validate and further improve previous quantitative genetic studies that reported QTL responsible for variation in the mandible shape of laboratory mice using a new backcross between C57BL/6J and A/J inbred strains. Despite the increasing availability of 3D imaging techniques, artificial flattening of the mandible by 2D imaging techniques seems at first an acceptable compromise for large-scale phenotyping protocols, thanks to an abundance of low-cost digital imaging systems such as microscopes or digital cameras. We evaluated the gain of information from considering explicitly this additional third dimension, and also from capturing variation on the bone surface where no precise anatomical landmark can be marked. Multivariate QTL mapping conducted with different landmark configurations (2D vs. 3D; manual vs. semilandmarks) broadly agreed with the findings of previous studies. Significantly more QTL (23) were identified and more precisely mapped when the mandible shape was captured with a large set of semilandmarks coupled with manual landmarks. It appears that finer phenotypic characterization of the mandibular shape with 3D landmarks, along with higher density genotyping, yields better insights into the genetic architecture of mandibular development. Most of the main variation is, nonetheless, preferentially embedded in the natural 2D plane of the hemi-mandible, reinforcing the results of earlier influential investigations. PMID:26921296

  1. Mesodermal Tbx1 is required for patterning the proximal mandible in mice

    PubMed Central

    Aggarwal, Vimla S.; Carpenter, Courtney; Freyer, Laina; Liao, Jun; Petti, Marilena; Morrow, Bernice E.

    2010-01-01

    Defects in the lower jaw, or mandible, occur commonly either as isolated malformations or in association with genetic syndromes. Understanding its formation and genetic pathways required for shaping its structure in mammalian model organisms will shed light into the pathogenesis of malformations in humans. The lower jaw is derived from the mandibular process of the first pharyngeal arch (MdPA1) during embryogenesis. Integral to the development of the mandible, is the signaling interplay between Fgf8 and Bmp4 in the rostral ectoderm and their downstream effector genes in the underlying neural crest derived mesenchyme. The non-neural crest MdPA1 core mesoderm is needed to form muscles of mastication, but its role in patterning the mandible is unknown. Here, we show that mesoderm specific deletion of Tbx1, a T- box transcription factor and gene for velo-cardio-facial/DiGeorge syndrome, results in defects in formation of the proximal mandible by shifting expression of Fgf8, Bmp4 and their downstream effector genes in mouse embryos at E10.5. This occurs without significant changes in cell proliferation or apoptosis at the same stage. Our results elucidate a new function for the non-neural crest core mesoderm and specifically, mesodermal Tbx1, in shaping the lower jaw. PMID:20501333

  2. mRNA expression characteristics are different in irreversibly atrophic intrinsic muscles of the forepaw compared with reversibly atrophic biceps in a rat model of obstetric brachial plexus palsy (OBPP).

    PubMed

    Wu, Ji-Xin; Chen, Liang; Ding, Fei; Chen, Le-Zi; Gu, Yu-Dong

    2016-04-01

    In obstetric brachial plexus palsy (OBPP), irreversible muscle atrophy occurs much faster in intrinsic muscles of the hand than in the biceps. To elucidate the mechanisms involved, mRNA expression profiles of denervated intrinsic muscles of the forepaw (IMF) and denervated biceps were determined by microarray using the rat model of OBPP where atrophy of IMF is irreversible while atrophy of biceps is reversible. Relative to contralateral control, 446 dysregulated mRNAs were detected in denervated IMF and mapped to 51 KEGG pathways, and 830 dysregulated mRNAs were detected in denervated biceps and mapped to 52 KEGG pathways. In denervated IMF, 10 of the pathways were related to muscle regulation; six with down-regulated and one with up-regulated mRNAs. The remaining three pathways had both up- and down-regulated mRNAs. In denervated biceps, 13 of the pathways were related to muscle regulation, six with up-regulated and seven with down-regulated mRNAs. Five of the pathways with up-regulated mRNAs were related to regrowth and differentiation of muscle cells. Among the 23 pathways with dysregulated mRNAs, 13 were involved in regulation of neuromuscular junctions. Our results demonstrated that mRNAs expression characteristics in irreversibly atrophic denervated IMF were different from those in reversibly atrophic denervated biceps; dysregulated mRNAs in IMF were associated with inactive pathways of muscle regulation, and in biceps they were associated with active pathways of regrowth and differentiation. Lack of self-repair potential in IMF may be a major reason why atrophy of IMF becomes irreversible much faster than atrophy of biceps after denervation. PMID:26902607

  3. Sexual dimorphism of the mandible in a contemporary Chinese Han population.

    PubMed

    Dong, Hongmei; Deng, Mohong; Wang, WenPeng; Zhang, Ji; Mu, Jiao; Zhu, Guanghui

    2015-10-01

    A present limitation of forensic anthropology practice in China is the lack of population-specific criteria on contemporary human skeletons. In this study, a sample of 203 maxillofacial Cone beam computed tomography (CBCT) images, including 96 male and 107 female cases (20-65 years old), was analyzed to explore mandible sexual dimorphism in a population of contemporary adult Han Chinese to investigate the potential use of the mandible as sex indicator. A three-dimensional image from mandible CBCT scans was reconstructed using the SimPlant Pro 11.40 software. Nine linear and two angular parameters were measured. Discriminant function analysis (DFA) and logistic regression analysis (LRA) were used to develop the mathematics models for sex determination. All of the linear measurements studied and one angular measurement were found to be sexually dimorphic, with the maximum mandibular length and bi-condylar breadth being the most dimorphic by univariate DFA and LRA respectively. The cross-validated sex allocation accuracies on multivariate were ranged from 84.2% (direct DFA), 83.5% (direct LRA), 83.3% (stepwise DFA) to 80.5% (stepwise LRA). In general, multivariate DFA yielded a higher accuracy and LRA obtained a lower sex bias, and therefore both DFA and LRA had their own advantages for sex determination by the mandible in this sample. These results suggest that the mandible expresses sexual dimorphism in the contemporary adult Han Chinese population, indicating an excellent sexual discriminatory ability. Cone beam computed tomography scanning can be used as alternative source for contemporary osteometric techniques. PMID:26146162

  4. Bone micro-architectural analysis of mandible and tibia in ovariectomised rats

    PubMed Central

    Liu, H.; Li, W.; Liu, Y. S.

    2016-01-01

    Objectives This study aims to evaluate if micro-CT can work as a method for the 3D assessment and analysis of cancellous bone by comparing micro-CT with undecalcified histological sections in OVX rats. Methods The mandible and tibia of sham, ovariectomised (OVX) and zoledronate-injected ovariectomised (OVX-ZOL) rats were assessed morphometrically. Specimens were scanned by micro-CT. Undecalcified histological sections were manufactured from the specimen scanned by micro-CT and stained with haematoxylin and eosin. Bivariate linear regressions and one-way analysis of variance were undertaken for statistics using SPSS 16.0.1 software. Results There were highly significant correlations between undecalcified histological sections and micro-CT for all parameters (bone volume density (BV/TV), bone surface density (BS/BV), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular separation (Tb.Sp))in the mandible and tibia. Bone histomorphometric parameters analysed by both methods exhibited significant differences among sham, OVX, and OVX-ZOL groups. There were significant correlations between mandible and tibia in BV/TV, BS/BV, and Tb.Sp. Conclusions Micro-CT is a complementary tool to histological sections in basic research that could improve our understanding of bone histomorphometry. The mandible can be used as an effective site to assess bone morphometry of OVX or metabolic bone disease rat models. Cite this article: H. Liu, W. Li, Y. S. Liu, Y. S. Zhou. Bone micro-architectural analysis of mandible and tibia in ovariectomised rats: A quantitative structural comparison between undecalcified histological sections and micro-CT. Bone Joint Res 2016;5:253–262. PMID:27354715

  5. A novel 3D template for mandible and maxilla reconstruction: Rapid prototyping using stereolithography

    PubMed Central

    Kumta, Samir; Kumta, Monica; Jain, Leena; Purohit, Shrirang; Ummul, Rani

    2015-01-01

    Introduction: Replication of the exact three-dimensional (3D) structure of the maxilla and mandible is now a priority whilst attempting reconstruction of these bones to attain a complete functional and aesthetic rehabilitation. We hereby present the process of rapid prototyping using stereolithography to produce templates for modelling bone grafts and implants for maxilla/mandible reconstructions, its applications in tumour/trauma, and outcomes for primary and secondary reconstruction. Materials and Methods: Stereolithographic template-assisted reconstruction was used on 11 patients for the reconstruction of the mandible/maxilla primarily following tumour excision and secondarily for the realignment of post-traumatic malunited fractures or deformity corrections. Data obtained from the computed tomography (CT) scans with 1-mm resolution were converted into a computer-aided design (CAD) using the CT Digital Imaging and Communications in Medicine (DICOM) data. Once a CAD model was constructed, it was converted into a stereolithographic format and then processed by the rapid prototyping technology to produce the physical anatomical model using a resin. This resin model replicates the native mandible, which can be thus used off table as a guide for modelling the bone grafts. Discussion: This conversion of two-dimensional (2D) data from CT scan into 3D models is a very precise guide to shaping the bone grafts. Further, this CAD can reconstruct the defective half of the mandible using the mirror image principle, and the normal anatomical model can be created to aid secondary reconstructions. Conclusion: This novel approach allows a precise translation of the treatment plan directly to the surgical field. It is also an important teaching tool for implant moulding and fixation, and helps in patient counselling. PMID:26933279

  6. Congenital basis of posterior fossa anomalies

    PubMed Central

    Cotes, Claudia; Bonfante, Eliana; Lazor, Jillian; Jadhav, Siddharth; Caldas, Maria; Swischuk, Leonard

    2015-01-01

    The classification of posterior fossa congenital anomalies has been a controversial topic. Advances in genetics and imaging have allowed a better understanding of the embryologic development of these abnormalities. A new classification schema correlates the embryologic, morphologic, and genetic bases of these anomalies in order to better distinguish and describe them. Although they provide a better understanding of the clinical aspects and genetics of these disorders, it is crucial for the radiologist to be able to diagnose the congenital posterior fossa anomalies based on their morphology, since neuroimaging is usually the initial step when these disorders are suspected. We divide the most common posterior fossa congenital anomalies into two groups: 1) hindbrain malformations, including diseases with cerebellar or vermian agenesis, aplasia or hypoplasia and cystic posterior fossa anomalies; and 2) cranial vault malformations. In addition, we will review the embryologic development of the posterior fossa and, from the perspective of embryonic development, will describe the imaging appearance of congenital posterior fossa anomalies. Knowledge of the developmental bases of these malformations facilitates detection of the morphological changes identified on imaging, allowing accurate differentiation and diagnosis of congenital posterior fossa anomalies. PMID:26246090

  7. Work flow for the prosthetic rehabilitation of atrophic patients with a minimal-intervention CAD/CAM approach.

    PubMed

    Ciocca, Leonardo; Ragazzini, Sara; Fantini, Massimiliano; Corinaldesi, Giuseppe; Scotti, Roberto

    2015-07-01

    The implant-supported fixed rehabilitation of patients with an atrophic edentulous crest remains a challenge if bone augmentation is not planned. A minimal intervention approach for bone regeneration is necessary to minimize the flap overextension needed to close the defect over the augmented bone. Prosthetically guided bone regeneration can determine the amount of bone augmentation necessary for definitive prosthetic fixed rehabilitation. The positions of the implants and prosthetic restoration were planned; a 0.3 mm thick titanium mesh was customized for bone augmentation by using computer-aided design and computer-aided manufacturing and rapid prototyped by laser sintering, and the definitive prosthetic rehabilitation was carried out according to the initial treatment plan. This resulted in minimal bone augmentation relative to the functional needs of the definitive prosthetic rehabilitation. PMID:25862269

  8. Sickle cell disease and posterior reversible leukoencephalopathy.

    PubMed

    Geevasinga, Nimeshan; Cole, Catherine; Herkes, Geoffrey K; Barnett, Yael; Lin, Jamie; Needham, Merrilee

    2014-08-01

    Sickle cell disease can present with neurological manifestations. One such presentation is with posterior reversible leukoencephalopathy also known as reversible posterior leukoencephalopathy. The condition is classically described as reversible over time; it commonly presents with oedematous changes involving the white matter of the occipital and parietal regions. Only a few patients with the association between sickle cell disease and posterior reversible leukoencephalopathy have been described in the adult literature. We present two patients from our institutions to emphasise the association between the two conditions and summarise the published cases in the literature. PMID:24656986

  9. Treatment of the edentulous atrophic maxilla using zygomatic implants: evaluation of survival rates over 5-10 years.

    PubMed

    Yates, J M; Brook, I M; Patel, R R; Wragg, P F; Atkins, S A; El-Awa, A; Bakri, I; Bolt, R

    2014-02-01

    The aim of this retrospective observational cohort study was to analyse and report the 5-10-year survival rates of endosseous zygomatic implants used in the rehabilitation of the atrophic maxilla. Forty-three consecutive zygomatic implant placements in 25 patients were evaluated over a 5-10-year period. All zygomatic implant surgery was carried out under general anaesthesia. Nobel Biocare zygomatic machined-surface implants were used, and placement was undertaken using the modified sinus slot method. The main outcome measures and determinants for success were survival of the restored implants and the proportion of originally planned prostheses delivered to patients. Of the 25 patients treated, 12 were male and 13 were female; 19 were non-smokers, and the mean age at time of surgery was 64 years. Patients were treatment-planned for implant-retained bridgework, a removable prosthesis retained by fixed cast gold or milled titanium beams, or magnet-retained removable prostheses. A combination of zygomatic and conventional implants was used in all but one patient. In this study it was shown that the overall success rate for zygomatic implants was 86%, with six of the implants either failing to integrate or requiring removal due to persistent infection associated with the maxillary sinus. All patients received their planned prosthesis, although in six cases the method of retention required modification. This study illustrates that zygomatic implants are a successful and important treatment option when trying to restore the atrophic maxilla, with the potential to avoid additional augmentation/grafting procedures and resulting in a high long-term success rate. PMID:24120903

  10. Brief communication: bilateral aplasia of the condyles in a 1,400-year-old mandible from Israel.

    PubMed

    Nagar, Y; Arensburg, B

    2000-01-01

    A rare pathological mandible, manifesting bilateral absence of the condyles, is discussed. The pathology was identified as hemifacial microsomia. The mandible, dated to the Byzantine period in Israel, manifests bilateral aplasia of the condyles and extreme shortness, but normal width, of the body. The extremely well-developed coronoid process, the grooved masseter insertion area, and the manifestation of a medial pterygoid tubercle (MPT) suggest hypertrophy of the occlusal muscles. The presence of a large MPT is considered a Neanderthal autapomorphy. Studying the biomechanic forces acting on the deformed mandible in hemifacial microsomia patients may shed light on the mastication process in Neanderthals. PMID:10618592

  11. Two cases of posterior open bite caused by the thickness of retrodiscal tissue in the temporomandibular joint.

    PubMed

    Hasegawa, T; Shibuya, Y; Minamikawa, T; Komori, T

    2014-09-01

    There have been few reports of mouth closing disturbances in the final phase of occlusion caused by the posterior thickness of the retrodiscal tissue. Two such cases are described here. The first was a 70-year-old female suffering from a painless mouth closing disturbance on the right side of the temporomandibular joint (TMJ). She complained of a feeling like there was an air cushion. The second case was a 51-year-old male with a painless mouth closing disturbance on the left side of the TMJ. In both cases, magnetic resonance imaging (MRI) revealed enlargement of the posterior joint space on the affected side. The conditions of these two cases were improved by local injection of steroid preparations; however further additional treatments were required, including mandible traction in one case and dental prosthetics in the other. Consequently, we consider that the local injection of steroid preparations is useful as an initial treatment, while the use of local injection of steroid preparations alone is not sufficient for the treatment of posterior thickness of the retrodiscal tissue. PMID:24907131

  12. Muscular invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge is associated with cervical lymph node metastasis

    PubMed Central

    2016-01-01

    Objectives To assess the association between muscle invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge and cervical lymph node metastasis on the basis of preoperative magnetic resonance imaging (MRI). Materials and Methods Twenty-six patients with oral squamous cell carcinoma of the posterior mandibular alveolar ridge were evaluated by MRI. The associations between cervical lymph node metastasis and independent factors evaluated by MRI were analyzed. Overall survival was also analyzed in this manner. Representative biopsy specimens were stained with anti-podoplanin and anti-CD34 antibodies. Results Mylohyoid muscle invasion was associated with cervical lymph node metastasis. A combinational factor of mylohyoid and/or buccinator muscle invasion was also associated with cervical lymph node metastasis. Cervical lymph node metastasis and masticator space invasion had a negative effect on overall survival. No lymphatic vessels were identified near the tumor invasion front within the mandible. In contrast, lymphatic vessels were identified near the front of tumor invasion in the muscles. Conclusion This study demonstrates an association between muscular invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge and cervical lymph node metastasis.

  13. Posterior Reversible Encephalopathy Syndrome in ALL.

    PubMed

    Millichap, J Gordon

    2015-07-01

    Investigators from Soochow University, Suzhou, China, studied the possible pathogenetic mechanisms and treatment of posterior reversible encephalopathy syndrome (PRES) observed in 11 cases of pediatric acute lymphoblastic leukemia (ALL) after induction chemotherapy. PMID:26933594

  14. Posterior cruciate ligament (PCL) injury - aftercare

    MedlinePlus

    ... posterior cruciate ligament (PCL) is located inside your knee joint and connects the bones of your upper and ... such as a knee dislocation , you will need knee surgery to repair the joint. For milder injuries, you may not need surgery. ...

  15. Cryptorchidism in boys with posterior urethral valves.

    PubMed

    Krueger, R P; Hardy, B E; Churchill, B M

    1980-07-01

    A review of 207 male children with poterior urethral valves revealed an over-all incidence of cryptorchidism of 12 per cent. This association of cryptorchidism in boys with posterior urethral valves has not been described previously. PMID:6106069

  16. Posterior Hip Pain in an Athletic Population

    PubMed Central

    Frank, Rachel M.; Slabaugh, Mark A.; Grumet, Robert C.; Virkus, Walter W.; Bush-Joseph, Charles A.; Nho, Shane J.

    2010-01-01

    Context: Posterior hip pain is a relatively uncommon but increasingly recognized complaint in the orthopaedic community. Patient complaints and presentations are often vague or nonspecific, making diagnosis and subsequent treatment decisions difficult. The purposes of this article are to review the anatomy and pathophysiology related to posterior hip pain in the athletic patient population. Evidence Acquisition: Data were collected through a thorough review of the literature via a MEDLINE search of all relevant articles between 1980 and 2010. Results: Many patients who complain of posterior hip pain actually have pain referred from another part of the body—notably, the lumbar spine or sacroiliac joint. Treatment options for posterior hip pain are typically nonoperative; however, surgery is warranted in some cases. Conclusions: Recent advancements in the understanding of hip anatomy, pathophysiology, and treatment options have enabled physicians to better diagnosis athletic hip injuries and select patients for appropriate treatment. PMID:23015944

  17. Oval capsulorhexis for phacoemulsification in posterior polar cataract with preexisting posterior capsule rupture.

    PubMed

    Singh, Kiranjit; Mittal, Vikas; Kaur, Harmit

    2011-07-01

    We describe use of an oval capsulorhexis rather than the conventional circular capsulorhexis for phacoemulsification in posterior polar cataract with preexisting posterior capsule rupture. An oval capsulorhexis minimizes the turbulence in the capsular bag by increasing the area available for efflux of fluid. It also enables end-to-end nuclear sculpting, removal of the nuclear fragment from the bag, intraocular lens (IOL) implantation, and vitrectomy without stretching the capsular bag. The smaller axis of the oval capsulorhexis facilitates optic capture of a sulcus-fixated IOL. The oval capsulorhexis can be used safely for phacoemulsification of all grades of nuclear sclerosis in posterior polar cataract with preexisting posterior capsule rupture. PMID:21700098

  18. Characterization of Posterior Glenoid Bone Loss

    PubMed Central

    Yanke, Adam Blair; Frank, Rachel M.; Shin, Jason J.; Van Thiel, Geoffrey S.; Verma, Nikhil N.; Cole, Brian J.; Romeo, Anthony A.; Provencher, Matthew T.

    2016-01-01

    Objectives: The purpose of this study was to characterize the morphology and location of posterior glenoid bone loss in pat ients with posterior instability instability utilizing computed tomography (CT). Methods: Clinical data was selected for patients with posterior shoulder instability that had undergone posterior stabilization (open or arthroscopic) or posterior osseous augmentation (distal tibia or iliac crest). Three fellowship-trained surgeons from two institutions contributed patients. Pre-operative CT data was collected for all patients. The axial cuts were segmented and reformatted in three-dimensions for glenoid analysis using Osirix. From this three-dimensional model, the following was calculated: percent bone loss (Nobuhara), total arc of the defect (degrees), and a clock-face description (start point, stop point, and average or direction). Pearson correlation coefficients were performed using significance of p<0.05. Results: Fifty shoulders from 50 patients were reviewed. Fourteen patients (average age 30 years; 93% male) had evidence of posterior glenoid bone loss and were included for evaluation. Defects on average involved 13.7±8.6% of the glenoid (range, 2-35%). The average start time (assuming all right shoulders) on the clock face was 10 o’clock ± 40 minutes and stopped at 6:30 ± 25 minutes. The average direction of the defect pointed toward 8:15 ± 25 minutes. The percent bone loss correlated with the total arc of the defect (Pearson: 0.93, p<0.05, R2: 0.86) and the direction of the bone loss (Pearson: 0.64, p<0.05, R2: 0.40). The direction of bone loss significantly moved more posterosuperior the larger the defect became (Pearson: 0.63, p<0.05, R2: 0.40). Conclusion: Posterior bone loss associated with posterior glenohumeral instability is typically directed posteriorly at 8:15 on the clock. As defect get bigger, this direction moves more posterosuperior. This information will help guide clinicians in understanding the typical location of

  19. Deciduous teeth of the Neandertal mandible from Molare Shelter, near Scario (Salerno, Italy).

    PubMed

    Mallegni, F; Ronchitelli, A T

    1989-08-01

    Excavations at hearth levels at the Molare Shelter in 1985 yielded the mandible of a 3-4-year-old child. The associated lithic artifacts recovered with it are Mousterian. Its features, although quite archaic, are within the known range of variation of Neandertals. Four deciduous molars are still preserved in the mandible. They were compared with other known specimens, which date to the Middle and Upper Pleistocene. The metrical characteristics are surprisingly primitive, within the range of variation of Homo erectus, or at least within that of European Pre-Neandertals, more so than within the variability of typical Neandertal specimens. On the other hand, the morphological characteristics, except for a few that are decidedly plesiomorph, are predominantly Neandertal. PMID:2672830

  20. Genetic Divergence in Mandible Form in Relation to Molecular Divergence in Inbred Mouse Strains

    PubMed Central

    Atchley, W. R.; Newman, S.; Cowley, D. E.

    1988-01-01

    Genetic divergence in the form of the mandible is examined in ten inbred strains of mice. Several univariate and multivariate genetic distance estimates are given for the morphological data and these estimates are compared to measures of genealogical and molecular divergence. Highly significant divergence occurs among the ten strains in all 11 mandible traits considered individually and simultaneously. Genealogical relationship among strains is highly correlated with genetic divergence in single locus molecular traits. However, the concordance between genealogical relationship and multivariate genetic divergence in morphology is much more complex. Whether there is a significant correlation between morphological divergence and genealogy depends upon the method of analysis and the particular genetic distance statistic being employed. PMID:3220250

  1. Non small-cell lung cancer with metastasis to thigh muscle and mandible: two case reports

    PubMed Central

    2013-01-01

    Introduction Lung cancer is the leading cause of cancer-related death in Europe and the US. Isolated metastases to skeletal muscle and the mandible are very uncommon. Case presentation This report presents two cases. Case 1 concerns a 45-year-old Caucasian woman affected by muscle metastasis of the right thigh from non-small-cell lung cancer. Case 2 concerns a 61-year-old Caucasian man affected by mandible metastasis from non-small-cell lung cancer. Both metastases were detected by diagnostic imaging studies. Both patients were treated with radiation therapy with palliative and antalgic intent. Conclusion Radiation therapy was effective and well tolerated in both cases. Both our patients are alive, with follow-up of 18 months and five months, respectively. PMID:23566415

  2. Unicystic Ameloblastoma Presenting as a Multilocular Radiolucency in the Anterior Mandible: A Case Report

    PubMed Central

    R. Figueiredo, Nigel; Meena, Manoj; D. Dinkar, Ajit; Malik, Sonam; Khorate, Manisha

    2015-01-01

    Ameloblastomas are tumors of odontogenic epithelial origin. The term unicystic ameloblastoma is used to describe cystic lesions with clinico-radiographic features resembling an odontogenic cyst, but histologically showing the presence of ameloblastomatous epithelium lining part of the cyst cavity. A large majority of lesions are found in the mandible, and usually cause a painless swelling of the jaws. They can be radiographically subdivided into 'dentigerous' and 'non-dentigerous' types. The unicystic ameloblastoma is believed to be less aggressive than a solid/multicystic ameloblastoma, and thus has a more favorable response to enucleation and curettage. This case report presents a case of unicystic ameloblastoma with a multilocular radiographic appearance in the anterior mandible of a 45-year-old female patient, along with a literature review of the topic. PMID:26697154

  3. [Pulmonary tuberculosis complicated with tuberculosis of oral mucosa, mandible and cervical lymph nodes].

    PubMed

    Matsumoto, K; Ueda, S; Horie, T

    1995-04-01

    A case of pulmonary tuberculosis complicated with tuberculous of oral mucosa, mandible and cervical lymph nodes in 53-year-old man is reported. He was firstly treated for right side dental caries. He also received routinely an empiric antibiotic therapy, but discharge of pus continued. Then, pain of oral cavities spread to the right shoulder. The diagnosis of oral mucosa, osteomyelitis of mandible and lymph node tuberculosis was made by the histological examination of biopsy specimens and positive smear test for M. tuberculosis in granulation. The chest X-ray film showed multiple nodular shadows in bilateral lungs. The combination of INH, RFP and SM was applied initially and then SM was replaced by CS due to its side effect. Negative smear test for M. tuberculosis of oral mucosa was achieved five months after the initiation of treatment. PMID:7760539

  4. Mandible shape and dwarfism in squirrels (Mammalia, Rodentia): interaction of allometry and adaptation

    NASA Astrophysics Data System (ADS)

    Hautier, Lionel; Fabre, Pierre-Henri; Michaux, Jacques

    2009-06-01

    Squirrels include several independent lineages of dwarf forms distributed into two ecological groups: the dwarf tree and flying squirrels. The mandible of dwarf tree squirrels share a highly reduced coronoid process and a condylar process drawn backwards. Dwarf flying squirrels on the other hand, have an elongated coronoid process and a well-differentiated condylar process. To interpret such a difference, Elliptic Fourier Transform was used to evaluate how mandible shape varies with dwarfism in sciurids. The results obtained show that this clear-cut difference cannot be explained by a simple allometric relationship in relation with size decrease. We concluded that the retention of anteriorly positioned eye sockets, in relation with distance estimation, allowed the conservation of a well-differentiated coronoid process in all flying species, despite the trend towards its reduction observed among sciurids as their size decreases.

