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Sample records for mandibular anterior region

  1. Anterior mandibular ameloblastoma

    PubMed Central

    Bhandarwar, Ajay H.; Bakhshi, Girish D.; Borisa, Ashok D.; Wagh, Amol; Kapoor, Rajat; Kori, Channabasappa G.

    2012-01-01

    Ameloblastoma is a benign odontogenic tumor. These are usually asymptomatic until a large size is attained. Ameloblastoma has tendency to spread locally and has a high recurrence rate. Majority of ameloblastomas (80%) arise from the mandible. Ameloblastoma arising from anterior mandibular region (symphysis-menti) is rare. Very few cases of midline anterior ameloblastomas are reported in the literature. They often require wide local excision. Reconstruction of mandible in these cases is challenging. We present a case of mandibular ameloblastoma arising from symphysis-menti. Patient underwent wide surgical excision of the tumor followed by immediate reconstruction using free fibular vascular flap, stabilized with titanium reconstructive plates. A brief case report ands review of literature is presented. PMID:24765429

  2. Cutaneous metastasis of medullary carcinoma thyroid masquerading as subcutaneous nodules anterior chest and mandibular region.

    PubMed

    Mannan, Rahul; Kaur, Jasmine; Kaur, Jasleen; Piplani, Sanjay; Kaur, Harjot; Kaur, Harleen

    2014-01-01

    Cutaneous metastasis of underlying primary malignancies can present to dermatologist with chief complaints of cutaneous lesions. The underlying malignancy is generally diagnosed much later after a complete assessment of the concerned case. Medullary carcinoma thyroid (MCT) is a relatively uncommon primary neoplasia of the thyroid. Very few cases presenting as cutaneous metastases of MCT have been reported in the literature. Most of the cases which have been reported are of the papillary and the follicular types. We here report a case of a patient who presented in the dermatology clinic with the primary complaint of multiple subcutaneous nodules in anterior chest wall and left side of body of mandible. By systematic application of clinical and diagnostic skills these nodules were diagnosed as cutaneous metastasis of MCT bringing to the forefront a history of previously operated thyroid neoplasm. So clinically, the investigation of a flesh coloured subcutaneous nodule, presenting with a short duration, particularly in scalp, jaw, or anterior chest wall should include possibility of metastastic deposits. A dermatologist should keep a possibility of an internal organ malignancy in patients while investigating a case of flesh coloured subcutaneous nodules, presenting with short duration. A systematic application of clinical and diagnostic skills will eventually lead to such a diagnosis even when not suspected clinically at its primary presentation. A prompt and an emphatic diagnosis and treatment will have its bearing on the eventual outcome in all these patients. PMID:25478248

  3. Interforaminal hemorrhage during anterior mandibular implant placement: An overview

    PubMed Central

    Kusum, Chandan Kumar; Mody, Pranav V.; Indrajeet; Nooji, Deviprasad; Rao, Suhas K.; Wankhade, Bhushan Ganesh

    2015-01-01

    Implant surgery in mandibular anterior region may turn from an easy minor surgery into a complicated one for the surgeon, due to inadequate knowledge of the anatomy of the surgical area and/or ignorance toward the required surgical protocol. Hence, the purpose of this article is to present an overview on the: (a) Incidence of massive bleeding and its consequences after implant placement in mandibular anterior region. (b) Its etiology, the precautionary measures to be taken to avoid such an incidence in clinical practice and management of such a hemorrhage if at all happens. An inclusion criterion for selection of article was defined, and an electronic Medline search through different database using different keywords and manual search in journals and books was executed. Relevant articles were selected based upon inclusion criteria to form the valid protocols for implant surgery in the anterior mandible. Further, from the selected articles, 21 articles describing case reports were summarized separately in a table to alert the dental surgeons about the morbidity they could come across while operating in this region. If all the required adequate measures for diagnosis and treatment planning are taken and appropriate surgical protocol is followed, mandibular anterior region is no doubt a preferable area for implant placement. PMID:26288617

  4. Interforaminal hemorrhage during anterior mandibular implant placement: An overview.

    PubMed

    Kusum, Chandan Kumar; Mody, Pranav V; Indrajeet; Nooji, Deviprasad; Rao, Suhas K; Wankhade, Bhushan Ganesh

    2015-01-01

    Implant surgery in mandibular anterior region may turn from an easy minor surgery into a complicated one for the surgeon, due to inadequate knowledge of the anatomy of the surgical area and/or ignorance toward the required surgical protocol. Hence, the purpose of this article is to present an overview on the: (a) Incidence of massive bleeding and its consequences after implant placement in mandibular anterior region. (b) Its etiology, the precautionary measures to be taken to avoid such an incidence in clinical practice and management of such a hemorrhage if at all happens. An inclusion criterion for selection of article was defined, and an electronic Medline search through different database using different keywords and manual search in journals and books was executed. Relevant articles were selected based upon inclusion criteria to form the valid protocols for implant surgery in the anterior mandible. Further, from the selected articles, 21 articles describing case reports were summarized separately in a table to alert the dental surgeons about the morbidity they could come across while operating in this region. If all the required adequate measures for diagnosis and treatment planning are taken and appropriate surgical protocol is followed, mandibular anterior region is no doubt a preferable area for implant placement. PMID:26288617

  5. Morphological assessment of the anterior loop of the mandibular canal in Koreans

    PubMed Central

    Yu, Sun-Kyoung; Kim, Seog; Kang, Shin Gu; Kim, Jae Hyuk; Lim, Kyeong Ok; Hwang, Seong-Ik

    2015-01-01

    The mandibular canal divides into the mental and incisive canals at the premolar region, forms the anterior loop which crosses anterior to the mental foramen, and turns back to reach the mental foramen. The aim of this study was to elucidate the general anatomical structure of the anterior loop of the mandibular canal using morphometry. Twenty-six hemimandibles from 19 cadavers (16 males, 3 females; mean age at death, 54.4 years) were studied by meticulous dissection with the aid of a surgical microscope. The location of the anterior loop, the diameters of the mandibular, mental, and incisive canals, and their distances from bony landmarks were measured using digital calipers. The anterior loop of the mandibular canal was located 3.05±1.15 mm (mean±SD) anterior to the anterior margin of the mental foramen and 2.72±1.41 mm inferior to the superior margin of the mental foramen, and was 4.34±1.46 mm long. The diameters of the mandibular, mental, and incisive canals were 2.8±0.49, 2.63±0.64, and 2.22±0.59 mm, respectively. The distances between the inferior border of the mandible and each of these canals were 7.82±1.52, 10.11±1.27, and 9.08±1.66 mm, respectively. The anterior loop of the mandibular canal was located a mean of 3.1 mm anterior and 2.7 mm inferior to the mental foramen, and continued upward and backward into the mental canal, and forward into the incisive canal. These detailed morphological features of the anterior loop of the mandibular canal represent useful practical anatomical knowledge regarding the interforaminal region. PMID:25806125

  6. [The influences of anterior disc displacement on oral mandibular function and morphology and their biological mechanisms].

    PubMed

    Xia, Wendi; Fu, Kiayuan

    2016-03-01

    Anterior disc displacement is a common subtype seen in temporomandibular disorders (TMD) patients. It may cause mandibular movement disorders, such as clicking of joint, intermittent closed lock, limitation of mouth opening, etc. These disorders may affect the life qualities of patients. Anterior disc displacement may also cause mandibular malformations, especially among adolescents, which may affect the growth of condyle, therefore may have a correlation with mandibular retrusion or mandibular deviation when grown up. This paper going to review the influences of anterior disc displacement on oral mandibular function and morphology and their biological mechanisms. PMID:26980658

  7. Anterior Mandibular Lingual Foramina: An In Vivo Investigation

    PubMed Central

    Rastelli, Claudio; Leuter, Cinzia; Gatto, Roberto; Continenza, Maria Adelaide

    2014-01-01

    In descriptions of surgical procedures in mandible, often there is no mention of an anatomical variance, the genial spinal foramina, where nerves and vessels go through. Aim of this study is to investigate frequency, shape, and dimensions of these foramina. 56 computed tomography dentascans were analyzed with an implant planning software. The considered parameters were frequency, number, position, diameters, and length of canals; the collected data were inserted in a spreadsheet and statistically analyzed; therefore, they were compared with those found in the literature. The measurements agree with the ones found in earlier studies, except for the length of the inferior spinal canals, which resulted lesser than that found in the literature. The frequency of the inferior spinal foramina, the data related to the inferior spinal foramina diameter (cross scan), and the measurements related to the superior spinal foramina diameter (axial scan) resulted to be major compared to those reported in literature. These obtained results are clinically interesting because an implant planning software has been employed, daily used by operators, and that permits in vivo investigations. Furthermore, due to the possibility of hemorrhagic accidents in this mandibular region, these data are particularly interesting for all of the operators who make interventions in this area. PMID:25215238

  8. Relationship of Anterior Alveolar Dimensions with Mandibular Divergence in Class I Malocclusion – A Cephalometric Study

    PubMed Central

    Korath, Vinoth Abraham; Nagachandran; Vijayalakshmi, Devaki; Parameswaran, Ratna; Raman, Priya; Sunitha, Catherine; Khan, Nayeemullah

    2016-01-01

    Introduction One of the major limiting factors in retraction of proclined teeth is the width of the alveolus both in maxilla and mandible. Aim The objective of this study was to assess the maxillary and mandibular anterior alveolar dimensions and to correlate with mandibular divergence in Class I bi-dento-alveolar protrusion patients. Materials and Methods Pretreatment lateral cephalograms (n=88) were analysed using a composite analysis with cephalometric software. Both maxillary and mandibular anterior alveolar widths and heights were measured and correlated with mandibular divergence. One-way analysis (ANOVA) and Pearson correlation test were used to compare and establish the significance between groups. Results Segregation of the data based on variation in the bi-cortical widths and heights showed that lesser alveolar widths and greater alveolar heights were associated with the high angled subjects and greater alveolar widths and lesser heights were associated with low angled subjects. Conclusion Patients with hyperdivergent mandible exhibited thin anterior alveolar width and greater alveolar height whereas low angled subjects had wider alveolar width and lesser alveolar height. Orthodontic treatment plan for retraction of anterior teeth must be based on these differences caused by variations in mandibular divergence. PMID:27437356

  9. Assessment of the anterior loop of the mandibular canal: A study using cone-beam computed tomography

    PubMed Central

    do Nascimento, Eduarda Helena Leandro; dos Anjos Pontual, Maria Luiza; dos Anjos Pontual, Andréa; da Cruz Perez, Danyel Elias; Figueiroa, José Natal; Frazão, Marco Antônio Gomes

    2016-01-01

    Purpose Sufficient area in the interforaminal region is required for dental implant placement, and the anterior loop of the mandibular canal is located within the limits of this area. The aim of this study was to evaluate the prevalence and extent of the anterior loop in a Brazilian sample population using cone-beam computed tomography (CBCT). Materials and Methods CBCT images from 250 patients (500 hemimandibles) obtained for various clinical indications were randomly selected and evaluated to determine the presence and length of the anterior loop. The length of the anterior loop was then compared based on gender, age, and the side of the mandible. The data were analyzed using the Pearson chi-square test and linear regression analysis. Results An anterior loop was identified in 41.6% of the cases, and its length ranged from 0.25 mm to 4.00 mm (mean, 1.1±0.8 mm). The loop had a greater mean length and was significantly more prevalent in males (p=0.014). No significant differences were found between the right and left sides regarding length (p=0.696) or prevalence (p=0.650). Conclusion In this study, a high prevalence of the anterior loop of the mandibular canal was found, and although its length varied greatly, in most cases it was less than 1 mm long. Although this is a prevalent anatomical variation, safety limits for the placement of implants in this region cannot be established before an accurate evaluation using imaging techniques in order to identify and preserve the neurovascular bundles. PMID:27358813

  10. Efficacy of 3-Dimensional plates over Champys miniplates in mandibular anterior fractures

    PubMed Central

    Barde, Dhananjay H; Mudhol, Anupama; Ali, Fareedi Mukram; Madan, R S; Kar, Sanjay; Ustaad, Farheen

    2014-01-01

    Background: Mandibular fractures are treated surgically by either rigid or semi-rigid fixation, two techniques that reflect almost opposite concept of craniomaxillofacial osteosynthesis. The shortcomings of these fixations led to the development of 3 dimensional (3D) miniplates. This study was designed with the aim of evaluating the efficiency of 3D miniplate over Champys miniplate in anterior mandibular fractures. Materials & Methods: This study was done in 40 patients with anterior mandibular fractures. Group I consisting of 20 patients in whom 3D plates were used for fixation while in Group II consisting of other 20 patients, 4 holes straight plates were used. The efficacy of 3D miniplate over Champy’s miniplate was evaluated in terms of operating time, average pain, post operative infection, occlusion, wound dehiscence, post operative mobility and neurological deficit. Results: The mean operation time for Group II was more compared to Group I (statistically significant).There was significantly greater pain on day of surgery and at 2nd week for Group II patients but there was no significant difference between the two groups at 4th week. The post operative infection, occlusal disturbance, wound dehiscence, post operative mobility at facture site, neurological deficit was statistically insignificant (chi square test). Conclusion: The results of this study suggest that fixation of anterior mandibular fractures with 3D plates provides three dimensional stability and carries low morbidity and infection rates. The only probable limitation of these 3D plates may be excessive implant material, but they seem to be easy alternative to champys miniplate. How to cite the article: Barde DH, Mudhol A, Ali FM, Madan RS, Kar S, Ustaad F. Efficacy of 3-Dimensional plates over Champys miniplates in mandibular anterior fractures. J Int Oral Health 2014;6(1):20-6. PMID:24653598

  11. A Guided, Conservative Approach for the Management of Localized Mandibular Anterior Tooth Wear.

    PubMed

    Mehta, Shamir B; Francis, Selar; Banerji, Subir

    2016-03-01

    The successful management of the worn mandibular anterior dentition may present an awkward challenge to the dental operator. The purpose of this article is to describe a case report illustrating the use of a guided, three-dimensional protocol for the ultra-conservative and predictable restoration of the worn lower anterior dentition using direct resin composite. This technique utilizes information based on established biomechanical and occlusal principles to fabricate a diagnostic wax-up, which is duplicated in dental stone. This is used to prepare a vacuum-formed modified stent, assisting the clinician to place directly bonded resin composite restorations to restore the worn lower anterior dentition. The technique, described in 2012 and referred to as 'injection moulding' has the potential to offer optimal form, function and an aesthetic outcome in an efficient manner. CPD/Clinical Relevance: This article aims to describe an alternative technique to simplify the processes involved with restoration of worn lower anterior teeth. PMID:27188126

  12. Histological and histomorphometric investigation of the condylar cartilage of juvenile pigs after anterior mandibular displacement.

    PubMed

    Proff, Peter; Gedrange, Tomas; Franke, Reiner; Schubert, Harald; Fanghänel, Jochen; Miehe, Bärbel; Harzer, Winfried

    2007-01-01

    The condylar cartilage of the mandible is considered a secondary growth center and represents a joint cartilage different from other cartilage structures regarding its histological structure, its histochemical and immunohistochemical properties and its growth pattern. This study aimed to histologically and histomorphometrically investigate the condylar cartilage after anterior mandibular displacement similar to functional orthopedic treatment. A total of 12 pigs (sus scrofa domesticus) aged 10 weeks were divided into an experimental group and a control group comprising 6 animals each. The experimental animals were provided bilaterally with synthetic occlusal build-ups in the posterior area which induced anterior displacement of the mandible in terminal occlusion. After 4 weeks, the temporomandibular structures were removed en bloc and the condylar cartilage was analyzed histologically and histomorphometrically. As a result, the experimental animals displayed a significantly increased total cartilage thickness of the posterocranial mandibular condyle which was primarily caused by an increase in thickness of the hypertrophic and chondogenic layers. Similarly, the proliferative layer showed a significant increase, whereas significant differences in thickness were absent in the articular layer. Increased cell proliferation was not observed in the experimental animals as compared to the controls. The changes found in the condylar cartilage area suggest that the zonal structure of the condylar cartilage may be modified by an altered spatial relationship between the mandibular condyle and the glenoid fossa. PMID:17534034

  13. Ultrastructural characterization of the rabbit mandibular condyle following experimental induction of anterior disk displacement.

    PubMed

    Sharawy, M; Ali, A M; Choi, W S; Larke, V

    2000-01-01

    Previous studies in our laboratory have shown that surgical induction of anterior disk displacement (ADD) in the rabbit craniomandibular joint (CMJ) leads to cellular and extracellular alterations consistent with osteoarthritis. Similar findings were also reported in human ADD as well as osteoarthritis of other joints. The purpose of this study was to further characterize these histopathological findings at the ultrastructural level. The right joint of 15 rabbits was exposed surgically and all discal attachments were severed except for the posterior attachment. The disk was then repositioned anteriorly and sutured to the zygomatic arch. The left joint served as a sham-operated control. Ten additional joints were used as nonoperated controls. Mandibular condyles were excised 2 weeks following surgery and processed for transmission electron microscopy. Experimental condyles showed neovascularization, fibrillation and vacuolation of the extracellular matrix and an increase in the number of apoptotic cells compared to controls. In addition, chondrocytes in osteoarthritic cartilage showed an increase in the amounts of rough endoplasmic reticulum and Golgi complex suggesting an increase in protein synthesis. The presence of thick collagen fibers in osteoarthritic cartilage supports our previous immunohistochemical results of the presence of type I collagen instead of normally existing type II collagen. It was concluded that surgical induction of ADD in the rabbit CMJ leads to ultrastructural changes in the mandibular condylar cartilage consistent with degenerative alterations known to occur in osteoarthritis. PMID:10899715

  14. Strategic camouflage treatment of skeletal Class III malocclusion (mandibular prognathism) using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy.

    PubMed

    Seo, Yu-Jin; Lin, Lu; Kim, Seong-Hun; Chung, Kyu-Rhim; Nelson, Gerald

    2016-01-01

    This case report presents the camouflage treatment that successfully improved the facial profile of a patient with a skeletal Class III malocclusion using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy. The patient was an 18-year-old woman with chief complaints of crooked teeth and a protruded jaw. Camouflage treatment was chosen because she rejected orthognathic surgery under general anesthesia. A hybrid type of bone-borne rapid maxillary expander with palatal mini-implants was used to correct the transverse discrepancy, and a mandibular anterior subapical osteotomy was conducted to achieve proper overjet with normal incisal inclination and to improve her lip and chin profile. As a result, a Class I occlusion with a favorable inclination of the anterior teeth and a good esthetic profile was achieved with no adverse effects. Therefore, the hybrid type of bone-borne rapid maxillary expander and a mandibular anterior subapical osteotomy can be considered effective camouflage treatment of a skeletal Class III malocclusion, providing improved inclination of the dentition and lip profile. PMID:26718385

  15. Incidence of mandibular fractures in black sea region of Turkey

    PubMed Central

    Şener, İsmail; Şenel, Erman; Özkan, Nilüfer; Yilmaz, Nergiz

    2015-01-01

    Background The aim of this study is to review the incidence of mandibular fractures in the Black Sea Region of Turkey and to present our treatment protocol. Material and Methods Data were collected regarding age, sex, etiology, time distribution, site of the fracture and the associated injuries and evaluated. These patients were treated at Ondokuz Mayıs University Department of Oral and Maxillofacial Surgery between 2003 and 2010. Data were collected from patient files in the archive and were analyzed using SPSS version 20.0 software. Results A total of 82 patients with 133 mandibular fractures were included in this study. After the follow up period of the patients, the results were achieved from 58 (70.7%) males and 24 (29.3%) females, whose ages ranged from 5 to 72 years and the mean age was 29. Fractures were most seen in 2008 and the busiest month was August. Falls (40.2%) were the major causes of mandibular fractures followed by traffic accidents and violence. The mandibular anatomical sites of higher fracture incidence were: condyle (34.6%), body and symphysis. The number of the fractures and injuries which were seen in other places such as zygomatic arch, alveolar process, tongue, upper and lower lips, orbita, arms was 14. 53 (64.6%) patients were treated by closed reduction, whereas 13 (15.8%) patients were treated by open reduction. Conclusions We concluded that our results were widely similar with the studies in developing countries. Socio-economic factors, cultures, geographic conditions and education could affect the etiology of the mandibular fractures and cause different results between the studies conducted in different countries. Key words:Mandibular fractures, etiology, trauma, treatment, complication. PMID:26330940

  16. Anterior mandibular displacement and condylar growth. An experimental study in the rat

    SciTech Connect

    Tonge, E.A.; Heath, J.K.; Meikle, M.C.

    1982-10-01

    Anterior displacement of the mandible was produced in twenty-eight 1-month-old female rats by two methods: (1) cast-gold splints cemented to the maxillary incisor teeth and (2) a removable stainless steel mesh appliance worn 6 hours each day, during which time the animals were sedated. The controls were littermates without appliances and in the mesh group were also sedated. Animals in the splint group were killed after 24 hours, 1 week, and 1 month; those in the mesh group were killed after 24 hours and after 1 week. the condyles were removed and cultured for 24 hours in medium containing /sup 3/H-thymidine. One condyle from each animal was processed for routine histologic and autoradiographic study. The other was digested in phosphate-buffered saline containing RNA-ase and pronase, and the specific activity of /sup 3/H-thymidine incorporation expressed as dpm/microgramDNA. Anterior mandibular displacement produced by both methods failed to result in a significant increase in the incorporation of /sup 3/H-thymidine into explant DNA. In the 7-day mesh experiment, however, there was a significant increase in the DNA content of the condylar explants from the displacement group, suggesting an increase in the cell population. This finding should be treated with caution because of the small numbers of animals involved, but it indicates an important area for further study. Changes in the distribution of labeled cells within the proliferative zone (PZ) were also observed autoradiographically in the mesh group, but there was little to suggest that mandibular displacement was accompanied by a significant increase in cell division within the PZ. Remodeling changes affecting both the articular tissue and the subchondral bone were a characteristic feature of the 1-month bit plane group.

  17. Angiosarcoma of Anterior Mandibular Gingiva Showing Recurrence – A Case Report with Immunohistochemistry

    PubMed Central

    Koneru, Anila; Vanishree, M.; Manvikar, Vardendra

    2016-01-01

    Angiosarcomas of oral cavity and salivary gland represent 1% of all cases reported in the literature and are therefore considered as extremely rare. To the best of our knowledge very few cases of angiosarcomas involving mandibular gingiva have been reported previously. Here, we report a case of angiosarcoma occurring in the gingiva with review of literature on clinical features. A 30-year-old female patient presented with a complaint of a small growing mass in relation to lower front teeth. Intraoral examination revealed a soft sessile growth arising from the labial gingiva in relation to 31 and 41 on the labial aspect extending distally to 32. The lesion was locally excised. Histolopathological analysis showed that the tumour was composed of spindle shaped to polygonal cells with hyperchromatic nuclei, conspicuous nucleoli and intracytoplasmic vacuoles, mitotic figure were also scattered. Immunohistochemical staining revealed that the tumour cells was positive for factor VIII-related antigen, CD31 and CD34. An excisional biopsy showed a diagnosis of angiosarcoma. After two months patient reported back with the same chief complaint. This present case is a 17th case report of angiosarcoma arising in anterior mandiblular gingiva.

  18. Soft tissue stability in segmental distraction of the anterior mandibular alveolar process. A 2-year follow-up.

    PubMed

    Joss, C U; Triaca, A; Antonini, M; Kiliaridis, S; Kuijpers-Jagtman, A M

    2012-05-01

    This study evaluated soft tissue changes in adult patients treated with distraction osteogenesis (DOG) of the anterior mandibular alveolar process and related it to different parameters. 33 patients (27 females; 6 males) were analysed retrospectively before surgery at T1 (17.0 days), after surgery at T2 (mean 6.5 days), at T3 (mean 24.4 days), and at T4 (mean 2.0 years). Lateral cephalograms were traced by hand, digitized, superimposed, and evaluated. Statistical analysis was carried out using Kolmogorov-Smirnov test, paired t test, Pearson's correlation coefficient, and linear backward regression analysis. 2 years postoperatively (T4), the net effect of the soft tissue at point B' was 100% of the advancement at point B whilst the lower lip (labrale inferior) followed the advancement of incision inferior to 46%. Increased preoperative age was correlated (p<0.05) with more horizontal backward movement (T4-T3) for labrale superior and pogonion'. Higher NL/ML' angles were significantly correlated (p<0.05) with smaller horizontal soft tissue change at point B'. Gender and the amount of skeletal and dental advancement were not correlated with postoperative soft tissue changes (T4-T3). DOG of the anterior mandibular alveolar process is a valuable alternative for mandibular advancement regarding soft tissue change and predictability. PMID:22204924

  19. Skeletal and dental stability of segmental distraction of the anterior mandibular alveolar process. A 2-year follow-up.

    PubMed

    Joss, C U; Triaca, A; Antonini, M; Kiliaridis, S; Kuijpers-Jagtman, A M

    2012-05-01

    33 patients (27 females; 6 males) were retrospectively analysed for skeletal and dental relapse before distraction osteogenesis (DOG) of the mandibular anterior alveolar process at T1 (17.0 days), after DOG at T2 (mean 6.5 days), at T3 (mean 24.4 days), and at T4 (mean 2.0 years). Lateral cephalograms were traced by hand, digitized, superimposed, and evaluated. Skeletal correction (T3-T1) was mainly achieved through the distraction of the anterior alveolar segment in a rotational manner where the incisors were more proclined. The horizontal backward relapse (T4-T3) measured -0.8mm or 19.0% at point B (p<0.001) and -1.6mm or 25.0% at incision inferior (p<0.001). Age, gender, amount and type (rotational versus translational) of advancement were not correlated with the amount of relapse. High angle patients (NL/ML'; p<0.01) and patients with large gonial angle (p<0.05) showed significantly smaller relapse rates at point B. Overcorrection of the overjet achieved by the distraction was seen in a third of the patients and could be a reason for relapse. Considering the amount of skeletal relapse the DOG could be an alternative to bilateral sagittal split osteotomy for mandibular advancement in selected cases. PMID:22356741

  20. Supplemental Mandibular Mesiodens: A Diagnostic Challenge

    PubMed Central

    Naganahalli, Manjunath; Honnappa, Adarsh; Chaitanya, Nallan CSK

    2013-01-01

    Developmental anomalies affecting the number of teeth are occasionally encountered clinically. The incidence of supernumerary teeth is approximately 1–3%. Among these are the maxillary anterior teeth, the maxillary molars, and the maxillo-mandubular premolars, in terms of descending order of occurrence. Supernumeraries occur rarely in the mandibular anterior teeth region. They may be either supplemental or rudimentary. We are reporting case of a supplemental type of supernumerary tooth in the mandibular anterior region and steps which were followed to distinguish supernumerary tooth from the normal series. PMID:24551732

  1. 3D Mandibular Superimposition: Comparison of Regions of Reference for Voxel-Based Registration

    PubMed Central

    Ruellas, Antonio Carlos de Oliveira; Yatabe, Marilia Sayako; Souki, Bernardo Quiroga; Benavides, Erika; Nguyen, Tung; Luiz, Ronir Raggio; Franchi, Lorenzo; Cevidanes, Lucia Helena Soares

    2016-01-01

    Introduction The aim was to evaluate three regions of reference (Björk, Modified Björk and mandibular Body) for mandibular registration testing them in a patients’ CBCT sample. Methods Mandibular 3D volumetric label maps were built from CBCTs taken before (T1) and after treatment (T2) in a sample of 16 growing subjects and labeled with eight landmarks. Registrations of T1 and T2 images relative to the different regions of reference were performed, and 3D surface models were generated. Seven mandibular dimensions were measured separately for each time-point (T1 and T2) in relation to a stable reference structure (lingual cortical of symphysis), and the T2-T1 differences were calculated. These differences were compared to differences measured between the superimposed T2 (generated from different regions of reference: Björk, Modified Björk and Mandibular Body) over T1 surface models. ICC and the Bland-Altman method tested the agreement of the changes obtained by nonsuperimposition measurements from the patients’ sample, and changes between the overlapped surfaces after registration using the different regions of reference. Results The Björk region of reference (or mask) did work properly only in 2 of 16 patients. Evaluating the two other masks (Modified Björk and Mandibular body) on patients’ scans registration, the concordance and agreement of the changes obtained from superimpositions (registered T2 over T1) compared to results obtained from non superimposed T1 and T2 separately, indicated that Mandibular Body mask displayed more consistent results. Conclusions The mandibular body mask (mandible without teeth, alveolar bone, rami and condyles) is a reliable reference for 3D regional registration. PMID:27336366

  2. Tomographic Evaluation of Mandibular Thickness on Premolar and Molar Regions Related to Monocortical Screws.

    PubMed

    Ribeiro, Jonathan; Marin, Charles; Homsi, Nicolas; Rocha Junior, Hernando; Magacho, Luiz; Fidalgo, Guto; Zanela, Manuella

    2016-06-01

    The aim of this study was to measure the thickness of the mandible from the external cortical plate to the teeth roots on premolar and molar regions using CT scan to determine the safety margin for the application of monocortical screws for internal rigid fixation. Thirty-one patients underwent CT-scan imaging for surgical planning. The images were used to measure bilaterally the distance from the external cortex of the mandible to the roots of teeth on premolar and molar region by means of Dental Slice software (Bioparts Prototipagem Biomedica, Brasília, DF, Brazil). Mean, median, standard deviation, one-way ANOVA and post hoc Tukey's test were used for statistical analysis. No statistical differences for thickness were found between right and left side (p = 0.1652). The mean thickness for the left side was 4.17 ± 1.68 mm and for right side 3.93 ± 1.49 mm. Increase in mandibular thickness from anterior to posterior regions in both sides was observed and statistical difference was found among the different groups according to the measured region (p < 0.05). The present results can predict the safety zone for the use of monocortical screws in the mandible, but the use of CT scan is imperative and individual analysis is desired owing to anatomical variations. Further studies with larger samples are necessary to confirm these data and should include other anatomic structures, different regions of mandible/maxilla, as well as other ethnic groups. PMID:27162564

  3. Cone-beam computed tomography study of the root and canal morphology of mandibular permanent anterior teeth in a Chongqing population

    PubMed Central

    Zhengyan, Yang; Keke, Lu; Fei, Wang; Yueheng, Li; Zhi, Zhou

    2016-01-01

    Objective To investigate the root and canal morphology of permanent mandibular anterior teeth in a Chongqing population using cone-beam computed tomography (CBCT). Methods CBCT images of 1,725 patients in a Chongqing population were selected, and a total of 9,646 mandibular anterior teeth were analyzed. The number of root canals and the canal configurations were investigated. Results In total, 0.3% (11/3,257) of lateral incisors and 0.8% (26/3,014) of canines had double roots, and 3.8% (127/3,375) of central incisors, 10.6% (345/3,257) of lateral incisors, and 4.2% (127/3,014) of canines had multi-root canals. The difference in the incidence of multi-canals in lateral incisors between female and male was statistically significant. The frequency of multi-canals in the different age groups was 5.0% for central incisors for ages 21–30 years, 14.7% for lateral incisors for ages 41–50 years, and 8.1% for canines for ages 41–50 years. Conclusion With the limitations of the current study, we found that a high percentage of mandibular anterior teeth had multiple canals in the studied Chinese Chongqing population. The current data may provide clinicians practicing in Chongqing with a more thorough understanding of root canal morphology. PMID:26730198

  4. Soft tissue stability after segmental distraction of the anterior mandibular alveolar process: a 5.5 year follow-up.

    PubMed

    Joss, C U; Triaca, A; Antonini, M; Kiliaridis, S; Kuijpers-Jagtman, A M

    2013-03-01

    Soft tissue changes were analysed retrospectively in 17 patients following distraction osteogenesis (DO) of the mandibular anterior alveolar process. Lateral cephalograms were traced by hand, digitized, superimposed, and evaluated at T1 (17.0 days), after DO at T2 (mean 6.5 days), at T3 (mean 24.4 days), at T4 (mean 2.0 years), and at T5 (mean 5.5 years). Statistical analysis was carried out using Kolmogorov-Smirnov test, paired t-test, Pearson's correlation coefficient, and linear backward regression analysis. 5.5 years postoperatively, the net effect for the soft tissue at point B' was 88% of the advancement at point B while the lower lip (labrale inferior) followed the advancement of incision inferior to 24%. Increased preoperative age was correlated (p<0.05) with more horizontal backward movement (T5-T3) for labrale inferior and pogonion'. Higher NL/ML' angles were significantly correlated (p<0.05) to smaller horizontal soft tissue change at labrale inferior (T5-T3). The amount of advancement at point B was significantly correlated with an upward movement (T5-T3) of labrale inferior (p<0.01) and stomion inferior (p<0.05). It can be concluded that further change in soft tissues occurred between 2.0 and 5.5 years postoperatively. The physiological process of ageing and loss of soft tissue elasticity should be considered as possible reasons. PMID:23182400

  5. Mandibular hypo-hyperdontia: A report of three cases

    PubMed Central

    Nirmala, S. V. S. G.; Sandeep, C.; Nuvvula, Sivakumar; Mallineni, Sreekanth Kumar

    2013-01-01

    Dental anomalies of tooth number in development of the permanent dentition are quite common than the primary dentition, however, the combined occurrence of hypodontia and hyperdontia is a rare phenomenon, especially in the same dental arch. The purpose of this report is to describe a case of concomitant hypo-hyperdontia (CHH) in three patients (one girl and two boys) with missing mandibular central incisor and an erupted mandibular mesiodens. Three rare cases of mandibular CHH were observed during routine examination, where the two anomalies manifested in the anterior region of the mandible. Furthermore, these are the only cases exhibited taurodontism in association with mandibular CHH. PMID:24778987

  6. Bilateral Mandibular Paramolars

    PubMed Central

    Dhull, Rachita Singh; Panda, Swagatika; Acharya, Sonu; Yadav, Shweta; Mohanty, Gatha

    2014-01-01

    ABSTRACT Supernumerary tooth is a developmental anomaly and has been argued to arise from multiple etiologies. These teeth may remain embedded in the alveolar bone or can erupt into the oral cavity. They can cause a variety of complications in the develo­ping dentition. Supernumerary teeth can present in various forms and in any region of the mandible or maxilla, but have a predisposition for the anterior maxilla. Here is the presentation of a case of unusual location of supernumerary teeth located in between mandibular first and second molar region bilaterally. How to cite this article: Dhull KS, Dhull RS, Panda S, Acharya S, Yadav S, Mohanty G. Bilateral Mandibular Paramolars. Int J Clin Pediatr Dent 2014;7(1):40-42. PMID:25206236

  7. 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

    The aim of this study has been to evaluate and correlate the anatomical features of the posterior mandibular region (submandibular fossa depth, bone height and thickness, and mandibular canal corticalization) to improve accident prevention and allow safe planning in implantology. Four parasagittal sections of cone-beam computed tomography (CBCT) from 100 patients were bilaterally analyzed. Linear measurements of the submandibular fossa depth, bone height and thickness were performed. The submandibular fossa was also classified into non-influential undercuts and influential undercuts for implant placement. Mandibular canal corticalization was also evaluated and classified according to the visualization. Data on patient age and gender were also collected. Forty-one scans (41%) were from male patients, and 59 (59%) were from female patients. Patient age ranged between 18 and 84 years, with an average age of 51.37 years. The submandibular fossa depth and implant bone thickness had a significant effect on the variability of the sample (46.1% and 22.3%, respectively). The submandibular fossa depth was quite variable, and the highest values were observed in the posterior regions. In 18.27% of the cases, the presence of the fossa directly influenced implant placement, considering a bone height of 10mm (standard implant). A significant correlation was observed between fossa depth and bone thickness. Thus, greater attention should be paid to thick ridges; although thick ridges are favorable, they may be associated with deeper submandibular fossae. The mandibular canal was the most influential anatomical structure in the premolar region due to the reduced bone height in this region and the greater difficulty in viewing the canal, and the submandibular fossa was the most influential structure in the molar region due to lower bone height leading up to the fossa and the greater fossa depth in this region. Therefore, CBCT is an important tool for assessing the mandibular region

  8. Regional Variation of Bone Tissue Properties at the Human Mandibular Condyle

    PubMed Central

    Kim, Do-Gyoon; Jeong, Yong-Hoon; Kosel, Erin; Agnew, Amanda M.; McComb, David W.; Bodnyk, Kyle; Hart, Richard T.; Kim, Min Kyung; Han, Sang Yeun; Johnston, William M.

    2015-01-01

    The temporomandibular joint (TMJ) bears different types of static and dynamic loading during occlusion and mastication. As such, characteristics of mandibular condylar bone tissue play an important role in determining the mechanical stability of the TMJ under the macro-level loading. Thus, the objective of this study was to examine regional variation of the elastic, plastic, and viscoelastic mechanical properties of human mandibular condylar bone tissue using nanoindentation. Cortical and trabecular bone were dissected from mandibular condyles of human cadavers (9 males, 54 to 96 years). These specimens were scanned using microcomputed tomography to obtain bone tissue mineral distribution. Then, nanoindentation was conducted on the surface of the same specimens in hydration. Plastic hardness (H) at a peak load, viscoelastic creep (Creep/Pmax), viscosity (η), and tangent delta (tan δ) during a 30 second hold period, and elastic modulus (E) during unloading were obtained by a cycle of indentation at the same site of bone tissue. The tissue mineral and nanoindentation parameters were analyzed for the periosteal and endosteal cortex, and trabecular bone regions of the mandibular condyle. The more mineralized periosteal cortex had higher mean values of elastic modulus, plastic hardness, and viscosity but lower viscoelastic creep and tan δ than the less mineralized trabecular bone of the mandibular condyle. These characteristics of bone tissue suggest that the periosteal cortex tissue may have more effective properties to resist elastic, plastic, and viscoelastic deformation under static loading, and the trabecular bone tissue to absorb and dissipate time-dependent viscoelastic loading energy at the TMJ during static occlusion and dynamic mastication. PMID:25913634

  9. Skeletal and dental stability of segmental distraction of the anterior mandibular alveolar process. A 5.5-year follow-up.

    PubMed

    Joss, C U; Triaca, A; Antonini, M; Kiliaridis, S; Kuijpers-Jagtman, A M

    2013-03-01

    17 patients (14 female; 3 male) were analysed retrospectively for skeletal and dental relapse before distraction osteogenesis (DO) of the mandibular anterior alveolar process at T1 (17.0 days), after DO at T2 (mean 6.5 days), at T3 (mean 24.4 days), at T4 (mean 2.0 years), and at T5 (mean 5.5 years). Lateral cephalograms were traced by hand, digitized, superimposed, and evaluated. Skeletal correction (T5-T1) was mainly achieved through the distraction of the anterior alveolar segment in a rotational manner where the incisors were more proclined. The horizontal backward relapse (T5-T3) measured -0.3mm or 8.3% at point B (non-significant) and -1.8mm or 29.0% at incision inferior (p<0.01). Age, gender, amount and type (rotational vs. translational) of advancement were not correlated with the amount of relapse. High angle patients (NL/ML'; p<0.01) showed significant smaller relapse rates at point B. Overcorrection of the overjet achieved by the distraction could be a reason for dental relapse. Considering the amount of long-term skeletal relapse the DO could be an alternative to bilateral sagittal split osteotomy for mandibular advancement in selected cases. PMID:23153785

  10. Accuracy of Computerized Vertical Measurements on Digital Orthopantomographs: Posterior Mandibular Region

    PubMed Central

    Assaf, Mohammad; Gharbyah, Alaa’ Z. Abu

    2014-01-01

    Objectives: Orthopantomographs are commonly used for diagnosis in clinical dentistry. Although the manufacturers claim a constant magnification effect, the reliability of measuring dimensions on the panoramic radiographs is not clear. The aim of this study was to evaluate the accuracy of measuring vertical dimensions in the posterior mandibular area on digital orthopantomographs. Materials and Methods: A retrospective survey of 20 orthopantomographs with unrestored implants (only with cover screw) in the mandibular posterior region (molars and premolars) was conducted. All radiographs were taken using the same machine by skilled technicians. Two examiners were asked to measure the vertical dimension of the implants seen on the radiographs viewed using two differently sized display screens. Inter-examiner and intra-examiner reliability tests were performed. Differences between the measured length and the actual length using each screen type were compared. Results: High coefficients of reliability were observed on intra- and inter-examiner correlation. The overall reliability of measuring the vertical dimensions of implants between both examiners for the large screen and the small screen were 97.4% (Cronbach's alpha 0.993) and 94.0% (Cronbach's alpha 0.984), respectively. There were no significant differences between the errors seen with either the large screen or the small screen, when each of them was compared to the original length (P = 0.146). Conclusion: This study shows that vertical dimensions in the posterior mandibular region (molar and premolars) can be reliably measured on an orthopantomograph using a calibrated machine and special software. PMID:25806135

  11. Anatomical Relationship of Lingual Nerve to the Region of Mandibular Third Molar

    PubMed Central

    de Carvalho Leite Leal Nunes, Carla Maria; de Almeida Lopes, Maria Cândida

    2013-01-01

    ABSTRACT Objectives This study evaluated the relationship of the lingual nerve with the adjacent anatomical structures of the mandibular third molar region, influencing the dentist to be aware of the variability of these relationships. Material and Methods Samples of 24 human corpse half-heads were selected and divided according with the presence or absence of the mandibular third molars. The lingual nerve (LN) was explored, showing its run from the oblique line until its crossing with the submandibular gland duct. The measurements along the LN and the adjacent anatomical structures were taken at the retromolar, molar and sublingual region with the use of a digital caliper. Results The distance from the LN and the third molar socket, which represents the horizontal distance of the lingual plate to the nerve, on average, was 4.4 mm (SD 2.4 mm). The distance from the LN and the lingual alveolar rim, which represents the vertical relationship between the nerve and the lingual alveolar rim of the third molar socket, on average, was 16.8 mm (SD 5.7 mm). The LN has a varied topography that leaves it very vulnerable during any procedure executed in this region. Conclusions Unless adequate protection of the lingual nerve is acquired by following an adequate surgical technique, the lingual nerve will always be vulnerable to damage during surgical intervention or manipulation in this region. PMID:24478912

  12. A michigan-type occlusal splint with spring-loaded mandibular protrusion functionality for treatment of anterior disk dislocation with reduction.

    PubMed

    Proff, Peter; Richter, Ernst-Jürgen; Blens, Torsten; Fanghänel, Jochen; Hützen, Daniel; Kordass, Bernd; Gedrange, Tomas; Rottner, Kurt

    2007-01-01

    For treatment of temporomandibular disorders Michigan-type splints are frequently used, as are mandibular advancement appliances for patients diagnosed with anterior disk dislocation. As both types show good results, the combination of these two mechanisms into one bimaxillary appliance was tested on eight patients where splint therapy had brought reduction but not complete elimination of the symptoms. An existing maxillary Michigan splint was modified so that advancement springs could be fitted and the generated forces were transmitted to a mandibular retainer, which did not interfere with the function of the splint. Treatment progress was monitored with computerized axiography and in all cases the axiographic tracings after the bimaxillary treatment showed no pattern indicative of disk dislocation under normal jaw movements. Myofascial pain symptoms, already improved by the pre-treatment with the Michigan splint, were found to be reduced further or eliminated completely. The approach of retrofitting a Michigan splint with the springs allowed for a versatile appliance, which required no occlusal alteration to the finely adapted splint but could as easily be brought back to the simple splint-functionality either for daytime use or for a period of stabilization of the result after successful treatment. Compliance was found to be very good and the short treatment period, together with the small force levels did not produce any detectable dental side effects. PMID:17695993

  13. Maxillary and mandibular anterior crown width/height ratio and its relation to various arch perimeters, arch length, and arch width groups

    PubMed Central

    Shahid, Fazal; Alam, Mohammad Khursheed; Khamis, Mohd Fadhli

    2015-01-01

    Objective: To investigate the maxillary and mandibular anterior crown width/height ratio and its relation to various arch perimeters, arch length, and arch width (intercanine, interpremolar, and intermolar) groups. Materials and Methods: The calculated sample size was 128 subjects. The crown width/height, arch length, arch perimeter, and arch width of the maxilla and mandible were obtained via digital calliper (Mitutoyo, Japan). A total of 4325 variables were measured. The sex differences in the crown width and height were evaluated. Analysis of variance was applied to evaluate the differences between arch length, arch perimeter, and arch width groups. Results: Males had significantly larger mean values for crown width and height than females (P ≤ 0.05) for maxillary and mandibular arches, both. There were no significant differences observed for the crown width/height ratio in various arch length, arch perimeter, and arch width (intercanine, interpremolar, and intermolar) groups (P ≤ 0.05) in maxilla and mandible, both. Conclusions: Our results indicate sexual disparities in the crown width and height. Crown width and height has no significant relation to various arch length, arch perimeter, and arch width groups of maxilla and mandible. Thus, it may be helpful for orthodontic and prosthodontic case investigations and comprehensive management. PMID:26929686

  14. Ameloblastic Fibrodentinoma Presenting as a False Gingival Enlargement in the Maxillary Anterior Region

    PubMed Central

    Joseph, Shiny; Priya, Lakshmi; Gopal, Dinesh; Devachen, Mary; Narayan, Ajay; Afnan, Muhammed

    2015-01-01

    Ameloblastic fibrodentinoma is a rare benign mixed odontogenic neoplasm usually occurring in the first two decades of life. It is more common in males and the most common site of occurrence is in the mandibular premolar molar area. This report presents a case of ameloblastic fibrodentinoma in a 12-year-old boy in the maxillary anterior region, a less common site for the occurrence of ameloblastic fibrodentinoma. A 12-year-old boy presented with a midline diastema in 11 and 21 region and a swelling in the palatal aspect of 11 and 12. Intraoral periapical radiograph showed the presence of rarefaction of bone on the mesial aspect of the cervical and middle third of the root of 11. Excision biopsy was done. The specimen was processed and stained with hematoxylin and eosin. Microscopic examination showed islands, chords and strands of odontogenic epithelium in a primitive ectomesenchyme resembling dental papilla. The odontogenic epithelium exhibited peripheral ameloblast-like and central stellate reticulum-like cells. The presence of dentinoid material was seen adjacent to the odontogenic epithelium in some foci. The lesion was diagnosed as ameloblastic fibrodentinoma. PMID:25709845

  15. Ameloblastic fibrodentinoma presenting as a false gingival enlargement in the maxillary anterior region.

    PubMed

    Joseph, Shiny; Priya, Lakshmi; Gopal, Dinesh; Devachen, Mary; Narayan, Ajay; Afnan, Muhammed

    2015-01-01

    Ameloblastic fibrodentinoma is a rare benign mixed odontogenic neoplasm usually occurring in the first two decades of life. It is more common in males and the most common site of occurrence is in the mandibular premolar molar area. This report presents a case of ameloblastic fibrodentinoma in a 12-year-old boy in the maxillary anterior region, a less common site for the occurrence of ameloblastic fibrodentinoma. A 12-year-old boy presented with a midline diastema in 11 and 21 region and a swelling in the palatal aspect of 11 and 12. Intraoral periapical radiograph showed the presence of rarefaction of bone on the mesial aspect of the cervical and middle third of the root of 11. Excision biopsy was done. The specimen was processed and stained with hematoxylin and eosin. Microscopic examination showed islands, chords and strands of odontogenic epithelium in a primitive ectomesenchyme resembling dental papilla. The odontogenic epithelium exhibited peripheral ameloblast-like and central stellate reticulum-like cells. The presence of dentinoid material was seen adjacent to the odontogenic epithelium in some foci. The lesion was diagnosed as ameloblastic fibrodentinoma. PMID:25709845

  16. Multiple Mandibular Exostoses: A Rare Case Report

    PubMed Central

    Bansal, Mansi; Rastogi, Sanjay; Sharma, Anamika

    2013-01-01

    Multiple maxillary and mandibular exostoses are common localized overgrowths of the bone. They are non-neoplastic and are thought to be reactive or developmental in origin. These exostoses need to be accurately distinguished from the other more diagnostically significant lesions, notably from the exosteal osteomas. The aetiology of exostosis has been investigated by different authors, but no consensus has been reached so far. We are reporting a rare case of an otherwise healthy 38 year old female with multiple exostoses in the mandibular anterior region, which correlated both clinically and radiographically. PMID:24086919

  17. Masticatory demands induce region-specific changes in mandibular bone density in growing rats.

    PubMed

    Mavropoulos, Anestis; Ammann, Patrick; Bresin, Andrea; Kiliaridis, Stavros

    2005-07-01

    This study investigates the structural adaptation of the mandibular bone when subjected to different masticatory functional and mechanical demands during growth. The effect of two experimental factors, the insertion of a bite block and the alteration of food consistency, on the bone mineral density (BMD) of the mandible was investigated in growing rats. Fifty-two male albino rats were divided into two equal groups, fed with either the standard hard diet or soft diet, at the age of four weeks. After two weeks, half the animals in both groups had their upper molars fitted with an upper posterior bite block. The remaining animals served as a control. Region-specific BMD of the mandible was subsequently measured using dual-energy X-ray absorptiometry (DXA). Soft diet and the consequent reduction of the forces applied to the mandible during mastication resulted in the reduction of BMD in all regions under study. The insertion of the bite-opening appliance (bite block) and the resulting stretching of the soft tissues led to the application of a continuous light force on the lower molars, which was associated with a significant increase of the BMD in the part of the alveolar process just below the root apices. These results raise the question of whether orthodontic treatment with similar appliances may have some, previously unsuspected, short- or long-term effects on the mandibular bone during growth and whether their effects depend on the individual soft-tissue characteristics. PMID:16097232

  18. Incidence and pattern of mandibular fractures in Rohilkhand region, Uttar Pradesh state, India: A retrospective study

    PubMed Central

    Giri, Kolli Yada; Singh, Aishwarya Pratap; Dandriyal, Ramakant; Indra, Niranjanaprasad; Rastogi, Sanjay; Mall, Sunil Kumar; Chowdhury, Shouvik; Singh, Himanshu Pratap

    2015-01-01

    Aims To understand and evaluate the significance of various aetiological factors in determining the incidence and dictating the patterns of mandibular fractures in Rohilkhand region. Methods The patient records and radiographs for 144 patients treated for mandibular fractures were reviewed between the time periods from January 2012 to December 2013. Data on age, gender, aetiology, use of intoxicants, head injury, associated injuries, days of the week, anatomic site and multiple fractures within the mandible were recorded and assessed. Results Maximum incidence of fractures was observed among the individuals in 3rd decade (35.4%) followed by 2nd and 4th decades, which exhibited 32 and 30 cases (22.2% and 20.8%), respectively. Male to female ratio was biased (4:1) portraying a male predominance. Road traffic accidents (RTAs) were observed to be the predominant aetiological factor responsible accounting for 79.2% of the total injuries followed by assaults (11.8%) and falls (9%). Parasymphysis exhibited the highest incidence (32.63%) amongst the anatomic sites, followed by body (18.75%), angle (16.66%), condyle (15.27%), symphysis (12.50%), ramus (2.77%) and coronoid (1.38%). Conclusion The study reveals that majority of affected patients were in the 2nd and 3rd decades. A definitive relationship existed between RTA and the incidence of mandibular fractures. The frequency further increased with consumption of social intoxicants. The most commonly fractured site was parasymphysis either isolated or associated with other fractures in the mandible. PMID:26587379

  19. Biomechanical Evaluation of Different Fixation Methods for Mandibular Anterior Segmental Osteotomy Using Finite Element Analysis, Part Two: Superior Repositioning Surgery With Bone Allograft.

    PubMed

    Kilinç, Yeliz; Erkmen, Erkan; Kurt, Ahmet

    2016-01-01

    In this study, the biomechanical behavior of different fixation methods used to fix the mandibular anterior segment following various amounts of superior repositioning was evaluated by using Finite Element Analysis (FEA). The three-dimensional finite element models representing 3 and 5 mm superior repositioning were generated. The gap in between segments was assumed to be filled by block bone allograft and resignated to be in perfect contact with the mandible and segmented bone. Six different finite element models with 2 distinct mobilization rate including 3 different fixation configurations, double right L (DRL), double left L (DLL), or double I (DI) miniplates with monocortical screws, correspondingly were created. A comparative evaluation has been made under vertical, horizontal and oblique loads. The von Mises and principal maximum stress (Pmax) values were calculated by finite element solver programme. The first part of our ongoing Finite Element Analysis research has been addressed to the mechanical behavior of the same fixation configurations in nongrafted models. In comparison with the findings of the first part of the study, it was concluded that bone graft offers superior mechanical stability without any limitation of mobilization and less stress on the fixative appliances as well as in the bone. PMID:26703029

  20. Three-dimensional maxillary and mandibular regional superimposition using cone beam computed tomography: a validation study.

    PubMed

    Koerich, L; Burns, D; Weissheimer, A; Claus, J D P

    2016-05-01

    This study aimed to validate a novel method for fast regional superimposition of cone beam computed tomography (CBCT) scans. The method can be used with smaller field of view scans, thereby allowing for a lower radiation dose. This retrospective study used two dry skulls and secondary data from 15 patients who had more than one scan taken using the same machine. Two observers tested two types of regional voxel-based superimposition: maxillary and mandibular. The registration took 10-15s. Three-dimensional surface models of the maxillas and mandibles were generated via standardized threshold segmentation, and the accuracy and reproducibility of the superimpositions were assessed using the iterative closest point technique to measure the root mean square (RMS) distance between the images. Five areas were measured and a RMS≤0.25 was considered successful. Descriptive statistics and the intra-class correlation coefficient (ICC) were used to compare the intra-observer measurement reproducibility. The ICC was ≥0.980 for all of the variables and the highest RMS found was 0.241. The inter-observer reproducibility was assessed case by case and was perfect (RMS 0) for 68% (23 out of 34) of the superimpositions done and not clinically significant (RMS≤0.25) for the other 32%. The method is fast, accurate, and reproducible and is an alternative to cranial base superimposition. PMID:26794399

  1. Fishing for jaws in early vertebrate evolution: a new hypothesis of mandibular confinement.

    PubMed

    Miyashita, Tetsuto

    2016-08-01

    The evolutionary origin of the vertebrate jaw persists as a deeply puzzling mystery. More than 99% of living vertebrates have jaws, but the evolutionary sequence that ultimately gave rise to this highly successful innovation remains controversial. A synthesis of recent fossil and embryological findings offers a novel solution to this enduring puzzle. The Mandibular Confinement Hypothesis proposes that the jaw evolved via spatial confinement of the mandibular arch (the most anterior pharyngeal arch within which the jaw arose). Fossil and anatomical evidence reveals: (i) the mandibular region was initially extensive and distinct among the pharyngeal arches; and (ii) with spatial confinement, the mandibular arch acquired a common pharyngeal pattern only at the origin of the jaw. The confinement occurred via a shift of a domain boundary that restricted the space the mesenchymal cells of the mandibular arch could occupy. As the surrounding domains replaced mandibular structures at the periphery, this shift allowed neural crest cells and mesodermal mesenchyme of the mandibular arch to acquire patterning programs that operate in the more posterior arches. The mesenchymal population within the mandibular arch was therefore no longer required to differentiate into specialized feeding and ventilation structures, and was remodelled into a jaw. Embryological evidence corroborates that the mandibular arch must be spatially confined for a jaw to develop. This new interpretation suggests neural crest as a key facilitator in correlating elements of the classically recognized vertebrate head 'segmentation'. PMID:25899041

  2. A Rare Case of Mandibular Exostoses and its Review

    PubMed Central

    Nayak, Sunil S

    2016-01-01

    Mandibular exostosis is a type of bony prominence caused due to hyperostosis in the mandibular bone. They are benign, broad-based surface masses on the outer or facial aspect of the jaw bones; slowly enlarge over the years to form the bulky masses. During the period between the 10th to 13th week of intrauterine life, changes in the structure of the Meckel’s cartilage and the protrusion of the medial lamina of the mandible onto the cartilage can result in the formation of such exostosis. We discuss here a very rare case of a 49-year-old male, in which the buccal exostoses formed underwent changes in size and shape due to certain factors, resulting in a bony bar formation in the mandibular anterior region. PMID:26894053

  3. Regional and temporal changes in the synthesis of matrix metalloproteinases and TIMP-1 during development of the rabbit mandibular condyle.

    PubMed Central

    Breckon, J J; Hembry, R M; Reynolds, J J; Meikle, M C

    1994-01-01

    Connective tissues synthesise and secrete a family of matrix metalloproteinases (MMPs; collagenases, gelatinases and stromelysins) capable of degrading all the components of connective tissue matrices at physiological pH. We document the patterns of synthesis and distribution of MMPs and the tissue inhibitor of metalloproteinases-1 (TIMP-1) within the developing rabbit mandibular condyle using immunofluorescence microscopy. MMPs and TIMP-1 were detected both as bright intracellular accumulations within Golgi vesicles and also as diffuse matrix-bound extracellular deposits. Cells in the articular zone, proliferative zone, condylar cartilage and bone of the mandibular ramus were shown to produce all 3 classes of MMPs and TIMP-1 with the exception of stromelysin, which was not synthesised by cells of the bone of spongiosum. Temporal synthesis of MMPs and TIMP-1 within these regions varied during the period 18 d postcoitum to 14 d postnatum. Our results document unique patterns of MMP and TIMP-1 synthesis during embryonic and early postnatal development of condylar cartilage and support the concept that cells synthesise and secrete MMPs and TIMP-1 before undergoing proliferation and hypertrophy. A comparison of these results with data in the rabbit growth plate show many similarities, but some differences exist that probably reflect differences in the modes of growth of the 2 cartilages. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:8157496

  4. Regionalization of the anterior hypothalamus in the chick embryo.

    PubMed

    Caqueret, Aurore; Coumailleau, Pascal; Michaud, Jacques L

    2005-06-01

    Loss-of-function experiments in mice have shown that the transcription factors Sim1, Otp, Sim2, and Brn2 form a cascade essential for the differentiation of neuroendocrine cells of the anterior hypothalamus that produce vasopressin, oxytocin, somatostatin (SS), thyrotropin-releasing hormone (TRH), and corticotropin-releasing hormone (CRH). Very little is known about how the differentiation of these cell types is regulated in chick. Here, we report the cloning of the chick homolog of Otp. Moreover, we have systematically compared the expression of Sim1, Sim2, Brn2, and Otp with that of the markers of terminal differentiation TRH, SS, CRH, vasotocin, and mesotocin during development of chick embryos. We have found that the cell types studied generally develop in domains expressing these transcriptional regulators but that the pattern of neuronal differentiation and the spatial distribution of some regulators were not the same as in mice. Our results provide a framework useful for the functional analysis of hypothalamus development in chick. PMID:15844192

  5. A Rare and Extensive Case of Oral Malignant Melanoma involving Mandibular Gingiva.

    PubMed

    Rathore, Rajendrasinh S; Phulari, Rashmi Gs; Vasavada, Dharmesh G; Patel, Dipen K

    2016-02-01

    Oral malignant melanoma is an infrequent but an aggressive neoplasm of unknown etiology, seen most commonly in middle age male patients and is more frequently seen at the hard palate and gingiva. The tumor tends to metastasize or locally invade tissue more readily than other malignant tumors in the oral region. In this article, we report a rare case of extensive oral melanoma in a 55-year-old male patient, with a chief complaint of painless growth in mandibular anterior gingiva measuring about 2.6 X 1.7 X 0.8 cm and extending bilaterally till posterior mandibular gingiva and unilaterally to right buccal mucosa. The most common site being hard palate and maxillary gingiva, it is extremely rare in mandibular gingiva (less than 7%) and hence, this rare occurrence in mandibular gingiva is reported, the diagnosis of which was confirmed by histopathology and immunohistochemistry. PMID:27042595

  6. A Rare and Extensive Case of Oral Malignant Melanoma involving Mandibular Gingiva

    PubMed Central

    Rathore, Rajendrasinh S; Vasavada, Dharmesh G; Patel, Dipen K

    2016-01-01

    Oral malignant melanoma is an infrequent but an aggressive neoplasm of unknown etiology, seen most commonly in middle age male patients and is more frequently seen at the hard palate and gingiva. The tumor tends to metastasize or locally invade tissue more readily than other malignant tumors in the oral region. In this article, we report a rare case of extensive oral melanoma in a 55-year-old male patient, with a chief complaint of painless growth in mandibular anterior gingiva measuring about 2.6 X 1.7 X 0.8 cm and extending bilaterally till posterior mandibular gingiva and unilaterally to right buccal mucosa. The most common site being hard palate and maxillary gingiva, it is extremely rare in mandibular gingiva (less than 7%) and hence, this rare occurrence in mandibular gingiva is reported, the diagnosis of which was confirmed by histopathology and immunohistochemistry. PMID:27042595

  7. Evaluation of Hi-Tec Implant Restoration in Mandibular First Molar Region- A Prospective Clinical Study

    PubMed Central

    Sreeram, Roopa Rani. S.; Prasad, L Krishna; Chakravarthi, P Srinivas; Devi, Naga Neelima; Sreeram, Sanjay Krishna

    2015-01-01

    Background and Aims Missing teeth lead to loss of structural balance, inefficient function, poor aesthetics and psychological effects on human beings, which needs restoration for normal contour, function and aesthetics. Several natural or synthetic substitutes are being used for replacement of missing tooth since centuries. Implants are the latest modality of replacement. So, the study was aimed to assess clinical success rate of Hi-Tec implant; which is economical and new in market. Results of the study will help clinician for appropriate implant selection. Materials and Methods The study included 10 patients from 19 to 31 years and needed restoration of missing mandibular first molar. Restoration had done using Hi Tec Single-tooth implants with metal-ceramic single crown prosthesis after three months of osseointegration. The implants were evaluated clinically (bleeding on probing, probing depth, implant mobility- periotest) and radiographically (marginal bone loss and peri-implant radiolucency) for six years. The observers were blinded for the duration of the study to prevent bias. Results All the patients had uneventful post-surgical healing. No bleeding on probing, Implant mobility, peri-implant radiolucency with minimal marginal bone loss and constant probing depths were observed well within the normal range during follow-up periods. Conclusion Two stage single-tooth Hi Tec implant restoration can be used as a successful treatment modality for replacing mandibular first molar in an economic way. However, these results were obtained after 6 years of follow up with a smaller sample size, so long term multi center studies with a larger sample size is recommended for the predictability of success rate conclusively. PMID:26436053

  8. Biomechanical considerations in mandibular incisor extraction cases.

    PubMed

    Rachala, Madhukar Reddy; Aileni, Kaladhar Reddy; Dasari, Arun Kumar; Sinojiya, Jay

    2015-01-01

    Mandibular incisor extraction can be regarded as a valuable treatment option in certain malocclusions to obtain excellence in orthodontic results in terms of function, aesthetics and stability. This treatment alternative is indicated in clinical situations like mild to moderate class III malocclusion, mild anterior mandibular tooth size excess, periodontally compromised teeth, ectopic eruption of mandibular incisor and minimal openbite tendencies. Unlike in premolar extraction cases, space closure in mandibular incisor extraction cases is unique in which the extraction space will be in the middle of the arch. The end result of space closure in these cases should be well aligned, upright, anterior teeth with parallel roots and the goal can be achieved with the bodily tooth movement through proper application of biomechanics. The purpose of this article is to explain the biomechanics of space closure in mandibular incisor extraction cases. PMID:25881386

  9. Right Anterior Insula: Core Region of Hallucinations in Cognitive Neurodegenerative Diseases

    PubMed Central

    Blanc, Frédéric; Noblet, Vincent; Philippi, Nathalie; Cretin, Benjamin; Foucher, Jack; Armspach, Jean-Paul; Rousseau, François

    2014-01-01

    Objectives We investigated the neural basis of hallucinations Alzheimer's disease (AD) by applying voxel-based morphometry (VBM) to anatomical and functional data from the AD Neuroimaging Initiative. Methods AD patients with hallucinations, based on the Neuropsychiatric Inventory (NPI-Q) (AD-hallu group; n = 39), were compared to AD patients without hallucinations matched for age, sex, educational level, handedness and MMSE (AD-c group; n = 39). Focal brain volume on MRI was analyzed and compared between the two groups according to the VBM method. We also performed voxel-level correlations between brain volume and hallucinations intensity. A similar paradigm was used for the PET analysis. “Core regions” (i.e. regions identified in both MRI and PET analyses, simply done by retaining the clusters obtained from the two analyses that are overlapping) were then determined. Results Regions with relative atrophy in association with hallucinations were: anterior part of the right insula, left superior frontal gyrus and lingual gyri. Regions with relative hypometabolism in association with hallucinations were a large right ventral and dorsolateral prefrontal area. "Core region" in association with hallucinations was the right anterior part of the insula. Correlations between intensity of hallucinations and brain volume were found in the right anterior insula, precentral gyrus, superior temporal gyrus, and left precuneus. Correlations between intensity of hallucinations and brain hypometabolism were found in the left midcingulate gyrus. We checked the neuropathological status and we found that the 4 patients autopsied in the AD-hallu group had the mixed pathology AD and Dementia with Lewy bodies (DLB). Conclusion Neural basis of hallucinations in cognitive neurodegenerative diseases (AD or AD and DLB) include a right predominant anterior-posterior network, and the anterior insula as the core region. This study is coherent with the top-down/bottom-up hypotheses on

  10. Oral squamous cell carcinoma of the mandibular region presenting as multiple discharging sinuses: imperative of magnetic resonance imaging and computerized tomography.