  5. Ameloblastic carcinoma of the mandible: Report of a case and review

    PubMed Central

    Kallianpur, Shreenivas; Jadwani, Sanjay; Misra, Biswajit; Sudheendra, U S

    2014-01-01

    Ameloblastic carcinoma is a rare malignant odontogenic neoplasm that can arise either as a de novo lesion or from pre-existing ameloblastoma. Histopathologically, the tumor retains an ameloblastomatous differentiation pattern but shows cytological features of malignancy. Owing to variable biologic behavior and paucity of long-term follow-up cases, there has been no clear consensus on treatment protocol. The present case of ameloblastic carcinoma arose in the mandible of a 24-year-old male. Surgical treatment involved resection of the mandible along with regional lymph nodes. The patient has been on follow up for the past one year without any recurrence or metastases. An update on ameloblastic carcinoma encompassing the histogenesis, immunohistochemical features and treatment aspects are included. PMID:25364189

  6. Sitting Nasal Intubation With Fiberoptic in an Elective Mandible Surgery Under General Anesthesia

    PubMed Central

    Etemadi, Seyyed Hassan; Bahrami, Amir; Farahmand, Ali Mohammad; Zamani, Mohammad Mahdi

    2015-01-01

    Introduction: Patients with mandible deformity may die, as a result of airway management failures. The awake nasal fiberoptic intubation is known as the optimum intubation method, in the mentioned patients, although, in several cases, fiberoptic intubation fails. Case Presentation: The present case discusses a patient with severe deformity of mandible that was admitted for correction with free-flap. The following intubation techniques were used for her airway management, respectively: blind awake nasal intubation, awake oral fiberoptic and awake nasal fiberoptic, which failed all. We therefore decided to perform awake nasal intubation, with fiberoptic, in sitting position. Conclusions: In this case, after failure of awake fiberoptic intubation, awake direct laryngoscopy and blind nasal intubation, finally awake nasal intubation in sitting position, using fiberoptic led to success. PMID:26705521

  7. Metastatic clear cell variant of renal cell carcinoma of the mandible: Review and case report

    PubMed Central

    Shah, Ajaz; Jahan, Shahi; Najar, Latief; Hassan, Shahid; Mohammad, Manzoor

    2016-01-01

    A case of metastatic renal cell carcinoma (RCC) to the mandible is reported. A 22-year-old man consulted us for hypoesthesia of the right lower lip. Panorama X-ray film showed a radiolucent lesion in the right mandibular body. A diagnosis of a metastatic tumor to the mandible from the right kidney was made after evaluation by computed tomography and bone scan with Tc99 methyl diphosphonate which also revealed multiple bone metastases. Histologically diagnosis was clear cell variant of RCC. Patient has been put on radiotherapy for symptomatic treatment and a molecularly targeted drug. The therapy effectively stopped the progressive growth of oral and other metastatic lesions. The quality of life is relatively well maintained with tolerable adverse effects. The patient is still on our follow-up with an improved quality of life.

  8. Mandible shape and dwarfism in squirrels (Mammalia, Rodentia): interaction of allometry and adaptation.

    PubMed

    Hautier, Lionel; Fabre, Pierre-Henri; Michaux, Jacques

    2009-06-01

    Squirrels include several independent lineages of dwarf forms distributed into two ecological groups: the dwarf tree and flying squirrels. The mandible of dwarf tree squirrels share a highly reduced coronoid process and a condylar process drawn backwards. Dwarf flying squirrels on the other hand, have an elongated coronoid process and a well-differentiated condylar process. To interpret such a difference, Elliptic Fourier Transform was used to evaluate how mandible shape varies with dwarfism in sciurids. The results obtained show that this clear-cut difference cannot be explained by a simple allometric relationship in relation with size decrease. We concluded that the retention of anteriorly positioned eye sockets, in relation with distance estimation, allowed the conservation of a well-differentiated coronoid process in all flying species, despite the trend towards its reduction observed among sciurids as their size decreases. PMID:19288073

  9. Metastatic clear cell variant of renal cell carcinoma of the mandible: Review and case report.

    PubMed

    Shah, Ajaz; Jahan, Shahi; Najar, Latief; Hassan, Shahid; Mohammad, Manzoor

    2016-01-01

    A case of metastatic renal cell carcinoma (RCC) to the mandible is reported. A 22-year-old man consulted us for hypoesthesia of the right lower lip. Panorama X-ray film showed a radiolucent lesion in the right mandibular body. A diagnosis of a metastatic tumor to the mandible from the right kidney was made after evaluation by computed tomography and bone scan with Tc99 methyl diphosphonate which also revealed multiple bone metastases. Histologically diagnosis was clear cell variant of RCC. Patient has been put on radiotherapy for symptomatic treatment and a molecularly targeted drug. The therapy effectively stopped the progressive growth of oral and other metastatic lesions. The quality of life is relatively well maintained with tolerable adverse effects. The patient is still on our follow-up with an improved quality of life. PMID:27563625

  10. Experiment K-310: The effect of spaceflight on osteogenesis and dentinogenesis in the mandibles of rats

    NASA Technical Reports Server (NTRS)

    Simmons, D. J.; Russell, J. E.; Winter, F.; Rosenberg, G. D.; Walker, W. V.

    1981-01-01

    Normal rates of dentinogenesis and osteogenesis in the body of the mandible were observed. The total calcium, inorganic phosphorus and hydroxyproline levels in the jaws and incisors of the flight rats were normal. Gravity density fractionation studies suggested, however, that spaceflight caused a delay in the normal maturation of bone mineral and matrix; normal values were reestablished by 6 days postflight. The teeth were spared. The circadian and ultradian patterns of dentin calcification were normal during spaceflight and recovery periods, but the enamel rhythms displayed a greater amplitude of sulfur concentrations and this abnormal calcium to sulfur ratios only during exposure to zero gravity. The rat mandible and teeth do not suffer the deficits of bone formation common to weight bearing parts of the skeleton during spaceflight. The only derangements detected were in the quality of the matrix and mineral moieties.

  11. Gene expression of ornithine decarboxylase, cyclooxygenase-2, and gastrin in atrophic gastric mucosa infected with Helicobacter pylori before and after eradication therapy.

    PubMed

    Konturek, Peter C; Rembiasz, Kazimierz; Konturek, Stanislaw J; Stachura, Jerzy; Bielanski, Wladyslaw; Galuschka, K; Karcz, Danuta; Hahn, Eckhart G

    2003-01-01

    H. pylori (Hp) -induced atrophic gastritis is a well-known risk factor for the development of gastric cancer. Whether Hp eradication can prevent or retard the progress of atrophy and metaplasia has been the topic of numerous studies but the subject remains controversial. Recently, the increased expression of ornithine decarboxylase (ODC), gastrin and cyclooxygenase (COX)-2 has been shown to be increased in premalignant lesions in gastric mucosa and to play an essential role in the malignant transformation. The aim of the study is to assess the effect of eradication therapy on atrophic gastritis and analyze the gene expression for ODC, COX-2 and gastrin in gastric mucosa after succesful eradication in patients with atrophic gastritis. Twenty patients with chronic atrophic gastritis including both corpus and antrum of the stomach were included in this study. Four antral mucosal biopsy specimens were obtained from antrum and four from corpus. The histopathologic evaluation of gastritis was based on Sydney classification of gastritis. All patients were Hp positive based on the [13C] urea breath test (UBT) and the presence of anti-Hp IgG and anti-CagA-antibodies detected by ELISA. The patients were then eradicated with triple therapy consiting of omeprazol (2 x 20 mg), amoxycillin (2 x 1 g) and clarithromycin (2 x 500 mg) for seven days and vitamin C 1 g/day for three months. In gastric mucosal samples obtained from the antrum and corpus before and after eradication, the mRNA expression for ODC, COX-2, and gastrin was assessed by reverse-transcription polymerase chain reaction (RT-PCR). In all patients the gastric secretory analysis was performed by measuring gastric acid output and serum gastrin levels. After triple therapy the successful eradication assessed by UBT was observed in 95% of patients. In 45% of patients the infection with CagA-positive Hp strain was observed. Three months after eradication a significant reduction in the gastric activity (neutrophilic

  12. Non-pulsatile traumatic pseudoaneurysm of the internal maxillary artery following trauma to mandible.

    PubMed

    Soh, Hui Yuh; Muda, Ahmad Sobri; Jabar, Nazimi Abd; Nordin, Rifqah; Nabil, S; Ramli, Roszalina

    2015-12-01

    Traumatic pseudoaneurysm involving the maxillary artery is rare. Owing to its anatomic location, internal maxillary artery is usually protected by its surrounding structures. Formation of pseudoaneurysm usually takes place after several weeks to months of the initial injury. In this case, we reported a pseudoaneurysm arising from left internal maxillary artery following blunt injuries within 3 hours after a road accident and the treatment with endovascular embolization with titanium coils prior to open reduction and internal fixation of the fractured mandibles. PMID:25903486

  13. An innovative simplified method for assessing available bone in mandible for implant.

    PubMed

    Binsu, S; Nair, K Chandrasekharan; Nayar, Sanjana; Tella, Suchita

    2016-01-01

    The primary factor that determines the success of implant is the amount of available bone in the edentulous site. Diagnostic imaging and techniques help to develop and implement a cohesive and comprehensive treatment plan according to the available bone. In the following case report an innovative simplified method (poor man CT) is used to fabricate a three dimensional model to assess the available bone for implant placement in mandible. PMID:27141175

  14. Spontaneous resolution of an eosinophilic granuloma of the mandible following open biopsy.

    PubMed

    Plona, Gregory A; Wiltz, Mauricio; Kelsch, Robert

    2016-08-01

    Langerhans cell histiocytosis X is a clonal proliferation of dendritic cells of the immune system, which can affect multiple organ systems and range in behavior from a benign inflammatory process to a much more aggressive process. Only few isolated cases have been reported in the jaws. This case represents an example of Langerhans cell histiocytosis X in the mandible, which resolved following incisional biopsy without any further surgical intervention. PMID:27033671

  15. Adaptation of BAp crystal orientation to stress distribution in rat mandible during bone growth

    NASA Astrophysics Data System (ADS)

    Nakano, T.; Fujitani, W.; Ishimoto, T.; Umakoshi, Y.

    2009-05-01

    Biological apatite (BAp) c-axis orientation strongly depends on stress distribution in vivo and tends to align along the principal stress direction in bones. Dentulous mandible is subjected to a complicated stress condition in vivo during chewing but few studies have been carried out on the BAp c-axis orientation; so the adaptation of BAp crystal orientation to stress distribution was examined in rat dentulous mandible during bone growth and mastication. Female SD rats 4 to 14 weeks old were prepared, and the bone mineral density (BMD) and BAp crystal orientation were analyzed in a cross-section of mandible across the first molar focusing on two positions: separated from and just under the tooth root on the same cross-section perpendicular to the mesiodistal axis. The degree of BAp orientation was analyzed by a microbeam X-ray diffractometer using Cu-Kα radiation equipped with a detector of curved one-dimensional PSPC and two-dimensional PSPC in the reflection and transmission optics, respectively. BMD quickly increased during bone growth up to 14 weeks, although it was independent of the position from the tooth root. In contrast, BAp crystal orientation strongly depended on the age and the position from the tooth root, even in the same cross-section and direction, especially along the mesiodistal and the biting axes. With increased biting stress during bone growth, the degree of BAp orientation increased along the mesiodistal axis in a position separated from the tooth root more than that near the tooth root. In contrast, BAp preferential alignment clearly appeared along the biting axis near the tooth root. We conclude that BAp orientation rather than BMD sensitively adapts to local stress distribution, especially from the chewing stress in vivo in the mandible.

  16. Beneficial role of periosteum in distraction osteogenesis of mandible: its preservation prevents the external bone resorption.

    PubMed

    Takeuchi, Sawako; Matsuo, Akira; Chiba, Hiroshige

    2010-01-01

    Distraction osteogenesis (DO) is a surgical process of new bone generation through the gradual extension of two segments of existing bone. DO is applied for maxillofacial surgeries to manage defects in mandibular continuity. Vertical DO with an oral device is often employed to augment the alveolar bone height for better implant anchorage for esthetic purposes or functional prosthetic requirements. To determine how the periosteum affects the vertical DO in mandibular reconstruction, we extracted the teeth and resected the alveolar parts of the mandible on both sides of dogs, along with removal of the surrounding periosteum in the right, but not left side. Three months later, box-shaped bone segments (vectors) were prepared from the resected alveolar part, and the segments were vertically elongated using a distraction device on both sides at 0.9 mm/day for one week. The extent of bone formation after distraction was determined with micro-focused computed tomography and by measuring incorporation of tetracycline and calcein with confocal laser scanning microscopy. During the initial two months after distraction, new bone formation was observed more prominently in the left side than in the right side of mandible with the periosteum. However, this difference was less clear during the bone-remodeling period. One notable change was the reduced height of the alveolar part of the right-side mandible, a sign of external bone resorption, observed in two out of three dogs at 6-month post-consolidation. These findings suggest that preservation of periosteum prevents the external bone resorption during the vertical DO of mandible. PMID:20046054

  17. Rare Case of a Chondrosarcoma of the Mandible in a Child

    PubMed Central

    Deichen, Jan Thiess; Scheer, Fabian; Andresen, Reimer; Talanow, Roland

    2013-01-01

    Chondrosarcoma of the mandible is rare, especially in children. The available literature consists mostly of a few case reports which are partly integrated in small studies. Growing this small pool of literature is helpful in solidifying knowledge about this disease and facilitating appropriate treatment for children. Therefore, we present such a case in a 12-year-old boy, exhibit comprehensive and relevant information concerning this entity, and discuss our findings in the context of other publications. PMID:24349816

  18. Mandible-Powered Escape Jumps in Trap-Jaw Ants Increase Survival Rates during Predator-Prey Encounters

    PubMed Central

    Larabee, Fredrick J.; Suarez, Andrew V.

    2015-01-01

    Animals use a variety of escape mechanisms to increase the probability of surviving predatory attacks. Antipredator defenses can be elaborate, making their evolutionary origin unclear. Trap-jaw ants are known for their rapid and powerful predatory mandible strikes, and some species have been observed to direct those strikes at the substrate, thereby launching themselves into the air away from a potential threat. This potential escape mechanism has never been examined in a natural context. We studied the use of mandible-powered jumping in Odontomachus brunneus during their interactions with a common ant predator: pit-building antlions. We observed that while trap-jaw ant workers escaped from antlion pits by running in about half of interactions, in 15% of interactions they escaped by mandible-powered jumping. To test whether escape jumps improved individual survival, we experimentally prevented workers from jumping and measured their escape rate. Workers with unrestrained mandibles escaped from antlion pits significantly more frequently than workers with restrained mandibles. Our results indicate that some trap-jaw ant species can use mandible-powered jumps to escape from common predators. These results also provide a charismatic example of evolutionary co-option, where a trait that evolved for one function (predation) has been co-opted for another (defense). PMID:25970637

  19. Heterochrony in mandible development of larval shrimp (Decapoda: Caridea)--a comparative morphological SEM study of two carideans.

    PubMed

    Batel, Annika; Melzer, Roland R; Anger, Klaus; Geiselbrecht, Hannes

    2014-11-01

    Mandible development in the larval stages I-V of two palaemonid shrimp species, Palaemon elegans and Macrobrachium amazonicum, was analyzed using scanning electron microscopy, light microscopy, and confocal laser scanning microscopy. In contrast to the zoea I of P. elegans, first-stage larvae of M. amazonicum are nonfeeding. At hatching, the morphology of the mandibles is fully expressed in P. elegans, while it appears underdeveloped in M. amazonicum, presenting only small precursors of typical caridean features. In successive zoeal stages, both species show similar developmental changes, but the mandibular characters of the larvae in M. amazonicum were delayed compared to the equivalent stages in P. elegans, especially in the development of submarginal setae and mandible size. In conclusion, our results indicate heterochrony (postdisplacement) of mandible development in M. amazonicum compared to that in P. elegans, which is related to initial lack of mandible functionality or planktivorous feeding at hatching, respectively. This conclusion is supported by comparison with other palaemonid zoeae exhibiting different feeding modes. Our data suggest that an evolutionary ground pattern of mandible morphology is present even in species with nonfeeding first-stage larvae. PMID:24888760

  20. Development and Clinical Evaluation of MatrixMANDIBLE Subcondylar Plates System (Synthes).

    PubMed

    Cortelazzi, Roberto; Altacera, Mario; Turco, Monica; Antonicelli, Viviana; De Benedittis, Michele

    2015-06-01

    In this article, authors report the different steps of development and clinical validation of MatrixMANDIBLE Subcondylar Plates (Synthes, Soletta, Switzerland), a specialized osteosynthesis system developed by Synthes during the past 4 years. Between 2009 and 2013, a total of 62 patients were treated for subcondylar and condylar neck fractures via a preauricular or retromandibular/transparotid approach. The MatrixMANDIBLE Subcondylar Plates System consists of a Trapezoidal Plate, a three-dimensional (3D) 4-hole 1.0-mm plate for smaller fracture areas, the Lambda Plate, a 7-hole 1.0-mm linear plate which mimics the two miniplates technique, and the Strut Plate, a 3D 1.0-mm plate with great versatility of employment. All devices satisfy the principles of a functionally stable osteosynthesis as stated by Champy et al. None of the plates broke and no macroscopic condylar displacement was noted on radiological follow-up. Clinical and functional parameters assessed at 6 months postoperative (mandibular range of motion, pain, dental occlusion) were almost restored. MatrixMANDIBLE Subcondylar Plates System (Synthes) has proved to provide sufficient mechanical stiffness and anatomically accurate fracture reduction to avoid major postoperative drawbacks of subcondylar and condylar neck fractures. PMID:26000078

  1. Development and Clinical Evaluation of MatrixMANDIBLE Subcondylar Plates System (Synthes)

    PubMed Central

    Cortelazzi, Roberto; Altacera, Mario; Turco, Monica; Antonicelli, Viviana; De Benedittis, Michele

    2014-01-01

    In this article, authors report the different steps of development and clinical validation of MatrixMANDIBLE Subcondylar Plates (Synthes, Soletta, Switzerland), a specialized osteosynthesis system developed by Synthes during the past 4 years. Between 2009 and 2013, a total of 62 patients were treated for subcondylar and condylar neck fractures via a preauricular or retromandibular/transparotid approach. The MatrixMANDIBLE Subcondylar Plates System consists of a Trapezoidal Plate, a three-dimensional (3D) 4-hole 1.0-mm plate for smaller fracture areas, the Lambda Plate, a 7-hole 1.0-mm linear plate which mimics the two miniplates technique, and the Strut Plate, a 3D 1.0-mm plate with great versatility of employment. All devices satisfy the principles of a functionally stable osteosynthesis as stated by Champy et al. None of the plates broke and no macroscopic condylar displacement was noted on radiological follow-up. Clinical and functional parameters assessed at 6 months postoperative (mandibular range of motion, pain, dental occlusion) were almost restored. MatrixMANDIBLE Subcondylar Plates System (Synthes) has proved to provide sufficient mechanical stiffness and anatomically accurate fracture reduction to avoid major postoperative drawbacks of subcondylar and condylar neck fractures. PMID:26000078

  2. Cephalometric Angular Measurements of the Mandible Using Three-Dimensional Computed Tomography Scans in Koreans

    PubMed Central

    Kim, Yong Hyun; Kang, Seok Joo

    2016-01-01

    Background We conducted this study to analyze the values of the key cephalometric angular measurements of the mandible using 3-dimensional (3D) computed tomography scans. Methods In the 106 enrolled patients, a 3D cephalometric analysis was performed to measure the angular variables of the mandible. These values were compared between the two sides and between the two sexes. Results The frontal measurements revealed that the mandibular body curve angle was larger on the left (Lt) side (right [Rt], 141.24±7.54; Lt, 142.68±6.94; P=0.002) and the gonial angle was larger on the right side (Rt, 134.37±8.44; Lt, 131.54±7.14; P<0.001). The sagittal measurements showed that the gonial angle was larger on the right side (Rt, 134.37±8.44; Lt, 131.54±7.14; P>0.05). Further, the transverse measurements revealed that the mandibular body curve angle was larger on the right side (Rt, 140.28±7.05; Lt, 137.56±6.23; P<0.001). Conclusions These results provide an average of the mandibular angular measurements for the Korean population, establishing a standard for determining surgical patient groups and outcome evaluations in the field of mandible contour surgery. PMID:26848443

  3. Quantitative assessment of interradicular bone density in the maxilla and mandible: implications in clinical orthodontics

    PubMed Central

    2013-01-01

    Background Bone density at the interradicular area plays an important role during orthodontic treatment. In view of this fact, the study was designed to quantitatively evaluate the bone density at the interradicular areas of the alveolar and basal bones of maxilla and mandible by computed tomography. Methods One hundred and nine computed tomographic images were randomly selected, and bone density was measured in Hounsfield units (HU) with bone mineral density software (Siemens VA20A_SP3A). The sample consisted of 78 males (mean age 29.5 years, range 20 to 40 years) and 31 females (mean age 27.6 years, range 20 to 40 years). Cortical and cancellous bone density was measured at the interradicular areas at the alveolar and basal bone levels of the maxilla and mandible, and the data was subjected to statistical analysis for comparisons. Results The highest cortical bone density was observed between the second premolar and first molar at the alveolar bone level and between the first and second molars at the basal bone level in the maxilla. Maxillary tuberosity showed the least bone density. The density of the cortical bone was greater in the mandible than in the maxilla and showed a progressive increase from the incisor to the retromolar area. The basal bone showed a higher density thanthe alveolar bone. Conclusion Different qualities of the bone were found in the anatomic regions studied, which confirms the importance of knowledge of site-specific bone tissue density to correlate with various clinical findings. PMID:24325883

  4. Nonossifying fibroma (metaphyseal fibrous defect) of the mandible in a 15-year-old boy.

    PubMed

    Mannan, Abul Ala; Singh, N Gopendro; Al-Waheeb, Salah; Taher, Taher N; Mohammed, Emad El Din El Din

    2015-06-01

    We describe a rare case of nonossifying fibroma of the mandible in a 15-year-old boy who presented with a left mandibular swelling. Conventional imaging showed an expansile radiolucent lesion involving the angle and the body of the left mandible. The lesion was curetted, and a miniplate was implanted at the excision site. Microscopic examination of the removed specimen revealed a cellular lesion characterized by a proliferation of uniform spindle-shaped cells in a vague but prominent storiform pattern, which represented the classic appearance of nonossifying fibroma. Three months later, radiography detected a fracture of the implantation plate. The area was re-explored with curettage of the soft tissue, which on microscopy demonstrated findings similar to the initial curettage findings. Follow-up radiology revealed satisfactory healing of the jaw, and no further recurrence was seen 2 years after the initial surgery. We present this case to highlight the importance of recognizing nonossifying fibroma in the mandible, which can be easily confused with more common mandibular lesions. PMID:26053991

  5. A comparison of external and internal maxilla and mandible morphology of water bugs (Hemiptera: Heteroptera: Nepomorpha).

    PubMed

    Brożek, Jolanta

    2013-01-01

    This paper describes the file of the mandible, the apices of the maxillae, the rupturing device on the maxillae, and the internal structures of the mouthparts in sixty representatives of the nepomorphan families (Heteroptera), using scanning electron microscopy. Eight morphologically distinct types of files are identified on the mandibular tip, as well as six distinct types of the maxillary endings, and three distinct types of rupturing devices of the maxillae. The features of the internal maxillary and mandibular structures share a common connection model, differing only by virtue of specific appendages in different subfamilies. The water bugs morphological ground plan is represented by a mandibular file identically serrated, asymmetrical apices of maxillae (left maxilla tapers with lobe + right maxilla tapers and straight), rupturing device evidently exposed ventrally and inner structures: the maxillae are extended dorso-laterally, forming a wide lobe; symmetrical processes connect with the mandibles. The main patterns (belostomatid and nepid) together with two more specialized patterns (gelastocorids, corixids, micronectids, and diaprepocorids) and (ochterid, aphelocheirid, naucorid, notonectid, pleid and helotrephid) are reported. Diversity of the elements (maxillae and mandibles) are analyzed from a phylogenetic signals and nutrition perspective. Finally, further lines of study are suggested for future work on the phylogeny of the group based on the studied characters. PMID:26097953

  6. Recently recovered Kenyapithecus mandible and its implications for great ape and human origins.

    PubMed

    McCrossin, M L; Benefit, B R

    1993-03-01

    We report here a Kenyapithecus africanus juvenile mandible recovered from middle Miocene (ca. 14-16 million years) deposits of Maboko Island (Lake Victoria), Kenya. Symphyseal and dental attributes of the mandible distinguish K. africanus, a species widely regarded as the earliest known member of the great ape and human clade, from other Miocene large-bodied hominoids. The Maboko Island mandible exhibits a markedly proclined symphyseal axis, massive inferior transverse torus, mesiodistally narrow, high-crowned, and strongly procumbent lateral incisor, and molars with cingula restricted to the median buccal cleft. Although the presence of some of these conditions in Kenyapithecus was suggested earlier, the fragmentary and ill-preserved nature of previously known specimens led certain authorities to doubt their validity. Our assessment of mandibular and dental morphology indicates that K. africanus diverged after Proconsul and Griphopithecus but prior to the last common ancestor of Sivapithecus, extant great apes, and humans. The robustly constructed mandibular symphysis and anterior dentition suggest that incisal biting played as important a role as thick molar enamel in the dietary adaptations of K. africanus. PMID:8446615

  7. A Rare Case of an Artery Passing through the Median Perforating Canal of the Mandible

    PubMed Central

    Iwanaga, Joe; Watanabe, Koichi; Saga, Tsuyoshi; Tabira, Yoko; Yamaki, Koh-ichi

    2016-01-01

    Along with the popularization of dental implant surgery, there has been considerable research on the lingual foramen using cone-beam computed tomography. Anatomical research has also revealed that the arteries entering the lingual foramina are branches of the submental and sublingual arteries. There have been no reports, however, of the submental or sublingual artery entering the mandible from the lingual foramen, perforating it, and then distributing to the inferior labial region. A 69-year-old man who donated his body to our department in 2015 was dissected. The mandible with overlying soft tissue of the mental region was resected and examined with microcomputed tomography, which showed that the canal perforated from the lingual foramen to the midline of the labial cortical plate. The canal was thus named the median perforating canal. To the best of our knowledge, there have been no other reports of a perforating artery of the mandible, so this case is thought to be rare. Hence, the existence of perforating arteries, such as in the present case, should be taken into consideration in preoperative diagnoses such as for dental implant surgery. Thus, the fusion of anatomical and radiological study is useful and necessary to understand surgical anatomy. PMID:27213060

  8. An Early Pleistocene hominin mandible from Atapuerca-TD6, Spain

    PubMed Central

    Carbonell, E.; Bermúdez de Castro, J. M.; Arsuaga, J. L.; Allue, E.; Bastir, M.; Benito, A.; Cáceres, I.; Canals, T.; Díez, J. C.; van der Made, J.; Mosquera, M.; Ollé, A.; Pérez-González, A.; Rodríguez, J.; Rodríguez, X. P.; Rosas, A.; Rosell, J.; Sala, R.; Vallverdú, J.; Vergés, J. M.

    2005-01-01

    We present a mandible recovered in 2003 from the Aurora Stratum of the TD6 level of the Gran Dolina site (Sierra de Atapuerca, northern Spain). The specimen, catalogued as ATD6-96, adds to the hominin sample recovered from this site in 1994–1996, and assigned to Homo antecessor. ATD6-96 is the left half of a gracile mandible belonging to a probably female adult individual with premolars and molars in place. This mandible shows a primitive structural pattern shared with all African and Asian Homo species. However, it is small and exhibits a remarkable gracility, a trait shared only with the Early and Middle Pleistocene Chinese hominins. Furthermore, none of the mandibular features considered apomorphic in the European Middle and Early Upper Pleistocene hominin lineage are present in ATD6-96. This evidence reinforces the taxonomic identity of H. antecessor and is consistent with the hypothesis of a close relationship between this species and Homo sapiens. PMID:15824320

  9. Conservatism and Adaptability during Squirrel Radiation: What Is Mandible Shape Telling Us?

    PubMed Central

    Casanovas-Vilar, Isaac; van Dam, Jan

    2013-01-01

    Both functional adaptation and phylogeny shape the morphology of taxa within clades. Herein we explore these two factors in an integrated way by analyzing shape and size variation in the mandible of extant squirrels using landmark-based geometric morphometrics in combination with a comparative phylogenetic analysis. Dietary specialization and locomotion were found to be reliable predictors of mandible shape, with the prediction by locomotion probably reflecting the underlying diet. In addition a weak but significant allometric effect could be demonstrated. Our results found a strong phylogenetic signal in the family as a whole as well as in the main clades, which is in agreement with the general notion of squirrels being a conservative group. This fact does not preclude functional explanations for mandible shape, but rather indicates that ancient adaptations kept a prominent role, with most genera having diverged little from their ancestral clade morphologies. Nevertheless, certain groups have evolved conspicuous adaptations that allow them to specialize on unique dietary resources. Such adaptations mostly occurred in the Callosciurinae and probably reflect their radiation into the numerous ecological niches of the tropical and subtropical forests of Southeastern Asia. Our dietary reconstruction for the oldest known fossil squirrels (Eocene, 36 million years ago) show a specialization on nuts and seeds, implying that the development from protrogomorphous to sciuromorphous skulls was not necessarily related to a change in diet. PMID:23593456

  10. Recently recovered Kenyapithecus mandible and its implications for great ape and human origins.

    PubMed Central

    McCrossin, M L; Benefit, B R

    1993-01-01

    We report here a Kenyapithecus africanus juvenile mandible recovered from middle Miocene (ca. 14-16 million years) deposits of Maboko Island (Lake Victoria), Kenya. Symphyseal and dental attributes of the mandible distinguish K. africanus, a species widely regarded as the earliest known member of the great ape and human clade, from other Miocene large-bodied hominoids. The Maboko Island mandible exhibits a markedly proclined symphyseal axis, massive inferior transverse torus, mesiodistally narrow, high-crowned, and strongly procumbent lateral incisor, and molars with cingula restricted to the median buccal cleft. Although the presence of some of these conditions in Kenyapithecus was suggested earlier, the fragmentary and ill-preserved nature of previously known specimens led certain authorities to doubt their validity. Our assessment of mandibular and dental morphology indicates that K. africanus diverged after Proconsul and Griphopithecus but prior to the last common ancestor of Sivapithecus, extant great apes, and humans. The robustly constructed mandibular symphysis and anterior dentition suggest that incisal biting played as important a role as thick molar enamel in the dietary adaptations of K. africanus. Images Fig. 1 Fig. 2 PMID:8446615

  11. Chewing on the trees: Constraints and adaptation in the evolution of the primate mandible.

    PubMed

    Meloro, Carlo; Cáceres, Nilton Carlos; Carotenuto, Francesco; Sponchiado, Jonas; Melo, Geruza Leal; Passaro, Federico; Raia, Pasquale

    2015-07-01

    Chewing on different food types is a demanding biological function. The classic assumption in studying the shape of feeding apparatuses is that animals are what they eat, meaning that adaptation to different food items accounts for most of their interspecific variation. Yet, a growing body of evidence points against this concept. We use the primate mandible as a model structure to investigate the complex interplay among shape, size, diet, and phylogeny. We find a weak but significant impact of diet on mandible shape variation in primates as a whole but not in anthropoids and catarrhines as tested in isolation. These clades mainly exhibit allometric shape changes, which are unrelated to diet. Diet is an important factor in the diversification of strepsirrhines and platyrrhines and a phylogenetic signal is detected in all primate clades. Peaks in morphological disparity occur during the Oligocene (between 37 and 25 Ma) supporting the notion that an adaptive radiation characterized the evolution of South American monkeys. In all primate clades, the evolution of mandible size is faster than its shape pointing to a strong effect of allometry on ecomorphological diversification in this group. PMID:26095445

  12. A new method to standardize CBCT for quantitative evaluation of alveolar ridge preservation in the mandible: a case report and review of the literature.

    PubMed

    Xia, Yang; Xie, Lizhe; Zhou, Yi; Song, Tianxi; Zhang, Feimin; Gu, Ning

    2015-12-01

    Cone-beam computerized tomography (CBCT) is an effective technique for assessment of changes to the alveolar ridge (AR). However, its accuracy and reliability could be improved by standardization of imaging positions to remain unchanged during measurements. In this study, an alveolar ridge preservation procedure was performed on a left third molar (38) socket by filling it with a radiotransparent synthetic bone graft, mineralized collagen (MC). Photographic, X-ray and CBCT images were captured before and 3, 6 and 12 months after surgery. A new method was developed to standardize CBCT for quantitative evaluation. Obtained CBCT images showed good comparability. The post-extraction alveolar width and height were both over 95% of the original values, but some resorption of the lingual bone wall (>50%) and inter-crestal bone (>30%). It is concluded that an effective positional standardization method was developed for CBCT assessment of AR dimensional changes in the posterior mandible. The use of MC in combination with a collagen membrane improved dimensional preservation of the AR. PMID:26816648

  13. A new method to standardize CBCT for quantitative evaluation of alveolar ridge preservation in the mandible: a case report and review of the literature

    PubMed Central

    Xia, Yang; Xie, Lizhe; Zhou, Yi; Song, Tianxi; Zhang, Feimin; Gu, Ning

    2015-01-01

    Cone-beam computerized tomography (CBCT) is an effective technique for assessment of changes to the alveolar ridge (AR). However, its accuracy and reliability could be improved by standardization of imaging positions to remain unchanged during measurements. In this study, an alveolar ridge preservation procedure was performed on a left third molar (38) socket by filling it with a radiotransparent synthetic bone graft, mineralized collagen (MC). Photographic, X-ray and CBCT images were captured before and 3, 6 and 12 months after surgery. A new method was developed to standardize CBCT for quantitative evaluation. Obtained CBCT images showed good comparability. The post-extraction alveolar width and height were both over 95% of the original values, but some resorption of the lingual bone wall (>50%) and inter-crestal bone (>30%). It is concluded that an effective positional standardization method was developed for CBCT assessment of AR dimensional changes in the posterior mandible. The use of MC in combination with a collagen membrane improved dimensional preservation of the AR. PMID:26816648

  14. Avoiding injury to the inferior alveolar nerve by routine use of intraoperative radiographs during implant placement.

    PubMed

    Burstein, Jeffrey; Mastin, Chris; Le, Bach

    2008-01-01

    Injury to the inferior alveolar nerve during implant placement in the posterior atrophic mandible is a rare but serious complication. Although a preoperative computerized tomography scan can help determine the distance from the alveolar ridge to the nerve canal, variables such as magnification errors, ridge anatomy, and operator technique can increase the chance for complications. The routine use of intraoperative periapical radiographs during the drilling sequence is an inexpensive and reliable tool, allowing the operator to confidently adjust the direction and depth of the implant during placement. Most important, it helps avoid the risk of injury to the inferior alveolar nerve in cases in which there is limited vertical alveolar bone. Using this technique for 21 implants placed in the posterior atrophic mandible, with less than 10 mm of vertical bone to the inferior alveolar nerve canal, the authors observed no incidents of postoperative paresthesia. PMID:18390241

  15. Posterior Predictive Bayesian Phylogenetic Model Selection

    PubMed Central

    Lewis, Paul O.; Xie, Wangang; Chen, Ming-Hui; Fan, Yu; Kuo, Lynn

    2014-01-01

    We present two distinctly different posterior predictive approaches to Bayesian phylogenetic model selection and illustrate these methods using examples from green algal protein-coding cpDNA sequences and flowering plant rDNA sequences. The Gelfand–Ghosh (GG) approach allows dissection of an overall measure of model fit into components due to posterior predictive variance (GGp) and goodness-of-fit (GGg), which distinguishes this method from the posterior predictive P-value approach. The conditional predictive ordinate (CPO) method provides a site-specific measure of model fit useful for exploratory analyses and can be combined over sites yielding the log pseudomarginal likelihood (LPML) which is useful as an overall measure of model fit. CPO provides a useful cross-validation approach that is computationally efficient, requiring only a sample from the posterior distribution (no additional simulation is required). Both GG and CPO add new perspectives to Bayesian phylogenetic model selection based on the predictive abilities of models and complement the perspective provided by the marginal likelihood (including Bayes Factor comparisons) based solely on the fit of competing models to observed data. [Bayesian; conditional predictive ordinate; CPO; L-measure; LPML; model selection; phylogenetics; posterior predictive.] PMID:24193892

  16. [Mining analysis and experience summary for chronic atrophic gastritis cases treated by Professor LIU Feng-bin].

    PubMed

    Hou, Zheng-kun; Liu, Feng-bin; Li, Pei-wu; Zhuang, Kun-hai

    2015-06-01

    To summarize Professor LIU Feng-bin's clinical experience and theoretical thoughts on chronic atrophic gastritis (CAG), the study group designed a retrospective study on his case series and expert interview. First of all, the data of CAG patients treated in the First Affiliated Hospital of Guangzhou University of Chinese Medicine between 2009 and 2013, e. g. herbs, diseases, syndrome type, prescription amount and number of herbs, was collected and processed. The statistical description and binary logistic regression were used to determined the syndrome type, initial basic remedy and modification. During the statistics, a complete and sub-group analysis was performed simultaneously. After the expert interview, the syndrome type and medication were finalized. As a result, a total of 228 CAG patients aged at (50.30 ± 10.18) were collected, including 151 males (66.23%). Of them, the TCM diagnosis and syndrome type were extracted from the information of 157 patients, including 115 cases with gastric stuffiness, 23 cases with gastric pain, 19 missing cases, 2 cases with spleen-stomach weakness syndrome, 57 cases with spleen deficiency and dampness-heat syndrome, 18 cases with spleen-stomach disharmony syndrome, 23 cases with syndrome of liver depression syndrome, 21 cases with liver qi invading stomach syndrome and 26 qi and yin deficiency syndrome, respectively. All of the 228 patients used totally 104 herbs, while the subgroups with 157 patients used 94 herbs. The most frequently used 15 herbs used in each groups were analyzed to determine the initial basic remedy and modification. Subsequently, based on the information of the sub-groups with 157 patients, with the syndrome type as the dependent variable, the logistic regression analysis was made on the most frequently used 32 herbs, in order to determined the modification in herbs for different syndrome types. After experts reviewed and modified, they believed the main causes of CAG were dietary irregularities

  17. Horizontal Resorption of Fresh-Frozen Corticocancellous Bone Blocks in the Reconstruction of the Atrophic Maxilla at 5 Months

    PubMed Central

    Pereira, Eugénio; Messias, Ana; Dias, Ricardo; Judas, Fernando; Salvoni, Alexander; Guerra, Fernando

    2015-01-01

    Background Reliable implant-supported rehabilitation of an alveolar ridge needs sufficient volume of bone. In order to achieve a prosthetic-driven positioning, bone graft techniques may be required. Purpose This prospective cohort study aims to clinically evaluate the amount of resorption of corticocancellous fresh-frozen allografts bone blocks used in the reconstruction of the severe atrophic maxilla. Materials and Methods Twenty-two partial and totally edentulous patients underwent bone augmentation procedures with fresh-frozen allogenous blocks from the iliac crest under local anesthesia. Implants were inserted into the grafted sites after a healing period of 5 months. Final fixed prosthesis was delivered ± 4 months later. Ridge width analysis and measurements were performed with a caliper before and after grafting and at implant insertion. Bone biopsies were performed in 16 patients. Results A total of 98 onlay block allografts were used in 22 patients with an initial mean alveolar ridge width of 3.41 ± 1.36 mm. Early exposure of blocks was observed in four situations and one of these completely resorbed. Mean horizontal bone gain was 3.63 ± 1.28 mm (p < .01). Mean buccal bone resorption between allograph placement and the reopening stage was 0.49 ± 0.54 mm, meaning approximately 7.1% (95% confidence interval: [5.6%, 8.6%]) of total ridge width loss during the integration period. One hundred thirty dental implants were placed with good primary stability (≥ 30 Ncm). Four implants presented early failure before the prosthetic delivery (96.7% implant survival). All patients were successfully rehabilitated. Histomorphometric analysis revealed 20.9 ± 5.8% of vital bone in close contact to the remaining grafted bone. A positive strong correlation (adjusted R2 = 0.44, p = .003) was found between healing time and vital bone percentage. Conclusions Augmentation procedures performed using fresh-frozen allografts from the

  18. Micro-evolutionary divergence patterns of mandible shapes in wild house mouse (Mus musculus) populations

    PubMed Central

    2011-01-01

    Background Insights into the micro-evolutionary patterns of morphological traits require an assessment of the natural variation of the trait within and between populations and closely related species. The mouse mandible is a particularly suitable morphological trait for such an analysis, since it has long been used as a model to study the quantitative genetics of shape. In addition, many distinct populations, sub-species and closely related species are known for the house mouse. However, morphological comparisons among wild caught animals require an assessment in how far environmental and technical factors could interfere with the shape change measurements. Results Using geometric morphometrics, we have surveyed mandible shapes in 15 natural populations of the genus Mus, with a focus on the subspecies Mus musculus domesticus. In parallel we have carefully assessed possibly confounding technical and biological factors. We find that there are distinct differences on average between populations, subspecies and species, but these differences are smaller than differences between individuals within populations. Populations from summer-dry regions, although more ancestral, are less distinct from each other than are populations from the more recently colonized northern areas. Populations with especially distinct shapes occur in an area of sympatry of M. m. domesticus and M. spretus and on recently colonized sub-antarctic islands. We have also studied a number of inbred strains to assess in how far their mandible shapes resemble those from the wild. We find that they fall indeed into the shape space of natural variation between individuals in populations. Conclusions Although mandible shapes in natural populations can be influenced by environmental variables, these influences are insufficient to explain the average extent of shape differences between populations, such that evolutionary processes must be invoked to explain this level of diversity. We discuss that adaptive

  19. Posterior osseous bridging of C1.

    PubMed

    Simsek, Serkan; Yigitkanli, Kazim; Comert, Ayhan; Acar, Halil I; Seckin, Hakan; Er, Uygur; Belen, Deniz; Tekdemir, Ibrahim; Elhan, Alaittin

    2008-06-01

    The sulcus of the vertebral artery is located behind the lateral mass of the atlas and in some cases is converted into a foramen by anomalous ossification known as the posterior ponticulus (osseous bridge). This study involved anatomical observations of 158 isolated anatomical specimens of dry C1 vertebrae. The incidence and types of posterior osseous bridging were identified for the 158 dry samples of atlas vertebrae. In nine (5.6%) dry C1 vertebrae, partial osseous bridging was detected (bilaterally in eight vertebrae and unilaterally on the left in one). Complete osseous bridging (arcuate foramen) was observed in six (3.8%) dry C1 vertebrae (bilaterally in one vertebra, unilaterally on the left in three, and on the right in two). Awareness of the types of posterior osseous bridging of C1 in craniocervical junction surgery is essential, and may be helpful in surgical interventions in this region. PMID:18378457

  20. Posterior predictive checking of multiple imputation models.

    PubMed

    Nguyen, Cattram D; Lee, Katherine J; Carlin, John B

    2015-07-01

    Multiple imputation is gaining popularity as a strategy for handling missing data, but there is a scarcity of tools for checking imputation models, a critical step in model fitting. Posterior predictive checking (PPC) has been recommended as an imputation diagnostic. PPC involves simulating "replicated" data from the posterior predictive distribution of the model under scrutiny. Model fit is assessed by examining whether the analysis from the observed data appears typical of results obtained from the replicates produced by the model. A proposed diagnostic measure is the posterior predictive "p-value", an extreme value of which (i.e., a value close to 0 or 1) suggests a misfit between the model and the data. The aim of this study was to evaluate the performance of the posterior predictive p-value as an imputation diagnostic. Using simulation methods, we deliberately misspecified imputation models to determine whether posterior predictive p-values were effective in identifying these problems. When estimating the regression parameter of interest, we found that more extreme p-values were associated with poorer imputation model performance, although the results highlighted that traditional thresholds for classical p-values do not apply in this context. A shortcoming of the PPC method was its reduced ability to detect misspecified models with increasing amounts of missing data. Despite the limitations of posterior predictive p-values, they appear to have a valuable place in the imputer's toolkit. In addition to automated checking using p-values, we recommend imputers perform graphical checks and examine other summaries of the test quantity distribution. PMID:25939490

  1. Imaging the posterior mediastinum: a multimodality approach

    PubMed Central

    Occhipinti, Mariaelena; Heidinger, Benedikt H.; Franquet, Elisa; Eisenberg, Ronald L.; Bankier, Alexander A.

    2015-01-01

    The posterior mediastinum contains several structures that can produce a wide variety of pathologic conditions. Descending thoracic aorta, esophagus, azygos and hemiazygos veins, thoracic duct, lymph nodes, adipose tissue, and nerves are all located in this anatomical region and can produce diverse abnormalities. Although chest radiography may detect many of these pathologic conditions, computed tomography and magnetic resonance are the imaging modalities of choice for further defining the relationship of posterior mediastinal lesions to neighboring structures and showing specific imaging features that narrow the differential diagnosis. This review emphasizes modality-related answers to morphologic questions, which provide precise diagnostic information. PMID:25993732

  2. Imaging the posterior mediastinum: a multimodality approach.

    PubMed

    Occhipinti, Mariaelena; Heidinger, Benedikt H; Franquet, Elisa; Eisenberg, Ronald L; Bankier, Alexander A

    2015-01-01

    The posterior mediastinum contains several structures that can produce a wide variety of pathologic conditions. Descending thoracic aorta, esophagus, azygos and hemiazygos veins, thoracic duct, lymph nodes, adipose tissue, and nerves are all located in this anatomical region and can produce diverse abnormalities. Although chest radiography may detect many of these pathologic conditions, computed tomography and magnetic resonance are the imaging modalities of choice for further defining the relationship of posterior mediastinal lesions to neighboring structures and showing specific imaging features that narrow the differential diagnosis. This review emphasizes modality-related answers to morphologic questions, which provide precise diagnostic information. PMID:25993732

  3. Arthroscopic Approach to Posterior Ankle Impingement.

    PubMed

    Theodoulou, Michael H; Bohman, Laura

    2016-10-01

    Posterior ankle pain can occur for many reasons. If it is produced by forced plantarflexion of the foot, it is often a result of impingement from an enlarged posterior talar process or an os trigonum. This condition may present in an acute or chronic state. Management is initially nonoperative, but surgical treatments are available. This condition is often seen in athletes, so procedures that limit surgical trauma and allow early return to activity are ideal. An arthroscopic approach for this disorder produces good outcomes with limited complications. Understanding the indications, local anatomy, and surgical technique, allows good, reproducible outcomes. PMID:27599438

  4. Predictability of short implants (< 10 mm) as a treatment option for the rehabilitation of atrophic maxillae. A systematic review

    PubMed Central

    García-Sala-Bonmatí, Fernando; Martínez-González, Amparo; García-Dalmau, Carlos; Mañes-Ferrer, José-Félix; Brotons-Oliver, Alejandro

    2016-01-01

    Background Short implants (< 10 mm) are one of the treatment options available in cases of limited vertical bone. A purpose of this paper is to evaluate the predictability of short implants as an alternative to technically molthough such implants are now widely used, there is controversy regarding their clinical reliability. There complex treatments in patients with atrophic maxillae, based on a systematic review of the literature and the analysis of the implant survival rates, changes in peri-implant bone level, and associated complications. It is postulated that short implants offer clinical results similar to those of longer implants. Material and Methods A Medline-PubMed search was made covering the period between January 2004 and December 2014 (both included). Studies in English published in indexed journals, involving at least 20 implants and with a follow-up period of at least 12 months were considered. A manual search in four high impact journals was also conducted. Results A total of 37 studies meeting the inclusion criteria were included in this review. 9792 implants placed in over 5000 patients were analyzed. Conclusions Based on the results of this review, short implants are seen to offer clinical results in terms of survival, bone loss and complications similar to those of longer implants. Key words:Survival rate, clinical results, dental implants, oral implants, short implants, short lengt PMID:26946199

  5. [Relation between Helicobacter pylori and pathogenesis of chronic atrophic gastritis and the research of its prevention and treatment].

    PubMed

    Zhang, L; Yang, L W; Yang, L J

    1992-09-01

    The total detectable rate of Helicobacter pylori (HP) of 485 patients suffering from gastric diseases was 59.6%. The HP in gastric mucosa of chronic atrophic gastritis (CAG) patients was separated from the cell culture in vitro and transferred successively. The mice were perfused with exciccate alum, and the rabbits with aspirin to injure their gastric mucosa, then HP was perfused. Result showed that the change of experimental animals was identical with that of CAG patients by means of bacteriological and pathological examination. It revealed that HP was in agreement with Robert Koch's three principles about pathogenic bacteria. According to the bacterial infectious hypothesis of CAG, 53 Chinese medicinal herbs and prescriptions were investigated with bacteriostatic test. Panax notogenseng and Magnolia officinalis were discovered to be sensitive, Prunus mume and Corydalis yanhusuo were moderate sensitive, and Coptis chinensis and Rheum palmatum highly sensitive to HP. Decoction of Clearing up the Heat and Relieving the Blood Stasis and No.2 recipe of Huowei were used to treat 70 CAG patients with Stomach Heat Syndrome. The effective rate of gastroscopic examination was 85.7%, that of pathological study was 80%. In comparing with the group of Shanjiu Weitai, there was significant difference between the traditional Chinese medicine treated group and Shanjiu Weitai control group, the former being markedly better. PMID:1298465

  6. Atrophic thyroid follicles and inner ear defects reminiscent of cochlear hypothyroidism in Slc26a4-related deafness.

    PubMed

    Dror, Amiel A; Lenz, Danielle R; Shivatzki, Shaked; Cohen, Keren; Ashur-Fabian, Osnat; Avraham, Karen B

    2014-08-01

    Thyroid hormone is essential for inner ear development and is required for auditory system maturation. Human mutations in SLC26A4 lead to a syndromic form of deafness with enlargement of the thyroid gland (Pendred syndrome) and non-syndromic deafness (DFNB4). We describe mice with an Slc26a4 mutation, Slc26a4 (loop/loop) , which are profoundly deaf but show a normal sized thyroid gland, mimicking non-syndromic clinical signs. Histological analysis of the thyroid gland revealed defective morphology, with a majority of atrophic microfollicles, while measurable thyroid hormone in blood serum was within the normal range. Characterization of the inner ear showed a spectrum of morphological and molecular defects consistent with inner ear pathology, as seen in hypothyroidism or disrupted thyroid hormone action. The pathological inner ear hallmarks included thicker tectorial membrane with reduced β-tectorin protein expression, the absence of BK channel expression of inner hair cells, and reduced inner ear bone calcification. Our study demonstrates that deafness in Slc26a4 (loop/loop) mice correlates with thyroid pathology, postulating that sub-clinical thyroid morphological defects may be present in some DFNB4 individuals with a normal sized thyroid gland. We propose that insufficient availability of thyroid hormone during inner ear development plays an important role in the mechanism underlying deafness as a result of SLC26A4 mutations. PMID:24760582

  7. The Effect of Pimecrolimus Cream 1% Compared with Triamcinolone Acetonide Paste in Treatment of Atrophic-Erosive Oral Lichen Planus

    PubMed Central

    Pakfetrat, Atessa; Delavarian, Zahra; Falaki, Farnaz; Khorashadizadeh, Mahboubeh; Saba, Mina

    2015-01-01

    Introduction: Oral lichen planus (OLP) is a common chronic mucocutaneous disease. Patients with atrophic and erosive types of OLP often have symptoms of soreness, and require proper treatment. The main treatment for OLP has been the administration of topical or systemic corticosteroids. The objective of this study was to compare the efficacy of adcortyl cream (triamcinolone acetonide in orabase) with topical pimecrolimus cream for the treatment of erosive OLP. Materials and Methods: Twenty-eight patients with OLP were enrolled in a single blind clinical trial and assigned to either a pimecrolimus 1% cream group or an adcortyl 0.1% cream group. The medication was applied every day for 2 months and patients were assessed every 2 weeks. Results: The mean lesion size and mean pain and burning sensation scores did not differ between the pimecrolimus and adcortyl cream groups. The pimecrolimus cream was well tolerated. No clinical drug-related adverse events were observed. Conclusion: Topical pimecrolimus cream may be recommended as a safe and effective alternative therapy in the treatment of OLP. Pimecrolimus cream is as effective as adcortyl cream in managing the signs and symptoms of OLP. PMID:25938083

  8. Immunogenicity and efficacy of three recombinant subunit Pasteurella multocida toxin vaccines against progressive atrophic rhinitis in pigs

    USGS Publications Warehouse

    Liao, Chih-Ming; Huang, Chienjin; Hsuan, Shih-Ling; Chen, Zeng-Weng; Lee, Wei-Cheng; Liu, Cheng-I; Winton, James R.; Chien, Maw-Sheng

    2006-01-01

    Three short fragments of recombinant subunit Pasteurella multocida toxin (rsPMT) were constructed for evaluation as candidate vaccines against progressive atrophic rhinitis (PAR) of swine. PMT-specific antibody secreting cells and evidence of cellular immunity were detected in rsPMT-immunized pigs following authentic PMT challenge or homologous antigen booster. Piglets immunized with rsPMT fragments containing either the N-terminal or the C-terminal portions of PMT developed high titers of neutralizing antibodies. Pregnant sows immunized with rsPMT had higher levels of maternal antibodies in their colostrum than did those immunized with a conventional PAR-toxoid vaccine. Offspring from rsPMT vaccinated sows had better survival after challenge with a five-fold lethal dose of authentic PMT and had better growth performance after challenge with a sublethal dose of toxin. Our findings indicate these non-toxic rsPMT proteins are attractive candidates for development of a subunit vaccine against PAR in pigs.

  9. Stomach microbiota composition varies between patients with non-atrophic gastritis and patients with intestinal type of gastric cancer

    PubMed Central

    Aviles-Jimenez, Francisco; Vazquez-Jimenez, Flor; Medrano-Guzman, Rafael; Mantilla, Alejandra; Torres, Javier

    2014-01-01

    We aimed to characterize microbiota of the gastric mucosa as it progress to intestinal type of cancer. Study included five patients each of non-atrophic gastritis (NAG), intestinal metaplasia (IM) and intestinal-type gastric cancer (GC). Gastric tissue was obtained and DNA extracted for microbiota analyses using the microarray G3 PhyloChip. Bacterial diversity ranged from 8 to 57, and steadily decreased from NAG to IM to GC (p = 0.004). A significant microbiota difference was observed between NAG and GC based on Unifrac-presence/absence and weighted-Unifrac-abundance metrics of 283 taxa (p < 0.05). HC-AN analyses based on presence/absence of 238 taxa revealed that GC and NAG grouped apart, whereas IM overlapped with both. An ordinated analyses based on weighted-Unifrac distance given abundance of 44 taxa showing significance across categories revealed significant microbiota separation between NAG and GC. This study is the first to show a gradual shift in gastric microbiota profile from NAG to IM to GC. PMID:24569566

  10. Use of Narrow-Diameter Implants in Treatment of Severely Atrophic Maxillary Anterior Region With Implant-Supported Fixed Restorations.

    PubMed

    Froum, Stuart J; Cho, Sang-Choon; Florio, Salvatore; Misch, Craig M

    2016-05-01

    The edentulous anterior atrophic maxilla represents a challenge for the surgeon and restorative dentist. Soft- and hard-tissue augmentation procedures are often required prior to, or simultaneously with, implant placement. A well-planned treatment protocol, patient compliance, and collaboration between the treating clinicians and the laboratory are requirements in achieving predictable long-term outcomes that satisfy patient expectations. Avoiding transmucosal loading and movement of the graft during the healing phase are crucial factors in achieving lasting success. In this case report, a fixed provisional restoration supported by four immediately loaded narrow-diameter implants (NDIs) was used to enable function during healing and protect the grafted site. Two of the NDIs, along with three conventional-diameter implants, were subsequently used to support the final restoration. NDIs with diameters of less than 3 mm can achieve excellent long-term osseointegration and may be used together with conventional implants for definitive prosthodontic treatment as demonstrated by the 11-year follow-up reported in this case. PMID:27213779

  11. [Therapy of posterior and posterolateral knee instability].