    PubMed

    Sehgal, Virendra N; Sehgal, Shruti; Oberai, Rakesh; Verma, Prashant; Sharma, Sonal; Pahwa, Pooja; Dogra, Sunil

    2013-01-01

    A 40-year-old woman presented with red swelling of the right mandibular region of the face. She had several painful, progressive, ulcerative, raised serosanguinous discharging sinuses. The presence of granules and bony contents were not reported. She was an habitual tobacco and betel chewer for the past 20 years. There was no history of injury/trauma over the site in the past. Progressive loss of appetite and body weight was prominent. She was nonambulatory and denied treatment. PMID:23930361

  11. 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

  12. 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

  13. Prefrontal Thinning Affects Functional Connectivity and Regional Homogeneity of the Anterior Cingulate Cortex in Depression

    PubMed Central

    Späti, Jakub; Hänggi, Jürgen; Doerig, Nadja; Ernst, Jutta; Sambataro, Fabio; Brakowski, Janis; Jäncke, Lutz; grosse Holtforth, Martin; Seifritz, Erich; Spinelli, Simona

    2015-01-01

    Major depressive disorder (MDD) is associated with structural and functional alterations in the prefrontal cortex (PFC) and anterior cingulate cortex (ACC). Enhanced ACC activity at rest (measured using various imaging methodologies) is found in treatment-responsive patients and is hypothesized to bolster treatment response by fostering adaptive rumination. However, whether structural changes influence functional coupling between fronto-cingulate regions and ACC regional homogeneity (ReHo) and whether these functional changes are related to levels of adaptive rumination and treatment response is still unclear. Cortical thickness and ReHo maps were calculated in 21 unmedicated depressed patients and 35 healthy controls. Regions with reduced cortical thickness defined the seeds for the subsequent functional connectivity (FC) analyses. Patients completed the Response Style Questionnaire, which provided a measure of adaptive rumination associated with better response to psychotherapy. Compared with controls, depressed patients showed thinning of the right anterior PFC, increased prefrontal connectivity with the supragenual ACC (suACC), and higher ReHo in the suACC. The suACC clusters of increased ReHo and FC spatially overlapped. In depressed patients, suACC ReHo scores positively correlated with PFC thickness and with FC strength. Moreover, stronger fronto-cingulate connectivity was related to higher levels of adaptive rumination. Greater suACC ReHo and connectivity with the right anterior PFC seem to foster adaptive forms of self-referential processing associated with better response to psychotherapy, whereas prefrontal thinning impairs the ability of depressed patients to engage the suACC during a major depressive episode. Bolstering the function of the suACC may represent a potential target for treatment. PMID:25598428

  14. Structural basis of empathy and the domain general region in the anterior insular cortex

    PubMed Central

    Mutschler, Isabella; Reinbold, Céline; Wankerl, Johanna; Seifritz, Erich; Ball, Tonio

    2013-01-01

    Empathy is key for healthy social functioning and individual differences in empathy have strong implications for manifold domains of social behavior. Empathy comprises of emotional and cognitive components and may also be closely linked to sensorimotor processes, which go along with the motivation and behavior to respond compassionately to another person's feelings. There is growing evidence for local plastic change in the structure of the healthy adult human brain in response to environmental demands or intrinsic factors. Here we have investigated changes in brain structure resulting from or predisposing to empathy. Structural MRI data of 101 healthy adult females was analyzed. Empathy in fictitious as well as real-life situations was assessed using a validated self-evaluation measure. Furthermore, empathy-related structural effects were also put into the context of a functional map of the anterior insular cortex (AIC) determined by activation likelihood estimate (ALE) meta-analysis of previous functional imaging studies. We found that gray matter (GM) density in the left dorsal AIC correlates with empathy and that this area overlaps with the domain general region (DGR) of the anterior insula that is situated in-between functional systems involved in emotion–cognition, pain, and motor tasks as determined by our meta-analysis. Thus, we propose that this insular region where we find structural differences depending on individual empathy may play a crucial role in modulating the efficiency of neural integration underlying emotional, cognitive, and sensorimotor information which is essential for global empathy. PMID:23675334

  15. Mandibular incisor extraction treatment in Angle's Class I malocclusion with peg-shaped maxillary lateral incisors

    PubMed Central

    Shah, Ankit H; Shah, Darshit H

    2016-01-01

    Accurate diagnosis and treatment planning are essential for obtaining ideal treatment result in cases involving mandibular incisor extraction. This case report describes a 15-year-old female with balanced soft-tissue profile, peg-shaped maxillary lateral incisors, and moderate mandibular anterior crowding treated with a mandibular incisor extraction. Ideal overbite and overjet were achieved. “Black triangle” formation was avoided due to the bodily movement of mandibular incisors and the use of uprighting springs for ideal axial inclination of mandibular incisors. A mandibular incisor extraction can be an effective treatment option in carefully selected clinical situations. PMID:27556022

  16. Evaluation of immediately loaded dental implants bioactivated with platelet-rich plasma placed in the mandibular posterior region: A clinico-radiographic study

    PubMed Central

    Anand, Ullas; Mehta, D. S.

    2012-01-01

    Background and Objectives: The purpose of the present study was to clinically and radiographically assess the soft and hard tissue changes around the immediately loaded single tooth implants bioactivated with platelet-rich plasma (PRP), placed in the mandibular posterior region. Materials and Methods: A total of 11 patients having single tooth edentulous space in the mandibular posterior region were selected. An endosseous implant was placed after clinical and radiographic examination in each selected site using single stage surgical approach. The patients were followed up at 3, 6, 9, and at 12 months of post implant insertion. The patients were subjected to recording of clinical parameters like modified plaque index, modified gingival index, probing depth, and clinical implant mobility scale. Radiographs made at different intervals were subjected to assessment of bone level mesial and distal to each implant using computer assisted image analysis. Results: Scores for clinical parameters were minimal and comparable. The probing depth around the implant was measured during the follow-up period and the changes observed were statistically non-significant. None of the implants were clinically mobile during the follow-up period. Radiographically, the peri-implant bone resorption both on mesial and distal sides was within normal limit after one year of immediate loading. Finally, the overall success rate for the immediately loaded bioactivated implant placed in the mandibular posterior region was recorded as 100%. Interpretation and Conclusion: The use of platelet-rich plasma may lead to improved early bone apposition around the implant; and thus, results in increased rate of osseointegration. Single stage implant procedure with the adjunctive use of PRP enhances the ability of peri-implant healing tissue to create favorable soft and hard tissue relationships. It also gives the added advantage of psychological boost for the patient by getting fixed replacement of tooth

  17. Early rehabilitation after anterior cruciate ligament reconstruction under regional analgesia: a case report.

    PubMed

    Al-Nasser, Bassam; Palacios, Jean Luc; Lapasset, Lionel; Hattée, Bernard; Leroy, Frédéric

    2004-02-01

    Patients undergoing major knee surgery may experience postoperative pain, which could be exacerbated by early postoperative continuous passive motion or active mobilization. This pain may result in poor functional recovery. Use of regional analgesia techniques to achieve more consistent pain relief and to facilitate rapid rehabilitation can play an important role in optimizing postoperative outcome after anterior cruciate ligament repair (ACLR). This case study concerns a 20-year-old male soldier, otherwise healthy, who underwent ACLR. We inserted a catheter in the fascia iliaca compartment and performed postoperative analgesia with low-concentration ropivacaine by using an elastomeric pump. The patient started early rehabilitation under fascia iliaca compartment analgesia. We discuss the case and the influence of regional analgesia techniques on postoperative and clinical outcomes. PMID:14966725

  18. Regional lymph node radiotherapy in breast cancer: single anterior supraclavicular field vs. two anterior and posterior opposed supraclavicular fields

    PubMed Central

    Houshyari, Mohammad; Kashi, Amir Shahram Yousefi; Varaki, Sakineh Soleimani; Rakhsha, Afshin; Blookat, Eftekhar Rajab

    2015-01-01

    Background: The treatment of lymph nodes engaged in breast cancer with radiotherapy leads to improved locoregional control and enhanced survival rates in patients after surgery. The aim of this study was to compare two treatment techniques, namely single anterior posterior (AP) supraclavicular field with plan depth and two anterior and posterior opposed (AP/PA) supraclavicular fields. In the study, we also examined the relationships between the depth of supraclavicular lymph nodes (SCLNs) and the diameter of the wall of the chest and body mass index (BMI). Methods: Forty patients with breast cancer were analyzed using computed tomography (CT) scans. In planning target volume (PTV), the SCLNs and axillary lymph nodes (AXLNs) were contoured, and, with the attention to PTV, supraclavicular (SC) depth was measured. The dosage that reached the aforementioned lymph nodes and the level of hot spots were investigated using two treatment methods, i.e., 1) AP/PA and 2) AP with three-dimensional (3D) planning. Each of these methods was analyzed using the program Isogray for the 6 MV compact accelerator, and the diameter of the wall of the chest was measured using the CT scan at the center of the SC field. Results: Placing the plan such that 95% of the target volume with 95% or greater of the prescribed dose of 50 Gy (V95) had ≥95% concordance in both treatment techniques. According to the PTV, the depth of SCLNs and the diameter of the wall of the chest were 3–7 and 12–21cm, respectively. Regression analysis showed that the mean SC depth (the mean Plan depth) and the mean diameter of the wall of the chest were related directly to BMI (p<0.0001, adjusted R2=0.67) and (p<0.0001, adjusted R2=0.71), respectively. Conclusion: The AP/PA treatment technique was a more suitable choice of treatment than the AP field, especially for overweight and obese breast cancer patients. However, in the AP/PA technique, the use of a single-photon, low energy (6 MV) caused more hot spots

  19. Selective functional integration between anterior temporal and distinct fronto-mesolimbic regions during guilt and indignation

    PubMed Central

    Green, Sophie; Lambon Ralph, Matthew A.; Moll, Jorge; Stamatakis, Emmanuel A.; Grafman, Jordan; Zahn, Roland

    2010-01-01

    It has been hypothesized that the experience of different moral sentiments such as guilt and indignation is underpinned by activation in temporal and fronto-mesolimbic regions and that functional integration between these regions is necessary for the differentiated experience of these moral sentiments. A recent fMRI study revealed that the right superior anterior temporal lobe (ATL) was activated irrespective of the context of moral feelings (guilt or indignation). This region has been associated with context-independent conceptual social knowledge which allows us to make fine-grained differentiations between qualities of social behaviours (e.g. “critical” and “faultfinding”). This knowledge is required to make emotional evaluations of social behaviour. In contrast to the context-independent activation of the ATL, there were context-dependent activations within different fronto-mesolimbic regions for guilt and indignation. However, it is unknown whether functional integration occurs between these regions and whether regional patterns of integration are distinctive for the experience of different moral sentiments. Here, we used fMRI and psychophysiological interaction analysis, an established measure of functional integration to investigate this issue. We found selective functional integration between the right superior ATL and a subgenual cingulate region during the experience of guilt and between the right superior ATL and the lateral orbitofrontal cortex for indignation. Our data provide the first evidence for functional integration of conceptual social knowledge representations in the right superior ATL with representations of different feeling contexts in fronto-mesolimbic regions. We speculate that this functional architecture allows for the conceptually differentiated experience of moral sentiments in healthy individuals. PMID:20493953

  20. Regional variation of tibialis anterior tendon mechanics is lost following denervation.

    PubMed

    Arruda, Ellen M; Calve, Sarah; Dennis, Robert G; Mundy, Kevin; Baar, Keith

    2006-10-01

    Denervation or inactivity is known to decrease the mass and alter the phenotype of muscle. The mechanical response of tendon to inactivity that has been determined experimentally differs from what is reported by patients. We investigated the hypothesis that this difference was the result of artifacts of the testing process and did not represent what occurred in vivo. To test this hypothesis, a novel approach was used to determine the mechanical properties of the tibialis anterior (TA) tendon by optically measuring the end-to-end mechanical strains as well as the local strains at specific regions of excised TA tendon units. When the end-to-end strain of normal TA tendon is determined, stress-strain response curves show considerably more extensibility than when strain is measured across only the midsection of the tendon (mid-tendon). The strain experienced by the region close to the muscle (muscle tendon) is five times greater than the strain in either the mid-tendon or near the bone (bone-tendon). Five weeks of denervation decreased muscle mass by 67%; increased tendon mass by 10%; and changed the entire shape of the nonlinear response curve, including a loss in regional variation in strain, a 3.9-fold increase in end-to-end tangent modulus, and a 70% reduction in the toe region, as a result of a drastic reduction of the extensibility in the muscle-tendon region. The stress-strain response in the mid-tendon region of a normal TA tendon is therefore not indicative of its overall ability to deform in vivo as it transmits forces from muscle to bone. PMID:16728516

  1. Stress analysis of mandibular two-implant overdenture with different attachment systems.

    PubMed

    Takeshita, Shin; Kanazawa, Manabu; Minakuchi, Shunsuke

    2011-01-01

    This study aimed to investigate the influence of different overdenture attachment systems on the stress generated in peri-implant bone during overdenture dislodgement and loading. Two implants were placed in the canine regions on an acrylic edentulous mandibular model. Four strain gauges were attached to the resin surface adjacent to the left implant. Bar, ball, and magnetic attachments were examined. Three experimental overdentures were fabricated, and the denture parts of the attachment systems were incorporated into the mucosal surface. Retentive forces and strains generated in peri-implant bone during three types of dislodgement (vertical, anterior and posterior) and loading (left first molar region, right first molar region and mid-anterior region) were measured. The bar attachment showed the highest retentive force and reduced strain on posterior dislodgement. The ball attachment demonstrated the largest strain on loading at molar regions. The magnetic attachment showed the smallest retentive force and little strain. PMID:22123019

  2. Early development of the anterior body region of the grey widow spider Latrodectus geometricus Koch, 1841 (Theridiidae, Araneae).

    PubMed

    Liu, Yu; Maas, Andreas; Waloszek, Dieter

    2009-09-01

    We document the early morphogenesis of Latrodectus geometricus, particularly of the anterior body region. Significant changes in the development of the external prosomal structures revealed with scanning electron microscopy (SEM) images include: (1) reorganisation of each pre-cheliceral lobe by subdivision and internalisation of its central area; (2) shortening of the ventro-median bridge connecting the pre-cheliceral lobes and its eventual disappearance; (3) appearance and expansion of a prospective mouth region between the pre-cheliceral lobes with a recessed median area surrounded by lip-like borders, the anterior lip-part developing into the hypostome; (4) reduction of the mouth region to an area around the hypostome and the lip-like latero-posterior border of the mouth opening; (5) change of the position of the mouth region from anterior to the insertions of the chelicerae to posterior to them; (6) eventual shortening of the mouth opening to a slit overhung by the hypostome; (7) origination of the prosomal shield from the anterior margin of the pre-cheliceral lobes and the tergal portions of the four posterior-most prosomal segments; and (8) expansion of a 'ventral sulcus' from the cheliceral to the fifth opisthosomal segment separating the sides of these segments. Embryonic features are compared across the Chelicerata and discussed briefly in a phylogenetic context. PMID:19374954

  3. Diagnostic agreement of conventional and inverted scanned panoramic radiographs in the detection of the mandibular canal and the mental foramen.

    PubMed

    Sakakura, Celso Eduardo; Loffredo, Leonor de Castro Monteiro; Scaf, Gulnara

    2004-01-01

    The aim of this study was to evaluate the diagnostic agreement of conventional panoramic radiographs and their inverted scanned images in the detection of the mandibular canal and mental foramen. A total of 77 panoramic radiographs obtained from the files of totally edentulous patients were used. Digitization was done by means of a scanner with brightness and contrast adjustment, as well as image inversion. The extension of mandibular canal was divided into anterior, middle, and posterior regions, and the presence of a radiopaque line that characterized the mandibular canal was classified according to a 5-point confidence scale. The mental foramen was classified in 4 types: continuous, separated, diffuse, and unidentified. Both conventional and inverted scanned panoramic radiographs were evaluated by 3 calibrated implantologists at 2 distinct moments with a minimum interval of 10 days between them. Intraexaminer agreement was evaluated by Kappa statistics by point and by 95% confidence interval. Because the intraexaminer level of agreement was low, interexaminer agreements could not be carried out. The results showed a substantial (in 2 situations), moderate (in 16 situations), and fair (in 18 situations) intraexaminer agreement for mandibular canal and a substantial (in 1 situation), fair (in 1 situation), and moderate (in 10 situations) intraeaminer agreement for mental foramen. There were no statistically significant differences in most instances. In conclusion, the diagnostic agreement of conventional and inverted scanned panoramic radiographs for detection of mandibular canal and mental foramen was low. PMID:15008448

  4. Change in the width of the mandibular body from 6 to 23 years of age: an implant study.

    PubMed

    Işeri, H; Solow, B

    2000-06-01

    After the ossification of the mandibular symphysis, shortly after birth, changes in mandibular width would be expected to occur only by surface apposition or resorption on the buccal surfaces of the left and right mandibular halves. However, evidence for an opening hinge movement of the two mandibular halves around a vertical axis located in the region of the mandibular symphysis was recently found in longitudinal studies of 29 subjects with unilateral implant markers in the mandible. These subjects were followed from 8.5 to 15.5 years of age (Korn and Baumrind, 1990; Baumrind and Korn, 1992). The aim of the present investigation was to examine whether the presence of such an age-related increase in mandibular body width could be confirmed in a sample with bilateral implant markers in the mandible. The sample comprised 10 subjects (3F, 7M) from the files of another longitudinal study with implant markers (Björk, 1968). A total of 122 pairs of annual lateral and postero-anterior (p-a) cephalometric records were available, covering longitudinal observation periods ranging from 8 to 16 years within an age interval of between 6 and 23 years. The width between a right and left side mandibular implant marker was measured with digital callipers on all p-a radiographs. Each measurement was corrected mathematically for various sources of radiographic enlargement. A small, but statistically significant increase in the distance between the right and left implant markers, i.e. in the bilateral width of the mandibular body, was observed in all subjects. The total increase in width in each subject ranged from 0.7 to 1.7 mm for the various periods of observation (P < or = 0.01). For the 12-year period from 6 to 18 years, the average total increase was 1.6 mm (P < or = 0.001, SD = 0.42), i.e. 0.13 mm/year. After this age there was no systematic trend. The mechanism for this increase in width is unknown. It is suggested that during postnatal growth, an increasing load from the

  5. Biomechanical scaling of the hominoid mandibular symphysis.

    PubMed

    Daegling, D J

    2001-10-01

    Experimental investigation of mandibular bone strain in cercopithecine primates has established that the mandible is bent in the transverse plane during the power stroke of mastication. Additional comparative work also supports the assumption that the morphology of the mandibular symphysis is functionally linked to the biomechanics of lateral transverse bending, or "wishboning" of the mandibular corpus. There are currently no experimental data to verify that lateral transverse bending constitutes an important loading regime among hominoid primates. There are, however, allometric models from cercopithecoid primates that allow prediction of scaling patterns in hominoid mandibular dimensions that would be consistent with a mechanical environment that includes wishboning as a significant component. This study uses computed tomography (CT) scans to visualize cortical bone distribution in the anterior corpus of a sample of four genera of extant hominoids. From the cortical bone contours, area properties of the mandibular symphysis are calculated, and these variables are subjected to an allometric analysis to detect whether scaling of jaw dimensions are consistent with a wishboning loading regime. Scaling of the hominoid symphysis recalls patterns observed in cercopithecoid monkeys, which lends indirect support for the hypothesis that wishboning is an integral part of the masticatory loading environment in living apes. Inclination of the symphysis, rather than changes in cross-sectional shape or development of the superior transverse torus, represents a morphological solution for minimizing the potentially harmful effects of wishboning in the jaws of these primates. PMID:11599012

  6. Splinted mandibular protraction appliance.

    PubMed

    Jena, Ashok Kumar; Singh, Satinder Pal

    2015-03-01

    Advancement of mandible rather than tooth movement is an ideal treatment for the correction of Class II malocclusion resulting from mandibular retrusion. In growing patients, forward repositioning of mandible by mandibular repositioning appliances is considered as a treatment of choice. Correction of mandibular retrusion by the conventional mandibular protraction appliances (MPAs) is mainly due to dento-alveolar changes and by altering the design of original MPAs, these limitations were minimized. The modified design enhanced the mandibular growth and contributed for the better skeletal correction of Class II malocclusion as compared to the conventional MPAs. This article highlights the design and fabrication of a splinted MPA for the correction of Class II malocclusion due to mandibular retrusion and also describes a patient managed by this appliance. PMID:25821367

  7. Splinted mandibular protraction appliance

    PubMed Central

    Jena, Ashok Kumar; Singh, Satinder Pal

    2015-01-01

    Advancement of mandible rather than tooth movement is an ideal treatment for the correction of Class II malocclusion resulting from mandibular retrusion. In growing patients, forward repositioning of mandible by mandibular repositioning appliances is considered as a treatment of choice. Correction of mandibular retrusion by the conventional mandibular protraction appliances (MPAs) is mainly due to dento-alveolar changes and by altering the design of original MPAs, these limitations were minimized. The modified design enhanced the mandibular growth and contributed for the better skeletal correction of Class II malocclusion as compared to the conventional MPAs. This article highlights the design and fabrication of a splinted MPA for the correction of Class II malocclusion due to mandibular retrusion and also describes a patient managed by this appliance. PMID:25821367

  8. Vascularized metatarsal transfer in mandibular reconstruction.

    PubMed

    Macleod, A M

    1994-01-01

    Adequate reconstruction of the mandible when associated with a mucosal deficit requires an osteocutaneous component in which the skin is closely associated with the bone. A curve in the bony framework to simulate the curvature of the mandible is required when the defect is in the anterior segment. The second metatarsal and toe osteocutaneous flap can provide such a mandibular mucosal replacement and has been used successfully for eighteen years. PMID:8035671

  9. A digital volumetric tomography (DVT) study in the mandibular molar region for miniscrew placement during mixed dentition

    PubMed Central

    Bhattad, Mayur S.; Baliga, Sudhindra; Vibhute, Pavan

    2015-01-01

    OBJECTIVE: To assess bone thickness for miniscrew placement in the mandible during mixed dentition by using digital volumetric tomograph (DVT). MATERIAL AND METHODS: A total of 15 healthy patients aged 8-10 years old, with early exfoliated mandibular second deciduous molar, were included. DVT images of one quadrant of the mandible were obtained using Kodak extraoral imaging systems and analyzed by Kodak dental imaging software. The error of the method (EM) was calculated using Dahlberg's formula. Mean and standard deviation were calculated at 6 and 8 mm from the cementoenamel junction (CEJ).Paired t-test was used to analyze the measurements. RESULTS: Buccal cortical bone thickness, mesiodistal width and buccolingual bone depth at 6 mm were found to be 1.73 + 0.41, 2.15 + 0.49 and 13.18 + 1.22 mm, respectively; while at 8 mm measurements were 2.42 + 0.34, 2.48 + 0.33 and 13.65 + 1.25 mm, respectively. EM for buccal cortical bone thickness, mesiodistal width and buccolingual bone depth was 0.58, 0.40 and 0.48, respectively. The difference in measurement at 6 and 8 mm for buccal cortical plate thickness (P < 0.05) and buccolingual bone thickness (P < 0.05) was found to be significant, whereas for mesiodistal width it was insignificant (P > 0.05). CONCLUSION: Bone thickness measurement has shown promising evidence for safe placement of miniscrews in the mandible during mixed dentition. The use of miniscrew is the best alternative, even in younger patients. PMID:25992988

  10. Cone Beam Computed Tomographic Analyses of the Position and Course of the Mandibular Canal: Relevance to the Sagittal Split Ramus Osteotomy

    PubMed Central

    Sekerci, Ahmet Ercan; Sahman, Halil

    2014-01-01

    Purpose. The aim of this study was to document the position and course of the mandibular canal through the region of the mandibular angle and body in dental patients, using cone beam computed tomographic imaging. Methods. The position and course of the mandibular canal from the region of the third molar to the first molar were measured at five specific locations in the same plane: at three different positions just between the first and second molars; between the second and third molars; and just distal to the third molar. Results. The study sample was composed of 500 hemimandibles from 250 dental patients with a mean age of 26.32. Significant differences were found between genders, distances, and positions. B decreased significantly from the anterior positions to the posterior positions in both females and males. The mean values of S and CB increased significantly from the posterior positions to the anterior positions in both females and males. Conclusion. Because the sagittal split ramus osteotomy is a technically difficult procedure, we hope that the findings of the present study will help the surgeon in choosing the safest surgical technique for the treatment of mandibular deformities. PMID:24719896

  11. Immediate Implant Placement in Anterior Aesthetic Region and Assessment using Cone-Beam Computed Tomography Scan Technology

    PubMed Central

    Joshi, Vaibhav; Gupta, Shalini

    2015-01-01

    The esthetics and functional integrity of the periodontal tissues may be compromised by the dental loss. Dental implants have become an additional tool in the armamentarium of treatment options to offer the patient for the replacement of a missing tooth or teeth. Diagnosis and treatment planning is the key factors in achieving the successful outcome after placing and restoring implants placed immediately after tooth extraction. The introduction of cone-beam computed tomography (CBCT) for the maxillofacial region provides opportunities for dental practitioners to request multiplanar imaging. This case report demonstrates the use of CBCT scan technology in immediate implant placement in the maxillary anterior teeth region. PMID:26668494

  12. 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

  13. Cone-beam computed tomography based evaluation of rotational patterns of dentofacial structures in skeletal Class III deformity with mandibular asymmetry

    PubMed Central

    Ryu, Hyeong-Seok; An, Ki-Yong

    2015-01-01

    Objective The purpose of this study was to assess rotational patterns of dentofacial structures according to different vertical skeletal patterns by cone-beam computed tomography (CBCT) and analyze their influence on menton deviation in skeletal Class III deformity with mandibular asymmetry. Methods The control group consisted of 30 young adults (15 men, 15 women) without any severe skeletal deformity. The asymmetry group included 55 adults (28 men, 27 women) with skeletal Class III deformity and at least 3-mm menton deviation from the midsagittal plane; it was divided into the hyperdivergent and hypodivergent subgroups using a mandibular plane angle cutoff of 35°. Fourteen rotational variables of the dental arches and mandible were measured and compared among the groups. Correlations between menton deviation and the other variables were evaluated. Results The asymmetry group showed significantly larger measurements of roll and yaw in the mandible than the control group. The hypodivergent subgroup showed significant differences in maxillary posterior measurements of yaw (p < 0.01) and maxillary anterior shift (p < 0.05) compared with the hyperdivergent subgroup. All the mandibular measurements had significant correlations with menton deviation (p < 0.01). Most measurements of roll were positively correlated with one another (p < 0.01). Measurements of yaw and roll in the posterior regions were also positively correlated (p < 0.05). Conclusions Menton deviation in skeletal Class III deformity with mandibular asymmetry is influenced by rotation of mandibular posterior dentofacial structures. The rotational patterns vary slightly according to the vertical skeletal pattern. PMID:26258061

  14. The Xenopus homologue of Otx2 is a maternal homeobox gene that demarcates and specifies anterior body regions.

    PubMed

    Pannese, M; Polo, C; Andreazzoli, M; Vignali, R; Kablar, B; Barsacchi, G; Boncinelli, E

    1995-03-01

    In this paper we study Xotx2, a Xenopus homeobox gene related to orthodenticle, a gene expressed in the developing head of Drosophila. The murine cognate, Otx2, is first expressed in the entire epiblast of prestreak embryos and later in very anterior regions of late-gastrulae, including the neuroectoderm of presumptive fore- and mid-brain. In Xenopus, RNase protection experiments reveal that Xotx2 is expressed at low levels throughout early development from unfertilized egg to late blastula, when its expression level significantly increases. Whole-mount in situ hybridization shows a localized expression in the dorsal region of the marginal zone at stage 9.5. At stage 10.25 Xotx2 is expressed in dorsal bottle cells and in cells of the dorsal deep zone fated to give rise to prechordal mesendoderm, suggesting a role in the specification of very anterior structures. In stage 10.5 gastrulae, Xotx2 transcripts start to be detectable also in presumptive anterior neuroectoderm, where they persist in subsequent stages. Various treatments of early embryos cause a general reorganization of Xotx2 expression. In particular, retinoic acid treatment essentially abolishes Xotx2 expression in neuroectoderm. Microinjection of Xotx2 mRNA in 1-, 2- and 4-cell stage embryos causes the appearance of secondary cement glands and partial secondary axes in embryos with reduced trunk and tail structures. The presence of the Xotx2 homeodomain is required to produce these effects. In particular, this homeodomain contains a specific lysine residue at position 9 of the recognition helix. Microinjected transcripts of Xotx2 constructs containing a homeodomain where this lysine is substituted by a glutamine or a glutamic acid residue fail to cause these effects. PMID:7720578

  15. Mandibular growth and function in Archaeolemur.

    PubMed

    Ravosa, M J; Simons, E L

    1994-09-01

    Ontogenetic changes in the morphology of the mandibular symphysis are described in Archaeolemur so as to infer the functional significance of symphyseal fusion in this subfossil Malagasy lemur. The first regions of the symphysis to show a more complex morphology were the lower and anterior borders of the joint and, to a lesser extent, the lingual borders of the superior and inferior transverse tori. During growth, these regions became increasingly rugose and encroached upon a centrally located, smooth, "oval" region, which may have been a principal pathway for neurovascular structures communicating with the unfused joint. In subadults, the symphysis was completely fused except for the lingual surface of the inferior transverse torus, where a patent suture and potential space were present between dentaries. Thus, in Archaeolemur there was an age- and size-related pattern of increased symphyseal ossification or fusion that was complete by adulthood. The morphology of the interlocking bony processes and the sequence of ossification in the symphysis suggest that increased dorsoventral shear stress during mastication was the most likely determinant of symphyseal fusion in Archaeolemur. The allometric pattern of greater symphyseal fusion may be linked to the presence of relatively greater dorsoventral shear in adults due to an increased recruitment of balancing-side jaw-muscle force. There is little indication that the symphysis of juvenile Archaeolemur was buttressed to resist forces associated with "wishboning" during mastication or vertical bending during incision. Our observations, as well as those of others, suggest that symphyseal fusion in primates occurs initially as a response to increased dorsoventral shear during mastication. Therefore, wishboning stress might only become a major determinant of symphyseal form and function in those taxa that develop a fused symphysis to counter increased dorsoventral shear. PMID:7998602

  16. Effect of Connector Design on Fracture Resistance in Zirconia-based Fixed Partial Dentures for Upper Anterior Region.

    PubMed

    Ogino, Yasushi; Nomoto, Syuntaro; Sato, Toru

    2016-01-01

    The purpose of this study was to investigate the influence of the cross-sectional form and area of the connector on fracture resistance in three-unit zirconia fixed partial denture (FPD) frameworks for the upper anterior region. Sixty FPD framework specimens were fabricated using the CAD/CAM system. The cross-sectional form (Type I, II, or III) and area (9.0, 7.0, 5.0, or 3.0 mm(2)) of the connectors differed. The specimens were fixed to a jig capable of applying a load axially to the abutment teeth at an angle of 135 degrees. Each specimen was subjected to fracture load measurements using a universal testing machine and cross-sectional microscopic examination. Fracture load fell significantly with a decrease in cross-sectional area (p <0.01). In terms of cross-sectional form, an isosceles triangle with a gingival base yielded the highest fracture load. These results suggest that the connector of a three-unit zirconia-based FPD framework for the upper anterior region should be triangular, have a gingival base, sufficient height in the loading direction, and a cross-sectional area of >5.0 mm(2). PMID:27320295

  17. [Tangential projection for depiction of the anterior regions of the jaws performed with the dental X-ray set].

    PubMed

    Sewerin, I

    1991-08-01

    The tangential projection represents an extraoral projection which with success can be performed with the dental X-ray set. The film is placed lateral to the angle of the mouth in a vertical position level with either the maxilla or the mandible. If a view of the midline is wanted the film is placed parallel with the sagittal plane; if e.g. the canine region is of interest the film is angulated. The central X-ray is directed horizontally and perpendicularly to the film passing (as a tangent) the anterior surface of either the maxilla or mandible. The beam area used for periapical projections is ideal also for this projection. The tangential projection is indicated as a supplemental projection for three-dimensional localization of e.g. supernumerary teeth in the maxillary anterior region and for the buccolingual position of an impacted canine. It is also very useful in combination with frontal projections in the planning of insertion of dental implants. According to the Danish legislation it is not allowed to use the dental X-ray set for extraoral projections unless intensifying screens are used. However, the Danish Institute of Radiation Hygiene has accepted tangential projections using dental X-ray films and omitting intensifying screens in edentulous patients due to their better resolution, which is of particular importance in the planning of implant insertion. PMID:1948706

  18. Apathy is associated with white matter abnormalities in anterior, medial brain regions in persons with HIV infection

    PubMed Central

    Kamat, Rujvi; Brown, Gregory G.; Bolden, Khalima; Fennema-Notestine, Christine; Archibald, Sarah; Marcotte, Thomas D.; Letendre, Scott L.; Ellis, Ronald J.; Woods, Steven Paul; Grant, Igor; Heaton, Robert K.

    2015-01-01

    Apathy is a relatively common psychiatric syndrome in HIV infection, but little is known about its neural correlates. In the present study, we examined the associations between apathy and diffusion tensor imaging (DTI) indices in key frontal white matter regions in the thalamocorticostriatal circuit that has been implicated in the expression of apathy. Nineteen participants with HIV infection and 19 demographically comparable seronegative comparison subjects completed the Apathy subscale of the Frontal Systems Behavioral Scale as a part of a comprehensive neuropsychiatric research evaluation. When compared to the seronegative participants, the HIV+ group had significantly more frontal white matter abnormalities. Within HIV+ persons, and as predicted, higher ratings of apathy were associated with greater white matter alterations in the anterior corona radiata, genu, and orbital medial prefrontal cortex. The associations between white matter alterations and apathy were independent of depression and were stronger among participants with lower current CD4 counts. All told, these findings indicate that apathy is independently associated with white matter abnormalities in anterior, medial brain regions in persons infected with HIV, particularly in the setting of lower current immune functioning, which may have implications for antiretroviral therapy. PMID:25275424

  19. Furcation lesion in a mandibular canine.

    PubMed

    Fonseca, Dimitri Ribas; Sena, Larryson Goncalves; Santos, Maria Helena; Goncalves, Patricia Furtado

    2011-01-01

    Morphological changes can complicate dental treatment. This report presents a rare case of a furcation lesion in a mandibular canine with two roots. A 39-year-old man in general good health sought dental care for severe pain in his maxillary anterior teeth. The clinical examination showed localized swelling in the vestibular mucosa close to the mandibular left canine. Radiographic examination revealed two distinct roots and vertical bone resorption in the canine's mesial surface. Periodontal evaluation led to a diagnosis of periodontal abscess associated with furcation lesion. Despite the occurrence in an atypical location, the site of periodontal furcation received conventional therapy for initial decontamination, including tissue debridement and a combination of polyvinylpyrrolidone irrigation and antibiotics. To improve access, the decontamination was completed with surgical techniques and scaling and root planing. Early diagnosis of this rare morphological change helped to determine appropriate, timely treatment planning and optimal patient recovery. PMID:21903558

  20. Change in the Pathologic Supraspinatus: A Three-Dimensional Model of Fiber Bundle Architecture within Anterior and Posterior Regions.

    PubMed

    Kim, Soo Y; Sachdeva, Rohit; Li, Zi; Lee, Dongwoon; Rosser, Benjamin W C

    2015-01-01

    Supraspinatus tendon tears are common and lead to changes in the muscle architecture. To date, these changes have not been investigated for the distinct regions and parts of the pathologic supraspinatus. The purpose of this study was to create a novel three-dimensional (3D) model of the muscle architecture throughout the supraspinatus and to compare the architecture between muscle regions and parts in relation to tear severity. Twelve cadaveric specimens with varying degrees of tendon tears were used. Three-dimensional coordinates of fiber bundles were collected in situ using serial dissection and digitization. Data were reconstructed and modeled in 3D using Maya. Fiber bundle length (FBL) and pennation angle (PA) were computed and analyzed. FBL was significantly shorter in specimens with large retracted tears compared to smaller tears, with the deeper fibers being significantly shorter than other parts in the anterior region. PA was significantly greater in specimens with large retracted tears, with the superficial fibers often demonstrating the largest PA. The posterior region was absent in two specimens with extensive tears. Architectural changes associated with tendon tears affect the regions and varying depths of supraspinatus differently. The results provide important insights on residual function of the pathologic muscle, and the 3D model includes detailed data that can be used in future modeling studies. PMID:26413533

  1. Change in the Pathologic Supraspinatus: A Three-Dimensional Model of Fiber Bundle Architecture within Anterior and Posterior Regions

    PubMed Central

    Kim, Soo Y.; Sachdeva, Rohit; Li, Zi; Lee, Dongwoon; Rosser, Benjamin W. C.

    2015-01-01

    Supraspinatus tendon tears are common and lead to changes in the muscle architecture. To date, these changes have not been investigated for the distinct regions and parts of the pathologic supraspinatus. The purpose of this study was to create a novel three-dimensional (3D) model of the muscle architecture throughout the supraspinatus and to compare the architecture between muscle regions and parts in relation to tear severity. Twelve cadaveric specimens with varying degrees of tendon tears were used. Three-dimensional coordinates of fiber bundles were collected in situ using serial dissection and digitization. Data were reconstructed and modeled in 3D using Maya. Fiber bundle length (FBL) and pennation angle (PA) were computed and analyzed. FBL was significantly shorter in specimens with large retracted tears compared to smaller tears, with the deeper fibers being significantly shorter than other parts in the anterior region. PA was significantly greater in specimens with large retracted tears, with the superficial fibers often demonstrating the largest PA. The posterior region was absent in two specimens with extensive tears. Architectural changes associated with tendon tears affect the regions and varying depths of supraspinatus differently. The results provide important insights on residual function of the pathologic muscle, and the 3D model includes detailed data that can be used in future modeling studies. PMID:26413533

  2. REGIONAL PATTERNING OF HORMONES IN THE FEMALE RAT ANTERIOR PITUITARY: DISPROPORTIONATE CHANGES OVER THE ESTROUS CYCLE

    EPA Science Inventory

    The present study addressed the possibility that regional differences exist in the typical patterning of anterlor pituitary hormones seen over the estrous cycle. he results show that LH in the rostral area of the pituitary, significantly higher than in other regions on diestrus, ...

  3. Etiology, treatment, and complications of mandibular fractures.

    PubMed

    Munante-Cardenas, Jose Luis; Facchina Nunes, Paulo Henrique; Passeri, Luis Augusto

    2015-05-01

    The objective of this retrospective study was to evaluate some epidemiological characteristics, surgical treatment methods, and complications of cases involving mandibular fractures. Records from 119 patients treated for mandibular fractures between January 2006 and December 2011 were analyzed. We find mandibular fractures mostly affect Caucasian (72.2%) men (80.7%). The mean age of the patients was 28.1 years. Road traffic accidents (RTA) caused the most fractures (49.5%), followed by physical violence, including gunshot wounds (21%). Motorcycle accidents were the most common cause of RTA (76.2%). The most affected mandibular regions were the parasymphysis (26.9%) and the mandible angle (25.1%). Both surgical and nonsurgical treatments were applied (90.4% and 9.6%, respectively). The most common surgical approach was the intraoral (64.9%), using the 2.0-mm fixation system (88.0%). Complications such as postoperative infections, malocclusion, and paresthesia occurred in 36 patients (30.2%). This research revealed interesting features about the etiology of mandibular fractures that were mostly associated with RTA. Severity of the trauma and noncompliance of the patients were factors that contributed to the development of postoperative complications. PMID:25643329

  4. Mandibular osteonecrosis due to bisphosphonate use

    PubMed Central

    Şalvarcı, Ahmet; Altınay, Serdar

    2015-01-01

    Due to their efficient osteoclastic inhibitor effect in bone metabolism and antiangiogenic activity, bisphosphonates are widely used in many cancer diseases particularly in prostate cancers with bone metastasis, lung cancer, breast cancer and multiple myeloma, as well as in systemic diseases such as osteoporosis, osteopenia, Paget disease and osteogenesis imperfect for the last 13 years. Prostate cancer is a common cancer in males and it is the leading cause of bone metastasis. Mandibular metastasis is rarely encountered during the course of prostate cancer. Mandibular osteonecrosis as well has begun to be observed along with the availability of more efficient and stronger formulations developed following the use of bisphosphonates. Zolendronic acid, which has been used also by our patient, has widely come into practice as a 3rd generation bisphosphonate. Because of prostate cancer and widespread bone metastases, our patient has been receiving zolendronic acid with maximum androgen blockage for 4 years. Tomography of the patient, who has undergone intensive treatment because of submandibular abscess, demonstrated extensive osteonecrosis in the fovea sublingual region of the mandible corpus. In large series, although, mandibular osteonecrosis was widely seen due to bisphosphonate use for the metastases of lung and breast cancers, this rate was between 9.6% and 11% for prostate cancer within the series. Although our patient had no mandibular metastasis before, mandibular necrosis was observed due to long-term bisphosphonate use. We are going to present our patient who had this rare complication with his clinical picture. PMID:26328198

  5. Relationship of the lingual frenum to the mandibular central incisors

    PubMed Central

    Gupta, Swati; Garg, Sanchit; Tandan, Amrit; Dwivedi, Ravi; Gupta, Narendra Kumar; Agarwal, Garima

    2015-01-01

    Clinical implication The purpose of this study is to record the vertical distance between anterior attachment of lingual frenum and incisal edge of mandibular central incisors in dentulous subjects and then determine the mean vertical distance and to suggest guidelines for positioning of mandibular central incisors in complete dentures. Method In this study, 150 dentulous subjects (75 males and 75 females) were chosen based on predecided inclusion criteria. A mandibular cast was obtained from irreversible hydrocolloid impression in modified stock trays for each subject. All subjects were instructed to elevate the tongue while the impressions were made. The vertical distance between the anterior attachment of the lingual frenum and incisal edges of mandibular central incisors was measured on the casts and then the values were statistically analyzed. Result The distance between anterior attachment of lingual frenum (AALF) mesioincisal edge of mandibular central incisor (CI) in male, female and total (male + female) subjects was measured. In males it ranged from 7.3 to 8.9 mm with mean (±SD) 8.29 ± 0.36 mm while in females it ranged from 7.1 to 9.0 mm with mean (±SD) 8.21 ± 0.38 mm. Conclusion It is believed that the application of this anatomic relation can provide a reliable point for arranging and checking the position of the mandibular central incisors for complete dentures in patients with class I ridge relationship. PMID:25853047

  6. Finite Element Reconstruction of a Mandibular First Molar

    PubMed Central

    Ehsani, Sara; Mirhashemi, Fatemeh Sadat; Asgary, Saeed

    2013-01-01

    Introduction Mandibular first molar is the most important tooth with complicated morphology. In finite element (FE) studies, investigators usually prefer to model anterior teeth with a simple and single straight root; it makes the results deviate from the actual case. The most complicated and time-consuming step in FE studies is modeling of the desired tooth, thus this study was performed to establish a finite element method (FEM) of reconstructing a mandibular first molar with the greatest precision. Materials and Methods An extracted mandibular first molar was digitized, and then radiographed from different aspects to achieve its outer and inner morphology. The solid model of tooth and root canals were constructed according to this data as well as the anatomy of mandibular first molar described in the literature. Result A three-dimensional model of mandibular first molar was created, giving special consideration to shape and root canal system dimensions. Conclusion This model may constitute a basis for investigating the effect of different clinical situations on mandibular first molars in vitro, especially on its root canal system. The method described here seems feasible and reasonably precise foundation for investigations. PMID:23717327

  7. A new technique for mandibular osteotomy

    PubMed Central

    Puricelli, Edela

    2007-01-01

    Sagittal split osteotomy (SSO) is a surgical technique largely employed for mandibular mobilizations in orthognatic procedures. However, the traditional design of buccal osteotomy, located at the junction of mandibular ramus and body, may prevent more extensive sliding between the bone segments, particularly on the advance, laterality and verticality of the mandibular body. The author proposes a new technical and conceptual solution, in which osteotomy is performed in a more distal region, next to the mental formamen. Technically, the area of contact between medullary-cancellous bone surfaces is increased, resulting in larger sliding rates among bone segments; it also facilitates the use of rigid fixation systems, with miniplates and monocortical screws. Conceptually, it interferes with the resistance arm of the mandible, seen as an interpotent lever of the third gender. PMID:17355642

  8. Multiple mandibular fractures. Treatment outlines.

    PubMed

    Elia, Giovanni; Franco, Elena; Clauser, Luigi C

    2016-02-01

    Multiple mandibular comminuted fractures usually occur in high energy traumas. The authors describe the management and treatment of multiple mandibular fractures in a young patient after a suicide attempt. PMID:26862697

  9. Neonatal mandibular distraction osteogenesis.

    PubMed

    Flores, Roberto L

    2014-11-01

    Mandibular distraction has revolutionized the treatment of Robin sequence associated with severe airway obstruction. The distraction technique remains the only intervention that directly corrects mandibular hypoplasia and the retropositioned tongue, providing efficient relief of airway stenosis. Multiple studies have demonstrated the efficacy of distraction in avoiding tracheostomy and decreasing the severity airway obstruction in this patient population. The benefit to avoiding tracheostomy and relieving airway obstruction is superior to that of tongue-lip adhesion. It is, therefore, not surprising that mandibular distraction has become the first-line intervention at many centers for the surgical treatment of Robin sequence. The complication profile associated with mandibular distraction appears low; the most common complication is infection, which can be treated by antibiotics alone. The severity of airway obstruction can be quantified by polysomnogram: This tool has become one of the most widely used objective metrics in the Robin sequence population. Therefore indications for surgery, timing of palatoplasty and long-term assessment of airway function should be performed in conjunction with sleep study analysis. The effects of mandibular lengthening on feeding difficulty in Robin sequence patient remains a topic of controversy. Studies have demonstrated conflicting results: This can be an area of future study. Agreed-upon indications for surgery and definitive protocols of care have yet to be formulized; future research should focus on achieving these goals. Such studies would require agreed-upon terminology for Robin sequence, an increase in comparative and prospective analysis, and the use of quantifiable metrics of clinical results. PMID:25383055

  10. Neonatal Mandibular Distraction Osteogenesis

    PubMed Central

    Flores, Roberto L.

    2014-01-01

    Mandibular distraction has revolutionized the treatment of Robin sequence associated with severe airway obstruction. The distraction technique remains the only intervention that directly corrects mandibular hypoplasia and the retropositioned tongue, providing efficient relief of airway stenosis. Multiple studies have demonstrated the efficacy of distraction in avoiding tracheostomy and decreasing the severity airway obstruction in this patient population. The benefit to avoiding tracheostomy and relieving airway obstruction is superior to that of tongue–lip adhesion. It is, therefore, not surprising that mandibular distraction has become the first-line intervention at many centers for the surgical treatment of Robin sequence. The complication profile associated with mandibular distraction appears low; the most common complication is infection, which can be treated by antibiotics alone. The severity of airway obstruction can be quantified by polysomnogram: This tool has become one of the most widely used objective metrics in the Robin sequence population. Therefore indications for surgery, timing of palatoplasty and long-term assessment of airway function should be performed in conjunction with sleep study analysis. The effects of mandibular lengthening on feeding difficulty in Robin sequence patient remains a topic of controversy. Studies have demonstrated conflicting results: This can be an area of future study. Agreed-upon indications for surgery and definitive protocols of care have yet to be formulized; future research should focus on achieving these goals. Such studies would require agreed-upon terminology for Robin sequence, an increase in comparative and prospective analysis, and the use of quantifiable metrics of clinical results. PMID:25383055

  11. Reconstruction of Mandibular Defects

    PubMed Central

    Chim, Harvey; Salgado, Christopher J.; Mardini, Samir; Chen, Hung-Chi

    2010-01-01

    Defects requiring reconstruction in the mandible are commonly encountered and may result from resection of benign or malignant lesions, trauma, or osteoradionecrosis. Mandibular defects can be classified according to location and extent, as well as involvement of mucosa, skin, and tongue. Vascularized bone flaps, in general, provide the best functional and aesthetic outcome, with the fibula flap remaining the gold standard for mandible reconstruction. In this review, we discuss classification and approach to reconstruction of mandibular defects. We also elaborate upon four commonly used free osteocutaneous flaps, inclusive of fibula, iliac crest, scapula, and radial forearm. Finally, we discuss indications and use of osseointegrated implants as well as recent advances in mandibular reconstruction. PMID:22550439

  12. Evaluation of mandibular bone mineral density using the dual-energy X-ray absorptiometry technique in edentulous subjects living in an endemic fluorosis region

    PubMed Central

    Buyukkaplan, US; Guldag, MU

    2012-01-01

    Objectives Fluoride is one of the biological trace elements with a strong affinity for osseous, cartilaginous and dental tissue. The dental and skeletal effects of high fluoride intake have already been studied in the literature, but little is known about the effects of high fluoride intake on edentulous mandibles. The purpose of this study was to evaluate the effects of high fluoride intake on mandibular bone mineral density (BMD) measured by the dual-energy X-ray absorptiometry (DXA) technique in edentulous individuals with systemic fluorosis. Methods 32 people who were living in an endemic fluorosis area since birth and 31 people who were living in a non-endemic fluorosis area since birth (control group) participated in this study. Systemic fluorosis was diagnosed in the patients using the sialic acid (NANA)/glycosaminoglycan (GAG) ratio. The BMDs of the mandibles were determined by the DXA technique. Results The serum NANA/GAG ratios in the fluorosis group were significantly lower than those in the control group (p < 0.001). There was also a statistically significant difference in mandibular BMD measurements (p < 0.05) between the systemic fluorosis and control groups, as measured by the DXA technique. Mandibular body BMD measurements were higher in the fluorosis group (1.25 ± 0.24 g cm−2) than in the control group (1.01 ± 0.31 g cm−2). Conclusions The results of the study showed that fluoride intake higher than the optimum level causes increased mandibular BMD in edentulous individuals. Further dose-related studies are needed to determine the effects of high fluoride intake on bony structures of the stomatognathic system. PMID:22241885

  13. [Lingual mandibular osteonecrosis].

    PubMed

    de Visscher, J G A M; Dietvorst, D P; van der Meij, E H

    2013-04-01

    A 47-year-old man was referred to an oral and maxillofacial surgeon by his dentist because ofa painful ulcer with exposed bone at the lingual side of teeth 47 and 48. The lesion was diagnosed as lingual mandibular osteonecrosis. Characteristics of lingual mandibular osteonecrosis are exposed bone in the molar area and sequestration. The disorder can appear spontaneously or following damage to the mucous membrane. Treatment options are surgical smoothening of exposed bone, surgical removal of necrotic bone and awaiting spontaneous sequestration. PMID:23654048

  14. Measuring mandibular motions

    NASA Technical Reports Server (NTRS)

    Dimeff, J.; Rositano, S.; Taylor, R. C.

    1977-01-01

    Mandibular motion along three axes is measured by three motion transducers on floating yoke that rests against mandible. System includes electronics to provide variety of outputs for data display and processing. Head frame is strapped to test subject's skull to provide fixed point of reference for transducers.

  15. Treatment options for the replacement of missing mandibular incisors.

    PubMed

    Fleigel, Jeffrey D; Salmon, Cade A; Piper, James M

    2011-07-01

    The replacement of a mandibular incisor is a dental treatment warranting special consideration. Some of the challenges associated with the anterior mandible are limited space, challenging surrounding anatomy, and tough esthetic requirements. Proper diagnosis and treatment planning may require a multidisciplinary approach to successfully meet the demands of replacing a missing tooth in this sextant. Several treatment options currently exist for mandibular incisor replacement. These options include (1) resin-bonded fixed dental prostheses (RBFDPs), (2) orthodontic treatment, (3) full-veneer fixed dental prostheses (FDPs), (4) dental implants for single-tooth replacement, (5) possible extraction of one or more incisors and restoration with implant-supported FDPs, (6) possible extraction of one or more teeth and restoration with FDPs from #22 to 27, (7) possible extraction of one or more teeth and restoration with removable dental prostheses (RDPs). This manuscript outlines the various treatment options for the replacement of mandibular incisors and discusses benefits and drawbacks of each. PMID:21631631

  16. Progressive condylar resorption after mandibular advancement.

    PubMed

    Kobayashi, Tadaharu; Izumi, Naoya; Kojima, Taku; Sakagami, Naoko; Saito, Isao; Saito, Chikara

    2012-03-01

    Progressive condylar resorption is an irreversible complication and a factor in the development of late skeletal relapse after orthognathic surgery. We have evaluated cephalometric characteristics, signs and symptoms in the temporomandibular joint (TMJ), and surgical factors in six patients (one man and five women) who developed it after orthognathic surgery. The findings in preoperative cephalograms indicated that the patients had clockwise rotation of the mandible and retrognathism because of a small SNB angle, a wide mandibular plane angle, and a "minus" value for inclination of the ramus. There were erosions or deformities of the condyles, or both, on three-dimensional computed tomography (CT) taken before treatment. The mean (SD) anterior movement of the mandible at operation was 12.1 (3.9)mm and the mean relapse was -6.4 (2.5)mm. The mean change in posterior facial height was 4.5 (2.1)mm at operation and the mean relapse was -5.3 (1.8)mm. Two patients had click, or pain, or both, preoperatively. The click disappeared in one patient postoperatively, but one of the patients who had been symptom-free developed crepitus postoperatively. In the classified resorption pattern, posterior-superior bone loss was seen in three cases, anterior-superior bone loss in two, and superior bone loss in one. Progressive condylar resorption after orthognathic surgery is multifactorial, and some of the risk factors are inter-related. Patients with clockwise rotation of the mandible and retrognathism in preoperative cephalograms; erosion, or deformity of the condyle, or both, on preoperative CT; and wide mandibular advancement and counterclockwise rotation of the mandibular proximal segment at operation, seemed to be at risk. The mandible should therefore be advanced only when the condyles are stable on radiographs, and careful attention should be paid to postoperative mechanical loading on the TMJ in high-risk patients. PMID:21440343

  17. Subepithelial Connective Tissue Graft in Combination with a Tunnel Technique for the Treatment of Miller Class II and III Gingival Recessions in Mandibular Incisors: Clinical and Esthetic Results.

    PubMed

    Nart, Jose; Valles, Cristina

    2016-01-01

    There is limited evidence regarding the effect of the subepithelial connective tissue graft (SCTG) on root coverage in the mandibular anterior region. A sample of 15 Miller Class II and III recessions were treated in 15 patients using a SCTG with a tunnel technique. After a mean follow-up of 20.53 months, the mean percentage of root coverage was 83.25% for all treated recessions. Furthermore, a statistically significant increase of keratinized tissue was observed at the end of the evaluation period (2.66 mm; P = .001). The combination of tunnel technique and SCTG should be considered a treatment option to obtain root coverage in mandibular incisors with Class II and III recession defects. PMID:27333018

  18. 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

  19. Lower molar and incisor displacement associated with mandibular remodeling.

    PubMed

    Baumrind, S; Bravo, L A; Ben-Bassat, Y; Curry, S; Korn, E L

    1997-01-01

    The purpose of this study was to quantify the amount of alveolar modeling at the apices of the mandibular incisor and first molar specifically associated with appositional and resorptive changes on the lower border of the mandible during growth and treatment. Cephalometric data from superimpositions on anterior cranial base, mandibular implants of the Björk type, and anatomical "best fit" of mandibular border structures were integrated using a recently developed strategy, which is described. Data were available at annual intervals between 8.5 and 15.5 years for a previously described sample of approximately 30 children with implants. The average magnitudes of the changes at the root apices of the mandibular first molar and central incisor associated with modeling/remodeling of the mandibular border and symphysis were unexpectedly small. At the molar apex, mean values approximated zero in both anteroposterior and vertical directions. At the incisor apex, mean values approximated zero in the anteroposterior direction and averaged less than 0.15 mm/year in the vertical direction. Standard deviations were roughly equal for the molar and the incisor in both the anteroposterior and vertical directions. Dental displacement associated with surface modeling plays a smaller role in final tooth position in the mandible than in the maxilla. It may also be reasonably inferred that anatomical best-fit superimpositions made in the absence of implants give a more complete picture of hard tissue turnover in the mandible than they do in the maxilla. PMID:9107373

  20. Unilateral mandibular ramus elongation by intraoral distraction osteogenesis.

    PubMed

    Kofod, Thomas; Nørholt, Sven Erik; Pedersen, Thomas Klit; Jensen, John

    2005-03-01

    Successful correction of facial asymmetry by mandibular distraction osteogenesis relies on mastering vector control. Lack of necessary vector control continues to compromise the treatment modality. The purpose of this study was to describe a new simplified method for vector transfer and to evaluate this method according to the outcome and the efficacy of distraction osteogenesis in the correction of unilateral mandibular hypoplasia and asymmetry. Twenty-seven patients with unilateral hypoplasia of the mandibular ramus underwent unilateral mandibular distraction osteogenesis with intraoral distraction devices. Posterior-anterior and lateral cephalograms were analyzed by digitalization. Changes in sagittal, vertical, and transversal linear and angular dimensions after the distraction treatment were evaluated by measurements performed on headfilms taken before and after surgery. Means and variances were calculated for selected cephalometric variables for each time point. The differences between the control and the treatment side were calculated, statistically described, and compared with a paired Student t test. Correction of the mandibular asymmetry, chin position, and the canting of the occlusal plane was obtained in all patients clinically, as well as radiographically, by the use of intraoral unidirectional distraction osteogenesis. PMID:15750421

  1. Long-term changes in mandibular and facial widths after mandibular setback surgery using intraoral vertical ramus osteotomy.

    PubMed

    Choi, Y J; Ha, Y-D; Lim, H; Huh, J-K; Chung, C J; Kim, K-H

    2016-09-01

    This study was performed to evaluate the long-term changes in mandibular width, lower facial width, and ramus angulation after intraoral vertical ramus osteotomy (IVRO) and to identify the factors influencing these changes. This retrospective study included 53 consecutive patients with mandibular prognathism who underwent IVRO with (n=33) or without (n=20) Le Fort I osteotomy. Postero-anterior cephalograms and frontal facial photographs obtained before, 1 month after, and at least 24 months after IVRO were used for measurements. A linear mixed model and paired t-tests were used to analyze temporal changes and the associated influencing factors. The mandibular width increased immediately after surgery (P<0.05), but decreased continuously thereafter. The ramus angulation showed negligible change within the first month (P>0.05) and decreased thereafter up to approximately 36 months. The amounts of mandibular setback and posterior impaction and the length of time postoperative influenced these changes. The lower facial width changed, although inconsistently, within 3mm over time (P>0.05). In conclusion, the mandibular width increased after IVRO but seemed to normalize within approximately 3 years. The lower facial width did not reflect underlying skeletal changes. Therefore, long-term transverse changes after IVRO can be considered clinically irrelevant. PMID:27156429

  2. Prospective study of treatment outcome of implant retained mandibular overdenture: Two years follow-up

    PubMed Central

    Arora, Vimal; Kumar, Dinesh; Legha, V. S.; Arun Kumar, K. V.

    2014-01-01

    Aims: The aim of this study is to evaluate the treatment outcome of immediately loaded Implants in the interforaminal region of anterior mandible. Materials and Methods: A total of 15 completely edentulous patients aged between 50 and 70 years were selected satisfying certain inclusion and exclusion criteria. Two implants were placed in 33 and 43 region (B and D location) and the implants were loaded immediately by mandibular overdenture retained with O-ring attachments. The implants were evaluated for various clinical parameters at 6 months, 1 year, 1.5 years, and 2 years intervals after initial placement. Results: There was increased marginal bone loss around implants during the 1st year after that the bone loss was insignificant. Clinical stability of immediately loaded implants was lower initially for 6 months, but improved by the end of 1st year. Survival rate for immediately loaded implants was 96.6% at the end of the period of study. Conclusion: Immediate loading of interforaminal mandibular implants demonstrated a highly acceptable clinical success at the end of 2 years. However, initially the marginal bone level and clinical stability were significantly lower which showed improvement with time. PMID:24963237

  3. Sexual dimorphism of the internal mandibular chamber in Fayum Pliohyracidae (Mammalia)

    USGS Publications Warehouse

    de Blieux, D.D.; Baumrind, M.R.; Simons, E.L.; Chatrath, P.S.; Meyer, G.E.; Attia, Y.S.

    2006-01-01

    An internal mandibular fenestra and chamber are found in many fossil hyracoids. The internal mandibular fenestra is located on the lingual surface of the mandibular corpus and opens into a chamber within the mandible. The mandibular chamber is maximally developed in late Eocene Thyrohyrax meyeri and early Oligocene Thyrohyrax domorictus from the Fayum Province of Egypt. The function of this chamber is unknown as it is not found in extant hyraxes, nor is it known to occur in any other mammal. In Thyrohyrax, this feature appears to be sexually dimorphic because it is confined to roughly one half of the specimens that otherwise cannot be separated by dental characteristics or measurements. It has been suggested that the chamber is found in females based on the presumed distribution of this character in other fossil hyracoids. Fossils from Fayum Quarry L-41, preserving the sexually dimorphic anterior dentition, show that, in Thyrohyrax meyeri and Thyrohyrax domorictus, the internal mandibular chamber is found in males. In Thyrohyrax litholagus, an internal mandibular fenestra and inflated mandibular chamber occurs in males whereas females show the variable presence of an internal mandibular fossa or fenestra but lack an expanded chamber. Other genera show differing patterns of sexual variation in which some Fayum hyracoids have an internal mandibular fenestra in both sexes but with the greatest development of the mandibular chamber occurring in males. We review functions proposed for the internal mandibular chamber and suggest that it housed a laryngeal air sac that may have had a vocal function by acting as a resonating chamber. ?? 2006 by the Society of Vertebrate Paleontology.

  4. Rootless eruption of a mandibular permanent canine.

    PubMed

    Shapira, Yehoshua; Kuftinec, Mladen M

    2011-04-01

    The purpose of this article was to describe the rootless eruption of a mandibular permanent canine in a 10-year-old boy; his mandible had been fractured in a car accident. The fracture was at the region of the developing canine, resulting in arrested root formation and causing abnormal, rootless eruption. Current theories on tooth eruption and the important role of the dental follicle in the process of eruption are discussed. PMID:21457868

  5. Ultrasound and multidetector computed tomography of mandibular salivary gland adenocarcinoma in two dogs

    PubMed Central

    Lenoci, D.; Ricciardi, M.

    2015-01-01

    Malignant tumors of the salivary glands are rare in dogs, with adenocarcinoma being the most represented. Parotid and mandibular glands are most commonly affected in dogs. Because of local invasivity and high metastatic potential, preoperative imaging evaluation of mandibular region and tumoral staging is essential along with biopsy sampling. The present manuscript describes the ultrasound and computed tomographic imaging findings of mandibular gland adenocarcinoma in two dogs and discusses their clinical utility. PMID:26753133

  6. Anterior Maxillary Intrusion and Retraction with Corticotomy-Facilitated Orthodontic Treatment and Burstone Three Piece Intrusive Arch

    PubMed Central

    Prabhakar, Ramachandra; Karthikeyan, M.K; Saravanan, R.; Kannan, K.S.; Arun Raj, M.R.

    2013-01-01

    An adult patient with proclination and spacing was performed orthodontic treatment combined with corticotomy and the burstone three piece intrusive arch who desired a shortened treatment period. The patient had Angle’s Class I malocclusion with flaring of the maxillary and mandibular incisors. Pre adjusted edgewise appliance (MBT prescription) was fixed to the maxillary and mandibular teeth. Then corticotomy was performed on the cortical bone of the buccal sides in the maxillary anterior regions. Intrusion and retraction initiated immediately after the corticotomy. The intrusive arch was adjusted once in every 2 weeks. The total treatment time for intrusion was 5 months. Cephalometric superimpositions showed no anchorage loss, and panoramic radiographs showed neither significant reduction in the crestal bone height nor marked apical root resorption. A corticotomy-facilitated orthodontic treatment shortened treatment period without any anchorage loss or adverse effects. PMID:24551742

  7. Anterior maxillary intrusion and retraction with corticotomy-facilitated orthodontic treatment and burstone three piece intrusive arch.

    PubMed

    Prabhakar, Ramachandra; Karthikeyan, M K; Saravanan, R; Kannan, K S; Arun Raj, M R

    2013-12-01

    An adult patient with proclination and spacing was performed orthodontic treatment combined with corticotomy and the burstone three piece intrusive arch who desired a shortened treatment period. The patient had Angle's Class I malocclusion with flaring of the maxillary and mandibular incisors. Pre adjusted edgewise appliance (MBT prescription) was fixed to the maxillary and mandibular teeth. Then corticotomy was performed on the cortical bone of the buccal sides in the maxillary anterior regions. Intrusion and retraction initiated immediately after the corticotomy. The intrusive arch was adjusted once in every 2 weeks. The total treatment time for intrusion was 5 months. Cephalometric superimpositions showed no anchorage loss, and panoramic radiographs showed neither significant reduction in the crestal bone height nor marked apical root resorption. A corticotomy-facilitated orthodontic treatment shortened treatment period without any anchorage loss or adverse effects. PMID:24551742

  8. Mandibular Advancement Splints.

    PubMed

    Bamagoos, Ahmad A; Sutherland, Kate; Cistulli, Peter A

    2016-09-01

    Although mandibular advancement splints (MAS) are not as efficacious as continuous positive airway pressure (CPAP) in reducing obstructive respiratory events, patient adherence and preference are greater than CPAP. Additionally, the effectiveness of both treatments on general health outcomes, cognitive function, and quality of life appears to be equivalent. The main barrier for the implementation of MAS treatment in clinical practice is the interindividual variability in response to MAS treatment. Several prediction tools have been proposed to enhance patient selection for MAS treatment. Phenotyping obstructive sleep apnea patients may reveal patient characteristics that enable the prediction of response to MAS treatment. PMID:27542880

  9. Transmigration of mandibular canine – case report

    PubMed Central

    Gruszka, Katarzyna; Różyło, T. Katarzyna; Różyło-Kalinowska, Ingrid; Denkiewicz, Katarzyna; Masłowska, Klaudia

    2014-01-01

    Summary Background Transmigration is a phenomenon of movement of an unerupted tooth in the bone across the midline. This anomaly is not often found. Transmigration is more prevalent in females than in males, and more often encountered in the mandible than maxilla, it affects mostly canines. Case Report The aim of this study was to present a case report of a mandibular canine transmigration in a patient aged 12. Intraoral examination determined hypodontia of right second premolar and delayed eruption of left second premolar in maxilla, as well as persistent deciduous teeth: right second molar, left canine and second molar. The patient was referred for a Cone-Beam CT examination, which allowed precise visualization of the transmigrating canine as well as ruled out resorption of roots of mandibular incisors. Results The treatment with a maxillary fixed orthodontic appliance was finished after obtaining a satisfactory result. Proper alignment of the incisors in the anterior-posterior plane and correct midline position were accepted by the patient. Transmigrating canine after consultation with the surgeon was designed to further radiological observation. PMID:24520309

  10. Immediate regional endocardial surface expansion following coronary occlusion in the canine left ventricle: disproportionate effects of anterior versus inferior ischemia.

    PubMed

    Picard, M H; Wilkins, G T; Gillam, L D; Thomas, J D; Weyman, A E

    1991-03-01

    The exact time of onset of functional expansion after acute myocardial infarction/ischemia remains unclear in spite of its potential link to chronic pathologic infarct expansion and its potential implications for therapy. To examine this early change in ventricular morphology, 14 open-chest dogs were studied with two-dimensional echocardiography before and after occlusion (10 minutes) of the left anterior descending coronary artery (LAD, n = 7) or circumflex artery (CIRC, n = 7). The endocardial surface area (ESA) and the area of abnormal wall motion (AWM) were reconstructed from the echocardiographic data using a previously reported technique for quantitatively mapping the ESA and extent of AWM. For the total group (N = 14), the mean ESA before occlusion was 48.9 +/- 9.8 cm2, increasing to 65.7 +/- 18.9 cm2 at 10 minutes occlusion (p less than 0.001). For the LAD subgroup, the mean ESA before occlusion was 50.7 +/- 9.3 cm2, increasing to 79.1 +/- 14.1 cm2 at 10 minutes following occlusion (p less than 0.001). For the CIRC subgroup, the mean ESA before occlusion was 47.1 +/- 10.8 cm2, increasing to 52.3 +/- 12.6 cm2 at 10 minutes after occlusion (p less than 0.001). The ESA increase for the LAD subgroup was significantly larger than that of the CIRC subgroup (LAD range 14.5 to 49.9 cm2 versus CIRC range 1.5 to 9 cm2, p less than 0.0001). Coronary occlusion resulted in similarly sized regions of AWM for both subgroups (LAD, 31.3 +/- 12.2 cm2 versus CIRC, 25.9 +/- 10.3 cm2, p = n.s.). For the LAD group, the largest increase in endocardial circumference occurred within the zone of AWM at the apex (39.9 +/- 12%). The endocardial surface area therefore expands immediately after coronary occlusion and the magnitude of this process is primarily related to the site (anteroapical) rather than to the extent of AWM. PMID:2000741

  11. Cemented and screw-retained implant-supported single-tooth restorations in the molar mandibular region: A retrospective comparison study after an observation period of 1 to 4 years

    PubMed Central

    Peñarrocha-Diago, Miguel; Pradíes, Guillermo; Sola-Ruiz, María-Fernanda; Agustín-Panadero, Rubén

    2015-01-01

    Objectives: The aim of this study was to evaluate the survival and compare the appearance of different mechanical and biological complications, in screw-retained and cemented-retained single-tooth implant-supported restorations localized in the molar mandibular region, over a period of 1 to 4 years. Material and Methods: A retrospective study was carried out with a total of eighty implant-supported restorations, which were placed in eighty patients for prosthetic rehabilitation of a mandibular molar. Forty patients were rehabilitated with a cemented-retained restoration and the other forty with a screw-retained restoration. The presence of the following complications was recorded for both types of prostheses: Fractures of the ceramic veneering, loosening screws, mucositis and peri-implantitis. Debonding of the restoration was analyzed in the cemented-retained restoration group. The clinical survival of crowns was analyzed with a Kaplan-Meier test and the clinical complications were compared, using a Student t test and Log-rank test. Results: 27 patients registered some complication. The average rate of complications was 37,5% for cemented-retained restorations and 30% for screw-retained restorations. The complications more common in the cemented-retained restoration were the presence of mucositis (14,87%), while in the screw-retained restorations was the loosening screw (20%). Student t test and Log-Rank test found significant differences (p=0,001) between the screw loosening and presence of mucositis. Conclusions: The cemented-retained restorations seem to prevent screw loosening, but the presence of cement seem to increase the complications around the soft tissues, however in the screw-retained restorations the presence of mucositis and peri-implantitis are lower than cemented-retained restorations. The incidence of fracture of ceramic veneering was similar in both groups. Key words:Screw-retained restorations, cemented-retained restorations, screw loosening

  12. Glandular Odontogenic Cyst of the Anterior Mandible

    PubMed Central

    Raju, Srinivasa Pathapati; Reddy, Sridhar Padala; Ananthnag, Jakkula

    2015-01-01

    Context: Glandular odontogenic cyst (GOC) is a rare cyst occurring in the middle-age people with mandibular anterior as the common site of occurrence. Case Report: We report a case of massive GOC in a 65-year-old female with an emphasis on its clinical course, histological features, and treatment modalities. Conclusion: The aggressiveness and recurrences of GOC warrants clinicians for the careful examination, treatment, and long-term follow-up. PMID:25789251

  13. 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

  14. The position of the mandibular canal and histologic feature of the inferior alveolar nerve.

    PubMed

    Kilic, C; Kamburoğlu, K; Ozen, T; Balcioglu, H A; Kurt, B; Kutoglu, T; Ozan, H

    2010-01-01

    The inferior alveolar nerve is the one of the large branches of the mandibular division of the trigeminal nerve. It is vulnerable during surgical procedures of the mandible. Despite its importance, no anatomical and histological examination has been conducted to provide a detailed cross-sectional morphology of the mandibular canal according to dental status. Therefore, the present study aimed to identify the position of the mandibular canal through direct measurement and to determine the branches of the inferior alveolar nerve through histologic examination. The area between the anterior margin of the third molar and the anterior margin of the second premolar of dentulous, partially dentulous, and edentulous hemimandible specimens (n = 49) from 26 human cadavers was serially sectioned into seven segments, and specific distances were measured using digital calipers. Following this, 5-microm cross-sections were prepared along the mandibular canal and mental foramen, and examined by fluorescence microscopy. The mandibular canal was located at a mean distance of 10.52 mm above the inferior margin of the mandible. The mean maximum diameters of the mandibular canal, inferior alveolar nerve, inferior alveolar artery, and inferior alveolar vein were 2.52, 1.84, 0.42, and 0.58 mm, respectively. This study found that the inferior alveolar nerve often gives rise to several branches at each level (range 0-3). To minimize the risk of injury, knowledge of the small branches of the nerve and of the detailed findings regarding the position of the mandibular canal reported here should be considered when planning mandibular surgery, especially during implant placement. PMID:19918867

  15. Fixation of bilateral condylar fractures with maxillary and mandibular nerve blocks

    PubMed Central

    Parthasarathy, S.; Sripriya, R.

    2015-01-01

    Mandibulo facial injuries present special problems to the anesthesiologist in terms of the difficult airway. Hence, if regional anesthesia could be possible, it necessarily removes the major concern with airway access. We present a case of bilateral mandibular condylar fracture dislocation with the maxillary and mandibular nerve blocks on both sides. The surgery went on smoothly without any perioperative problems. PMID:26417146

  16. Evaluation of mandibular cortical bone thickness for placement of temporary anchorage devices (TADs)

    PubMed Central

    Kim, Jung-Hoon

    2012-01-01

    Objective In this study, we measured the cortical bone thickness in the mandibular buccal and lingual areas using computed tomography in order to evaluate the suitability of these areas for application of temporary anchorage devices (TADs) and to suggest a clinical guide for TADs. Methods The buccal and lingual cortical bone thickness was measured in 15 men and 15 women. Bone thickness was measured 4 mm apical to the interdental cementoenamel junction between the mandibular canine and the 2nd molar using the transaxial slices in computed tomography images. Results The cortical bone in the mandibular buccal and lingual areas was thicker in men than in women. In men, the mandibular lingual cortical bone was thicker than the buccal cortical bone, except between the 1st and 2nd molars on both sides. In women, the mandibular lingual cortical bone was thicker in all regions when compared to the buccal cortical bone. The mandibular buccal cortical bone thickness increased from the canine to the molars. The mandibular lingual cortical bone was thickest between the 1st and 2nd premolars, followed by the areas between the canine and 1st premolar, between the 2nd premolar and 1st molar, and between the 1st molar and 2nd molar. Conclusions There is sufficient cortical bone for TAD applications in the mandibular buccal and lingual areas. This provides the basis and guidelines for the clinical use of TADs in the mandibular buccal and lingual areas. PMID:23112941

  17. Novel three-dimensional position analysis of the mandibular foramen in patients with skeletal class III mandibular prognathism

    PubMed Central

    Kim, Yeon-Ho; Won, Yu-Jin; Kim, Moon-Key

    2016-01-01

    Purpose To analyze the relative position of the mandibular foramina (MnFs) in patients diagnosed with skeletal class III malocclusion. Materials and Methods Computed tomography (CT) images were collected from 85 patients. The vertical lengths of each anatomic point from the five horizontal planes passing through the MnF were measured at the coronoid process, sigmoid notch, condyle, and the gonion. The distance from the anterior ramus point to the posterior ramus point on the five horizontal planes was designated the anteroposterior horizontal distance of the ramus for each plane. The perpendicular distance from each anterior ramus point to each vertical plane through the MnF was designated the horizontal distance from the anterior ramus to the MnF. The horizontal and vertical positions were examined by regression analysis. Results Regression analysis showed the heights of the coronoid process, sigmoid notch, and condyle for the five horizontal planes were significantly related to the height of the MnF, with the highest significance associated with the MnF-mandibular plane (coefficients of determination (R2): 0.424, 0.597, and 0.604, respectively). The horizontal anteroposterior length of the ramus and the distance from the anterior ramus point to the MnF were significant by regression analysis. Conclusion The relative position of the MnF was significantly related to the vertical heights of the sigmoid notch, coronoid process, and condyle as well as to the horizontal anteroposterior length of the ascending ramus. These findings should be clinically useful for patients with skeletal class III mandibular prognathism. PMID:27358814

  18. Restoring primary anterior teeth.

    PubMed

    Waggoner, William F

    2002-01-01

    A variety of esthetic restorative materials are available for restoring primary incisors. Knowledge of the specific strengths, weakness, and properties of each material will enhance the clinician's ability to make the best choice of selection for each individual situation. Intracoronal restorations of primary teeth may utilize resin composites, glass ionomer cements, resin-modified ionomers, or polyacid-modified resins. Each has distinct advantages and disadvantages and the clinical conditions of placement may be a strong determining factor as to which material is utilized. Full coronal restoration of primary incisors may be indicated for a number of reasons. Crowns available for restoration of primary incisors include those that are directly bonded onto the tooth, which generally are a resin material, and those crowns that are luted onto the tooth and are some type of stainless steel crown. However, due to lack of supporting clinical data, none of the crowns can be said to be superior to the others under all circumstances. Though caries in the mandibular region is rare, restorative solutions for mandibular incisors are needed. Neither stainless steel crowns nor celluloid crown forms are made specifically for mandibular incisors. Many options exist to repair carious primary incisors, but there is insufficient controlled, clinical data to suggest that one type of restoration is superior to another. This does not discount the fact that dentists have been using many of these crowns for years with much success. Operator preferences, esthetic demands by parents, the child's behavior, and moisture and hemorrhage control are all variables which affect the decision and ultimate outcome of whatever restorative treatment is chosen. PMID:12412967

  19. Costal Grafting in Mandibular Reconstruction

    PubMed Central

    Bourlet, Jerôme; Château, Joseph; Jacquemart, Mathieu; Dufour, Clémence; Mojallal, Ali; Gleizal, Arnaud

    2015-01-01

    Background: Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery, and free fibular flap is the gold standard for this indication. However, there are alternatives; nonvascular bone grafting is one of them, and we present the costal grafting for mandibular reconstruction, a classic technique that is reliable, efficient, and produced less morbidity than the technique of using composite free flaps. Method: A 9-year retrospective review of 54 patients treated surgically for mandibular reconstruction was performed. The criterion mainly analyzed was graft survival. The surgical technique was described in detail. Results: A total of 54 patients with mandibular bone defect were identified. Five symphysis, 46 corpus, and 20 ramus defects were considered. These patients underwent reconstruction by costal grafting, and the engrafting was successful in 92.6% of cases. Dental rehabilitation with dental implants was realized in 70% of cases. Conclusions: The approach described in this article allowed the authors to obtain good results with costal grafting for mandibular reconstruction and dental rehabilitation. Costal grafting is a good alternative for fibula free flap in specific indications. Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery. Since the 1980s, the gold standard for these defects is the use of free fibular flap.1 In some cases, this technique is contradicted; the surgeon then has several possibilities for the use of free osteomyocutaneous flaps (iliac crest, scapula, and serrato-costal flaps).2–8 PMID:26893990

  20. Correlation between Focal Nodular Low Signal Changes in Hoffa's Fat Pad Adjacent to Anterior Femoral Cartilage and Focal Cartilage Defect Underlying This Region and Its Possible Implication

    PubMed Central

    Ng, Wuey Min

    2016-01-01

    Purpose. This study investigates the association between focal nodular mass with low signal in Hoffa's fat pad adjacent to anterior femoral cartilage of the knee (FNMHF) and focal cartilage abnormality in this region. Method. The magnetic resonance fast imaging employing steady-state acquisition sequence (MR FIESTA) sagittal and axial images of the B1 and C1 region (described later) of 148 patients were independently evaluated by two reviewers and categorized into four categories: normal, FNMHF with underlying focal cartilage abnormality, FNMHF with normal cartilage, and cartilage abnormality with no FNMHF. Results. There was a significant association (p = 0.00) between FNMHF and immediate adjacent focal cartilage abnormality with high interobserver agreement. The absence of focal nodular lesions next to the anterior femoral cartilage has a very high negative predictive value for chondral injury (97.8%). Synovial biopsy of focal nodular lesion done during arthroscopy revealed some fibrocollagenous tissue and no inflammatory cells. Conclusion. We postulate that the FNMHF adjacent to the cartilage defects is a form of normal healing response to the cartilage damage. One patient with FHMHF and underlying cartilage abnormality was rescanned six months later. In this patient, the FNMHF disappeared and normal cartilage was observed in the adjacent region which may support this theory. PMID:27213085

  1. Classifications of mandibular canal branching: A review of literature

    PubMed Central

    Castro, Mauricio Augusto Aquino; Lagravere-Vich, Manuel Oscar; Amaral, Tânia Mara Pimenta; Abreu, Mauro Henrique Guimaraes; Mesquita, Ricardo Alves

    2015-01-01

    AIM: To gather existing radiographic classifications of mandibular canals branching, considering the criteria on which these were based. METHODS: The search for studies on mandibular canals based on imaging exams included literature reviews, epidemiological studies of prevalence, descriptive studies, or case reports. An electronic search in the MEDLINE (OvidSP), PubMed, EMBASE (OvidSP), Web of Science (Thompson Reuters), and Scopus (Elsevier) databases was performed, as well as a manual evaluation of the references of the selected articles. Combinations of key words were placed in each database. No restrictions were imposed regarding the year of publication or language. References collected in duplicate were removed by the authors. A table was drawn up, containing the included studies and respective interest data. RESULTS: Six classifications of mandibular canals branching were selected for the present literature review. Four were based on two-dimensional radiographic exams, and two were performed based on three-dimensional tomographic exams. Three-dimensional classifications were determined based on the analysis found in the least number of exams, comparatively to two-dimensional studies. The prevalence of mandibular canal branching varied from 0% to 38.75% in the works based on two-dimensional exams, while those found in three-dimensional exams ranged from 15.6% to 65%. The studies were mostly referred to branches that began in the mandibular ramus. Just one classification considered the branches that began in the mandibular body region. CONCLUSION: Three-dimensional exams appear to be the best method to view mandibular canal branching. Further studies are warranted to determine its true prevalence and questions concerning to associations. PMID:26753068

  2. Mandibular asymmetry: a three-dimensional quantification of bilateral condyles

    PubMed Central

    2013-01-01

    Introduction The shape and volume of the condyle is considered to play an important role in the pathogenesis of the mandibular deviation. Curvature analysis is informative for objectively assess whether the shape of the condyles matches that of the glenoid fossa. In this study, a three-dimensional (3-D) quantification of bilateral asymmetrical condyles was firstly conducted to identify the specific role of 3-D condylar configuration for mandibular asymmetry. Methods 55 adult patients, 26 males (26 ± 5 yrs) and 29 females (26 ± 5 yrs), diagnosed with mandibular asymmetry were included. The examination of deviation of chin point, deviation of dental midlines, inclination of occlusal plane, and depth of the mandibular occlusal plane were conducted. After the clinical investigation, computed tomography images from the patients were used to reconstruct the 3-D mandibular models. Then the condylar volume, surface size, surface curvature and bone mineral density were evaluated independently for each patient on non-deviated and deviated sides of temporomandibular joint. Results Both the condylar surface size and volume were significantly larger on deviated side (surface size: 1666.14 ± 318.3 mm2, volume: 1981.5 ± 418.3 mm3). The anterior slope of the condyle was flatter (0.12 ± 0.06) and the posterior slope (0.39 ± 0.08) was prominently convex on the deviated side. The corresponding bone mineral density values were 523.01 ±118.1 HU and 549.07 ±120. 6 HU on anterior and posterior slopes. Conclusions The incongruence presented on the deviated side resulted in a reduction in contact areas and, thus, an increase in contact stresses and changes of bone density. All aforementioned results suggest that the difference existing between deviated and non-deviated condyles correlates with facial asymmetrical development. In mandibular asymmetry patients, the 3-D morphology of condyle on deviated side differ from the non-deviated side, which

  3. 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

  4. Split-Framework in Mandibular Implant-Supported Prosthesis

    PubMed Central

    2015-01-01

    During oral rehabilitation of an edentulous patient with an implant-supported prosthesis, mandibular flexure must be considered an important biomechanical factor when planning the metal framework design, especially if implants are installed posterior to the interforaminal region. When an edentulous mandible is restored with a fixed implant-supported prosthesis connected by a fixed full-arch framework, mandibular flexure may cause needless stress in the overall restorative system and lead to screw loosening, poor fit of prosthesis, loss of the posterior implant, and patient's discomfort due to deformation properties of the mandible during functional movements. The use of a split-framework could decrease the stress with a precise and passive fit on the implants and restore a more natural functional condition of the mandible, helping in the longevity of the prosthesis. Therefore, the present clinical report describes the oral rehabilitation of an edentulous patient by a mandibular fixed implant-supported prosthesis with a split-framework to compensate for mandibular flexure. Clinical Significance. The present clinical report shows that the use of a split-framework reduced the risk of loss of the posterior implants or screws loosening with acceptable patient comfort over the period of a year. The split-framework might have compensated for the mandibular flexure during functional activities. PMID:26770841

  5. Sagittal mandibular osteotomy for removal of intraosseous lesion.

    PubMed

    de Oliveira, Júlio César Silva; Garcia, Idelmo Rangel; de Melo, Willian Morais; de Matos Barbosa, Saulo; Rabêlo, Paulo Maria Santos; Bastos, Eider Guimarães

    2014-05-01

    The ramus sagittal split osteotomy or mandibular body is an established technique for correction of dentofacial deformities but can have an accurate indication in cases requiring surgical access to remove lesions or more teeth included in the region of the mandibular angle. The main advantages of this technique are the possibility of preservation of the inferior alveolar nerve bundle and significant reduction in postoperative morbidity. In this article, the authors show a case in which the sagittal osteotomy of the mandible was used to gain access for removal of a lesion (complex odontoma). PMID:24820725

  6. True chondroma of the mandibular condyle: A rare case

    PubMed Central

    Dhirawani, Rajesh B.; Anand, Kavneet; Lalwani, Gaurav; Pathak, Sanyog; Thakkar, Bhushan

    2014-01-01

    Chondroma of the mandibular condyle is a rare benign tumor, with just a handful of cases reported in the literature. Chondromas are rare in the maxillofacial region, but are quite common in the bones of the hands and feet. So far only eight cases of true chondroma have been reported. Here, we present a case of true chondroma of the mandibular condyle of the right side, for which condylectomy was done. No signs of recurrence are noted at 2 years follow-up. PMID:25593880

  7. Adolescent Mandibular Central Odontoameloblastoma: A Rare Case Report.

    PubMed

    Arun Kumar, K V; Mowar, Apoorva; Gupta, Rajat; Deepa, D

    2016-03-01

    Odontoameloblastoma is a rare odontogenic tumour, characterised by simultaneous occurrence of an ameloblastoma and a compound or complex odontoma in the same tumoral mass. The tumour is seen in first three decades and affects mandible or maxilla equally, commonly found posterior to the canines. The management is similar to unicystic ameloblastoma and odontoma excision. A long term follow up is a must to observe the recurrence. Here we present a rare case of odontoameloblastoma in a 17 year old male, presenting as an asymptomatic anterior mandibular swelling with chief complaint of missing lower front teeth. PMID:26929561

  8. Mandibular incisive canal in relation to periapical surgery

    PubMed Central

    Bilginaylar, Kani; Orhan, Kaan; Uyanik, Lokman Onur

    2016-01-01

    The aim of the present paper is to emphasize the importance of the mandibular interforaminal neurovascular bundle with a case and make a warning to dentists and surgeons during oral and maxillofacial surgeries, such as implant replacement, bone harvesting, genioplasty, open reduction of a mandibular fracture, and cyst enucleations at this region. In this paper, we present a 58-year-old male who referred with pain and a tingling sensation on the left lower lip. After radiographical, extraoral and intraoral examinations, findings indicated the lesion to be a cyst which was related with a periapical lesion of the canine tooth and extracted socket of first premolar tooth. After removal of a cyst, the mandibular incisive nerve was documented which was in relation to cyst cavity. PMID:27041907

  9. Secondary mandibular reconstruction after oral squamous cell carcinoma resection: clinical reevaluation of transport disk distraction osteogenesis.

    PubMed

    Seitz, Oliver; Harth, Marc; Ghanaati, Shahram; Lehnert, Thomas; Vogl, Thomas J; Sader, Robert; Klein, Cornelius M

    2010-01-01

    Besides bone grafting, transport disk distraction osteogenesis (TDDO) is an alternative approach that can be used for the reconstruction of the mandibular arch after neoplastic surgery. Although several animal experiments are reporting about the applicability of this technique, little is known about its long-term success in human beings. In this study, we report about the successful treatment of patients with defects of their mandibular arch due to tumor resection by means of the external bifocal TDDO. A total of 7 patients (n = 3 with lateral, n = 4 with anterior defects) were followed up for a mean period of 56 months. Although neither adjuvant nor neoadjuvant chemotherapy negatively influenced callus formation, prereconstructive radiation with a dose of 51 Gy led to an insufficient callus formation. The reconstruction of anterior defects was unsatisfying because tensions from the soft tissue on the fragile and rubber-like callus negatively influenced the natural arch shaping.In these cases, additional surgery was often required. However, reconstruction of lateral defects of the mandibular arch was more successful and resulted in functional bone with good quality, in which dental implants could be inserted. The results of this study emphasize that TDDO by means of bifocal distraction provides functional bone comparable to residual bone.Lateral defects of mandibular arch can be better reconstructed, whereas anterior defects often require additional surgery. PMID:20061975

  10. Osteochondroma of bilateral mandibular condyle: a case report

    PubMed Central

    Zhou, Qin; Yang, Chi; Chen, Min-Jie

    2015-01-01

    Osteochondroma represents the largest group of benign tumors of bone, which usually develops in long bones and relatively uncommon in the craniofacial region. The condyle and coronoid tip are the most common sites of occurrence in the mandible, but both sides of condyle involved has never been reported. Here, we describe a case of osteochondroma arising from the bilateral mandibular condyle. PMID:25932269

  11. Multiple long-standing massive oral mandibular granuloma gravidarum (pregnancy tumour).

    PubMed

    Rihani, Farouk Bassam; Ersheidat, Ala' Ahmad; Alsmadi, Hasan Faiz; Al-Nahar, Lina A

    2013-01-01

    Oral granuloma gravidarum (OGG) is a distinct clinical entity used to describe pyogenic granuloma developing mainly on the gingiva of pregnant women, possibly propagated by gingival high levels of active progesterone and poor oral hygiene. We report herein a 41-year-old woman presented 7 months after childbirth with two painless masses of OGG in mandibular gingiva that developed at the end of first trimester and increased gradually in size even after delivery. Surgical excisional biopsy was performed under general anaesthesia with extraction of periodontally involved mandibular anterior teeth. Proper oral hygiene in pregnant women is mandatory to prevent such oral condition. PMID:23813519

  12. Multiple long-standing massive oral mandibular granuloma gravidarum (pregnancy tumour)

    PubMed Central

    Rihani, Farouk Bassam; Ersheidat, Ala’ Ahmad; Alsmadi, Hasan Faiz; Al-Nahar, Lina A

    2013-01-01

    Oral granuloma gravidarum (OGG) is a distinct clinical entity used to describe pyogenic granuloma developing mainly on the gingiva of pregnant women, possibly propagated by gingival high levels of active progesterone and poor oral hygiene. We report herein a 41-year-old woman presented 7 months after childbirth with two painless masses of OGG in mandibular gingiva that developed at the end of first trimester and increased gradually in size even after delivery. Surgical excisional biopsy was performed under general anaesthesia with extraction of periodontally involved mandibular anterior teeth. Proper oral hygiene in pregnant women is mandatory to prevent such oral condition. PMID:23813519

  13. Hybrid approach to fabrication of hollow internally weighted mandibular denture: A case report

    PubMed Central

    Hazari, Puja; Mishra, Sunil Kumar

    2015-01-01

    Preservation of ridge dimensions is critical for denture success. For long the concept of an internally weighted denture, which suggested that gravity and the additional weight to the mandibular complete denture aids in prosthetic retention is widely accepted. However, excessive weight and pressure can accelerate bone resorption. Here, we describe a unique modification of internally weighted metal denture base for the resorbed mandibular ridge with an incorporated additional hollow section over the anterior knife-edge ridge. The weight provided retention and stability while the hollow portion prevented further resorption of the bone. PMID:26604604

  14. Interspecies difference in placement of developing teeth and its relationship with cross-sectional geometry of the mandibular symphysis in four primate species including modern humans.

    PubMed

    Fukase, Hitoshi

    2012-02-01

    The form of the anthropoid mandibular symphysis has recently been addressed in association with spatial requirements for the forming anterior teeth. To evaluate potential relationships between the symphyseal shape and teeth further, the growth patterns of the symphyseal region and the positioning of the tooth crypts were examined using CT data, comparing four primate species (modern humans, chimpanzees, Japanese monkeys, and hamadryas baboons) with varied symphyseal curvature and tooth size. First, results showed that interspecies differences in overall mandibular shape including symphyseal inclination and bicanine width are consistently expressed throughout postnatal ontogeny, although local symphyseal configurations related to the superior transverse torus (STT) tended to change considerably during growth in chimpanzees. Second, the four species were found to exhibit differentiated formation positions of the incisor and canine crypts. In particular, I2 developed between I1 and C in humans with a broad bicanine space and small teeth, whereas it was positioned posterior to I1 and above C in the cercopithecines with an extremely narrow bicanine space. In chimpanzees, despite the large bicanine width, I1 and I2 grew with a large antero-posterior overlap owing to their large size. These results indicate that the dental positioning is determined in concert with the size balance of the available mandibular space and forming teeth. Finally, the positions/contours of I2 crypt were shown to correspond strongly with the STT across the taxa. This suggests that interspecies differences in symphyseal shape should be interpreted partially by the species-specific positional relationships of the developing anterior teeth. PMID:22120684

  15. Growth differentiation factor 11 signals through the transforming growth factor-beta receptor ALK5 to regionalize the anterior-posterior axis.

    PubMed

    Andersson, Olov; Reissmann, Eva; Ibáñez, Carlos F

    2006-08-01

    Growth differentiation factor 11 (GDF11) contributes to regionalize the mouse embryo along its anterior-posterior axis by regulating the expression of Hox genes. The identity of the receptors that mediate GDF11 signalling during embryogenesis remains unclear. Here, we show that GDF11 can interact with type I receptors ALK4, ALK5 and ALK7, but predominantly uses ALK4 and ALK5 to activate a Smad3-dependent reporter gene. Alk5 mutant embryos showed malformations in anterior-posterior patterning, including the lack of expression of the posterior determinant Hoxc10, that resemble defects found in Gdf11-null mutants. A heterozygous mutation in Alk5, but not in Alk4 or Alk7, potentiated Gdf11(-/-)-like phenotypes in vertebral, kidney and palate development in an Acvr2b(-/-) background, indicating a genetic interaction between the two receptor genes. Thus, the transforming growth factor-beta (TGF-beta) receptor ALK5, which until now has only been associated with the biological functions of TGF-beta1 to TGF-beta3 proteins, mediates GDF11 signalling during embryogenesis. PMID:16845371

  16. Regional cerebral metabolic patterns demonstrate the role of anterior forebrain mesocircuit dysfunction in the severely injured brain

    PubMed Central

    Fridman, Esteban A.; Beattie, Bradley J.; Broft, Allegra; Laureys, Steven; Schiff, Nicholas D.

    2014-01-01

    Although disorders of consciousness (DOCs) demonstrate widely varying clinical presentations and patterns of structural injury, global down-regulation and bilateral reductions in metabolism of the thalamus and frontoparietal network are consistent findings. We test the hypothesis that global reductions of background synaptic activity in DOCs will associate with changes in the pattern of metabolic activity in the central thalamus and globus pallidus. We compared 32 [18F]fluorodeoxyglucose PETs obtained from severely brain-injured patients (BIs) and 10 normal volunteers (NVs). We defined components of the anterior forebrain mesocircuit on high-resolution T1-MRI (ventral, associative, and sensorimotor striatum; globus pallidus; central thalamus and noncentral thalamus). Metabolic profiles for BI and NV demonstrated distinct changes in the pattern of uptake: ventral and association striatum (but not sensorimotor) were significantly reduced relative to global mean uptake after BI; a relative increase in globus pallidus metabolism was evident in BI subjects who also showed a relative reduction of metabolism in the central thalamus. The reversal of globus pallidus and central thalamus profiles across BIs and NVs supports the mesocircuit hypothesis that broad functional (or anatomic) deafferentation may combine to reduce central thalamus activity and release globus pallidus activity in DOCs. In addition, BI subjects showed broad frontoparietal metabolic down-regulation consistent with prior studies supporting the link between central thalamic/pallidal metabolism and down-regulation of the frontoparietal network. Recovery of left hemisphere frontoparietal metabolic activity was further associated with command following. PMID:24733913

  17. Regional cerebral metabolic patterns demonstrate the role of anterior forebrain mesocircuit dysfunction in the severely injured brain.

    PubMed

    Fridman, Esteban A; Beattie, Bradley J; Broft, Allegra; Laureys, Steven; Schiff, Nicholas D

    2014-04-29

    Although disorders of consciousness (DOCs) demonstrate widely varying clinical presentations and patterns of structural injury, global down-regulation and bilateral reductions in metabolism of the thalamus and frontoparietal network are consistent findings. We test the hypothesis that global reductions of background synaptic activity in DOCs will associate with changes in the pattern of metabolic activity in the central thalamus and globus pallidus. We compared 32 [(18)F]fluorodeoxyglucose PETs obtained from severely brain-injured patients (BIs) and 10 normal volunteers (NVs). We defined components of the anterior forebrain mesocircuit on high-resolution T1-MRI (ventral, associative, and sensorimotor striatum; globus pallidus; central thalamus and noncentral thalamus). Metabolic profiles for BI and NV demonstrated distinct changes in the pattern of uptake: ventral and association striatum (but not sensorimotor) were significantly reduced relative to global mean uptake after BI; a relative increase in globus pallidus metabolism was evident in BI subjects who also showed a relative reduction of metabolism in the central thalamus. The reversal of globus pallidus and central thalamus profiles across BIs and NVs supports the mesocircuit hypothesis that broad functional (or anatomic) deafferentation may combine to reduce central thalamus activity and release globus pallidus activity in DOCs. In addition, BI subjects showed broad frontoparietal metabolic down-regulation consistent with prior studies supporting the link between central thalamic/pallidal metabolism and down-regulation of the frontoparietal network. Recovery of left hemisphere frontoparietal metabolic activity was further associated with command following. PMID:24733913

  18. 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

  19. Radiographic evaluation of the course and visibility of the mandibular canal

    PubMed Central

    Jung, Yun-Hoa

    2014-01-01

    Purpose This study was performed to investigate the course of the mandibular canal on panoramic radiography and the visibility of this canal on both panoramic radiography and cone-beam computed tomography (CBCT). Materials and Methods The study consisted of panoramic radiographs and CBCT images from 262 patients. The course of the mandibular canal, as seen in panoramic radiographs, was classified into four types: linear, elliptical, spoon-shaped, and turning curves. The visibility of this canal from the first to the third molar region was evaluated by visually determining whether the mandibular canal was clearly visible, probably visible, or invisible. The visibihlity of the canal on panoramic radiographs was compared with that on CBCT images. Results Elliptical curves were most frequently observed along the course of the mandibular canal. The percentage of clearly visible mandibular canals was the highest among the spoon-shaped curves and the lowest among the linear curves. On panoramic radiographs, invisible mandibular canals were found in 22.7% of the examined sites in the first molar region, 11.8% in the second molar region, and 1.3% in the third molar region. On CBCT cross-sectional images, the mandibular canal was invisible in 8.2% of the examined sites in the first molar region, 5.7% in the second molar region, and 0.2% in the third molar region. Conclusion The visibility of this canal was lower in the first molar region than in the third molar region. The mandibular canal presented better visibility on CBCT images than on panoramic radiographs. PMID:25473634

  20. Management of mandibular angle fracture.

    PubMed

    Braasch, Daniel Cameron; Abubaker, A Omar

    2013-11-01

    Fractures through the angle of the mandible are one of the most common facial fractures. The management of such fractures has been controversial, however. This controversy is related to the anatomic relations and complex biomechanical aspects of the mandibular angle. The debate has become even more heated since the evolution of rigid fixation and the ability to provide adequate stability of the fractured segments. This article provides an overview of the special anatomic and biomechanical features of the mandibular angle and their impact on the management of these fractures. PMID:24183373

  1. Bilateral molariform mandibular second premolars.

    PubMed

    Acharya, Sonu; Kumar Mandal, Pradip; Ghosh, Chiranjit

    2015-01-01

    Macrodontia is a rare dental anomaly that refers to teeth that appear larger than normal. Generalised macrodontia can be associated with certain medical conditions and syndromes. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 14-year-old child. The patient was referred to the clinic with local crowding of maxillary and mandibular teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolar on one side and erupted macrodontic premolar on the other side and their distinct morphological appearance, characterized by large, multitubercular, and molariform crowns and tapering, single roots. PMID:25685564

  2. Overwhelming hypercalcaemia in mandibular ameloblastoma.

    PubMed

    Lo, Tom Edward Ngo; Villafuerte, Cesar Vincent; Acampado, Laura Trajano

    2014-01-01

    Ameloblastoma is considered to be a benign odontogenic tumour of epithelial in origin that is slow growing but recurrent and invasive in nature. Some of its features have been sources of debate among experts regarding its benign or malignant character. We report a case of a 20-year-old Filipino woman with right mandibular ameloblastoma presenting with overwhelming hypercalcaemia. Work ups for hypercalcaemia eventually revealed tumoral hypercalcaemia, which was initially controlled with intravenous bisphosphanate. The patient eventually underwent tumour excision and mandibular reconstruction, which totally corrected hypercalcaemia. This case will highlight the rare association of hypercalcaemia among patients with ameloblastoma. PMID:25326561

  3. Bifocal mandibular fractures: which should be treated first?

    PubMed

    Dell' Aversana Orabona, Giovanni; Iaconetta, Giorgio; Abbate, Vincenzo; Califano, Luigi

    2012-11-01

    Fractures of the mandible have been reported to account between 40% and 62% of all facial fractures. Most surveys show that just under 50% are isolated, the same amount are doubly fractured. This study aims to clarify, according to our experience, the correct surgical sequence which should be followed in order to treat bifocal mandibular fractures. From January 2004 to January 2009, we have conducted a retrospective study on a sample of patients operated on in our department because of bifocal mandibular fractures. We include only those cases in which the jaw was fractured in 2 places, in particular patients who suffer a fracture in tooth-bearing areas (symphysis, parasymphysis, and anterior body) and also contralaterally in non-tooth-bearing areas (posterior body, angle, ramus, and condyle). The sample was divided into 2 groups based on the fracture sequence of reduction. At 1-year follow-up, the group of patients who received first the tooth-bearing fractured areas treatment, followed by treatment of non-tooth-bearing fractured area on bifocal mandibular fracture, showed less postoperative complications and reduced surgical time and costs. It is recommended from this study that reduction of the tooth-bearing fragment be prior to that of the tooth-free fragment for the bifocal mandible. PMID:23147333

  4. Peripharyngeal tissue deformation, stress distributions, and hyoid bone movement in response to mandibular advancement.

    PubMed

    Amatoury, Jason; Kairaitis, Kristina; Wheatley, John R; Bilston, Lynne E; Amis, Terence C

    2015-02-01

    Mandibular advancement (MA) increases upper airway (UA) patency and decreases collapsibility. Furthermore, MA displaces the hyoid bone in a cranial-anterior direction, which may contribute to MA-associated UA improvements via redistribution of peripharyngeal tissue stresses (extraluminal tissue pressure, ETP). In the present study, we examined effects of MA on ETP distributions, deformation of the peripharyngeal tissue surface (UA geometry), and hyoid bone position. We studied 13 supine, anesthetized, tracheostomized, spontaneously breathing adult male New Zealand White rabbits. Graded MA was applied from 0 to ∼4.5 mm. ETP was measured at six locations distributed throughout three UA regions: tongue, hyoid, and epiglottis. Axial computed tomography images of the UA (nasal choanae to glottis) were acquired and used to measure lumen geometry (UA length; regional cross-sectional area) and hyoid displacement. MA resulted in nonuniform decreases in ETP (greatest at tongue region), ranging from -0.11 (-0.15 to -0.06) to -0.82 (-1.09 to -0.54) cmH2O/mm MA [linear mixed-effects model slope (95% confidence interval)], across all sites. UA length decreased by -0.5 (-0.8 to -0.2) %/mm accompanied by nonuniform increases in cross-sectional area (greatest at hyoid region) ranging from 7.5 (3.6-11.4) to 18.7 (14.9-22.5) %/mm. The hyoid bone was displaced in a cranial-anterior direction by 0.42 (0.36-0.44) mm/mm MA. In summary, MA results in nonuniform changes in peripharyngeal tissue pressure distributions and lumen geometry. Displacement of the hyoid bone with MA may play a pivotal role in redistributing applied MA loads, thus modifying tissue stress/deformation distributions and determining resultant UA geometry outcomes. PMID:25505028

  5. A Clinical Study of Mandibular Angle Fracture

    PubMed Central

    Yoon, Wook-Jae; Kim, Su-Gwan; Oh, Ji-Su; You, Jae-Seek; Lim, Kyung-Seop; Shin, Seung-Min; Kim, Cheol-Man

    2014-01-01

    Purpose: To establish management protocol for mandibular angle fracture, we describe pertinent factors including cause, impacted third molar and recent treatment tendency. Methods: We examined the records of 62 patients who had unilateral mandibular angle fracture. Sixty patients who had open reduction surgery were examined at postoperative weeks 1, 4, 8, 12, and 28. Results: Left mandibular angle fracture is frequent in younger males. Presence of the mandibular third molar can increase fracture risk. Because of attached muscle, favorable fractures occurred primarily in the mandibular angle area. Conclusion: Extracting the mandibular third molar can prevent angle fractures, and open reduction with only one plate adaptation is generally the proper treatment method for mandibular angle fracture. PMID:27489834

  6. Pediatric maxillary and mandibular tumors.

    PubMed

    Trosman, Samuel J; Krakovitz, Paul R

    2015-02-01

    Pediatric maxillary and mandibular tumors offer considerable challenges to otolaryngologists, oral surgeons, pathologists, and radiologists alike. Because of the close proximity to vital structures, appropriate steps toward a definitive diagnosis and treatment plan are of paramount importance. This article reviews the most common causes of pediatric jaw masses and discusses diagnostic and therapeutic considerations and recommendations. PMID:25442129

  7. Mandibular development in Australopithecus robustus.

    PubMed

    Cofran, Zachary

    2014-07-01

    Australopithecus robustus has a distinct mandibular anatomy, with a broad and deep corpus and a tall, relatively upright ramus. How this anatomy arose through development is unknown, as gross mandibular size and shape change have not been thoroughly examined quantitatively in this species. Herein, I investigate A. robustus mandibular growth by comparing its ontogenetic series with a sample of recent humans, examining age-related size variation in 28 linear measurements. Resampling is used to compare the amount of proportional size change occurring between tooth eruption stages in the small and fragmentary A. robustus sample, with that of a more complete human skeletal population. Ontogenetic allometry of corpus robusticity is also assessed with least squares regression. Results show that nearly all measurements experience greater average increase in A. robustus than in humans. Most notably, A. robustus corpus breadth undergoes a spurt of growth before eruption of M1 , likely due in part to delayed resorption of the ramus root on the lateral corpus. Between the occlusion of M1 and M2 , nearly all dimensions experience greater proportional size change in A. robustus. Nested resampling analysis affirms that this pattern of growth differences between species is biologically significant, and not a mere byproduct of the fossil sample size. Some species differences are likely a function of postcanine megadontia in A. robustus, although the causes of other differences are less clear. This study demonstrates an important role of the postnatal period for mandibular shape development in this species. PMID:24820665

  8. The effect of bite-opening appliances on mandibular rotational growth and remodeling in the rhesus monkey (Macaca mulatta).

    PubMed

    Rowe, T K; Carlson, D S

    1990-12-01

    Previous experimental studies that have used a bite-block cemented to the maxillary dental arch have shown that the direction of growth of the maxillary complex is redirected in a superior and anterior direction for approximately 12 weeks but reassumes a normal inferior and anterior direction after that time. The purposes of this study were (1) to examine the effect of increased vertical dimension and altered mandibular posture on growth of the mandible and (2) to determine whether or not an alteration in chronic mandibular position alters mandibular intramatrix rotation. Eleven Macaca mulatta monkeys wore 15 mm vertical bite-opening appliances for 24 or 48 weeks. Nine untreated animals were used as controls. All animals received tantalum bone implants to facilitate cephalometric analysis. Serial lateral radiographs of the mandible were traced and superimposed on bone implants for each animal to determine overall changes in mandibular shape (gonial angle) and the location of bone remodeling. During normal growth, the gonial angle closed an average of 0.1 degrees over a 48-week period. In the experimental animals, the gonial angle opened 6.4 degrees (p less than 0.005) as a result of remodeling during the period that mandibular posture was altered. Once normal mandibular posture was restored, this process was reversed; the gonial angle once again became more acute over time, and remodeling along the body and ramus of the mandible was similar to that observed in control animals. These results suggest that mandibular growth and remodeling can be influenced by altered mandibular vertical posture. PMID:2248233

  9. Analysis and evaluation of relative positions of mandibular third molar and mandibular canal impacts

    PubMed Central

    Kim, Hang-Gul

    2014-01-01

    Objectives This study used cone-beam computed tomography (CBCT) images to categorize the relationships between the mandibular canal and the roots and investigated the prevalence of nerve damage. Materials and Methods Through CBCT images, contact and three-dimensional positional relationships between the roots of the mandibular third molar and the mandibular canal were investigated. With this data, prevalence of nerve damage according to the presence of contact and three-dimensional positional relationships was studied. Other factors that affected the prevalence of nerve damage were also investigated. Results When the mandibular third molar and the mandibular canal were shown to have direct contact in CBCT images, the prevalence of nerve damage was higher than in other cases. Also, in cases where the mandibular canal was horizontally lingual to the mandibular third molar and the mandibular canal was vertically at the cervical level of the mandibular third molar, the prevalence of nerve damage was higher than in opposite cases. The percentage of mandibular canal contact with the roots of the mandibular third molar was higher when the mandibular canal was horizontally lingual to the mandibular third molar. Finally, the prevalence of nerve damage was higher when the diameter of the mandibular canal lumen suddenly decreased at the contact area between the mandibular canal and the roots, as shown in CBCT images. Conclusion The three-dimensional relationship of the mandibular third molar and the mandibular canal can help predict nerve damage and can guide patient expectations of the possibility and extent of nerve damage. PMID:25551092

  10. Distribution of the lingual foramina in mandibular cortical bone in Koreans

    PubMed Central

    Kim, Dae Hyun; Kim, Moon Yong

    2013-01-01

    Objectives The interforminal region, between the mandibular foramen, is known as a relatively safe area that is free of anatomic structures, such as inferior alveolar nerve, submandibular fossa, and lingual side of the mandible is occasionally neglected for its low clinical importance. Even in the case of a severely constricted alveolus, perforation of the lingual cortical bone had been intended. However, anterior extension of the inferior alveolar canal, important anatomic structure, such as concavity of lingual bone, lingual foramina, and lingual canal, has recently been reported through various studies, and untypical bleeding by perforation of the lingual plate on implantation has also been reported. Therefore, in this study, we performed radiographic and statistical analysis on distribution and appearance frequencies of the lingual foramina that causes perforation of the mandibular lingual cortical bone to prevent complications, such as untypical bleeding, during surgical procedure. Materials and Methods We measured the horizontal length from a midline of the mandible to the lingual foramina, as well as the horizontal length from the alveolar crest to the lingual foramina and from the lingual foramina to the mandibular border by multi-detector computed tomography of 187 patients, who visited Dankook University Dental Hospital for various reasons from January 1, 2008 to August 31, 2012. Results From a total of 187 human mandibles, 110 (58.8%) mandibles had lingual foramina; 39 (20.9%) had bilateral lingual foramen; 34 (18.2%) had the only left lingual foramen; and 37 (19.8%) had the only right lingual foramen. Conclusion When there is consistent bleeding during a surgical procedure, clinicians must consider damages on the branches of the sublingual artery, which penetrate the lingual foramina. Also, when there is a lingual foramina larger than 1 mm in diameter on a pre-implantation computed tomography, clinicians must beware of vessel damage. In order to prevent

  11. A comparative study of incisor procumbency and mandibular morphology in vampire bats.

    PubMed

    Davis, Jillian S; Nicolay, Christopher W; Williams, Susan H

    2010-07-01

    The three species of vampire bats (Phyllostomidae: Desmodontinae), Desmodus rotundus, Diaemus youngi, and Diphylla ecaudata, are the only mammals that obtain all nutrition from vertebrate blood (sanguinivory). Because of the unique challenges of this dietary niche, vampire bats possess a suite of behavioral, physiological, and morphological specializations. Morphological specializations include a dentition characterized by small, bladelike, non-occlusive cheek teeth, large canines, and extremely large, procumbent, sickle-shaped upper central incisors. The tips of these incisors rest in cuplike pits in the mandible behind the lower incisors (mandibular pits). Here, we use microCT scanning and high-resolution radiography to describe the morphology of the mandible and anterior dentition in vampire bats, focusing on the relationship between symphyseal fusion, mandibular pit size, incisor size, and procumbency. In Desmodus and Diaemus, highly procumbent upper incisors are associated with relatively small mandibular pits, an unfused mandibular symphysis with substantial bony interdigitations linking the dentaries, and a diastema between the lower central incisors that helps to facilitate the lapping of blood from a wound. In Diphylla, less procumbent upper incisors are associated with relatively large mandibular pits, a completely fused mandibular symphysis, and a continuous lower toothrow lacking a central diastema. We hypothesize that symphyseal morphology and the presence or absence of the diastema are associated with the angle of upper incisor procumbency and mandibular pit development, and that spatial constraints influence the morphology of the symphysis. Finally, this morphological variation suggests that Diphylla utilizes a different feeding strategy as compared to Desmodus and Diaemus, possibly resulting from the functional demands of specialization on avian, rather than mammalian, blood. PMID:20544874

  12. Two-Year Success Rate of Implant-Retained Mandibular Overdentures by Novice General Dentistry Residents.

    PubMed

    Malmstrom, Hans; Xiao, Jin; Romanos, Georgios; Ren, Yan-Fang

    2015-06-01

    The purpose of the present study was to evaluate the clinical success and patient satisfaction when dental implant-retained mandibular overdentures are placed and restored by novice general dentistry residents. A total of 50 subjects who were dissatisfied with their mandibular complete dentures were enrolled in the study. Two dental implants were placed in the anterior mandible between the mental foramina by novice general dentistry residents under the direct supervision of the principal investigator. The resident attached the denture to the implants 3 to 4 months later using locator attachments. The implant success rate was determined by measuring bone loss, mobility, pocket probing depth, and gingival and plaque indices. Subjects were asked to complete a satisfaction questionnaire with the prosthesis at 3 months, 1 year, and 2 years after overdenture delivery. A total of 100 implants were placed in the 50 study subjects. Of these, 2 implants were lost in 1 subject, and 1 subject died due to unrelated causes. Of the 48 remaining subjects, 45 have had their implants restored with overdentures. The subjects' overall satisfaction with fit and ability to chew hard foods with their mandibular overdentures improved significantly (P < .05) following the denture attachment to the dental implants. We conclude that novice general dentistry residents can successfully place mandibular implants and restore them with overdentures under direct supervision, subsequently enhancing the subjects' satisfaction with their mandibular dentures. PMID:24188137

  13. Assessment of Growth Using Mandibular Canine Calcification Stages and Its Correlation with Modified MP3 Stages

    PubMed Central

    Nayak, US Krishna; Hegde, Gautam

    2010-01-01

    Background and objectives Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. Methods A total of 160 periapical radiographs (80 males and 80 females), of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian’s stages of dental calcification and the modified MP3 stages. Results The correlation between the developmental stages of MP3 and the mandibular right canine in male and female groups, is of high statistical significance (p = 0.001). The correlation coefficient between MP3 stages and developmental stages of mandibular canine and chronological age in male and females was found to be not significant. Conclusions The correlation between the mandibular canine calcification stages and MP3 stages was found to be significant. The developmental stages of the mandibular canine could be used very reliably as a sole indicator for assessment of skeletal maturity.

  14. 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

  15. Comparison of sexual dimorphism of permanent mandibular canine with mandibular first molar by odontometrics

    PubMed Central

    Agrawal, Aditi; Manjunatha, Bhari Shranesha; Dholia, Bhavik; Althomali, Yousef

    2015-01-01

    Background and Objectives: Sexual dimorphism is one of important tool of forensic science. The objective of this study is to assess the dimorphic status of mesio-distal (MD) and bucco-lingual (BL) diameter of mandibular canine with mandibular first molar among the students of dental college. This study is of definite significance as sex chromosomes and hormonal production influenced tooth morphology. Materials and Methods: The descriptive study adopted the purposive sampling technique, of 50 male and 50 female aged 17-25 years, using study casts for mesio-distal and bucco-lingual dimensions of mandibular canine with mandibular first molar were taken using digital Vernier caliper. The data obtained were subjected to statistical analysis using descriptive statistics and t-test to compare MD and BL dimensions in male and female populations and P ≤ 0.05 was found statistically significant. Results: Sexual dimorphism can be predicted by measuring mesiodistal dimension of mandibular canine and mandibular first molar. The left mandibular canine showed more sexual dimorphism (12.66%) in comparison to left mandibular first molar (0.824%) only. Right mandibular canine showed greater dimorphism in MD dimensions (10.94%) in comparison to right mandibular first molar (6.96%). In bucco-lingual dimensions mandibular canine showed less variability when compared with mandibular first molar, thus our study showed more significance on mesio-distal dimensions of both teeth. Conclusion: The present study concludes statistically significant sexual dimorphism in mandibular canine over mandibular first molar on study casts. The MD dimensions in mandibular canine and mandibular first molar can help in determining sex and identification of unknown person. PMID:26816466

  16. Mandibular implant-supported fixed dental prosthesis with a modified design: a clinical report.

    PubMed

    Tourah, Anita; Moshaverinia, Alireza; Chee, Winston W

    2014-02-01

    This clinical report describes the rehabilitation of a patient with a mandibular implant-supported fixed dental prosthesis. Because of the limited restorative space available in the posterior mandible and in considering the higher wear rate of acrylic resin in comparison with titanium when it opposes metal ceramic restorations, the treatment used a milled titanium bar with acrylic resin denture teeth, which replaced the anterior teeth with milled titanium for the posterior occluding surfaces. PMID:24262946

  17. Pearls of Mandibular Trauma Management

    PubMed Central

    Koshy, John C.; Feldman, Evan M.; Chike-Obi, Chuma J.; Bullocks, Jamal M.

    2010-01-01

    Mandibular trauma is a common problem seen by plastic surgeons. When fractures occur, they have the ability to affect the patient's occlusion significantly, cause infection, and lead to considerable pain. Interventions to prevent these sequelae require either closed or open forms of reduction and fixation. Physicians determining how to manage these injuries should take into consideration the nature of the injury, background information regarding the patient's health, and the patient's comorbidities. Whereas general principles guide the management of the majority of injuries, special consideration must be paid to the edentulous patient, complex and comminuted fractures, and pediatric patients. These topics are discussed in this article, with a special emphasis on pearls of mandibular trauma management. PMID:22550460

  18. Quantified regional and laminar distribution of the noradrenaline innervation in the anterior half of the adult rat cerebral cortex.

    PubMed

    Audet, M A; Doucet, G; Oleskevich, S; Descarries, L

    1988-08-15

    The regional and laminar distribution of the noradrenaline (NA) innervation in the adult rat cerebral cortex was quantified in radioautographs of semithin sections from whole hemisphere slices incubated with tritiated catecholamines and a monoamine oxidase inhibitor. Uptake-labeled axonal varicosities (aggregates of silver grains) were counted with the help of a computerized image analyzer in seven cytoarchitectonic areas of the rostral half of the cortex: Cg3, rostral AID, Cg2, Fr1, Par1, caudal AID, and Pir (prepiriform) according to Zilles's nomenclature. Both dopamine (DA) and NA terminals were detected after incubation with [3H]DA and citalopram or with [3H]NA alone. In the presence of desipramine (DMI), DA terminals alone were demonstrated; the number of NA terminals was then obtained by subtraction from counts in adjacent slices incubated with or without DMI. These counts suggested that DA and NA varicosities were fully visualized only after labeling with their respective tritiated amine. Similar numbers of labeled NA varicosities as inferred after [3H]NA incubation with or without DMI were observed after [3H]NA incubation in the presence of benztropine (BZ). This indicated that NA terminals were then maximally detected to the exclusion of the DA ones, and the latter approach was adopted for the acquisition of normative data. Since the average diameter of the labeled NA varicosities was known from earlier measurements in electron microscope radioautographs, the initial counts of labeled sites/mm2 of histological section could be expressed as numbers of varicosities/mm3 of tissue following a double correction for incomplete detection at the chosen duration of radioautographic exposure and section thickness. The overall density of NA innervation was thus estimated at 1.2 million varicosities/mm3 of tissue, with no statistically significant differences between the seven cortical areas examined. In every region, the number of NA terminals was the greatest in the

  19. Regenerative Approach to Bilateral Rostral Mandibular Reconstruction in a Case Series of Dogs

    PubMed Central

    Arzi, Boaz; Cissell, Derek D.; Pollard, Rachel E.; Verstraete, Frank J. M.

    2015-01-01

    Extensive rostral mandibulectomy in dogs typically results in instability of the mandibles that may lead to malocclusion, difficulty in prehension, mastication, and pain of the temporomandibular joint. Large rostral mandibular defects are challenging to reconstruct due to the complex geometry of this region. In order to restore mandibular continuity and stability following extensive rostral mandibulectomy, we developed a surgical technique using a combination of intraoral and extraoral approaches, a locking titanium plate, and a compression resistant matrix (CRM) infused with rhBMP-2. Furthermore, surgical planning that consisted of computed tomographic (CT) scanning and 3D model printing was utilized. We describe a regenerative surgical technique for immediate or delayed reconstruction of critical-size rostral mandibular defects in five dogs. Three dogs had healed with intact gingival covering over the mandibular defect and had immediate return to normal function and occlusion. Two dogs had the complication of focal plate exposure and dehiscence, which was corrected with mucosal flaps and suturing; these dogs have since healed with intact gingival covering over the mandibular defect. Mineralized tissue formation was palpated clinically within 2 weeks and solid bone formation within 3 months. CT findings at 6 months postoperatively demonstrated that the newly regenerated mandibular bone had increased in mineral volume with evidence of integration between the native bone, new bone, and CRM compared to the immediate postoperative CT. We conclude that rostral mandibular reconstruction using a regenerative approach provides an excellent solution for restoring mandibular continuity and preventing mandibular instability in dogs. PMID:26664933

  20. Adenomatoid odontogenic tumor associated with an unerupted mandibular lateral incisor: a case report

    PubMed Central

    2015-01-01

    Adenomatoid odontogenic tumor (AOT) is a rare, benign odontogenic tumor that predominantly appears in the second decade of life in female patients. Most AOTs occur in the anterior part of the maxilla and are usually associated with impacted anterior teeth. There are three types of AOT, follicular, extrafollicular, and peripheral, which are classified based on the location of the lesion and its association with the impacted tooth. We report a rare case of AOT associated with an impacted right mandibular lateral incisor in an 11-year-old female patient. PMID:26734563

  1. Genetic Variation in Myosin 1H Contributes to Mandibular Prognathism

    PubMed Central

    Tassopoulou-Fishell, Maria; Deeley, Kathleen; Harvey, Erika M.; Sciote, James; Vieira, Alexandre R.

    2013-01-01

    Introduction Several candidate loci have been suggested as influencing mandibular prognathism (1p22.1, 1p22.2, 1p36, 3q26.2, 5p13-p12, 6q25, 11q22.2-q22.3, 12q23, 12q13.13, and 19p13.2). The goal of this study was to replicate these results in a well-characterized homogeneous sample set. Methods Thirty-three single nucleotide polymorphisms spanning all candidate regions were studied in 44 prognathic and 35 Class I subjects from the University of Pittsburgh School of Dental Medicine Dental Registry and DNA Repository. The 44 mandibular prognathism subjects had an average age of 18.4 years, 31 were females and 13 males, and 24 were White, 15 African American, two Hispanic, and three Asian. The 35 Class I subjects had an average age of 17.6 years, 27 were females and 9 males, and 27 were White, six African Americans, one Hispanic, and two Asian. Skeletal mandibular prognathism diagnosis included cephalometric values indicative of Class III such as ANB smaller than two degrees, negative Witts appraisal, and positive A–B plane. Additional mandibular prognathism criteria included negative OJ and visually prognathic (concave) profile as determined by the subject's clinical evaluation. Orthognathic subjects without jaw deformations were used as a comparison group. Mandibular prognathism and orthognathic subjects were matched based on race, sex and age. Genetic markers were tested by polymerase chain reaction using TaqMan chemistry. Chi-square and Fisher exact tests were used to determine overrepresentation of marker allele with alpha of 0.05. Results An association was unveiled between a marker in MYO1H (rs10850110) and the mandibular prognathism phenotype (p=0.03). MYO1H is a Class-I myosin that is in a different protein group than the myosin isoforms of muscle sarcomeres, which are the basis of skeletal muscle fiber typing. Class I myosins are necessary for cell motility, phagocytosis and vesicle transport. Conclusions More strict clinical definitions may increase

  2. Anatomy of Mandibular Vital Structures. Part II: Mandibular Incisive Canal, Mental Foramen and Associated Neurovascular Bundles in Relation with Dental Implantology

    PubMed Central

    Wang, Hom-Lay; Sabalys, Gintautas

    2010-01-01

    ABSTRACT Objectives The purpose of the present study was to review the literature of how to identify the mental foramen, mandibular incisive canal and associated neurovascular bundles during implant surgery and how to detect and avoid the damage of these vital structures during implant therapy. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandibular incisive canal, mental foramen, mental nerve, anterior mental loop. The search was restricted to English language articles, published from 1979 to November 2009. Additionally, a manual search in the major anatomy, dental implant, and periodontal journals and books was performed. Results In total, 47 literature sources were obtained and reviewed. The morphology and variations of the mandibular incisive canal, mental foramen and associated neurovascular bundles were presented as two entities. It suggested that clinicians should carefully assess these vital structures to avoid nerve/artery damage. Conclusions The mandibular incisive canal, mental foramen and associated neurovascular bundles exist in different locations and possess many variations. Individual, gender, age, race, assessing technique used and degree of edentulous alveolar bone atrophy largely influence these variations. It suggests that the clinicians should carefully identify these anatomical landmarks, by analyzing all influencing factors, prior to their implant surgical operation. PMID:24421959

  3. Findings of a Four-Year Randomized Controlled Clinical Trial Comparing Two-Piece and One-Piece Zirconia Abutments Supporting Single Prosthetic Restorations in Maxillary Anterior Region.

    PubMed

    Paolantoni, Guerino; Marenzi, Gaetano; Blasi, Andrea; Mignogna, Jolanda; Sammartino, Gilberto

    2016-01-01

    The purpose of this randomized controlled study is to investigate the clinical results obtained over four years and incidence of complications associated with one- versus two-piece custom made zirconia anchorages, in single tooth implant-supported restorations of the maxillary anterior region. Sixty-five patients, with a total of 74 missing maxillary teeth, were selected in the period from February 2007 to July 2010. Two different ways of custom made zirconia abutment and final prosthetic restoration were evaluated: a standard zirconia abutment associated with a pressed layer of lithium disilicate with an all-ceramic cemented restoration versus one-piece restoration with the facing porcelain fired and pressed straight to the custom made zirconia abutment. In 29 cases, the restoration consisted of an all-ceramic restoration for cementation (two pieces); in 45 cases the restoration was a screw-retained restoration (one piece). Three all-ceramic restorations broke during the observation time. Two one-piece restorations fractured after 26 months. At follow-up examination there were no significant differences between one-piece and two-piece groups regarding the PI, BI, and MBL. Awaiting studies with longer follow-up times, a careful conclusion is that zirconia anchorages for single-implant restorations seem to demonstrate good short-term technical and biological results. PMID:27027093

  4. Findings of a Four-Year Randomized Controlled Clinical Trial Comparing Two-Piece and One-Piece Zirconia Abutments Supporting Single Prosthetic Restorations in Maxillary Anterior Region

    PubMed Central

    Paolantoni, Guerino; Marenzi, Gaetano; Blasi, Andrea; Mignogna, Jolanda; Sammartino, Gilberto

    2016-01-01

    The purpose of this randomized controlled study is to investigate the clinical results obtained over four years and incidence of complications associated with one- versus two-piece custom made zirconia anchorages, in single tooth implant-supported restorations of the maxillary anterior region. Sixty-five patients, with a total of 74 missing maxillary teeth, were selected in the period from February 2007 to July 2010. Two different ways of custom made zirconia abutment and final prosthetic restoration were evaluated: a standard zirconia abutment associated with a pressed layer of lithium disilicate with an all-ceramic cemented restoration versus one-piece restoration with the facing porcelain fired and pressed straight to the custom made zirconia abutment. In 29 cases, the restoration consisted of an all-ceramic restoration for cementation (two pieces); in 45 cases the restoration was a screw-retained restoration (one piece). Three all-ceramic restorations broke during the observation time. Two one-piece restorations fractured after 26 months. At follow-up examination there were no significant differences between one-piece and two-piece groups regarding the PI, BI, and MBL. Awaiting studies with longer follow-up times, a careful conclusion is that zirconia anchorages for single-implant restorations seem to demonstrate good short-term technical and biological results. PMID:27027093

  5. Geometry of anterior open bite correction.

    PubMed

    Abramson, Zachary R; Susarla, Srinivas M; Lawler, Matthew E; Choudhri, Asim F; Peacock, Zachary S

    2015-05-01

    Correction of anterior open bite is a frequently encountered and challenging problem for the craniomaxillofacial surgeon and orthodontist. Accurate clinical evaluation, including cephalometric assessment, is paramount for establishing the diagnosis and appropriate treatment plan. The purposes of this technical note were to discuss the basic geometric principles involved in the surgical correction of skeletal anterior open bites and to offer a simple mathematical model for predicting the amount of posterior maxillary impaction with concomitant mandibular rotation required to establish an adequate overbite. Using standard geometric principles, a mathematical model was created to demonstrate the relationship between the magnitude of the open bite and the magnitude of the rotational movements required for correction. This model was then validated using a clinical case. In summary, the amount of open bite closure for a given amount of posterior maxillary impaction depends on anatomic variables, which can be obtained from a lateral cephalogram. The clinical implication of this relationship is as follows: patients with small mandibles and steep mandibular occlusal planes will require greater amounts of posterior impaction. PMID:25950521

  6. Fusion or gemination? An unusual mandibular second molar

    PubMed Central

    Camargo, Angela Jordão; Arita, Emiko Saito; Watanabe, Plauto Christopher Aranha

    2015-01-01

    Fusion and gemination is not an uncommon finding and affected most primary dentition and the permanent maxillary incisors. These changes can develop a series of complication. A 11-year-old male presented radiography finding: an unusual mandibular second molar. A well-documented case brings a challenge for radiologists classify between fusion and gemination. In conclusion, this alteration although common in other regions, there are no case in the literature involving “second and third” molar. PMID:26945485

  7. Fusion or gemination? An unusual mandibular second molar.

    PubMed

    Camargo, Angela Jordão; Arita, Emiko Saito; Watanabe, Plauto Christopher Aranha

    2016-01-01

    Fusion and gemination is not an uncommon finding and affected most primary dentition and the permanent maxillary incisors. These changes can develop a series of complication. A 11-year-old male presented radiography finding: an unusual mandibular second molar. A well-documented case brings a challenge for radiologists classify between fusion and gemination. In conclusion, this alteration although common in other regions, there are no case in the literature involving "second and third" molar. PMID:26945485

  8. Alterations in brain connectivity in three sub-regions of the anterior cingulate cortex in heroin-dependent individuals: Evidence from resting state fMRI.