    PubMed

    Jakob, R P; Rüegsegger, M

    1993-11-01

    The natural course after posterior cruciate ligament (PCL) tear is a slow process of degeneration starting in the medial compartment. Functional disability is mainly present in those instabilities that are combined with posterolateral insufficiency. The surgical treatment at present mainly addresses these combined types of posterior-posterolateral instability. It is generally agreed that suture of the torn PCL alone is insufficient and augmentation with autologous structures, such as the patellar ligament, are mandatory. Synthetic augmentation to facilitate after treatment is another adjunct. Because of the difficulty of precise tibial tunnel placement a two-stage procedure is advocated, an anterior approach with the patient supine being used for femoral graft placement. If a posterior approach with the patient prone is used, a straight posterior incision is made between the two heads of the gastrocnemius and the neuromuscular bundle. With this approach the tibial bone block is placed in a trough. The accuracy of graft placement and the immediate functional aftertreatment facilitated by the use of osseous fixation of a synthetic augmentation device at both ends have made better results of surgical reconstruction of the PCL possible. PMID:8309701

  12. Subspecialization in the human posterior medial cortex

    PubMed Central

    Bzdok, Danilo; Heeger, Adrian; Langner, Robert; Laird, Angela R.; Fox, Peter T.; Palomero-Gallagher, Nicola; Vogt, Brent A.; Zilles, Karl; Eickhoff, Simon B.

    2014-01-01

    The posterior medial cortex (PMC) is particularly poorly understood. Its neural activity changes have been related to highly disparate mental processes. We therefore investigated PMC properties with a data-driven exploratory approach. First, we subdivided the PMC by whole-brain coactivation profiles. Second, functional connectivity of the ensuing PMC regions was compared by task-constrained meta-analytic coactivation mapping (MACM) and task-unconstrained resting-state correlations (RSFC). Third, PMC regions were functionally described by forward/reverse functional inference. A precuneal cluster was mostly connected to the intraparietal sulcus, frontal eye fields, and right temporo-parietal junction; associated with attention and motor tasks. A ventral posterior cingulate cortex (PCC) cluster was mostly connected to the ventromedial prefrontal cortex and middle left inferior parietal cortex (IPC); associated with facial appraisal and language tasks. A dorsal PCC cluster was mostly connected to the dorsomedial prefrontal cortex, anterior/posterior IPC, posterior midcingulate cortex, and left dorsolateral prefrontal cortex; associated with delay discounting. A cluster in the retrosplenial cortex was mostly connected to the anterior thalamus and hippocampus. Furthermore, all PMC clusters were congruently coupled with the default mode network according to task-constrained but not task-unconstrained connectivity. We thus identified distinct regions in the PMC and characterized their neural networks and functional implications. PMID:25462801

  13. Posterior instability caused by batter's shoulder.

    PubMed

    Kang, Richard W; Mahony, Gregory T; Harris, Thomas C; Dines, Joshua S

    2013-10-01

    In summary, batter’s shoulder is a rare and only recently recognized entity. This condition is posterior shoulder instability caused by a missed attempt at hitting a pitch, especially with an outside pitch. The lack of counterforce from hitting a ball produces increased forces imparted on the posterior capsulolabral complex of the lead shoulder during batting. If the player fails conservative management, she or he can undergo an arthroscopic posterior labral repair instead of debridement. After treatment, the player can expect to return to play after approximately 6 to 7 months. Initial results from a small, retrospective series demonstrate greater than 90% excellent results. These findings are similar to current literature for arthroscopic treatment of posterior instability, which reports success rates that range from 75% to 91%. Longer-term follow-up will be needed to determine the natural history and prognosis or batter’s shoulder. Based on initial results, the authors predict good to excellent results for most players with batter’s shoulder who undergo proper treatment. Additionally, with the exception of switch hitters, the nonthrowing arm is affected. This can also improve the athlete’s return to play. PMID:24079435

  14. Posterior Probabilities for a Consensus Ordering.

    ERIC Educational Resources Information Center

    Fligner, Michael A.; Verducci, Joseph S.

    1990-01-01

    The concept of consensus ordering is defined, and formulas for exact and approximate posterior probabilities for consensus ordering are developed under the assumption of a generalized Mallows' model with a diffuse conjugate prior. These methods are applied to a data set concerning 98 college students. (SLD)

  15. Cortical Bone Morphological and Trabecular Bone Microarchitectural Changes in the Mandible and Femoral Neck of Ovariectomized Rats

    PubMed Central

    Hsu, Pei-Yu; Tsai, Ming-Tzu; Wang, Shun-Ping; Chen, Ying-Ju; Wu, Jay; Hsu, Jui-Ting

    2016-01-01

    Objective This study used microcomputed tomography (micro-CT) to evaluate the effects of ovariectomy on the trabecular bone microarchitecture and cortical bone morphology in the femoral neck and mandible of female rats. Materials and Methods Twelve female Wister rats were divided into two groups: the control and ovariectomized groups. The rats in the ovariectomized group received ovariectomy at 8 weeks of age; all the rats were sacrificed at 20 weeks of age, and their mandibles and femurs were removed and scanned using micro-CT. Four microstructural trabecular bone parameters were measured for the region below the first mandibular molar and the femoral neck region: bone volume fraction (BV/TV), trabecular thickness (TbTh), trabecular separation (TbSp), and trabecular number (TbN). In addition, four cortical bone parameters were measured for the femoral neck region: total cross-sectional area (TtAr), cortical area (CtAr), cortical bone area fraction (CtAr/TtAr), and cortical thickness (CtTh). The CtTh at the masseteric ridge was used to assess the cortical bone morphology in the mandible. The trabecular bone microarchitecture and cortical bone morphology in the femoral necks and mandibles of the control group were compared with those of the ovariectomized group. Furthermore, Spearman’s correlation (rs) was conducted to analyze the correlation between the osteoporosis conditions of the mandible and femoral neck. Results Regarding the trabecular bone microarchitectural parameters, the BV/TV of the trabecular bone microarchitecture in the femoral necks of the control group (61.199±11.288%, median ± interquartile range) was significantly greater than that of the ovariectomized group (40.329±5.153%). Similarly, the BV/TV of the trabecular bone microarchitecture in the mandibles of the control group (51.704±6.253%) was significantly greater than that of the ovariectomized group (38.486±9.111%). Furthermore, the TbSp of the femoral necks in the ovariectomized group

  16. Utility of Extra-Oral Aiming Device in Imaging Periapical Regions of Posterior Teeth

    PubMed Central

    P, Ramaswamy; B, Smitha; G, Uday

    2014-01-01

    Background: Intraoral film placement and the film holding equipments are not acceptable by many due to varied reasons. Objective: To evaluate the utility of extra-oral aiming device developed by Chia-hui chen for imaging the periapical regions of posterior teeth employing the technique suggested by saberi et al. Materials and Methods: The study subjects included 20 patients in the age group of 10-35 y. The subjects were further subdivided according to the area to be imaged into four groups, with 5 in each. Imaging was done using the device developed by chia-hui chen, with the method employed by newmann and saberi et al., The radiographs were then interpreted for complete coverage of the anatomical structure. The findings were recorded and subjected to Analysis of variance (ANOVA) statistical analysis. Results: The visibility of imaging area was more in mandible (95%) than maxilla (86.5%). The overall accuracy was 90.75%. These findings were statistically non-significant (F- 2.152 & P-0.134). Among the reason for reduced accuracy, overlapping of the opposite arch (4%) was more common and the horizontal overlapping (0.5%) was least common. Conclusion: This technique is not meant to replace conventional intraoral radiography. It is a useful supplementary aid to our clinical practice. PMID:25478448

  17. Morphology of Thai Edentulous Mandible Using 3D Reverse Engineering: Relevance to Immediate Loading Dental Implant Design

    NASA Astrophysics Data System (ADS)

    Kasemsarn, Suthasinee; Mahaisavariya, Banchong; Sitthiseripratip, Kriskrai; Suwanprateeb, Jintamai

    The dimension and number of implants as well as the splinting concept of the superstructure are the impact factors of the immediate loading implant-supported prostheses. The purpose of this study is to determine the morphometric data of Thai lower edentulous jaws between two metal foramens for optimizing the design. Sixty-four Thai cadaveric edentulous mandibles were CT scanned and 3D models were reconstructed. Arch forms, dimensions, and the area of the greatest concavity in the body of the mandibles between the metal foramens were defined in geometric terms based on reverse engineering methods. The arch forms, represented by average values of angle and distance of panoramic arc, were 116.4 ±9.5 degrees and 46.7 ±3.9mm respectively. The dimensions of the mandibles, determined by the height and width of the body of the mandibles as well as the angle between the axis of the mandibular body to the mandibular plane, were 25.3 ±0.6mm, 11.6 ±0.6mm and 61.3 ±1.7 degrees respectively. The area of greatest concavity was 8.3 ±1.9mm. Morphology of the Thai edentulous mandible determines the maximum length of an implant placed for immediate loading protocol as 17mm, with a maximum diameter of 3.5-5mm. The maximum number of implants that can be placed in the anterior region is 5.

  18. Biomechanical loading test on reconstructed mandibles with fibular, iliac crest or scapula graft: a comparative study.

    PubMed

    Grohmann, Isabella; Raith, Stefan; Mücke, Thomas; Stimmer, Herbert; Rohleder, Nils; Kesting, Marco R; Hölzle, Frank; Steiner, Timm

    2015-10-01

    Advantages and disadavantages of the three most commonly-used bone grafts for mandibular reconstruction are widely known, but biomechanical experimental studies are rare. We have done loading tests on cadaveric mandibles reconstructed with fibular, iliac crest, and scapular grafts using 3 different osteosynthesis systems to detect and compare their primary stability. Loading tests were done on mandibles with grafts from the fibula and iliac crest and published previously. A 4.5cm paramedian L-type defect was reconstructed with scapula using 2 monocortical non-locking plates, 2 monocortical locking plates, or a single bicortical locking plate/fracture gap in 18 human cadaveric mandibles. These were loaded on to the "Mandibulator" test bench and the movement of fragments in 3 dimensions was assessed and quantified by a PONTOS® optical measurement system. Comparison of the osteosynthesis groups showed that the miniplate was significantly superior to the 6-hole TriLock® plate for both fibular and iliac crest grafts. The fibular graft gave greater stability than the iliac crest and scapular grafts for all 3 osteosynthesis systems. All bony specimens offered sufficient resistance to mechanical stress within the recognised range of biting forces after mandibular reconstruction, independently of the choice of bone graft and osteosynthesis system used. Anatomical and surgical advantages need to be taken into account when choosing a graft. Stability can be maximised with a fibular graft, and further optimised by enlarging the binding area by using the "double barrel" method. Computer simulated experiments could segregate factors that biased results, such as morphological differences among cadavers. PMID:26088156

  19. BONE REGENERATION AND DOCKING SITE HEALING AFTER BONE TRANSPORT DISTRACTION OSTEOGENESIS IN THE CANINE MANDIBLE

    PubMed Central

    Nagashima, Lucy K; Newby, Michelle Rondon; Zakhary, Ibrahim E; Nagy, William W; Zapata, Uriel; Dechow, Paul C; Opperman, Lynne A; Elsalanty, Mohammed E

    2011-01-01

    Purpose Bone transport distraction osteogenesis (BTDO) provides a promising alternative to traditional grafting techniques. However, existing BTDO devices have many limitations. The purpose of this research was to test a new device, the mandibular bone transport reconstruction plate (BTRP), in an animal model with comparable mandible size to humans and to histologically and mechanically examine the regenerate bone. Materials and methods Eleven adult foxhound dogs were divided into an unreconstructed control group of 5 animals, and an experimental group of 6 animals. In each animal, a 34 mm segmental defect was created in the mandible. The defect was reconstructed with BTRP. Histological and biomechanical characteristics of the regenerate and un-repaired defect were analyzed and compared to bone on the contralateral side of the mandible after 4 weeks of consolidation. Results The reconstructed defect was bridged with new bone, with little bone in the control defect. Regenerate density and microhardness were 22.3% and 42.6% lower than the contralateral normal bone, respectively. Likewise, the anisotropy of the experimental group was statistically lower than in the contralateral bone. Half the experimental animals showed non-union at the docking site. Conclusion The device was very stable and easy to install and activate. After one month of consolidation, the defect has been bridged with new bone with evidence of active bone formation. Regenerate bone was less mature than the control bone. Studies are underway to identify when the regenerate properties compare to normal bone, and to identify methods to augment bone union at the docking site. PMID:21601342

  20. Osteoradionecrosis and Radiation Dose to the Mandible in Patients With Oropharyngeal Cancer

    SciTech Connect

    Tsai, Chiaojung Jillian; Hofstede, Theresa M.; Sturgis, Erich M.; Garden, Adam S.; Lindberg, Mary E.; Wei Qingyi; Tucker, Susan L.; Dong Lei

    2013-02-01

    Purpose: To determine the association between radiation doses delivered to the mandible and the occurrence of osteoradionecrosis (ORN). Methods and Materials: We reviewed the records of 402 oropharyngeal cancer patients with stage T1 or T2 disease treated with definitive radiation between January 2000 and October 2008 for the occurrence of ORN. Demographic and treatment variables were compared between patients with ORN and those without. To examine the dosimetric relationship further, a nested case-control comparison was performed. One to 2 ORN-free patients were selected to match each ORN patient by age, sex, radiation type, treatment year, and cancer subsite. Detailed radiation treatment plans for the ORN cases and matched controls were reviewed. Mann-Whitney test and conditional logistic regression were used to compare relative volumes of the mandible exposed to doses ranging from 10 Gy-60 Gy in 10-Gy increments. Results: In 30 patients (7.5%), ORN developed during a median follow-up time of 31 months, including 6 patients with grade 4 ORN that required major surgery. The median time to develop ORN was 8 months (range, 0-71 months). Detailed radiation treatment plans were available for 25 of the 30 ORN patients and 40 matched ORN-free patients. In the matched case-control analysis, there was a statistically significant difference between the volumes of mandible in the 2 groups receiving doses between 50 Gy (V50) and 60 Gy (V60). The most notable difference was seen at V50, with a P value of .02 in the multivariate model after adjustment for the matching variables and dental status (dentate or with extraction). Conclusions: V50 and V60 saw the most significant differences between the ORN group and the comparison group. Minimizing the percent mandibular volume exposed to 50 Gy may reduce ORN risk.

  1. Amifostine Remediates the Degenerative Effects of Radiation on the Mineralization Capacity of the Murine Mandible

    PubMed Central

    Tchanque-Fossuo, Catherine N.; Donneys, Alexis; Deshpande, Sagar S.; Nelson, Noah S.; Boguslawski, Matt J.; Gallagher, K. Kelly; Sarhaddi, Deniz; Poushanchi, Behdod; Goldstein, Steven A.; Buchman, Steven R.

    2012-01-01

    Background Although radiotherapy is a cornerstone in head and neck cancer treatment it causes substantial morbidity to the normal adjoining bone. Our specific aim is to assess the radioprotective effect of Amifostine (AMF) therapy on the mineralization of the mandible using micro-computed tomography (μCT). We hypothesize that AMF will safeguard the mandible from radiation-induced disruption of the mineralization process and the associated failure of new bone creation. Methods Male Sprague Dawley rats were randomized into 3 groups: Control (n=8), XRT (n=5) and AMF (n=8). XRT and AMF underwent human bioequivalent radiation of 70Gy in 5 fractions to the left hemimandible. 56 days post-radiation, the hemimandibles were harvested for radiomorphometric analyses. Results AMF exhibited less alopecia, mucositis and weight loss as well as increased cortical density in comparison to XRT. Bone and Tissue Mineral Densities showed statistically significant improvement in AMF versus XRT and no difference was observed between AMF versus Control. Detailed μCT analysis further demonstrated significant differences in the mineralization profile when comparing XRT and AMF. AMF maintained regions of lower mineralization consistent with the preservation of normal remodeling. Conclusion We have successfully demonstrated the ability of AMF pre-treatment to protect the natural mineralization profile of bone. This reflects the capacity of AMF prophylaxis to safeguard the normal surrounding mandible from the impediments of collateral damage imposed by radiation. Further study can now be directed at correlating these findings with the potential use of AMF to prevent the devastating associated morbidities of radiotherapy such as pathologic fractures and osteoradionecrosis. PMID:22456378

  2. Peroxisome proliferator activated receptor gamma loaded dental implant improves osteogenesis of rat mandible.

    PubMed

    Bhattarai, Govinda; Lee, Young-Hee; Yi, Ho-Keun

    2015-04-01

    Peroxisome proliferator activated receptor gamma (PPARγ) has been known for their anti-inflammatory effects. But the application of this molecule in implant-induced inflammation has not been clearly studied yet. Here, we determined in vivo anti-inflammatory and osteogenic effects of PPARγ coated dental implant in the rat mandible. We used chitosan gold nanoparticles (Ch-GNPs) as a non viral vector to carry PPARγ plasmid DNA. Ch-GNPs were conjugated with PPARγ plasmid DNA through a coacervation process. Conjugation was cast over titanium (Ti) implants (4.5 × 0.8 mm) by dipping, and implants were installed in rat mandibles. One, 2, 3, and 6 weeks post-implantation, mandibles were examined by microcomputed tomography (µCT), immunohistochemistry, hematoxylin & eosin, and tartrate resistance acid phosphatase (TRAP) staining. In vivo Ch-GNPs/PPARγcoated implants were associated with inhibition of implant induced inflammatory molecules interleukin-1β and receptor activator of nuclear factor kappa-B ligand and enhanced expression of osteogenic molecules like bone morphogenetic protein 2 and 7 (BMP-2/-7) by up-regulating anti-oxidant molecules heme oxygenase-1. µCT demonstrated that PPARγ overexpression increased the density and volume of newly formed bone surrounding the implants compared to control (n = 4; p < 0.05). Also, PPARγ reduced the number of TRAP positive cells. These results support the view that PPARγ overexpression diminishes inflammation and enhances osteogenesis around the dental implants. Thus, implant coated with anti-inflammatory molecules could have a significant utilization for the preparation of new biomaterials and may serve as prosthetic materials in patients suffering from inflammatory bone disease. PMID:24962969

  3. Unusual Unilateral Fracture of the Condylar and Coronoid Processes of the Mandible

    PubMed Central

    Baykul, Timuçin; Aydın, M Asım; Aksoy, Müge Çına; Fındık, Yavuz

    2014-01-01

    The incidence of condylar fracture is very high and most are not caused by direct trauma. On the other hand, fracture of the coronoid process is reported less often than fracture of other parts of the mandible. We report a case of right subcondylar and coronoid fractures without any evidence of direct trauma to the zygomatic area or an indirect trauma to the mandibular corpus or sypmheseal region. The possible cause was identified as acute reflex contraction of the temporalis muscles leading to coronoid and condylar stress fractures. PMID:25379353

  4. Osteosarcoma of the Mandible Masquerading as a Dental Abscess: Report of a Case

    PubMed Central

    Anil, Sukumaran; Krishnan, Anitha P.; Rajendran, R.

    2012-01-01

    An aggressive and fatal case of osteosarcoma of the mandible in a 19-year-old female is reported. Six weeks after the clinical appearance of the swelling, the patient died. This paper is unique in that the age of occurrence and the biologic behavior of the tumor were not consistent with the reported literature. The case report is followed by a brief review of osteosarcoma of the jaw with a note on its clinical presentation, diverse radiologic appearance, varied histopathologic picture, and prognosis. PMID:23243522

  5. Giant aneurysmal bone cyst of the mandible: A case report and review of literature

    PubMed Central

    Bharadwaj, Gaurav; Singh, Neeraj; Gupta, Amit; Sajjan, Anand K.

    2013-01-01

    Aneurysmal bone cysts are rare benign lesions of bone tissue. They are composed of vascular spaces blood-filled and surrounded by fibrous tissue septa. They are considered as pseudo cysts because of lack of epithelial lining. Here, we describe a giant case of ABC in 12-year-old female child having a massive swelling over the right side of the mandible treated with segmental resection and reconstruction with a reconstruction plate. Case is also discussed with the review of literature. PMID:24163565

  6. Primary Tuberculous Osteomyelitis of the Mandible Mimicking a Parotid Gland Abscess.

    PubMed

    Dalmia, Deepak; Shah, Pankil; Pillai, Jeena

    2016-06-01

    Tuberculosis has become a rare disease in the developed countries but it is still a serious problem in the developing countries. Incidence of tuberculous osteomyelitis of the jaw bones is very low. This rare incidence is the primary reason that the lesion gets misdiagnosed many times. Here we report the diagnosis, treatment and follow up of a case which is not a classical presentation of tuberculous osteomyelitis of mandible. Early diagnosis of tuberculous osteomyelitis will certainly reduce the morbidity of this disease condition. PMID:27340647

  7. A Pathological Fracture of the Mandible due to Osteomyelitis following a Full Dental Clearance.

    PubMed

    Jauhar, Preeti; Handley, Thomas; Hammersley, Nicholas

    2016-03-01

    Orofacial infections following dental extractions are a common referral to an oral and maxillofacial department as an emergency, especially when combined with swelling and limited mouth opening. The case presented demonstrates a rare complication of chronic suppurative osteomyelitis with bilateral pathological fractures of the mandible, which occurred following a staged dental clearance. CPD/Clinical Relevance: Dental extractions are one of the most common treatments carried out by oral surgeons and general dental practitioners. This case highlights a rare but encountered complication of routine oral surgery and demonstrates when it is necessary to make an immediate referral to the local oral and maxillofacial surgery unit. PMID:27188132

  8. De novo myeloid sarcoma involving mandible in a child: Report of a rare occurrence

    PubMed Central

    Sengupta, Moumita; Das, Indranil; Chatterjee, Uttara; Majumdar, Boby

    2016-01-01

    Myeloid sarcoma (MS) is a rare malignant disease defined as extramedullary infiltration of immature myeloid cells. We reporte a 2-year-old male of isolated MS who presented with swelling over the left side of the body of the mandible. Proper histological examination and adequate panels of immunohistochemical stain led to the accurate diagnosis. Early intervention with systemic chemotherapy regimens based on cytarabine is the treatment of choice. The role of chromosomal aberrations and genetic abnormality related to prognosis remain uncertain. PMID:27601827

  9. Mandibles and labrum-epipharynx of tiger beetles: basic structure and evolution (Coleoptera, Carabidae, Cicindelitae)

    PubMed Central

    Ball, George E.; Acorn, John H.; Shpeley, Danny

    2011-01-01

    Abstract Using for comparison with, and as outgroups for, supertribe Cicindelitae, we describe and illustrate the mandibles and labrum-epipharynx of the basal geadephagans Trachypachus gibbsii LeConte, 1861 (family Trachypachidae), and family Carabidae: Pelophila rudis (LeConte, 1863) (supertribe Nebriitae, tribe Pelophilini) and Ceroglossus chilensis (Eschscholtz, 1829) (supertribe Carabitae, tribe Ceroglossini). The range and pattern of variation in structure of mandibles and labrum-epipharynx within the supertribe Cicindelitae was assessed using scanning-electron (SEM) images of these structures in nine exemplar taxa: Amblycheila baroni (Rivers, 1890), Omus californicus (Eschscholtz, 1829) and Picnochile fallaciosa (Chevrolat, 1854) (representing the Amblycheilini); Manticora tuberculata (DeGeer, 1778) (representing the Manticorini): Tetracha carolina (Linnaeus, 1767) (representing the Megacephalini); Pogonostoma chalybeum (Klug, 1835) (representing the Collyridini); and Therates basalis Dejean, 1826, Oxycheila species, and Cicindela longilabris Say, 1824 (representing the Cicindelini). An evolutionary transformation series was postulated for the mandibles and labrum-epipharynx, based on a reconstructed phylogenetic sequence, which, in turn, was based on morphological and DNAevidence.Principal features of the transformation series for the mandibles included development of a densely setose basal face; wide quadridentate retinaculum; a lengthened incisor tooth; a multidentate terebra (one to five teeth; two-three most frequent), followed by subsequent loss of one or more such teeth; development of a diastema in the occlusal surface; development and subsequent loss of scrobal setae, and reduction and loss of the scrobe. Principal features of the transformation series for the labrum included evolution of form from transverse, sub-rectangular to elongate almost square, to triangular; position and number of setae evolved from dorsal to insertion on the apical margin

  10. Calcifying cystic odontogenic tumor associated with ameloblastic fibro-odontoma of the anterior mandible.

    PubMed

    Lee, Jun; Song, Young-Gook; Moon, Seong-Yong; Choi, Boyoung; Kim, Bong Chul; Yoon, Jung-Hoon

    2014-05-01

    Calcifying cystic odontogenic tumor, which was formerly named calcifying odontogenic cyst, is a benign odontogenic tumor containing clusters of ghost cells within ameloblastic epithelium. Calcifying cystic odontogenic tumors have been associated with other odontogenic tumors, a finding that is a rare event in other types of odontogenic cysts or tumors. This report describes a case of hybrid odontogenic tumor composed of calcifying cystic odontogenic tumor and ameloblastic fibroma-odontoma of the anterior mandible that occurred in a 4-year-old Korean girl. PMID:24785751

  11. De novo myeloid sarcoma involving mandible in a child: Report of a rare occurrence.

    PubMed

    Sengupta, Moumita; Das, Indranil; Chatterjee, Uttara; Majumdar, Boby

    2016-01-01

    Myeloid sarcoma (MS) is a rare malignant disease defined as extramedullary infiltration of immature myeloid cells. We reporte a 2-year-old male of isolated MS who presented with swelling over the left side of the body of the mandible. Proper histological examination and adequate panels of immunohistochemical stain led to the accurate diagnosis. Early intervention with systemic chemotherapy regimens based on cytarabine is the treatment of choice. The role of chromosomal aberrations and genetic abnormality related to prognosis remain uncertain. PMID:27601827

  12. Primary Malignant Mixed Germ Cell Tumour with Squamous Cell Carcinoma of the Mandible; A Rare Entity

    PubMed Central

    Paul, Arun; Parmar, Harshad; Chacko, Rabin

    2015-01-01

    Germ cell Tumours (GCT) are neoplasm derived from germ cells. GCT usually occurs inside the gonads. Extragonadal GCT’s are rare. Most common GCT associated with head and neck region are the teratomas. Of the few teratomas found in the head and neck, malignant transformation of a teratomatous element is very uncommon, and primary bone involvement within the head and neck is even rare. We present a case of primary malignant mixed germ cell Tumour involving the mandible, the present case presented malignant transformation of the epithelial component showing foci of squamous cell carcinoma within the GCT. PMID:26266228

  13. Bony fusion of the maxilla and mandible as a sequelae of noma: A rare case report

    PubMed Central

    Awasthi, Ujjwala Rastogi; Mody, Bharat M.; Suma, Gundareddy N.; Garg, Shruti

    2015-01-01

    Noma is a gangrenous disease of the orofacial region that leads to severe facial tissue destruction and is a significant cause of death among children. With the advent of modern antibiotics and improved nutrition, children with noma may survive into adulthood, but must face the challenge of undergoing repair of the sequelae of noma. This report describes a case of bony fusion of the maxilla and mandible in a 28-year-old female patient, which was a sequelae of a childhood case of noma. PMID:26389063

  14. Arteriovenous malformation of the mandible presented as massive upper gastrointestinal bleeding: report of one case.

    PubMed

    Su, Kuan-Wen; Peng, Yen-Shih; Wu, Yu-Nian; Tsai, Ya-Huei; Lee, Hung-Chang

    2006-01-01

    Arteriovenous malformation is an uncommon cause of upper gastrointestinal bleeding in children. It should be taken into consideration when a child has upper gastrointestinal bleeding because without proper management, it might be fatal. We report a 10-year-old boy whose initial presentation was massive hematemesis and impending shock. After angiography, arteriovenous malformation (AVM) of the mandible was found and treated with embolization. This 10-year-old boy also had chicken pox during admission. Case reports regarding AVM of dental arches in literature are reviewed and the proposed managements are summarized. Embolization combined with surgical excision might be the optimal way to manage AVM of dental arches. PMID:17180789