    PubMed

    Zhang, Y; Gong, J; Xie, C; Ye, E M; Jin, X; Song, H; Yang, Z; Shao, Y

    2015-01-22

    Previous studies that utilized task-based approaches have demonstrated that the chronic use of heroin is associated with altered activity of the anterior cingulate cortex (ACC). However, few studies have focused on examining the variation in resting-state functional connectivity in heroin-dependent individuals, which might help further understanding the mechanisms underlying heroin addiction. Due to the structural and functional heterogeneity of the ACC, we systematically mapped the resting-state functional connectivity patterns of three sub-regions of the ACC in heroin-dependent individuals, wondered whether the partition of three sub-regions of the ACC is feasible in heroin-dependent individuals, and identified how heroin affected the correlated activities among three sub-regions of the ACC using resting-state functional magnetic resonance imaging (fMRI). In the present study, fMRI data were acquired from 21 heroin-dependent individuals (Her group) and 15 non-addicted controls (CN group). Compared to controls, there were reduced functional connectivities in the dorsal ACC (dACC) and rostral ACC (rACC) networks with different areas of the dorsal striatum (the caudate and the putamen) in the Her group. Meanwhile, there exhibited an inverted alteration of pattern for orbital frontal cortex (OFC) and superior frontal gyrus (SFG) in the functional connectivity network with the dACC and subcallosal ACC (sACC), and a different alteration of the cerebellum and the amygdala in the functional connectivity network with the rACC and the sACC. In addition, we also found reduced connectivities between dACC and rACC, as well as reduced connectivities between sACC and dACC. Our findings of variations of functional connectivities in three sub-regions of ACC in Her group implied that these sub-regions of the ACC together with other key brain areas (such as dorsal striatum, OFC, SFG, cerebellum, amygdale, etc.) might potentially play independent and/or overlapping roles in heroin

  9. Endodontic disease of the mandibular first molar tooth secondary to caudal crossbite in a young Shetland sheepdog.

    PubMed

    Brine, E J

    1999-03-01

    A six month-old intact female Shetland sheepdog was referred to the University of Illinois Veterinary Dental Clinic with a left-sided mandibular deviation and a thickened left ventral mandible in the region of the first molar tooth. On oral examination, left caudal crossbite was diagnosed. Dental radiographs revealed endodontic disease of the mandibular first molar tooth involved in the crossbite. Because of the difficulty of treating caudal crossbite and the potential of a pathological mandibular fracture, the endodontically affected tooth was extracted. Ten months following the extraction, mandibular deviation and alveolar bone lysis were resolved, but alveolar ridge resorption was present. The abnormal occlusal relationship caused by the caudal crossbite may have led to movement of the tooth, resorption of the tooth alveolus, and irreversible pulpal damage. Although not employed in this case, use of alveolar ridge preservation techniques can prevent mandibular bone loss after extractions. PMID:10863516

  10. 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

  11. Mandibular incisive canal in Han Chinese using cone beam computed tomography.

    PubMed

    Kong, N; Hui, M; Miao, F; Yuan, H; Du, Y; Chen, N

    2016-09-01

    The aim of this study was to provide reference information for implantology and chin bone harvesting in people of Han Chinese ethnicity by studying the mandibular incisive canal (MIC) using cone beam computed tomography (CBCT). Fifty subjects were included in the study. CBCT scans were obtained for all subjects, and 22 also underwent panoramic radiography to evaluate the visibility of the MIC. The CBCT data of the 50 subjects were reconstructed to measure MIC diameter, length, and location within the mandible. A MIC was identified in 38.6% of panoramic radiographs, with good clarity in 13.6%, while a MIC was identified in 100% of CBCT images, with good clarity in 63.6%. The diameter of the MIC decreased from origin to end. The left and right average MIC lengths were 17.84mm and 17.73mm, respectively. The MIC was close to the buccal cortical border and lower margin of the mandible. In conclusion, the MIC is an anatomical structure in the mandible that can be identified reliably with CBCT. On insertion, implants should be inclined slightly towards the lingual aspect of the anterior mandible to protect the MIC. The chin bone harvesting depth should be limited to 4mm; the harvesting site can be adjusted to the region above or below the MIC. PMID:27184354

  12. Immediate Esthetic Rehabilitation of Periodontally Compromised Anterior Tooth Using Natural Tooth as Pontic

    PubMed Central

    Kumar, K. Pavan; Nujella, Surya Kumari; Gopal, S. Sujatha

    2016-01-01

    For patients who require removal of anterior teeth and their replacement various treatment modalities are available. With advancement in technology and availability of glass/polyethylene fibres, use of natural tooth as pontic with fibre reinforced composite restorations offers the promising results. The present case report describes management of periodontally compromised mandibular anterior tooth using natural tooth pontic with fibre reinforcement. A 1-year follow-up showed that the bridge was intact with good esthetics and no problem was reported. PMID:27195156

  13. Immediate Esthetic Rehabilitation of Periodontally Compromised Anterior Tooth Using Natural Tooth as Pontic.

    PubMed

    Kumar, K Pavan; Nujella, Surya Kumari; Gopal, S Sujatha; Roy, K Karthik

    2016-01-01

    For patients who require removal of anterior teeth and their replacement various treatment modalities are available. With advancement in technology and availability of glass/polyethylene fibres, use of natural tooth as pontic with fibre reinforced composite restorations offers the promising results. The present case report describes management of periodontally compromised mandibular anterior tooth using natural tooth pontic with fibre reinforcement. A 1-year follow-up showed that the bridge was intact with good esthetics and no problem was reported. PMID:27195156

  14. Giant osteochondroma of the mandibular condyle

    PubMed Central

    Sekhar, MR Muthu; Loganathan, S

    2015-01-01

    Osteochondroma or osteocartilaginous exostosis is an exophytic lesion that arises from the cortex of the bone and is cartilage-capped. Osteochondroma of the mandibular condyle is extremely rare. The following is a case report of an osteochondroma of the mandibular condyle removed via extended preauricular approach to the temporomandibular joint. PMID:26980978

  15. Volumetric stability of autogenous bone graft with mandibular body bone: cone-beam computed tomography and three-dimensional reconstruction analysis

    PubMed Central

    Lee, Hyeong-Geun

    2015-01-01

    Objectives The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated. Materials and Methods Ninety-five patients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric stability was evaluated by serial CBCT images. Results No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was 74.6%±8.4%. Conclusion Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want dental implants regardless of atrophic alveolar bone. PMID:26568924

  16. Sertraline induced acute mandibular dystonia

    PubMed Central

    Raveendranathan, Dhanya; Rao, Swaminath Gopala

    2015-01-01

    Specific serotonin reuptake inhibitors have been linked with the occurrence of drug-induced parkinsonism, dystonia, dyskinesia, and akathisia. Here, we describe a patient with a diagnosis of emotionally unstable personality disorder and depression who developed severe mandibular dystonia with sertraline in the absence of concurrent prescription of medications, which have potential action on the dopaminergic system. This case highlights the need for clinicians to be aware of this alarming acute adverse effect with sertraline, which is conventionally considered to be well-tolerated and safe. PMID:26752908

  17. Osteochondroma of the mandibular condyle: Resection and reconstruction using vertical sliding osteotomy of the mandibular ramus.

    PubMed

    González-Otero, Sergio; Navarro-Cuéllar, Carlos; Escrig-de Teigeiro, Margarita; Fernández-Alba-Luengo, Javier; Navarro-Vila, Carlos

    2009-04-01

    Osteochondroma is one of the most common benign bone tumours, although not in the craniofacial region. More than half of these appear in the coronoid process. It can appear on the mandibular condyle, especially in its medial half, and mainly affects women aged around forty years. We present the case of a 51-year-old woman with pain of several months' duration in the right temporomandibular joint (TMJ) and no other symptoms. Panoramic radiography showed an enlarged condyle with no subchondral cysts. Computed tomography showed a bony proliferation with benign signs and a scintigraphy revealed an increased uptake in the condyle. Due to the painful clinical symptoms, a surgical procedure using preauricular and retromandibular approaches was performed to excise the condyle. The resulting defect, which was 9 mm high, was reconstructed by means of a vertical sliding osteotomy of the mandibular ramus and two miniplates for osteosynthesis. Almost two years later, the patient is symptom-free and has a normal opening with no malocclusion or deviation in the opening pattern. We present and discuss different reconstruction options after condylectomy. PMID:19333189

  18. Phacoemulsification in anterior megalophthalmos.

    PubMed

    Lee, Graham A; Hann, Joshua V; Braga-Mele, Rosa

    2006-07-01

    This case outlines the phacoemulsification technique used to overcome the challenge of the hyperdeep anterior chamber, weak zonules, abnormal anterior capsule, and large capsular bag. Key steps included trypan blue staining of the anterior capsule, a large capsulorhexis, prolapse of the nucleus into the anterior chamber with phacoemulsification anterior to the capsulorhexis, and a posterior chamber-placed iris-clip intraocular lens. Successful visual rehabilitation is achievable in these anatomically challenging eyes. PMID:16857490

  19. Frenectomy with anterior lingual sulcoplasty for an implant-supported overdenture: A clinical report.

    PubMed

    Perri de Carvalho, Paulo Sergio; Janjacomo, Luiz Antonio; Ponzoni, Daniela

    2016-04-01

    This clinical report describes the deepening of a patient's anterior mandibular lingual sulcus in combination with frenectomy and the use of an acrylic resin guiding device fixed to an osseointegrated dental implant to maintain the patency of the new sulcular depth. PMID:26723097

  20. Mandibular arch perimeter changes with lip bumper treatment.

    PubMed

    Osborn, W S; Nanda, R S; Currier, G F

    1991-06-01

    The effects of lip bumper treatment on the mandibular arch were observed in 32 patients with late transitional and early permanent dentitions. Dental cast measurements were made for arch perimeter, arch length, and arch width. Cephalometric radiographs were used to determine labial tipping of the incisors and distal movement of the molars. Arch circumference increased in all patients, ranging from 0.7 mm to 8.8 mm, with an average of 4.1 mm. The mean increase in arch length was 1.2 mm and was largely attributed to anterior tipping of the mandibular incisors. Change in arch length was the most predictive variable for the increase in arch circumference. Passive changes in arch width were recorded, with a mean increase of 2.0 mm in the intercanine distance and 2.5 mm in the first premolar distance. Arch width increments contributed to the increase in arch circumference, but the increases in arch width were not found to be predictive of the change in arch circumference. Changes in either arch circumference or arch length were not related to the duration of treatment, age and sex of the patient, or the eruption status of the permanent second molars. PMID:2038972

  1. Conservative orthodontic treatment of mandibular bilateral condyle fracture.

    PubMed

    Gašpar, Goran; Brakus, Ivan; Kovačić, Ivan

    2014-09-01

    Maxillofacial trauma is rare in children younger than the age of 5 years (range 0.6%-1.2%), and they can require different clinical treatment strategies compared with fractures in the adult population because of concerns regarding mandibular growth and development of dentition. A 5-year-old girl with a history of falling from a bicycle 7 hours earlier was referred to the department of oral and maxillofacial surgery. Multislice computed tomographic examination demonstrated a bilateral fracture of the mandibular condyle neck associated with minimal fracture of the alveolar ridge of the maxilla. The multislice computed tomographic scan also demonstrated dislocation on the right condyle neck and, on the left side, a medial inclination of approximately 45 degrees associated with greenstick fracture of the right parasymphysis region. In this particular case, orthodontic rubber elastics in combination with fixed orthodontic brackets provided good results in the treatment of bilateral condyle neck fractures associated with greenstick fracture of parasymphysis. PMID:25098573

  2. Ultrastructure of the mandibular gland of the ant Myrmoteras iriodum.

    PubMed

    Billen, Johan; Hashim, Rosli; Ito, Fuminori

    2016-07-01

    The mandibular gland in workers of the formicine ant Myrmoteras iriodum differs from other ants both in its general morphology and ultrastructural organization. The secretory cells appear in a pseudo-epithelial arrangement that gives them a clear polarity. At their apical side, the cells are characterized by a large cup-like extension of the reservoir, from which a bulbous invagination connects to a branched end apparatus. At the basal side, the cells show a labyrinth of basal invaginations, while the lateral cell contacts show clear interdigitations. The cytoplasmic composition reveals the presence of numerous round or elongate inclusions that contain crystalline material. Microtubules are abundant, and locally fibrillar regions are found. The function of the mandibular gland in M. iriodum has not yet been documented, and should be studied using gland extracts and behavioural observations. PMID:27130260

  3. Complications in the use of the mandibular body, ramus and symphysis as donor sites in bone graft surgery. A systematic review

    PubMed Central

    Cobo-Vázquez, Carlos; Monteserín-Matesanz, Marta; López-Quiles, Juan

    2016-01-01

    Background To develop a systematic review by assessing and comparing the different complications that occurs in bone graft surgery using the mandibular body, ramus and symphysis as donor sites. Material and Methods In order to respond to the following question, a systematic review was developed: does the use of intraoral mandibular body and ramus as donor sites in bone graft surgery, produce fewer and less severe complications in comparison to the use of the mandibular symphysis in patients that present bone resorption that needs augmentation using autologous grafts? The review was carried out between January 1990 and 2015, during which only clinical essays with a minimum follow-up period of six months were included. Results The initial search yielded a total of 2912 articles, of which 6 were finally selected. In total, 259 graft surgeries were performed; 118 using the mandibular body and ramus as donor sites, and 141, the symphysis. The most frequent complications that arose when using the mandibular symphysis were temporary sensory alterations in the anterior teeth (33.87%), followed by sensory alterations of the skin and mucosa (18.57%). As for the mandibular body and ramus donor sites, the most frequent complications relate to temporary sensory alterations of the mucosa (8.19%) and to minor postoperative bleeding (6.55%). Conclusions The analyzed results show a higher prevalence and severity of complications when using mandibular symphysis bone grafts, producing more discomfort for the patient. Therefore, it would be advisable to perform further clinical essays due to the lack of studies found. Key words:Alveolar ridge augmentation, autogenous bone, mandibular bone grafts, chin, mandibular symphysis, mandibular ramus. PMID:26827063

  4. Spontaneous fracture of the mandibular genial tubercles. A case report.

    PubMed

    Gallego, Lorena; Junquera, Luis; Villarreal, Pedro; de Vicente, Juan Carlos

    2007-12-01

    Fracture of the mandibular genial tubercles is an uncommon pathology affecting edentulous patients with severe maxillary atrophy. Usually occurs spontaneously which complicates the diagnosis. Their importance lies in the functional alterations, which occur as a consequence of the disinsertion of the genihyoid and genioglossus muscles. The treatment of fracture of the genial tubercles is controversial, including no surgical intervention, excision of the avulsed bone fragments, and muscular repositioning. There have been only 11 cases reported in the literature of this fracture, most of them spontaneous. We present a difficult diagnosis situation of spontaneous fracture of the genial tubercles in an 86-year-old edentulous female with a painful sublingual and submental hematoma and anterior cervical echimosis. Computerized Tomography should be made to confirm the diagnosis. Surgical treatment was not necessary, and follow-up at 6 months revealed complete symptomatic recovery, and full return of function. PMID:18059247

  5. Segregation of anterior temporal regions critical for retrieving names of unique and non-unique entities reflects underlying long-range connectivity.

    PubMed

    Mehta, Sonya; Inoue, Kayo; Rudrauf, David; Damasio, Hanna; Tranel, Daniel; Grabowski, Thomas

    2016-02-01

    Lesion-deficit studies support the hypothesis that the left anterior temporal lobe (ATL) plays a critical role in retrieving names of concrete entities. They further suggest that different regions of the left ATL process different conceptual categories. Here we test the specificity of these relationships and whether the anatomical segregation is related to the underlying organization of white matter connections. We reanalyzed data from a previous lesion study of naming and recognition across five categories of concrete entities. In voxelwise logistic regressions of lesion-deficit associations, we formally incorporated measures of disconnection of long-range association fiber tracts (FTs) and covaried for recognition and non-category-specific naming deficits. We also performed fiber tractwise analyses to assess whether damage to specific FTs was preferentially associated with category-selective naming deficits. Damage to the basolateral ATL was associated with naming deficits for both unique (famous faces) and non-unique entities, whereas the damage to the temporal pole was associated with naming deficits for unique entities only. This segregation pattern remained after accounting for comorbid recognition deficits or naming deficits in other categories. The tractwise analyses showed that damage to the uncinate fasciculus (UNC) was associated with naming impairments for unique entities, while damage to the inferior longitudinal fasciculus (ILF) was associated with naming impairments for non-unique entities. Covarying for FT transection in voxelwise analyses rendered the cortical association for unique entities more focal. These results are consistent with the partial segregation of brain system support for name retrieval of unique and non-unique entities at both the level of cortical components and underlying white matter fiber bundles. Our study reconciles theoretic accounts of the functional organization of the left ATL by revealing both category-related processing

  6. A multi-centre retrospective study of mandibular fractures: do occlusal support and the mandibular third molar affect mandibular angle and condylar fractures?

    PubMed

    Hasegawa, T; Sadakane, H; Kobayashi, M; Tachibana, A; Oko, T; Ishida, Y; Fujita, T; Takenono, I; Komatsubara, H; Takeuchi, J; Ichiki, K; Miyai, D; Komori, T

    2016-09-01

    This retrospective study was performed to investigate the influence of occlusal support and the presence, state, and position of mandibular third molars on the incidence of mandibular angle and condylar fractures. The following variables were investigated: age, sex, cause of fracture, presence and state (impaction, angulation, and the number of roots) of the mandibular third molars, site of the mandibular fracture, presence of occlusal support, duration of intermaxillary fixation, and postoperative complications. Various risk factors for mandibular angle and condylar fractures were investigated by univariate analysis. The risk of mandibular angle fracture was significantly higher in patients with occlusal support and mandibular third molars. The risk of condylar fracture was significantly higher in patients without occlusal support or mandibular third molars. The position and angulation of the mandibular third molars were not significant risk factors in mandibular angle and condylar fractures. This study demonstrated the influence of occlusal support and the presence of mandibular third molars on the incidence of mandibular angle and condylar fractures. The presence of occlusal support may be a more important factor affecting mandibular angle or condylar fractures than the position of the mandibular third molars. PMID:27134046

  7. Lower lip numbness due to the mandibular canal narrowing after dental reimplantation: A case report

    PubMed Central

    Shamloo, Nafiseh; Safi, Yaser; Fathpour, Kamyar; Yaghmaei, Masood; Bahemmat, Nika

    2015-01-01

    Mandibular canal is the most important anatomical landmark in the body of mandible which always must be considered for implant surgery in posterior mandibular region. Damage to vessels and inferior alveolar nerve that passes through the mandibular canal can cause problems such as hemorrhage and neurosensory disturbances. Damage to the mandibular canal can occur during implant surgery. Depending on the severity of injuries, it would result in temporary or permanent neurosensory disturbances. We have reported a case that mandibular canal narrowing occurred following implant surgery and resulted in anesthetic and hypoesthetic areas in the lower lip. Patient had a history of implant surgery in the region of teeth numbered 30 and numbered 31. The inserted implant failed after 6 years, and reimplantation was done in this area, but due to lower lip numbness in the right side, the second implant was removed, and another implant was inserted in the region of the tooth numbered 32. After 2 years, right lower lip numbness was reported again by the patient. Cone beam computed tomography images showed canal narrowing in the region of the tooth numbered 31 where the second implant was inserted. It seems that the main cause for anesthesia and hypoesthesia in this patient is canal narrowing due to damage during implant replacement and removal. PMID:26288630

  8. A 22-year follow-up of the nonsurgical expansion of maxillary and mandibular arches in a young adult: Are the outcomes stable, relapsed, or unstable with aging?

    PubMed

    Valladares-Neto, José; Evangelista, Karine; Miranda de Torres, Hianne; Melo Pithon, Matheus; Alves Garcia Santos Silva, Maria

    2016-09-01

    Adult maxillary and mandible arch expansion without a surgical approach can be uncertain when long-term stability is considered. This case report describes the treatment of a 19-year-old woman with an Angle Class I malocclusion with constricted maxillary and mandibular arches. The patient's main complaint was mandibular anterior crowding. The treatment plan included expansion of the mandibular arch concurrent with semirapid maxillary expansion. An edgewise appliance was used to adjust the final occlusion. Smile esthetics and dental alignment were improved without straightening the profile. This outcome was followed up with serial dental casts for 22 years after treatment. At the end of that period, the occlusion and tooth alignment were clinically satisfactory, further supported by mandibular fixed retention. However, the transverse widths were continuously and gradually reduced over time, superposing orthodontic transverse relapse and natural arch constriction caused by aging. PMID:27585782

  9. A quantitative cytochrome oxidase mapping study, cross-regional and neurobehavioural correlations in the anterior forebrain of an animal model of Attention Deficit Hyperactivity Disorder.

    PubMed

    Papa, M; Berger, D F; Sagvolden, T; Sergeant, J A; Sadile, A G

    1998-07-01

    The aim of this study was to trace by molecular imaging techniques the neural substrates of attention deficit hyperactivity disorder (ADHD) using the spontaneously hypertensive rat (SHR) as animal model. Adult SHR and Wistar-Kyoto (WKY) controls were used throughout this study. In experiment 1, naive male SHR and WKY were used, whereas in experiment 2 SHR and WKY rats of both genders were trained on a multiple fixed interval (FI (120 s for water, 5-min extinction)) paradigm and sacrificed 6 months later. In both experiments coronal sections of the anterior forebrain were processed for quantitative cytochrome oxidase (COase) histochemistry by the method of Gonzalez-Lima. Optical density values were transformed into actual enzyme activity units by using tissue-calibrated standards. In experiment 1, non-trained male rats of the SHR line showed lower COase activity in the medial and lateral prefrontal cortices, compared with WKY controls. In experiment 2, there was a line x treatment interaction effect in the pole of the nucleus accumbens (ACB). Regional correlative analyses revealed that: (i) under basal conditions, SHR are more synchronized than WKY rats in the COase level of different brain regions; and (ii) the training desynchronizes COase activity in the WKY, further synchronizes it and increases the cross-talk between hemispheres in male SHR only. Neurobehavioral covariations between behavioural scores and metabolic capacity in the medial and lateral prefrontal/frontal cortices, the caudate-putamen complex (CPU), the pole, core, and shell of the accumbal complex (ACB), and the ventral pallidum (VP), indicated that, in the WKY rats, the frequency of lever pressing covaried positively with the COase activity in the CPU, whereas in the SHR covaried with both medial and lateral prefrontal/frontal cortices. The bursts of activity during the 1-1.33-s segment was positively correlated, in the WKY rats only, with the core and shell of the ACB, and with the VP. Finally

  10. Complications and Risk after Mandibular Reconstruction with Fibular Free Flaps in Patients with Oral Squamous Cell Carcinoma: A Retrospective Cohort Study.

    PubMed

    Lodders, J N; Schulten, E A J M; de Visscher, J G A M; Forouzanfar, T; Karagozoglu, K H

    2016-07-01

    Background We retrospectively analyzed the incidence and types of postoperative complications after mandibular continuity reconstructions with fibular free flaps (FFF) in patients with oral squamous cell carcinoma (OSCC) and identified potential risk factors for postoperative complications. Methods Data were retrieved from the medical records in the Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands from April 1995 to September 2013, and were statistically analyzed. Results In this study, 85 patients were included in whom 86 FFFs were used for mandibular reconstruction. Thirty-seven patients (43%) developed ≥ 1 surgical complication and 9 patients (10.5%) developed ≥ 1 systemic complication. Three patients (3.5%) developed total flap failure and six patients (7.0%) developed partial flap failure. Surgical complications were correlated with tobacco use, partial glossectomy, type of mandibular defect, and anatomic staging. Systemic complications were associated with age > 60 years and Charlson comorbidity index > 2. Hospitalization > 30 days was associated with type of mandibular defect. Conclusions The use of the FFF for reconstructing mandibular continuity defects in OSCC patients may be associated with postoperative complications. Patients with coexisting medical conditions and anterior mandibular defects have an increased risk for developing complications. Patients who undergo segmental mandibular resection including a partial glossectomy could have a reduced risk for complications. PMID:26848563

  11. A retrospective study of temporomandibular joint ankylosis secondary to surgical treatment of mandibular condylar fractures.

    PubMed

    Xiang, Guo-lin; Long, Xing; Deng, Mo-hong; Han, Qian-chao; Meng, Qing-gong; Li, Bo

    2014-03-01

    We investigated the incidence of ankylosis of the temporomandibular joint (TMJ) after open operations for fractures of the mandibular condyle, and analysed possible risk factors in a total of 385 patients with 492 condylar fractures who had been operated on in our department from 2001 to 2010. Sixteen patients developed postoperative ankylosis of the TMJ with 26 joints (5%) affected during a follow-up of 6 months-10 years. Of the 492 condylar fractures, the most common ones that were associated with postoperative ankylosis were those of the condylar head (20/248), followed by the condylar neck (6/193). Subcondylar fractures did not cause postoperative ankylosis (0/51). Among the 16 patients with postoperative ankylosis, 13 had associated anterior mandibular fractures. Long-screw (bicortical screw) fixation of fractures of the condylar head seemed to be associated with a lower incidence of postoperative ankylosis than fixation by miniplate and wire or removal of the fractured fragment. The articular discs were damaged in all ankylosed joints, and the remaining fractured fragment was found in 10 ankylosed joints after fractures of the condylar head. The results suggest that fractures of the condylar head are more prone to lead to postoperative ankylosis of the TMJ, and that the possible risk factors seem to include the technique used for fixation and damage to the disc, together with an anterior mandibular fracture with the fractured fragment remaining. PMID:24485809

  12. New Therapeutics in Promoting and Modulating Mandibular Growth in Cases with Mandibular Hypoplasia

    PubMed Central

    Alhadlaq, Adel

    2013-01-01

    Children with mandibular growth deficiency may develop airway obstruction. The standard treatment of severe airway obstruction involves invasive procedures such as tracheostomy. Mandibular distraction osteogenesis has been proposed in neonates with mandibular deficiency as a treatment option to avoid tracheostomy procedure later in life. Both tracheostomy and distraction osteogenesis procedures suffer from substantial shortcomings including scarring, unpredictability, and surgical complications. Forward jaw positioning appliances have been also used to enhance mandible growth. However, the effectiveness of these appliances is limited and lacks predictability. Current and future approaches to enhance mandibular growth, both experimental and clinical trials, and their effectiveness are presented and discussed. PMID:23819121

  13. Anterior vaginal wall repair

    MedlinePlus

    ... Cystocele Anterior vaginal wall repair (surgical treatment of urinary incontinence) - series References Lentz GM. Anatomic defects of the ... 72. Read More Anterior Inflatable artificial sphincter Stress urinary incontinence Urinary catheters Urinary incontinence - injectable implant Urinary incontinence - ...

  14. Paradental (mandibular inflammatory buccal) cyst.

    PubMed

    Chrcanovic, Bruno Ramos; Reis, Brenda Mayra Maciel Vasconcelos; Freire-Maia, Belini

    2011-06-01

    The paradental cyst is commonly misinterpreted when associated with atypical clinical and radiographic characteristics, in turn causing diagnostic problems. For this reason, the study of the differential diagnosis of this lesion has become extremely important. In addition, the correlation of clinical, histologic, and radiographic findings are also of great value in obtaining accurate diagnoses. The minor variations in the clinical appearance of paradental cysts make it feasible to consider the two main groups of cysts separately: those associated with 1st and 2nd permanent molars of the mandible and those associated with the 3rd mandibular molar. Moreover, this distinction in localization may well dictate the necessary treatment. Bearing in mind the minor clinical variations, the present article aims to discuss the differential diagnosis of this lesion and its different possible treatments by presenting a case report to illustrate the findings. PMID:21161456

  15. [Surgery of palatal and mandibular torus].

    PubMed

    Castro Reino, O; Perez Galera, J; Perez Cosio Martin, J; Urbon Caballero, J

    1990-06-01

    Surgical techniques for the exeresis of torus, both palatal and mandibular. We observe indications, contraindications and complications as well as enumerate all the right events to realize correctly the said techniques. PMID:2206647

  16. Proximity of the mandibular molar root apex from the buccal bone surface: a cone-beam computed tomographic study

    PubMed Central

    Kim, Dokyung; Jin, Myoung-Uk

    2016-01-01

    Objectives The purpose of this study was to evaluate the proximity of the mandibular molar apex to the buccal bone surface in order to provide anatomic information for apical surgery. Materials and Methods Cone-beam computed tomography (CBCT) images of 127 mandibular first molars and 153 mandibular second molars were analyzed from 160 patients' records. The distance was measured from the buccal bone surface to the root apex and the apical 3.0 mm on the cross-sectional view of CBCT. Results The second molar apex and apical 3 mm were located significantly deeper relative to the buccal bone surface compared with the first molar (p < 0.01). For the mandibular second molars, the distance from the buccal bone surface to the root apex was significantly shorter in patients over 70 years of age (p < 0.05). Furthermore, this distance was significantly shorter when the first molar was missing compared to nonmissing cases (p < 0.05). For the mandibular first molars, the distance to the distal root apex of one distal-rooted tooth was significantly greater than the distance to the disto-buccal root apex (p < 0.01). In mandibular second molar, the distance to the apex of C-shaped roots was significantly greater than the distance to the mesial root apex of non-C-shaped roots (p < 0.01). Conclusions For apical surgery in mandibular molars, the distance from the buccal bone surface to the apex and apical 3 mm is significantly affected by the location, patient age, an adjacent missing anterior tooth, and root configuration. PMID:27508159

  17. Mandibular lip bumper for molar torque control.

    PubMed

    Celentano, Giuseppe; Longobardi, Annalisa; Cannavale, Rosangela; Perillo, Letizia

    2011-01-01

    Treatment effects of lip bumpers alone include flaring of the mandibular incisors, distalization and uprighting of the mandibular first molars, and buccal expansion of the canines, premolars, and molar. Lip forces are transmitted through this appliance onto the molars. Moreover the lip bumper is able to derotate, expand or constrict, upright and reinforce the anchorage whereas torque control is lacking. Aim of this paper is the presentation of a new type of lip bumper that allows the molar torque control. PMID:21515237

  18. Irradiation autogenous mandibular grafts in primary reconstructions

    SciTech Connect

    Hamaker, R.C.

    1981-07-01

    The procedure, irradiated mandibular autografts, for primary reconstruction, is presented with an immediate success rate of 88%. Eight cases have undergone primary mandibular reconstruction with the tumorous mandible irradiated to 10,000 rads in a single dose. The longest follow-up is 2 3/4 years. The autograft has proven to be an ideal implant. Major resections of the mandible in conjunction with large myocutaneous flaps have been reconstructed utilizing this implant.

  19. Impacted Mandibular Third Molars: Review of Literature and a Proposal of a Combined Clinical and Radiological Classification

    PubMed Central

    Santosh, P

    2015-01-01

    Tooth impaction is a pathological situation where a tooth fails to attain its normal functional position. Impacted third molars are commonly encountered in routine dental practice. The impaction rate is higher for third molars when compared with other teeth. The mandibular third molar impaction is said to be due to the inadequate space between the distal of the second mandibular molar and the anterior border of the ascending ramus of the mandible. Impacted teeth may remain asymptomatic or may be associated with various pathologies such as caries, pericoronitis, cysts, tumors, and also root resorption of the adjacent tooth. Even though various classifications exist in the literature, none of those address the combined clinical and radiologic assessment of the impacted third molar. Literature search using the advanced features of various databases such as PubMed, Scopus, Embase, Google Scholar, Directory of Open Access Journals and Cochrane electronic databases was carried out. Keywords like impaction, mandibular third molar, impacted mandibular third molar, complications, anatomy, inferior alveolar nerve injury, lingual nerve injury were used to search the databases. A total of 826 articles were screened, and 50 articles were included in the review which was obtained from 1980 to February 2015. In the present paper, the authors have proposed a classification based on clinical and radiological assessment of the impacted mandibular third molar. PMID:26229709

  20. Impacted Mandibular Third Molars: Review of Literature and a Proposal of a Combined Clinical and Radiological Classification.

    PubMed

    Santosh, P

    2015-01-01

    Tooth impaction is a pathological situation where a tooth fails to attain its normal functional position. Impacted third molars are commonly encountered in routine dental practice. The impaction rate is higher for third molars when compared with other teeth. The mandibular third molar impaction is said to be due to the inadequate space between the distal of the second mandibular molar and the anterior border of the ascending ramus of the mandible. Impacted teeth may remain asymptomatic or may be associated with various pathologies such as caries, pericoronitis, cysts, tumors, and also root resorption of the adjacent tooth. Even though various classifications exist in the literature, none of those address the combined clinical and radiologic assessment of the impacted third molar. Literature search using the advanced features of various databases such as PubMed, Scopus, Embase, Google Scholar, Directory of Open Access Journals and Cochrane electronic databases was carried out. Keywords like impaction, mandibular third molar, impacted mandibular third molar, complications, anatomy, inferior alveolar nerve injury, lingual nerve injury were used to search the databases. A total of 826 articles were screened, and 50 articles were included in the review which was obtained from 1980 to February 2015. In the present paper, the authors have proposed a classification based on clinical and radiological assessment of the impacted mandibular third molar. PMID:26229709

  1. Stimulation of Anterior Thalamic Nuclei Protects Against Seizures and Neuronal Apoptosis in Hippocampal CA3 Region of Kainic Acid-induced Epileptic Rats

    PubMed Central

    Meng, Da-Wei; Liu, Huan-Guang; Yang, An-Chao; Zhang, Kai; Zhang, Jian-Guo

    2016-01-01

    Background: The antiepileptic effect of the anterior thalamic nuclei (ANT) stimulation has been demonstrated; however, its underlying mechanism remains unclear. The aim of this study was to investigate the effect of chronic ANT stimulation on hippocampal neuron loss and apoptosis. Methods: Sixty-four rats were divided into four groups: The control group, the kainic acid (KA) group, the sham-deep brain stimulation (DBS) group, and the DBS group. KA was used to induce epilepsy. Seizure count and latency to the first spontaneous seizures were calculated. Nissl staining was used to analyze hippocampal neuronal loss. Polymerase chain reaction and Western blotting were conducted to assess the expression of caspase-3 (Casp3), B-cell lymphoma-2 (Bcl2), and Bcl2-associated X protein (Bax) in the hippocampal CA3 region. One-way analysis of variance was used to determine the differences between the four groups. Results: The latency to the first spontaneous seizures in the DBS group was significantly longer than that in the KA group (27.50 ± 8.05 vs. 16.38 ± 7.25 days, P = 0.0005). The total seizure number in the DBS group was also significantly reduced (DBS vs. KA group: 11.75 ± 6.80 vs. 23.25 ± 7.72, P = 0.0002). Chronic ANT-DBS reduced neuronal loss in the hippocampal CA3 region (DBS vs. KA group: 23.58 ± 6.34 vs. 13.13 ± 4.00, P = 0.0012). After chronic DBS, the relative mRNA expression level of Casp3 was decreased (DBS vs. KA group: 1.18 ± 0.37 vs. 2.09 ± 0.46, P = 0.0003), and the relative mRNA expression level of Bcl2 was increased (DBS vs. KA group: 0.92 ± 0.21 vs. 0.48 ± 0.16, P = 0.0004). The protein expression levels of CASP3 (DBS vs. KA group: 1.25 ± 0.26 vs. 2.49 ± 0.38, P < 0.0001) and BAX (DBS vs. KA group: 1.57 ± 0.49 vs. 2.80 ± 0.63, P = 0.0012) both declined in the DBS group whereas the protein expression level of BCL2 (DBS vs. KA group: 0.78 ± 0.32 vs. 0.36 ± 0.17, P = 0.0086) increased in the DBS group. Conclusions: This study demonstrated

  2. Evaluation of Mental Index, Mandibular Cortical Index and Panoramic Mandibular Index on Dental Panoramic Radiographs in the Elderly

    PubMed Central

    Hastar, Esin; Yilmaz, H. Huseyin; Orhan, Hikmet

    2011-01-01

    Objectives: The aims of this study were to evaluate the influence of gender and dental status on the mental index, mandibular cortical index and panoramic mandibular index from dental panoramic radiographs in elderly who had osteoporosis or did not have osteoporosis. Methods: Panoramic radiographs of 487 elderly dental patients (age range 60–88 years) were evaluated. It were recorded osteoporotic status according to the patients’ medical anamnesis and values of the mandibular cortical index (MCI), panoramic mandibular index (PMI), mandibular cortical width (MCW) Results: Dental status was statistically significantly associated with the mandibular cortical width, panoramic mandibular index and the categories of MCI (P<.05). There were statistically different mandibular cortical width and panoramic mandibular index values in patients with osteoporosis and without osteoporosis (P<.05) Conclusions: Our study showed that there were statistically significant differences according to gender, dental status, and values of the MCW, MCI and PMI between patients with and those without osteoporosis. PMID:21228957

  3. Surgical treatment and a unique management of rostral mandibular fracture with cerclage wire in a horse.

    PubMed

    Naddaf, Hadi; Sabiza, Soroush; Kavosi, Narges

    2015-01-01

    A 3-year-old Arabian colt was presented for a major gingiva wound at the right rostral part of mandible. After clinical assessments, rostral mandibular fracture was determined. Stabilization of fractured region was achieved via cerclage wire application under general anesthesia. Fixation wires were left in place for 6 weeks. A 3 -month follow up revealed complete fracture healing. The purpose of this case report was to give clinical information about rostral mandibular fractures and treatment of these fractures and nutrition protocol in a horse, as this fracture is of the most common type of jaw fracture sustained by young horses. PMID:26261717

  4. Surgical treatment and a unique management of rostral mandibular fracture with cerclage wire in a horse

    PubMed Central

    Naddaf, Hadi; Sabiza, Soroush; Kavosi, Narges

    2015-01-01

    A 3-year-old Arabian colt was presented for a major gingiva wound at the right rostral part of mandible. After clinical assessments, rostral mandibular fracture was determined. Stabilization of fractured region was achieved via cerclage wire application under general anesthesia. Fixation wires were left in place for 6 weeks. A 3 -month follow up revealed complete fracture healing. The purpose of this case report was to give clinical information about rostral mandibular fractures and treatment of these fractures and nutrition protocol in a horse, as this fracture is of the most common type of jaw fracture sustained by young horses. PMID:26261717

  5. Economic and health implications of routine CBCT examination before surgical removal of the mandibular third molar in the Danish population

    PubMed Central

    Olsen, K R; Matzen, L H; Vaeth, M; Wenzel, A

    2015-01-01

    Objectives: This epidemiological study aimed to analyse economical and societal consequences in Denmark if CBCT is used routinely as a diagnostic method before removal of the mandibular third molar. Furthermore, the aim was to calculate the excess cancer incidence from this practice. Methods: 17 representative dental clinics in the regions of Denmark were visited by two observers, who registered the total number of patients in each clinic, the number of removed mandibular third molars from patients' files together with the age and gender of these patients. The data were collected from 2008 to 2014. The total number of removed mandibular third molars in Denmark each year was derived from the collected data and information on patients' contacts with dentists from Statistics Denmark as a sum of contributions from each region. The contribution of a region was obtained as the number of removed mandibular third molars in the selected clinics in the region times the ratio of the number of patients in the selected clinics in the region to the total number of patients with contact to a general practitioner in the region in 2011. Existing knowledge on the costs for panoramic and CBCT imaging was used to calculate total costs. The cancer incidence was calculated from lifetime attributable risk curves based on linear risk assumptions. Results: The selected clinics included 109,686 patients, and 1369 mandibular third molars had been surgically removed. Using data from Statistics Denmark gave an estimated annual number of removed mandibular third molars of 36,882 at a total cost of €6,633,400. The additional cancer incidence was estimated to be approximately 0.46 per year. Conclusions: The data should be used in a cost-effectiveness analysis of the clinical efficacy of CBCT imaging before removal of mandibular third molars. PMID:25785820

  6. Mandibular lateral incisor with Vertucci Type IV root canal morphological system: A rare case report

    PubMed Central

    Aggarwal, Kanika

    2016-01-01

    Abnormalities in the root canal anatomy are commonly occurring phenomenon. A thorough knowledge of root canal anatomy and its variation is necessary for successful completion of endodontic treatment. Mandibular anteriors are known for having extra canals. The role of genetics and racial variations may result in difference of incidence of root number and canal number. This paper attempts at explaining a rare case of successful endodontic management of two-rooted lateral incisor with awareness of data pertaining to number of canals, knowledge of canal morphology, correct radiographic interpretation, and tactile examination of canal wall which are important in detecting the presence of multiple canals. PMID:27003981

  7. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

    PubMed Central

    Guven, Yeliz; Zorlu, Sevgi; Cankaya, Abdulkadir Burak; Aktoren, Oya; Gencay, Koray

    2015-01-01

    The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case. PMID:26339511

  8. Ectopic third molar in the mandibular sigmoid notch: Report of a case and literature review

    PubMed Central

    Baykul, Timuçin

    2015-01-01

    Purpose: To evaluate the etiopathogenesis, clinical features and surgical approaches for removal of ectopic third molars in the mandible. Methods: We report a case of an impacted mandibular third molar dislocated on mandibular sigmoid notch. 20 cases of ectopic mandibular third molars reported in the English-language literature, identified from Pubmed and Medline databases are also reviewed. Results: Among the 20 article reported in the presented study, ectopic third molars were generally located in the condylar region. The common symptoms of the clinical examination were pain, trismus, swelling, temporomandibular joint syndroms or no symptoms. Conclusions: Ectopic third molar may be asymptomatic initially with clinical manifestations, later on as adjacent structures are affected. The surgical approach must be carefully planned for the aim of choosing the more conservative technique that produces the minimum trauma to patients. Key words:Ectopic third molar, sigmoid notch, cyst. PMID:25810825

  9. Fusion of a supernumerary tooth to right mandibular second molar: a case report and literature review.

    PubMed

    Zhu, Min; Liu, Chao; Ren, Shuangshuang; Lin, Zintong; Miao, Leiying; Sun, Weibin

    2015-01-01

    Gemination or fusion is a rare occurrence in the mandibular posterior teeth. The aim of this article is to describe the problems encountered and the strategy employed in treating such cases. A 34 years old patient came with the complaint of spontaneous and radiating pain in the right mandibular posterior region. The tooth in concern was an anomalous 'double' second mandibular molar diagnosed as having necrotic pulp with chronic apical abscess of endodontic origin. The present case emphasizes the importance of identifying anatomical anomalies during treatment of fused teeth with supernumerary tooth, and the need for the use of advanced imaging modalities like CBCT which is a critical aid in the diagnosis of such cases. Fused teeth can be managed quite efficiently by an overall combined treatment including both endodontic and periodontal therapy. PMID:26550101

  10. Dentoalveolar comparative study between removable and fixed cribs, associated to chincup, in anterior open bite treatment

    PubMed Central

    TORRES, Fernando César; de ALMEIDA, Renato Rodrigues; de ALMEIDA-PEDRIN, Renata Rodrigues; PEDRIN, Fernando; PARANHOS, Luiz Renato

    2012-01-01

    Objective The aim of this prospective study was to compare the dentoalveolar effects produced by two types of palatal crib, removable (Rpc+C) and fixed (Fpc+C), combined with chincup in growing patients with anterior open bite. Material and Methods Each group comprised 30 patients, in the mixed dentition phase, with similar cephalometric characteristics and skeletal ages. Group 1 (Rpc+C) presented initial mean age of 8.3 years and mean anterior open bite of 4.0 mm. Group 2 (Fpc+C) presented initial mean age of 8.54 years and mean anterior open bite of 4.3 mm. The evaluation period comprised 12 months between initial (T1) and second lateral radiograph (T2). The T2-T1 changes were compared cephalometrically in the 2 groups using the non-paired t-test. Results Vertical changes in the posterior dentoalveolar region were similar between the groups (about 1 mm) and no significant differences were found in molar mesialization. The Fpc+C group had in average 1.6 mm more improvement of the overbite as a result of greater maxillary incisor extrusion (1.3 mm). Patients in this group also presented less lingual tipping of maxillary incisors and more mandibular incisors uprighting. Conclusions The Fpc+C combination was more efficient in the correction of the negative overbite mainly due to greater extrusion of the maxillary incisors. However, the Rpc+C appliance promoted better upper and lower incisor inclination, resulting in a more adequate overjet. PMID:23138739

  11. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the...

  12. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the...

  13. Influence of mandibular length on mouth opening.

    PubMed

    Dijkstra, P U; Hof, A L; Stegenga, B; de Bont, L G

    1999-02-01

    Theoretically, mouth opening not only reflects the mobility of the temporomandibular joints (TMJs) but also the mandibular length. Clinically, the exact relationship between mouth opening, mandibular length, and mobility of TMJs is unclear. To study this relationship 91 healthy subjects, 59 women and 32 men (mean age 27.2 years, s.d. 7.5 years, range 13-56 years) were recruited from the patients of the Department of Oral and Maxillofacial Surgery of University Hospital, Groningen. Mouth opening, mobility of TMJs and mandibular length were measured. The mobility of TMJs was measured as the angular displacement of the mandible relative to the cranium, the angle of mouth opening (AMO). Mouth opening (MO) correlated significantly with mandibular length (ML) (r = 0.36) and AMO (r = 0.66). The regression equation MO = C1 x ML x AMO + C2, in which C = 0.53 and C2 = 25.2 mm, correlated well (r = 0.79) with mouth opening. It is concluded that mouth opening reflects both mobility of the TMJs and mandibular length. PMID:10080308

  14. Prostatic adenocarcinoma with mandibular metastatic lesion: case report.

    PubMed

    Reyes Court, Daniel; Encina, Susana; Levy, Irene

    2007-10-01

    Metastatic lesions of primary tumors, which originate in different parts of the body, comprise almost 1 % of different types of oral cancers. These lesions can affect either bones or soft tissues in the maxillofacial region. Whenever the maxillofacial area is affected, the most common location is in the molar region of the mandible. The clinical presentation of mandibular metastasis follows a clinical pattern characterized by irradiated dental pain in the third molar region. The most frequent sign is parethesia of the area innervated by the mandibular alveolar dental nerve. Differential diagnosis and treatment of these patients can be extremely difficult because there a number of pathologic conditions with similar symptoms and because diagnostic examination can be highly confusing. The aim of this article is to present a case of prostatic adenocarcinoma where the only metastasis was found in the jaw. A literature review will be presented, hoping to contribute to the scarce information regarding this lesion, due to its low frequency and atypical expression of this type of metastasis in terms of etiology, biological behavior and treatment. PMID:17909506

  15. Unilateral mandibular advancement with bilateral intraoral vertical ramus osteotomy.

    PubMed

    Chung, Seung-Won; Jung, Hwi-Dong; Park, Hyung-Sik; Jung, Young-Soo

    2015-05-01

    Intraoral vertical ramus osteotomy (IVRO) is an effective surgical procedure that is used for the correction of mandibular prognathism. However, application of IVRO for mandibular advancement has been limited because of the instability of the proximal segments caused by the gap between the distal and proximal segments. We report a case of unilateral mandibular advancement with bilateral IVRO for the correction of facial asymmetry. This case shows possible application of bilateral IVRO for unilateral mandibular advancement without any means of fixation. PMID:25974825

  16. Adrenal neuroblastoma with metastatic mandibular mass: An unusual presentation.

    PubMed

    Mittal, Deepak; Mandelia, Ankur; Bajpai, Minu; Agarwala, Sandeep

    2015-01-01

    Neuroblastoma very rarely presents as a mandibular mass. We report the case of a 3-year-old female child who presented to us with a right mandibular mass of 3 months duration. She was investigated and diagnosed as a case of stage 4 right adrenal neuroblastoma with mandibular and skull metastasis. PMID:26458598

  17. Comprehensive Analysis of Mandibular Residual Asymmetry after Bilateral Sagittal Split Ramus Osteotomy Correction of Menton Point Deviation

    PubMed Central

    Lin, Qiuping; Huang, Xiaoqiong; Xu, Yue; Yang, Xiaoping

    2016-01-01

    Purpose Facial asymmetry often persists even after mandibular deviation corrected by the bilateral sagittal split ramus osteotomy (BSSRO) operation, since the reference facial sagittal plane for the asymmetry analysis is usually set up before the mandibular menton (Me) point correction. Our aim is to develop a predictive and quantitative method to assess the true asymmetry of the mandible after a midline correction performed by a virtual BSSRO, and to verify its availability by evaluation of the post-surgical improvement. Patients and Methods A retrospective cohort study was conducted at the Hospital of Stomatology, Sun Yat-sen University (China) of patients with pure hemi-mandibular elongation (HE) from September 2010 through May 2014. Mandibular models were reconstructed from CBCT images of patients with pre-surgical orthodontic treatment. After mandibular de-rotation and midline alignment with virtual BSSRO, the elongation hemi-mandible was virtually mirrored along the facial sagittal plane. The residual asymmetry, defined as the superimposition and boolean operation of the mirrored elongation side on the normal side, was calculated, including the volumetric differences and the length of transversal and vertical asymmetry discrepancy. For more specific evaluation, both sides of the hemi-mandible were divided into the symphysis and parasymphysis (SP), mandibular body (MB), and mandibular angle (MA) regions. Other clinical variables include deviation of Me point, dental midline and molar relationship. The measurement of volumetric discrepancy between the two sides of post-surgical hemi-mandible were also calculated to verify the availability of virtual surgery. Paired t-tests were computed and the P value was set at .05. Results This study included 45 patients. The volume differences were 407.8±64.8 mm3, 2139.1±72.5 mm3, and 422.5±36.9 mm3; residual average transversal discrepancy, 1.9 mm, 1.0 mm, and 2.2 mm; average vertical discrepancy, 1.1 mm, 2.2 mm, and 2

  18. Early Loaded Single Implant Reinforced Mandibular Overdenture.

    PubMed

    Nischal, K; Chowdhary, R

    2016-01-01

    Rehabilitating atrophied mandible with two-implant supported denture is a common treatment modality for implant retained removable overdenture in mandible. This paper aims to design a treatment modality where single implant reinforced overdenture is fabricated for a severely atrophied mandibular ridge with early loading protocol. Results of studies have shown that a single implant mandibular overdenture significantly increases the satisfaction and quality of life of patients with edentulism. Midline fracture of the prosthesis is the most common complication related to single implant and two-implant retained mandibular overdentures. To manage such complication, a thin metal mesh is used to reinforce the overdenture and also to make the prostheses lighter and cost effective as compared to conventional cast metal framework. PMID:27403350

  19. Diagnosis and classification of mandibular osteomyelitis.

    PubMed

    Suei, Yoshikazu; Taguchi, Akira; Tanimoto, Keiji

    2005-08-01

    To establish a unified classification system for mandibular osteomyelitis, various diagnostic terms were critically assessed and clinicopathologic findings of the lesions were carefully reviewed. We recommend classifying mandibular osteomyelitis into bacterial osteomyelitis and osteomyelitis associated with the synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome. Other diagnostic terms were excluded because they were not appropriate for classification. Diagnostic criteria for bacterial osteomyelitis are suppuration and osteolytic change. The lesions are easily cured by antibiotic treatments. Mandibular osteomyelitis in SAPHO syndrome is characterized by nonsuppuration and a mixed pattern on radiography, with solid type periosteal reaction, external bone resorption, and bone enlargement. The presence of osteomyelitis in other bones, arthritis, or skin diseases (palmoplantar pustulosis, pustular psoriasis, and acne) strongly suggests this syndrome. Antibiotic therapy is usually ineffective and the symptoms of SAPHO syndrome are often persistent. PMID:16037779

  20. Early Loaded Single Implant Reinforced Mandibular Overdenture

    PubMed Central

    Chowdhary, R.

    2016-01-01

    Rehabilitating atrophied mandible with two-implant supported denture is a common treatment modality for implant retained removable overdenture in mandible. This paper aims to design a treatment modality where single implant reinforced overdenture is fabricated for a severely atrophied mandibular ridge with early loading protocol. Results of studies have shown that a single implant mandibular overdenture significantly increases the satisfaction and quality of life of patients with edentulism. Midline fracture of the prosthesis is the most common complication related to single implant and two-implant retained mandibular overdentures. To manage such complication, a thin metal mesh is used to reinforce the overdenture and also to make the prostheses lighter and cost effective as compared to conventional cast metal framework. PMID:27403350

  1. Localized periodontal defect associated with unusual furcation involvement on a mandibular incisor.

    PubMed

    Kwon, TaeHyun; Intini, Giuseppe; Kim, David M; Levin, Liran

    2013-10-01

    A localized periodontal defect associated with an unusual furcation on a mandibular central incisor and its treatment sequences are presented. A 54-year-old woman presented with a persistent localized periodontal defect, which was not responsive to nonsurgical periodontal therapy. An exploratory surgery revealed complete through and through furcation involvement on the right mandibular central incisor, resulting in a three-walled infrabony defect. Following thorough mechanical debridement and root planing, the infrabony aspect of the defect was grafted with freeze-dried bone allograft combined with the recombinant human platelet-derived growth factor-BB. The flaps were positioned to enable patient's home care and professional dental cleaning. Follow-up examination revealed uneventful healing and resolution of the infrabony periodontal defect. Clinicians should be aware of this unusual condition and consider it as a potential etiology when dealing with a persistent localized periodontal defect in the mandibular anterior sextant, which may not respond to the conventional nonsurgical periodontal therapy. Eliminating the active disease as well as enabling careful maintenance and oral hygiene may prevent further deterioration and result in a stable long-term outcome preserving the compromised tooth. PMID:23878844

  2. Magnesium-enriched hydroxyapatite as bone filler in an ameloblastoma mandibular defect

    PubMed Central

    Grigolato, Roberto; Pizzi, Natalia; Brotto, Maria C; Corrocher, Giovanni; Desando, Giovanna; Grigolo, Brunella

    2015-01-01

    The aim of this study was to evaluate the clinical performance of a magnesium-enriched hydroxyapatite biomaterial used as bone substitute in a case of mandibular ameloblastoma treated with conservative surgery. A 63 year old male patient was treated for an ameloblastoma in the anterior mandibular profile. After tissue excision, the bone defect was filled with a synthetic hydroxyapatite biomaterial enriched with magnesium ions, in order to promote bone tissue regeneration and obtain a good aesthetic result. Twenty-five months after surgery, due to ameloblastoma recurrence in an area adjacent to the previously treated one, the patient underwent to a further surgery. In that occasion the surgeon performed a biopsy in the initially treated area, in order to investigate the nature of the newly-formed tissue and to evaluate the bone regenerative potential of this biomaterial by clinical, radiographic and histological analyses. The clinical, radiographic and histological evaluations showed various characteristics of bone remodeling stage with an ongoing osteogenic formation and a good osteo-integration. In conclusion, magnesium-enriched hydroxyapatite used as bone substitute in a mandibular defect due to ameloblastoma excision showed an effective bone regeneration at 25 months follow-up, demonstrating an excellent biocompatibility and a high osteo-integration property. PMID:25784998

  3. Masticatory mandibular movements for different foods textures related to onomatopoetic words.

    PubMed

    Nakajima, J; Hideshima, M; Takahashi, M; Taniguchi, H; Ohyama, T

    2001-12-01

    This study aimed to investigate the effects of different sensory-evaluated food textures on masticatory movements, and to identify meaningful factors that correspond to different food textures. Masticatory movements of three healthy subjects were evaluated with a jaw movement tracking device using five different test foods: almond, hard and light rice crackers, apple, and chewing gum. The movements of the incisor point, working and non-working condyle and the entire mandible at the occlusal phase in the horizontal plane were analyzed. For harder foods, the incisor entered the intercuspal position from a rear and lateral, the working condyle showed anterior and noticeable medial movements as the entire mandible translated posteriorly and medially. For soft foods, the incisor movements were nearly coincidental with the lateral border movements, and the mandible rotated towards the inner side near the working condyle. Although the overall paths of the mandibular movements are individually different, it appeared that jaw movement at the final closure is particular to the food texture. From the standpoint of mandibular movements, it is suggested that masticatory movements during the occlusal phase in the horizontal plane is useful for revealing the relationship between mandibular movements and food textures that were evaluated with onomatopoetic words. PMID:12160249

  4. Reattachment of fractured teeth fragments in mandibular incisors: a case report

    PubMed Central

    Yousef, Mohammed K

    2015-01-01

    The majority of dental trauma involves anterior teeth, especially the maxillary central incisors. A mandibular incisor fracture with or without pulp tissue involvement is considerably less common. Different approaches for treating these fractured teeth have been reported in the literature. The type of treatment rendered depends mainly on the extent of fracture, pulp involvement, radicular fracture, biologic width infringement or violation, and presence of the fractured piece. This case report illustrates reattachment of fractured fragments on two mandibular incisors without pulp exposure using a new proposed reattachment method using a combination of two different types of composite materials together with an orthodontic lingual retention wire. An 8-year-old female patient presented with fractured mandibular left incisors (Ellis class II fracture). Broken pieces were saved and brought in a closed container in water. Periapical radiographs revealed no evidence of pulpal involvement in either tooth and no periapical radiolucency was noticed. Fractured fragments and the broken teeth were prepared with circumferential bevels. Reattachment of the fractured fragments were done using two types of composite resin materials and a lingual orthodontic retention wire was also used. The patient was recalled after 8 months to follow up both teeth. Clinical examination revealed excellent composite restorations covering the fracture lines. PMID:25897267

  5. Great auricular communication with the marginal mandibular nerve - a previously unreported anatomical variant.

    PubMed

    Brennan, Peter A; Webb, Roger; Kemidi, Flora; Spratt, Jonathan; Standring, Susan

    2008-09-01

    The great auricular nerve that originates from the cervical plexus and supplies sensation to the lower part of the auricle and the skin overlying the angle of the mandible has no motor component. During an elective neck dissection for a squamous cell carcinoma of the tongue, we found that the anterior division of the great auricular nerve divided, with a long branch that passed into the submandibular triangle anterior and superficial to the facial vein, and was joined on its deep surface by the marginal mandibular division of the facial nerve. Although anatomical variants of other branches of the cervical plexus have been described, this is, to our knowledge, the first time a communication between the great auricular nerve and a branch of the facial nerve has been reported outside the parotid gland. PMID:18242803

  6. Mandibular and para-mandibular tumors in children. Report of 16 cases.

    PubMed

    Kozlowski, K; Masel, J; Sprague, P; Tamaela, L; Kan, A; Middleton, R

    1981-01-01

    Sixteen cases of mandibular tumors or paramandibular soft tissue tumors with mandibular involvement are reported. These include such rare mandibular tumors or tumor-like conditions as melanotic progonoma, intraosseous haematoma secondary to von Willebrand's disease, post-irradiation osteosarcoma, monostotic eosinophilic granuloma, aneurysmal bone cyst and osseous hemangiopericytoma. Three cases of cherubism, one of fibrous dysplasia or aggressive fibromatosis and one of central giant cell reparative granuloma are also reported. The soft tissue tumors comprise round cell sarcoma, parotid adeno-carcinoma with generalised metastases, embryonal rhabdo-myo-sarcoma, neuro-fibro-sarcoma and congenital cystic hygroma. In all the cases the disease was well advanced when the patient presented for X-ray examination. The specific X-ray diagnosis of mandibular and paramandibular tumors in childhood is more difficult than that of similar tumors in other parts of the body. PMID:6275331

  7. Reconstruction of mandibular defects - clinical retrospective research over a 10-year period -

    PubMed Central

    2011-01-01

    Backround Functional and cosmetic defects in the maxillofacial region are caused by various ailments and these defects are addressed according to their need. Simplicity of procedure, intact facial function and esthetic outcome with the least possible donor site morbidity are the minimum requirements of a good reconstruction. Oro-mandibular reconstruction, although a challenge for the head and neck reconstructive surgeon, is now reliable and highly successful with excellent long-term functional and aesthetic outcomes with the use of autogenous bone grafts. Reconstruction of trauma- or mandibular oncologic defects with bony free flaps is considered the gold standard. However the the optimal reconstruction of mandibular defects is still controversial in regards to reconstructive options which include the donor site selection and the timing of surgery. The purpose of this study was to determine the outcome of different osseous reconstruction options using autogenous bone grafts for mandibular reconstructions. Methods This study was carried out on 178 patients with mandibular bone defects. They were reconstructed with autogenous bone grafts from different donor sites. At post operative visits they were evaluated for functional and cosmetic results. Results The success rate found in this study was around 90%. Only 7.6% of the cases showed poor results regarding facial contours and mouth opening. All other patients were satisfied with their cosmesis and mouth opening at the recipient sites was in the normal range during last follow-up visits. Donor sites were primarily closed in all cases and there was no hypertrophic scar. Conclusion Based on this study, autogenous bone grafts are a reliable treatment modality for the reconstruction of mandibular bone defects with predictable aesthetic and functional outcomes. As the free vascularized fibular flap has the least resorption and failure rate, it should be the first choice for most cases of mandiblular reconstruction. PMID

  8. Effect of surgical treatment of mandibular fracture: electromyographic analysis, bite force, and mandibular mobility.

    PubMed

    Pepato, André Oliveira; Palinkas, Marcelo; Regalo, Simone Cecilio Hallak; de Medeiros, Eduardo Henrique Pantosso; de Vasconcelos, Paulo Batista; Sverzut, Cássio Edvard; Siéssere, Selma; Trivellato, Alexandre Elias

    2014-09-01

    This study aimed to examine individuals undergoing surgery for the treatment of the fractured mandibular angle, using bite force, mandibular mobility, and electromyographic (EMG) analysis in many different clinical conditions, after 2 months postoperatively. Bite force was recorded with a digital dynamometer, model IDDK. The EMG activity (Myosystem-Br1) included the analysis of the masseter and temporal muscles. Mandibular mobility was measured using a digital pachymeter. The subjects were divided into 3 groups: G1, mandibular angle fracture (n = 7); G2, condylar process fracture (n = 5); and G3, control (n = 12). Data were tabulated and submitted to statistical analysis using the repeated-measure test carried out over time and the Student's t-test (P < 0.05), using the Statistical Package for the Social Sciences software, version 19 (SPSS Inc, Chicago, IL). G1 and G2 had an increase in bite force. In G1, there was a regular decrease in the EMG activity in the second postoperative month. G2 presented an irregular pattern in EMG data during the period tested. Regarding the mandibular mobility, both groups obtained amplitude of all mandibular movements with a high percentage, when compared with control. A good functional recovery was achieved by the individuals who had a mandible angle fracture or condylar process fracture, after 2 postoperative months. PMID:25203573

  9. Mandibular advancement and obstructive sleep apnoea: a method for determining effective mandibular protrusion.

    PubMed

    Dort, L C; Hadjuk, E; Remmers, J E

    2006-05-01

    The objectives of the study were to test the hypotheses that it is possible, during routine polysomnography (PSG), to prospectively identify favourable candidates for mandibular repositioning appliance (MRA) therapy in the treatment of obstructive sleep apnoea (OSA) and to accurately estimate an optimal protrusive distance at which to fabricate the MRA. A series of subjects underwent a remotely controlled mandibular positioner (RCMP) test during PSG monitoring. The ability of the RCMP test to eliminate OSA and the target protrusion at which that occurred was compared with the success of a custom oral MRA in the 33 subjects who completed the protocol. The RCMP test was a success in 15 subjects and a failure in 18 subjects. Appliance therapy was initiated in 38 subjects and completed in 33. MRA therapy was successful at target protrusion in 80% of subjects who had a successful RCMP test and failed in 78% of those who failed the RCMP test. In conclusion the remotely controlled mandibular positioner test outcome demonstrated a statistically significant association with mandibular repositioning appliance outcome. The target protrusion determined during the remotely controlled mandibular positioner test was the effective therapeutic protrusion in subjects with a successful remotely controlled mandibular positioner test. PMID:16707396

  10. Potential new method of design for reconstruction of complicated mandibular defects: a virtual deformable mandibular model.