  15. An Unusual Cause of Posterior Elbow Impingement: Detachment of a Hypertrophied Posterior Fat Pad.

    PubMed

    Hamada, Daisuke; Matsuura, Tetsuya; Sugiura, Kosuke; Higuchi, Tadahiro; Suzue, Naoto; Goto, Tomohiro; Tsutsui, Takahiko; Wada, Keizo; Fukuta, Shoji; Sairyo, Koichi

    2015-01-01

    We report a case of a 47-year-old woman who developed posterior impingement of the elbow due to detachment of a hypertrophied posterior fat pad. She reported acute left elbow pain after leaning back onto a hard object with her hand and subsequently experienced a "catching" sensation. Comparison with the magnetic resonance images of a normal elbow revealed a hypertrophied posterior fat pad interposed between the olecranon and olecranon fossa in both elbows, with the fat pad in the left elbow located more inferiorly than that in the right elbow. Elbow arthroscopy showed the olecranon fossa covered by the fat pad, a portion of which was detached from the rest of the pad. Debridement of the detached portion was performed until no impingement was evident. Postoperatively, full extension of the elbow did not elicit pain. Clinicians should include this pathology among the differential diagnoses for posterior elbow pain. PMID:26613057

  16. Posterior cruciate-retaining versus posterior-stabilized total knee arthroplasty: a meta-analysis.

    PubMed

    Bercik, Michael J; Joshi, Ashish; Parvizi, Javad

    2013-03-01

    The objective of this meta-analysis was to compare outcomes of posterior cruciate-retaining and posterior stabilized prostheses. A computerized literature search was conducted to identify randomized controlled trials comparing the clinical outcomes of cruciate-retaining and posterior-stabilized designs. The table of contents of four major Orthopaedic journals and the references section of two arthroplasty text books were reviewed to identify other relevant studies. Ultimately, 1114 patients (1265 knees) were compared. Statistical analysis revealed a significant difference in flexion and range of motion in favor of posterior-stabilized knees, but no difference in complication rates. The clinical importance of this remains unknown. The decision to use one design versus the other should rest with the surgeon's preference and comfort with a particular design. PMID:23433255

  17. An Unusual Cause of Posterior Elbow Impingement: Detachment of a Hypertrophied Posterior Fat Pad

    PubMed Central

    Hamada, Daisuke; Matsuura, Tetsuya; Sugiura, Kosuke; Higuchi, Tadahiro; Suzue, Naoto; Goto, Tomohiro; Tsutsui, Takahiko; Wada, Keizo; Fukuta, Shoji; Sairyo, Koichi

    2015-01-01

    We report a case of a 47-year-old woman who developed posterior impingement of the elbow due to detachment of a hypertrophied posterior fat pad. She reported acute left elbow pain after leaning back onto a hard object with her hand and subsequently experienced a “catching” sensation. Comparison with the magnetic resonance images of a normal elbow revealed a hypertrophied posterior fat pad interposed between the olecranon and olecranon fossa in both elbows, with the fat pad in the left elbow located more inferiorly than that in the right elbow. Elbow arthroscopy showed the olecranon fossa covered by the fat pad, a portion of which was detached from the rest of the pad. Debridement of the detached portion was performed until no impingement was evident. Postoperatively, full extension of the elbow did not elicit pain. Clinicians should include this pathology among the differential diagnoses for posterior elbow pain. PMID:26613057

  18. A Cadaveric Study of Bilateral Configuration of Posterior Bifurcation of Posterior Communicating Artery in Indian Population

    PubMed Central

    Saha, Anubha; Mandal, Shyamash

    2015-01-01

    Introduction: Various studies have been done regarding variations of circle of Willis, but few literatures are available about the detail configurations on Indian population. Posterior communicating artery is the main collateral channel between the vertebrobasilar and carotid system. It may act as a main source of blood flow via posterior cerebral artery if fetal configuration is present. Aim of the study is to see the bilateral configurations to compare the blood supply of both cerebral hemispheres via posterior cerebral artery in human cadavers. Materials and Methods: Fifty six formalin fixed brains were used for study. The specimens were classified into 3 types and 21 subtypes according to the configuration of the vessel of both hemispheres. As hemodynamic balance is dependent on the calibre of the vessel, the diameter of the arteries were also taken into consideration. Pearson’s correlation had been done. Result: In present study type I is 57.2%, type II is 37.5% and type III is 5.4%. Incidence of unilateral fetal type posterior cerebral artery is in high percentage (33.9%). Greatest diameter of posterior communicating artery is 3.8mm on right and 3.6mm on left side. Significant correlations also have been found between arterial segments of different types. Conclusion: It is expected that the study will help to enrich the knowledge about the arterial predominance of origin of posterior cerebral artery of both cerebral hemispheres in normal or variant cases and its effect on perfusion images. PMID:25954608

  19. Posterior Wnts Have Distinct Roles in Specification and Patterning of the Planarian Posterior Region

    PubMed Central

    Sureda-Gómez, Miquel; Pascual-Carreras, Eudald; Adell, Teresa

    2015-01-01

    The wnt signaling pathway is an intercellular communication mechanism essential in cell-fate specification, tissue patterning and regional-identity specification. A βcatenin-dependent signal specifies the AP (Anteroposterior) axis of planarians, both during regeneration of new tissues and during normal homeostasis. Accordingly, four wnts (posterior wnts) are expressed in a nested manner in central and posterior regions of planarians. We have analyzed the specific role of each posterior wnt and the possible cooperation between them in specifying and patterning planarian central and posterior regions. We show that each posterior wnt exerts a distinct role during re-specification and maintenance of the central and posterior planarian regions, and that the integration of the different wnt signals (βcatenin dependent and independent) underlies the patterning of the AP axis from the central region to the tip of the tail. Based on these findings and data from the literature, we propose a model for patterning the planarian AP axis. PMID:26556349

  20. Arthroscopic approach to the posterior compartment of the knee using a posterior transseptal portal

    PubMed Central

    Ohishi, Tsuyoshi; Takahashi, Masaaki; Suzuki, Daisuke; Matsuyama, Yukihiro

    2015-01-01

    Arthroscopic surgery of the posterior compartment of the knee is difficult when only two anterior portals are used for access because of the inaccessibility of the back of the knee. Since its introduction, the posterior transseptal portal has been widely employed to access lesions in the posterior compartment. However, special care should be taken to avoid neurovascular injuries around the posteromedial, posterolateral, and transseptal portals. Most importantly, popliteal vessel injury should be avoided when creating and using the transseptal portal during surgery. Purpose of the present study is to describe how to avoid the neurovascular injuries during establishing the posterior three portals and to introduce our safer technique to create the transseptal portal. To date, we have performed arthroscopic surgeries via the transseptal portal in the posterior compartments of 161 knees and have not encountered nerve or vascular injury. In our procedure, the posterior septum is perforated with a 1.5-3.0-mm Kirschner wire that is protected by a sheath inserted from the posterolateral portal and monitored from the posteromedial portal to avoid popliteal vessel injury. PMID:26301179

  1. Posterior Wnts Have Distinct Roles in Specification and Patterning of the Planarian Posterior Region.

    PubMed

    Sureda-Gómez, Miquel; Pascual-Carreras, Eudald; Adell, Teresa

    2015-01-01

    The wnt signaling pathway is an intercellular communication mechanism essential in cell-fate specification, tissue patterning and regional-identity specification. A βcatenin-dependent signal specifies the AP (Anteroposterior) axis of planarians, both during regeneration of new tissues and during normal homeostasis. Accordingly, four wnts (posterior wnts) are expressed in a nested manner in central and posterior regions of planarians. We have analyzed the specific role of each posterior wnt and the possible cooperation between them in specifying and patterning planarian central and posterior regions. We show that each posterior wnt exerts a distinct role during re-specification and maintenance of the central and posterior planarian regions, and that the integration of the different wnt signals (βcatenin dependent and independent) underlies the patterning of the AP axis from the central region to the tip of the tail. Based on these findings and data from the literature, we propose a model for patterning the planarian AP axis. PMID:26556349

  2. Longitudinal Analysis of Osteogenic and Angiogenic Signaling Factors in Healing Models Mimicking Atrophic and Hypertrophic Non-Unions in Rats

    PubMed Central

    Minkwitz, Susann; Faßbender, Mirja; Kronbach, Zienab; Wildemann, Britt

    2015-01-01

    Impaired bone healing can have devastating consequences for the patient. Clinically relevant animal models are necessary to understand the pathology of impaired bone healing. In this study, two impaired healing models, a hypertrophic and an atrophic non-union, were compared to physiological bone healing in rats. The aim was to provide detailed information about differences in gene expression, vascularization and histology during the healing process. The change from a closed fracture (healing control group) to an open osteotomy (hypertrophy group) led to prolonged healing with reduced mineralized bridging after 42 days. RT-PCR data revealed higher gene expression of most tested osteogenic and angiogenic factors in the hypertrophy group at day 14. After 42 days a significant reduction of gene expression was seen for Bmp4 and Bambi in this group. The inhibition of angiogenesis by Fumagillin (atrophy group) decreased the formation of new blood vessels and led to a non-healing situation with diminished chondrogenesis. RT-PCR results showed an attempt towards overcoming the early perturbance by significant up regulation of the angiogenic regulators Vegfa, Angiopoietin 2 and Fgf1 at day 7 and a further continuous increase of Fgf1, -2 and Angiopoietin 2 over time. However µCT angiograms showed incomplete recovery after 42 days. Furthermore, lower expression values were detected for the Bmps at day 14 and 21. The Bmp antagonists Dan and Twsg1 tended to be higher expressed in the atrophy group at day 42. In conclusion, the investigated animal models are suitable models to mimic human fracture healing complications and can be used for longitudinal studies. Analyzing osteogenic and angiogenic signaling patterns, clear changes in expression were identified between these three healing models, revealing the importance of a coordinated interplay of different factors to allow successful bone healing. PMID:25910190

  3. Role of the IL-11/STAT3 signaling pathway in human chronic atrophic gastritis and gastric cancer.

    PubMed

    Wang, D Q; Ding, X P; Yin, S; Mao, Y D

    2016-01-01

    The expression of interleukin-11 (IL-11) and its products STAT3 and phospho-STAT3 (p-STAT3) in patients with chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG), and gastric cancer (GC) may provide insight into the diagnostic role of the IL-11/STAT3 signaling pathway in GC. Gastric mucosa specimens and serum samples were collected from 90 patients with CSG, CAG, and GC (30/group). The expression of IL-11, STAT3, and p-STAT3 was detected via immunohistochemistry and western blot. Additionally, serum levels of IL-11 were measured by enzyme-linked immunosorbent assay. For IL-11, 60% stained positive in CAG and 83.3% stained positive in GC, which were both higher than the value observed for CSG (33.3%). Moreover, the percent positive for IL-11 in GC was higher than that in CAG (P < 0.05). The percent positive for STAT3 in CAG (80%) and GC (83.3%) was higher than that in CSG (53.3%) (P < 0.05). Compared with CSG (36.7%), the percent positive for p-STAT3 in CAG (63.3%) and GC (86.7%) was also significantly higher. STAT3 expression was similar in GC and CAG, which was significantly higher than that in CSG. Expectedly, p-STAT3 expression gradually increased from CSG to CAG to GC. Furthermore, p-STAT3 levels were higher in GC tissues than in CAG (P < 0.01). Intriguingly, serum IL-11 levels gradually increased from CSG to CAG to GC, which coincided with disease severity. Together, these results suggest that the IL-11/STAT3 signaling pathway plays a critical role in human CAG, and may provide new targets to prevent and treat GC. PMID:27173233

  4. An Observational Study on Aberrant Methylation of Runx3 With the Prognosis in Chronic Atrophic Gastritis Patients.

    PubMed

    Zhao, Chunna; Li, Ping; Zhang, Lili; Wang, Bei; Xiao, Lili; Guo, Feng; Wei, Yueguang

    2016-05-01

    The aim of this study is to discuss whether the methylation levels of Runx3 could be used as the early biomarker for predicting the prognosis in chronic atrophic gastritis (CAG) patients. A total of 200 subjects including 60 controls without CAG (Group 1), 70 patients with mild CAG (Group 2), and 70 patients with moderate and severe CAG (Group 3) were recruited for this cross-sectional investigation in the Department of Gastroenterology in Daqing Oilfield General Hospital from July 2013 to May 2014. The MlALDI-TOF-MS was used to measure the methylation levels of Runx3 in all of the subjects. Real-time quantitative reverse transcription polymerase chain reaction and western blotting were chosen to determine the expression levels of Runx3. The correlations between methylation levels of Runx3 among these CAG patients and their prognosis were shown by logistic regression models. The results demonstrated that the methylation levels of CpG13, CpG14, and CpG15 in Runx3 were higher in Group 3 than those in Groups 1 and 2 (P <0.05), whereas the mRNA and protein expression levels of Runx3 were lower in Group 3 than those in Groups 1 and 2 (P <0.05). There were significantly negative correlations between the methylation levels of Runx3 with its expression and the healing prognosis of CAG patients. In brief, this study proved that the hypermethylation modifications of CpG13, CpG14, and CpG15 in the promoter region of Runx3 could result in the down regulation of Runx3 expression to affect the prognosis of CAG. So the methylation levels of these CpG sites in Runx3 in the peripheral blood can be used as the biomarker for predicting the healing prognosis of CAG patients. PMID:27196446

  5. Smoking and choroidal thickness in patients over 65 with early-atrophic age-related macular degeneration and normals

    PubMed Central

    Sigler, E J; Randolph, J C; Calzada, J I; Charles, S

    2014-01-01

    Objective To compare macular choroidal thickness between cigarette smokers, those with a history of smoking, and nonsmokers in patients over 65 years of age with early-atrophic age-related macular degeneration (AMD) and normals. Methods Prospective, consecutive, observational case series. Enhanced depth imaging spectral domain optical coherence tomography 12-line radial scans were performed and choroidal thickness manually quantified at 84 points in the central 3 mm of the macula. Data of normals, soft drusen alone, and soft drusen with additional features of early AMD were compared. A multivariate analysis of variance (MANOVA) model, controlling for age, was constructed to evaluate the effect of smoking history and AMD features on choroidal thickness. Results A history of smoking was significantly associated with a thinner choroid across all patients via logistic regression (P=0.004; O.R.=12.4). Mean macular choroidal thickness was thinner for smokers (148±63 μm) than for nonsmokers (181±65 μm) among all diagnosis categories (P=0.003). Subgroup analysis of patients with AMD features revealed a similar decreased choroidal thickness in smokers (121±41 μm) compared with nonsmokers (146±46 μm, P=0.006). Bivariate analysis revealed an association between increased pack-years of smoking and a thin choroid across all patients (P<0.001) and among patients with features of early AMD (P<0.001). Both the presence of features of macular degeneration (P<0.001) and a history of smoking (P=0.024) were associated with decreased choroidal thickness in a MANOVA model. Conclusion Chronic cigarette smoke exposure may be associated with decreased choroidal thickness. There may be an anatomic sequelae to chronic tobacco smoke exposure that underlies previously reported AMD risk. PMID:24833184

  6. Increased risk of esophageal squamous cell carcinoma in patients with gastric atrophy: independent of the severity of atrophic changes.

    PubMed

    de Vries, Annemarie C; Capelle, Lisette G; Looman, Caspar W N; van Blankenstein, Mark; van Grieken, Nicole C T; Casparie, Mariël K; Meijer, Gerrit A; Kuipers, Ernst J

    2009-05-01

    An association between gastric atrophy and esophageal squamous cell carcinomas (ESCC) has been described. However, the mechanism of this association is unknown. In this study, we aimed to examine this relationship in a cohort of patients with varying grades of gastric atrophy to increase the understanding about the causality of the association. Patients diagnosed with gastric atrophy between 1991 and 2005 were identified in the Dutch nationwide histopathology registry (PALGA). The incidence of ESCC and, presumably unrelated, small cell lung carcinomas (SCLC) observed in these patients was compared with that in the general Dutch population. Relative risks (RRs) and 95% confidence intervals were calculated by a Poisson model. At baseline histological examination, 97,728 patients were diagnosed with gastric atrophy, of whom 23,278 with atrophic gastritis, 65,934 with intestinal metaplasia and 8,516 with dysplasia. During follow-up, 126 patients were diagnosed with ESCC and 263 with SCLC (overall rates 0.19, respectively 0.39/1,000 person-years at risk). Compared with the general Dutch population, patients with gastric atrophy ran a RR of developing ESCC of 2.2 [95% CI 1.8-2.6] and of SCLC of 1.8 [95% CI 1.6-2.1]. The risk of ESCC did not increase with increasing severity of gastric atrophy (p = 0.90). In conclusion, this study found an association between gastric atrophy and both ESCC and SCLC, but the risk of ESCC did not increase with the severity of gastric atrophy. Therefore, a causal relationship seems unlikely. Confounding factors, such as smoking, may explain both associations. PMID:19107937

  7. An Observational Study on Aberrant Methylation of Runx3 With the Prognosis in Chronic Atrophic Gastritis Patients

    PubMed Central

    Zhao, Chunna; Li, Ping; Zhang, Lili; Wang, Bei; Xiao, Lili; Guo, Feng; Wei, Yueguang

    2016-01-01

    Abstract The aim of this study is to discuss whether the methylation levels of Runx3 could be used as the early biomarker for predicting the prognosis in chronic atrophic gastritis (CAG) patients. A total of 200 subjects including 60 controls without CAG (Group 1), 70 patients with mild CAG (Group 2), and 70 patients with moderate and severe CAG (Group 3) were recruited for this cross-sectional investigation in the Department of Gastroenterology in Daqing Oilfield General Hospital from July 2013 to May 2014. The MlALDI-TOF-MS was used to measure the methylation levels of Runx3 in all of the subjects. Real-time quantitative reverse transcription polymerase chain reaction and western blotting were chosen to determine the expression levels of Runx3. The correlations between methylation levels of Runx3 among these CAG patients and their prognosis were shown by logistic regression models. The results demonstrated that the methylation levels of CpG13, CpG14, and CpG15 in Runx3 were higher in Group 3 than those in Groups 1 and 2 (P <0.05), whereas the mRNA and protein expression levels of Runx3 were lower in Group 3 than those in Groups 1 and 2 (P <0.05). There were significantly negative correlations between the methylation levels of Runx3 with its expression and the healing prognosis of CAG patients. In brief, this study proved that the hypermethylation modifications of CpG13, CpG14, and CpG15 in the promoter region of Runx3 could result in the down regulation of Runx3 expression to affect the prognosis of CAG. So the methylation levels of these CpG sites in Runx3 in the peripheral blood can be used as the biomarker for predicting the healing prognosis of CAG patients. PMID:27196446

  8. Response of gastric epithelial progenitors to Helicobacter pylori Isolates obtained from Swedish patients with chronic atrophic gastritis.

    PubMed

    Giannakis, Marios; Bäckhed, Helene Kling; Chen, Swaine L; Faith, Jeremiah J; Wu, Meng; Guruge, Janaki L; Engstrand, Lars; Gordon, Jeffrey I

    2009-10-30

    Helicobacter pylori infection is associated with gastric adenocarcinoma in some humans, especially those that develop an antecedent condition, chronic atrophic gastritis (ChAG). Gastric epithelial progenitors (GEPs) in transgenic gnotobiotic mice with a ChAG-like phenotype harbor intracellular collections of H. pylori. To characterize H. pylori adaptations to ChAG, we sequenced the genomes of 24 isolates obtained from 6 individuals, each sampled over a 4-year interval, as they did or did not progress from normal gastric histology to ChAG and/or adenocarcinoma. H. pylori populations within study participants were largely clonal and remarkably stable regardless of disease state. GeneChip studies of the responses of a cultured mouse gastric stem cell-like line (mGEPs) to infection with sequenced strains yielded a 695-member dataset of transcripts that are (i) differentially expressed after infection with ChAG-associated isolates, but not with a "normal" or a heat-killed ChAG isolate, and (ii) enriched in genes and gene functions associated with tumorigenesis in general and gastric carcinogenesis in specific cases. Transcriptional profiling of a ChAG strain during mGEP infection disclosed a set of responses, including up-regulation of hopZ, an adhesin belonging to a family of outer membrane proteins. Expression profiles of wild-type and DeltahopZ strains revealed a number of pH-regulated genes modulated by HopZ, including hopP, which binds sialylated glycans produced by GEPs in vivo. Genetic inactivation of hopZ produced a fitness defect in the stomachs of gnotobiotic transgenic mice but not in wild-type littermates. This study illustrates an approach for identifying GEP responses specific to ChAG-associated H. Pylori strains and bacterial genes important for survival in a model of the ChAG gastric ecosystem. PMID:19723631

  9. Helicobacter pylori evolution during progression from chronic atrophic gastritis to gastric cancer and its impact on gastric stem cells

    PubMed Central

    Giannakis, Marios; Chen, Swaine L.; Karam, Sherif M.; Engstrand, Lars; Gordon, Jeffrey I.

    2008-01-01

    We have characterized the adaptations of Helicobacter pylori to a rarely captured event in the evolution of its impact on host biology—the transition from chronic atrophic gastritis (ChAG) to gastric adenocarcinoma—and defined the impact of these adaptations on an intriguing but poorly characterized interaction between this bacterium and gastric epithelial stem cells. Bacterial isolates were obtained from a single human host colonized with a single dominant strain before and after his progression from ChAG to gastric adenocarcinoma during a 4-year interval. Draft genome assemblies were generated from two isolates, one ChAG-associated, the other cancer-associated. The cancer-associated strain was less fit in a gnotobiotic transgenic mouse model of human ChAG and better able to establish itself within a mouse gastric epithelial progenitor-derived cell line (mGEP) that supports bacterial attachment. GeneChip-based comparisons of the transcriptomes of mGEPs and a control mouse gastric epithelial cell line revealed that, upon infection, the cancer-associated strain regulates expression of GEP-associated signaling and metabolic pathways, and tumor suppressor genes associated with development of gastric cancer in humans, in a manner distinct from the ChAG-associated isolate. The effects on GEP metabolic pathways, some of which were confirmed in gnotobiotic mice, together with observed changes in the bacterial transcriptome are predicted to support aspects of an endosymbiosis between this microbe and gastric stem cells. These results provide insights about how H. pylori may adapt to and influence stem cell biology and how its intracellular residency could contribute to gastric tumorigenesis. PMID:18332421

  10. Split Face Comparative Study of Microneedling with PRP Versus Microneedling with Vitamin C in Treating Atrophic Post Acne Scars

    PubMed Central

    Chawla, Simran

    2014-01-01

    Introduction: Acne scars are largely preventable complications of acne. 95% of the scars occur over the face thus impacting the quality of life. Correction of scars is the priority for acne patients. Materials and Methods: Thirty patients with post acne atrophic facial scars attending the OPD during the period from April to October 2013 were offered four sittings of microneedling with PRP on one side and microneedling with vitamin C on other side of the face at an interval of 1 month. Results: Twenty-seven out of the total 30 patients completed the treatment schedule. Two patients were lost to follow up and one dropped out of the study due to severe PIH. Mean age of the patients was 27.5 years. Out of 30 patients, 23 achieved reduction in scarring by one or two grades. Excellent response was seen in five (18.5%) patients with platelet-rich plasma (PRP) as compared to two (7%) patients who received treatment with vitamin C according to physician's assessment. As far as up gradation by 1 score is considered, i.e., good response, it was similar in both cases. Vitamin C did not prove to be as efficacious as PRP since 10 (37%) patients had poor response in vitamin C-treated area compared to only 6 (22.2%) patients who underwent PRP therapy, but vitamin C proved to be efficacious in dealing with post inflammatory hyper-pigmentation secondary to acne. Patients were more satisfied with PRP as compared to vitamin C. The results were evaluated and statistical analysis was done using SPSS 16.0.2. Conclusions: Overall results were better with microneedling and PRP. Vitamin C combined with microneedling also showed improvement with respect to firmness and smoothness of skin; as well as post inflammatory hyper-pigmentation. Microneedling combined with PRP proved to be good in treating boxcar and rolling scars but had limited efficacy in dealing with ice pick scars. PMID:25722599

  11. Fixed Bicortical Screw and Blade Implants as a Non-Standard Solution to an Edentulous (Toothless) Mandible

    PubMed Central

    Strecha, Juraj; Jurkovic, Richard; Siebert, Tomas; Prachar, Patrik; Bartakova, Sonia

    2010-01-01

    Aim This paper deals with the treatment of an atrophied toothless mandible with a fixing bridge carried by two non-standard implant systems. Methodology Four bicortical screws were implanted into the frontal part of the mandible and one implant on each side was placed into the distal area of the mandible as a support for a fixing bridge. Results During the years 2002 – 2007 the authors placed a total of 256 bicortical screw and 84 blade implants. During this period only four bicortical screws and one blade implant failed. The primary and secondary surgical success rate was therefore above 98%, while the prosthetic success rate was 100%. (Bridges which had to be re-fabricated due to implant failure were not taken into account.) Conclusion This approach is recommended as a highly successful and affordable option for a wide range of patients. PMID:20737937

  12. A new 2-dimensional method for constructing visualized treatment objectives for distraction osteogenesis of the short mandible.

    PubMed

    van Beek, H

    2010-01-01

    Open bite development during distraction of the mandible is common and partly due to inaccurate planning of the treatment. Conflicting guidelines exist in the literature. A method for Visualized Treatment Objective (VTO) construction is presented as an aid for determining the correct orientation of monodirectional and multidirectional distractors. Distraction on the left and on the right side of the mandible takes place in a parallel manner in order to maintain intercondylar width. It follows that in the absence of marked asymmetry, the amount of mandibular body distraction, the amount of ramus distraction and (should it apply), the amount of closure of the gonial angle, can be derived from a simple 2-dimensional plan. After presurgical orthodontic treatment, a cephalogram is taken and a VTO is constructed, that aims at a good occlusion with the enhanced mandible in centric relation, with little or no change of the original position of the rami. PMID:19837600

  13. Random Positional Variation Among the Skull, Mandible, and Cervical Spine With Treatment Progression During Head-and-Neck Radiotherapy

    SciTech Connect

    Ahn, Peter H. Ahn, Andrew I.; Lee, C. Joe; Shen Jin; Miller, Ekeni; Lukaj, Alex; Milan, Elissa; Yaparpalvi, Ravindra; Kalnicki, Shalom; Garg, Madhur K.

    2009-02-01

    Purpose: With 54{sup o} of freedom from the skull to mandible to C7, ensuring adequate immobilization for head-and-neck radiotherapy (RT) is complex. We quantify variations in skull, mandible, and cervical spine movement between RT sessions. Methods and Materials: Twenty-three sequential head-and-neck RT patients underwent serial computed tomography. Patients underwent planned rescanning at 11, 22, and 33 fractions for a total of 93 scans. Coordinates of multiple bony elements of the skull, mandible, and cervical spine were used to calculate rotational and translational changes of bony anatomy compared with the original planning scan. Results: Mean translational and rotational variations on rescanning were negligible, but showed a wide range. Changes in scoliosis and lordosis of the cervical spine between fractions showed similar variability. There was no correlation between positional variation and fraction number and no strong correlation with weight loss or skin separation. Semi-independent rotational and translation movement of the skull in relation to the lower cervical spine was shown. Positioning variability measured by means of vector displacement was largest in the mandible and lower cervical spine. Conclusions: Although only small overall variations in position between head-and-neck RT sessions exist on average, there is significant random variation in patient positioning of the skull, mandible, and cervical spine elements. Such variation is accentuated in the mandible and lower cervical spine. These random semirigid variations in positioning of the skull and spine point to a need for improved immobilization and/or confirmation of patient positioning in RT of the head and neck.

  14. Distinctive anabolic roles of 1,25-dihydroxyvitamin D(3) and parathyroid hormone in teeth and mandible versus long bones.

    PubMed

    Liu, Hong; Guo, Jian; Wang, Lin; Chen, Ning; Karaplis, Andrew; Goltzman, David; Miao, Dengshun

    2009-11-01

    To assess the roles of 1,25-dihydroxyvitamin D (1,25(OH)(2)D) and parathyroid hormone (PTH) in hard tissue formation in oro-facial tissues, we examined the effect of either 1,25(OH)(2)D or PTH deficiency on dentin and dental alveolar bone formation and mineralization in the mandibles, and osteoblastic bone formation in long bones of 1alpha-hydroxylase knockout (1alpha(OH)ase(-/-)) mice. Compared with wild-type mice, the mineral density was decreased in the teeth and mandibles, and unmineralized dentin (predentin and biglycan immunopositive dentin) and unmineralized bone matrix in the dental alveolar bone were increased in 1alpha(OH)ase(-/-) mice. The dental volume, reparative dentin volume, and dentin sialoprotein immunopositive areas were reduced in 1alpha(OH)ase(-/-) mice. The cortical thickness, dental alveolar bone volume, and osteoblast number were all decreased significantly in the mandibles; in contrast, the osteoblast number and surface were increased in the trabecular bone of the tibiae in 1alpha(OH)ase(-/-) mice consistent with their secondary hyperparathyroidism. The expression of PTH receptor and IGF1 was reduced slightly in mandibles, but enhanced significantly in the long bones in the 1alpha(OH)ase(-/-) mice. To control for the role of secondary hyperparathyroidism, we also examined teeth and mandibles in 6-week-old PTH(-/-) mice. In these animals, dental and bone volumes in mandibles were not altered when compared with their wild-type littermates. These results suggest that 1,25(OH)(2)D(3) plays an anabolic role in both dentin and dental alveolar bone as it does in long bones, whereas PTH acts predominantly in long bones rather than mandibular bone. PMID:19713218

  15. Bridging Plate Development for Treatment of Segmental Bone Defects of the Canine Mandible: Mechanical Tests and Finite Element Method.

    PubMed

    de Freitas, Elisângela Perez; Rahal, Sheila Canevese; Shimano, Antonio Carlos; da Silva, Jorge Vicente Lopes; Noritomi, Pedro Yoshito; El-Warrak, Alexander Oliveira; Melchert, Alessandra

    2016-03-01

    With regard to the canine mandible, a mistaken concept of application is to assume that systemic plate-bone resistance is provided by the implant so that biomechanical position could be ignored. Because the alveolar border of the mandible is a tensile zone, the plate would ideally be positioned near this area while avoiding important structures. The aim of this study was to develop 2 bridging plates for the treatment of a segmental bone defect of the canine mandible using monocortical screws to avoid damage to the tooth roots and remaining neurovascular structures. Computed tomography images of the heads of 4 dogs (rottweiler, Doberman, boxer, and miniature poodle breeds) were used as models to develop the project. The images were reconstructed in 3-dimensional (3D) format. For each dog breed, 6 mandible prototypes were produced, each with a segmental bone defect in the right mandible. The mandibular reconstruction was performed with pure titanium bridging plate and locking screws. One plate model was developed for medium- and large-breed dogs and another for small-breed dogs. Mechanical testing showed the platemandible system resists the bite forces in all dog breeds. All safety factors were greater than I in the platemandible system for medium- and large-breed dogs and greater than 10 in the plate-mandible system for small-breed dogs. Thus, bridging plates designed with differentiated geometry and monocortical locking screws showed mechanical resistance to support simulated induced bone model defects and were able to support at least 5 times the value of bite force for each evaluated dog. PMID:27487652

  16. Changes in the sexual dimorphism of the human mandible during the last 1200 years in Central Europe.

    PubMed

    Bejdová, Sárka; Krajíček, Václav; Velemínská, Jana; Horák, Martin; Velemínský, Petr

    2013-12-01

    According to many investigations, changes in mandibular morphology can occur synchronously with changes in the environment, and sexual dimorphism of the mandible can be influenced by the environment. Sexual dimorphism during the last 1200 years was evaluated using geometric morphometric analysis of virtual cranial models. The method of geometric morphometrics allows differences in size and shape to be assessed separately. We analyzed groups of adult individuals dating to Early Middle Ages, High Middle Ages, Early Modern Ages and from a modern Czech population (21st century). Significant sexual dimorphism in mandibular size was found in all populations. A trend in the sexual dimorphism of size was seen, with differences between the sexes increasing gradually over time. Size changes in female mandibles were a better reflection of environmental conditions and climate than size changes in male mandibles. Regarding changes in the sexual dimorphism of shape, significant dimorphism was found in all four samples. However, the pattern of mandibular shape dimorphism was different and varied considerably between samples. There was only one stable shape trait showing sexual dimorphism across all four samples in our study: the gonion lies more laterally in male than in female mandibles and male mandibles are relatively wider than female mandibles. Sexual dimorphism of shape is not influenced by the climate; instead sexual selection might play a role. This research supports earlier studies that have found that the degree and pattern of sexual dimorphism is population-specific and the factors regulating sexual dimorphism today may not be the same as those in the past. PMID:24004582

  17. Posterior fossa lesions associated with neuropsychiatric symptomatology.

    PubMed

    Pollak, L; Klein, C; Rabey, J M; Schiffer, J

    1996-11-01

    We reviewed 7 cases with posterior fossa structural abnormalities (3 tumors, 2 megacisterna magna and 2 Dandy-Walker syndrome) presenting with neuropsychiatric symptomatology. Derangement in the balance of dopamine, serotonin and noradrenergic networks has been implicated in the pathogenesis of schizophrenia, affective and even personality disorders. Disruption of the cerebellar output to mesial dopaminergic areas, locus coeruleus and raphe nuclei, or deafferentation of the thalamolimbic circuits by a cerebellar lesion may lead to behavioral changes. Seven patients (pts) (comprising 4 men and 3 women with mean age 22 years) were diagnosed as suffering from psychosis (2 pts), major depression (1 pt), personality disorders (2 pts) and somatoform disorders (2 pts) (DSM-IV criteria). Brain CT scan (7 pts) and MRI (4 pts) revealed tumors of the posterior fossa (2 pts), megacisterna magna (2 pts) and Dandy-Walker variant (2 pts). In one patient a IVth ventricle tumor was removed in childhood. PMID:9003973

  18. Fractures of posterior teeth in adults.

    PubMed

    Eakle, W S; Maxwell, E H; Braly, B V

    1986-02-01

    Examined in this study were 191 patients with 206 complete or incomplete fractures of posterior teeth. The patients ranged in age from 14 to 76 years, with 66.5% younger than 40 years. The number of fractures occurring in each arch was almost equal. The mandibular first molar was the most frequently fractured posterior tooth. The lingual cusps of mandibular molars fractured more often than did the buccal cusps of mandibular molars by a ratio of 2 to 1. In maxillary molars, buccal and lingual cusps fractured with almost equal frequency, but, in maxillary premolars, the lingual cusps fractured slightly more often than buccal cusps. Data gathered on the widths of the isthmuses of restorations in 109 teeth showed that fewer fractures occurred in teeth with more conservative restorations, with widths of isthmuses a quarter of the inter-cusp distance, and intact marginal ridges. PMID:3456380

  19. Reconstruction of the mandible and the maxilla: the evolution of surgical technique.

    PubMed

    Genden, Eric M

    2010-01-01

    The upper and lower jaws play an essential role in mastication, articulation, and cosmetic form. The mandible provides support for tongue position and elevation of the larynx during swallowing, while the maxilla provides support for the nasal structures as well as an opposing structure to the mandible during mastication. The evolution of mandibular and maxillary reconstruction dates back to the early 19th century. Before the introduction of free tissue transfer, a variety of local flaps, regional flaps, and prosthetics were introduced, yet each was met with eventual failure. Since the introduction of free tissue transfer, mandibular and maxillary reconstruction has become as much of an art as it has a science. Whether the mandibular or the palatomaxillary defects are a result of trauma, congenital deformity, or tumor extirpation, the resultant effect often disrupts both form and function. With these considerations taken together, jaw reconstruction is a unique undertaking in which the artistic reconstruction of the facial skeleton is met with the science of reestablishing the mechanics of mastication. The site, size, and associated soft-tissue defects represent the 3 most important factors in determining the impact of a given defect on function and aesthetics. There is also an inherent difference between defects that are sustained in a controlled fashion, such as during cancer ablation, and those that result from trauma. The consideration of these complexities in jaw reconstruction is reflected in the wide variety of approaches and techniques that have evolved over the past century. PMID:20231587

  20. Histomorphometry of the tibia and mandible of healthy female Wistar rats at different stages of growth

    PubMed Central

    Nenda, María M.; Lewicki, Marianela; Mandalunis, Patricia M.

    2015-01-01

    Female Wistar rats are frequently used in experimental models to study hormone and bone pathologies and treatments. Most experimental studies involving histomorphometric evaluation assessed long bones, and few reports also studied mandibular bone. The aim of this work was to clarify and distinguish the age-related histomorphometric changes that occur in the tibia (subchondral bone) and in the mandible (interradicular bone), and thus obtain reference histomorphometric data of healthy female Wistar rats at different growth stages. Three groups of 8 healthy female Wistar rats were euthanized at 6 (GI), 10 (GII), and 14 (GIII) weeks. The tibiae and mandible were resected and histologically processed to obtain H&E stained sections of the tibia and the lower first molar to analyze the following histomorphometric parameters: Bone volume, trabecular width, trabecular number (Th.N)(1/mm), growth cartilage width, hypertrophic cartilage width and number of osteoclasts per area in the tibiae, and bone volume and number of osteoclasts per area N.Oc/mm2 in the interradicular bone of the first lower molar. A significant decrease in subchondral bone volume as a result of a decrease in trabecular number and growth cartilage width was observed in 14-week-old rats. Conversely, interradicular bone volume was found to increase with age. The results highlight the importance of analyzing both types of bone to better understand the response of two different trabecular bones, contributing in turn to decision making regarding treatment strategies and disease management. PMID:26568145

  1. Pierre Robin Sequence and Treacher Collins Hypoplastic Mandible Comparison Using Three-Dimensional Morphometric Analysis

    PubMed Central

    Chung, Michael T.; Levi, Benjamin; Hyun, Jeong S.; Lo, David D.; Montoro, Daniel T.; Lisiecki, Jeffrey; Bradley, James P.; Buchman, Steven R.; Longaker, Michael T.; Wan, Derrick C.

    2012-01-01

    Pierre Robin sequence and Treacher Collins syndrome are both associated with mandibular hypoplasia. It has been hypothesized, however, that the mandible may be differentially affected. The purpose of this study was to therefore compare mandibular morphology in children with Pierre Robin sequence to children with Treacher Collins syndrome using three-dimensional analysis of computed tomography (CT) scans. A retrospective analysis was performed identifying children with Pierre Robin sequence and Treacher Collins syndrome receiving CT scans. Three-dimensional reconstruction was performed and ramus height, mandibular body length, and gonial angle were measured. These were then compared to control children with normal mandibles and to clinical norms corrected for age and sex based on previously published measurements. Mandibular body length was found to be significantly shorter for children with Pierre Robin sequence while ramus height was significantly shorter for children with Treacher Collins syndrome. This resulted in distinctly different ramus height/mandibular body length ratios. In addition, the gonial angle was more obtuse in both the Pierre Robin sequence and Treacher Collins syndrome groups compared with the controls. Three-dimensional mandibular morphometric analysis in patients with Pierre Robin sequence and Treacher Collins syndrome thus revealed distinctly different patterns of mandibular hypoplasia relative to normal controls. These findings underscore distinct considerations which must be made in surgical planning for reconstruction. PMID:23154353

  2. Direct radiocarbon dating and genetic analyses on the purported Neanderthal mandible from the Monti Lessini (Italy).

    PubMed

    Talamo, Sahra; Hajdinjak, Mateja; Mannino, Marcello A; Fasani, Leone; Welker, Frido; Martini, Fabio; Romagnoli, Francesca; Zorzin, Roberto; Meyer, Matthias; Hublin, Jean-Jacques

    2016-01-01

    Anatomically modern humans replaced Neanderthals in Europe around 40,000 years ago. The demise of the Neanderthals and the nature of the possible relationship with anatomically modern humans has captured our imagination and stimulated research for more than a century now. Recent chronological studies suggest a possible overlap between Neanderthals and anatomically modern humans of more than 5,000 years. Analyses of ancient genome sequences from both groups have shown that they interbred multiple times, including in Europe. A potential place of interbreeding is the notable Palaeolithic site of Riparo Mezzena in Northern Italy. In order to improve our understanding of prehistoric occupation at Mezzena, we analysed the human mandible and several cranial fragments from the site using radiocarbon dating, ancient DNA, ZooMS and isotope analyses. We also performed a more detailed investigation of the lithic assemblage of layer I. Surprisingly we found that the Riparo Mezzena mandible is not from a Neanderthal but belonged to an anatomically modern human. Furthermore, we found no evidence for the presence of Neanderthal remains among 11 of the 13 cranial and post-cranial fragments re-investigated in this study. PMID:27389305

  3. Intraosseous Vascular Access through the Anterior Mandible – A Cadaver Model Pilot Study

    PubMed Central

    Goldschalt, Christin; Doll, Sara; Ihle, Brit; Kirsch, Joachim; Mutzbauer, Till Sebastian

    2014-01-01

    Background Several insertion sites have been described for intraosseous puncture in cases of emergencies when a conventional vascular access cannot be established. This pilot study has been designed to evaluate the feasibility of the mandibular bone for the use of an intraosseous vascular access in a cadaver model. Methodology/Principal Findings 17 dentistry and 16 medical students participating in a voluntary course received a short introduction into the method and subsequently used the battery powered EZ-IO system with a 15 mm cannula for a puncture of the anterior mandible in 33 cadavers. The time needed to perform each procedure was evaluated. India ink was injected into the accesses and during the anatomy course cadavers were dissected to retrace the success or failure of the puncture. Dental students needed 25.5±18.9(mean±standard deviation)s and medical students 33±20.4 s for the procedure (p = 0.18). Floor of mouth extravasation occurred in both groups in 3 cases. Success rates were 82 and 75% (p = 0.93). Conclusions/Significance Despite floor of mouth extravasation of injected fluid into a mandibular intraosseous access might severely complicate this procedure, the anterior mandible may be helpful as an alternative to other intraosseous and intravenous insertion sites when these are not available in medical emergencies. PMID:25405476

  4. Unilocular radiolucencies of anterior mandible in young patients: A 10 year retrospective study

    PubMed Central

    Mohanty, Sujata; Gulati, Ujjwal; Mediratta, Akshat; Ghosh, Sujoy

    2013-01-01

    Introduction: Mandibular anterior region is an uncommon site for occurrence of intrabony pathologies. Unilocular presentation of a lesion is again less common than multilocular appearance. Demographically, most lesions occur in middle to elderly age group. The study is designed to review the pathologies manifesting a combination of these rare demographic and radiological criteria. Materials and Methods: A retrospective analysis of patients with anterior unilocular radiolucencies of mandible in young patients was done. Records of past 10 years were searched. There were a total of 17 patients. Their clinical history and radiographs were reviewed from the case files and correlated with histopathological examination of the lesion. Results: Nine different pathologies constituted the sample size of 17. A wide array of lesions was found to manifest similar signs and symptoms and radiographic findings namely ameloblastoma (three), adenomatoid odontogenic tumor (AOT, four), odontogenic keratocyst (OKC, three), ossifying fibroma (OF, two), idiopathic bone cavity (IBC, one), dentigerous cyst (DC, one), radicular cyst (RC, one), central giant cell granuloma (CGCG, one), and calcifying odontogenic cyst (COC, one). Conclusion: Anterior mandible is a rare site for occurrence of intrabony pathologies. Majority of patients are females. Lesions acquire large size before they are detected. Growth occurs more in length than in width. Root resorption is not uncommon and root displacement is almost a consistent feature. PMID:24163555

  5. Tooth hardness increases with zinc-content in mandibles of young adult leaf-cutter ants.

    PubMed

    Schofield, Robert M S; Nesson, Michael H; Richardson, Kathleen A

    2002-12-01

    A wide variety of arthropods and members of other phyla have elevated concentrations of Zn, Mn, other heavy metals and halogens in their jaws, leg claws, and other "tools" for interacting with the environment. While measured Zn concentrations reach 25% of dry mass in scorpion stings, concentrations are often lower than this and the enriched structures are not heavily biomineralized like vertebrate teeth and the radula of mollusks. For this reason, the degree to which the inorganic components of these structures modify their mechanical properties is in question. Here we address this problem by measuring hardness during the development of Zn accumulations in ant mandibles. We found that Zn is incorporated into the mandibular teeth of leaf-cutter ants during early adult life, reaching concentrations of about 16% of dry mass. We show that the hardness of the mandibular teeth increases nearly three-fold as the adults age and that hardness correlates with Zn content ( r=0.91). We suggest that young adults rarely cut leaves partly because their mandibles are not yet rich in Zn. Zinc enrichment (along with enrichment by other heavy metals and halogens) may play an unrecognized role in the behavioral ecology and evolution of a wide variety of invertebrates. PMID:12536282

  6. Histomorphometry of the tibia and mandible of healthy female Wistar rats at different stages of growth.

    PubMed

    Nenda, María M; Lewicki, Marianela; Mandalunis, Patricia M

    2016-05-20

    Female Wistar rats are frequently used in experimental models to study hormone and bone pathologies and treatments. Most experimental studies involving histomorphometric evaluation assessed long bones, and few reports also studied mandibular bone. The aim of this work was to clarify and distinguish the age-related histomorphometric changes that occur in the tibia (subchondral bone) and in the mandible (interradicular bone), and thus obtain reference histomorphometric data of healthy female Wistar rats at different growth stages. Three groups of 8 healthy female Wistar rats were euthanized at 6 (GI), 10 (GII), and 14 (GIII) weeks. The tibiae and mandible were resected and histologically processed to obtain H&E stained sections of the tibia and the lower first molar to analyze the following histomorphometric parameters: Bone volume, trabecular width, trabecular number (Th.N)(1/mm), growth cartilage width, hypertrophic cartilage width and number of osteoclasts per area in the tibiae, and bone volume and number of osteoclasts per area N.Oc/mm(2) in the interradicular bone of the first lower molar. A significant decrease in subchondral bone volume as a result of a decrease in trabecular number and growth cartilage width was observed in 14-week-old rats. Conversely, interradicular bone volume was found to increase with age. The results highlight the importance of analyzing both types of bone to better understand the response of two different trabecular bones, contributing in turn to decision making regarding treatment strategies and disease management. PMID:26568145

  7. Myxoid chondrosarcoma of the mandible in a 22-year-old man: A case report

    PubMed Central

    Chen, Ying; Zhang, Ying

    2016-01-01

    This study describes a case of myxoid chondrosarcoma of the mandible in a 22-year-old male patient. A tumour in the buccal gingiva of the lower left premolar region had been identified 2 years earlier. Whole-jaw panoramic radiographs showed a hypodense shadow in the mesiodistal area near the roots of teeth 34 and 35. A maxillofacial computed tomography scan revealed a mass in the lower left premolar soft tissue, with a shadow indicating bone destruction, a clear boundary and uniform density. The preliminary diagnosis at the outpatient department was 34–35 epulis. The patient underwent surgery for 34–35 gingival tumour resection, 34 and 35 extraction, and 34 and 35 immediate implantation. The postoperative pathological examination revealed a cellular type extraskeletal myxoid chondrosarcoma of the lower left mandible. Under general anaesthesia, the patient underwent lower left mandibular block and segmental resection, submandibular triangle dissection and vessel disassociation, and musculocutaneous flap repair in the oral and maxillofacial defect area. After 9 months of follow-up, the patient had no complaints of discomfort, and tumour recurrence was not observed on imaging examinations. PMID:27602220

  8. Local therapy in non-metastatic primary Ewing sarcoma of the mandible and maxilla in children.

    PubMed

    Qureshi, S S; Bhagat, M; Laskar, S; Kembhavi, S; Vora, T; Ramadwar, M; Chinnaswamy, G; Prasad, M; Khanna, N; Shah, S; Talole, S

    2016-08-01

    Ewing sarcoma (ES) of the jaw bones comprises a small fraction of ES at all sites. Due to their rarity, a specific policy for local treatment is lacking. The aim of this study was to evaluate the local therapy for ES and recommend measures to individualize treatment options. Patients with primary non-metastatic ES of the jaw bones treated between August 2005 and February 2015 were analyzed. All patients received primary induction chemotherapy, following which lesions amenable to resection based on specific radiological criteria were resected; those with unresectable lesions were offered definitive radiotherapy. The maxilla was the primary site in 13 patients and the mandible in eight. The median age of patients was 11.6 years (range 5-17 years). Overall, surgery was performed in 17 patients and definitive radiotherapy was used in four patients. Postoperative radiotherapy was administered to 12 patients and was avoided in five patients with 100% tumour necrosis. The 3-year overall survival, event-free survival, and local control were 68.1%, 63.6%, and 80.2%, respectively. Mandible primary and a histological response to chemotherapy were significant prognostic factors. The stratification of patients based on radiological criteria aids in selecting local therapy. In eligible patients, surgery with contemporary reconstruction results in optimal oncological and functional outcomes. Surgery also has the added advantage of identifying patients who may not need radiotherapy. PMID:27026058

  9. Modeling the human mandible under masticatory loads: which input variables are important?

    PubMed

    Gröning, Flora; Fagan, Michael; O'Higgins, Paul

    2012-05-01

    Finite element analyses (FEA) that have simulated masticatory loadings of the human mandible differ significantly with regard to their basic input variables such as material properties, constraints, and applied forces. With sensitivity analyses it is possible to assess how the choice of different input values and the degree of model simplification affect FEA results. However, published FEA studies are rarely accompanied by sensitivity analyses so that the robusticity of their results is impossible to assess. Here, we conduct a sensitivity analysis with an FE model of a human mandible to quantify the relative importance of several modeling decisions: (1) the material properties assigned to the cancellous bone tissue; (2) the inclusion or not of the periodontal ligament; (3) the constraints at the joints and bite point; and (4) the orientation of applied muscle forces. We study the effects of varying these properties by analysing the strain magnitudes and directions across the model surface. In addition, we perform a geometric morphometric analysis of the deformation resulting from the loading of each model. The results show that the effects of altering the different model properties can be significant and that most effects are potentially large enough to cause problems for the biological interpretation of FEA results. We therefore recommend that researchers conduct more sensitivity analyses than at present to assess the robusticity of their FEA results and their biological conclusions. PMID:22467624

  10. Reconstruction of the mandible by prefabricated autogenous bone grafts. An experimental study in minipigs.

    PubMed

    Schliephake, H; Langner, M

    1997-08-01

    The aim of the present experimental study was to evaluate the use of prefabricated bone grafts for reconstruction of the mandible. In 20 adult Göttingen minipigs, prefabricated bone grafts 10 x 12 x 40 mm in size were cultivated in scaffolds of pyrolized bovine bone under a polylactic membrane on the outside of the mandible during a period of five months. The grafts were harvested and transferred to bridge 2- and 4-cm lower mandibular border defects and discontinuity defects. Five animals served as ungrafted controls and evaluation of the grafts was performed three and five months after grafting. At both intervals and in both graft-length groups, the grafted bone volume was almost completely preserved inside the scaffolds and exhibited a slight (3 months) to marked (5 months) increase in bone density by appositional bone growth. The inserted screws were histologically integrated into the transplanted bone and the grafts were linked to the adjacent mandibular bone without intervening soft tissue. The grafts, which were transferred to bridge discontinuity defects, were likewise well preserved with direct fusion between the grafted bone and local bone. It was concluded that bone grafts can be prefabricated from underlying mandibular bone and used for the repair of mandibular defects of various length and shape. PMID:9258711

  11. Distraction osteogenesis of free flap reconstructed mandible following ameloblastoma resection for optimal functional rehabilitation.

    PubMed

    Bousdras, V A; Kalavrezos, N

    2014-01-01

    This case highlights the use of a custom-made distractor (Synthes GmbH, Oberdorf, Switzerland), used to increase bone height prior to rehabilitation with implant placement, in a patient following excision of an ameloblastoma and reconstruction of her mandible with a fibular flap. A 27-year-old patient had her mandible reconstructed following wide resection of an ameloblastoma. Although a 2.0 LOCK reconstruction plate (Synthes GmbH, Oberdorf, Switzerland) was used for fixation of the fibular bone, the vertical deficiency between the reconstructed segment and the occlusal plane made oral rehabilitation impossible. To overcome this, the fibular bone segment was vertically distracted following a latency period of 4 days. Distractor was left in place for 20 weeks for bone consolidation. Following device removal implants were placed. The novelty of this approach included fixation of the lower arm of the distractor on the LOCK plate. The distractor was unidirectional with two arms of different length. The lower arm composed of a 2.0 mini-plate to fit exactly on the 2.0 LOCK plate whereas the upper arm used a standard 1.5 mini-plate. Advantages of this custom-made distractor included: (i) No need for removal of the reconstruction plate, (ii) no need for an extraoral surgical approach, and (iii) no need for additional drilling to fit the lower arm of the distractor. Technical details and limitations are presented. PMID:25593885

  12. Direct radiocarbon dating and genetic analyses on the purported Neanderthal mandible from the Monti Lessini (Italy)

    PubMed Central

    Talamo, Sahra; Hajdinjak, Mateja; Mannino, Marcello A.; Fasani, Leone; Welker, Frido; Martini, Fabio; Romagnoli, Francesca; Zorzin, Roberto; Meyer, Matthias; Hublin, Jean-Jacques

    2016-01-01

    Anatomically modern humans replaced Neanderthals in Europe around 40,000 years ago. The demise of the Neanderthals and the nature of the possible relationship with anatomically modern humans has captured our imagination and stimulated research for more than a century now. Recent chronological studies suggest a possible overlap between Neanderthals and anatomically modern humans of more than 5,000 years. Analyses of ancient genome sequences from both groups have shown that they interbred multiple times, including in Europe. A potential place of interbreeding is the notable Palaeolithic site of Riparo Mezzena in Northern Italy. In order to improve our understanding of prehistoric occupation at Mezzena, we analysed the human mandible and several cranial fragments from the site using radiocarbon dating, ancient DNA, ZooMS and isotope analyses. We also performed a more detailed investigation of the lithic assemblage of layer I. Surprisingly we found that the Riparo Mezzena mandible is not from a Neanderthal but belonged to an anatomically modern human. Furthermore, we found no evidence for the presence of Neanderthal remains among 11 of the 13 cranial and post-cranial fragments re-investigated in this study. PMID:27389305

  13. The use of SPECT to evaluate growth cessation of the mandible in unilateral condylar hyperplasia.

    PubMed

    Pripatnanont, P; Vittayakittipong, P; Markmanee, U; Thongmak, S; Yipintsoi, T

    2005-06-01

    In unilateral condylar hyperplasia, for surgical intervention to be effective, the status of condylar bone growth has to be assessed correctly. Previously this assessment relied on serial clinical observations. This study aimed to evaluate the MDP-SPECT method of assessing condylar growth in unilateral condylar hyperplasia. Twenty-six MDP-SPECT of the mandible had been performed; 21 were diagnosed as condylar hyperplasia and five as non-mandibular disease. Three isotope parameters: isotope counts, pixel counts and counts per pixel were summed for each condyle per subject. The percentage difference in isotope uptake of the three parameters between the two condyles was calculated as the ratio of the combined counts of the two sides. These differences significantly correlated with each other (Pearson r=0.78-0.98) and with the clinical status of bone growth (Spearman rho=0.72-0.86). There was a significant difference for the count per pixel between the 'growing' condyle (transaxial, T: 15.05+/-7.14, coronal, C: 12.29+/-7.88), the 'no further growth' condyle (T: 5.22+/-4.08, C: 5.67+/-3.88) and the 'normal' condyle (T: 0.82+/-0.76, C: 1.34+/-0.66). This method was able to separate 'active growth' from 'growth cessation' of the condyle by a single MDP-SPECT of the mandible. However, further studies are needed to confirm this finding. PMID:16053843

  14. A modified method of immediate loading using Brånemark implants in edentulous mandibles.

    PubMed

    Hatano, Naoki; Yamaguchi, Masahiko; Suwa, Tomihiko; Watanabe, Kouzo

    2003-09-01

    According to the original protocol, Brånemark implants require a two-step surgical procedure in order to become osseointegrated. The two-stage surgery is sometimes uncomfortable for the patient, and recent research has shown that osseointegration can also be achieved with a one-stage technique with early or immediate loading of the implants in good quality bone, which simplifies and shortens treatment for the patient's benefit. The aim of this study was to evaluate the immediate loading of Brånemark implants with a screw-retained prosthesis in edentulous mandibles. Forty-three patients each had three Brånemark implants of varying lengths and diameters installed in the inter-foramina mandibular area. The implant installation procedures were performed according to the standard protocol with avoidance of over-preparation of the implant sites. The prosthesis framework was prefabricated in advance and was cast and separated into three parts, followed by adjustment in the mouth, with a soldering, impression made in situ; finally, the framework was sent to the laboratory for completion of the bridge. The fixed implant bridge was usually delivered to the patient later the same day. Three of the 129 implants failed to osseointegrate, yielding a success rate of 97.6%, with a follow-up period ranging from 3 to 49 months. The results obtained in this study were encouraging, and thus far this modified method of immediate loading in the anterior edentulous mandible appears to be predictable. PMID:14505188

  15. A mandible arresting system in neotropical social wasps (Vespidae; Polistinae): structural diversity within homogeneous functionality

    NASA Astrophysics Data System (ADS)

    López-Cubillos, Sofía; Sarmiento, Carlos E.