    PubMed

    Chen, Quan; Zhigang, Cai; Xin, Peng; Yang, Wang; Chuanbin, Guo

    2016-02-01

    The treatment of complicated mandibular defects, including misshaped and missing bones, is challenging, and the success of reconstruction depends to a large extent on the formulation of a precise surgical plan. There is still no ideal preoperative method of design for reconstruction to deal with large, cross-midline, mandibular, segmental defects. We have built a virtual deformable mandibular model (VDMM) with 3-dimensional animation software. Sixteen handles were set on the model, and these could be easily controlled with a computer mouse to change the morphology of the deformable mandibular model. The computed tomographic (CT) data from 10 normal skulls was used to validate the adjustability of the VDMM. According to the positions of the mandibular fossa of the temporomandibular joint, the maxillary dental arch, and the craniomaxillofacial profile, the model could be adjusted to an ideal contour, which was coordinated with the skull. The VDMM was then adjusted further according to the morphology of the original mandible. A 3-dimensional comparison was made between the model of the deformed mandible and the original mandible. Using 16 control handles, the VDMM could be adjusted to a new outline, which was similar in shape to the original mandible. Within 3mm deviation either way, the absolute mean distribution of deviation between the contour of the deformed model and the original mandible was 92.5%. The VDMM might be useful for preoperative design of reconstruction of complicated mandibular defects. PMID:26711316

  11. Abnormal mandibular growth and the condylar cartilage.

    PubMed

    Pirttiniemi, Pertti; Peltomäki, Timo; Müller, Lukas; Luder, Hans U

    2009-02-01

    Deviations in the growth of the mandibular condyle can affect both the functional occlusion and the aesthetic appearance of the face. The reasons for these growth deviations are numerous and often entail complex sequences of malfunction at the cellular level. The aim of this review is to summarize recent progress in the understanding of pathological alterations occurring during childhood and adolescence that affect the temporomandibular joint (TMJ) and, hence, result in disorders of mandibular growth. Pathological conditions taken into account are subdivided into (1) congenital malformations with associated growth disorders, (2) primary growth disorders, and (3) acquired diseases or trauma with associated growth disorders. Among the congenital malformations, hemifacial microsomia (HFM) appears to be the principal syndrome entailing severe growth disturbances, whereas growth abnormalities occurring in conjunction with other craniofacial dysplasias seem far less prominent than could be anticipated based on their often disfiguring nature. Hemimandibular hyperplasia and elongation undoubtedly constitute the most obscure conditions that are associated with prominent, often unilateral, abnormalities of condylar, and mandibular growth. Finally, disturbances of mandibular growth as a result of juvenile idiopathic arthritis (JIA) and condylar fractures seem to be direct consequences of inflammatory and/or mechanical damage to the condylar cartilage. PMID:19164410

  12. Orthodontic extrusion of horizontally impacted mandibular molars

    PubMed Central

    Ma, Zhigui; Yang, Chi; Zhang, Shanyong; Xie, Qianyang; Shen, Yuqing; Shen, Pei

    2014-01-01

    Objective: To introduce and evaluate a novel approach in treating horizontally impacted mandibular second and third molars. Materials and methods: An orthodontic technique was applied for treatment of horizontally impacted mandibular second and third molars, which included a push-type spring for rotation first, and then a cantilever for extrusion. There were 8 mandibular third molars (M3s) and 2 second molars (M2s) in this study. Tooth mobility, extraction time, the inclination and parallelism of the impacted tooth, alveolar bone height of the adjacent tooth, and the relationship of impacted M3 and the inferior alveolar nerve (IAN) were evaluated. Results: Two horizontally impacted M2s could be upright in the arch and good occlusal relationships were obtained after treatment. All impacted M3s were successfully separated from the IAN, without any neurologic consequences. The average extraction time was 5 minutes. There was a significant change in the inclination and parallelism of the impacted tooth after treatment. A new bone apposition with the average height of 3.2 mm was noted distal to the adjacent tooth. Conclusions: This two-step orthodontic technique as presented here may be a safe and feasible alternative in management of severely horizontally impacted mandibular molars, which achieves a successful separation of M3s from the IAN and an excellent position for M2s. PMID:25419364

  13. Bilateral Mandibular Supernumerary Canines: A Case Report

    PubMed Central

    Abouei Mehrizi, Ehsan; Semyari, Hassan; Eslami Amirabadi, Gholamreza

    2010-01-01

    Supernumerary teeth are defined as the teeth developed in excess of the number found in a normal dentition. Supernumerary canine is an extremely rare finding particularly in the mandible. This case report presents a 25-year-old female patient with the unique feature of bilateral mandibular supplemental supernumerary canines. The patient was non-syndromic without any other supernumerary teeth. PMID:23346342

  14. [Isolated anterior cervical hypertrichosis].

    PubMed

    Monteagudo, B; Cabanillas, M; de las Heras, C; Cacharrón, J M

    2009-01-01

    Anterior cervical hypertrichosis was described by Trattner and coworkers in 1991. It consists of a of hair at the anterior cervical level just above the laryngeal prominence. To date, only 28 cases of anterior cervical hypertrichosis have been reported. Although it is normally an isolated finding, it may be associated with mental retardation, hallux valgus, retinal disorders, other hair disorders, facial dysmorphism, or sensory and motor peripheral neuropathy. We report the case of a 27-year-old woman who presented with this condition as an isolated finding. PMID:19268113

  15. Effect of unilateral mandibular distraction osteogenesis on mandibular morphology in rabbits with antigen-induced temporomandibular joint arthritis.

    PubMed

    Andersen, K; Pedersen, T K; Svendsen, P; Hauge, E M; Schou, S; Nørholt, S E

    2015-08-01

    Aim was to evaluate effect of unilateral distraction osteogenesis (DO) on mandibular morphology in rabbits with antigen-induced arthritis in the temporomandibular joint (TMJ). Forty 8-week-old rabbits were divided into four groups. In groups A,C, arthritis was induced in the right TMJ. Groups A,B underwent DO. Group D served as control group. Cephalometric analysis of mandibular angle, mandibular ramus height, mandibular collum height, and total posterior mandibular height was done on CT-scans preoperatively (T0), after distraction (T1), and at euthanasia (T2). Two-factor ANOVA evaluated the effect of DO and antigen-induced arthritis. No effect of DO or arthritis was observed on mandibular angle or mandibular collum height. For T0-T1, DO increased mandibular ramus height 12.3% (95% CI 5.2-19.4%) in group B (P=0.001) and total posterior mandibular height 6.2% (95% CI 0.3-12.1%) in group A (P=0.04) and 10.0% (95% CI 4.3-15.7%) in group B (P=0.001). For T1-T2, no significant changes occurred in arthritic rabbits (group A). In conclusion, DO increased total posterior mandibular height in rabbits with arthritis. Postoperatively, no significant effect of DO was observed in rabbits with arthritis. Mandibular DO could be a viable treatment modality in patients with TMJ-arthritis. PMID:25835759

  16. Validity of a Manual Soft Tissue Profile Prediction Method Following Mandibular Setback Osteotomy

    PubMed Central

    Kolokitha, Olga-Elpis

    2007-01-01

    Objectives The aim of this study was to determine the validity of a manual cephalometric method used for predicting the post-operative soft tissue profiles of patients who underwent mandibular setback surgery and compare it to a computerized cephalometric prediction method (Dentofacial Planner). Lateral cephalograms of 18 adults with mandibular prognathism taken at the end of pre-surgical orthodontics and approximately one year after surgery were used. Methods To test the validity of the manual method the prediction tracings were compared to the actual post-operative tracings. The Dentofacial Planner software was used to develop the computerized post-surgical prediction tracings. Both manual and computerized prediction printouts were analyzed by using the cephalometric system PORDIOS. Statistical analysis was performed by means of t-test. Results Comparison between manual prediction tracings and the actual post-operative profile showed that the manual method results in more convex soft tissue profiles; the upper lip was found in a more prominent position, upper lip thickness was increased and, the mandible and lower lip were found in a less posterior position than that of the actual profiles. Comparison between computerized and manual prediction methods showed that in the manual method upper lip thickness was increased, the upper lip was found in a more anterior position and the lower anterior facial height was increased as compared to the computerized prediction method. Conclusions Cephalometric simulation of post-operative soft tissue profile following orthodontic-surgical management of mandibular prognathism imposes certain limitations related to the methods implied. However, both manual and computerized prediction methods remain a useful tool for patient communication. PMID:19212468

  17. Lingual mandibular bony defects: CT in the buccolingual plane

    SciTech Connect

    Slasky, B.S.; Bar-Ziv, J.

    1996-05-01

    Our goal was to record the appearance of lingular mandibular bony defects (LMBD) on CT imaging of the mandible in the buccolingual plane. During the CT evaluation of patients planning to undergo dental implant surgery, five cases of LMBD were found. Axial 1.2 x 1.00 mm overlapping CT sections of the mandible and the maxilla were obtained. Then with use of specific software (DentaCT; Elscint), panoramic and cross-sectional (buccolingual) images of the mandible and maxilla were reformatted. Five cases of posterior LMBD were identified; one patient had both a posterior as well as the much rarer anterior LMBD. All cases were incidental findings and all were asymptomatic. CT features of LMBD were displayed it axial, panoramic, and buccolingual planes. The characteristic opening of the bony defect in the lingual aspect of the mandible was clearly displayed on the axial as well as the buccolingual images; however, this key feature was not manifest on the panoramic images; however, this key feature was not manifest on the panoramic images of the mandible. CT features of LMBD in the buccolingual plane are added to the known radiologic description of this entity. 8 refs., 6 figs.

  18. An Analysis of Visibility and Anatomic Variations of Mandibular Canal in Digital Panoramic Radiographs of Dentulous and Edentulous Patients in Northern Iran Populations

    PubMed Central

    Nemati, Somayeh; Ashouri Moghadam, Anahita; Dalili Kajan, Zahra; Mohtavipour, Seyedeh Tahereh; Amouzad, Hasan

    2016-01-01

    Statement of the Problem Insufficient information about the anatomical positions and structure of mandibular canal provokes unwanted damage to this important structure of mandible. Purpose The aim of this study was to determine the visibility and anatomical variations of mandibular canal in digital panoramic radiographs of dentulous and edentulous patients in a sample of Iranian population. Materials and Method In this retrospective-analytical research, 249 digital panoramic radiographs in dentulous group and 126 in edentulous group were studied by an expert oral and maxillofacial radiologist. In both groups, the visibility of canal borders in anterior, middle, and posterior areas were examined. In dentulous group, the distance between the canal and apex of the first and second molars were measured. Canal-to-alveolar crest distance and lower mandibular border was measured in three different points for both groups. Finally, the upper-lower positions of canals were determined. Results In both groups, most visibility occurred in 1/3 of posterior and the least visibility was detected in 1/3 of anterior, with the intermediate being the most visible part (Type 2). There was no significant difference between the left and right sides in all cases. In dentulous group, no correlation was found between the visibility, age, and gender (p> 0.05); however, canal position was related to gender (p= 0.03 and p= 0.04 in right and left sides, respectively). High position was more frequent in females and intermediate position was more common in males. In edentulous group, no correlation was found between age, gender, and canal position (p> 0.05). Conclusion The most visibility of mandibular canal was in its third posterior and the least was in its third anterior part. Although the middle position of canal was more frequently visible than the high position in this study, it does not refute the possibility of damaging the mandibular canal in critical surgeries. PMID:27284556

  19. Use of an Implant O-Ring Attachment for the Tooth Supported Mandibular Overdenture: A Clinical Report

    PubMed Central

    Guttal, Satyabodh S.; Tavargeri, Anand K.; Nadiger, Ramesh K.; Thakur, Srinath L.

    2011-01-01

    Retention of a mandibular denture can be achieved by an implant-retained or natural tooth-retained bar and stud attachment in the anterior segment of the mandible. The same design principles holds true for both implant-retained and tooth-retained methods of anchoring the bar and stud attachment. A simple and cost effective treatment for more complex implant overdenture is the concept of conventional tooth-retained overdentures. When few firm teeth still remain in a compromised dentition, preservation of these teeth for overdentures can improve retention and stability. The authors present a clinical report of a patient treated with a mandibular tooth-borne overdenture with bar and O-ring attachment. A splinted bar supported the prosthesis and an O-ring retained the denture. PMID:21769276

  20. Automated classification of mandibular cortical bone on dental panoramic radiographs for early detection of osteoporosis

    NASA Astrophysics Data System (ADS)

    Horiba, Kazuki; Muramatsu, Chisako; Hayashi, Tatsuro; Fukui, Tatsumasa; Hara, Takeshi; Katsumata, Akitoshi; Fujita, Hiroshi

    2015-03-01

    Findings on dental panoramic radiographs (DPRs) have shown that mandibular cortical index (MCI) based on the morphology of mandibular inferior cortex was significantly correlated with osteoporosis. MCI on DPRs can be categorized into one of three groups and has the high potential for identifying patients with osteoporosis. However, most DPRs are used only for diagnosing dental conditions by dentists in their routine clinical work. Moreover, MCI is not generally quantified but assessed subjectively. In this study, we investigated a computer-aided diagnosis (CAD) system that automatically classifies mandibular cortical bone for detection of osteoporotic patients at early stage. First, an inferior border of mandibular bone was detected by use of an active contour method. Second, regions of interest including the cortical bone are extracted and analyzed for its thickness and roughness. Finally, support vector machine (SVM) differentiate cases into three MCI categories by features including the thickness and roughness. Ninety eight DPRs were used to evaluate our proposed scheme. The number of cases classified to Class I, II, and III by a dental radiologist are 56, 25 and 17 cases, respectively. Experimental result based on the leave-one-out cross-validation evaluation showed that the sensitivities for the classes I, II, and III were 94.6%, 57.7% and 94.1%, respectively. Distribution of the groups in the feature space indicates a possibility of MCI quantification by the proposed method. Therefore, our scheme has a potential in identifying osteoporotic patients at an early stage.

  1. Regional anesthesia for an upper extremity amputation for palliative care in a patient with end-stage osteosarcoma complicated by a large anterior mediastinal mass

    PubMed Central

    Hakim, Mumin; Burrier, Candice; Bhalla, Tarun; Raman, Vidya T; Martin, David P; Dairo, Olamide; Mayerson, Joel L; Tobias, Joseph D

    2015-01-01

    Tumor progression during end-of-life care can lead to significant pain, which at times may be refractory to routine analgesic techniques. Although regional anesthesia is commonly used for postoperative pain care, there is limited experience with its use during home hospice care. We present a 24-year-old male with end-stage metastatic osteosarcoma who required anesthetic care for a right-sided above-the-elbow amputation. The anesthetic management was complicated by the presence of a large mediastinal mass, limited pulmonary reserve, and severe chronic pain with a high preoperative opioid requirement. Intraoperative anesthesia and postoperative pain management were provided by regional anesthesia using an interscalene catheter. He was discharged home with the interscalene catheter in place with a continuous local anesthetic infusion that allowed weaning of his chronic opioid medications and the provision of effective pain control. The perioperative applications of regional anesthesia in palliative and home hospice care are discussed. PMID:26442759

  2. Single-rooted primary first mandibular molar

    PubMed Central

    Haridoss, SelvaKumar; Swaminathan, Kavitha; Rajendran, Vijayakumar; Rajendran, Bharathan

    2014-01-01

    Morphological variations like single-rooted molar in primary dentition are scarce. Understanding the root canal anatomy and variations is necessary for successful root canal therapy. The purpose of the present article is to report successful endodontic treatment of primary left mandibular first molar with an abnormal morphology of a single root. This case report highlights the importance of knowledge and its applications in the management of anomalous anatomic variants which play a crucial role in the success of endodontic treatment. PMID:25150245

  3. Complicated canal morphology of mandibular first premolar

    PubMed Central

    Pallavi, Vyapaka; Kumar, Janga Ravi; Mandava, Ramesh Babu; Rao, Subramanian Hari

    2015-01-01

    The aim of this article was to report an unusual anatomic variation of mandibular first premolar, with one root and three distinct canals, which leave pulp chamber and merge short of apex to exit as two separate apical foramina. The incidence of three canals existing as two apical foramina has only been documented in the literature by a few case reports. To achieve successful endodontic treatment, the clinician has to identify the different canal configurations and treat them properly. PMID:26538977

  4. Mandibular asymmetry and the fourth dimension.

    PubMed

    Kaban, Leonard B

    2009-03-01

    This paper represents more than 30 years of discussion and collaboration with Drs Joseph Murray and John Mulliken in an attempt to understand growth patterns over time (ie, fourth dimension) in patients with hemifacial microsomia (HFM). This is essential for the development of rational treatment protocols for children and adults with jaw asymmetry. Traditionally, HFM was thought of as a unilateral deformity, but it was recognized that 20% to 30% of patients had bilateral abnormalities. However, early descriptions of skeletal correction addressed almost exclusively lengthening of the short (affected) side of the face. Based on longitudinal clinical observations of unoperated HFM patients, we hypothesized that abnormal mandibular growth is the earliest skeletal manifestation and that restricted growth of the mandible plays a pivotal role in progressive distortion of both the ipsilateral and contralateral facial skeleton. This hypothesis explains the progressive nature of the asymmetry in patients with HFM and provides the rationale for surgical lengthening of the mandible in children to prevent end-stage deformity. During the past 30 years, we have learned that this phenomenon of progressive distortion of the adjacent and contralateral facial skeleton occurs with other asymmetric mandibular undergrowth (tumor resection, radiation therapy, or posttraumatic defects) and overgrowth (mandibular condylar hyperplasia) conditions. In this paper, I describe the progression of deformity with time in patients with mandibular asymmetry as a result of undergrowth and overgrowth. Understanding these concepts is critical for the development of rational treatment protocols for adults with end-stage asymmetry and for children to minimize secondary deformity. PMID:19182686

  5. Unilateral Mydriasis After Mandibular Fracture Fixation Surgery

    PubMed Central

    Nesioonpour, Sholeh; Khiabani, Kazem; Hassanijirdehi, Marzieh

    2014-01-01

    Introduction: Unilateral mydriasis is a seriously significant finding in neurologic examinations indicating life-threatening conditions such as cerebral vascular injuries. Case Presentation: A 24 year old woman with mandibular trauma was referred to our center after five days for a reduction of the right mandibular angle fracture. The patient had no history of any loss of consciousness after the accident. Her physical examination showed no abnormalities, except those related to her mandibular fracture. The laboratory results were normal as well. At 8:30 am a general anesthesia was induced. The patient’s eyes were kept shut throughout the surgical procedure. The operation included an intraoral open reduction and fixation using two miniplates without any complications. After the operation, it was noticed that the left eye was completely dilated with no reaction to light, while the right eye was normal. The management and outcomes in this patient were described in the present case report. Conclusions: Evaluating the size of the patient’s pupils before, during and after the operation, careful history, consult, CT scan and MRI would help to diagnosis. Although no probable cause was found to explain the transient mydriasis in our patient. PMID:24829881

  6. Late treatment of a mandibular gunshot wound

    PubMed Central

    de Gouveia, Marcia Maria; Alves, Carlos Augusto Ferreira; Migliolo, Rodrigo Chenu

    2015-01-01

    Mandibular gunshot injuries are esthetically and functionally devastating, causing comminuted fractures and adjacent tissue destruction depending on the weapon gauge, projectile shape, impact kinetic energy, and density of the injured structures. If the mandibular fracture is not adequate or promptly treated, the broken fragments will fail to heal. In case of a treatment delay, progressive bone loss and fracture contracture will require a customized approach, which includes open reduction, removal of fibrous tissue between the bony stumps, and fixation of the fracture with a reconstruction plate and autogenous graft. The authors report the case of a 34-year-old man wounded on the mandible 15 years ago. With the aid of computed tomography and a prototype, a surgical plan was designed including open reduction and internal fixation of the segmental mandibular defect with a reconstruction plate and bone graft harvested from the iliac crest. The postoperative follow-up was uneventful and the 12-month follow up showed a positive aesthetic and functional result. PMID:26484326

  7. New prediction equations for the estimation of maxillary mandibular canine and premolar widths from mandibular incisors and mandibular first permanent molar widths: A digital model study

    PubMed Central

    Shahid, Fazal; Khamis, Mohd Fadhli

    2016-01-01

    Objective The primary aim of the study was to generate new prediction equations for the estimation of maxillary and mandibular canine and premolar widths based on mandibular incisors and first permanent molar widths. Methods A total of 2,340 calculations (768 based on the sum of mandibular incisor and first permanent molar widths, and 1,572 based on the maxillary and mandibular canine and premolar widths) were performed, and a digital stereomicroscope was used to derive the the digital models and measurements. Mesiodistal widths of maxillary and mandibular teeth were measured via scanned digital models. Results There was a strong positive correlation between the estimation of maxillary (r = 0.85994, r2 = 0.7395) and mandibular (r = 0.8708, r2 = 0.7582) canine and premolar widths. The intraclass correlation coefficients were statistically significant, and the coefficients were in the strong correlation range, with an average of 0.9. Linear regression analysis was used to establish prediction equations. Prediction equations were developed to estimate maxillary arches based on Y = 15.746 + 0.602 × sum of mandibular incisors and mandibular first permanent molar widths (sum of mandibular incisors [SMI] + molars), Y = 18.224 + 0.540 × (SMI + molars), and Y = 16.186 + 0.586 × (SMI + molars) for both genders, and to estimate mandibular arches the parameters used were Y = 16.391 + 0.564 × (SMI + molars), Y = 14.444 + 0.609 × (SMI + molars), and Y = 19.915 + 0.481 × (SMI + molars). Conclusions These formulas will be helpful for orthodontic diagnosis and clinical treatment planning during the mixed dentition stage. PMID:27226963

  8. Bilaterally impacted mandibular supernumerary premolars associated with unusual clinical complications

    PubMed Central

    Pasha, Zameer; Choudhari, Sameer; Rathod, Azhar; Sulabha, A. N.

    2013-01-01

    Supernumerary teeth are extra teeth in comparison to the normal dentition. Their prevalence varies between 0.1% and 3.8%. Supernumeraries are more common in permanent dentition and its incidence is higher in maxillary incisor region, followed by maxillary third molar and mandibular molar, premolar, canine, and lateral incisor. The prevalence of supernumerary premolars is between 0.075-0.26%, and they may occur in single or multiple numbers Bilateral occurrence is uncommon and large percentage of supernumerary premolars remains impacted, unerupted, and usually asymptomatic; radiograph plays an important role in diagnosis of these. The present paper reports a case of bilaterally impacted completely developed supernumerary premolars associated with common clinical complication in unusual manner along with taurodontism of the upper and lower molars. PMID:23833524

  9. Reconstruction of Beagle Hemi-Mandibular Defects with Allogenic Mandibular Scaffolds and Autologous Mesenchymal Stem Cells

    PubMed Central

    Luo, JinChao; Liu, HuaWei; Hu, Min; Yue, Wen

    2014-01-01

    Objective Massive bone allografts are frequently used in orthopedic reconstructive surgery, but carry a high failure rate of approximately 25%. We tested whether treatment of graft with mesenchymal stem cells (MSCs) can increase the integration of massive allografts (hemi-mandible) in a large animal model. Methods Thirty beagle dogs received surgical left-sided hemi-mandibular defects, and then divided into two equal groups. Bony defects of the control group were reconstructed using allografts only. Those of the experimental group were reconstructed using allogenic mandibular scaffold-loaded autologous MSCs. Beagles from each group were killed at4 (n = 4), 12 (n = 4), 24 (n = 4) or 48 weeks (n = 3) postoperatively. CT and micro-CT scans, histological analyses and the bone mineral density (BMD) of transplants were used to evaluate defect reconstruction outcomes. Results Gross and CT examinations showed that the autologous bone grafts had healed in both groups. At 48 weeks, the allogenic mandibular scaffolds of the experimental group had been completely replaced by new bone, which has a smaller surface area to that of the original allogenic scaffold, whereas the scaffold in control dogs remained the same size as the original allogenic scaffold throughout. At 12 weeks, the BMD of the experimental group was significantly higher than the control group (p<0.05), and all micro-architectural parameters were significantly different between groups (p<0.05). Histological analyses showed almost all transplanted allogeneic bone was replaced by new bone, principally fibrous ossification, in the experimental group, which differed from the control group where little new bone formed. Conclusions Our study demonstrated the feasibility of MSC-loaded allogenic mandibular scaffolds for the reconstruction of hemi-mandibular defects. Further studies are needed to test whether these results can be surpassed by the use of allogenic mandibular scaffolds loaded with a

  10. Mandibular changes during initial alignment with SmartClip self-ligating and conventional brackets: A single-center prospective randomized controlled clinical trial

    PubMed Central

    Bayram, Mehmet; Nur, Metin; Kilkis, Dogan

    2015-01-01

    Objective To test the null hypothesis that SmartClip self-ligating brackets are more effective than conventional brackets for initial mandibular alignment and identify influential factors. Methods Fifty patients were randomly allocated to two equal treatment groups by using an online randomization program: self-ligating group (SmartClip brackets) and conventional group (Gemini brackets). The archwire sequence was standardized. Changes in anterior irregularity index, intercanine width, and intermolar width were assessed on plaster models at 8th and 16th weeks. Changes in incisor position and inclination were assessed on lateral cephalometric radiographs at 16 weeks. Intragroup and intergroup comparisons were performed with paired t-test and Student's t-test, respectively. Multiple linear regression was performed to identify variables affecting improvement in anterior ambiguity. Results Data of 46 patients were analyzed; those missing an appointment (n = 2) or showing bracket breakage (n = 2) were excluded. Incisor inclination (p < 0.05), intercanine width (p < 0.05), and intermolar width (p > 0.05) increased at 8 and 16 weeks in both the groups; no significant intergroup differences were noted (p > 0.05). Initial anterior irregularity index and intercanine width change were significantly associated with improvement in anterior irregularity (p < 0.001). Conclusions The null hypothesis was rejected. Bracket type has little effect on improvement in anterior ambiguity during initial mandibular alignment. PMID:25798415

  11. Low-cost Design and Manufacturing of Surgical Guides for Mandibular Reconstruction Using a Fibula

    PubMed Central

    Nakamura, Hiroko; Sowa, Yoshihiro; Nishino, Kenichi

    2016-01-01

    Background: Surgical cutting guides are used in mandibular reconstruction involving osteotomy of the mandible and fibula. Cutting guides produced using computer-aided design (CAD) and computer-aided manufacturing (CAM) technologies have been reported recently. These guides aim to increase the benefits to patients by improving the accuracy, shortening the operating time, and correcting occlusion. However, the availability of these advanced technologies is limited in some regions of the world. To test whether we could produce low-cost surgical cutting guides, we made surgical guides and investigated their accuracy. Methods: Using free CAD software, we designed surgical cutting guides for the mandible and fibula and used these to perform virtual mandibular segmental osteotomies and fibula transplants in 12 model surgeries. The cutting guides were printed on a 3-dimensional (3D) printer. The model surgeries were performed using 3D mandibular models and cutting guides to check their accuracy. Deviations between the virtually simulated plan and the actual model surgery were investigated. Results: CAD and CAM technologies were used to design and 3D print the cutting guides and models. The guided surgeries were performed. The deviations were about 1.3 mm for mandibular osteotomy, less than 1 mm for fibular osteotomy, and within 2.4 mm for reconstructions of the mandible. Conclusions: Without using expensive software or products, we were able to design surgical cutting guides for the mandible and fibula and used these to perform virtual simulation of mandibular segmental osteotomy and fibular reconstruction. Model surgeries using 3D-printed surgical guides showed that the accuracy of reconstruction was within a 3-mm deviation. In circumstances where commercial CAD/CAM guides are not available, it may be possible to use CAD/CAM surgical guides in the clinic if doctors are willing to volunteer their time for the design and printing. PMID:27536484

  12. Congenital anterior urethral diverticulum.

    PubMed

    Singh, Sanjeet Kumar; Ansari, Ms

    2014-09-01

    Congenital anterior urethral diverticulum (CAUD) may be found all along the anterior urethra and may present itself at any age, from infant to adult. Most children with this condition present with difficulty in initiating micturition, dribbling of urine, poor urinary stream, or urinary tract infection. A careful history will reveal that these children never had a good urinary stream since birth, and the telltale sign is a cystic swelling of the penile urethra. In this paper, we present two cases of CAUD that were managed by excision of the diverticulum with primary repair. PMID:26328174

  13. Mandibular Exostosis in Canine with Single Tooth Recession – A Rare Case Report

    PubMed Central

    Jain, Rachna; Kapoor, Daljit; Sujay, J

    2014-01-01

    Buccal exostoses occur along the buccal aspect of the maxilla or mandible, usually in the premolar and molar areas. It has been suggested that the bony outgrowth represents a reaction to increased or abnormal occlusal stress to the teeth in the involved areas. Gingival recessions may occur without any symptoms but may give rise to the patient concern about poor esthetics, dentine hypersensitivity, inability to perform oral hygiene procedures, and loss of the tooth. This article presents a rare case of exostosis in the mandibular right canine region and single tooth recession in the mandibular left central incisor region which was successfully managed by a combination of osseous resective surgery done to treat exostosis and lateral pedicle technique for root coverage. PMID:25214741

  14. Evaluation of the Mandibular Function, after Nonsurgical Treatment of Unilateral Subcondylar Fracture: A 1-Year Follow-Up Study.

    PubMed

    K M, Sudheesh; Desai, Rajendra; K Sn, Siva Bharani; S, Subhalakshmi

    2016-09-01

    There are no clearly defined guidelines for when an open or closed treatment is indicated for treatment of mandibular condylar fractures. The aim of the study is to analyze the mandibular function after nonsurgical treatment of unilateral subcondylar fractures, in a prospective study. A prospective study was conducted on 30 patients with unilateral mandibular subcondylar fracture undergoing nonsurgical treatment. Clinical and radiographic examinations were done prior to treatment and at 12-month follow-up. Pain, perceived occlusion, mouth opening, protrusion, and horizontal movements of the mandible were evaluated by clinical examination. Radiologic evaluation was done using Panoramic and Reverse Towne's radiographs. At 12-month follow-up, there was minimal pain in the temporomandibular joint region, there was an improvement in the perceived occlusion, and mouth opening did not reduce. There was insignificant absolute difference between left and right lateral mandibular movements. The amount of increase in the protrusion of mandible was insignificant. On radiographic evaluation, the degree of coronal and sagittal displacement was insignificant at follow-up. Mean ramus height pretreatment and 12 months posttreatment were 0.98 ± 0.50 and 0.87 ± 0.47, respectively. Based on this study, patients had adequate mandibular function and minimal pain after nonsurgical treatment. Unilateral subcondylar fractures of the mandible can be treated nonsurgically in patients with minimal occlusal discrepancies, adequate mouth opening, minimal displacement of condyle, and minimal ramus height shortening. PMID:27516838

  15. A new system for assessment of growth using mandibular canine calcification stages and its correlation with modified MP3 stages

    PubMed Central

    Hegde, Gautham; Hegde, Nanditha; Kumar, Anil; Keshavaraj

    2014-01-01

    Objective: Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. Materials and Methods: A total of 160 periapical radiographs, of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian's stages of dental calcification and the modified MP3 stages. Results and Discussion: The correlation coefficient between MP3 stages and developmental stages of mandibular canine was found to be significant in both male and female groups. When the canine calcification stages were compared with the MP3 stages it was found that with the exception of the D stage of canine calcification the remaining stages showed a very high correlation with the modified MP3 stages. Conclusion: The correlation between the mandibular canine calcification stages, and the MP3 stages was found to be significant. The canine calcification could be used as a sole indicator for assessment of skeletal maturity. PMID:25210386

  16. Evaluation of the potential of automatic segmentation of the mandibular canal using cone-beam computed tomography.

    PubMed

    Gerlach, Nicolaas Lucius; Meijer, Gerrit Jacobus; Kroon, Dirk-Jan; Bronkhorst, Ewald Maria; Bergé, Stefaan Jozef; Maal, Thomas Jan Jaap

    2014-11-01

    We aimed to investigate the effectiveness of software for automatically tracing the mandibular canal on data from cone-beam computed tomography (CT). After the data had been collected from one dentate and one edentate fresh cadaver head, both a trained Active Shape Model (ASM) and an Active Appearance Model (AAM) were used to automatically segment the canals from the mandibular to the mental foramen. Semiautomatic segmentation was also evaluated by providing the models with manual annotations of the foramina. To find out if the tracings were in accordance with the actual anatomy, we compared the position of the automatic mandibular canal segmentations, as displayed on cross-sectional cone-beam CT views, with histological sections of exactly the same region. The significance of differences between results were analysed with the help of Fisher's exact test and Pearson's correlation coefficient. When tracings based on AAM and ASM were used, differences between cone-beam CT and histological measurements varied up to 3.45mm and 4.44mm, respectively. Manual marking of the mandibular and mental foramina did not improve the results, and there were no significant differences (p=0.097) among the methods. The accuracy of automatic segmentation of the mandibular canal by the AAM and ASM methods is inadequate for use in clinical practice. PMID:25156043

  17. Mandibular osteonecrosis following herpes zoster infection in the mandibular branch of the trigeminal nerve: a case report and literature review

    PubMed Central

    2015-01-01

    Herpes zoster virus (HZV) infections are caused by reactivation of the varicella zoster virus. Reactivation symptoms commonly affect the thoracolumbar trunk, and rarely affect the mandibular branches of the trigeminal nerve. When the mandibular branches are involved, lesions appear proximal to the innervation area. This condition may be associated with exfoliation of the teeth and osteonecrosis of the jawbone. We report a case of mandibular osteomyelitis after herpes zoster infection and we present a review of the literature on mandibular-branch involvement of HZV-related osteonecrosis. PMID:26733193

  18. Abnormal changes in both mandibular salivary glands in a dog: Non-mineral radiopaque sialoliths

    PubMed Central

    Suh, Hyun-Jung; Chung, Dai Jung; Lee, A-Jin; Chung, Hyo-Jin; Kim, Dae-Hyun; Eom, Ki-Dong; Do, Sun Hee; Kim, Hwi-Yool

    2015-01-01

    A 10-year-old Maltese dog was presented with a firm mass on the left side of his neck. Physical examination confirmed a firm mass in the left and a submandibular swelling in the right cervical region. Sialolithiasis and associated sialocele in both mandibular salivary glands were suspected and bilateral sialoadenectomy was performed. The stones were identified as non-mineral sialoliths. PMID:26483575

  19. Abnormal changes in both mandibular salivary glands in a dog: Non-mineral radiopaque sialoliths.

    PubMed

    Suh, Hyun-Jung; Chung, Dai Jung; Lee, A-Jin; Chung, Hyo-Jin; Kim, Dae-Hyun; Eom, Ki-Dong; Do, Sun Hee; Kim, Hwi-Yool

    2015-10-01

    A 10-year-old Maltese dog was presented with a firm mass on the left side of his neck. Physical examination confirmed a firm mass in the left and a submandibular swelling in the right cervical region. Sialolithiasis and associated sialocele in both mandibular salivary glands were suspected and bilateral sialoadenectomy was performed. The stones were identified as non-mineral sialoliths. PMID:26483575

  20. [Toxic anterior segment syndrome].

    PubMed

    Cornut, P-L; Chiquet, C

    2011-01-01

    Toxic anterior segment syndrome (TASS) is a general term used to describe acute, sterile postoperative inflammation due to a non-infectious substance that accidentally enters the anterior segment at the time of surgery and mimics infectious endophthalmitis. TASS most commonly occurs acutely following anterior segment surgery, typically 12-72h after cataract extraction. Anterior segment inflammation is usually quite severe with hypopyon. Endothelial cell damage is common, resulting in diffuse corneal edema. No bacterium is isolated from ocular samples. The causes of TASS are numerous and difficult to isolate. Any device or substance used during the surgery or in the immediate postoperative period may be implicated. The major known causes include: preservatives in ophthalmic solutions, denatured ophthalmic viscosurgical devices, bacterial endotoxin, and intraocular lens-induced inflammation. Clinical features of infectious and non-infectious inflammation are initially indistinguishable and TASS is usually diagnosed and treated as acute endophthalmitis. It usually improves with local steroid treatment but may result in chronic elevation of intraocular pressure or irreversible corneal edema due to permanent damage of trabecular meshwork or endothelial cells. PMID:21176994

  1. A finite element analysis of stress distribution in the bone, around the implant supporting a mandibular overdenture with ball/o ring and magnetic attachment.

    PubMed

    John, Jins; Rangarajan, V; Savadi, Ravindra C; Satheesh Kumar, K S; Satheesh Kumar, Preeti

    2012-03-01

    Today implant dentistry has made great inroads into the treatment modalities that are available in treating an edentulous patient. Popularity of a two implant retained overdenture has created a necessity to examine the various attachment systems being used and the stresses that are transmitted to the alveolar bone. Hence a Three dimensional Finite Element Analysis was done to analyze the stress distribution in the mandibular bone with implant-supported overdenture having Ball/O-ring and Magnet attachments of different diameters. A segment of the anterior region of the mandible was modeled with implant and the overdenture. Four different models were generated having Ball/O-Ring and Magnet Attachments. Forces of 10 N, 35 N and 70 N were applied from the horizontal, vertical and oblique directions respectively and the stress distribution studied. It was concluded that the greatest stress concentrations were seen at the crest of the cortical bone and could be reduced by using smaller sized attachments for implant supported-overdenture. PMID:23450217

  2. Mandibular trauma treatment: A comparison of two protocols

    PubMed Central

    Kommers, Sofie C.; Roccia, Fabio; Forouzanfar, Tymour

    2015-01-01

    Objectives: The aim of this study was to evaluate the treatment of mandibular fractures treated in two European centre in 10 years. Study Design: This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures in two centers in Turin, Italy and in Amsterdam, the Netherlands for ten years. Only patients who were admitted for mandibular fractures were considered for this study. Results: Between 2001 and 2010, a total of 752 patients were admitted at Turin hospital with a total of 1167 mandibular fractures not associated with further maxillofacial fractures, whereas 245 patients were admitted at Amsterdam hospital with a total of 434 mandibular fractures. At Amsterdam center, a total of 457 plates (1.5 - 2.7 mm) were used for the 434 mandibular fracture lines, whereas at Turin center 1232 plates (1.5 – 2.5 mm) were used for the management of the 1167 mandibular fracture lines. At Turin center, 190 patients were treated primarily with IMF, whereas 35 patients were treated with such treatment option at Amsterdam center. Conclusions: Current protocols for the management of mandibular fractures are quite efficient. It is difficult to obtain a uniform protocol, because of the difference of course of each occurring fracture and because of surgeons’ experiences and preferences. Several techniques can still be used for each peculiar fracture of the mandible. Key words:Mandibular fracture, facial trauma, maxillofacial, treatment, multicentre, database. PMID:25475782

  3. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  4. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  5. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  6. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  7. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  8. Management of mandibular deviation after mandibulectomy by simplified approach.

    PubMed

    Arora, Varuni; Singh, Kamleshwar; Agrawal, Kaushal Kishor; Alvi, Habib Ahmed

    2013-01-01

    Unfavourable sequelae from mandibular surgeries include malocclusion and temporomandibular joint dysfunction. The management of the situation before these complications arise is largely based on experience. This report presents a case where mandibular deviation is decreased through an additional row of teeth in the maxillary removable partial denture, and by decreasing scar contracture in the surgical site by means of a simple exercise. PMID:23625665

  9. Unusual complication of repair of fractured mandibular angle.

    PubMed

    Delpachitra, S; Rahmel, B; Ramalingam, L

    2015-02-01

    Internal fixation with miniplates remains an accepted and reliable approach to the management of mandibular fractures, and erosion through the oral mucosa is a well-recognised long-term complication. We report a case of erosion of a miniplate through the skin 5 years after internal fixation of a fracture of the left mandibular angle. PMID:25532968

  10. The Effect of Altered Loading on Mandibular Condylar Cartilage

    PubMed Central

    Kaul, Raman; O’Brien, Mara H.; Dutra, Eliane; Lima, Alexandro; Utreja, Achint; Yadav, Sumit

    2016-01-01

    Objective The purpose of this study was to delineate the cellular, mechanical and morphometric effects of altered loading on the mandibular condylar cartilage (MCC) and subchondral bone. We hypothesized that altered loading will induce differentiation of cells by accelerating the lineage progression of the MCC. Materials and Methods Four-week-old male Dkk3 XCol2A1XCol10A1 mice were randomly divided into two groups: (1) Loaded-Altered loading of MCC was induced by forced mouth opening using a custom-made spring; (2) Control-served as an unloaded group. Mice were euthanized and flow cytometery based cell analysis, micro-CT, gene expression analysis, histology and morphometric measurements were done to assess the response. Results Our flow cytometery data showed that altered loading resulted in a significant increase in a number of Col2a1-positive (blue) and Col10a1-positive (red) expressing cells. The gene expression analysis showed significant increase in expression of BMP2, Col10a1 and Sox 9 in the altered loading group. There was a significant increase in the bone volume fraction and trabecular thickness, but a decrease in the trabecular spacing of the subchondral bone with the altered loading. Morphometric measurements revealed increased mandibular length, increased condylar length and increased cartilage width with altered loading. Our histology showed increased mineralization/calcification of the MCC with 5 days of loading. An unexpected observation was an increase in expression of tartrate resistant acid phosphatase activity in the fibrocartilaginous region with loading. Conclusion Altered loading leads to mineralization of fibrocartilage and drives the lineage towards differentiation/maturation. PMID:27472059

  11. Assessing the mobility of the mandibular condyle by sonography

    PubMed Central

    Chen, Han-Yu; Wu, Shyi-Kuen; Lu, Chuan-Chin; You, Jia-Yuan; Lai, Chung-Liang

    2014-01-01

    Purpose Traditionally, the measurement of the maximal mouth opening was regarded as the mobility of the temporomandibular joint. The information, however, was not reliable. Sonography was often used to diagnose disc displacement in the temporomandibular joint and its validity was well established. The tool was also appropriate for measuring the outcome of temporomandibular disorders management. Therefore, the purpose of the study was to examine completely the reliability and error for evaluating the mobility of the mandibular condyle by sonography. In addition, the existing methods were modified to improve the repeatability. Patients and methods The reliability examinations included between-image and within-image explorations to represent the reliabilities of the image capturing and the mobility measuring, respectively. Sixty-two subjects were recruited to receive ultrasonic examination for condylar mobility. The images of the condyle in mouth closing and opening were captured and the horizontal displacement of the condyles was measured as the anterior translation of the condyle. To confirm that the probe did not move during mouth opening, a marker was placed between the skin and the ultrasonic probe as the landmark. Results The results demonstrated that the intrarater and interrater reliabilities in the within-image test were 0.986 and 0.970 and the reliabilities in the between-image test were 0.904 and 0.857, respectively. The standard errors of measurement in the within-image and between-image tests were 0.04 cm and 0.09 cm, respectively. Conclusion Sonography is a reliable tool to assess condylar mobility and can be used to measure the treatment outcome for temporomandibular disorders. PMID:25342888

  12. Role of the anterior region of the third ventricle in the cardiovascular responses produced by systemic injection of a nitric oxide synthase inhibitor

    NASA Technical Reports Server (NTRS)

    Lewis, S. J.; Whalen, E. J.; Beltz, T. G.; Johnson, A. K.

    1999-01-01

    This study examined whether a prior electrolytic lesion of the tissue surrounding the anteroventral third ventricle (AV3V) would affect the increase in mean arterial blood pressure (MAP) and the fall in heart rate (HR) produced by systemic injection of the nitric oxide synthesis (NOS) inhibitor, NG-nitro-L-arginine methyl ester (L-NAME; 25 micromol/kg, i.v.) in conscious rats. L-NAME produced a smaller increase in MAP in AV3V-lesion than in sham-lesion rats (+19+/-3 vs. +40+/-3 mmHg, respectively; P<0.05). In contrast, L-NAME produced similar falls in HR in the AV3V-lesion and sham-lesion rats (-103+/-15 vs. -97+/-8 bpm, respectively; P<0.05). These findings demonstrate that the L-NAME-induced pressor response is dependent upon the integrity of the AV3V region, whereas the L-NAME-induced bradycardia is not. Copyright 1999 Elsevier Science B. V.

  13. Clinical Efficiency of Two Sequences of Orthodontic Wires to Correct Crowding of the Lower Anterior Teeth

    PubMed Central

    Maria de Castro Serafim, Cláudia; de Araújo Gurgel, Júlio; Mota Tiago, Carollyne; Rodolfo de Jesus Tavarez, Rudys; Matos Maia Filho, Etevaldo

    2015-01-01

    This study compared time to correction of mandibular anterior crowding using two arch wire sequences, one with conventional nickel-titanium (NiTi) arch wires and the other with conventional and NiTi heat-activated arch wires. Twenty-two boys and girls (mean age: 16.68 ± 2.66) with moderate crowding (3–6 mm) were assigned randomly to one of two groups and followed up for five months (six assessments) when arch wires were changed. Time to crowding correction was analyzed statistically using the Kaplan-Meier method. Data were collected during the five-month follow-up, and time to correction was compared between groups using the log rank test. At the end of follow-up, mandibular crowding was corrected in 100% of the cases in the group treated with the sequence that included NiTi heat-activated arch wires, whereas about 30% of those treated with NiTi arch wires were not completely corrected. There was a significant difference in time to complete treatment between groups (log rank = 5.996; p < 0.05). In the group treated with the sequence that included heat-activated wires, alignment and leveling of mandibular anterior teeth were completed earlier than in the group treated only with conventional NiTi arch wires. Clinical trial registration is found at RBR-7g5zng. PMID:26176018

  14. Clinical Efficiency of Two Sequences of Orthodontic Wires to Correct Crowding of the Lower Anterior Teeth.

    PubMed

    Serafim, Cláudia Maria de Castro; Gurgel, Júlio de Araújo; Tiago, Carollyne Mota; Tavarez, Rudys Rodolfo de Jesus; Maia Filho, Etevaldo Matos

    2015-01-01

    This study compared time to correction of mandibular anterior crowding using two arch wire sequences, one with conventional nickel-titanium (NiTi) arch wires and the other with conventional and NiTi heat-activated arch wires. Twenty-two boys and girls (mean age: 16.68 ± 2.66) with moderate crowding (3-6 mm) were assigned randomly to one of two groups and followed up for five months (six assessments) when arch wires were changed. Time to crowding correction was analyzed statistically using the Kaplan-Meier method. Data were collected during the five-month follow-up, and time to correction was compared between groups using the log rank test. At the end of follow-up, mandibular crowding was corrected in 100% of the cases in the group treated with the sequence that included NiTi heat-activated arch wires, whereas about 30% of those treated with NiTi arch wires were not completely corrected. There was a significant difference in time to complete treatment between groups (log rank = 5.996; p < 0.05). In the group treated with the sequence that included heat-activated wires, alignment and leveling of mandibular anterior teeth were completed earlier than in the group treated only with conventional NiTi arch wires. Clinical trial registration is found at RBR-7g5zng. PMID:26176018

  15. Unusual solitary osteochondroma of the mandibular ramus.

    PubMed

    Anupam, Mishra; Shukla, G K; Mishra, S C; Bhatia, Naresh; Srivastava, A N; Mishra, Nimisha

    2002-01-01

    Mandibular osteochondromas, although rare, predominantly involve the condyloid and coronoid processes. An extremely rare case arising from the inner aspect of the gonion is reported here. Only one such case has been reported in the literature so far. Despite being very slow growing and having a benign course, histopathological examination showed reactive changes that may be confused with sarcomatous transformation. We advocate surgical excision using a combined external and internal approach followed by regular post-operative review. The relevant literature has been reviewed but various surgical approaches as advocated in the past have not been found suitable. PMID:11860660

  16. Cephradine (Velosef) penetration of mandibular bone.

    PubMed

    Middlehurst, R J; Rood, J P

    1990-04-01

    The concentration of cephradine in serum and mandibular bone was assayed in 28 patients undergoing 3rd molar surgery following a single 1 g intravenous injection. Serum and cortical bone samples taken simultaneously, contained mean cephradine concentrations of 42.11 micrograms/ml and 2.61 micrograms/g respectively. These results, when compared with those reported for other bony sites including the femoral head and knee, show a reduced bone penetration with a bone-to-serum ratio of approximately 0.06:1. PMID:2111359

  17. Late development of a mandibular second premolar

    PubMed Central

    Doruk, Cenk; Babacan, Hasan

    2012-01-01

    In this report, we present the case of a girl with delayed odontogenesis of a lower second premolar for which she was followed up for 8.5 years. Congenital absence of permanent mandibular second premolars was observed at the initial radiographic examination at 8 years and 1 month. One year later, during the treatment period, an unexpected odontogenesis of a right second premolar was diagnosed on follow-up radiography. The original treatment plan was revised and a new plan was successfully implemented. Th is unusual case showed that the orthodontist's clinical philosophy must be flexible because unexpected situations can arise, especially when treating growing patients. PMID:23112938

  18. Surgical orthodontic correction of mandibular laterognathism

    PubMed Central

    Singh, Harpreet; Srivastava, Dhirendra; Kapoor, Pranav; Sharma, Poonam

    2016-01-01

    This case report describes the successful treatment of a patient with mandibular laterognathism and associated facial asymmetry with combined surgical orthodontic approach. After 7 months of presurgical orthodontic treatment, intraoral vertical ramus osteotomy, and straightening genioplasty were performed as two step surgeries to reposition the deviated mandible and chin, respectively. The total active treatment period was 14 months. After surgical orthodontic treatment, significant improvement in occlusion, masticatory function, and facial appearance was discernible. Posttreatment records at 3 years showed stable results with good occlusion. PMID:27127755

  19. Stereopsis after anterior temporal lobectomy.

    PubMed

    Verhoef, Bram-Ernst; Decramer, Thomas; van Loon, Johannes; Goffin, Jan; Van Paesschen, Wim; Janssen, Peter; Theys, Tom

    2016-09-01

    Brain areas critical for stereopsis have been investigated in non-human primates but are largely unknown in the human brain. Microelectrode recordings and functional MRI (fMRI) studies in monkeys have shown that in monkeys the inferior temporal cortex is critically involved in 3D shape categorization. Furthermore, some human fMRI studies similarly suggest an involvement of visual areas in the temporal lobe in depth perception. We aimed to investigate the role of the human anterior temporal neocortex in stereopsis by assessing stereoscopic depth perception before and after anterior temporal lobectomy. Eighteen epilepsy surgery patients were tested, pre- and postoperatively, in 3 different depth discrimination tasks. Sensitivity for local and global disparity was tested in a near-far discrimination task and sensitivity for 3D curvature was assessed in a convex-concave discrimination task, where 3D shapes were presented at different positions in depth. We found no evidence that temporal lobe epilepsy surgery has a significant effect on stereopsis. In contrast with earlier findings, we conclude that local as well as global stereopsis is maintained after unilateral resection of the temporal pole in epilepsy surgery patients. Our findings, together with previous studies, suggest that in humans more posterior visual regions underlie depth perception. PMID:27344239

  20. Remotely controlled mandibular positioner predicts efficacy of oral appliances in sleep apnea.

    PubMed

    Tsai, Willis H; Vazquez, Juan-Carlos; Oshima, Tsutomu; Dort, Leslie; Roycroft, Brian; Lowe, Alan A; Hajduk, Eric; Remmers, John E

    2004-08-15

    Anterior mandibular positioners (AMPs) have become increasingly popular as alternatives to continuous positive airway pressure for the treatment of obstructive sleep apnea. However, widespread acceptance of AMP is limited by an efficacy rate of 50-80% and an inability to predict which patients will respond to therapy. We evaluated 23 patients with obstructive sleep apnea (respiratory disturbance index [RDI] >/= 15 h(-1)) with a remotely controlled mandibular positioner (RCMP), a temporary oral appliance that can advance or retract the mandible in a process analogous to changing the mask pressure during a continuous positive airway pressure titration study. We hypothesized that the elimination of respiratory events and significant nocturnal oxygen desaturation during an RCMP overnight study would predict AMP efficacy, as defined by an absolute reduction in RDI to less than 15 h(-1), a relative reduction in RDI of more than 30% from baseline, and a subjective improvement in symptoms. AMP compliance was 82%, and therapeutic efficacy was 53%. Among compliant patients, the positive and negative predictive value of an RCMP study in predicting AMP treatment success was 90% and 89%, respectively. An overnight RCMP study is highly predictive of AMP response. PMID:15105166

  1. Mandibular reconstruction in the radiated patient: the role of osteocutaneous free tissue transfers

    SciTech Connect

    Duncan, M.J.; Manktelow, R.T.; Zuker, R.M.; Rosen, I.B.

    1985-12-01

    This paper discusses our experience with the second metatarsal and iliac crest osteocutaneous transfers for mandibular reconstruction. The prime indication for this type of reconstruction was for anterior mandibular defects when the patient had been previously resected. Midbody to midbody defects were reconstructed with the metatarsal and larger defects with the iliac crest. In most cases, an osteotomy was done to create a mental angle. The evaluation of speech, oral continence, and swallowing revealed good results in all patients unless lip or tongue resection compromised function. Facial contour was excellent in metatarsal reconstructions. The iliac crest cutaneous flap provided a generous supply of skin for both intraoral reconstruction and external skin coverage but tended to be bulky, particularly when used in the submental area. Thirty three of 36 flaps survived completely. Flap losses were due to anastomosis thrombosis (1), pedicle compression (1), and pedicle destruction during exploration for suspected carotid blowout (1). Ninety three percent of bone junctions developed a solid bony union despite the mandible having had a full therapeutic dose of preoperative radiation. Despite wound infections in 8 patients, and intraoral dehiscence with bone exposure in 12 patients, all but one of these transfers went on to good bony union without infection in the bone graft.

  2. Gingival Biotype Assessement: Visual Inspection Relevance And Maxillary Versus Mandibular Comparison

    PubMed Central

    Cuny-Houchmand, Madline; Renaudin, Stéphane; Leroul, Mustapha; Planche, Lucie; Guehennec, Laurent Le; Soueidan, Assem

    2013-01-01

    Objective: This clinical study was aimed at evaluating the accuracy of gingival visual inspection procedures during clinical examination and determining whether differences existed between the maxillary and mandibular gingival biotypes. Materials and Methods: The study included 53 patients and 124 clinicians. The clinicians were asked to assign to each subject, using photographic documents, one of three biotypes: thin-scalloped, thick-scalloped, or thick-flat gingival biotype. A total of 19716 responses were collected for statistical analysis. Results: Identification accuracy of the gingival biotype and the intra-examiner repeatability presented poor highlighting of the limited relevance of visual inspection. In addition, the percent of agreement between classifications based on the global view of both the maxilla and mandible and the classification based on the individual mandibular or maxillary anterior teeth was not statistically significant. Conclusion: Based on the above results, it can be concluded that a simple visual inspection is not effective for the identification of gingival biotype. Furthermore, evidence suggests that a difference of biotype between the maxilla and the mandible in the same patient is conceivable. Therefore, orthodontic clinical examination should incorporate a reproducible method of determining the individualized gingival biotype for each group of teeth that will be moved. PMID:23400554

  3. Anterior urethral stricture review

    PubMed Central

    Stein, Marshall J.

    2013-01-01

    Male anterior urethral stricture disease is a commonly encountered condition that presents to many urologists. According to a National Practice Survey of Board Certified Urologist in the United States most urologists treat on average 6-20 urethral strictures yearly. Many of those same urologists surveyed treat with repeated dilation or internal urethrotomy, despite continual recurrence of the urethral stricture. In point of fact, the urethroplasty despite its high success rate, is underutilized by many practicing urologists. Roughly half of practicing urologist do not perform urethroplasty in the United States. Clearly, the reconstructive ladder for urethral stricture management that was previously described in the literature may no longer apply in the modern era. The following article reviews the etiology, diagnosis, management and comparisons of treatment options for anterior urethral strictures. PMID:26816721

  4. Superficial temporal artery pseudoaneurysm: report of a rare case secondary to mandibular condylar fracture.

    PubMed

    Li, Wei; Long, Xing; Deng, Mohong

    2013-07-01

    A rare case of superficial temporal artery pseudoaneurysm secondary to mandibular condylar fracture is presented. A 21-year-old man referred to the Department of Oral and Maxillofacial Surgery with limited mouth opening and left preauricular swelling for more than 40 days after a traffic accident injury. He had received mandibulomaxillary fixation in the emergency department. Computed tomography showed left mandibular condylar fracture, and digital subtraction angiography confirmed left superficial temporal artery pseudoaneurysm. Endovascular embolization of the left external carotid artery was performed, followed by excision of the traumatic pseudoaneurysm and open reduction internal fixation of the left condylar fracture. Six months after treatment, the patient can open his mouth to approximately 35 mm and showed no swelling in the left preauricular region. PMID:23851869

  5. Non-syndromic occurrence of true generalized microdontia with mandibular mesiodens - a rare case

    PubMed Central

    2011-01-01

    Abnormalities in size of teeth and number of teeth are occasionally recorded in clinical cases. True generalized microdontia is rare case in which all the teeth are smaller than normal. Mesiodens is commonly located in maxilary central incisor region and uncommon in the mandible. In the present case a 12 year-old boy was healthy; normal in appearance and the medical history was noncontributory. The patient was examined and found to have permanent teeth that were smaller than those of the average adult teeth. The true generalized microdontia was accompanied by mandibular mesiodens. This is a unique case report of non-syndromic association of mandibular hyperdontia with true generalized microdontia. PMID:22035324

  6. Treatment of Bi-maxillary Protrusion with Impacted Maxillary and Mandibular Canines: Case Report.

    PubMed

    Shdrma, Vipul Kumar; Yadav, Kirti; Nagar, Amit; Tandon, Pradeep; Chaturvedi, Thakur Prasad

    2016-01-01

    Bi-maxillary protrusion in adolescent patients has traditionally been treated by extraction of the four first premolars and retraction ofthe anterior teeth. The ectopic eruption of the maxiIlary permanent canines is a frequently encountered clinical problem. Orthodontic treatment of the impacted teeth remains a challenge for clinicians. If it is associated with other dental and skeletalproblems, there will be further complications to the treatment plan. In such cases, if we extract canines, then problems with this approach are restricted to anatomical and functional limitations ofpremolars substitution of canines. Here, we are presenting a case report of bi-maxillary dento-alveolar protrusion with the impacted maxillary and mandibular left canines and its management. PMID:27319045

  7. "Rules of 10"--guidelines for successful planning and treatment of mandibular edentulism using dental implants.

    PubMed

    Cooper, Lyndon F; Limmer, Bryan M; Gates, W Day

    2012-05-01

    The three "Rules of 10" for treatment planning dental implant therapy in the edentulous mandible are designed to improve the success of both the endosseous implants and the prosthesis. These "rules" acknowledge and provide a method to control the mechanical environment, addressing factors affecting implant and prosthesis longevity, including magnitude of forces, resistance of the prosthesis against these forces, and the biology of bone and its ability to respond to loading environments. The rules specify that for any IRO or ISFP, there must be a minimum of 10 mm of alveolar dimension (inferior/superior) and a minimum of 10 mm of interocclusal (restorative) dimension measured from the soft-tissue ridge crest to the occlusal plane. Additionally, for an ISFP, the anterior/posterior distribution of implants must be greater than 10 mm. This article provides support in the literature for these rules and illustrates their application in the treatment of mandibular edentulism. PMID:22616215

  8. Replacement of mandibular central incisors with implant-supported crowns: a case report.

    PubMed

    Bäumer, Daniel; Zuhr, Otto; Hürzeler, Markus

    2016-01-01

    Anterior teeth are often affected by accidental dental trauma and may eventually be lost. When the neighboring teeth are unharmed, implant-supported crowns are often the preferred treatment choice. When not only the teeth but also the supporting hard and soft tissue has been lost, surgical reconstruction may be needed. However, in combined horizontal and vertical class III defects, the available augmentation techniques are often not predictable. In this case report, two neighboring mandibular central incisors were replaced by two implants after soft and hard tissue augmentation with the cortical bone plate method. The interdental soft tissue was reconstructed with remarkable success, making this an example of what can be achieved in cases such as this. PMID:27092347

  9. Anterior perineal sinus.

    PubMed

    Oliver, G C; Rubin, R J; Salvati, E P; Eisenstat, T E; Lott, J

    1991-09-01

    Each year we treat several patients with an anterior perineal sinus tract. They do not conform to commonly encountered perineal problems such as pilonidal disease, epidermal cysts, hidradenitis, fistulous abscess, or inflammatory bowel disease. In an effort to improve understanding of the problem and its clinical significance, we reviewed our practice records for the period from 1968 through 1988. Fifty-six patients underwent surgery for an anterior perineal sinus tract. In 31 patients, the clinical and pathologic condition defied classical diagnostic categorization. We have termed these lesions "anterior perineal sinuses." Their clinical characteristics, treatment, and pathologic assessment from the body of this report. Male predominance (87 percent) and midlife presentation (average age, 44 years) characterized this group. Local symptoms were present from several weeks to several years prior to treatment. Local anesthesia (74 percent) and limited surgery (100 percent) resulted in complete healing in all patients (average, 7 weeks). A 15 percent recurrence rate was noted. The pathologic evaluation demonstrated acute and chronic dermal and subcutaneous inflammation. The etiology of this process remains uncertain. Its predominance along the median raphe suggests a congenital midline inclusion disorder. PMID:1914743

  10. Mandibular Fractures in Iraq: An Epidemiological Study

    PubMed Central

    Bede, Salwan

    2014-01-01

    The purpose of this study was to evaluate the epidemiological characteristics of the mandibular fractures relating to gender, age, the etiology of injury, and the rendered treatment modalities and complications. The data of the patients who sustained mandibular fractures were retrieved and were analyzed retrospectively, and based on these data a descriptive analysis was conducted. A total of 112 patients were included in this study; the most common cause was road traffic accidents (RTAs) followed by assaults and missile injuries. The most frequently involved age group was 11 to 20 years, treatment modalities included conservative, closed reduction and indirect fixation, and open reduction and internal fixation (ORIF) in 11.6, 79.5, and 8.9% of the cases, respectively. Most of the major complications were injury related. This study showed RTAs to be the most frequent cause followed by assaults, it also showed that a high percentage of assault victims were females mainly of low socioeconomic status. Another distinguishing feature in this study was the high incidence of missile injuries in the form of bullets and blasts. Closed reduction still has an important role in the treatment of fractures of mandible especially when the necessary equipments for ORIF are not readily available. A higher complication rate was observed in patients diagnosed with multiple and comminuted fractures as well as those caused by violence in the form of missile and assault injuries. PMID:25709754

  11. Arsenic Trioxide-Induced Mandibular Osteomyelitis.

    PubMed

    Lu, Pei-Chen; Wu, Ju-Hui; Chen, Chun-Ming; Du, Je-Kang

    2015-09-01

    Previously, arsenic was a popular devitalizing agent used to necrotize inflamed dental pulp to lower the pulp sensitivity owing to the unavailability of appropriate anesthesia. However, leakage from the apical foramen, lateral or accessory canals, or cracks in the tooth is common. This can be dangerous because of the reportedly high toxic effects of arsenic in both hard and soft tissues, leading to gingival and osseous necrosis and, consequently, osteomyelitis. Therefore, arsenic can prove fatal for both bones and teeth and is no longer used. We encountered a case involving a 50-year-old man who had developed mandibular osteomyelitis with lower lip paresthesia caused by arsenic trioxide used during endodontic treatment. The patient was treated with appropriate antibiotics, adjunctive hyperbaric oxygen therapy, and adequate surgical debridement. Hyperbaric oxygen therapy can induce neovascularization in necrosed tissues and improve bone and soft tissue healing. At a 4-year follow-up visit, bone healing was observed, with restoration of periodontal health, although the paresthesia had persisted. We describe this case, present a review of the relevant published data, and discuss the possible causes, diagnosis, treatment, and follow-up protocol of mandibular osteomyelitis caused by arsenic trioxide. PMID:25896568

  12. A retrospective study of patients with mandibular fractures treated at a Swedish University Hospital 1999-2008

    PubMed Central

    Ramadhan, Anwar; Gavelin, Petter; Hirsch, Jan M.; Sand, Lars P.