    2013-05-01

    Microtrichia are epidermal protuberances that may serve as temporary adhesive devices. Several insects possess these structures; however, they have not previously been reported in social wasps. With scanning electron microscopy, we characterize the shape and abundance of microtrichia in ten species of social wasps (Vespidae: Polistinae) and three species of related taxa (Vespidae: Eumeninae, Pompilidae, and Scoliidae). Semi-thin sections of the head of Leipomeles spilogastra and Apoica albimacula were also studied. We found microtrichia on a thin, flexible membrane connected to the mandible in all the Vespidae specimens. The flexible membrane can be divided into three regions: the basal region that covers the mandibular mesial emargination, the medial region located around the height of the mandibular condyles, and the distal region that appears anterior to the apodeme folding. Basal and distal regions of the membrane are extensively covered by microtrichia while the medial region has either less microtrichia or is entirely devoid of them. The shape and density of the microtrichia differed between species, and these traits are unrelated with nest material construction or phylogenetic closeness. We propose that the microtrichial membrane described is a passive mechanism to keep the wasps' mandibles retracted through a mechanical interlocking system. It is possible that this energy-saving mechanism is present in other mandibulate insects.

  16. Ciprofloxacin-associated posterior reversible encephalopathy

    PubMed Central

    Al Bu Ali, Waleed Hammad

    2013-01-01

    Posterior reversible encephalopathy syndrome (PRES) is a clinico-neuroradiological syndrome characterised by numerous symptoms and of no specific aetiology. Headache, confusion, seizures, cortical visual disturbances or blindness are the key symptoms. As this syndrome is reversible and readily treated by interrupting or discontinuing the aetiology, it should sharply be acknowledged. Ciprofloxacin was associated with PRES in an adolescent male treated from chest infection. It was managed in a hospital intensive care unit and was observed until disappearance. PMID:23585504

  17. The mechanism of continence after posterior urethroplasty

    PubMed Central

    Bagga, Herman S.; Angermeier, Kenneth W.

    2015-01-01

    The standard of care after a pelvic fracture urethral injury is a repair via a one-stage anastomotic posterior urethroplasty using a step-wise perineal approach. The initial injury, immediate postoperative management, and surgical repair can all affect urinary continence in these patients. Proximal continence mechanisms, particularly the bladder neck, are particularly important in maintaining urinary continence in these patients. Patients with bladder neck dysfunction should be counselled about the greater risk of urinary incontinence. PMID:26019981

  18. Cervical disc hernia operations through posterior laminoforaminotomy

    PubMed Central

    Yolas, Coskun; Ozdemir, Nuriye Guzin; Okay, Hilmi Onder; Kanat, Ayhan; Senol, Mehmet; Atci, Ibrahim Burak; Yilmaz, Hakan; Coban, Mustafa Kemal; Yuksel, Mehmet Onur; Kahraman, Umit

    2016-01-01

    Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years). Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%). On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis. PMID:27217655

  19. A Radiological Review of Ewing's Sarcoma of Mandible: A Case Report with One Year Follow-up

    PubMed Central

    Thomas, Valsa; Kattoor, Jayasree; Kusumakumari, P

    2013-01-01

    ABSTRACT Ewing's sarcoma (ES) is an uncommon round cell tumor with an aggressive course affecting mainly children and young adults. Only 1% of cases is reported with jaw involvement and have mandibular predilection. Radiographic finding in ES reflect many destructive nature of the lesion, like osteolysis, cortical erosion, periostitis and soft tissue mass. A case of ES of the mandible is reported with special consideration to the radiological appearance. How to cite this article: Krishna KBB, Thomas V, Kattoor J, Kusumakumari P. A Radiological Review of Ewing's Sarcoma of Mandible: A Case Report with One Year Follow-up. Int J Clin Pediatr Dent 2013;6(2):109-114. PMID:25206203

  20. A Radiological Review of Ewing's Sarcoma of Mandible: A Case Report with One Year Follow-up.

    PubMed

    Krishna, Kb Bimal; Thomas, Valsa; Kattoor, Jayasree; Kusumakumari, P

    2013-05-01

    Ewing's sarcoma (ES) is an uncommon round cell tumor with an aggressive course affecting mainly children and young adults. Only 1% of cases is reported with jaw involvement and have mandibular predilection. Radiographic finding in ES reflect many destructive nature of the lesion, like osteolysis, cortical erosion, periostitis and soft tissue mass. A case of ES of the mandible is reported with special consideration to the radiological appearance. How to cite this article: Krishna KBB, Thomas V, Kattoor J, Kusumakumari P. A Radiological Review of Ewing's Sarcoma of Mandible: A Case Report with One Year Follow-up. Int J Clin Pediatr Dent 2013;6(2):109-114. PMID:25206203

  1. Pre-tapped and self-tapping screws in children's mandibles. A scanning electron microscopic examination of the implant beds.

    PubMed

    Bähr, W; Stoll, P

    1991-10-01

    One hundred 2 mm AO miniscrews were inserted into the mandibles of eight fresh cadavers aged 8 to 12 years. Scanning electron microscopic examination of the implant beds showed cracks and accumulated bone material, as well as signs of crushing and shearing stress, regardless of whether the screws were pre-tapped or not. When, during screw insertion, the axis of the screw deviated by at least 10 degrees from the axis of the tap, two intersecting threads resulted. It is concluded that during osteosynthesis in child mandibles pre-tapping is not recommended. PMID:1742264

  2. The diagnostic dilemma of the posterior mediastinal thymus: CT manifestations

    SciTech Connect

    Cohen, M.D.; Weber, T.R.; Sequeira, F.W.; Vane, D.W.; King, H.

    1983-03-01

    Extension of the normal thymus into the posterior mediastinum is rare. The CT appearance of this anomaly in an infant is presented. A mass of soft-tissue density extended from the anterior mediastinum to the posterior chest wall. The absence of any tissue-cleavage plane in the lesion and a smooth continuous lateral margin are signs of posterior extension of the thymus, and they help to distinguish this from a normal anterior thymus being present with a posterior tumor.

  3. Indocyanine green angiography in posterior uveitis

    PubMed Central

    Agrawal, Rupesh V; Biswas, Jyotirmay; Gunasekaran, Dinesh

    2013-01-01

    Literature review for indocyanine green angiography and evaluate the role of indocyanine green angiogram (ICGA) in patients with posterior uveitis seen at a tertiary referral eye care centre. Detailed review of the literature on ICGA was performed. Retrospective review of medical records of patients with posterior uveitis and dual fundus and ICGA was done after institutional board approval. Eighteen patients (26 eyes) had serpiginous choroiditis out of which 12 patients had active choroiditis and six patients had healed choroiditis, six patients (12 eyes) had ampiginous choroiditis, six patients (12 eyes) had acute multifocal posterior placoid pigment epitheliopathy, eight patients (10 eyes) had multifocal choroiditis, four patients (eight eyes) had presumed ocular histoplasmosis syndrome, four patients (eight eyes) had presumed tuberculous choroiditis, two patients (four eyes) had multiple evanescent white dot syndrome and two patients (four eyes) had Vogt Koyanagi Harada (VKH) syndrome. The most characteristic feature noted on ICGA was the presence of different patterns of hypofluorescent dark spots, which were present at different stages of the angiogram. ICGA provides the clinician with a powerful adjunctive tool in choroidal inflammatory disorders. It is not meant to replace already proven modalities such as the fluorescein angiography, but it can provide additional information that is useful in establishing a more definitive diagnosis in inflammatory chorioretinal diseases associated with multiple spots. It still needs to be determined if ICGA can prove to be a follow up parameter to evaluate disease progression. PMID:23685486

  4. Electrocardiographic diagnosis of remote posterior wall myocardial infarction using unipolar posterior lead V9

    SciTech Connect

    Rich, M.W.; Imburgia, M.; King, T.R.; Fischer, K.C.; Kovach, K.L. )

    1989-09-01

    The accuracy of four electrocardiographic criteria for diagnosing remote posterior myocardial infarction was assessed prospectively in 369 patients undergoing exercise treadmill testing with thallium scintigraphy. Criteria included the following: (1) R-wave width greater than or equal to 0.04 s and R-wave greater than or equal to S-wave in V1; (2) R-wave greater than or equal to S-wave in V2; (3) T-wave voltage in V2 minus V6 greater than or equal to 0.38 mV (T-wave index); (4) Q-wave greater than or equal to 0.04 s in left paraspinal lead V9. Twenty-seven patients (7.3 percent) met thallium criteria for posterior myocardial infarction, defined as a persistent perfusion defect in the posterobase of the left ventricle. Sensitivities for the four criteria ranged from 4 to 56 percent, and specificities ranged from 64 to 99 percent. Posterior paraspinal lead V9 provided the best overall predictive accuracy (94 percent), positive predictive value (58 percent), and ability to differentiate patients with and without posterior myocardial infarction of any single criterion (p less than .0001). Combining the T-wave index with lead V9 further enhanced the diagnostic yield: the sensitivity for detecting posterior infarction by at least one of these criteria was 78 percent, and when both criteria were positive, specificity was 98.5 percent. It is concluded that a single, unipolar posterior lead in the V9 position is superior to standard 12-lead electrocardiographic criteria in diagnosing remote posterior myocardial infarction, and that combining V9 with the T-wave index maximizes the diagnostic yield.

  5. Assessment of mandibular posterior regional landmarks using cone-beam computed tomography in dental implant surgery.

    PubMed

    de Souza, Lílian Azevedo; Souza Picorelli Assis, Neuza Maria; Ribeiro, Rosangela Almeida; Pires Carvalho, Antônio Carlos; Devito, Karina Lopes

    2016-05-01

    and planning for safe implant installation in the posterior mandible. Furthermore, comprehensive evaluation of the characteristics of this region is necessary, as the variables - submandibular fossa depth, bone height and thickness, and mandibular canal corticalization - are related and must be considered together when planning. PMID:26851559

  6. Correlation Analysis of the Hyoid Bone Position in Relation to the Cranial Base, Mandible and Cervical Part of Vertebra with Particular Reference to Bimaxillary Relations / Teleroentgenogram Analysis

    PubMed Central

    Deljo, Emsudina; Filipovic, Mediha; Babacic, Rafeta; Grabus, Jasmina

    2012-01-01

    Introduction: The relationship among the orofacial system and the rest of the body ,both in functional and anatomical terms was the subject of numerous scientific studies. The optimum position of the bone structures of orofacial system provides performance of intact vital functions, such as breathing or swallowing. Hyoid bone represents a link between the head and neck. Although located in the neck, hyoid bone due to its brachial origin belongs to the visceral skeleton. The purpose of the research: a) To determine the position of the hyoid bone, in relation to the cranial base, mandible and cervical part of the vertebra; b) To determine the linear measures of hyoid bone and its constituents and c) to Identify on the profile teleroengen image, whether there are differences in the position of hyoid bone depending on the saggital maxillo-mandibular relationship. The examinees and methods: 30 profile teleroengen images of patients aged 17-18 years of both sexes were used for this study. To study the position of hyoid bone depending on the saggital maxillo-mandibular relationship respondents were divided into groups based on the ANB-angle values. The first group is ortognat patients with ANBangle values, from 1 to 4°. The second group included patients with distal jaw relationship, that is, whose values of ANB-angle were greater than / or 5°. The third group consists of patients with ANB-angle value of 0 or negative. Results and Conclusion: The position of hyoid bone is not constant, but depends on the maxillo-mandibular anterior posterior relationships. Length of hyoid bones and greater horns of hyoid bone differs with respect to the sagittal malocclusion. In relation to the cranial base and maxillary bones flat position of the hyoid bone is highly correlated. A positive correlation was found with relation to the cervical vertebra, while the dependence is determined in relation to the steep mandibular plane. PMID:23322951

  7. Association of two ERCC4 tagSNPs with susceptibility to atrophic gastritis and gastric cancer in Chinese.

    PubMed

    Gong, Yantao; He, Caiyun; Duan, Zhipeng; Sun, Liping; Xu, Qian; Xing, Chengzhong; Yuan, Yuan

    2013-05-01

    Genetic polymorphisms in excision repair cross-complementing group 4 (ERCC4) may contribute to the risk of cancer development. However, there are few reports regarding to susceptibility to gastric cancer (GC) or its precursor, atrophic gastritis (AG). Thereby, we investigated the association between two tag single nucleotide polymorphisms (tagSNPs) rs6498486 and rs254942, which represents the majority of common SNPs of ERCC4 gene, and the risks of GC and AG development in a sex- and age-matched case-control designed study. We found that rs6498486 polymorphism was associated with a reduced AG risk in total population (for AC vs. AA: OR=0.69, 95%CI=0.52-0.94, P=0.016; for AC/CC vs. AA: OR=0.68, 95%CI=0.51-0.92, P=0.010) as well as in the subpopulation of youngers (age<60years) (for AC/CC vs. AA: OR=0.67, 95%CI=0.45-0.99, P=0.048). For the rs254942 polymorphism, compared with the common TT genotype, the genotypes of CT and CT/CC were only observed to reduce AG risk in the subgroups of males (for CT vs. TT: OR=0.64, 95%CI=0.45-0.90, P=0.012; for CT/CC vs. TT: OR=0.66, 95%CI=0.47-0.92, P=0.016) and youngers (for CT vs. TT: OR=0.72, 95%CI=0.53-0.97, P=0.035; for CT/CC vs. TT: OR=0.74, 95%CI=0.55-0.99, P=0.045). However, no significant statistical association of the two SNPs with GC susceptibility was observed in the total population. Only rs6498486 AC and AC/CC genotypes were found to be marginally associated with a reduced GC risk in the subgroup of males (for AC vs. AA: OR=0.69, 95%CI=0.49-0.99, P=0.043; for AC/CC vs. AA: OR=0.71, 95%CI=0.50-0.99, P=0.046). Our findings suggested that the ERCC4 rs6498486 and rs254942 may be associated with AG risk. Further validation of our results in larger populations and additional studies evaluating their molecular function are required. PMID:23415627

  8. Anterior and posterior fixation for delayed treatment of posterior atlantoaxial dislocation without fracture.

    PubMed

    Yu, Hai Ming; Malhotra, Karan; Butler, Joseph S; Wu, Shi Qiang

    2015-01-01

    Posterior atlantoaxial dislocation (PAAD) without fracture of the odontoid process is a rare injury. Authors have variously reported closed or open reduction, followed by either anterior or posterior fixation, but there is no consensus on best treatment. We present a particularly unstable case of PAAD. Open reduction through a retropharyngeal approach with odontoidectomy was required for reduction. Anterior fixation with transarticular lag screws was required prior to posterior fixation with pedicle screws. Despite non-compliance with postoperative immobilisation, imaging at 20-month follow-up confirmed solid fusion. The patient is pain-free with a good range of movement of the neck and has returned to a manual job. Our case had a greater degree of instability than was previously reported, which necessitated 360° fixation. This is the first reported case of this treatment strategy, which provided a very stable fixation allowing fusion despite early movement and without causing undue stiffness. PMID:26516249

  9. Usefulness of three posterior chest leads for the detection of posterior wall acute myocardial infarction.

    PubMed

    Aqel, Raed A; Hage, Fadi G; Ellipeddi, Pavani; Blackmon, Linda; McElderry, Hugh T; Kay, G Neal; Plumb, Vance; Iskandrian, Ami E

    2009-01-15

    A significant proportion of patients with myocardial infarction are missed upon initial presentation to the emergency department. The 12-lead electrocardiogram (ECG) has a low sensitivity for the detection of acute myocardial infarction, especially if the culprit lesion is in the left circumflex artery (LCA). This study was designed to evaluate the benefit of adding 3 posterior chest leads on top of the 12-lead ECG to detect ischemia resulting from LC disease, using a model of temporary balloon occlusion to produce ischemia. We studied 53 consecutive patients who underwent clinically indicated coronary interventions. At the time of coronary angiography, the balloon was inflated to produce complete occlusion of the proximal LCA. We recorded and analyzed the changes noted on the 15-lead ECG, which included 3 posterior leads in addition to the standard 12 leads. In response to acute occlusion of the LCA, the posterior chest leads showed more ST elevation than the other leads, and more patients had ST elevation in the posterior leads than in any other lead. The 15-lead ECG was able to detect>or=0.5 mm (74% vs 38%, p<0.0001) and >or=1 mm (62% vs 34%, p<0.0001) ST elevation in any 2 contiguous leads more frequently than the 12-lead ECG. In conclusion, the 15-lead ECG identified more patients with posterior myocardial wall ischemia because of temporary balloon occlusion of the LC than the 12-lead ECG. This information may enhance the detection of posterior MI in the emergency department and potentially facilitate early institution of reperfusion therapy. PMID:19121429

  10. Strong selection on mandible and nest features in a carpenter bee that nests in two sympatric host plants

    PubMed Central

    Flores-Prado, Luis; Pinto, Carlos F; Rojas, Alejandra; Fontúrbel, Francisco E

    2014-01-01

    Host plants are used by herbivorous insects as feeding or nesting resources. In wood-boring insects, host plants features may impose selective forces leading to phenotypic differentiation on traits related to nest construction. Carpenter bees build their nests in dead stems or dry twigs of shrubs and trees; thus, mandibles are essential for the nesting process, and the nest is required for egg laying and offspring survival. We explored the shape and intensity of natural selection on phenotypic variation on three size measures of the bees (intertegular width, wing length, and mandible area) and two nest architecture measures (tunnel length and diameter) on bees using the native species Chusquea quila (Poaceae), and the alloctonous species Rubus ulmifolius (Rosaceae), in central Chile. Our results showed significant and positive linear selection gradients for tunnel length on both hosts, indicating that bees building long nests have more offspring. Bees with broader mandibles show greater fitness on C. quila but not on R. ulmifolius. Considering that C. quila represents a selective force on mandible area, we hypothesized a high adaptive value of this trait, resulting in higher fitness values when nesting on this host, despite its wood is denser and hence more difficult to be bored. PMID:24963379

  11. Strong selection on mandible and nest features in a carpenter bee that nests in two sympatric host plants.

    PubMed

    Flores-Prado, Luis; Pinto, Carlos F; Rojas, Alejandra; Fontúrbel, Francisco E

    2014-05-01

    Host plants are used by herbivorous insects as feeding or nesting resources. In wood-boring insects, host plants features may impose selective forces leading to phenotypic differentiation on traits related to nest construction. Carpenter bees build their nests in dead stems or dry twigs of shrubs and trees; thus, mandibles are essential for the nesting process, and the nest is required for egg laying and offspring survival. We explored the shape and intensity of natural selection on phenotypic variation on three size measures of the bees (intertegular width, wing length, and mandible area) and two nest architecture measures (tunnel length and diameter) on bees using the native species Chusquea quila (Poaceae), and the alloctonous species Rubus ulmifolius (Rosaceae), in central Chile. Our results showed significant and positive linear selection gradients for tunnel length on both hosts, indicating that bees building long nests have more offspring. Bees with broader mandibles show greater fitness on C. quila but not on R. ulmifolius. Considering that C. quila represents a selective force on mandible area, we hypothesized a high adaptive value of this trait, resulting in higher fitness values when nesting on this host, despite its wood is denser and hence more difficult to be bored. PMID:24963379

  12. Correlation of changes in the mandible and retina/choroid vasculature of a rat model of BRONJ.

    PubMed

    Borke, James L; McAllister, Bennett; Harris, Tiffenie; Neiberg, Maryke; Guevarra-Toth, Chestine; Fulzele, Sadanand; Stoianovici, Charles; Guerra, Carlos

    2015-09-01

    Bisphosphonate-related osteonecrosis of the jaw (BRONJ) causes bones of the mandible and maxilla to become necrotic and protrude into the oral cavity. Compromised blood supply to bone is also a feature of BRONJ. The design of this study was first to use our established technique of molar extraction and IV bisphosphonate injection to produce features of BRONJ in rats that mimic the human disease; second to confirm vascular changes in the mandible and eye using micro-CT of vascular casts, and image analysis of retina/choroid images; and third to show parallel bisphosphonate-induced changes in the structure and markers of the vasculature of the bone and eye. The results of this study show structural changes in the eye and mandible as well as biochemical changes including the up-regulation of VEGF in response to the bisphosphonate-associated ischemia. These changes are not associated with angiogenesis in either the eye or mandible as determined by reduced vascular complexity. These results suggest that observations of direct changes to the vasculature in the retina/choroid structures of the eye in patients taking bisphosphonates could serve as a window to the progression of debilitating changes occurring as a result of bisphosphonate therapy. PMID:26154398

  13. Surgical options for posterior tibial plateau fracture

    PubMed Central

    Chen, Hongwei; Wu, Lijun

    2015-01-01

    Objective: To investigate surgical methods and clinical effectiveness of posteromedial and posterolateral approaches for the posterior tibial plateau fracture. Method: 21 cases who received surgery through posterior approaches for the treatment of posterior tibial plateau fractures (PTPFs) were included. Results: 21 cases were subject to follow-up for 12-24 months (an average of 16.2 months). No cases developed incision inflammation, neurovascular injury, internal fixation loosening and breakage. All fractures were healed. No cases developed knee varus and valgus deformity and fracture dislocation. After surgery, Rasmussen score for knee joint functions was 13-30 points (a mean of 24.2). The results were excellent in 12 cases, good in 7 cases and fair in 2 cases. The percentage of excellent and good results was 90.5%. Rasmussen radiology score was 10-18 points (a mean of 15.6 points). The results were excellent in 13 cases, good in 7 cases and fair in 1 cases. The percentage of excellent and good results was 95.2%. 1 case had significant limited range of knee flexion and extension, which was improved after phase II release under arthroscopy combined with function exercise. 2 cases developed traumatic arthritis, which was relieved after intra-articular injection with sodium hyaluronate and oral nonsteroidal anti-inflammatory drug. Conclusion: The posteromedial and posterolateral approaches for PTPF is good for reduction and fixation of PTPF. The approaches have benefits such as clear exposure, convenient placement of internal fixation, less trauma and good clinical outcome. PMID:26885086

  14. Complications when augmenting the posterior maxilla.

    PubMed

    Fugazzotto, Paul; Melnick, Philip R; Al-Sabbagh, Mohanad

    2015-01-01

    The maxillary posterior edentulous region presents a challenge when planning for restoring missing teeth with a dental implant. The available bone in such cases is often not dense and not adequate for the placement of a properly sized implant because of maxillary sinus pneumatization and alveolar bone loss. Maxillary sinus lift is a predictable procedure to provide adequate bone height for the purpose of implant placement. However, complications are encountered during or after the execution of the sinus lift procedure. In this article, the prevention and management of maxillary sinus complications are discussed. PMID:25434561

  15. Trigeminal neuralgia secondary to posterior fossa tumor.

    PubMed

    Agrawal, Mamta; Agrawal, Vikrant; Agrawal, Rajiv; Pramod, D S R

    2010-01-01

    Trigeminal neuralgia (TN) is by no means an uncommon entity presenting as typical or atypical pain syndrome with a standard treatment protocol consisting of medical and surgical therapies. The diagnosis of TN is mainly dependent on the characteristics of symptoms conveyed by the patient and the clinical presentation. Careful history taking, proper interpretation of the signs and symptoms and cranial nerve assessment are necessary for proper diagnosis. Here, we report a case of TN, treated for dental problems and then for neuralgia with only short-term relief. Subsequently, the patient underwent neuroimaging and was found to be having an uncommon space-occupying lesion in the posterior cranial fossa. PMID:22442556

  16. A Rare Case of Intraosseous Fibrolipoma of the Mandible: Diagnosis and Treatment

    PubMed Central

    Castellani, Andrea; Bocchialini, Gabriele; Ferrari, Luca

    2015-01-01

    Lipomas are common soft tissue tumors. Intraosseous lipoma is a rare lesion that constitutes not more than 0.1% of bone tumors. It can occur anywhere in the body and there have only been a few cases found in the mandible. Intraosseous fibrolipoma of the jaw is an uncommon histological variant of the classic lipoma and to the best of our knowledge only one case has previously been reported in the literature. The cause of this lesion is uncertain. Clinically the lesion is generally asymptomatic and its radiographic feature is a well-defined radiolucency. Surgery is the treatment of choice. We present a case of an intraosseous fibrolipoma in the right mandibular ramus in a 25-year-old female. PMID:25945266

  17. The cost of being an omnivore: mandible wear from plant feeding in a true bug

    NASA Astrophysics Data System (ADS)

    Roitberg, Bernard D.; Gillespie, David R.; Quiring, Donald M. J.; Alma, Colleen R.; Jenner, Wade H.; Perry, Jennifer; Peterson, Jason H.; Salomon, Maxence; Vanlaerhoven, Sherah

    2005-09-01

    Evolutionary and ecological transitions from carnivorous to omnivorous feeding may be constrained by the ability of the animal to cope with disparate types of foods, even if preadaptations for such behaviour exist. The omnivorous true bug, Dicyphus hesperus (Hemiptera: Miridae) requires both animals (small, soft-bodied insects) and plants in its diet and obtains the majority of its dietary and metabolic water from plant feeding. Serrations on the lateral margins of the mandibular stylets wear with age, and this wear is exacerbated when the insects feed on plants compared to those provided free water and no plants. D. hesperus that feed on plants attack fewer prey but consumed similar amounts of prey tissue compared to individuals that were provided free water. Although others have shown mandible wear for plant-chewing animals we show for the first time that plant feeding can impose similar wear on plant-piercing animals as well.