    2014-01-01

    Background: Fracture of the mandible is one of the most common fractures of the maxillofacial skeleton. However, the etiology, gender, and age distribution vary between different regions and countries, and the purpose of this study was to evaluate the current trend of patients with mandibular fractures at the Department of Oral and Maxillofacial Surgery, in Uppsala, Sweden. Aim: The aim of this retrospective study was to analyze patients with mandibular fractures treated in the University Hospital of Uppsala (the county capital of Uppland) Sweden during a 10-year period (1999-2008). Materials and Methods: This study was designed as a retrospective study of patients admitted to the Department of Oral and Maxillofacial Surgery at Uppsala University Hospital, Sweden. The location of fractures was evaluated clinically by the surgeon and on the X-rays. We classified the data according to gender, age, etiology, day of the week, month of the year, fracture site, and method of treatment of the fractures. Results: Records were collected from patient charts from 266 patients. One hundred eighty-seven patients (70%) with mandibular fractures were of male gender, and 132 patients (50%) were aged 16-30 years. Interpersonal violence constituted the most common etiological factor for mandibular fractures (24%), followed by falls (23%). Forty-nine percentages of the patients were treated surgically, and 51% were treated conservatively. There was an increase of the annual incidence of fractures toward the end of the period, even though not statistically significant. Conclusions: Mandibular fractures occurred primarily among younger men between 16- and 30-year-old. Condyle fractures were the most common fracture site and 50% of the patients required surgery. Summer months and weekends were the most common time of mandibular fractures. PMID:25593868

  13. Planning extensive esthetic restorations for anterior teeth: use of waxed-up study casts and composite resin mock-ups.

    PubMed

    Furuse, Adilson Yoshio; Baratto, Samantha Schaffer Pugsley; Spina, Denis Roberto Falcão; Correr, Gisele Maria; da Cunha, Leonardo Fernandes; Gonzaga, Carla Castiglia

    2016-01-01

    The aim of this case report is to highlight the importance of appropriate planning protocols when direct composite resin restorations are used to solve extensive esthetic problems. A 30-year-old patient complained about her small maxillary anterior teeth and short upper lip. All teeth were healthy and light colored, and the patient exhibited good oral hygiene. The anterior teeth were relatively short, resulting in a compromised esthetic relationship between height and width. The maxillary and mandibular right central incisors were in an edge-to-edge relationship. After diagnostic casts and waxed-up study casts were obtained, occlusal adjustment and recontouring of the incisal and labial surfaces of the mandibular right central incisor were performed to increase overjet. To increase the volume of the upper lip, composite resin restorations were planned for the maxillary anterior teeth. To confirm that the contours and color of the new smile were acceptable to the patient, composite resin esthetic mock-ups were made directly in the mouth before the definitive procedure. After definitive restoration of the anterior teeth, additional occlusal adjustments were performed. At the 36-month follow-up, no fracturing or severe wear of the restorations was observed. The restored anterior guidance provided excellent function after 3 years of clinical service. PMID:26742179

  14. A Method of Three-Dimensional Recording of Mandibular Movement Based on Two-Dimensional Image Feature Extraction

    PubMed Central

    Li, Zhongke; Yang, Huifang; Lü, Peijun; Wang, Yong; Sun, Yuchun

    2015-01-01

    Background and Objective To develop a real-time recording system based on computer binocular vision and two-dimensional image feature extraction to accurately record mandibular movement in three dimensions. Methods A computer-based binocular vision device with two digital cameras was used in conjunction with a fixed head retention bracket to track occlusal movement. Software was developed for extracting target spatial coordinates in real time based on two-dimensional image feature recognition. A plaster model of a subject’s upper and lower dentition were made using conventional methods. A mandibular occlusal splint was made on the plaster model, and then the occlusal surface was removed. Temporal denture base resin was used to make a 3-cm handle extending outside the mouth connecting the anterior labial surface of the occlusal splint with a detection target with intersecting lines designed for spatial coordinate extraction. The subject's head was firmly fixed in place, and the occlusal splint was fully seated on the mandibular dentition. The subject was then asked to make various mouth movements while the mandibular movement target locus point set was recorded. Comparisons between the coordinate values and the actual values of the 30 intersections on the detection target were then analyzed using paired t-tests. Results The three-dimensional trajectory curve shapes of the mandibular movements were consistent with the respective subject movements. Mean XYZ coordinate values and paired t-test results were as follows: X axis: -0.0037 ± 0.02953, P = 0.502; Y axis: 0.0037 ± 0.05242, P = 0.704; and Z axis: 0.0007 ± 0.06040, P = 0.952. The t-test result showed that the coordinate values of the 30 cross points were considered statistically no significant. (P<0.05) Conclusions Use of a real-time recording system of three-dimensional mandibular movement based on computer binocular vision and two-dimensional image feature recognition technology produced a recording

  15. Obstructive Sleep Apnea and Mandibular Advancement Splints: Occlusal Effects and Progression of Changes Associated with a Decade of Treatment

    PubMed Central

    Pliska, Benjamin T.; Nam, Hyejin; Chen, Hui; Lowe, Alan A.; Almeida, Fernanda R.

    2014-01-01

    Study Objectives: To evaluate the magnitude and progression of dental changes associated with long-term mandibular advancement splint (MAS) treatment of obstructive sleep apnea (OSA). Methods: Retrospective study of adults treated for primary snoring or mild to severe OSA with MAS for a minimum of 8 years. The series of dental casts of patients were analyzed with a digital caliper for changes in overbite, overjet, dental arch crowding and width, and inter-arch relationships. The progression of these changes over time was determined and initial patient and dental characteristics were evaluated as predictors of the observed dental side effects of treatment. Results: A total of 77 patients (average age at start of treatment: 47.5 ± 10.2 years, 62 males) were included in this study. The average treatment length was 11.1 ± 2.8 years. Over the total treatment interval evaluated there was a significant (p < 0.001) reduction in the overbite (2.3 ± 1.6 mm), overjet (1.9 ± 1.9 mm), and mandibular crowding (1.3 ± 1.8 mm). A corresponding significant (p < 0.001) increase of mandibular intercanine (0.7 ± 1.5 mm) and intermolar (1.1 ± 1.4 mm) width as well as incidence of anterior crossbite and posterior open bite was observed. Overbite and mandibular intermolar distance were observed to decrease less with time, while overjet, mandibular intercanine distance, and lower arch crowding all decreased continuously at a constant rate. Conclusions: After an average observation period of over 11 years, clinically significant changes in occlusion were observed and were progressive in nature. Rather than reaching a discernible end-point, the dental side effects of MAS therapy continue with ongoing MAS use. Commentary: A commentary on this article appears in this issue on page 1293. Citation: Pliska BT, Nam H, Chen H, Lowe AA, Almeida FR. Obstructive sleep apnea and mandibular advancement splints: occlusal effects and progression of changes associated with a decade of treatment. J

  16. Mandibular canine dimensions as an aid in gender estimation

    PubMed Central

    Rajarathnam, Basetty Neelakantam; David, Maria Priscilla; Indira, Annamalai Ponnuswamy

    2016-01-01

    Background: All humans have an identity in life; compassionate societies require this identity to be recognized even after death. Objectives: To measure the dimensions of the mandibular canine and assess the usefulness of the mandibular canine as an aid in gender estimation. Materials and Methods: The study population comprised 200 subjects inclusive of 100 males and 100 females with an age range of 18–25 years. Measurements made in mm at the contact point were of mesiodistal width of the right and left canines and intercanine distance both intraorally and on casts, and the mandibular canine index (MCI) was calculated. The obtained data were subjected to t-test/Mann-Whitney test and discriminant function analysis. Results: All parameters of mandibular canines, namely, intercanine distance, canine width, and canine index were greater in males compared to females suggesting significant sexual dimorphism of mandibular canines. On subjecting the data to discriminant function analysis, it classified sex correctly in 73% of the samples. Conclusion: The result of our study establishes the existence of significant sexual dimorphism in mandibular canines. We can therefore, recommend the use of mandibular canine dimensions as an applicable and additional method for gender determination in human identification. PMID:27555724

  17. Full mouth rehabilitation of a patient with mandibular implant screw retained Fp-3 prosthesis opposing maxillary acrylic removable over-denture

    PubMed Central

    Jain, Ashish R.; Nallaswamy, Deepak; Ariga, Padma; Philip, Jacob Mathew

    2013-01-01

    A hybrid denture is one that is fabricated over a metal framework and retained by screws threaded into the implant abutments. The anterior part of a mandibular hybrid denture is fixed on implants while the posterior part of the denture is extended and cantilevered from implants. This article presents the fabrication of a maxillary over-denture opposing mandibular implant retained hybrid prosthesis. A total of four implants were placed in the mandibular arch. Castable abutments were used to produce the optimal angulations. Framework was waxed, cast recovered, and the fit was refined until the framework seated passively on the master cast. The mandibular denture teeth were waxed to the hybrid framework, and a final wax try-in was performed to verify and correct maxillomandibular relations before processing. The prosthesis was inserted after verification of occlusion, retention, and stability. The rehabilitation of edentulous patients with hybrid dentures has been observed to achieve greater masticatory function and psychological satisfaction than with conventional over-dentures. Producing a passive-fitting substructure for a fixed removable screw retained hybrid prosthesis is arguably one of the most technically complex tasks in implant dentistry. The technique presented may not initially produce a perfectly passive framework, but use of disclosing media and adjusting the internal aspect of the casting can result in non-binding, fully seated prostheses. PMID:24015016

  18. Transoral versus extraoral approach for mandibular angle fractures: A comparative study

    PubMed Central

    Devireddy, Sathya Kumar; Kishore Kumar, R. V.; Gali, Rajasekhar; Kanubaddy, Sridhar Reddy; Dasari, Mallikarjuna Rao; Akheel, Mohammad

    2014-01-01

    Introduction: Mandibular fractures represent approximately two-thirds of all the maxillofacial fractures (nearly 70%) out of which fractures of mandibular angle represent for 26-35%. Aim of the Study: The aim of this study is to compare the transoral and extraoral (submandibular) approaches for fixation of mandibular angle fractures. Objectives of Study: The objectives of the following study are to evaluate ease of accessibility, time taken for the procedure, ease of anatomic reduction and complications. Materials and Methods: A prospective study was carried out in 30 patients reporting to the Department of Oral and Maxillofacial surgery, Narayana Dental College and Hospital, Nellore, Andhra Pradesh during the period of months from November 2011 to August 2013 who were randomly divided in two groups based on computer generated simple randomization chart. Group I patients underwent transoral reduction and fixation and Group II patients underwent extraoral reduction and fixation. The ease of accessibility was analysed by visual analogue scale by the operating surgeon, time taken from incision to closure with digital clock, difficulty level index of surgeon based on the time taken for the procedure and approach related complications. Results: The ease of accessibility in Group I was good in 53.3% while in Group II patients approached extraorally it was good in 86.7%. Group I patients approached transorally showed a mean of 49.7 min while that of Group II patients approached extraorally showed a mean of 73.4 min. Group I had a minimum difficulty level index in 60%, moderate difficulty level in 33.3% and severe difficulty level in 6.7% while Group II had a minimum and moderate difficulty level in 46.7% and severe difficulty level in 6.7%. There was 1 (6.7%) complication reported in each group. Conclusion: The statistical analysis of this study concludes that fracture line starting anterior to mandibular third molar and ending at anteroinferior border of the insertion of

  19. Lingual Guttering Technique for Removal of Impacted Mandibular Third Molars

    PubMed Central

    Kale, Tejraj P; Pandit, Vikram S; Patil, Shankargouda; Pawar, Vivek; Shetty, Nisha

    2014-01-01

    Background: To assess the clinical feasibility of lingual bone guttering technique for surgical extraction of mandibular third molars. Materials and Methods: 20 patients with thick lingual cortical plate were included in the study. Surgical extraction of mandibular third molars by lingual bone guttering technique was performed in all the subjects. These subjects were evaluated for integrity of lingual cortical plate and sensation of lingual nerve postoperatively. Results: All extractions done by lingual bone guttering technique were clinically feasible to perform and no complications were seen. Conclusion: Lingual bone guttering technique can be used safely in extraction of mandibular third molars with thick lingual cortical plate. PMID:25214725

  20. Modified trans-oral approach for mandibular condylectomy.

    PubMed

    Deng, M; Long, X; Cheng, A H A; Cheng, Y; Cai, H

    2009-04-01

    Different approaches to the mandibular condyle have been described. In this paper, a modified trans-oral technique to access the mandibular condyle is described and illustrated. This technique was used in a small group of patients; the clinical outcomes are promising. The technique can be used in various temporomandibular joint (TMJ) operations, such as condylar resection, high condylectomy or tumor removal. It provides adequate intra-oral surgical access to the mandibular condyle and avoids complications from extra-oral approaches to the TMJ. PMID:19282151

  1. Tibialis Anterior Tendon Transfer.

    PubMed

    Mulhern, Jennifer L; Protzman, Nicole M; Brigido, Stephen A

    2016-01-01

    Tendon transfer procedures are used commonly for the correction of soft tissue imbalances and instabilities. The complete transfer and the split transfer of the tibialis anterior tendon are well-accepted methods for the treatment of idiopathic equinovarus deformity in children and adults. Throughout the literature, complete and split transfer have been shown to yield significant improvements in ankle and foot range of motion and muscle function. At present, there is insufficient evidence to recommend one procedure over the other, although the split procedure has been advocated for consistently achieving inversion to eversion muscle balance without overcorrection. PMID:26590723

  2. Anatomy of Mandibular Vital Structures. Part I: Mandibular Canal and Inferior Alveolar Neurovascular Bundle in Relation with Dental Implantology

    PubMed Central

    Wang, Hom-Lay; Sabalys, Gintautas

    2010-01-01

    ABSTRACT Objectives It is critical to determine the location and configuration of the mandibular canal and related vital structures during the implant treatment. The purpose of the present study was to review the literature concerning the mandibular canal and inferior alveolar neurovascular bundle anatomical variations related to the implant surgery. Material and Methods Literature was selected through the search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandibular canal, inferior alveolar nerve, and inferior alveolar neurovascular bundle. The search was restricted to English language articles, published from 1973 to November 2009. Additionally, a manual search in the major anatomy, dental implant, prosthetic and periodontal journals and books were performed. Results In total, 46 literature sources were obtained and morphological aspects and variations of the anatomy related to implant treatment in posterior mandible were presented as two entities: intraosseous mandibular canal and associated inferior alveolar neurovascular bundle. Conclusions A review of morphological aspects and variations of the anatomy related to mandibular canal and mandibular vital structures are very important especially in implant therapy since inferior alveolar neurovascular bundle exists in different locations and possesses many variations. Individual, gender, age, race, assessing technique used and degree of edentulous alveolar bone atrophy largely influence these variations. It suggests that osteotomies in implant dentistry should not be developed in the posterior mandible until the position of the mandibular canal is established. PMID:24421958

  3. Management of severely impacted mandibular canines and congenitally missing mandibular premolars with protraction of autotransplanted maxillary premolar.

    PubMed

    Janakiraman, Nandakumar; Vaziri, Hamed; Safavi, Kamran; Nanda, Ravindra; Uribe, Flavio

    2016-08-01

    Transmigrated mandibular canines increase the treatment complexity in terms of both anchorage and biomechanical planning. Additionally, a Class II malocclusion with a deep overbite and associated dental anomalies such as hypodontia can further increase the treatment complexity and the overall treatment time. This case report describes the successful interdisciplinary treatment of a patient, aged 12.5 years, with transmigrated and severely impacted mandibular canines and congenitally missing mandibular second premolars. The transmigrated mandibular right canine was extracted, and a maxillary second premolar was autotransplanted to the missing mandibular right second premolar site with the aid of a stereolithographic donor tooth replica fabricated with 3-dimensional cone-beam computed tomography and a rapid prototyping technique. Furthermore, the autotransplanted tooth was protracted by 4 to 5 mm to close the space caused by the extraction of the mandibular right canine. The impacted mandibular left canine was orthodontically guided into its normal position in the arch. Good esthetic outcome and functional occlusion were achieved. PMID:27476368

  4. Remodeling of the Mandibular Bone Induced by Overdentures Supported by Different Numbers of Implants.

    PubMed

    Li, Kai; Xin, Haitao; Zhao, Yanfang; Zhang, Zhiyuan; Wu, Yulu

    2016-05-01

    The objective of this study was to investigate the process of mandibular bone remodeling induced by implant-supported overdentures. computed tomography (CT) images were collected from edentulous patients to reconstruct the geometry of the mandibular bone and overdentures supported by implants. Based on the theory of strain energy density (SED), bone remodeling models were established using the user material subroutine (UMAT) in abaqus. The stress distribution in the mandible and bone density change was investigated to determine the effect of implant number on the remodeling of the mandibular bone. The results indicated that the areas where high Mises stress values were observed were mainly situated around the implants. The stress was concentrated in the distal neck region of the distal-most implants. With an increased number of implants, the biting force applied on the dentures was almost all taken up by implants. The stress and bone density in peri-implant bone increased. When the stress reached the threshold of remodeling, the bone density began to decrease. In the posterior mandible area, the stress was well distributed but increased with decreased implant numbers. Changes in bone density were not observed in this area. The computational results were consistent with the clinical data. The results demonstrate that the risk of bone resorption around the distal-most implants increases with increased numbers of implants and that the occlusal force applied to overdentures should be adjusted to be distributed more in the distal areas of the mandible. PMID:26963740

  5. 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

  6. Mandibular morphology in two archaeological human skeletal samples from northwest Europe with different masticatory regimes.

    PubMed

    Mays, S

    2015-06-01

    Mandibular morphology, assessed osteometrically, is studied in two historic human skeletal series (N = 64 individuals) from northwest Europe, one from Zwolle, the Netherlands (19th century CE), the other from Wharram Percy, England (10th-19th century). Both groups show greater dental wear than modern Western populations, but the rate of wear is greater at Wharram Percy than at Zwolle, suggesting a more vigorous masticatory regime. The aim is to evaluate any differences in mandibular morphology between the two groups that might relate to the inferred difference in biomechanical loading upon the chewing apparatus consequent upon the different physical properties of the diets consumed. Results indicate that the mandibles from Zwolle are generally smaller than those from Wharram Percy, especially in the gonial and ramus region and in the height of the post-canine corpus. These differences are consistent with those predicted on biomechanical grounds. That clear differences were observed in two samples whose masticatory regimes were distinct but not very different is an indication of the sensitivity of mandibular morphology to biomechanical input, and supports its value for investigating differences in physical properties of diets in palaeopopulations. PMID:25724125

  7. Ectopic third molar in the mandibular condyle: A review of the literature

    PubMed Central

    Iglesias-Martin, Fernando; Torres-Carranza, Eusebio; Prats-Golczer, Victoria-Eugenia; Garcia-Perla-Garcia, Alberto

    2012-01-01

    Objectives: To evaluate the etiopathogenesis, clinical features, therapeutic options, and surgical approaches for removal of ectopic third molars in the mandibular condyle. Study design: MEDLINE search of articles published on ectopic third molars in the mandibular condyle from 1980 to 2011. 14 well-documented clinical cases from the literature were evaluated together with a new clinical case provided by the authors, representing a sample of 15 patients. Results: We found a mean age at diagnosis of 48.6 years and a higher prevalence in women. In 14 patients, associated radiolucent lesions were diagnosed on radiographic studies and confirmed histopathologically as odontogenic cysts. Clinical symptoms were pain and swelling in the jaw or preauricular region, trismus, difficulty chewing, cutaneous fistula and temporomandibular joint dysfunction. Treatment included conservative management in one case and in the other cases, surgical removal by intra- or extraoral approaches, the latter being the most common approach carried out. In most reported cases, serious complications were not outlined. Conclusions: The etiopathogenic theory involving odontogenic cysts in the displacement of third molars to the mandibular condyle seems to be the most relevant. They must be removed if they cause symptoms or are associated with cystic pathology. The surgical route must be planned according to the location and position of the ectopic third molar, and the possible morbidity associated with surgery. Key words:Third molar, ectopic tooth, condyle, mandible. PMID:22926463

  8. Interrami intraoral fixation technique for severe mandibular rifle fragmented bullet injury management.

    PubMed

    Shuker, Sabri T

    2013-07-01

    Interrami intraoral Kirschner wire fixation technique is presented for the reduction, stabilization, and immobilization of a pulverized and avulsed lower jaw caused by rifle fragmented bullet injuries. This indirect mandibular war injury fixation technique was tolerated by the patients and tissue more than any indirect external fixation. In addition, it is easier than open reduction using large bone plates for disrupted ballistics mandibular injury defects. An interrami intraoral fixation is appropriate for severely disrupted mandibular hard and soft tissues, and has been adapted in cases of mass casualties and limited resources. Benefits of use include limited hospital beds and fewer follow-up visits. Rifle fragmented bullet injuries need more attention for several reasons: not only because of the higher mortality and devastating nature of the injuries, but also because these injuries are responsible for an unreported type of bullet biomechanism wounding in the craniofacial region. In turn, this necessitates specialized victim management. The survival rates depend on immediate proper execution of airway, breathing, and circulation, which become more complicated as it relates to airway compromise and oropharyngeal hemorrhage resuscitation. Survival is predicated on the implementation of feasible, sensible, life-saving techniques that are applied at the appropriate time. PMID:23851763

  9. Multidetector CT of Mandibular Fractures, Reductions, and Complications: A Clinically Relevant Primer for the Radiologist.

    PubMed

    Dreizin, David; Nam, Arthur J; Tirada, Nikki; Levin, Martin D; Stein, Deborah M; Bodanapally, Uttam K; Mirvis, Stuart E; Munera, Felipe

    2016-01-01

    After the nasal bones, the mandible is the second most common site of facial fractures, and mandibular fractures frequently require open reduction. In the trauma injury setting, multidetector computed tomography (CT) has become the cornerstone imaging modality for determining the most appropriate treatment management, fixation method, and surgical approach. Multidetector CT is also used to assess the adequacy of the reduction and evaluate potential complications in the postoperative period. For successful restoration of the mandible's form and function, as well as management of posttraumatic and postoperative complications, reconstructive surgeons are required to have a detailed understanding of mandibular biomechanics, occlusion, and anatomy. To provide added value in the diagnosis, treatment planning, and follow-up of mandibular fractures, radiologists should be aware of these concepts. Knowledge of the techniques commonly used to achieve occlusal and anatomic reduction and of the rationale behind the range of available treatment options for different injury patterns-from isolated and nondisplaced fractures to multisite and comminuted fractures-also is essential. This article focuses on the use of multidetector CT for pre- and postoperative evaluation of mandibular fractures and outlines fundamental concepts of diagnosis and management-beginning with an explanation of common fracture patterns and their biomechanical underpinnings, and followed by a review of the common postoperative appearances of these fractures after semirigid and rigid fixation procedures. Specific considerations regarding fractures in different regions of the tooth-bearing and non-tooth-bearing mandible and the unique issues pertaining to the edentulous atrophic mandible are reviewed, and key features that distinguish major from minor complications are described. (©)RSNA, 2016. PMID:27618328

  10. Interproximal wear versus incisors extraction to solve anterior lower crowding: A systematic review

    PubMed Central

    de Almeida, Natália Valli; Silveira, Giordani Santos; Pereira, Daniele Masterson Tavares; Mattos, Claudia Trindade; Mucha, José Nelson

    2015-01-01

    OBJECTIVE: To determine by means of a systematic review the best treatment, whether interproximal wear or incisor extraction, to correct anterior lower crowding in Class I patients in permanent dentition. METHODS: A literature review was conducted using MEDLINE, Scopus and Web of Science to retrieve studies published between January 1950 and October 2013. In selecting the sample, the following inclusion criteria were applied: studies involving interproximal wear and/or extraction of mandibular incisors, as well as Class I cases with anterior lower crowding in permanent dentition. RESULTS: Out of a total of 943 articles found after excluding duplicates, 925 were excluded after abstract analysis. After full articles were read, 13 were excluded by the eligibility criteria and one due to methodological quality; therefore, only fours articles remained: two retrospective and two randomized prospective studies. Data were collected, analyzed and organized in tables. CONCLUSION: Both interproximal wear and mandibular incisor extraction are effective in treating Class I malocclusion in permanent dentition with moderate anterior lower crowding and pleasant facial profile. There is scant evidence to determine the best treatment option for each case. Clinical decision should be made on an individual basis by taking into account dental characteristics, crowding, dental and oral health, patient's expectations and the use of set-up models. PMID:25741827

  11. Uveitis (acute anterior)

    PubMed Central

    2010-01-01

    Introduction Anterior uveitis is rare, with an annual incidence of 12/100,000 population, although it is more common in Finland (annual incidence of 23/100,000), probably because of genetic factors, such as high frequency of HLA–B27 in the population. It is often self-limiting, but can, in some cases, lead to complications such as posterior synechiae, cataract, glaucoma, and chronic uveitis. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of anti-inflammatory eye drops on acute anterior uveitis? We searched: Medline, Embase, The Cochrane Library and other important databases up to November 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found six systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: corticosteroids, mydriatics, and non-steroidal anti-inflammatory drug eye drops. PMID:21736765

  12. Prosthetic rehabilitation of a patient with unilateral dislocated condyle fracture after treatment with a mandibular repositioning splint: a clinical report.

    PubMed

    Noh, Kwantae; Choi, Woojin; Pae, Ahran; Kwon, Kung-Rock

    2013-06-01

    This clinical report describes the use of a mandibular repositioning splint and the subsequent prosthodontic treatment of a unilateral dislocated condyle fracture for a patient whose injury resulted in significant mandibular deviation and malocclusion. The use of a mandibular repositioning splint considerably reduced the mandibular deviation, and a stable mandibular position was maintained with the definitive prosthesis. PMID:23763780

  13. Extra Corporeal Fixation of Fractured Mandibular Condyle

    PubMed Central

    Shenoy K, Vandana; Kengagsubbiah, Srivatsa; V, Sathyabhama; Priya, Vishnu

    2014-01-01

    Condylar fracture is the second most common site in the mandibular fractures. Motor vehicle accident and fall are the major causes of such fractures. Because of the anatomical weakness of the condyle and the shape of the condylar head the antero-medial dislocation of the condyle is common. Open reduction and closed reduction is always debatable. The open reduction will bring back the normal function much earlier than closed reduction. Medially dislocated condylar fracture fragments are always managed with open method. In superior or high condylar fractures,exact reduction with conventional open reduction can be difficult due to the limited surgical and visual fields. In such cases extracorporeal fixation of condyle using vertical ramus osteotomy may be better choice to achieve perfect alignment and absolute maintaince of vertical height of the ramus and facial symmetry. We here present a case of extracorporeal fixation of unilateral left high condylar fracture. PMID:25386546

  14. Bilateral mandibular fracture related to osteoradionecrosis

    PubMed Central

    Goyal, Shikha; Mohanti, Bidhu Kalyan

    2015-01-01

    Mandible is the most frequently affected bone during head and neck irradiation. Late changes in the mandible may manifest in the form of reduced bone density, dental caries, loss of spongiosa trabeculations, delayed healing following dental extraction, pathologic fractures, osteoradionecrosis, trismus, growth defects in children or second malignancies. Pathologic fractures of mandibular bone are rare and may be spontaneous or traumatic (following dental extraction). We report the case of a 55-year lady, who had undergone surgery and adjuvant radiotherapy for carcinoma oral tongue T2N0M0 on a cobalt-60 unit and was disease-free. After a follow-up of 8 years post-irradiation, she presented with sudden onset oral pain and inability to open mouth. Pantomogram showed fracture at the junction of body and ramus of the mandible bilaterally. PMID:26097342

  15. [Tumors of the mandibular condyle (author's transl)].

    PubMed

    Freidel, M; Beziat, J L; Bertoin, P; Bouvier, R; Dumas, P

    1981-01-01

    Three cases of tumors of the mandibular condyle are reported. One patient had metastases from a cutaneous melanoblastoma, another a benign osteochondroma, and the third a plasmocytosarcoma revealing the presence of Kahler disease. The authors emphasize the rare nature of these lesions, in spite of the technical advances made in the radiological and surgical exploration of the temporomandibular joint, and also the large variety of histological types reported in the literature. They discuss the main diagnostic features, especially in isolated lesions in patients with no relevant past history, and stress the importance of surgical biopsy. Therapy varies from surgical treatment in benign tumors, the prognosis being excellent, to usually palliative therapy in malignant lesions. PMID:6939076

  16. Mandibular ossifying fibroma in a dog.

    PubMed

    Miller, M A; Towle, H A M; Heng, H G; Greenberg, C B; Pool, R R

    2008-03-01

    An aged mongrel dog was admitted for hemimandibulectomy as treatment for a mandibular mass that had been diagnosed as osteosarcoma. The fibro-osseous mass that surrounded the first molar tooth and replaced alveolar and cortical bone was reclassified as ossifying fibroma on the basis of anatomic location and histologic features. The tumor was composed of isomorphic fusiform cells with few mitotic figures. Tumoral stroma contained trabeculae of woven bone that were bordered by a single layer of osteoblasts. Excision was deemed complete with no evidence of extension or metastasis by computed tomography of the skull or thoracic and abdominal radiography. The dog was reportedly healthy 6 months after initial presentation. Though far less common than osteosarcoma as a primary canine bone tumor, ossifying fibroma should be included in the differential diagnosis for fibro-osseous proliferations, especially those of the jaw. Although benign, en bloc excision may be necessary for surgical cure. PMID:18424835

  17. Material Properties of the Mandibular Trabecular Bone

    PubMed Central

    Lakatos, Éva; Magyar, Lóránt; Bojtár, Imre

    2014-01-01

    The present paper introduces a numerical simulation aided, experimental method for the measurement of Young's modulus of the trabecular substance in the human mandible. Compression tests were performed on fresh cadaveric samples containing trabecular bone covered with cortical layer, thus avoiding the destruction caused by the sterilization, preservation, and storage and the underestimation of the stiffness resulting from the individual failure of the trabeculae cut on the surfaces. The elastic modulus of the spongiosa was determined by the numerical simulation of each compression test using a specimen specific finite element model of each sample. The received mandibular trabecular bone Young's modulus values ranged from 6.9 to 199.5 MPa. PMID:27006933

  18. Effects of irradiation on mandibular scintigraphy

    SciTech Connect

    Aitasalo, K.; Ruotsalainen, P.

    1985-11-01

    Technetium-99m methylene diphosphonate (Sn) scintigraphy with computer analysis was used to investigate alterations in the pathophysiology of the normal mandible and the pathologic mandible during and after irradiation. Slight but significant elevations of uptake levels were recorded as an early effect of irradiation. The elevations correlated with the duration of treatment and normalized over a follow-up period of 6 to 12 mo. Increased mandibular metabolism was found during irradiation and in osteomyelitis and osteoradionecrosis of the mandible. Scintigraphy with computer analysis proved a simple and valid method in the evaluation of early irradiation damage and pathophysiologic conditions of the mandible. The method can also be used to predict whether the irradiation damage will become irreversible.

  19. Contemporary Management of Infected Mandibular Fractures

    PubMed Central

    Alpert, Brian; Kushner, George M.; Tiwana, Paul S.

    2008-01-01

    The treatment of infected mandibular fractures has advanced rather dramatically over the past 50 years. Immobilization with maxillomandibular fixation and/or splints, removal of diseased teeth in the fracture line, external fixation, use of antibiotics, debridement, and rigid internal fixation has played a role in management. Perhaps the most important advance was the realization that infected fractures also result from moving fragments and nonvital bone, not just bacteria. Controlling movement and eliminating the dead bone allowed body defenses to also eliminate bacteria. The next logical step in the evolution of treatment was primary bone grafting of the resulting defect following application of rigid internal fixation and debridement of the dead bone. We offer our results with this treatment in 21 infected fractures, 20 of which achieved primary union. PMID:22110786

  20. Morphology of Mandibular Incisors: A Study on CBCT

    PubMed Central

    Kamtane, Smita; Ghodke, Monali

    2016-01-01

    Summary Background The aim of the study was to identify the number of root canals and examine root canal morphology of permanent mandibular incisors in an Indian sub-population of Pune, Maharashtra, India using cone-beam computed tomography (CBCT). Material/Methods This study was conducted at Elite CBCT & Dental Diagnostics, Pune. One hundred mandibular incisors were evaluated for the number of root, root canals and root morphology. Results In the present study, amongst 102 mandibular incisors, all had one root, 36% of them had a second canal, and Vertucci Type I was the most common type. Conclusions CBCT imaging is an excellent method for detection of different canal configurations of mandibular incisors. PMID:26834865

  1. Autotransplantation of Mandibular Third Molar: A Case Report

    PubMed Central

    Ravi kumar, Pabbati; Jyothi, Mandava; Sirisha, Kantheti; Racca, Khushboo; Uma, Chalasani

    2012-01-01

    Autogenous transplantation is a feasible, fast, and economical option for the treatment of nonsalvageable teeth when a suitable donor tooth is available. This paper presents successful autotransplantation of a mature mandibular left third molar (38) without anatomical variances is used to replace a mandibular left second molar (37). The mandibular second molar was nonrestorable due to extensive root caries and resorption of distal root. After extraction of mandibular second and third molars, root canal therapy was done for the third molar extraorally, and the tooth was reimplanted into the extracted socket of second molar site. After one year, clinical and radiographic examination revealed satisfactory outcome with no signs or symptoms suggestive of pathology. In selected cases, autogenous tooth transplantation, even after complete root formation of the donor tooth, may be considered as a practical treatment alternative to conventional prosthetic rehabilitation or implant treatment. PMID:23346422

  2. Reliability of Panoramic Radiographs in the Localization of Mandibular Foramen

    PubMed Central

    Patil, Karthikeya; Guledgud, Mahima V

    2015-01-01

    Objective The present study evaluated the reliability and accuracy of panoramic radiographs in the localization of mandibular foramen. Materials and Methods Twenty five Indian dry human adult mandibles constituted the study material. Ten measurements were carried on each of them to evaluate the location of mandibular foramen with respect to adjacent anatomic landmarks. Panoramic radiographs were then made of the mandibles. Same distances were measured on the traced images of the radiographs. Paired t-test and Pearson’s correlation test were applied to evaluate the accuracy and reliability of panoramic radiographs in localization of mandibular foramen. Results The mean distances measured on dry mandibles and panoramic radiographs showed statistically significant difference (p<0.05). There was strong positive correlation between the measurements on dry mandible and panoramic radiographs. Conclusion The panoramic radiographs can serve as a guide in locating the anterosuperior point of mandibular foramen on panoramic radiographs. PMID:26155559

  3. Unilateral sagittal split mandibular ramus osteotomy: indications and geometry.

    PubMed

    Beukes, Jacques; Reyneke, Johan P; Damstra, Janalt

    2016-02-01

    Small mandibular asymmetries may be corrected by unilateral sagittal split ramus osteotomy (USSO). This study had two objectives: first to define the geometric changes in the mandibular condyle and the lower incisor teeth that result from the rotation of the major segment (n=26), and secondly to examine in a clinical study the temporomandibular joints (TMJ) of 23 patients after correction of mandibular asymmetry by USSO to find out if there were any long-term adverse effects. Small mandibular asymmetries (<5mm) can be corrected by USSO. Secondary anteroposterior changes as a result of setback or advancement on the operated side should be taken into account during the planning of treatment. The small rotational changes of the condyle did not adversely affect the TMJ. PMID:26774360

  4. Preoperative Planning of Virtual Osteotomies Followed by Fabrication of Patient Specific Reconstruction Plate for Secondary Correction and Fixation of Displaced Bilateral Mandibular Body Fracture.

    PubMed

    Thor, Andreas

    2016-06-01

    This paper describes the course of treatment of a severely diplaced bilateral mandibular body fracture, where the first osteosynthesis failed. The subject developed an open bite due to a posterior rotation of the distal part of the mandible and anterior rotation of the proximal parts of the mandible. This situation was evaluated with CBCT and the facial skeleton was segmented using computer software. Correct occlusion was virtually established by bilateral virtual osteotomies in the fracture areas of the mandible. After segmentation, the mandible was virtually rotated back into position and the open bite was closed. A patient specific mandibular reconstruction plate was outlined and fabricated from the new virtual situation and the plate was thereafter installed utilizing the preoperative plan. Osteotomy- and drill-guides was used and thus simplified the surgery resulting in uneventful healing. Virtual planning and patient specific implants and guides were valuable in this case of secondary reconstructive trauma surgery. PMID:27162581

  5. Reproducibility of mandibular third molar assessment comparing two cone beam CT units in a matched pairs design

    PubMed Central

    Matzen, L H; Hintze, H; Spin-Neto, R; Wenzel, A

    2013-01-01

    The aim of this study was to evaluate the reproducibility of the third molar assessment, comparing five observers and two cone beam CT (CBCT) units. 28 patients, each with two impacted mandibular third molars, were included. Each patient was randomly examined with a Scanora® 3D (Soredex, Helsinki, Finland) CBCT unit in one mandibular third molar region and with a Cranex® 3D (Soredex) CBCT unit in the other region. Five observers with varying CBCT experience assessed all third molars and recorded the following variables: number and morphology of the roots, relation to the mandibular canal in two directions, shape of the canal and whether there was a direct contact between the roots of the molar and the mandibular canal. The radiographic assessments were compared pairwise among all observers for all variables. Wilcoxon's signed-rank test was used to test the differences in observer accordance percentages among the recorded variables in the images from the two units, and kappa statistics expressed interobserver reproducibility. The mean percentages for observer accordance ranged from 65.4 to 92.9 for Scanora 3D and 60.3 to 94.8 for Cranex 3D. There was no significant difference between the observer accordance in the two CBCT units (p > 0.05), except for assessing root flex in the mesiodistal direction, for which the observer accordance was higher for Scanora 3D (p < 0.05). Kappa values ranged from 0.1 to 1.0 for Scanora 3D and from 0.2 to 0.9 for Cranex 3D. For the variable “direct contact”, the interobserver reproducibility was excellent for the two trained radiologists. The two units had almost similar interobserver reproducibility for mandibular third molar assessment. Observer variation existed, and experienced radiologists demonstrated the highest interobserver reproducibility for canal-related variables. PMID:24052253

  6. Bioengineered anterior cruciate ligament

    NASA Technical Reports Server (NTRS)

    Altman, Gregory (Inventor); Kaplan, David (Inventor); Vunjak-Novakovic, Gordana (Inventor); Martin, Ivan (Inventor)

    2001-01-01

    The present invention provides a method for producing an anterior cruciate ligament ex vivo. The method comprises seeding pluripotent stem cells in a three dimensional matrix, anchoring the seeded matrix by attachment to two anchors, and culturing the cells within the matrix under conditions appropriate for cell growth and regeneration, while subjecting the matrix to one or more mechanical forces via movement of one or both of the attached anchors. Bone marrow stromal cells are preferably used as the pluripotent cells in the method. Suitable matrix materials are materials to which cells can adhere, such as a gel made from collagen type I. Suitable anchor materials are materials to which the matrix can attach, such as Goinopra coral and also demineralized bone. Optimally, the mechanical forces to which the matrix is subjected mimic mechanical stimuli experienced by an anterior cruciate ligament in vivo. This is accomplished by delivering the appropriate combination of tension, compression, torsion, and shear, to the matrix. The bioengineered ligament which is produced by this method is characterized by a cellular orientation and/or matrix crimp pattern in the direction of the applied mechanical forces, and also by the production of collagen type I, collagen type III, and fibronectin proteins along the axis of mechanical load produced by the mechanical forces. Optimally, the ligament produced has fiber bundles which are arranged into a helical organization. The method for producing an anterior cruciate ligament can be adapted to produce a wide range of tissue types ex vivo by adapting the anchor size and attachment sites to reflect the size of the specific type of tissue to be produced, and also adapting the specific combination of forces applied, to mimic the mechanical stimuli experienced in vivo by the specific type of tissue to be produced. The methods of the present invention can be further modified to incorporate other stimuli experienced in vivo by the

  7. Transoral Miniplate Fixation of Mandibular Angle Fracture with and without 2 Weeks of Maxillomandibular Fixation: A Clinical Trial Study.

    PubMed

    Khiabani, Kazem S; Mehmandoost, Meghdad Khanian

    2013-06-01

    Background and Objectives The ideal line of osteosynthesis in mandibular angle fractures indicates that a plate might be placed either along or just below the external oblique ridge. Some authors believe that using one miniplate at this line at the mandibular angle region provides sufficient strength to stabilize the fracture but others imply a second plate is required. Such controversies exist in the use of maxillomandibular fixation (MMF). The intention of the present study was to compare efficiency and complications of using one miniplate with and without MMF in mandibular angle fractures. Methods and Materials Forty patients with facial trauma with mandibular angle fractures including displaced and unfavorable fractures were categorized into two groups of 20 persons. In all patients, one miniplate was placed on the external oblique ridge. In the first group, patients had light maxillomandibular elastic bands just after surgery but no rigid MMF. In the second group, patients had rigid MMF for 2 weeks after surgery. Patients were followed to evaluate complications and treatment efficiency. Conclusions Our study showed that use of a single miniplate in the external oblique ridge is a functionally stable treatment for all types of angle fractures (including displaced and unfavorable fractures) except comminuted and long oblique fractures, which were not included in our study. Use of postoperative MMF did not improve the results. PMID:24436745

  8. Cranial and mandibular shape variation in the genus Carollia (Mammalia: Chiroptera) from Colombia: biogeographic patterns and morphological modularity.

    PubMed

    López-Aguirre, Camilo; Pérez-Torres, Jairo; Wilson, Laura A B

    2015-01-01

    Neotropical bats of the genus Carollia are widely studied due to their abundance, distribution and relevance for ecosystems. However, the ecomorphological boundaries of these species are poorly differentiated, and consequently correspondence between their geographic distribution, ecological plasticity and morphological variation remains unclear. In this study, patterns of cranial and mandibular morphological variation were assessed for Carollia brevicauda, C. castanea and C. perspicillata from Colombia. Using geometric morphometrics, morphological variation was examined with respect to: differences in intraspecific variation, morphological modularity and integration, and biogeographic patterns. Patterns of intraspecific variation were different for each species in both cranial and mandibular morphology, with functional differences apparent according to diet. Cranial modularity varied between species whereas mandibular modularity did not. High cranial and mandibular correlation reflects Cranium-Mandible integration as a functional unit. Similarity between the biogeographic patterns in C. brevicauda and C. perspicillata indicates that the Andes do not act as a barrier but rather as an independent region, isolating the morphology of Andean populations of larger-bodied species. The biogeographic pattern for C. castanea was not associated with the physiography of the Andes, suggesting that large body size does not benefit C. brevicauda and C. perspicillata in maintaining homogeneous morphologies among populations. PMID:26413433

  9. Cranial and mandibular shape variation in the genus Carollia (Mammalia: Chiroptera) from Colombia: biogeographic patterns and morphological modularity

    PubMed Central

    Pérez-Torres, Jairo; Wilson, Laura A. B.

    2015-01-01

    Neotropical bats of the genus Carollia are widely studied due to their abundance, distribution and relevance for ecosystems. However, the ecomorphological boundaries of these species are poorly differentiated, and consequently correspondence between their geographic distribution, ecological plasticity and morphological variation remains unclear. In this study, patterns of cranial and mandibular morphological variation were assessed for Carollia brevicauda, C. castanea and C. perspicillata from Colombia. Using geometric morphometrics, morphological variation was examined with respect to: differences in intraspecific variation, morphological modularity and integration, and biogeographic patterns. Patterns of intraspecific variation were different for each species in both cranial and mandibular morphology, with functional differences apparent according to diet. Cranial modularity varied between species whereas mandibular modularity did not. High cranial and mandibular correlation reflects Cranium-Mandible integration as a functional unit. Similarity between the biogeographic patterns in C. brevicauda and C. perspicillata indicates that the Andes do not act as a barrier but rather as an independent region, isolating the morphology of Andean populations of larger-bodied species. The biogeographic pattern for C. castanea was not associated with the physiography of the Andes, suggesting that large body size does not benefit C. brevicauda and C. perspicillata in maintaining homogeneous morphologies among populations. PMID:26413433

  10. Transoral Miniplate Fixation of Mandibular Angle Fracture with and without 2 Weeks of Maxillomandibular Fixation: A Clinical Trial Study

    PubMed Central

    Khiabani, Kazem S.; Mehmandoost, Meghdad Khanian

    2013-01-01

    Background and Objectives The ideal line of osteosynthesis in mandibular angle fractures indicates that a plate might be placed either along or just below the external oblique ridge. Some authors believe that using one miniplate at this line at the mandibular angle region provides sufficient strength to stabilize the fracture but others imply a second plate is required. Such controversies exist in the use of maxillomandibular fixation (MMF). The intention of the present study was to compare efficiency and complications of using one miniplate with and without MMF in mandibular angle fractures. Methods and Materials Forty patients with facial trauma with mandibular angle fractures including displaced and unfavorable fractures were categorized into two groups of 20 persons. In all patients, one miniplate was placed on the external oblique ridge. In the first group, patients had light maxillomandibular elastic bands just after surgery but no rigid MMF. In the second group, patients had rigid MMF for 2 weeks after surgery. Patients were followed to evaluate complications and treatment efficiency. Conclusions Our study showed that use of a single miniplate in the external oblique ridge is a functionally stable treatment for all types of angle fractures (including displaced and unfavorable fractures) except comminuted and long oblique fractures, which were not included in our study. Use of postoperative MMF did not improve the results. PMID:24436745

  11. Mandibular Ramus Fracture: An Overview of Rare Anatomical Subsite

    PubMed Central

    Jadhav, Anendd; Mundada, Bhushan; Deshmukh, Rahul; Bhutekar, Umesh; Kala, Atul; Waghwani, Kapil; Mishra, Apoorva

    2015-01-01

    Aim. The present study aims at exemplifying the incidence, and aetiology and analyses the outcomes of open reduction internal fixation (ORIF) over closed treatment of mandibular ramus fractures. Patients and Method. In the present retrospective analysis of mandibular fracture patients, variables analysed were age, sex, cause of injury, pretreatment occlusion, treatment given, period of maxillo-mandibular fixation (MMF), and posttreatment occlusion. Results. Out of 388 mandibular fractures treated, ramus fractures were 12 (3.09%). In the present study, predominant cause of mandibular ramus fracture was road traffic accident (RTA) n = 07 (58.33%) followed by fall n = 04 (33.33%) and assault n = 1 (8.33%). The average age was 35.9 years with a male predilection. Of these, 9 patients were treated with ORIF while remaining 3 with closed treatment. The average MMF after closed treatment was 21 days and 3 to 5 days after ORIF. There was improvement in occlusion in all 12 patients posttreatment with no major complication except for reduced mouth opening in cases treated with ORIF which recovered with physiotherapy and muscle relaxants. Conclusion. Mandibular ramus fractures accounted for 3.09% with RTA as a common aetiology. ORIF of ramus fractures facilitated adequate functional and anatomic reduction with early return of function. PMID:26613050

  12. Anterior hip pain.

    PubMed

    O'Kane, J W

    1999-10-15

    Anterior hip pain is a common complaint with many possible causes. Apophyseal avulsion and slipped capital femoral epiphysis should not be overlooked in adolescents. Muscle and tendon strains are common in adults. Subsequent to accurate diagnosis, strains should improve with rest and directed conservative treatment. Osteoarthritis, which is diagnosed radiographically, generally occurs in middle-aged and older adults. Arthritis in younger adults should prompt consideration of an inflammatory cause. A possible femoral neck stress fracture should be evaluated urgently to prevent the potentially significant complications associated with displacement. Patients with osteitis pubis should be educated about the natural history of the condition and should undergo physical therapy to correct abnormal pelvic mechanics. "Sports hernias," nerve entrapments and labral pathologic conditions should be considered in athletic adults with characteristic presentations and chronic symptoms. Surgical intervention may allow resumption of pain-free athletic activity. PMID:10537384

  13. Effect of replacement of mandibular defects with a modular endoprosthesis on bone mineral density in a monkey model.

    PubMed

    Wong, R C W; Lee, S; Tideman, H; Merkx, M A W; Jansen, J; Liao, K

    2011-06-01

    The effect of mandibular modular endoprostheses on bone mineral density (BMD) in the stem regions was studied. Modular endoprostheses were inserted into standardized mandibular condyle or body defects in 16 Macaca fascicularis. Each group of eight monkeys was divided into two groups, one killed at 3 months, the other at 6 months post-surgery. The mandibles were harvested, sectioned and scanned with a micro-computed tomography scanner. The reconstructed slices, made at a right angles to the long axis of the prosthesis, were analysed using software to calculate BMD in regions of interest buccal, lingual and inferior to the stems of the endoprosthesis. Measurements of the contralateral sides of three monkeys that underwent a similar procedure were used as control/baseline BMD. BMD for the condyle replacement group did not differ significantly from the control group. At 6 months, BMD decreased slightly; significant only at the inferior region. BMD for the body replacement group was significantly lower in all regions compared with control and condyle replacement groups probably because of connection screw loosening and infection. Loss of BMD in the peri-implant region of a modular endoprosthesis for mandibular replacement is minimal up to 6 months postoperatively, provided the device remains stable and well-fixed. PMID:21216566

  14. Incongruity between affinity patterns based on mandibular and lower dental dimensions following the transition to agriculture in the Near East, Anatolia and Europe.

    PubMed

    Pinhasi, Ron; Eshed, Vered; von Cramon-Taubadel, Noreen

    2015-01-01

    While it has been suggested that malocclusion is linked with urbanisation, it remains unclear as to whether its high prevalence began 8,000 years earlier concomitant with the transition to agriculture. Here we investigate the extent to which patterns of affinity (i.e., among-population distances), based on mandibular form and dental dimensions, respectively, match across Epipalaeolithic, Mesolithic, and Neolithic samples from the Near East/Anatolia and Europe. Analyses were conducted using morphological distance matrices reflecting dental and mandibular form for the same 292 individuals across 21 archaeological populations. Thereafter, statistical analyses were undertaken on four sample aggregates defined on the basis of their subsistence strategy, geography, and chronology to test for potential differences in dental and mandibular form across and within groups. Results show a clear separation based on mandibular morphology between European hunter-gatherers, European farmers, and Near Eastern transitional farmers and semi-sedentary hunter-gatherers. In contrast, the dental dimensions show no such pattern and no clear association between the position of samples and their temporal or geographic attributes. Although later farming groups have, on average, smaller teeth and mandibles, shape analyses show that the mandibles of farmers are not simply size-reduced versions of earlier hunter-gatherer mandibles. Instead, it appears that mandibular form underwent a complex series of shape changes commensurate with the transition to agriculture that are not reflected in affinity patterns based on dental dimensions. In the case of hunter-gatherers there is a correlation between inter-individual mandibular and dental distances, suggesting an equilibrium between these two closely associated morphological units. However, in the case of semi-sedentary hunter-gatherers and farming groups, no such correlation was found, suggesting that the incongruity between dental and mandibular

  15. Incongruity between Affinity Patterns Based on Mandibular and Lower Dental Dimensions following the Transition to Agriculture in the Near East, Anatolia and Europe

    PubMed Central

    Pinhasi, Ron; Eshed, Vered; von Cramon-Taubadel, Noreen

    2015-01-01

    While it has been suggested that malocclusion is linked with urbanisation, it remains unclear as to whether its high prevalence began 8,000 years earlier concomitant with the transition to agriculture. Here we investigate the extent to which patterns of affinity (i.e., among-population distances), based on mandibular form and dental dimensions, respectively, match across Epipalaeolithic, Mesolithic, and Neolithic samples from the Near East/Anatolia and Europe. Analyses were conducted using morphological distance matrices reflecting dental and mandibular form for the same 292 individuals across 21 archaeological populations. Thereafter, statistical analyses were undertaken on four sample aggregates defined on the basis of their subsistence strategy, geography, and chronology to test for potential differences in dental and mandibular form across and within groups. Results show a clear separation based on mandibular morphology between European hunter-gatherers, European farmers, and Near Eastern transitional farmers and semi-sedentary hunter-gatherers. In contrast, the dental dimensions show no such pattern and no clear association between the position of samples and their temporal or geographic attributes. Although later farming groups have, on average, smaller teeth and mandibles, shape analyses show that the mandibles of farmers are not simply size-reduced versions of earlier hunter-gatherer mandibles. Instead, it appears that mandibular form underwent a complex series of shape changes commensurate with the transition to agriculture that are not reflected in affinity patterns based on dental dimensions. In the case of hunter-gatherers there is a correlation between inter-individual mandibular and dental distances, suggesting an equilibrium between these two closely associated morphological units. However, in the case of semi-sedentary hunter-gatherers and farming groups, no such correlation was found, suggesting that the incongruity between dental and mandibular

  16. Biomechanical comparison of four mandibular angle fracture fixation techniques.

    PubMed

    Muñante-Cardenas, Jose Luis; Passeri, Luis Augusto

    2015-06-01

    The aim of this study was to make a comparison of the biomechanical behavior of four different internal fixation systems for mandibular angle fractures. A total of 40 polyurethane mandible replicas were employed with different fixation methods: group 1SP, one 2.0-mm four-hole miniplate; group 2PPL, two 2.0-mm four-hole parallel miniplates; group 3DP, one 3D 2.0-mm four-hole miniplate; and group 3DPP, one 3D 2.0-mm eight-hole miniplate. Each group was subjected to incisal or homolateral molar region loading. The load resistance values were measured at load application causing tip displacement of 1, 3, and 5 mm, and at the time at which the system achieves its maximum strength (MS). Means and standard deviations were compared among groups using analysis of variance and the Tukey test. Group 2PPL showed higher strength for all the displacements. For incisal loading, no statistically significant differences were found between groups 1SP, 3DP, and 3DPP. For molar loading, group 1SP and 3DPP showed statistically significant differences. For MS testing, group 1SP and 2PPL showed statistically significant differences in incisal loading; group 1SP and 3DP showed no statistically significant differences; and group 3DPP showed lower values of strength. Two parallel miniplates provide the most favorable mechanical behavior under the conditions tested. PMID:26000083

  17. Biomechanical Comparison of Four Mandibular Angle Fracture Fixation Techniques

    PubMed Central

    Muñante-Cardenas, Jose Luis; Passeri, Luis Augusto

    2014-01-01

    The aim of this study was to make a comparison of the biomechanical behavior of four different internal fixation systems for mandibular angle fractures. A total of 40 polyurethane mandible replicas were employed with different fixation methods: group 1SP, one 2.0-mm four-hole miniplate; group 2PPL, two 2.0-mm four-hole parallel miniplates; group 3DP, one 3D 2.0-mm four-hole miniplate; and group 3DPP, one 3D 2.0-mm eight-hole miniplate. Each group was subjected to incisal or homolateral molar region loading. The load resistance values were measured at load application causing tip displacement of 1, 3, and 5 mm, and at the time at which the system achieves its maximum strength (MS). Means and standard deviations were compared among groups using analysis of variance and the Tukey test. Group 2PPL showed higher strength for all the displacements. For incisal loading, no statistically significant differences were found between groups 1SP, 3DP, and 3DPP. For molar loading, group 1SP and 3DPP showed statistically significant differences. For MS testing, group 1SP and 2PPL showed statistically significant differences in incisal loading; group 1SP and 3DP showed no statistically significant differences; and group 3DPP showed lower values of strength. Two parallel miniplates provide the most favorable mechanical behavior under the conditions tested. PMID:26000083

  18. Enamel thickness trends in Plio-Pleistocene hominin mandibular molars.

    PubMed

    Skinner, Matthew M; Alemseged, Zeresenay; Gaunitz, Charleen; Hublin, Jean-Jacques

    2015-08-01

    Enamel thickness continues to be an important morphological character in hominin systematics and is frequently invoked in dietary reconstructions of Plio-Pleistocene hominin taxa. However, to date, the majority of published data on molar enamel thickness of Pliocene and early Pleistocene hominins derive from naturally fractured random surfaces of a small number of specimens. In this study we systematically analyze enamel thickness in a large sample of Plio-Pleistocene fossil hominins (n = 99), extant hominoids (n = 57), and modern humans (n = 30). Based on analysis of 2D mesial planes of section derived from microtomography, we examine both average and relative enamel thickness, and the distribution of enamel across buccal, occlusal, and lingual components of mandibular molars. Our results confirm the trend of increasing enamel thickness during the Pliocene that culminates in the thick enamel of the robust Australopithecus species, and then decreases from early Homo to recent modern humans. All hominin taxa share a regional average enamel thickness pattern of thick occlusal enamel and greater buccal than lingual enamel thickness. Pan is unique in exhibiting the thinnest average enamel thickness in the occlusal basin. Statistical analysis indicates that among Pliocene hominins enamel thickness is a weak taxonomic discriminator. The data underlying these results are included in a table in the Supplementary Online Material. PMID:26024565

  19. Endoscope-Assisted Enucleation of Mandibular Odontogenic Keratocyst Tumors.

    PubMed

    Romano, Antonio; Orabona, Giovanni D A; Abbate, Vincenzo; Maglitto, Fabio; Solari, Domenico; Iaconetta, Giorgio; Califano, Luigi

    2016-09-01

    The keratocyst odontogenic tumor (KCOT) represents a rare and benign but locally aggressive developmental cystic lesion usually affecting the posterior aspect of the mandible bone, the treatment of which has always been raising debate, since Philipsen first described it as a distinct pathological entity in 1956.Recent studies have proposed the use of endoscope-assisted surgical technique, due to the possibility given by the endoscope of improving the effectiveness of the treatment of these lesions thanks to a better visualization of operative field and though a better understanding of the pathology. In this article, we would like to present our experience with the endoscope-assisted treatment of KCOT of the posterior region of the mandible.From April 2000 to April 2012, 32 patients treated for KCOT were enrolled in our retrospective study: patients were divided in 2 groups according to the type of treatment, that is, 18 were treated with traditional enucleation surgery (TES), and 14 patients underwent endoscopic assisted enucleation surgery (EES).Fischer exact test and Kaplan-Meier curves were used to compare the outcomes between the 2 focusing on the recurrence and complication rates. In the TES group, patients we found a higher recurrence rate (39%) and higher postoperative complication rate at 5-year follow-up.Our data suggested, though, that EES seems to be a feasible alternative for the treatment of posterior mandibular KCOT. Further studies and larger series are needed to confirm these results. PMID:27607111

  20. [Anterior cervical hypertrichosis: case report].

    PubMed

    Orozco-Gutiérrez, Mario H; Sánchez-Corona, José; García-Ortiz, José E; Castañeda-Cisneros, Gema; Dávalos-Rodríguez, Nory O; Corona-Rivera, Jorge R; García-Cruz, Diana

    2016-10-01

    The non-syndromic anterior cervical hypertrichosis (OMIM N° 600457) is a genetic disorder characterized by a patch of hair at the level of the laryngeal prominence. We present a 12-year-old boy with anterior cervical hypertrichosis and mild generalized hypertrichosis. He has no neurological, ophthalmological or skeletal anomalies. The clinical follow up is 10 years. PMID:27606653

  1. Relations between anterior permanent teeth, dental arches and hard palate.

    PubMed

    Petricević, Nikola; Stipetić, Jasmina; Antonić, Robert; Borcić, Josipa; Strujić, Mihovil; Kovacić, Ivan; Celebić, Asja

    2008-12-01

    The width and length of the anterior teeth, the dimensions of the frontal dental arches and the dimensions of the hard palate were measured (24 men and 56 women, age range of 18-30 years). The results showed gender-related dimorphism only for the cervical width of the maxillary canine, which were wider in men, p < 0.05. The width-to-length ratios of the maxillary frontal teeth varied from 0.82 to 0.91. The tooth-to-tooth width ratios among different maxillary frontal teeth varied from 0.78 to 0.91. The sum of all anterior maxillary teeth widths was equal to the hamular width and to the distal maxillary arch width (p > 0.05), meaning that the sum of the frontal artificial teeth width may be selected upon the measurement of the hamular width on the hard palate. The ratios between the maxillary and the mandibular frontal dental arch dimensions are representative values for the skeletal class I. PMID:19149214

  2. Anterior cerebral artery territory infarctions presenting with ascending tetraparesis.

    PubMed

    Okamoto, Kensho; Hamada, Eri; Okuda, Bungo

    2004-01-01

    We describe a patient with ascending tetraparesis following stroke. The patient presented initially with spastic paraparesis which acutely evolved to tetraparesis with abulia. Magnetic resonance imaging revealed acute infarctions in the bilateral medial frontal regions but not in the brainstem or spinal cord. Multiple infarctions in the anterior cerebral artery territory appeared to originate from artery to artery embolism. The present case provides distinct clinical features of anterior cerebral artery syndrome which mimic myelopathy or brainstem lesions. PMID:17903956

  3. Comparison of two imaging programs in predicting the soft tissue changes with mandibular advancement surgery.

    PubMed

    Ravindranath, Sneha; Krishnaswamy, Nathamuni Rengarajan; Sundaram, Venkateswaran

    2011-01-01

    Establishing common objectives and expectations concerning the outcome of proposed surgical orthodontic therapy is a crucial part of the treatment planning process, which has been greatly simplified by imaging software. The purpose of this study was to investigate the reliability of two surgical imaging programs--Dolphin Imaging 10 and Vistadent OC--in simulating the actual outcome of mandibular advancement surgery by using a visual analog scale (VAS) judged by a panel of orthodontists, oral surgeons, and laypersons. The predictions were also analyzed with soft tissue cephalometric evaluation. The results of the study showed that in predicting the surgical outcome evaluated by the VAS, both programs received a mean rating of fair. One was marginally superior for the overall assessment among all three panelist groups. Region-wise, rating indicated the lower lip region to be the least accurate, and the submental region received the highest scores. The soft tissue cephalometric parameters showed minimal differences except for the lower lip parameters. Thus, Dolphin Imaging 10 and Vistadent OC are reliable in predicting mandibular advancement surgical outcomes with inaccuracies chiefly in the lower lip region. PMID:22299108

  4. Endodontic management of a mandibular first molar with six root canal systems

    PubMed Central

    Jain, Dilip; Reddy, Smitha; Venigalla, Bhuvan Shome; Kamishetty, Shekhar

    2015-01-01

    Internal anatomy of pulp is complex. The first mandibular molars typically have two roots, one mesial with two root canals and another distal root, which contains one or two canals. A 20-year-old female patient reported with intermittent pain and incomplete root canal treatment in left lower back region since 1-week. Refined access cavity revealed initially two canals in mesial and two canals in the distal root. With operating microscope and cone beam computerized tomography, two additional canals (L-mesio-buccal and B-mesio-lingual) were identified in mesial root. One-year follow-up showed patient was asymptomatic and complete healing of periapical radiolucency. PMID:26430309

  5. Endodontic management of a mandibular first molar with six root canal systems.

    PubMed

    Jain, Dilip; Reddy, Smitha; Venigalla, Bhuvan Shome; Kamishetty, Shekhar

    2015-01-01

    Internal anatomy of pulp is complex. The first mandibular molars typically have two roots, one mesial with two root canals and another distal root, which contains one or two canals. A 20-year-old female patient reported with intermittent pain and incomplete root canal treatment in left lower back region since 1-week. Refined access cavity revealed initially two canals in mesial and two canals in the distal root. With operating microscope and cone beam computerized tomography, two additional canals (L-mesio-buccal and B-mesio-lingual) were identified in mesial root. One-year follow-up showed patient was asymptomatic and complete healing of periapical radiolucency. PMID:26430309

  6. The mouse olfactory peduncle. 2.The anterior limb of the anterior commissure

    PubMed Central

    Brunjes, Peter C.

    2013-01-01

    The central core of the olfactory peduncle [the tissue connecting the olfactory bulb (OB) to the forebrain] includes a white matter tract that extends caudally to the anterior commissure (AC). The purpose of the present study was to examine this “anterior limb of the anterior commissure” (ALAC) to determine if the axons that progress through it segregate on the basis of their point of origin, neurotransmitter type, size, or shape. While local differences in axon density were observed in the ALAC, they were not consistent between samples of the anterior and posterior peduncle, and no other compartmentalization within the tract was observed. The innervation of the caudal olfactory peduncle by neuromodulatory fibers was examined to determine if they enter the region via the ALAC. Cholinergic fibers (CHAT) densely filled the peduncle, followed in order by serotonergic, noradrenergic, histaminergic, and orexinergic processes. Differences in the distribution of the fibers were noted for each system. While each axon type could be observed in the ALAC, it is probable that they enter the peduncle though several routes. Data for axon caliber in the ALAC was compared to information previously collected on the peduncle's other white matter region, the lateral olfactory tract (LOT). Axons in the ALAC were smaller, suggesting that the olfactory system is organized with a fast system for distributing incoming sensory information and a more economical, distributed system for subsequent processing. PMID:23355812

  7. Flap Coverage of Anterior Abdominal Wall Defects

    PubMed Central

    Sacks, Justin M.; Broyles, Justin M.; Baumann, Donald P.