  18. Masseter flap for reconstruction of defects after excision of buccal mucosa cancers with intact mandible.

    PubMed

    Chaturvedi, Pankaj; Lerra, Sandeep; Ustad, Farheen; Pai, Prathamesh S; Chaukar, Devendra A; D'Cruz, Anil K

    2015-01-01

    Among the reconstructive options available for buccal mucosa defects with an intact mandible, free flap with microvascular anastomosis is the best option. However, in the developing world, with poor resources, limited infrastructure, and high patient load, this cannot be offered to all patients. We report on the success of the masseter flap for reconstruction of such defects in carefully selected patients. Despite some known limitations, this flap is easy to learn and carries acceptable complications. The results of this flap may not be comparable to those of microvascular reconstructions, but they are better than those from other options such as skin graft, nasolabial flap, submental flap, etc., in terms of surgical time required, no donor site morbidity, and minimal aesthetic deformity. PMID:26535825

  19. Endoscopic Removal of a Supernumerary Premolar in the Mandible during a Dental Implant Placement

    PubMed Central

    Beltrán, Víctor; Cantín, Mario; Fuentes, Ramón; Engelke, Wilfried

    2014-01-01

    The surgical removal of supernumerary teeth is necessary in some cases, especially before the commencement of any orthodontic or implant treatment procedure. In the mandibular supernumerary premolar, a more conservative approach is required because of the presence of complications associated with conventional surgery due to the close proximity of the said premolar to the alveolar inferior and mental nerves, and the need for bone conservation for implant placement. The endoscopic surgical approach has been used for the removal of the maxillary supernumerary tooth, impacted third molar, and implants. In this case report, we present an endoscopically assisted surgical technique for the removal of an unerupted supernumerary premolar in the mandible associated with a dental implant placement procedure. PMID:24772355

  20. Er:YAG Laser Assisted Treatment of Central Odontogenic Fibroma of the Mandible

    PubMed Central

    Monteiro, Luis Silva; Martins, Marco; Pacheco, José Júlio; Salazar, Filomena; Magalhães, João; Vescovi, Paolo; Meleti, Marco

    2015-01-01

    Central odontogenic fibroma is a very rare benign odontogenic tumour characterized by a fibrous mature stroma with variable strands or islands of inactive-looking odontogenic epithelium. Our aim is to report a case of a central odontogenic fibroma and describe the clinical usefulness of Er:YAG laser for the surgical treatment of this tumour. A 74-year-old woman presented with an expansive lesion located in a mandible with multilocular and mixed radiographic appearance. A conservative excision using Er:YAG laser was performed. Complete removal was obtained. There were no postoperative complications. The histopatologic features were consistent with the diagnosis of central odontogenic fibroma of rich-epithelium type. No recurrence was observed during follow-up. PMID:26457211

  1. Chondrosarcoma in the mental foramen region of the mandible: A case report

    PubMed Central

    Liu, Hongwei; Chen, Xiuhong; Wan, Teng; Li, Ren

    2016-01-01

    Chondrosarcoma is a malignant tumor that is characterized by the formation of cartilage by tumor cells. The tumor is commonly observed in regions where cartilage is already present. In total, 5–12% of chondrosarcomas occur in the head and neck region. However, the occurrence of chondrosarcoma in the mental foramen region is extremely rare. The aim of the present study was to report a case of chondrosarcoma in the mental foramen region. An 18-year-old man presented with a 3-month history of a painless mass over the labial aspect of the right mandible, which was associated with the patient feeling unwell and the loosening of the lower anterior teeth. The patient underwent segmental mandibulectomy and the final pathological diagnosis was chondrosarcoma. Following mandibulectomy, the patient continued to receive routine follow-up. In addition, the present study reviewed the literature concerning chondrosarcomas in the head and neck region. PMID:27602143

  2. Vertical distraction of a free vascularized osteocutaneous scapular flap in the reconstructed mandible for implant therapy.

    PubMed

    Hirota, M; Mizuki, N; Iwai, T; Watanuki, K; Ozawa, T; Maegawa, J; Matsui, Y; Tohnai, I

    2008-05-01

    This paper describes a case of vertical distraction osteogenesis of a free vascularized osteocutaneous scapular flap in the reconstructed mandible before implant therapy. The patient was a 67-year-old woman with squamous cell carcinoma of the right lower gingiva. She underwent segmental mandibulectomy for tumor ablation and reconstruction with an osteocutaneous scapular flap. The distraction protocol, clinical course and implant therapy are presented. Through this procedure, the bone height of the scapular graft increased by 10mm. Implants with adequate length could be placed in the distracted area. Two years after masticatory loading, the condition of these implants was stable. Vertical distraction osteogenesis of the scapular flap was considered effective when performed before implant therapy, to facilitate postoperative functional and esthetic restoration after tumor resection. PMID:18367380

  3. A Large Multifocal Aggressive Osteoblastoma of Mandible: an Immunohistochemistry Case Study Report

    PubMed Central

    D.P., Vinuth; Agarwal, Poonam; Gadewar, Dilip; Dube, Gunjan; Dhirawni, Rajesh

    2014-01-01

    Aggressive osteoblastoma (AO) is a benign osteoblastic tumor which is rare in the head and neck region. Clinical and histo-logical features are therefore overlap with other benign and low-grade malignant tumors. The aim of this article is to report and discuss the differential diagnosis of an aggressive osteoblastoma in the mandible. A 25-year-old male patient reported with pain and asymmetry on the left side of the face since 8 months previously. Radiographic evaluation showed a mixed lesion extending from approximately the lower left premolar to the third molar region. After incisional biopsy, resection with continuity defect was carried out. Microscopic findings showed woven bone and bony trabeculae with varied degrees of mineralization along with sheets of osteoblast cells. Immunohistochemistry showed that p53 and cytokeratin (CK) were negative and ki-67 index was 7%. Postoperative follow-up for 15 months showed no evidence of recurrence. PMID:25024840

  4. Psammomatoid juvenile ossifying fibroma of mandible in a 6-year-old child.

    PubMed

    Manjunatha, B S; Purohit, Sharad; Kiran, Sheetal; Mahita, V Naga

    2016-01-01

    Juvenile ossifying fibroma (JOF) is a rare fibro-osseous lesion of the jaw occurs at the early age of onset frequently under 15 years with a propensity to recur. It appears as a unilobulated/multilobulated lesion at an early stage followed by radiopaque appearance surrounded by radiolucent rimming at advanced stages. The psammomatous type of JOF (PsJOF) principally involves the bones of the orbit and paranasal sinuses. However in some cases, maxilla or rarely the mandible may be pretentious. Here, we report a challenging case of PsJOF in a 6-year-old child with a complaint of swelling imitating a cystic lesion in left back region of the lower jaw for 2 months. The authors propose that a careful examination and correlations of clinical, radiological, and histopathological features are essential to arrive at correct diagnosis and play a vital role in management of such patients. PMID:27134454

  5. Brown tumour of the mandible in primary hyperparathyroidism; a case report.

    PubMed

    Olsen, J; Sealey, C

    2015-09-01

    We present an uncommon diagnosis in a 34-year-old female with a non-healing extraction socket. Incisional biopsy revealed multi-nucleated giant cells suggestive of central giant cell granuloma (CGCG). The computed tomography (CT) report made incidental note of a parathyroid mass. The parathyroid hormone (PTH) level was checked and found to be abnormally high. A diagnosis of brown tumour of the mandible was made. The patient was referred to a head and neck surgeon and the parathyroid mass was removed. The mandibular lesion was managed conservatively and continues to regress post-normalisation of PTH levels. The inclusion of the parathyroid region on the CT scan in this case was fortuitous. There are a range of pathologies containing multinucleated giant cells that can arise from the maxillofacial region; PTH level should, nevertheless, be checked in all such jaw lesions. This allows the clinician to exclude brown tumour from the diagnostic sieve. PMID:26502600

  6. Psammomatoid juvenile ossifying fibroma of mandible in a 6-year-old child

    PubMed Central

    Manjunatha, B. S.; Purohit, Sharad; Kiran, Sheetal; Mahita, V. Naga

    2016-01-01

    Juvenile ossifying fibroma (JOF) is a rare fibro-osseous lesion of the jaw occurs at the early age of onset frequently under 15 years with a propensity to recur. It appears as a unilobulated/multilobulated lesion at an early stage followed by radiopaque appearance surrounded by radiolucent rimming at advanced stages. The psammomatous type of JOF (PsJOF) principally involves the bones of the orbit and paranasal sinuses. However in some cases, maxilla or rarely the mandible may be pretentious. Here, we report a challenging case of PsJOF in a 6-year-old child with a complaint of swelling imitating a cystic lesion in left back region of the lower jaw for 2 months. The authors propose that a careful examination and correlations of clinical, radiological, and histopathological features are essential to arrive at correct diagnosis and play a vital role in management of such patients. PMID:27134454

  7. Central Giant Cell Granuloma of the Mandible Requiring Multiple Treatment Modalities: A Case Report.

    PubMed

    Jerkins, David; Malotky, Maximilian; Miremadi, Reza; Dole, Mukund

    2016-08-01

    Central giant cell granuloma (CGCG) is a relatively rare non-neoplastic, intraosseous lesion that exhibits a wide spectrum of clinical behavior, and its management can be particularly challenging even for experienced clinicians. The etiopathogenesis of this disease process remains unclear, although factors such as trauma, inflammatory foci, and a genetic predisposition have been implicated. Although multiple treatment modalities have been used with varying degrees of success, there is no accepted algorithm for therapeutic intervention and little is known about the reasons for success or failure of a given treatment. This article reviews the epidemiology, presentation, classification, and currently used therapies for CGCG while describing the clinical course and successful therapeutic outcome of a young female patient with an aggressive CGCG of the mandible. PMID:27000410

  8. A rare case of intraosseous fibrolipoma of the mandible: diagnosis and treatment.

    PubMed

    Castellani, Andrea; Bocchialini, Gabriele; Ferrari, Luca

    2015-01-01

    Lipomas are common soft tissue tumors. Intraosseous lipoma is a rare lesion that constitutes not more than 0.1% of bone tumors. It can occur anywhere in the body and there have only been a few cases found in the mandible. Intraosseous fibrolipoma of the jaw is an uncommon histological variant of the classic lipoma and to the best of our knowledge only one case has previously been reported in the literature. The cause of this lesion is uncertain. Clinically the lesion is generally asymptomatic and its radiographic feature is a well-defined radiolucency. Surgery is the treatment of choice. We present a case of an intraosseous fibrolipoma in the right mandibular ramus in a 25-year-old female. PMID:25945266

  9. Osseointegrated implants and functional prosthetic rehabilitation in microvascular fibula free flap reconstructed mandibles.

    PubMed

    Zlotolow, I M; Huryn, J M; Piro, J D; Lenchewski, E; Hidalgo, D A

    1992-12-01

    The mandibulectomy deformity can be alleviated by immediate mandibular reconstruction using the microvascular fibula free flap. Before the advent of microvascular reconstruction, conventional and maxillofacial prosthetic rehabilitation offered limited success after surgery due to the failure to reestablish the bony foundation and soft tissues (tongue, floor of mouth, vestibule) anatomically and physiologically. With proper multidisciplinary pretreatment planning and postoperative treatment, osseointegrated implants can be strategically placed in patients with these reconstructed mandibles to restore occlusal and masticatory function. The records of seven patients who underwent reconstructive surgery and osseointegrated implants were reviewed, with an emphasis on the variety of prosthetic designs and principles used to maximize long-term efficiency and preservation of tissues. PMID:1463123

  10. Sex determination from the mandibular ramus flexure of Koreans by discrimination function analysis using three-dimensional mandible models.

    PubMed

    Lin, Chenghe; Jiao, Benzheng; Liu, Shanshan; Guan, Feng; Chung, Nak-Eun; Han, Seung-Ho; Lee, U-Young

    2014-03-01

    It has been known that mandible ramus flexure is an important morphologic trait for sex determination. However, it will be unavailable when mandible is incomplete or fragmented. Therefore, the anthropometric analysis on incomplete or fragmented mandible becomes more important. The aim of this study is to investigate the sex-discriminant potential of mandible ramus flexure on the Korean three-dimensional (3D) mandible models with anthropometric analysis. The sample consists of 240 three dimensional mandibular models obtained from Korean population (M:F; 120:120, mean age 46.2 y), collected by The Catholic Institute for Applied Anatomy, The Catholic University of Korea. Anthropometric information about 11 metric was taken with Mimics, anthropometry libraries toolkit. These parameters were subjected to different discriminant function analyses using SPSS 17.0. Univariate analyses showed that the resubstitution accuracies for sex determination range from 50.4 to 77.1%. Mandibular flexure upper border (MFUB), maximum ramus vertical height (MRVH), and upper ramus vertical height (URVH) expressed the greatest dimorphism, 72.1 to 77.1%. Bivariate analyses indicated that the combination of MFUB and MRVH hold even higher resubstitution accuracy of 81.7%. Furthermore, the direct and stepwise discriminant analyses with the variables on the upper ramus above flexure could predict sex in 83.3 and 85.0%, respectively. When all variables of mandibular ramus flexure were input in stepwise discriminant analysis, the resubstitution accuracy arrived as high as 88.8%. Therefore, we concluded that the upper ramus above flexure hold the larger potentials than the mandibular ramus flexure itself to predict sexes, and that the equations in bivariate and multivariate analysis from our study will be helpful for sex determination on Korean population in forensic science and law. PMID:24439155

  11. Transcriptional activator TAp63 is upregulated in muscular atrophy during ALS and induces the pro-atrophic ubiquitin ligase Trim63

    PubMed Central

    von Grabowiecki, Yannick; Abreu, Paula; Blanchard, Orphee; Palamiuc, Lavinia; Benosman, Samir; Mériaux, Sophie; Devignot, Véronique; Gross, Isabelle; Mellitzer, Georg; Gonzalez de Aguilar, José L; Gaiddon, Christian

    2016-01-01

    Mechanisms of muscle atrophy are complex and their understanding might help finding therapeutic solutions for pathologies such as amyotrophic lateral sclerosis (ALS). We meta-analyzed transcriptomic experiments of muscles of ALS patients and mouse models, uncovering a p53 deregulation as common denominator. We then characterized the induction of several p53 family members (p53, p63, p73) and a correlation between the levels of p53 family target genes and the severity of muscle atrophy in ALS patients and mice. In particular, we observed increased p63 protein levels in the fibers of atrophic muscles via denervation-dependent and -independent mechanisms. At a functional level, we demonstrated that TAp63 and p53 transactivate the promoter and increased the expression of Trim63 (MuRF1), an effector of muscle atrophy. Altogether, these results suggest a novel function for p63 as a contributor to muscular atrophic processes via the regulation of multiple genes, including the muscle atrophy gene Trim63. DOI: http://dx.doi.org/10.7554/eLife.10528.001 PMID:26919175

  12. A Comparative Evaluation of Low-Level Laser and Topical Steroid Therapies for the Treatment of Erosive-Atrophic Lichen Planus

    PubMed Central

    El Shenawy, Hanaa M.; Eldin, Amany Mohy

    2015-01-01

    BACKGROUND: Oral lichen planus (OLP) is a chronic inflammatory disease that causes bilateral white striations, papules, or plaques on the buccal mucosa, tongue, and gingivae. Erythema, erosions, and blisters may or may not be present. Several empirical therapies have been used in the treatment of (OLP). OBJECTIVE: To evaluate the effect of low level laser therapy (LLLT) versus topical steroids for the treatment of erosive-atrophic lichen planus. SUBJECTS AND METHODS: Twenty-four patients with erosive-atrophic (OLP) were categorized into two groups. In the first group patients were treated with 970 nm diode laser irradiation, while, in the second group patients used topical corticosteroids (0.1% triamcinolone acetonide orabase). The gender, medical history and pain score were recorded. The pain score was measured before and after treatment by visual analogue scale (VAS). RESULTS: Steroid-treated group (0.1% triamcinolone acetonide orabase) show reduced pain score than laser group. CONCLUSION: Topical steroids are more effective than LLLT. LLLT may be used as an alternative treatment for symptomatic OLP when steroids are contraindicated. PMID:27275271

  13. Clinical and histological results in the treatment of atrophic and hypertrophic scars using a combined method of radiofrequency, ultrasound, and transepidermal drug delivery.

    PubMed

    Trelles, Mario A; Martínez-Carpio, Pedro A

    2016-08-01

    Scars are problematic for thousands of patients. Scarring is a natural part of the healing process after an injury. However, the appearance of a scar and its treatment depend on multiple factors and on the experience of the therapist and the options available. Despite a plethora of rapidly evolving treatment options and technical advances, the management of atrophic and hypertrophic scars remains difficult. Innovative technologies provide an attractive alternative to conventional methods in the treatment of scars. The purpose of this trial was to determine the clinical and histological results of a method of treatment that combines radiofrequency, ultrasound, and transepidermal drug delivery. This was a prospective study conducted on 14 patients with scars of different sizes, types, and characteristics. All patients underwent six treatment sessions with the Legato device. Atrophic scars were treated with retinoic acid and hypertrophic scars with triamcinolone. Photographs and biopsies were taken before treatment and at 6 months after the last treatment session. The scars improved significantly (P < 0.0001). The mean attenuation in the severity of scars was 67% (range: 50-75%), where 100% indicates complete disappearance of the scar. Clinical and histological images of scar tissue in six patients in whom attenuation in the range of 55-75% was achieved are shown. Biopsies show regenerative changes in the scar tissue, in both the epidermis and dermis. The method makes it possible to treat extensive, heterogeneous scars on different sites with good results that are similar and predictable. PMID:26967960

  14. Chronic administration of thiamine pyrophosphate decreases age-related histological atrophic testicular changes and improves sexual behavior in male Wistar rats.

    PubMed

    Hernández-Montiel, H L; Vásquez López, C M; González-Loyola, J G; Vega-Anaya, G C; Villagrán-Herrera, M E; Gallegos-Corona, M A; Saldaña, C; Ramos Gómez, M; García Horshman, P; García Solís, P; Solís-S, J C; Robles-Osorio, M L; Ávila Morales, J; Varela-Echavarría, A; Paredes Guerrero, R

    2014-06-01

    Aging is a multifactorial universal process and constitutes the most important risk factor for chronic-degenerative diseases. Although it is a natural process, pathological aging arises when these changes occur quickly and the body is not able to adapt. This is often associated with the generation of reactive oxygen species (ROS), inflammation, and a decrease in the endogenous antioxidant systems, constituting a physiopathological state commonly found in chronic-degenerative diseases. At the testicular level, aging is associated with tissue atrophy, decreased steroidogenesis and spermatogenesis, and sexual behavior disorders. This situation, in addition to the elevated generation of ROS in the testicular steroidogenesis, provides a critical cellular environment causing oxidative damage at diverse cellular levels. To assess the effects of a reduction in the levels of ROS, thiamine pyrophosphate (TPP) was chronically administered in senile Wistar rats. TPP causes an activation of intermediate metabolism routes, enhancing cellular respiration and decreasing the generation of ROS. Our results show an overall decrease of atrophic histological changes linked to aging, with higher levels of serum testosterone, sexual activity, and an increase in the levels of endogenous antioxidant enzymes in TPP-treated animals. These results suggest that TPP chronic administration decreases the progression of age-related atrophic changes by improving the intermediate metabolism, and by increasing the levels of antioxidant enzymes. PMID:24371036

  15. [Effect of chewing training on the postural position of the mandible].

    PubMed

    Tzakis, M; Kiliarides, S; Carlsson, G E

    1989-01-01

    The aim of this project was to study possible effects of chewing gum training on the postural position of the mandible. The material consisted of 11 male and 14 female dental students which were divided in to an experimental and a control group. The subjects were thoroughly informed about the experiment and participated voluntarily. The participants were in good health had a complete natural dentition and had no complaints of mandibular dysfunction. They started chewing-gum training, one hour daily, for one month. The chewing-gum used for this experiment was the resin obtained of the bark of the mastiche tree grown in the greek island Chios which was selected because of its hardness in chewing. In every registration, free way space was measured 4 times with the phonetic method and the mean value was estimated at 5 different occasions. (15 days before the start of the experiment, the day the experiment started before and after half an hour chewing training, and at the end of the experiment, after one month systematic chewing training, one hour daily, free way space was measured again before and after half an hour chewing training. The results of this clinical experimental work indicate: 1) Systematic chewing training does not have any effect on the mandibular postural position of the mandible. 2) Fatigue of the stomatognathic system musculature, caused by half an hour chewing training, very significantly alters the mandibular postural position as it doubles free way space. A possible clinical use of these findings is that free way space does not correlate with the rate of use of the stomatognathic system.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2640524

  16. Hemorrhaging associated with endosseous implant placement in the anterior mandible: a review of the literature.

    PubMed

    Kalpidis, Christos D R; Setayesh, Reza M

    2004-05-01

    The placement of endosseous dental implants is largely considered a safe surgical procedure. However, upper airway obstruction secondary to severe bleeding in the floor of the mouth has been occasionally reported as a rare but potentially fatal complication of implant surgery. This review presents critical hemorrhagic episodes, related to dental implantation in the anterior segments of the mandible, published to date. Massive internal bleeding in the highly vascularized region of the floor of the mouth is the result of an arterial trauma induced by instrumentation, usually through a perforation of the lingual cortical plate. Depending on the clinical situation, hemorrhage may commence immediately or with some delay after the vascular insult. The progressively expanding lingual, sublingual, submandibular, and submental hematomas have the tendency of displacing the tongue and floor of the mouth to obstruct the airway. Because the course of airway deterioration to complete occlusion may be rapid, ensuring a patent airway is of highest priority. Even though upper airway obstruction is potentially life-threatening, a secure airway was successfully established in all patients without fatal consequences. In most cases, resolution of hemorrhage required a surgical intervention for ligation of the bleeding vessels and hematoma evacuation. To reduce the probability of such a grave complication, preventive and precautionary measures to be taken before, during, and after implant placement in the anterior mandible are presented. Issues related to the level of surgical experience, fine regional arterial anatomy, radiographic and clinical evaluation of the osseous morphology, angulation and length of implants, and timing of hemorrhage onset are discussed. In addition, airway and bleeding management strategies are provided. PMID:15212344

  17. Pre-programmed robotic osteotomies for fibula free flap mandible reconstruction: A preclinical investigation.

    PubMed

    Chao, Albert H; Weimer, Katie; Raczkowsky, Joerg; Zhang, Yaokun; Kunze, Mirko; Cody, Dianna; Selber, Jesse C; Hanasono, Matthew M; Skoracki, Roman J

    2016-03-01

    Bony free flap reconstruction of the facial skeleton remains a challenging area of reconstructive surgery. Despite technological advances that have aided planning and execution of these procedures, surgical inaccuracy is not insignificant. One source of error that has not been wholly addressed is that attributable to a human operator. In this study, we investigate the feasibility and accuracy of performing osteotomies robotically in pre-programmed fashion for fibula free flap mandible reconstruction as a method to reduce inaccuracies related to human error. A mandibular defect and corresponding free fibula flap reconstruction requiring six osteotomies were designed on a CAD platform. A methodology was developed to translate this virtual surgical plan data to a robot (KUKA, Augsburgs, Germany), which then executed osteotomies on three-dimensional (3D) printed fibula flaps with the aid of dynamic stereotactic navigation. Using high-resolution computed tomography, the osteotomized segments were compared to the virtually planned segments in order to measure linear and angular accuracy. A total of 18 robotic osteotomies were performed on three 3D printed fibulas. Compared to the virtual preoperative plan, the average linear variation of the osteotomized segments was 1.3 ± 0.4 mm, and the average angular variation was 4.2 ± 1.7°. This preclinical study demonstrates the feasibility of pre-programmed robotic osteotomies for free fibula flap mandible reconstruction. Preliminarily, this method exhibits high degrees of linear and angular accuracy, and may be of utility in the development of techniques to further improve surgical accuracy. © 2015 Wiley Periodicals, Inc. Microsurgery 36:246-249, 2016. PMID:26663239

  18. A dental perspective on the taxonomic affinity of the Balanica mandible (BH-1).

    PubMed

    Skinner, Matthew M; de Vries, Dorien; Gunz, Philipp; Kupczik, Kornelius; Klassen, R Paul; Hublin, Jean-Jacques; Roksandic, Mirjana

    2016-04-01

    The Middle Pleistocene represents a period of critical importance in human evolution, marked by encephalisation and dental reduction, and increasing diversification of temporally and spatially distributed hominin lineages in Africa, Asia and Europe. New specimens, especially from areas less well represented in the fossil record, can inform the debate on morphological changes to the skeleton and teeth and the phylogenetic course of human evolution during this period. The mandible from the cave of Mala Balanica, Serbia has recently been re-dated to at least 400 ka, and its well-preserved dentition presents an excellent opportunity to characterize molar crown morphology at this time period, and re-examine claims for a lack of Neandertal affinities in the specimen. In this study we employ microtomography to image the internal structure of the mandibular molars (focusing on the morphology of the enamel-dentine junction, or EDJ) of the BH-1 specimen and a comparative sample (n = 141) of Homo erectus sensu lato, Homo neanderthalensis, Pleistocene Homo sapiens, and recent H. sapiens. We quantitatively assess EDJ morphology using 3D geometric morphometrics and examine the expression of discrete dental traits at the dentine surface. We also compare third molar enamel thickness in BH-1 to those of H. neanderthalensis and both Pleistocene and recent H. sapiens, and document previously unreported morphology of the BH-1 premolar and molar roots. Our results highlight the reliability of the EDJ surface for classifying hominin taxa, indicate a primitive dental morphology for BH-1 molars, and confirm a general lack of derived Neandertal features for the Balanica individual. The plesiomorphic character of BH-1 is consistent with several competing models of Middle Pleistocene hominin evolution and provides an important regional and temporal example for reconstructing morphological changes in the mandible and teeth during this time period. PMID:27086056

  19. Automating skeletal expansion: An implant for distraction osteogenesis of the mandible

    PubMed Central

    Magill, John C.; Byl, Marten F.; Goldwaser, Batya; Papadaki, Maria; Kromann, Roger; Yates, Brent; Morency, Joseph R.; Kaban, Leonard B.; Troulis, Maria J.

    2010-01-01

    Background Distraction osteogenesis (DO) is a technique of bone lengthening that makes use of the body’s natural healing capacity. An osteotomy is created and a rigid distraction device is attached to the bone. After a latency period, the device is activated 2–4 times per day for a total of 1 mm/day of bone lengthening. This technique is used to correct a variety of congenital and acquired deformities of the mandible, midface and long bones. To shorten the treatment period and to eliminate the complications of patient activation of the device, an automated continuous distraction device would be desirable. It has been reported that continuous distraction generates adequate bone with lengthening at a rate of 2 mm/day, thereby reducing the treatment time. Method of Approach The device we describe here uses miniature high-pressure hydraulics, position feedback, and a digital controller to achieve closed-loop control of the distraction process. The implanted actuator can produce up to 40N of distraction force on linear trajectories as well as curved distraction paths. In the paper we detail the spring-powered hydraulic reservoir, controller, and user interface. Results Experiments to test the new device design were performed in a porcine cadaver head and in live pigs. In the cadaver head, the device performed an 11-day/11 mm distraction with a root-mean-squared position error of 0.09 mm. The device functioned for periods of several days in each of five live animals, though some component failures occurred, leading to design revisions. Conclusions The test series showed that the novel design of this system provides the capabilities necessary to automate distraction of the mandible. Further developments will focus on making the implanted position sensor more robust and then carrying out clinical trials. PMID:20740071

  20. Bisphosphonate-associated osteonecrosis of the mandible: reliable soft tissue reconstruction using a local myofascial flap.

    PubMed

    Lemound, Juliana; Eckardt, Andrè; Kokemüller, Horst; von See, Constantin; Voss, Pit Jacob; Tavassol, Frank; Rücker, Martin; Rana, Majeed; Gellrich, Nils-Claudius

    2012-08-01

    For the treatment of bisphosphonate-associated osteonecrosis of the jaw (BP-associated ONJ), poor cure rates are reported. In many cases, repeated osseous exposition and infection may occur. The currently recommended management of affected patients is antibiotic treatment and bony decortication, which is often complicated by soft tissue deficits due to chronic infection. In severe cases osteonecrosis can be managed often only by continuity resections of the mandible. For this purpose, we developed a new surgical procedure, which allows an effective closure of difficult jaw wounds in the lateral mandible. In the last 3 years, 20 patients with BP-associated osteonecrosis of the lower jaw were treated successfully with a modified defect-covering method using a myofascial flap. A mylohyoid muscle flap was detached from mylohyoid line and used to cover the bony defect. During 19 months mean follow-up, 90% of patients were asymptomatic, the oral mucosa was intact, and no exposed bone was observed. In consequence, we are able to demonstrate that a mylohyoid muscle flap provides a reliable wound closure in the lower jaw in patients treated with BPs. Although there are still no consensual therapy guidelines for patients affected by BP-associated ONJ, the results of the presented study provide evidence for an effective surgical therapy with long-term success. Covering compromised bone with well-vascularized tissue, a muscle flap, increased healing chances by enabling and supporting the necessary nutrition and defense against opportunistic infections. This therapy concept showed a good clinical outcome. PMID:21818568