    2012-01-01

    Reconstruction of complex defects of the anterior abdomen is both challenging and technically demanding for reconstructive surgeons. Advancements in the use of pedicle and free tissue transfer along with the use of bioprosthetic and synthetic meshes have provided for novel approaches to these complex defects. Accordingly, detailed knowledge of abdominal wall and lower extremity anatomy in combination with insight into the design, implementation, and limitations of various flaps is essential to solve these complex clinical problems. Although these defects can be attributed to a myriad of etiologic factors, the objectives in abdominal wall reconstruction are consistent and include the restoration of abdominal wall integrity, protection of intraabdominal viscera, and the prevention of herniation. In this article, the authors review pertinent anatomy and the various local, regional, and distant flaps that can be utilized in the reconstruction of these complex clinical cases of the anterior abdomen. PMID:23372457

  8. On the reversibility of mandibular symphyseal fusion.

    PubMed

    Scott, Jeremiah E; Lack, Justin B; Ravosa, Matthew J

    2012-09-01

    Experimental and comparative studies suggest that a major determinant of increased ossification of the mandibular symphysis is elevated masticatory stress related to a mechanically challenging diet. However, the morphology of this joint tracks variation in dietary properties in only some mammalian clades. Extant anthropoid primates are a notable exception: synostosis is ubiquitous in this speciose group, despite its great age and diverse array of feeding adaptations. One possible explanation for this pattern is that, once synostosis evolves, reversion to a lesser degree of fusion is unlikely or even constrained. If correct, this has important implications for functional and phylogenetic analyses of the mammalian feeding apparatus. To test this hypothesis, we generated a molecular tree for 76 vespertilionoid and noctilionoid chiropterans using Bayesian phylogenetic analysis and examined character evolution using parsimony and likelihood ancestral-state reconstructions along with the binary state speciation and extinction (BiSSE) model. Results indicate that reversals have occurred within Vespertilionoidea. In contrast, noctilionoids exhibit an anthropoid-like pattern, which suggests that more detailed comparisons of the functional and developmental bases for fusion in these bat clades may provide insight into why fusion is maintained in some lineages but not in others. Potential functional and developmental explanations for the lack of reversal are discussed. PMID:22946814

  9. Mandibular nerve paresthesia caused by endodontic treatment.

    PubMed

    Gallas-Torreira, M Mercedes; Reboiras-López, M Dolores; García-García, Abel; Gándara-Rey, José

    2003-01-01

    The paresthesias of the inferior dental nerve consists of a complication that can occur after performing various dental procedures such as cystectomies, extraction of impacted teeth, apicoectomies, endodontic treatments, local anesthetic deposition, preprosthetic or implantologic surgery. The possible mechanisms of nervous lesions are mechanical, chemical and thermal. Mechanical injury includes compression, stretching, partial or total resection and laceration. The lesion can cause a discontinuity to the nerve with Wallerian degeneration of the distal and integrated fibers of the covering (axonotmesis) or can cause the total sectioning of the nerve (neurotmesis). Chemical trauma can be due to certain toxic components of the endodontic filling materials (paraformaldehyde, corticoids or eugenol) and irrigating solutions (sodium hypochlorite) or local anesthetics. Thermal injury is a consequence of bone overheating during the execution of surgical techniques. We present a clinical case of paresthesia of the inferior dental nerve after the introduction of a gutta-percha point in the mandibular canal during the performance of a root canal therapy of the inferior first molar. The etiology and the treatment of this endodontic complication are described. PMID:12937392

  10. Mandibular sexual dimorphism analysis in CBCT scans.

    PubMed

    Gamba, Thiago de Oliveira; Alves, Marcelo Corrêa; Haiter-Neto, Francisco

    2016-02-01

    The aim of this study was to evaluate sexual dimorphism using anthropometric measurements on mandibular images obtained by cone beam computed tomography (CBCT). The sample consisted of 160 CT scans collected from a Brazilian population (74 males, 86 females) aged 18-60 years. The CBCT images were analyzed by five reviewers. Six measurements (ramus length, gonion-gnathion length, minimum ramus breadth, gonial angle, bicondylar breadth, and bigonial breadth) were collected for the sexual prediction analysis. For the statistical analysis, intraclass correlation was used to evaluate intra- and inter-reviewers, analysis of variance was used to compare the mean values of these measurements, binary logistic regression equations were created to predict sex. Using these four variables, the rate of correct sex classification was 95.1%. After, the discriminant function was used to validate the formula built. Accuracy of 93.33% and 94.74% was found for estimating male and females, respectively. Thus, the formula developed in this study can be used for sex estimation in forensic settings. PMID:26773251

  11. Relationship between mandibular condyle and angle fractures and the presence of mandibular third molars

    PubMed Central

    Mah, Deuk-Hyun; Moon, Seong-Yong; Oh, Ji-Su; You, Jae-Seek

    2015-01-01

    Objectives We retrospectively evaluated the impact of mandibular third molars on the occurrence of angle and condyle fractures. Materials and Methods This was a retrospective investigation using patient records and radiographs. The sample set consisted of 440 patients with mandibular fractures. Eruption space, depth and angulation of the third molar were measured. Results Of the 144 angle fracture patients, 130 patients had third molars and 14 patients did not. The ratio of angle fractures when a third molar was present (1.26 : 1) was greater than when no third molar was present (0.19 : 1; odds ratio, 6.58; P<0.001). Of the 141 condyle fractures patients, the third molar was present in 84 patients and absent in 57 patients. The ratio of condyle fractures when a third molar was present (0.56 : 1) was lower than when no third molar was present (1.90 : 1; odds ratio, 0.30; P<0.001). Conclusion The increased ratio of angle fractures with third molars and the ratio of condyle fractures without a third molar were statistically significant. The occurrence of angle and condyle fractures was more affected by the continuity of the cortical bone at the angle than by the depth of a third molar. These results demonstrate that a third molar can be a determining factor in angle and condyle fractures. PMID:25741462

  12. Computed tomographic study of the patterns of oesteoarthritic change which occur on the mandibular condyle.

    PubMed

    Lim, Mi-Ji; Lee, Jeong-Yun

    2014-12-01

    The aim of this study was to investigate which parts of the articular surface of the mandibular condyle are involved in osteoarthritic (OA) change (the occurring pattern) and the relationship of these patterns to clinical signs and symptoms. The computed tomographic (CT) images and clinical records of patients with OA involvement of one or both of their temporomandibular joints (TMJs) were reviewed (OA changes confirmed by CT; 684 TMJs included). The condylar articular surface was divided into nine imaginary sections on the CT images: antero-medial (AM), antero-central (AC), antero-lateral (AL), centri-medial (CM), centri-central (CC), centri-lateral (CL), postero-medial (PM), postero-central (PC), and postero-lateral (PL) section. The occurring patterns were classified with hierarchical cluster analysis based on the distribution of the sections involved by OA changes. OA changes were observed the most frequently on the AC (62.4%) followed by the AM (55.0%), CC (48.2%), AL (43.0%), CL (43.3%), CM (33.3%), PC (28.9%), PL (25.3%), and PM (23.1%). The occurring patterns were classified into three types among which subjective joint pain (P < 0.001) and noise (P < 0.05) were more frequently reported in the entire-involved type followed by lateral- and antero-medial types in descending order, while no significant differences for age, gender, side, pain on palpation, clicking, crepitus, mouth opening range and craniomandibular index were observed. OA changes are more likely to occur on the anterior than the posterior and on the medial than the lateral surface of the mandibular condyle, while subjective joint pain and noise are more frequently reported with OA changes involving the lateral or entire part. Pain on palpation, noise, and mouth opening range were not related to the occurring pattern of OA changes. PMID:25240743

  13. Multiple bilateral supernumerary mandibular premolars in a non-syndromic patient with associated orthokeratised odontogenic cyst- A case report and review of literature

    PubMed Central

    Kasat, Vikrant O.; Saluja, Harish; Kalburge, Jitendra V.; Kini, Yogesh; Nikam, Atul; Laddha, Ruchi

    2012-01-01

    Multiple supernumerary teeth are very rare, accounting for less than 1% of cases. They are commonly associated with syndromes like Gardner's syndrome and cleidocranial dysostosis and cleft lip and palate. Non-syndromic multiple supernumerary teeth have a predilection to occur in the mandibular premolar region. Orthokeratinized odontogenic cyst (OOC) is a relatively uncommon developmental cyst comprising about 10% of the cases that had been previously implied as odontogenic keratocysts. More than half of the cases of OOC are associated with impacted tooth; but not a single case of OOC associated with supernumerary teeth is reported. Hence, the purpose of this article is to report the first case of multiple supernumerary mandibular premolars associated with OOC in a 35-year-old male and to review the literature associated with multiple bilateral supernumerary mandibular premolars. PMID:23230374

  14. Anterior radical debridement and anterior instrumentation in tuberculosis spondylitis.

    PubMed

    Benli, I Teoman; Acaroğlu, Emre; Akalin, Serdar; Kiş, Mahmut; Duman, Evrim; Un, Ahmet

    2003-04-01

    The conventional procedure in the treatment of vertebral tuberculosis is drainage of the abscess, curettage of the devitalized vertebra and application of an antituberculous chemotherapy regimen. Posterior instrumentation results are encouraging in the prevention or treatment of late kyphosis; however, a second-stage operation is needed. Recently, posterolateral or transpedicular drainage without anterior drainage or posterior instrumentation following anterior drainage in the same session has become the preferred treatment, in order that kyphotic deformity can be avoided. Information on the use of anterior instrumentation along with radical debridement and fusion is scarce. This study reports on the surgical results of 63 patients with Pott's disease who underwent anterior radical debridement with anterior fusion and anterior instrumentation (23 patients with Z-plate and 40 patients with CDH system). Average age at the time of operation was 46.8+/-13.4 years. Average duration of follow-up was 50.9+/-12.9 months. Local kyphosis was measured preoperatively, postoperatively and at the last follow-up visit as the angle between the upper and lower end plates of the collapsed vertebrae. Vertebral collapse, destruction, cold abscess, and canal compromise were assessed on magnetic resonance (MR) images. It was observed that the addition of anterior instrumentation increased the rate of correction of the kyphotic deformity (79.7+/-20.1%), and was effective in maintaining it, with an average loss of 1.1 degrees +/-1.7 degrees. Of the 25 patients (39.7%) with neurological symptoms, 20 (80%) had full and 4 (16%) partial recoveries. There were very few intraoperative and postoperative complications (major vessel complication: 3.2%; secondary non-specific infection: 3.2%). Disease reactivation was not seen with the employment of an aggressive chemotherapy regimen. It was concluded that anterior instrumentation is a safe and effective method in the treatment of tuberculosis

  15. [Maxillary and mandibular fractures. Treatment concepts in maxillofacial surgery].

    PubMed

    Waiss, W; Gosau, M; Koyama, K; Reichert, T E

    2011-11-01

    Maxillary and mandibular fractures are a relatively frequent occurrence due to the exposed location of the jaws and are caused mainly by acts of violence, traffic and recreational accidents. Mandibular fractures can be treated conservatively with dental splints and intermaxillary fixation. Since Michelet, miniplate osteosynthesis via intraoral access has become the method of choice. Champy showed that the monocortical fixation of miniplates at the level of the linea obliqua results in stable osteosynthesis, despite postoperative micro-movements in the fracture gap, and postulated the principle of dynamic compression. Dislocated fractures of the mandibular collum are treated with stable osteosynthesis via an intra- or extraoral approach, while fractures of the mandibular joint are usually treated conservatively and early functional rehabilitation is favored. For mandibular fractures, the principle of load-bearing and load-sharing should be considered, i.e. in the case of sufficient bone and uncomplicated fractures, the bone can bear most of the force, such that miniplates are sufficient (load-sharing). If bones are weakened by atrophy or in the case of infected, comminuted or defect fractures osteosynthesis plates must bear the load alone (load-bearing). PMID:22012486

  16. Pathological mandibular fracture: A severe complication of periimplantitis

    PubMed Central

    Rodriguez-Campo, Francisco; Naval-Parra, Beatriz; Sastre-Pérez, Jesús

    2015-01-01

    Nowadays, dental implant treatment is a very common option for patients even in medical compromised conditons. Some complications related to them have been described. Periimplantitis (PI) is one of the biggest concerns complications of these kind of treatments, probably has a multifactorial aethiology. Usually the consequences of PI are the loss of the implants and prostheses, expenses of money and time for dentists and patients. Very often PI implies the necesity of repeating the treatment . Pathological mandibular fracture due to PI is a severe but infrequent complication after dental implant treatment, especially after PI. In this study we present three cases of mandibular pathologic fractures among patients with different medical and dental records but similar management: two of them had been treated years ago of oral squamous cell carcinoma with surgery and radiotherapy, the other patient received oral bisphosphonates for osteoporosis some years after implantation. We analized the causes, consequences and posible prevention of these fractures as well as the special features of this kind of mandibular fractures and the different existing treatments. Key words:Periimplantitis, pathological mandibular fracture, mandibular atrophy, bicortical implants. PMID:26155355

  17. Pathological mandibular fracture: A severe complication of periimplantitis.

    PubMed

    Naval-Gías, Luis; Rodriguez-Campo, Francisco; Naval-Parra, Beatriz; Sastre-Pérez, Jesús

    2015-04-01

    Nowadays, dental implant treatment is a very common option for patients even in medical compromised conditons. Some complications related to them have been described. Periimplantitis (PI) is one of the biggest concerns complications of these kind of treatments, probably has a multifactorial aethiology. Usually the consequences of PI are the loss of the implants and prostheses, expenses of money and time for dentists and patients. Very often PI implies the necesity of repeating the treatment . Pathological mandibular fracture due to PI is a severe but infrequent complication after dental implant treatment, especially after PI. In this study we present three cases of mandibular pathologic fractures among patients with different medical and dental records but similar management: two of them had been treated years ago of oral squamous cell carcinoma with surgery and radiotherapy, the other patient received oral bisphosphonates for osteoporosis some years after implantation. We analized the causes, consequences and posible prevention of these fractures as well as the special features of this kind of mandibular fractures and the different existing treatments. Key words:Periimplantitis, pathological mandibular fracture, mandibular atrophy, bicortical implants. PMID:26155355

  18. Feasibility of purely endoscopic intramedullary fixation of mandibular condyle fractures.

    PubMed

    Frake, Paul C; Goodman, Joseph F; Joshi, Arjun S

    2015-01-01

    The investigators of this study hypothesized that fractures of the mandibular condyle can be repaired using short-segment intramedullary implants and purely endoscopic surgical technique, using a basic science, human cadaver model in an academic center. Endoscopic instrumentation was used through a transoral mucosal incision to place intramedullary implants of 2 cm in length into osteotomized mandibular condyles. The surgical maneuvers that required to insert these implants, including condyle positioning, reaming, implant insertion, and seating of the mandibular ramus, are described herein. Primary outcome was considered as successful completion of the procedure. Ten cadaveric mandibular condyles were successfully repaired with rigid intramedullary internal fixation without the use of external incisions. Both insertion of a peg-type implant and screwing a threaded implant into the condylar head were possible. The inferior portion of the implant remained exposed, and the ramus of the mandible was manipulated into position on the implant using retraction at the sigmoid notch. The results of this study suggest that purely endoscopic repair of fractures of the mandibular condyle is possible by using short-segment intramedullary titanium implants and a transoral endoscopic approach without the need for facial incisions or punctures. The biomechanical advantages of these intramedullary implants, including improved strength and resistance to mechanical failure compared with miniplates, have been recently established. The combination of improved implant design and purely endoscopic technique may allow for improved fixation and reduced surgical- and implant-related morbidity in the treatment of condylar fractures. PMID:25534058

  19. Sex determination by mandibular ramus: A digital orthopantomographic study

    PubMed Central

    Samatha, K; Byahatti, Sujata Mohan; Ammanagi, Renuka Anand; Tantradi, Praveena; Sarang, Chandan Kaur; Shivpuje, Prachi

    2016-01-01

    Aims and Objectives: (1) To determine the usefulness of mandibular ramus as an aid in sex determination. (2) To evaluate Anteroposterior | superioinferior angle of mandibular condyle. Materials and Methods: A retrospective study was conducted using orthopantomographs of 60 males and 60 females, which were taken using Kodak 8000C Digital Panoramic and Cephalometric System (73 kVp, 12 mA, 13.9 s). The age group ranged between 18 – 45 years. Mandibular ramus measurements were carried out using Master View 3.0 software. The measurements of the mandibular ramus will be subjected to Discriminant function analysis. Results: Maximum ramus breadth, Minimum ramus breadth, Condylar height, Projective height of ramus Coronoid height were calculated for both the sexes differently with the formula & analyzed with Discriminant function analysis using Fischer exact test. The P value was statistically significant with the P value < 0.05 for the following parameters Max. ramus breadth, Condylar height and Projective height of ramus. Conclusion: Mandibular ramus measurements can be a useful tool for gender determination. PMID:27555726

  20. Radiographic evaluation of mandibular ramus for gender estimation: Retrospective study

    PubMed Central

    Damera, Ajit; Mohanalakhsmi, Jonnala; Yellarthi, Pavan Kumar; Rezwana, Begum Mohammed

    2016-01-01

    Background and Aims: Gender estimation is a very important part of a study in the field of anthropology and forensic sciences. In the skeleton, gender estimation is the first step of the identification process as subsequent methods for age and stature estimation are sex-dependent. Skeletal components such as the pelvis and skull are investigated for gender estimation and the mandible is a practical element to analyze sexual dimorphism in fragmented bones. The aim of the present study is to measure, compare, and evaluate various measurements of the mandibular ramus, observed in digital orthopantomographs and also to assess the usefulness of the mandibular ramus as an aid in gender estimation. Materials and Methods: A radiographic retrospective study was conducted using 80 digital orthopantomographs to measure, compare, and evaluate the measurements of the mandibular ramus such as maximum ramus breadth, maximum ramus height, and coronoid heightusing Planmeca ProMax® digital machine to assess the usefulness of mandibular measurements in gender estimation. Results: Descriptive statistics of various measurements and associated univariate F ratios for both the sexes were determined. Four variables were significant predictor in classifying a given sample (P < 0.001). The F-statistic values indicated that measurements expressing the greatest sexual dimorphism were noticed in the maximum ramus height. Conclusion: Mandibular ramus can be considered as a valuable tool in gender estimation and the most reliable measurements were obtained of linear objects in the horizontal plane by digital panoramic imaging.

  1. The Relevance of the Use of Radiographic Planning in Order to Avoid Complications in Mandibular Implantology: A Retrospective Study

    PubMed Central

    Sammartino, Gilberto; Prados-Frutos, Juan Carlos; Riccitiello, Francesco; Felice, Pietro; Cerone, Vincenzo; Gasparro, Roberta; Wang, Hom-Lay

    2016-01-01

    The aim of this retrospective radiological study was to evaluate the variability of the mandibular anatomy in the presence and absence of teeth and to consider how it could influence implant planning. 187 mandibular CT DentaScans were selected from our department archive according to the inclusion criteria. The axial height, vertical height, angulation of the bone crest, and the bone available for ideal implant placement were measured. The analysis of the data shows that the mandible contour presents a constant degree of angulation. The variation of angulation in the absence of teeth was statistically significant only in the region between the canine and the first premolar and in that between the second premolar and the first molar. The difference between the crest height and the available distance to place the implant was greater in the region of the second molar while in the other regions the implant planning was made complex by postextraction resorption. Alveolar bone resorption after tooth loss can be considered as a risk factor for lingual cortical perforation during the insertion of an implant. To avoid potential intra/postoperative complications, 3D radiographic examination is recommended in order to study the mandibular anatomy and identify the risk areas. PMID:27294136

  2. Anterior Knee Pain (Chondromalacia Patellae).

    ERIC Educational Resources Information Center

    Garrick, James G.

    1989-01-01

    This article presents a pragmatic approach to the definition, diagnosis, and management of anterior knee pain. Symptoms and treatment are described. Emphasis is on active involvement of the patient in the rehabilitation exercise program. (IAH)

  3. Anterior Repair with Processed Dermis

    MedlinePlus Videos and Cool Tools

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  4. Correlation of panoramic radiography and cone beam CT findings in the assessment of the relationship between impacted mandibular third molars and the mandibular canal

    PubMed Central

    Neves, F S; Souza, T C; Almeida, S M; Haiter-Neto, F; Freitas, D Q; Bóscolo, F N

    2012-01-01

    Objectives The aim of this study was to assess the reliability of four panoramic radiographic findings, both individually and in association, in predicting the absence of corticalization between the mandibular canal and the third molar on cone beam CT (CBCT) images. Methods The sample consisted of 72 individuals (142 mandibular third molars) who underwent pre-operative radiographic evaluation before extraction of impacted mandibular third molars. On panoramic radiographs, the most common signs of corticalization (darkening of roots, diversion of mandibular canal, narrowing of mandibular canal and interruption of white line) and the presence or absence of corticalization between the mandibular third molar and the mandibular canal on CBCT images were evaluated. Results Darkening of roots and interruption of white line associated with the absence of corticalization between the mandibular third molar and the mandibular canal on CBCT images were statistically significant, both as isolated findings (p = 0.0001 and p = 0.0006, respectively) and in association (p = 0.002). No statistically significant association was observed for the other panoramic radiographic findings, either individually or in association (p > 0.05). Conclusion Darkening of roots and interruption of white line observed on panoramic radiographs, both as isolated findings and in association, were effective in determining the risk relationship between the tooth roots and the mandibular canal, requiring three-dimensional evaluation of the case. PMID:22282507

  5. Memory-guided attention in the anterior thalamus.

    PubMed

    Leszczyński, Marcin; Staudigl, Tobias

    2016-07-01

    The anterior thalamus is densely connected with both the hippocampus and the prefrontal cortex. It is known to play a role in learning and episodic memory. Given its connectivity profile with the prefrontal cortex, it may also be expected to contribute to executive functions. Recent studies in both rodents and humans add to our understanding of anterior thalamic function, suggesting that it is a key region for allocating attention. We discuss the convergence between studies in rodents and humans, both of which imply that the anterior thalamus may play a key role in memory-guided attention. We suggest that efficient allocation of attention to memory representations requires interaction between the memory-related hippocampal and the attention related fronto-parietal networks. We further propose that the anterior thalamus is a hub that connects and modulates both systems. PMID:27130694

  6. 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

  7. The effect of anterior inclined plane treatment on the dentoskeletal of Class II division 1 patients.

    PubMed

    Emami, Meibodi Shahin; Jamilian, Abdolreza; Showkatbakhsh, Abdolrahman

    2007-01-01

    Most of Class II malocclusions are due to underdeveloped mandible with increased overjet and overbite. Lack of incisal contact results in the extrusion of the upper and lower anterior dentoalveolar complex, which helps to lock the mandible and prevent its normal growth and development, and this abnormality is exaggerated by soft tissue imbalance. The purpose of this study was to evaluate the skeletal and dental changes in patients treated with anterior inclined plane appliance in growing patients with moderate Class II Division 1 having deep overbite. In this study, 25 patients, including 15 girls and 10 boys, with a mean age of 9 +/-1.2 years were selected; all of them presented with moderate Class II deep bite with increased overjet and normal or horizontal growth pattern. Pre- and post-treatment X-rays and photos for an average of 8 months were taken. The statistical assessment of the data suggested that there were no significant changes in the vertical skeletal parameters. The mandibular incisors were protruded, whereas the maxillary incisors were retruded. Overbite and overjet were also reduced. There was significant increase in the mandibular length. The results revealed that in mixed dentition patients, the inclined plane corrected Class II discrepancies mostly through dentoskeletal changes. PMID:17951929

  8. Dentigerous Cyst associated with Horizontally Impacted Mandibular Second Premolar

    PubMed Central

    Tripathi, Abhay Mani; Rathore, Monika

    2014-01-01

    ABSTRACT Dentigerous Cyst/developmental cyst of benign odontogenic origin are ones that surround the crown of impacted, embedded, unerupted or developing teeth. Dentigerous cyst is second most common cyst of the oral cavity after radicular cyst. They are usually solitary in occurrence and mostly associated with the mandibular third molars. Dentigerous cysts involving impacted second premolars are rarely reported in the literatures. We present a rare case of dentigerous cyst in a 12-year-old female patient associated with an impacted mandibular second premolar. How to cite this article: Mishra R, Tripathi AM, Rathore M. Dentigerous Cyst associated with Horizontally Impacted Mandibular Second Premolar. Int J Clin Pediatr Dent 2014;7(1): 54-57. PMID:25206240

  9. Combined orthodontic-surgical management of a transmigrated mandibular canine.

    PubMed

    Cavuoti, Serena; Matarese, Giovanni; Isola, Gaetano; Abdolreza, Jamilian; Femiano, Felice; Perillo, Letizia

    2016-07-01

    The presence of an impacted mandibular canine is one of the most difficult challenges that an orthodontist will meet. Orthodontic treatment is planned on an individual basis after thoroughly considering the patient's overall facial and dentoskeletal characteristics; the duration, risks, and costs of treatment; patient preferences; and the orthodontist's experience. This article reports an orthodontic treatment of a boy, age 12.9 years, with an impacted mandibular canine in the permanent dentition that was successfully managed. Radiographic analysis indicated a transmigration of the mandibular right canine. The orthodontic treatment plan included extraction of the deciduous right canine followed by surgical exposure and ligation of the permanent canine. Eruption was properly guided, and the correct position of the tooth was achieved. This challenging treatment approach is described in detail, including the mechanics used to align the impacted canine. PMID:26502299

  10. A Three-rooted Mandibular Second Premolar: A Case Report

    PubMed Central

    Fathi, Zahra; Rahimi, Saeed; Tavakoli, Reza; Amini, Mahsa

    2014-01-01

    Presence of extra roots and canals should be considered before initiation of root canal treatment for the success of endodontic treatment. A mandibular second premolar with three separate roots is very rare and its prevalence has been reported to be around 0.1%. This case report explains non-surgical endodontic treatment of a mandibular second premolar with three separate roots and three separate mesiobuccal, midbuccal, and lingual canal orifices. Close attention to anatomic variations, thorough radiographic examinations, thorough evaluation of the pulp chamber floor, and use of magnifying and optical devices have been recommended for the success of endodontic treatment of mandibular second premolars with complicated root canal system anatomy. PMID:25346840

  11. Mandibular Overdenture Retained by Magnetic Assembly: A Clinical tip.

    PubMed

    Anupam, Purwar; Anandakrishna, G N; Vibha, Shetty; Suma, Janya; Shally, Khanna

    2014-12-01

    The preservation of remaining root structure and alveolar bone covering them with denture has been used since many years. Tooth-retained overdentures transfer occlusal forces to the alveolar bone through the periodontal ligament of the retained tooth roots and thereby prevent bone resorption. Applications of magnets in overdenture technique has been widely used in dentistry in the field of prosthodontics, as they can be manufactured in small dimensions as retentive devices for complete denture, removable partial dentures, obturators and maxillofacial prosthesis. This article presents a simple and efficient method of fabrication of mandibular over denture retained by magnets in a patient whose mandibular residual ridge is severely resorbed with few remaining teeth and maxillary conventional removable partial denture. Mandibular over denture retained by magnets assembly consist of magnet and coping with keeper on remaining tooth structure to rehabilitate the patient since magnetic attachments can provide support, stability and retention. PMID:26199541

  12. [Anatomical and radiographical studies of the bifid mandibular canal].

    PubMed

    Zhang, Zheng; Fan, Wanting; Zhang, Guozhi

    2016-03-01

    To review the recent progress about the anatomical and radiographical studies of bifid mandibular canal (BMC) in English literature recorded in PubMed from 2006 to 2015 to deepen our understanding of BMC. A BMC is an anatomical variation of the mandibular canal; its occurrence might be a result of the incomplete fusion of mandibular canal during prenatal development. The four types of BMC have been classified according to anatomical location and configuration. Characteristic radiographic features and identifying methods of BMC on panoramic radiography and cone beam computed tomography (CBCT) were described; the visibility of BMC on panoramic radiographs and CBCT images was compared. Clinical value of identifying the location as well as the configuration of BMC for surgical procedures that involve the mandible was discussed. PMID:26980659

  13. Mandibular third molar autotransplantation--literature review with clinical cases.

    PubMed

    Mendes, Rui Amaral; Rocha, Germano

    2004-12-01

    Autotransplantation of mandibular third molars in a precocious phase of development is indicated when a substitute for adjacent compromised or missing molars is needed, and when mesial movements of the posterior teeth, the resultant loss of space, and overeruption of opposing teeth and consequent changes in the occlusion must be avoided. Provided that the apices of the mandibular third molar are immature, the immediate replacement of a lost or compromised tooth usually ensures a good outcome. Transplantation of third molars helps to maintain alveolar bone and enables endosseous implantation without requiring bone regeneration. We present examples of transplantation of mandibular third molars and review the factors that affect the success or failure of this procedure, such as atraumatic extraction and adequate immobilization of the transplanted tooth and root development after transplantation. Sex or age seem to have no effect on the final outcome. PMID:15588551

  14. A retrospective study of six patients with mandibular metastatic carcinoma

    PubMed Central

    CAI, ZHEN; ZHU, CHAO; WANG, LIZHEN; ZHU, LING; ZHANG, ZHIYUAN; ZHU, HANGUANG; WANG, YAN'AN

    2016-01-01

    Mandibular metastatic carcinoma is a rare lesion that accounts for <1% of all oral malignancies. To provide greater experience in this field, the present study was conducted in which 6 cases of mandibular metastatic carcinoma were retrospectively reviewed. The origin of the lesions was the prostate in 2 cases, the lungs in 2 cases, the breast in 1 case and the thyroid gland in 1 case. The clinical and computed tomography features, surgical management and follow-up outcomes were investigated. The study indicated that surgeons should include the suspicion of metastasis in the differential diagnosis for mandibular tumor, particularly in patients who have a history of malignancy. A poor prognosis was associated with the examined patients. To extend the survival time as long as possible, a treatment strategy using multiple therapies, including segmental mandibulectomy, radiotherapy and chemotherapy, is recommended. PMID:27284368

  15. Experience with Mandibular Reconstruction Using Transport-Disc-Distraction Osteogenesis

    PubMed Central

    Pingarrón-Martín, Lorena; Otero, T. González; Gallo, L.J. Arias

    2014-01-01

    The goal of transport-disc-distraction osteogenesis (TDDO) is to restore bone continuity by using in-situ bone. It may be useful following trauma, gunshot injuries, or tumor ablation, especially when there may be contraindications at the donor site or for prolonged surgery. To the best of the authors' knowledge, this is the first time TDDO has been used for mandibular reconstruction reporting additional procedures, which include osseointegrated dental implants rehabilitation and orthognathic surgery. A retrospective study is performed analyzing all mandibular reconstruction cases that may be suitable for distraction from January 2006 to December 2011. A thorough description of the documented cases includes details about sex, gender, complications, duration of hospitalization, etiology, size, and location of the defect. Eight cases of mandibular reconstruction were included. Six cases correspond to mandibular ameloblastoma. The remaining two cases were mandibular gunshot comminuted fractures. Range of the defects was from 45 to 60 mm. Length of the transport disc was 15 to 20 mm. Protocolized technique consisted of 5 days of latency period, 19 to 45 days of activation term (average 30 days), and 8 to 12 weeks for consolidation. Mean distraction length achieved was 40.45 mm. We can conclude that TDDO is an alternative to conventional and more invasive procedures, when we face severe segmental mandibular defects reconstruction. It shows the potential to restore a better anatomical bone regeneration, also providing soft tissues and reducing donor-site morbidity. Patients' education and awareness about the proper use of the transport-disc-distraction device is important to optimize functional outcomes. PMID:26000082

  16. The anterior temporal lobes support residual comprehension in Wernicke's aphasia.

    PubMed

    Robson, Holly; Zahn, Roland; Keidel, James L; Binney, Richard J; Sage, Karen; Lambon Ralph, Matthew A

    2014-03-01

    Wernicke's aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory-verbal comprehension is significantly impaired in Wernicke's aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke's aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke's aphasia and 12 control participants performed semantic animate-inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke's aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke's aphasia group displayed an 'over-activation' in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke's aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions. PMID:24519979

  17. Nonodontogenic mandibular lesions: differentiation based on CT attenuation

    PubMed Central

    Özgür, Anıl; Kara, Engin; Arpacı, Rabia; Arpacı, Taner; Esen, Kaan; Kara, Taylan; Duce, Meltem Nass; Apaydın, Feramuz Demir

    2014-01-01

    Mandibular lesions are classified as odontogenic and nonodontogenic based on the cell of origin. Odontogenic lesions are frequently encountered at head and neck imaging. However, several nonodontogenic pathologies may also involve mandible and present further diagnostic dilemma. Awareness of the imaging features of nonodontogenic lesions is crucial in order to guide clinicians in proper patient management. Computed tomography (CT) may provide key information to narrow diagnostic considerations. Nonodontogenic mandibular lesions may have lytic, sclerotic, ground-glass, or mixed lytic and sclerotic appearances on CT. In this article, our aim is to present various nonodontogenic lesions of the mandible by categorizing them according to their attenuations on CT. PMID:25297390

  18. Immediate implant placement in posterior areas: the mandibular arch.

    PubMed

    Fugazzotto, Paul A; Hains, Frederick O

    2012-01-01

    When contemplating removal of a premolar or molar and its immediate replacement with an implant-supported prosthesis, the feasibility of other potentially less "aggressive" treatment approaches must first be considered. Treatment decisions must be made in the context of an appropriate definition of therapeutic success. Replacement of hopeless mandibular molars with implant restorations has undergone significant evolution since the introduction of osseointegrated implants some 30 years ago. Over the past decade, various treatment approaches have been advocated. This article discusses these approaches and other considerations needed for implant placement at the time of mandibular molar extraction. PMID:22908599

  19. Mandibular dysostosis without microphthalmia caused by OTX2 deletion.

    PubMed

    Latypova, Xénia; Bordereau, Sylvain; Bleriot, Alice; Pichon, Olivier; Poulain, Damien; Briand, Annaïg; Le Caignec, Cédric; Isidor, Bertrand

    2016-09-01

    Mutations in OTX2 are mostly identified in patients with anophthalmia/microphthalmia with variable severity. The OTX2 homeobox gene plays a crucial role in craniofacial morphogenesis during early embryo development. We report for the first time a patient with a mandibular dysostosis caused by a 120 kb deletion including the entire coding sequence of OTX2, identified by array CGH. No ocular malformations were identified after extended ophthalmologic examination. Our data refine the clinical spectrum associated with OTX2 mutations and suggests that OTX2 haploinsufficiency should be considered as a possible cause for isolated mandibular dysostosis. © 2016 Wiley Periodicals, Inc. PMID:27378064

  20. Asymmetric mandibular prognathism: a 30-year retrospective case report.

    PubMed

    Decker, Jay D

    2006-03-01

    A healthy white man with marked facial and dental asymmetry, a consequence of unilateral mandibular condylar hyperplasia, was treated with conventional fixed edgewise appliance therapy combined with orthognathic surgery (bilateral sagittal split osteotomy of the mandibular ramus). Pretreatment, posttreatment, and long-term follow up records for the patient at ages 26 years 11 months, 28 years 6 months, and 58 years 7 months are presented. Thirty years after treatment, the results remain stable. The pretreatment and posttreatment records were presented to the American Board of Orthodontics in 1976 in partial fulfillment of the requirements for board certification. PMID:16527643

  1. The retromandibular transparotid approach for reduction and rigid internal fixation using two locking miniplates in mandibular condylar neck fractures.

    PubMed

    Kanno, T; Sukegawa, S; Tatsumi, H; Nariai, Y; Ishibashi, H; Furuki, Y; Sekine, J

    2014-02-01

    We evaluated the safety, efficacy, and morbidity associated with the treatment of displaced mandibular condylar neck fractures using a retromandibular transparotid approach to reduce and rigidly fix using two 2.0-mm locking miniplates. Our surgical inclusion criteria were: patient selection of open reduction and fixation, displaced unilateral condylar fractures with derangement of occlusion, and bilateral condylar fractures with an anterior open bite. The study group consisted of 19 patients who underwent surgery for 19 mandibular condylar neck fractures; patients were analyzed prospectively, with more than 6 months of follow-up, and were evaluated in terms of functional results, scar formation, postoperative complications, and stability of fixation. The results showed that functional occlusion identical to the preoperative condition and correct anatomical reduction of the condylar segments in centric occlusion, followed by immediate functional recovery, was achieved in all patients. No patient suffered from any major or permanent complication postoperatively, although there were two cases (11%) of temporary facial nerve palsy, which resolved completely within 3 months. Surgical scars were barely visible. The retromandibular transparotid approach with open reduction and rigid internal fixation for displaced condylar neck fractures of the mandible is a feasible and safe, minimally invasive surgical technique that provides reliable clinical results. PMID:24070772

  2. 11,000 years of craniofacial and mandibular variation in Lower Nubia.

    PubMed

    Galland, Manon; Van Gerven, Denis P; Von Cramon-Taubadel, Noreen; Pinhasi, Ron

    2016-01-01

    The transition to agriculture was a key event in human history. The extent to which this transition is associated with biological changes in different world regions remains debated. Cultural and osteological records in Lower Nubia throughout the Holocene have been interpreted as a result of in situ differentiation or alternatively as migratory events and possible admixture with surrounding populations. Here we investigated the patterns of craniofacial and mandibular variation from Mesolithic hunting-gathering to late farming, a period spanning 11,000 years. We analyzed 102 adult specimens spanning five cultural horizons: Mesolithic, A-group, C-group, Pharaonic and Meroitic, by means of 3D geometric morphometric methods, in order to assess shape variation and diachronic patterns at the transition to farming and in subsequent periods. Our results highlight a strong morphometric distinction between Mesolithic hunter-gatherers and farmers as well as differences between transitional and intensive farmers in mandibular variation which is consistent with differential impact of selective pressures on different regions of the skull. This study corroborates a major biological change during the transition from hunting to farming, supporting the masticatory-functional hypothesis for the mandible and suggesting population continuity among farming populations throughout the Holocene based on the overall shape of the cranium. PMID:27503560

  3. Observation of lateral mandibular protuberance in Taiwan macaque (Macaca cyclopis) using computed tomography imaging.

    PubMed

    Kondo, Shintaro; Naitoh, Munetaka; Futagami, Chiharu; Hanamura, Hajime; Goto, Kenichi; Ariji, Eiichiro; Takai, Masanaru

    2009-01-01

    Morphological characteristics of the protuberance on the external surface of the mandible in Taiwan macaque (Macaca cyclopis) was investigated using cone-beam computed tomography. We observed 49 skulls of M. cyclopis. Of 7 skulls with deciduous and mixed dentitions in which M2s did not erupt, the protuberance was not found. Of the 13 skulls with mixed and permanent dentitions in which M2s had erupted, a palpable protuberance was found in one specimen. Of the 29 samples in which M3s had erupted completely, a perceptible protuberance was found in 2 samples, and palpable protuberance was found in 8 samples. Thus, the protuberance was found in 10 samples of the 29 samples with complete dentitions (34.5%), and the emergence of the protuberance may have been related to mandibular growth. In the case of the well-developed protuberance, it extended from the P4 to M3 region but did not extend to the mental foramina. By using cone-beam computed tomography, it was determined that the protuberance was composed of cortical bone and was the thickest in M2 region. Since the protuberance consisted of homogeneous cortical bone, it was considered to be the result of normal bone growth similar to the mandibular torus in humans. PMID:19828971

  4. 11,000 years of craniofacial and mandibular variation in Lower Nubia

    PubMed Central

    Galland, Manon; Van Gerven, Denis P.; Von Cramon-Taubadel, Noreen; Pinhasi, Ron

    2016-01-01

    The transition to agriculture was a key event in human history. The extent to which this transition is associated with biological changes in different world regions remains debated. Cultural and osteological records in Lower Nubia throughout the Holocene have been interpreted as a result of in situ differentiation or alternatively as migratory events and possible admixture with surrounding populations. Here we investigated the patterns of craniofacial and mandibular variation from Mesolithic hunting-gathering to late farming, a period spanning 11,000 years. We analyzed 102 adult specimens spanning five cultural horizons: Mesolithic, A-group, C-group, Pharaonic and Meroitic, by means of 3D geometric morphometric methods, in order to assess shape variation and diachronic patterns at the transition to farming and in subsequent periods. Our results highlight a strong morphometric distinction between Mesolithic hunter-gatherers and farmers as well as differences between transitional and intensive farmers in mandibular variation which is consistent with differential impact of selective pressures on different regions of the skull. This study corroborates a major biological change during the transition from hunting to farming, supporting the masticatory-functional hypothesis for the mandible and suggesting population continuity among farming populations throughout the Holocene based on the overall shape of the cranium. PMID:27503560

  5. Displacement of lower third molar into the lateral pharyngeal space in a case of mandibular angle fracture: An unusual complication

    PubMed Central

    Kasatwar, Akash; Bhola, Nitin; Borle, Rajiv; Rajanikanth, K.

    2016-01-01

    Fracture of the angle of the mandible accounts for nearly one-third of all fractures involved. The presence of lower third molar increases the risk of fracture in angle region. The third molar acts as an area of weakness leading to fracture lines passing medially, distally, and occasionally through it. Angle fracture leads to the mobility of the third molar and sometimes its displacement. Third molars maintain its position in favorable fracture and can be displaced in unfavorable fractures. Displacement of lower third molar in lateral pharyngeal space due to mandibular fracture is not seen commonly. To our knowledge, this is the first reported incidence of displacement of the third molar into lateral pharyngeal space in a case of mandibular fracture. PMID:27307673

  6. Using conservative condylectomy for management of a large osteochondroma of the mandibular condyle with 6-year follow-up.

    PubMed

    Santos, George Soares; Gomes, Julio Bisinotto; de Sousa Maia, Sergio; Bermejo, Patricia Rota; Shinohara, Elio Hitoshi; Sonoda, Celso Koogi; de Melo, Willian Morais

    2014-01-01

    Osteochondroma is a hamartomatous proliferation of cartilaginous tissue, which is the most common benign tumor of the long bones, but is relatively rare in the maxillofacial region. Most cases of mandibular condylar osteochondroma manifest with facial asymmetry or malocclusion with limited temporomandibular joint movements. Several approaches for management of this lesion have been proposed, as conservative condylectomy technique. This procedure has been suggested a valid approach to minimize facial asymmetry, contributing to the recovery of occlusion associated with no local tumor recurrence, and without condylar reconstruction procedure. Therefore, this article aims to describe a clinical report of a true osteochondroma of the mandibular condyle in a 35-year-old patient who was successfully treated using conservative condylectomy procedure. PMID:24469370

  7. BIOMECHANICAL ANALYSIS OF THE STRESSES GENERATED BY DIFFERENT DISOCCLUSION PATTERNS IN AN IMPLANT-SUPPORTED MANDIBULAR COMPLETE DENTURE

    PubMed Central

    Greco, Gustavo Diniz; Jansen, Wellington Corrêa; Landre, Janis; Seraidarian, Paulo Isaías

    2009-01-01

    Objectives: This study evaluated by three-dimensional finite element analysis the tensions generated by different disocclusion patterns (canine guide and bilateral balanced occlusion) in an implant-supported mandibular complete denture. Material and Methods: A three-dimensional model of implant-supported mandibular complete denture was fabricated according to the Brånemark protocol. A 5-element 3.75 x 13-mm screw-shape dental implant system was modeled for this study. The implants were located in the intermental foramen region with 3-mm-high prosthetic components joined by a nickel-chromium framework with 12-mm bilateral cantilever covered by acrylic resin and 12 acrylic denture teeth. SolidWorks® software was used before and after processing the simulations. The mechanical properties of the components were inserted in the model and a 15 N load was established in fixed points, in each one of the simulations. Data were collected in the entire nickel-chromium framework. The results were displayed three-dimensionally as color graphic scales. Results: The canine guide generated greater tensions in the region of the first implant, while the bilateral balanced occlusion generated great tensions in the entire metallic framework. The maximum tension found in the simulation of the bilateral balanced occlusion was 3.22 fold higher than the one found in the simulation of the disocclusion in canine guide. Conclusion: The pattern of disocclusion in canine guide is the ideal for implant-supported mandibular complete denture. PMID:19936535

  8. Strains around distally inclined implants retaining mandibular overdentures with Locator attachments: an in vitro study

    PubMed Central

    Setta, Fathi Abo; Khirallah, Ahmed Samir

    2016-01-01

    PURPOSE The aim of the present study was to evaluate, by means of strain gauge analysis, the effect of different implant angulations on strains around two implants retaining mandibular overdenture with Locator attachments. MATERIALS AND METHODS Four duplicate mandibular acrylic models were constructed. Two implants were inserted in the canine regions using the following degrees of distal inclinations: group I (control); 0°, group II; 10°, group III; 20°, and group IV; 30°. Locator pink attachments were used to connect the overdenture to the implants and Locator red (designed for severely angled implants) was used for group IV (group IVred). For each group, two linear strain gauges were attached at the mesial and distal surfaces of the acrylic resin around each implant. Peri-implant strain was measured on loading and non-loading sides during bilateral and unilateral loading. RESULTS For all groups, the mesial surfaces of the implants at loading and non-loading sides experienced compressive (negative) strains, while the distal implant surfaces showed tensile (positive) strains. Group IV showed the highest strain, followed by group III, group II. Both group I and group IVred showed the lowest strain. The strain gauges at the mesial surface of the loading side recorded the highest strain, and the distal surface at non-loading side showed the lowest strain. Unilateral loading recorded significantly higher strain than bilateral loading. CONCLUSION Peri-implant strains around two implants used to retain mandibular overdentures with Locator attachments increase as distal implant inclination increases, except when red nylon inserts were used. PMID:27141255

  9. Accessory roots and root canals in human anterior teeth: a review and clinical considerations.

    PubMed

    Ahmed, H M A; Hashem, A A

    2016-08-01

    Anterior teeth may have aberrant anatomical variations in the number of roots and root canals. A review of the literature was conducted using appropriate key words in major endodontic journals to identify the available reported cases as well as experimental and clinical investigations on accessory roots and root canals in anterior teeth. After retrieving the full text of related articles, cross-citations were identified, and the pooled data were then discussed. Results revealed a higher prevalence in accessory root/root canal variations in mandibular anterior teeth than in maxillary counterparts. However, maxillary incisor teeth revealed the highest tendency for accessory root/root canal aberrations caused by anomalies such as dens invaginatus and palato-gingival groove. Primary anterior teeth may also exhibit external and internal anatomical variations in the root, especially maxillary canines. Therefore, dental practitioners should thoroughly assess all teeth scheduled for root canal treatment to prevent the undesirable consequences caused by inadequate debridement of accessory configurations of the root canal system. PMID:26174943

  10. Trigeminocardiac Reflex by Mandibular Extension on Rat Pial Microcirculation: Role of Nitric Oxide

    PubMed Central

    Lapi, Dominga; Federighi, Giuseppe; Fantozzi, M. Paola; del Seppia, Cristina; Ghione, Sergio; Colantuoni, Antonio; Scuri, Rossana

    2014-01-01

    In the present study we have extended our previous findings about the effects of 10 minutes of passive mandibular extension in anesthetized Wistar rats. By prolonging the observation time to 3 hours, we showed that 10 minutes mandibular extension caused a significant reduction of the mean arterial blood pressure and heart rate respect to baseline values, which persisted up to 160 minutes after mandibular extension. These effects were accompanied by a characteristic biphasic response of pial arterioles: during mandibular extension, pial arterioles constricted and after mandibular extension dilated for the whole observation period. Interestingly, the administration of the opioid receptor antagonist naloxone abolished the vasoconstriction observed during mandibular extension, while the administration of Nω-Nitro-L-arginine methyl ester, a nitric oxide synthase inhibitor, abolished the vasodilation observed after mandibular extension. Either drug did not affect the reduction of mean arterial blood pressure and heart rate induced by mandibular extension. By qRT-PCR, we also showed that neuronal nitric oxide synthase gene expression was significantly increased compared with baseline conditions during and after mandibular extension and endothelial nitric oxide synthase gene expression markedly increased at 2 hours after mandibular extension. Finally, western blotting detected a significant increase in neuronal and endothelial nitric oxide synthase protein expression. In conclusion mandibular extension caused complex effects on pial microcirculation involving opioid receptor activation and nitric oxide release by both neurons and endothelial vascular cells at different times. PMID:25551566

  11. Anterior Orbit and Adnexal Amyloidosis

    PubMed Central

    Al Hussain, Hailah; Edward, Deepak P.

    2013-01-01

    Purpose: To describe six cases of anterior orbital and adnexal amyloidosis and to report on proteomic analysis to characterize the nature of amyloid in archived biopsies in two cases. Materials and Methods: The clinical features, radiological findings, pathology, and outcome of six patients with anterior orbit and adnexal amyloidosis were retrieved from the medical records. The biochemical nature of the amyloid was determined using liquid chromatography/mass spectroscopy archived paraffin-embedded tissue in two cases. Results: Of the six cases, three had unilateral localized anterior orbit and lacrimal gland involvement. Four of the six patients were female with an average duration of 12.8 years from the time of onset to presentation eyelid infiltration by amyloid caused ptosis in five cases. CT scan in patients with lacrimal gland involvement (n = 3) demonstrated calcified deformable anterior orbital masses and on pathological exmaintionamyloid and calcific deposits replaced the lacrimal gland acini. Ptosis repair was performed in three patients with good outcomes. One patient required repeated debulking of the mass and one patient had recurrenct disease. Proteomic analysis revealed polyclonal IgG-associated amyloid deposition in one patient and AL kappa amyloid in the second patient. Conclusion: Amyloidosis of the anterior orbit and lacrimal gland can present with a wide spectrum of findings with good outcomes after surgical excision. The nature of amyloid material can be precisely determined in archival pathology blocks using diagnostic proteomic analysis. PMID:24014979

  12. Management of Six Root Canals in Mandibular First Molar

    PubMed Central

    Gomes, Fabio de Almeida; Sousa, Bruno Carvalho

    2015-01-01

    Success in root canal treatment is achieved after thorough cleaning, shaping, and obturation of the root canal system. This clinical case describes conventional root canal treatment of an unusual mandibular first molar with six root canals. The prognosis for endodontic treatment in teeth with abnormal morphology is unfavorable if the clinician fails to recognize extra root canals. PMID:25685156

  13. The application of the Risdon approach for mandibular condyle fractures

    PubMed Central

    2013-01-01

    Background Many novel approaches to mandibular condyle fracture have been reported, but there is a relative lack of reports on the Risdon approach. In this study, the feasibility of the Risdon approach for condylar neck and subcondylar fractures of the mandible is demonstrated. Methods A review of patients with mandibular condylar neck and subcondylar fractures was performed from March 2008 to June 2012. A total of 25 patients, 19 males and 6 females, had 14 condylar neck fractures and 11 subcondylar fractures. Results All of the cases were reduced using the Risdon approach. For subcondylar fractures, reduction and fixation with plates was done under direct vision. For condylar neck fractures, reduction and fixation was done with the aid of a trochar in adults and a percutaneous threaded Kirschner wire in children. There were no malunions or nonunions revealed in follow-up care. Mild transient neuropraxia of the marginal mandibular nerve was seen in 4 patients, which was resolved within 1–2 months. Conclusions The Risdon approach is a technique for reducing the condylar neck and subcondylar fractures that is easy to perform and easy to learn. Its value in the reduction of mandibular condyle fractures should be emphasized. PMID:23829537

  14. Mandibular metastasis in a patient with follicular carcinoma of thyroid

    PubMed Central

    Bhadage, Chetan J.; Vaishampayan, Sagar; Umarji, Hemant

    2012-01-01

    Mandibular metastasis due to thyroid carcinoma is not very frequent and the cases described in the literature are few. Due to its bloodstream dissemination, most of them are a consequence of the follicular variant of thyroid carcinomas. We are presenting a case in which the metastatic lesion of mandible was detected before diagnosis of primary malignancy. PMID:22919227

  15. Mandibular tori as an incidental finding in MRI

    PubMed Central

    Schubert, Marika; Sieron, Dominik; Laniado, Michael

    2014-01-01

    Tori (singular: torus) are among the most common benign jaw lesions. The magnetic resonance imaging (MRI) characteristics have not been reported yet. We present a 72-year-old patient with mandibular tori, which were detected as an incidental finding on MRI and provide an overview of the imaging features of tori. PMID:24778803

  16. An epidemiological study on pattern and incidence of mandibular fractures.

    PubMed

    Natu, Subodh S; Pradhan, Harsha; Gupta, Hemant; Alam, Sarwar; Gupta, Sumit; Pradhan, R; Mohammad, Shadab; Kohli, Munish; Sinha, Vijai P; Shankar, Ravi; Agarwal, Anshita

    2012-01-01

    Mandible is the second most common facial fracture. There has been a significant increase in the number of cases in recent years with the advent of fast moving automobiles. Mandibular fractures constitute a substantial proportion of maxillofacial trauma cases in Lucknow. This study was undertaken to study mandibular fractures clinicoradiologically with an aim to calculate incidence and study pattern and the commonest site of fractures in population in and around Lucknow. Patient presenting with history of trauma at various centers of maxillofacial surgery in and around Lucknow were included in this study. Detailed case history was recorded followed by thorough clinical examination, and radiological interpretation was done for establishing the diagnosis and the data obtained was analyzed statistically. Out of 66 patients with mandibular fractures, highest percentage was found in 21-30 years of age with male predominance. Road traffic accidents were the most common cause of fracture with parasymphysis being commonest site. Commonest combination was parasymphysis with subcondyle. There was no gender bias in etiology with number of fracture sites. The incidence and causes of mandibular fracture reflect trauma patterns within the community and can provide a guide to the design of programs geared toward prevention and treatment. PMID:23227327

  17. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) Date PMA or notice of completion of a PDP is required. (1) Except as described in paragraph (c)(2) of this section, a PMA or a notice of completion of a PDP is required to be filed with the Food and Drug... other mandibular condyle prosthesis shall have an approved PMA or a declared completed PDP in...

  18. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) Date PMA or notice of completion of a PDP is required. (1) Except as described in paragraph (c)(2) of this section, a PMA or a notice of completion of a PDP is required to be filed with the Food and Drug... other mandibular condyle prosthesis shall have an approved PMA or a declared completed PDP in...

  19. The effectiveness of articaine in mandibular facial infiltrations

    PubMed Central

    Flanagan, Dennis F

    2016-01-01

    Four percent articaine local anesthetic has been successfully used to attain local anesthesia for dental procedures. Mandibular block anesthesia may consume longer time to attain and have a higher failure of local anesthesia compared to infiltration. Mandibular facial infiltration has been reported to successfully attain effective local anesthesia for dental procedures. This study involved only several tooth sites and found that 1.8 cc of 4% articaine facial infiltration in the mandible may be effective when the facial mandibular cortex is <2.0–3.0 mm. A waiting time of 5–10 minutes may be required for effective anesthesia. An additional 1.8 cc of dose may be required to attain anesthesia if an initial 1.8 cc of dose fails. The need for additional anesthetic may be predicted by a measurement of the facial cortex using cone beam computerized tomography. A study of mandibular sites is needed to delineate the anatomical dimensions, density of cortical bone, and apical neural location for ensuring successful local anesthetic infiltration. PMID:26730209

  20. Ultrastructure of the platypus and echidna mandibular glands.

    PubMed

    Krause, W J

    2011-10-01

    The secretory units of the platypus and echidna mandibular glands consist of a single serous cell type. Secretory granules within the cells of the platypus mandibular gland stained intensely with the periodic acid-Schiff staining procedure but failed to stain with Alcian Blue, suggesting the granules contained neutral glycoproteins. Secretory granules within the mandibular glands of the echidna failed to stain with the methods used indicating little if any glycoprotein was associated with the secretory granules. Ultrastructurally, secretory granules of the platypus mandibular gland were electron dense with a central core of less electron-dense material and were membrane bound. In contrast, those of the echidna presented a lamellated appearance and also were limited by a membrane. These secretory granules appeared to form as a result of concentric layering of lamellae within cisternae of the Golgi membranes. The intralobular ductal system of the platypus was more extensively developed than that of the echidna. The striated ducts of both species were characterized by elaborate infoldings of the basolateral plasmalemma and an abundance of associated mitochondria. PMID:21671995

  1. Multidirectional lip-closing force in adults with mandibular deviation.

    PubMed

    Kawabata, A; Kobayashi, T; Takagi, A; Kuroyanagi, F; Washino, K; Sabashi, K; Kitai, N

    2013-09-01

    The purpose of this study was to investigate the relationship between multidi-rectional lip-closing force and facial soft tissue morphology in adults with mandibular deviation. Fifteen Japanese adults with mandibular deviation participated in this study. The deviation value was defined as the horizontal distance between soft tissue menton and the facial midline. The side of the soft tissue menton relative to the facial midline was defined as the deviated side and the opposite side as the non-deviated side. The signals of directional lip-closing force (DLCF) were investigated in 8 directions. Total lip-closing force (TLCF) was calculated by adding DLCFs in 8 directions. Correlations and differences between the variables were analysed statistically. Significant positive correlations between TLCF and DLCFs were determined in six directions with the exception of the horizontal direction. Significant positive correlations for seven pairs of opposing DLCFs were found. The lower non-deviated DLCF was smaller than the three pairs of opposing lip-closing forces. Negative significant correlation was found between the deviation value and the upper deviated DLCF (P < 0·05). In individuals with mandibular deviation, lip-closing force in the lower non-deviated direction was found to be smaller than the opposing lip-closing forces. When mandibular deviation was greater, the upper deviated lip-closing force was smaller. PMID:23855528

  2. Correlation of calcification of permanent mandibular canine, mandibular premolars, and permanent mandibular first and second molars with skeletal maturity in Indian population

    PubMed Central

    Motghare, Pawan C.; Bedia, Aarti S.; Degwekar, Shirish S.; Indurkar, Atul D.; Bedia, Sumit

    2016-01-01

    Context: Morphological variation in children can be understood by the knowledge of growth and development. The state of dental development can be used in forensic odontology to ascertain the age of an unidentified child. Aims: This study aims to investigate the relationship of the stages of calcification of the permanent mandibular canine, mandibular premolars, and permanent mandibular first and second molars with skeletal maturity using panoramic and hand–wrist radiographs. Settings and Design: This descriptive work was designed as a cross-sectional study. Materials and Methods: The study was conducted on 300 healthy subjects (150 males and 150 females) ranging 7–20 years of age. Demirjian's method and Björk, Grave, and Brown's method were used to correlate teeth calcification and skeletal maturity, respectively. Statistical Analysis Used: Descriptive statistics and Spearman's rank correlation coefficient were used. Results: 1. Correlation coefficients between the skeletal maturity stages and the developmental stages of the five teeth ranged 0.461–0.877 for females and 0.480–0.790 for males. 2. The second molar showed the highest and the first molar showed the lowest relationship for female and male subjects in the Indian population. Conclusions: The findings of this study indicate that tooth calcification stages might be clinically used as a maturity indicator of the pubertal growth period.

  3. Variation of mandibular sexual dimorphism across human facial patterns.

    PubMed

    Alarcón, J A; Bastir, M; Rosas, A

    2016-06-01

    This study analysed how sex-specific features differed in male and female adult mandibles throughout the spectrum of vertical facial patterns (i.e., meso-, dolicho- and brachyfacial) and sagittal variations (the so-called skeletal Classes I, II and III; normal maxillo-mandibular relationship, maxillary prognathism vs. mandibular retrognathism, and maxillary retrognathism vs. mandibular prognathism, respectively). Specifically, we test the hypothesis that sexual dimorphism in the mandible is independent of such facial vertical and sagittal patterns. A sample of 187 European adults (92 males, 95 females; age range, 20-30 years; mean age 25.6 years, sd=4.2 years) from Granada (southern Spain) were randomly selected and grouped according to the standard cephalometric criteria of the sagittal and vertical patterns. Geometric morphometrics were used to analyse the size (centroid size) and shape (principal components analysis, mean shape comparisons) of the mandible. The patterns of sexual dimorphism were evaluated with a generalised linear model with interaction term. We found that sagittal and vertical facial patterns are associated with different mandibular morphologies (size and shape). Also, sexual dimorphism was present in all comparisons. The hypothesis was rejected only for vertical facial patterns. That is, the nature of sexual dimorphism was similar among the skeletal classes but different (e.g., distribution of dimorphic variables, interaction term) in meso-, dolicho-, and brachyfacial mandibles. In conclusion, sex-specific mandibular traits behave in a different way across vertical facial patterns. These results imply that an assessment of the vertical facial pattern of the individual is required before a sexual diagnosis of the mandible is proposed. PMID:26852041

  4. Biomechanical evaluation of a new design titanium miniplate for the treatment of mandibular angle fractures.

    PubMed

    Suer, B T; Kocyigit, I D; Kaman, S; Tuz, H H; Tekin, U; Atil, F

    2014-07-01

    The optimal management of mandibular angle fractures remains controversial. The aim of this experimental study was to test the stability and resistance to mechanical force of a new titanium miniplate design. Thirty fresh sheep hemimandibles, sectioned at the angle region, were used to evaluate two plating techniques. One group received fixation via a new design single non-compression titanium miniplate and the second group via a six-hole straight non-compression titanium miniplate. A custom-made biomechanical test model was used for the samples. Each hemimandible was subjected to compressive and tensile forces using an Instron machine. The biomechanical forces (N) that caused 4-mm displacement or fixation loosening were compared. Comparison between the groups showed that fixation with the new design miniplate had more resistance to lateral compression forces than with a six-hole straight miniplate (P<0.009). Moreover, the new design miniplate fixation displayed more resistance to vertical compression and tensile forces (P>0.46 and P>0.61, respectively). The study demonstrated that mandibular fracture fixation with the new design non-compression titanium miniplate offered greater resistance to lateral displacement forces and may also provide increased resistance to vertical compressive and tensile forces than a conventional six-hole straight miniplate. PMID:24582290

  5. Assessment of Masticatory Function Using Bite Force Measurements in Patients Treated for Mandibular Fractures

    PubMed Central

    Sybil, Deborah; Gopalkrishnan, K.

    2013-01-01

    Bite force measurements are excellent criteria for assessment of masticatory efficiency. The purpose of this study was to assess the effect of mandibular fractures on the bite forces of patients treated for such fractures. Patients who were surgically treated for isolated mandibular fractures in the Department of Oral and Maxillofacial Surgery from January 2006 to December 2007 were included in the study. Patients were asked to bite on a bite force transducer on the first, fourth, sixth, and ninth postoperative weeks. The bite force values were compared with those of age, sex, and weight-matched controls. A total of 60 patients were included in the study. It was found that maximum bite forces in patients were significantly less than in controls for several weeks after surgery. After the ninth postoperative week, the maximum bite force measured < 65% the normal in patients with isolated angle fractures and > 80% the normal in patients with isolated parasymphysis fractures. The same values reduced to < 60% in patients with fractures of angle and parasymphysis and < 70% in patients with fractures of parasymphysis and condylar complex. An inverse relationship was found between the bite force values and the number of fractures of the mandible. We also found lower bite forces and longer period for normalization in patients who had fractures in those regions of the mandible which are more significantly associated with the masticatory apparatus for example angle or condyle of the mandible. PMID:24436769

  6. Long-term outcome assessment of closed treatment of mandibular fractures.

    PubMed

    Fayazi, Sara; Bayat, Mohammad; Bayat-Movahed, Saeed; Sadr-Eshkevari, Pooyan; Rashad, Ashkan

    2013-05-01

    Mandibular fractures are among the most common trauma injuries of the craniomaxillofacial region. This study evaluated the late results of mandibles fractures treated with arch bar. Forty-nine patients were examined clinically and by questionnaires for late results of arch bar treatment. Demographic data (age, sex, etc), trigeminal nerve sensation (Weber test), temporomandibular joint evaluation, masticatory muscle function, and occlusion were recorded. The data were analyzed by χ test using Sigma Stat 2.0 software. Fifty-one percent of the patients with angular fractures complained of sensory disturbances. Condylar and angular fractures demonstrated higher levels of pain. According to Pearson χ test, a statistically significant relation between angular fracture and tenderness of the internal pterygoid muscles (P = 0.047), angular fracture and cross-bite (P = 0.021), parasymphysial fracture and pain upon wind blowing (P = 0.026), and body fracture and mastication discomfort (P = 0.038) was found. In closed reduction therapy, fracture location of the mandible seems to be more likely correlated in producing particular long-term complications. Regular follow-ups for functional treatments and physiotherapy of chewing muscles and temporomandibular joint, along with removal of occlusal abnormalities, should be considered following arch bar reduction of mandibular fractures. PMID:23714869

  7. Computer-aided system for measuring the mandibular cortical width on panoramic radiographs in osteoporosis diagnosis

    NASA Astrophysics Data System (ADS)

    Arifin, Agus Zainal; Asano, Akira; Taguchi, Akira; Nakamoto, Takashi; Ohtsuka, Masahiko; Tanimoto, Keiji

    2005-04-01

    Osteoporotic fractures are associated with substantial morbidity, increased medical cost and high mortality risk. Several equipments of bone assessment have been developed to identify individuals, especially postmenopausal women, with high risk of osteoporotic fracture; however, a large segment of women with low skeletal bone mineral density (BMD), namely women with high risk of osteoporotic fractures, cannot be identified sufficiently because osteoporosis is asymptomatic. Recent studies have been demonstrating that mandibular inferior cortical width manually measured on panoramic radiographs may be useful for the identification of women with low BMD. Automatic measurement of cortical width may enable us to identify a large number of asymptomatic women with low BMD. The purpose of this study was to develop a computer-aided system for measuring the mandibular cortical width on panoramic radiographs. Initially, oral radiologists determined the region of interest based on the position of mental foramen. Some enhancing image techniques were applied so as to measure the cortical width at the best point. Panoramic radiographs of 100 women who had BMD assessments of the lumbar spine and femoral neck were used to confirm the efficacy of our new system. Cortical width measured with our system was compared with skeletal BMD. There were significant correlation between cortical width measured with our system and skeletal BMD. These correlations were similar with those between cortical width manually measured by the dentist and skeletal BMD. Our results suggest that our new system may be useful for mass screening of osteoporosis.

  8. Effects of Decreased Occlusal Loading during Growth on the Mandibular Bone Characteristics

    PubMed Central

    Hichijo, Natsuko; Tanaka, Eiji; Kawai, Nobuhiko; van Ruijven, Leo J.; Langenbach, Geerling E. J.

    2015-01-01

    Background Bone mass and mineralization are largely influenced by loading. The purpose of this study was to evaluate the reaction of the entire mandibular bone in response to decreased load during growth. It is hypothesized that decreased muscular loading will lead to bone changes as seen during disuse, i.e. loss of bone mass. Methods and Findings Ten 21-day-old Wistar strain male rats were divided into two groups (each n=5) and fed on either a hard- or soft-diet for 11 weeks. Micro-computed tomography was used for the investigation of bone mineralization, bone volume, bone volume fraction (BV/TV) and morphological analysis. Mandibular mineralization patterns were very consistent, showing a lower degree of mineralization in the ramus than in the corpus. In the soft-diet group, mineralization below the molars was significantly increased (p<0.05) compared to the hard diet group. Also, bone volume and BV/TV of the condyle and the masseter attachment were decreased in the soft-diet group (p<0.05). Morphological analysis showed inhibited growth of the ramus in the soft-diet group (p<0.05). Conclusion Decreased loading by a soft diet causes significant changes in the mandible. However, these changes are very region-specific, probably depending on the alterations in the local loading regime. The results suggest that muscle activity during growth is very important for bone quality and morphology. PMID:26062027

  9. The use of autogeneous mandibular bone block grafts for reconstruction of alveolar defects

    PubMed Central

    Dolanmaz, Doğan; Esen, Alparslan; Yıldırım, Gülsün; İnan, Özgür

    2015-01-01

    Objective: Purpose of this retrospective study was to evaluate outcomes autogenous bone block grafts obtained from mandible for different indications. The healing of the donor and recipient sites in the postoperative period, morbidity and the resorption of the graft were investigated. Patients and Methods: Twenty-nine patients grafted with mandibular bone block graft were participated in the present study. Grafting was applied in these patients for three indications; reconstruction of alveolar cleft, lateral crest augmentation before dental implantation and sinus floor augmentation. All operations were performed under local anesthesia and in some cases sedation was used as well. Results: Minimal exposure of the block graft occurred in three alveolar cleft patients. Secondary epithelization was achieved in all cleft patients with no symptoms of infection. In one patient infection was seen in donor site 1-week after the operation. The region was curetted and antibiotics administrated again. Two patients showed an infection of recipient site, after 4 weeks the grafts were removed. In all the patients, as the screw head became apparent until 1 thread, amount of the resorption were considered <1.5 mm. Conclusion: The usage of mandibular block grafts is a simple and effective treatment modality for reconstruction of different types of alveolar defects and it also reduces cost of treatment. PMID:26389038

  10. Biomechanical Evaluation of a Mandibular Spanning Plate Technique Compared to Standard Plating Techniques to Treat Mandibular Symphyseal Fractures

    PubMed Central

    Richardson, Matthew; Hayes, Jonathan; Jordan, J. Randall; Puckett, Aaron; Fort, Matthew

    2015-01-01

    Purpose. The purpose of this study is to compare the biomechanical behavior of the spanning reconstruction plate compared to standard plating techniques for mandibular symphyseal fractures. Materials and Methods. Twenty-five human mandible replicas were used. Five unaltered synthetic mandibles were used as controls. Four experimental groups of different reconstruction techniques with five in each group were tested. Each synthetic mandible was subjected to a splaying force applied to the mandibular angle by a mechanical testing unit until the construct failed. Peak load and stiffness were recorded. The peak load and stiffness were analyzed using ANOVA and the Tukey test at a confidence level of 95% (P < 0.05). Results. The two parallel plates' group showed statistically significant lower values for peak load and stiffness compared to all other groups. No statistically significant difference was found for peak load and stiffness between the control (C) group, lag screw (LS) group, and the spanning plate (SP1) group. Conclusions. The spanning reconstruction plate technique for fixation of mandibular symphyseal fractures showed similar mechanical behavior to the lag screw technique when subjected to splaying forces between the mandibular gonial angles and may be considered as an alternative technique when increased reconstructive strength is needed. PMID:26649332

  11. Implant-supported overdenture with prefabricated bar attachment system in mandibular edentulous patient

    PubMed Central

    Ha, Seung-Ryong; Song, Seung-Il; Hong, Seong-Tae; Kim, Gy-Young

    2012-01-01

    Implant-supported overdenture is a reliable treatment option for the patients with edentulous mandible when they have difficulty in using complete dentures. Several options have been used for implant-supported overdenture attachments. Among these, bar attachment system has greater retention and better maintainability than others. SFI-Bar® is prefabricated and can be adjustable at chairside. Therefore, laboratory procedures such as soldering and welding are unnecessary, which leads to fewer errors and lower costs. A 67-year-old female patient presented, complaining of mobility of lower anterior teeth with old denture. She had been wearing complete denture in the maxilla and removable partial denture in the mandible with severe bone loss. After extracting the teeth, two implants were placed in front of mental foramen, and SFI-Bar® was connected. A tube bar was seated to two adapters through large ball joints and fixation screws, connecting each implant. The length of the tube bar was adjusted according to inter-implant distance. Then, a female part was attached to the bar beneath the new denture. This clinical report describes two-implant-supported overdenture using the SFI-Bar® system in a mandibular edentulous patient. PMID:23236580

  12. Comparison of marginal bone loss and patient satisfaction in single and double-implant assisted mandibular overdenture by immediate loading

    PubMed Central

    Khoshhal, Masume; Ebrahimzadeh, Zahra

    2015-01-01

    PURPOSE The purpose of this study was to compare the coronal bone level and patient satisfaction in 1-implant and 2-implant assisted mandibular overdentures. MATERIALS AND METHODS Twenty patients who had maladaptive mandibular dentures were treated in this study. Patients were randomly divided into two groups. The first group received 1 implant (Simple line II, Implantium, South Korea) in their mandibular midline and the second group received 2 implants in their B and D regions (according to Misch's category). If the primary stability of each implant was at least 60 ISQ, ball attachment was placed and denture relined with soft liner. After 6 weeks, retentive cap incorporated with hard acrylic resin. In the 6 and 12 months recalls, periapical digital radiograph were made and visual analogue scale questionnaires were used to record patient satisfaction. The Friedman test was done for comparing the presurgical and postsurgical parameters in each group and the U-Mann Whitney test (P<.05) was done for comparison of post-treatment results between the two groups. RESULTS All implants achieved sufficient primary stability to be immediately loaded. Patient satisfaction was high, and there were no significant differences between two groups (P>.05). In addition, mean marginal bone loss was 0.6 ± 0.67 mm in the first group and 0.6 ± 0.51 mm in the second group, after 12 month. Mean marginal bone loss showed no significant differences between two groups. CONCLUSION This preliminary one-year result indicated that mandibular overdentures anchored to a single implant can be a safe and cost-effective method as a starting step for implant-overdenture treatment. PMID:26140170

  13. Mandibular Fracture Associated with a Dentigerous Cyst: Report of a Case and Literature Review

    PubMed Central

    Kouhsoltani, Maryam; Mesgarzadeh, Ali Hossein; Moradzadeh Khiavi, Monir

    2015-01-01

    Background and aims. Pathological fractures are rare in the maxillofacial region and account for less than 2% of all fractures in this site. They are defined as fractures that take place when bone has been weakened by an underlying pathologic process. Among all pathoses, cysts (although so common in the maxillofacial region) constitute a very small part. Here we report a case of a dentigerous cyst in a 38-year-old man.The cyst was associated with a mandibular second premolar tooth and resulted in a pathologic fracture. Excision of the lesion was performed and bony union was observed after 6 months. In the literature review, only one case of dentigerous cyst causing pathologic fracture was found. In addition to the report of the present case, pathologic fractures associated with all types of odontogenic cysts (totally just 12 cases) are reviewed in this article to provide a comprehensive and detailed collection. PMID:26697153

  14. FIXED OR REMOVABLE APPLIANCE FOR EARLY ORTHODONTIC TREATMENT OF FUNCTIONAL ANTERIOR CROSSBITE.

    PubMed

    Wiedel, Anna-Paulina

    2015-01-01

    Anterior crossbite with functional shift also called pseudo Class III is a malocclusion in which the incisal edges of one or more maxillary incisors occlude with the incisal edges of the mandibular incisors in centric relationship: the mandible and mandibular incisors are then guided anteriorly in central occlusion resulting in an anterior crossbite. Early correction, at the mixed dentition stage, is recommended, in order to avoid a compromising dentofacial condition which could result in the development of a true Class III malocclusion and temporomandibular symptoms. Various treatment options are available. The method of choice for orthodontic correction of this condition should not only be clinically effective, with long-term stability, but also cost-effective and have high patient acceptance, i.e. minimal perceived pain and discomfort. At the mixed dentition stage, the condition may be treated by fixed (FA) or removable appliance (RA). To date there is insufficient evidence to determine the preferred method. The overall aim of this thesis was therefore to compare and evaluate the use of FA and RA for correcting anterior crossbite with functional shift in the mixed dentition, with special reference to clinical effectiveness, stability, cost-effectiveness and patient perceptions. Evidence-based, randomized controlled trial (RCT) methodology was used, in order to generate a high level of evidence. The thesis is based on the following studies: The material comprised 64 patients, consecutively recruited from the Department of Orthodontics, Faculty of Odontology, Malmö University, Sweden and from one Public Dental Health Service Clinic in Malmö, Skane County Council, Sweden. The patients were no syndrome and no cleft patients. The following inclusion criteria were applied: early to late mixed dentition, anterior crossbite affecting one or more incisors with functional shift, moderate space deficiency in the maxilla, no inherent skeletal Class III discrepancy, ANB

  15. The results of anterior radical debridement and anterior instrumentation in Pott's disease and comparison with other surgical techniques.

    PubMed

    Benli, I T; Kiş, M; Akalin, S; Citak, M; Kanevetçi, S; Duman, E

    2000-04-01

    involved vertebra's region did not change in the uninstrumented group, while it did so in instrumented groups which had normal range values postoperatively. Overall, 27 patients had neurologic deficits preoperatively. Twenty of these (74.1%) had complete, and 5 (18.5%) had partial recovery with a combined 92.6% neurologic improvement. All the patients had a solid fusion mass at the last controls. Reactivation was not seen. Additionally, contrary to the common belief, anterior instrumentation which anterior autologous strut grafting following anterior radical debridement can be a good treatment option with low complication rate, high correction rate in acute local kyphosis, and high fusion rate. PMID:11193503

  16. Are all mouthguards the same and safe to use? Part 2. The influence of anterior occlusion against a direct impact on maxillary incisors.

    PubMed

    Takeda, Tomotaka; Ishigami, Keiichi; Nakajima, Kazunori; Naitoh, Kaoru; Kurokawa, Katsuhide; Handa, Jun; Shomura, Masahito; Regner, Connell Wayne

    2008-06-01

    The purpose of this study was to clarify the influence anterior occlusion, of mouthguards, has on protecting against a direct collision to the maxillary anterior teeth. In other words, the support mandibular dentition has when wearing a mouthguard. Two types of mouthguards were used for this study, one with an appropriate anterior occlusion or a mouthguard with positive anterior occlusion (MGAO+) and another which was a single-layer mouthguard lacking the same occlusion or a mouthguard with negative anterior occlusion (MGAO-) but with the same thickness on the buccal side. The instruments used for testing were a pendulum-type impact device with two interchangeable impact objects (a steel ball and a baseball), with a plastic jaw model having artificial teeth. Four testing conditions were observed: one with the jaw open without a mouthguard (Open NoMG), the second with the jaw clenching (loaded with 30 kg weight) without a mouthguard (Clench. NoMG), the third with the jaw clenching with MGAO- (Clench. MGAO-) and the last with the jaw clenching with MGAO+ (Clench. MGAO+). The results are as follows: both types of mouthguards showed the effects in reducing the distortion of the teeth. However, the effect was significantly obvious (steel ball = about 57% shock absorption ability, baseball = about 26%) in the mouthguard with anterior occlusion or support by lower dentition through mouthguard (Clench. MGAO+) than Clench. MGAO-. Thus, the influence of anterior occlusion of mouthguards or the support of mandibular dentition through wearing a mouthguard (MGAO+) is indispensable in reducing the impact force and tooth distortion. The results of this research should further contribute to the establishment of guidelines for safer mouthguards. PMID:18489486

  17. Anterior callosal section is useful for the removal of large tumors invading the dorsal part of the anterior third ventricle: operative technique and results.

    PubMed

    Shiramizu, Hideki; Hori, Tomokatsu; Matsuo, Seigo; Niimura, Kaku; Yoshimoto, Haruko; Ishida, Atsushi; Asakuno, Keizoh; Yuzawa, Miki; Moriyama, Takashi

    2013-07-01

    Large tumors invading the dorsal part of the anterior third ventricle are difficult to manage. The anterior transcallosal approach is usually used to manage these tumors. In our clinic, anterior callosal section was combined with the anterior interhemispheric (AIH) translamina terminalis approach for these tumors with excellent results. The AIH approach is useful for removing tumors in and around the anterior part of the third ventricle. However, AIH alone is insufficient for large tumors invading the dorsal part of the anterior third ventricle. In such situations, simple anterior callosal section enables the neurosurgeon to extirpate the caudal part of the tumors deeply hidden from operative field, sparing the foramen of Monro, fornix, etc. We treated four large tumors (malignant teratoma, recurrent chordoid glioma, recurrent papillary tumor of pineal region occupying the third ventricle, and paraventricular meningioma) without major complications. The malignant teratoma case exhibited no recurrence with >10 years follow-up. The chordoid glioma and papillary tumor of pineal region were totally removed. The meningioma was subtotally removed except only a small tumor around the bilateral anterior cerebral artery. This simple technique is a new way to manage difficult large lesions in and around the third ventricle. PMID:23568695

  18. Familial congenital anterior cervical hypertrichosis associated with peripheral sensory and motor neuropathy--a new syndrome?

    PubMed

    Trattner, A; Hodak, E; Sagie-Lerman, T; David, M; Nitzan, M; Garty, B Z

    1991-11-01

    We present three patients with familial congenital hypertrichosis localized to the anterior cervical region, associated with peripheral sensory and motor neuropathy. This association may represent a new neurocutaneous syndrome. The association of anterior midline cutaneous lesions with an underlying malformation is discussed. PMID:1666396

  19. Three-dimensional analysis of mandibular growth and tooth eruption

    PubMed Central

    Krarup, S; Darvann, TA; Larsen, P; Marsh, JL; Kreiborg, S

    2005-01-01

    Normal and abnormal jaw growth and tooth eruption are topics of great importance for several dental and medical disciplines. Thus far, clinical studies on these topics have used two-dimensional (2D) radiographic techniques. The purpose of the present study was to analyse normal mandibular growth and tooth eruption in three dimensions based on computer tomography (CT) scans, extending the principles of mandibular growth analysis proposed by Björk in 1969 from two to three dimensions. As longitudinal CT data from normal children are not available (for ethical reasons), CT data from children with Apert syndrome were employed, because it has been shown that the mandible in Apert syndrome is unaffected by the malformation, and these children often have several craniofacial CT scans performed during childhood for planning of cranial and midface surgery and for follow-up after surgery. A total of 49 datasets from ten children with Apert syndrome were available for study. The number of datasets from each individual ranged from three to seven. The first CT scan in each of the ten series was carried out before 1 year of age, and the ages for the 49 scans ranged from 1 week to 14.5 years. The mandible and the teeth were segmented and iso-surfaces generated. Landmarks were placed on the surface of the mandible, along the mandibular canals, the inner contour of the cortical plate at the lower border of the symphysis menti, and on the teeth. Superimposition of the mandibles in the longitudinal series was performed using the symphysis menti and the mandibular canals as suggested by Björk. The study supported the findings of stability of the symphysis menti and the mandibular canals as seen in profile view previously reported by Björk & Skieller in 1983. However, the mandibular canals were, actually, relocated laterally during growth. Furthermore, the position of tooth buds remained relatively stable inside the jaw until root formation started. Eruption paths of canines and

  20. Leucothoe kawesqari, a new amphipod from Bernardo O'Higgins National Park (Chile), with remarks on the genus in the Magellan Region (Crustacea, Peracarida).

    PubMed

    Esquete, Patricia; Aldea, Cristian

    2015-01-01

    Although the genus Leucothoe has been reported repeatedly in the Magellan Region, the citations in the Channels and Fjords Ecoregion were either unidentified or attributed to the previously considered cosmopolitan Leucothoe spinicarpa. In this work, Leucothoe kawesqari sp. n. is described, which can be distinguished from other species of the genus in the Southern Ocean by having eyes present, epimeral plates with no setae, anterior coxae not acutely produced or excavate, coxa 5 slightly bilobed, accessory flagellum present, mandibular palp article 3 shorter than ½ article 2, pereopods 5-7 basis expanded, ovoid, posterior margin weakly crenulate and telson apex irregularly truncated. The new species was found in hard substrates, both unvegetated and with macroalgae, mainly in kelp forest of Macrocystis pyrifera. PMID:26798246

  1. Leucothoe kawesqari, a new amphipod from Bernardo O’Higgins National Park (Chile), with remarks on the genus in the Magellan Region (Crustacea, Peracarida)

    PubMed Central

    Esquete, Patricia; Aldea, Cristian

    2015-01-01

    Abstract Although the genus Leucothoe has been reported repeatedly in the Magellan Region, the citations in the Channels and Fjords Ecoregion were either unidentified or attributed to the previously considered cosmopolitan Leucothoe spinicarpa. In this work, Leucothoe kawesqari sp. n. is described, which can be distinguished from other species of the genus in the Southern Ocean by having eyes present, epimeral plates with no setae, anterior coxae not acutely produced or excavate, coxa 5 slightly bilobed, accessory flagellum present, mandibular palp article 3 shorter than ½ article 2, pereopods 5–7 basis expanded, ovoid, posterior margin weakly crenulate and telson apex irregularly truncated. The new species was found in hard substrates, both unvegetated and with macroalgae, mainly in kelp forest of Macrocystis pyrifera. PMID:26798246

  2. [Large distal anterior cerebral artery aneurysm associated with azygos anterior cerebral artery: case report].

    PubMed

    Suzuki, Y; Kawamata, T; Matsumoto, H; Kunii, N; Matsumoto, K

    1998-10-01

    A 51-year-old woman presented with a distal anterior cerebral artery aneurysm (DACAA) manifesting as severe headache and monoparesis of the left lower limb. Computed tomography revealed subarachnoid hemorrhage in the interhemispheric fissure, bilateral sylvian fissures, and basal cistern, and a hematoma in the supracallosal region. Angiography showed a large aneurysm (23 x 18 mm) located on the distal end of the azygos anterior cerebral artery (azygos ACA) at the supracallosal portion. T2-weighted magnetic resonance imaging demonstrated the hematoma as a mixed intensity mass, compressing the corpus callosum downward, and the aneurysm as a flow void anterior to the hematoma. Unilateral frontoparietal parasagittal craniotomy was performed with a horse-shoe shaped incision. The aneurysm was clipped via the interhemispheric approach, and the hematoma was aspirated. Postoperative angiography showed disappearance of the aneurysm and intact azygos ACA. The patient was discharged with mild monoparesis, paresthesia of the left lower limb and diagnostic dyspraxia. DACAA almost always arises at or near the genu of the corpus callosum and is often associated with vascular anomaly. In the literature, 22 of 26 cases of large and giant DACAA were located at or near the genu, but only 3 cases, including ours, in the supracallosal area. 11 cases were associated with azygos ACA. Therefore, hemodynamic stress caused by vascular anomaly may be involved in the formation of large or giant DACAA in contrast with cases of normal DACAA. PMID:9789300

  3. Investigating the functions of subregions within anterior hippocampus

    PubMed Central

    Zeidman, Peter; Lutti, Antoine; Maguire, Eleanor A.

    2015-01-01

    Previous functional MRI (fMRI) studies have associated anterior hippocampus with imagining and recalling scenes, imagining the future, recalling autobiographical memories and visual scene perception. We have observed that this typically involves the medial rather than the lateral portion of the anterior hippocampus. Here, we investigated which specific structures of the hippocampus underpin this observation. We had participants imagine novel scenes during fMRI scanning, as well as recall previously learned scenes from two different time periods (one week and 30 min prior to scanning), with analogous single object conditions as baselines. Using an extended segmentation protocol focussing on anterior hippocampus, we first investigated which substructures of the hippocampus respond to scenes, and found both imagination and recall of scenes to be associated with activity in presubiculum/parasubiculum, a region associated with spatial representation in rodents. Next, we compared imagining novel scenes to recall from one week or 30 min before scanning. We expected a strong response to imagining novel scenes and 1-week recall, as both involve constructing scene representations from elements stored across cortex. By contrast, we expected a weaker response to 30-min recall, as representations of these scenes had already been constructed but not yet consolidated. Both imagination and 1-week recall of scenes engaged anterior hippocampal structures (anterior subiculum and uncus respectively), indicating possible roles in scene construction. By contrast, 30-min recall of scenes elicited significantly less activation of anterior hippocampus but did engage posterior CA3. Together, these results elucidate the functions of different parts of the anterior hippocampus, a key brain area about which little is definitely known. PMID:26478961

  4. Influence of ridge inclination and implant localization on the association of mandibular Kennedy class I removable partial denture.

    PubMed

    Cunha, Lígia Del' Arco Pignatta; Pellizzer, Eduardo Piza; Verri, Fellippo Ramos; Falcón-Antenucci, Rosse Mary; Goiato, Marcelo Coelho

    2011-05-01

    The aim of this study was to evaluate the tendency of displacement of the supporting structures of the distal extension removable partial denture (DERPD) associated to the implant with different inclinations of alveolar ridge and implant localizations through a two-dimensional finite-element method. Sixteen mandibular models were fabricated, presenting horizontal, distally descending, distally ascending, or descending-ascending ridges. All models presented the left canine and were rehabilitated with conventional DERPD or implant-retained prosthesis with the ERA system. The models were obtained by the AutoCAD software and transferred to the finite-element software ANSYS 9.0 for analysis. A force of 50 N was applied on the cusp tips of the teeth, with 5 points of loading of 10 N. The results were visualized by displacement maps. For all ridge inclinations, the assembly of the DERPD with distal plate retained by an anterior implant exhibited the lowest requisition of the supporting structures. The highest tendency of displacement occurred in the model with distally ascending ridge with incisal rest. It was concluded that the association of the implant decreased the displacement of the DERPD, and the anterior positioning of the implant associated to the DERPD with the distal plate preserved the supporting structures for all ridges. PMID:21558932

  5. Morphometric evaluation and planning of anticurvature filing in roots of maxillary and mandibular molars.

    PubMed

    Oliveira, Maria Antonieta Veloso Carvalho; Venâncio, Jessyca Figueira; Raposo, Luís Henrique Araújo; Barbosa Júnior, Nelson; Biffi, João Carlos Gabrielli

    2015-01-01

    This study aimed to guide the planning of anticurvature filing using pre-determined anatomical points on teeth to establish directions for proper implementation of the technique. Two hundred digital periapical radiographs of human molar teeth were selected and divided into two groups (n = 100): MX (maxillary) and MD (mandibular) molars. Mesiobuccal roots were considered for the MX group and mesial roots for the MD group. Pre-determined anatomical points required for planning the anticurvature filing on the root canal path were located, and the distances between these points obtained. The anticurvature filing was simulated in two different protocols for each group, and the region of dentin removal and the remaining dentin thickness were measured in the safety and danger zones of the root canals. Statistical analysis was carried out at a significance level of 5%. The distances between the anatomical points and the thickness of remaining dentin showed significant differences when the two groups were compared (p < 0.001). No significant differences were found between the two experimental groups regarding the area of dentin removal at the root region, but differences were detected in comparison with dentin removal at the crown (p < 0.001). In terms of wear produced after simulation of both anticurvature filing protocols, significant differences were verified for all regions, except for the dentin remaining at the danger zone. The radiographic location of anatomical points allows for planning and implementation of controlled and efficient anticurvature filing and can be performed in the same manner for maxillary and mandibular molars. PMID:25466326

  6. Anterior spinal cord syndrome of unknown etiology

    PubMed Central

    Klakeel, Merrine; Thompson, Justin; McDonald, Frank

    2015-01-01

    A spinal cord injury encompasses a physical insult to the spinal cord. In the case of anterior spinal cord syndrome, the insult is a vascular lesion at the anterior spinal artery. We present the cases of two 13-year-old boys with anterior spinal cord syndrome, along with a review of the anatomy and vasculature of the spinal cord and an explanation of how a lesion in the cord corresponds to anterior spinal cord syndrome. PMID:25552812

  7. The doppelganger tooth: A diagnostic conundrum!

    PubMed Central

    Dhawan, Preeti; Gaurav, Vivek; Singh, Aditi

    2015-01-01

    Abnormalities in tooth morphology and number are not uncommon. However, an exact clone of a normal tooth is a recondite clinical finding. Presence of supplementary teeth is mostly noticed in maxillary anterior, molar or premolar region, followed by mandibular premolar region in descending order of its site of occurrence. Supplemental tooth in mandibular anterior has a low prevalence of 0.01%. This paper reports one such rare case of nonsyndromic incisive jumeaux in mandibular anterior region during mixed dentition period. PMID:26097343

  8. Anterior Hepatic Transection for Caudate Lobectomy

    PubMed Central

    Chaib, Eleazar; Ribeiro, Marcelo A F; de Souza, Yngrid Ellyn Dias Maciel; D’Albuquerque, Luiz Augusto C

    2009-01-01

    Resection of the caudate lobe (segment I- dorsal sector, segment IX- right paracaval region, or both) is often technically difficult due to the lobe’s location deep in the hepatic parenchyma and because it is adjacent to the major hepatic vessels (e.g., the left and middle hepatic veins). A literature search was conducted using Ovid MEDLINE for the terms “caudate lobectomy” and “anterior hepatic transection” (AHT) covering 1992 to 2007. AHT was used in 110 caudate lobectomies that are discussed in this review. Isolated caudate lobectomy was performed on 28 (25.4%) patients, with 11 case (11%) associated with hepatectomy, while 1 (0.9%) was associated with anterior segmentectomy. Complete caudate lobectomy was performed on 82 (74.5%) patients. Hepatocellular carcinoma was observed in 106 (96.3%) patients, while 1 (0.9%) had hemangioma and 3 (2.7%) had metastatic caudate tumors. AHT was used in 108 (98.1%) caudate resections, while AHT associated with a right-sided approach was performed in 2 (1.8%) cases. AHT is recommended for tumors located in the paracaval portion of the caudate lobe (segment IX). AHT is usually a safe and potentially curative surgical option. PMID:19936187

  9. Anterior eye protection with orbital neoplasia

    SciTech Connect

    Hancock, S.L.

    1986-01-01

    The administration of adequate doses of radiation to tumors involving the orbit and surrounding facial structures and sinuses is often complicated by the need to protect the sensitive ocular components, the lens and cornea. A technique has been devised that uses four photon beam fields and an optional electron field to treat the contents of both orbits and adjacent sinuses with effective, reproducible protection of cornea and lens. Essential features include: alignment of the corneal surfaces with the central plane of rotation of the treatment machine, use of a narrow eye block across the entire beam to shield a strip equal to the width of the cornea, positioned symmetrically across the central plane of rotation, fine alignment of the eye block with both corneal surfaces by altering pedestal angle, treatment with paired, wedged, anterior oblique fields to encompass desired orbital and sinus volumes with additional blocking placed as needed, and complementary, lateral strip fields using collimators set to eye block thickness to equalize dose in the posterior orbit shielded by the strip eye block. A similar anterior electron beam strip field may be added to boost the medial orbit and ethmoid regions covered by the eye block. Bite block head immobilization and easy, direct daily visualization of block position assures eye protection for each treatment and provides substantial reduction in dose to the cornea, lens and iris. Additional blocking may be incorporated to provide partial lacrimal and parotid sparing.

  10. Structural Asymmetry of Anterior Insula: Behavioral Correlates and Individual Differences

    PubMed Central

    Chiarello, Christine; Vazquez, David; Felton, Adam; Leonard, Christiana M.

    2013-01-01

    The current study investigated behavioral correlates of structural asymmetry of the insula, and traditional perisylvian language regions, in a large sample of young adults (N=200). The findings indicated 1) reliable leftward surface area asymmetry of the anterior insula, 2) association of this asymmetry with divided visual field lateralization of visual word recognition, and 3) modulation of the correlation of structural and linguistic asymmetry by consistency of hand preference. Although leftward asymmetry of cortical surface area was observed for the anterior insula, pars opercularis and triangularis, and planum temporale, only the anterior insula asymmetry was associated with lateralized word recognition. We interpret these findings within the context of recent structural and functional findings about the human insula. We suggest that leftward structural lateralization of earlier developing insular cortex may bootstrap asymmetrical functional lateralization even if the insula is only a minor component of the adult language network. PMID:23681069

  11. Treatment of displaced mandibular condylar fracture with botulinum toxin A.

    PubMed

    Akbay, Ercan; Cevik, Cengiz; Damlar, Ibrahim; Altan, Ahmet

    2014-04-01

    The aim of this case report is to discuss the effect on condylar reduction of botulinum toxin A treatment used in a child with displaced fracture at condylar neck of mandible. A 3-years old boy was admitted to our clinic for incomplete fracture of mandibular symphysis and displaced condylar fracture at the left side. An asymmetrical occlusal splint with intermaxillary fixation was used instead of open reduction and internal fixation because of incomplete fracture of symphysis and possible complications of condyle surgery. However, it was observed that condylar angulation persisted despite this procedure. Thus, botulinum toxin A was administered to masseter, temporalis and pterygoideus medialis muscles. At the end of first month, it was seen that mandibular condyle was almost completely recovered and that fusion was achieved. In conclusion, Botulinum A toxin injection aiming the suppression of masticatory muscle strength facilitates the reduction in the conservative management of displaced condyle in pediatric patients. PMID:24156980

  12. Surgical resection and prosthetic treatment of an extensive mandibular torus.

    PubMed

    Goncalves, Thais Marques Simek Vega; de Oliveira, Jonas Alves; Sanchez-Ayala, Alfonso; Rodrigues Garcia, Renata Cunha Matheus

    2013-01-01

    The aim of this case report was to describe the surgical removal of an extensive mandibular torus and the conventional prosthetic treatment that was performed. During surgery, the torus was exposed by a intrasulcular lingual incision from molar to contralateral molar side and displacement of the mucoperiosteal flap. The bone volume was carefully removed in three separate blocks by sculpting a groove in the superior lesion area and chiseling. After a 30-day postoperative period, a prosthetic treatment was performed using a conventional distal extension removable partial denture. The patient's esthetic and functional expectations were achieved. The surgical procedure and prosthetic treatment performed in the treatment of the mandibular torus in this clinical case is a viable treatment that produces few complications and re-establishes normal masticatory function. PMID:23302351

  13. Mandibular remains support taxonomic validity of Australopithecus sediba.

    PubMed

    de Ruiter, Darryl J; DeWitt, Thomas J; Carlson, Keely B; Brophy, Juliet K; Schroeder, Lauren; Ackermann, Rebecca R; Churchill, Steven E; Berger, Lee R

    2013-04-12

    Since the announcement of the species Australopithecus sediba, questions have been raised over whether the Malapa fossils represent a valid taxon or whether inadequate allowance was made for intraspecific variation, in particular with reference to the temporally and geographically proximate species Au. africanus. The morphology of mandibular remains of Au. sediba, including newly recovered material discussed here, shows that it is not merely a late-surviving morph of Au. africanus. Rather-as is seen elsewhere in the cranium, dentition, and postcranial skeleton-these mandibular remains share similarities with other australopiths but can be differentiated from the hypodigm of Au. africanus in both size and shape as well as in their ontogenetic growth trajectory. PMID:23580533

  14. [Anatomical rationale for lingual nerve injury prevention during mandibular block].

    PubMed

    Semkin, V A; Dydikin, S S; Kuzin, A V; Sogacheva, V V

    2015-01-01

    The topographic and anatomical study of lingual nerve structural features was done. It was revealed that during mandibular anesthesia possible lingual nerve injury can occur if puncture needle is lower than 1 cm. of molars occlusal surface level. The position of the lingual nerve varies withmandible movements. At the maximum open mouth lingual nerve is not mobile and is pressed against the inner surface of the mandibular ramus by the medial pterygoid muscle and the temporal muscle tendon. When closing the mouth to 1.25±0.2 cmfrom the physiological maximum, lingual nerve is displaced posteriorly from the internal oblique line of the mandible and gets mobile. On the basis of topographic and anatomic features of the lingual nervestructure the authors recommend the re-do of inferior alveolar nerve block, a semi-closed mouth position or the use the "high block techniques" (Torus anesthesia, Gow-Gates, Vazirani-Akinozi). PMID:26271698

  15. Biomechanical Configurations of Mandibular Transport Distraction Osteogenesis Devices

    PubMed Central

    Zapata, Uriel; Elsalanty, Mohammed E.; Dechow, Paul C.

    2010-01-01

    Mandibular bone transport (MBT) distraction osteogenesis devices are used for achieving reconstruction of mandibular defects in a predictable way, with few complications, less complexity than other alternative surgical procedures, and minimal tissue morbidity. However, selection of appropriate MBT device characteristics is critical for ensuring both their mechanical soundness and their optimal distraction function for each patient's condition. This article assesses six characteristics of currently available MBT devices to characterize their design and function and to classify them in a way that assists the selection of the best device option for each clinical case. In addition, the present work provides a framework for both the biomechanical conception of new devices and the modification of existing ones. PMID:19958167

  16. Assessment of a method for the prediction of mandibular rotation.

    PubMed

    Lee, R S; Daniel, F J; Swartz, M; Baumrind, S; Korn, E L

    1987-05-01

    A new method to predict mandibular rotation developed by Skieller and co-workers on a sample of 21 implant subjects with extreme growth patterns has been tested against an alternative sample of 25 implant patients with generally similar mean values, but with less extreme facial patterns. The method, which had been highly successful in retrospectively predicting changes in the sample of extreme subjects, was much less successful in predicting individual patterns of mandibular rotation in the new, less extreme sample. The observation of a large difference in the strength of the predictions for these two samples, even though their mean values were quite similar, should serve to increase our awareness of the complexity of the problem of predicting growth patterns in individual cases. PMID:3472458

  17. Removal of Deeply Impacted Mandibular Molars by Sagittal Split Osteotomy

    PubMed Central

    Isler, Sabri Cemil

    2016-01-01

    Mandibular third molars are the most common impacted teeth. Mandibular first and second molars do not share the same frequency of occurrence. In rare cases the occlusal surfaces of impacted molars are united by the same follicular space and the roots pointing in opposite direction; these are called kissing molars. In some cases, a supernumerary fourth molar can be seen as unerupted and, in this case, such a supernumerary, deeply impacted fourth molar is seen neighboring kissing molars. The extraction of deeply impacted wisdom molars from the mandible may necessitate excessive bone removal and it causes complications such as damage to the inferior alveolar nerve and iatrogenic fractures of the mandible. This case report describes the use of the sagittal split osteotomy technique to avoid extensive bone removal and protect the inferior alveolar nerve during surgical extruction of multiple impacted teeth. PMID:27429810

  18. [Muscular power of masticating muscles and mandibular osteoporosis].

    PubMed

    Morii, Hirotoshi; Takaishi, Yoshitomo

    2006-02-01

    Whereas the most powerful stimuli for bone formation is supposed to be a stretching of muscles, Frost HM classified the effect of muscle on bone mineral density (BMD) into various types: 1. age-related loss of bone mineral density (BMD) is partly due to loss of muscular wasting, 2. the increase of BMD in obesity is due to the increase in muscular power to support the increased body weight and 3. the decrease of BMD in chronic wasting disease is partly due to the decrease in muscular power. Likewise, the decrease in BMD in mandibular alveolar bones will be partly due to the decrease in the power of masticating muscles, if such exists. A case report of mitochondrial encephalo-myopathy associated with impaired function of cranial nerves involving trigeminus nerves and impaired function of masticating muscles and dysphagia. This patient showed decrease in alveolar BMD and atrophy of mandibular. PMID:16465028

  19. Free greater omental flap for treatment of mandibular osteoradionecrosis

    SciTech Connect

    Moran, W.J.; Panje, W.R.

    1987-04-01

    Osteoradionecrosis can involve the mandible following radical irradiation for treatment of oral cavity cancer. The radionecrosis of the mandible is often associated with severe intractable pain, local or extensive deformity, including pathologic fracture, orocutaneous fistula formation, and frequent loss of function. Treatment has ranged from analgesia and antibiotics to hyperbaric oxygen treatments to local or extensive sequestrectomies with partial or total mandibulectomy and restoration of tissue losses with unirradiated tissue. To our knowledge, this is the first report of the successful use of a free greater omental flap for immediate treatment of mandibular osteoradionecrosis and concomitant reconstruction. We found the omentum to be an excellent vascular bed that rapidly resolved the osteoradionecrosis and pain, promoted healing, and restored mandibular function with minimal discomfort to the patient.

  20. 38 CFR 3.379 - Anterior poliomyelitis.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Anterior poliomyelitis. 3... Specific Diseases § 3.379 Anterior poliomyelitis. If the first manifestations of acute anterior poliomyelitis present themselves in a veteran within 35 days of termination of active military service, it...

  1. A rare presentation of lipoma on mandibular mucogingival junction.

    PubMed

    Sharma, Gaurav; Jain, Kanu; Nagpal, Archna; Baiju, Chandrababu Sudha

    2016-01-01

    Lipoma is the most common tumor of mesenchymal tissues of body, but its occurrence in oral cavity is infrequent. Buccal mucosa is the most common intraoral site of lipoma followed by tongue, floor of the mouth, and buccal vestibule. The involvement of mucogingival junction is rare. We present a unique case report of oral lipoma occurring on mandibular mucogingival junction with review of literature which has emphasis on differential diagnosis. PMID:27143835

  2. Masticatory efficiency after rehabilitation of acquired maxillary and mandibular defects

    PubMed Central

    Vijayaraghavan, N. Vasantha; Ramesh, Ganesh; Thareja, Amit; Patil, Seema

    2015-01-01

    The effect of oral cancer with its therapeutic intervention involves significant facial and functional disabilities. It is customary to rehabilitate these patients by surgical or prosthetic means. Studies have been done to assess mastication and other functions after rehabilitation. A review of these studies for assessing masticatory function has been done under separate sections for maxillary and mandibular defects. Different masticatory tests are mentioned. Further scope for research has been highlighted. PMID:26392731

  3. Five Canalled and Three-Rooted Primary Second Mandibular Molar

    PubMed Central

    Selvakumar, Haridoss; Kavitha, Swaminathan; Bharathan, Rajendran; Varghese, Jacob Sam

    2014-01-01

    A thorough knowledge of root canal anatomy and its variation is necessary for successful completion of root canal procedures. Morphological variations such as additional root canals in human deciduous dentition are rare. A mandibular second primary molar with more than four canals is an interesting example of anatomic variations, especially when three of these canals are located in the distal root. This case shows a rare anatomic configuration and points out the importance of looking for additional canals. PMID:25147744

  4. A rare presentation of lipoma on mandibular mucogingival junction

    PubMed Central

    Sharma, Gaurav; Jain, Kanu; Nagpal, Archna; Baiju, Chandrababu Sudha

    2016-01-01

    Lipoma is the most common tumor of mesenchymal tissues of body, but its occurrence in oral cavity is infrequent. Buccal mucosa is the most common intraoral site of lipoma followed by tongue, floor of the mouth, and buccal vestibule. The involvement of mucogingival junction is rare. We present a unique case report of oral lipoma occurring on mandibular mucogingival junction with review of literature which has emphasis on differential diagnosis. PMID:27143835

  5. Extrusion of impacted mandibular second molar using removable appliance

    PubMed Central

    Karthikeyan, M. K.; Prabhakar, Ramachandran; Saravanan, R.; Vikram, N. Raj; Kumar, R. Vinoth; Prasath, R. Eshwara

    2014-01-01

    The purpose of this article is to review the principles of case management of impacted mandibular molars and to illustrate their potential to respond well to treatment. Although the scope of treatment may be influenced by the patient's age, past dental history, severity of impaction, dentoalveolar development, and root form, the case reports demonstrate the inherent potential for good treatment outcome even in the most unfavorable circumstances. PMID:25210378

  6. Five canalled and three-rooted primary second mandibular molar.

    PubMed

    Selvakumar, Haridoss; Kavitha, Swaminathan; Bharathan, Rajendran; Varghese, Jacob Sam

    2014-01-01

    A thorough knowledge of root canal anatomy and its variation is necessary for successful completion of root canal procedures. Morphological variations such as additional root canals in human deciduous dentition are rare. A mandibular second primary molar with more than four canals is an interesting example of anatomic variations, especially when three of these canals are located in the distal root. This case shows a rare anatomic configuration and points out the importance of looking for additional canals. PMID:25147744

  7. The Effect of Inter-Implant Distance on Retention and Resistance to Dislodging Forces for Mandibular Implant-Tissue-Supported Overdentures

    PubMed Central

    Tabatabaian, Farhad; Saboury, Abolfazl; Sobhani, Zahra Sadat; Petropoulos, Vicki C

    2014-01-01

    Objectives: The effect of inter-implant distance on retention and resistance of implant-tissue-supported overdentures is lacking in the literature. An in vitro study was performed to evaluate this effect for mandibular implant-tissue-supported overdentures retained by two ball attachments. Materials and Methods: An acrylic cast of an edentulous mandible was fabricated. Three pairs of implants were symmetrically placed at both sides of the midline. The inter-implant distance was 10, 25, and 35 millimeters in positions A, B and C, respectively. A framework simulating the overdenture was fabricated on the cast. Six attachment housings were placed within the overdenture. For each sample, two ball abutments were screwed onto the implant pairs and two pink nylon inserts were seated in their respective attachment housings. The samples were tested in three groups of 15 (A, B, and C). The testing machine applied tensile dislodging forces and peak loads were measured in three directions: vertical, oblique, and anterior-posterior. A one-way ANOVA followed by Tukey’s HSD was used to determine groups that were significantly different. Tests were carried out at 0.05 level of significance. Results: Peak loads for the anterior-posteriorly directed dislodging forces were significantly the highest for group C (P<0.05); 21.25 N±3.05 N, while there were no statistically significant differences among groups with vertically and obliquely directed forces (P>0.05). Conclusion: Inter-implant distance did not affect the vertical retention and oblique resistance of mandibular implant-tissue-supported overdentures; however, it affected anterior-posterior resistance. PMID:25628676

  8. Three-rooted mandibular first primary molar: Report of three cases

    PubMed Central

    Gupta, Shilpi; Nagaveni, N. B.; Chandranee, N. J.

    2012-01-01

    Accessory root formation in primary teeth is an uncommon finding. An awareness and understanding of the presence of additional roots and unusual root canal morphology is essential as it determines the successful outcome of the endodontic treatment. This paper presents three case reports on the presence of three-rooted mandibular first primary molar (primary three-rooted mandibular left first molar and bilateral mandibular first molar). PMID:22629056

  9. Accuracy of Panoramic Radiograph in Assessment of the Relationship Between Mandibular Canal and Impacted Third Molars

    PubMed Central

    Tantanapornkul, Weeraya; Mavin, Darika; Prapaiphittayakun, Jaruthai; Phipatboonyarat, Natnicha; Julphantong, Wanchanok

    2016-01-01

    Background: The relationship between impacted mandibular third molar and mandibular canal is important for removal of this tooth. Panoramic radiography is one of the commonly used diagnostic tools for evaluating the relationship of these two structures. Objectives: To evaluate the accuracy of panoramic radiographic findings in predicting direct contact between mandibular canal and impacted third molars on 3D digital images, and to define panoramic criterion in predicting direct contact between the two structures. Methods: Two observers examined panoramic radiographs of 178 patients (256 impacted mandibular third molars). Panoramic findings of interruption of mandibular canal wall, isolated or with darkening of third molar root, diversion of mandibular canal and narrowing of third molar root were evaluated for 3D digital radiography. Direct contact between mandibular canal and impacted third molars on 3D digital images was then correlated with panoramic findings. Panoramic criterion was also defined in predicting direct contact between the two structures. Results: Panoramic findings of interruption of mandibular canal wall, isolated or with darkening of third molar root were statistically significantly correlated with direct contact between mandibular canal and impacted third molars on 3D digital images (p < 0.005), and were defined as panoramic criteria in predicting direct contact between the two structures. Conclusion: Interruption of mandibular canal wall, isolated or with darkening of third molar root observed on panoramic radiographs were effective in predicting direct contact between mandibular canal and impacted third molars on 3D digital images. Panoramic radiography is one of the efficient diagnostic tools for pre-operative assessment of impacted mandibular third molars. PMID:27398105

  10. Early Experience with Biodegradable Fixation of Pediatric Mandibular Fractures.

    PubMed

    Mazeed, Ahmed Salah; Shoeib, Mohammed Abdel-Raheem; Saied, Samia Mohammed Ahmed; Elsherbiny, Ahmed

    2015-09-01

    This clinical study aims to evaluate the stability and efficiency of biodegradable self-reinforced poly-l/dl-lactide (SR-PLDLA) plates and screws for fixation of pediatric mandibular fractures. The study included 12 patients (3-12 years old) with 14 mandibular fractures. They were treated by open reduction and internal fixation by SR-PLDLA plates and screws. Maxillomandibular fixation was maintained for 1 week postoperatively. Clinical follow-up was performed at 1 week, 6 weeks, 3 months, and 12 months postoperatively. Radiographs were done at 1 week, 3 months, and 12 months postoperatively to observe any displacement and fracture healing. All fractures healed both clinically and radiologically. No serious complications were reported in the patients. Normal occlusion was achieved in all cases. Biodegradable osteofixation of mandibular fractures offers a valuable clinical solution for pediatric patients getting the benefit of avoiding secondary surgery to remove plates, decreasing the hospital stay, further painful procedures, and psychological impact. PMID:26269728

  11. Central condylar displacement with brain abscess from chronic mandibular osteomyelitis.

    PubMed

    Lee, Thomas; Green, Ross; Hsu, Jack

    2013-06-01

    In this case report, we describe a unique long-term complication from undiagnosed mandibular osteomyelitis. A 53-year-old female who underwent a dental extraction complicated by chronic postoperative odontogenic infection and cutaneous parotid fistula formation 2 years earlier presented with acute mental status change, gradual unilateral facial nerve palsy (House-Brackmann score V), and nontraumatic dislocation of the condylar head into the middle cranial fossa. The patient's chronic mandibular osteomyelitis led to glenoid fossa erosion, middle cranial fossa penetration, and temporal lobe abscess formation. A combined middle cranial fossa approach through a burr hole placed in the squamous temporal bone near the zygomatic root and intraoral mandibular approach to ipsilateral condylar head was performed to complete partial mandibulectomy, including condylectomy. The patient was treated with 6 weeks of meropenem perioperatively. Four months after the surgery, the patient had complete resolution of skull base osteomyelitis, parotid fistula, and neurologic deficits and full recovery of facial nerve function (House-Brackmann score of I). PMID:23315680

  12. The effect of anabolic steroids on mandibular growth.

    PubMed

    Gebhardt, Alexander; Pancherz, Hans

    2003-04-01

    The aim of this study was to assess the effect of nandrolone (Deca-Durabolin, AKZO Nobel, Cambridge, United Kingdom) on mandibular growth in juvenile and adult rats with radiographic cephalometry and immunoradiology. Juvenile (n = 16) and adult (n = 16) inbred female Wistar-Kyoto rats were compared. Each group was divided into 2 subgroups with 8 experimental (E) and 8 control (C) animals in each subgroup. Lateral headfilms taken before and after the 70-day study period were analyzed. Body weight and blood serum IGF-I levels were monitored weekly. The results showed marked mandibular growth changes in both the juvenile and the adult E rats. Body weight increase was larger in the E than in the C animals. The IGF-I blood serum levels were similar in the juvenile E and C rats but higher in the adult E animals than in the adult C animals. It was found that the anabolic steroid (Deca-Durabolin) had a significant effect on mandibular growth in both juvenile and adult rats. PMID:12695771

  13. [Diagnosis and treatment of temporo-mandibular disorders in orthodontics].

    PubMed

    Bocquet, Emmanuelle; Moreau, Alexis; Danguy, Michel; Danguy, Chantal

    2010-03-01

    Orthodontists are fully prepared to treat the problems of occlusion that they are called upon to deal with every day. On the other hand temporo-mandibular joint disorders present more obscure difficulties from the point of view of detection and diagnosis as well the management of their treatment. That is why a profound understanding of the anatomical and physiological functioning of the temporo-mandibular joint has become indispensable for today's orthodontists who are now asked to detect and diagnose an assortment of TMJ disturbances whose etiology may vary greatly. By performing a rigorous diagnostic procedure, based on a thorough clinical examination supported by careful axiographic and radiological studies, of temporo-mandibular malfunctioning and its underlying etiological causes, which are primarily dento-alveolar and occlusal in nature, orthodontists will be able to adopt an appropriate therapeutic approach that might be purely orthodontic or multi-disciplinary and carried out with the collaboration of specialists in occlusion, oral surgery, and even osteopathy. PMID:20359450

  14. Masticatory Mechanics of a Mandibular Distraction Osteogenesis Site: Interfragmentary Micromovement

    PubMed Central

    Sun, Zongyang; Rafferty, Katherine L.; Egbert, Mark A.; Herring, Susan W.

    2007-01-01

    Micromovement at a fracture or distraction osteogenesis (DO) site may play an important role in bone formation and healing. Mastication is an important physiological process that can cause substantial micromovement at a mandibular disjunction. The purpose of this study is to characterize and quantify the micromovement caused by mastication. Eighteen pigs, divided into three groups based on duration of consolidation, received a unilateral (right) mandibular angle distraction osteogenesis protocol. Differential variable reluctance transducers (DVRTs) and ultrasound crystals were used to measure the change of gap width as well as interfragmentary movement during mastication. Synchronized chewing video and interfragmentary movement recordings were used to determine the magnitude and direction of micromovement at different phases of the chewing cycle. The magnitude of micromovement did not increase significantly with distraction up to almost 5 mm, but did decrease gradually with consolidation. The average micromovement magnitude during the distraction phase was 0.2-0.3 mm, equaling 50,000-250,000 microstrain (με) on interfragmentary tissue. The dominant deformation pattern was bending in the sagittal plane. The most common direction of bending at the power stroke of chewing was concave dorsally, i.e. superior shortening and inferior lengthening. These findings elucidate how masticatory mechanics affect a mandibular distraction site, and the measurements may be useful for future simulation studies. PMID:17532283

  15. Individualized treatment for the mandibular segmental defect: a case report.

    PubMed

    Zhang, Zhen; Pan, Juli; Huang, Xin; Chen, Su

    2015-04-01

    Ameloblastomas are slowly growing, locally invasive tumors with high recurrence rate and more common in the mandible, if not treated they can grow to enormous size. Radical resection is the only predictable form of treatment for ameloblastomas. However, mandibular resection can lead to dysfunctions in appearance, speech, mastication, and deglutition, which severely impair the patients' quality of life. The reconstruction of extensive bone defects in the maxillofacial area is still challenging. To meet the demands of functional reconstruction, minimizing the negative influence of mandibular malformation, and disability on patients, the individualized systematic treatment plans highlight denture prosthodontics and require much consideration of multidisciplinary cooperation, with such related fields as maxillofacial surgery, oral implantology, prosthodontics, and radiology taken into account. In this report, we will present a case of reconstructing the mandibular segmental defect after the resection of a rarely giant ameloblastoma. In the case, we took the restoration of the missing teeth and the rehabilitation of the masticatory function as well as restoring bony continuities and facial appearance into consideration, communicated well with prosthodontists and implantologists before surgery, making the individualized systematic treatment plan more effective and efficient. PMID:25972644

  16. Evaluation of mandibular contour in patients with significant facial asymmetry.

    PubMed

    Fang, J-J; Tu, Y-H; Wong, T-Y; Liu, J-K; Zhang, Y-X; Leong, I-F; Chen, K-C

    2016-07-01

    Most previous studies on facial asymmetry have not specifically differentiated mandible deviation from structural asymmetry of the mandible. The purpose of this study was to assess the symmetry of the mandible by examining its contour in a cohort of patients with significant facial asymmetry. Eleven cases of facial asymmetry with chin deviation ≥10mm were enrolled. A voxel-paired median plane (optimal symmetry plane, OSP) and two landmark-based median planes were generated. The OSP was created by computing the best pairing of the bony voxels on the two sides. One side of the mandibular contour was mirrored onto the other side using the test plane. The contour differences were measured by distance and by area ratio. They were examined both in frontal and frontal downward inclined view. The contour symmetry of the mandible was that revealed by the plane that presented the best symmetry. The results showed that the OSP worked best in bisecting the contour into two symmetrical halves. Contour analysis showed relatively small discrepancies between the two sides. In conclusion, the mandibles retained an acceptable contour symmetry despite the presence of significant mandibular deviations. It is suggested that proper mandibular alignment be the primary objective in the correction of facial asymmetry. PMID:26976218

  17. Cholinergic traits in rat mandibular processes observed by electron microscopy.

    PubMed

    Tsuzuki, H; Kitamura, H

    1987-01-01

    Cholinergic traits in rat mandibular processes were examined histochemically, under the electron microscope, at early developmental stages (Stages 20 to 23, by Christie's nomenclature). The histochemical reaction for detection of enzymes was performed by the thiocholine method. Nonspecific cholinesterase (EC 3.1.1.8) activity was found in ectomesenchymal cells, vascular endothelial cells, and in some epidermal cells at stages 20 and 21. The enzymatic activity was localized in the perinuclear and endoplasmic reticular cisternae. At stage 22, the number of cells with enzymatic activity decreased gradually, except in the case of the capillary endothelial cells. At stage 23, when the trigeminal nerve fiber was obvious in the mandibular processes, nonspecific cholinesterase activity was restricted to some of the endothelial cells and trigeminal ganglionic cells. In contrast, acetylcholinesterase activity was found on the membrane of trigeminal nerve fiber. Thus, the transient, nonspecific, cholinesterase activity, found in rat mandibular processes, may serve some functions in transmission, lipid metabolism or destruction of toxic cholinesters during the period that precedes organogenesis. PMID:3631533

  18. Number of implants for mandibular implant overdentures: a systematic review

    PubMed Central

    Lee, Jeong-Yol; Kim, Ha-Young; Bryant, S. Ross

    2012-01-01

    PURPOSE The aim of this systematic review is to address treatment outcomes of Mandibular implant overdentures relative to implant survival rate, maintenance and complications, and patient satisfaction. MATERIALS AND METHODS A systematic literature search was conducted by a PubMed search strategy and hand-searching of relevant journals from included studies. Randomized Clinical Trials (RCT) and comparative clinical trial studies on mandibular implant overdentures until August, 2010 were selected. Eleven studies from 1098 studies were finally selected and data were analyzed relative to number of implants. RESULTS Six studies presented the data of the implant survival rate which ranged from 95% to 100% for 2 and 4 implant group and from 81.8% to 96.1% for 1 and 2 implant group. One study, which statistically compared implant survival rate showed no significant differences relative to the number of implants. The most common type of prosthetic maintenance and complications were replacement or reattaching of loose clips for 2 and 4 implant group, and denture repair due to the fracture around an implant for 1 and 2 implant groups. Most studies showed no significant differences in the rate of prosthetic maintenance and complication, and patient satisfaction regardless the number of implants. CONCLUSION The implant survival rate of mandibular overdentures is high regardless of the number of implants. Denture maintenance is likely not inflenced substantially by the number of implants and patient satisfaction is typically high again regardless os the number of implants. PMID:23236572

  19. Mandibular Tori: A source of autogenous bone graft

    PubMed Central

    Santhanakrishnan, Muthukumar; Rangarao, Suresh

    2014-01-01

    Restoration of lost alveolar bone support remains as one of the main objectives of periodontal surgery. Amongst the various types of bone grafts available for grafting procedures, autogenous bone grafts are considered to be the gold standard in alveolar defect reconstruction. Although there are various sources for autogenous grafts including the mandibular symphysis and ramus, they are almost invariably not contiguous with the area to be augmented. An alternative mandibular donor site that is continuous with the recipient area and would eliminate the need for an extra surgical site is the tori/exostoses. Bone grafting was planned for this patient as there were angular bone loss present between 35-36 and 36-37. As the volume of bone required was less and bilateral tori were present on the lingual side above the mylohyoid line, the tori was removed and used as a source of autogenous bone graft, which were unnecessary bony extensions present on the mandible and continuous with the recipient area. Post-operative radiographs taken at 6 and 12 month intervals showed good bone fill and also areas of previous pockets, which did not probe after treatment indicates the success of the treatment. The use of mandibular tori as a source of autogenous bone graft should be considered whenever a patient requires bone grafting procedure to be done and presents with a tori. PMID:25624635

  20. Morphological measurements of anatomic landmarks in human maxillary and mandibular molar pulp chambers.

    PubMed

    Deutsch, Allan S; Musikant, Barry Lee

    2004-06-01

    The aim of this in vitro study was to measure critical morphology of molar pulp chambers. One hundred random human maxillary and mandibular molars (200 teeth in total) were used. Each molar was radiographed mesiodistally on a millimeter grid. Using a stereomicroscope, the measurements were read to the nearest 0.5 mm. Results were as follows (mean, mm): pulp chamber floor to furcation, maxillary = 3.05 +/- 0.79, mandibular = 2.96 +/- 0.78; pulp chamber ceiling to furcation, maxillary = 4.91 +/- 1.06, mandibular = 4.55 +/- 0.91; buccal cusp to furcation, maxillary = 11.15 +/- 1.21, mandibular = 10.90 +/- 1.21; buccal cusp to pulp chamber floor, maxillary = 8.08 +/- 0.88, mandibular = 7.95 +/- 0.79; buccal cusp to pulp chamber ceiling, maxillary = 6.24 +/- 0.88, mandibular = 6.36 +/- 0.93; and pulp chamber height, maxillary = 1.88 +/- 0.69, mandibular = 1.57 +/- 0.68. The pulp chamber ceiling was at the level of the cementoenamel junction in maxillary, 98%, and mandibular, 97% of the specimens. The measurements showing the lowest percentage variance were buccal cusp to furcation (approximately 11%) and buccal cusp to pulp chamber ceiling (approximately 14%). The measurements were similar for both maxillary and mandibular molars. PMID:15167463

  1. Maxillary palatal ramp prosthesis: A prosthodontic solution to manage mandibular deviation following surgery

    PubMed Central

    (Bhattacharya), Sampa Ray; Majumdar, Dibyendu; Singh, Dilip K.; Islam, M. D. Rabiul; Ray, Pradip K.; Saha, Nilanjana

    2015-01-01

    Mandibular resection following surgical treatment for neoplastic lesions of the oral cavity leads to numerous complications including altered mandibular movements, disfigurement, difficult in swallowing, impaired speech and articulation, and deviation of the mandible towards the resected site. Various prosthetic methods are employed to reduce or minimize mandibular deviation and improve and restore the lost functions and esthetic, like maxillomandibular fixation, implant supported prosthesis, removable mandibular guide flange prosthesis, and palatal based guidance restoration. This clinical report describes the rehabilitation of a patient following segmental mandibulectomy using palatal ramp prosthesis. PMID:25821361

  2. Combined Mandibular Guidance Therapy in the Management of a Hemimandibulectomy Patient.

    PubMed

    Jamayet, Nafij Bin; Fard, Asa Yazdani; Husein, Adam; Ariffin, Zaihan; Alam, Mohammad Khursheed

    2015-01-01

    This case history report describes two different devices, maxillary ramp prostheses (MRP) and mandibular guide flange prostheses (MGFP), prescribed for managing a hemimandibulectomy patient's deviated mandible. The patient was given muscle reprogramming exercises with coordinated use of both guidance prostheses for 2 months, leading to improvements in both postsurgical mandibular deviation and occlusal equilibration. A successful intercuspal position was eventually accomplished through the use of the combination therapy. MRP and MGFP can be a useful approach to avoid mandibular deviation and compromised function following a partial mandibular resection. PMID:26523724

  3. Do flexible acrylic resin lingual flanges improve retention of mandibular complete dentures?

    PubMed Central

    Ahmed Elmorsy, Ayman Elmorsy; Ahmed Ibraheem, Eman Mostafa; Ela, Alaa Aboul; Fahmy, Ahmed; Nassani, Mohammad Zakaria

    2015-01-01

    Objectives: The aim of this study was to compare the retention of conventional mandibular complete dentures with that of mandibular complete dentures having lingual flanges constructed with flexible acrylic resin “Versacryl.” Materials and Methods: The study sample comprised 10 completely edentulous patients. Each patient received one maxillary complete denture and two mandibular complete dentures. One mandibular denture was made of conventional heat-cured acrylic resin and the other had its lingual flanges made of flexible acrylic resin Versacryl. Digital force-meter was used to measure retention of mandibular dentures at delivery and at 2 weeks and 45 days following denture insertion. Results: The statistical analysis showed that at baseline and follow-up appointments, retention of mandibular complete dentures with flexible lingual flanges was significantly greater than retention of conventional mandibular dentures (P < 0.05). In both types of mandibular dentures, retention of dentures increased significantly over the follow-up period (P < 0.05). Conclusions: The use of flexible acrylic resin lingual flanges in the construction of mandibular complete dentures improved denture retention. PMID:26539387

  4. Surgical Management of Mandibular Central Incisors with Dumbbell Shaped Periapical Lesion: A Case Report

    PubMed Central

    Venigalla, Bhuvan Shome; Patil, Jayaprakash D.; Jayaprakash, Thumu; Chaitanya, C. H. Krishna; Kalluru, Rama S.

    2014-01-01

    Dental traumatic injuries may affect the teeth and alveolar bone directly or indirectly. Pulpal necrosis and chronic and apical periodontitis with cystic changes are the most common sequelae of the dental traumatic injuries, if the teeth are not treated immediately. This case report focuses on the conventional and surgical management of mandibular central incisors. A twenty-four-year-old male patient presented with pain in the mandibular central incisors. Radiographic examination revealed mandibular central incisors with dumbbell shaped periapical lesion. After root canal treatment, parendodontic surgery was performed for mandibular central incisors. After one-year recall examination, the teeth were asymptomatic and periapical lesion had healed. PMID:25105031

  5. Mandibular third molar development after mantle radiation in long-term survivors of childhood Hodgkin's disease

    SciTech Connect

    McGinnis, J.P. Jr.; Hopkins, K.P.; Thompson, E.I.; Hustu, H.O.

    1987-05-01

    Sequential panoramic radiographs were assessed for mandibular third molar development in 47 long-term survivors of childhood Hodgkin's disease after treatment with 37 Gy mantle field radiation. To make a comparison, panoramic radiographs of 149 healthy, nonirradiated children were reviewed for the presence of mandibular third molars. In children between the ages of 7 and 12 years, bilateral agenesis of mandibular third molars was more frequent in patients who had been treated with mantle radiation than in nonirradiated patients. Unilateral agenesis, crown hypoplasia, and root growth impairment of mandibular third molars were also found. Similar, apparent, radiation-induced developmental anomalies were noted in maxillary third molars of the irradiated patients.

  6. Concomitant solitary median maxillary central incisor and fused right mandibular incisor in primary dentition

    PubMed Central

    Shilpa, G.; Nuvvula, Sivakumar; Gokhale, Niraj; Yamini, V.

    2012-01-01

    Solitary median maxillary central incisor (SMMCI) is a unique developmental anomaly in primary dentition. It involves central incisor tooth germs and may or may not be associated with other anomalies. Its presence, concomitant with fusion of right mandibular incisors has not previously been reported. A 5-year-old girl was presented with a single symmetrical primary maxillary incisor at the midline, with the absence of labial frenulum, an indistinct philtrum and a prominent midpalatal ridge. There was an associated fused tooth in the right incisor region and radiographic examination confirmed only one maxillary central incisor in both the dentitions. Family history revealed that the father of the girl also had a similar anomaly providing probable evidence of etiological role for heredity in SMMCI. PMID:23230364

  7. Low-Grade Myofibroblastic Sarcoma in the Mandibular Canal: A Case Report.

    PubMed

    Yu, Yueyuan; Xiao, Jin; Wang, Lan; Yang, Guiqiang

    2016-07-01

    Low-grade myofibroblastic sarcoma (LGMS) represents an atypical myofibroblastic tumor characterized by a diffusely infiltrating pattern of spindle-shaped tumor cells. It was classified as a distinct soft tissue tumor by the World Health Organization in 2002. LGMS occurs mostly in adult patients and has a predilection for the head and neck region. So far, only a few cases of LGMS located in the mandible have been reported. Aggressive surgical resection with clear margins is the primary treatment for LGMS. Because of its rarity, reports of radiation therapy are limited, and the therapeutic effect is still controversial. We present the case of an 8-year-old girl with LGMS of the mandibular canal to highlight the clinical features and rarity and to improve the understanding of the therapeutic effect of radiotherapy on LGMS. PMID:27020841

  8. Cell lineage analysis of the mandibular segment of the amphipod Orchestia cavimana reveals that the crustacean paragnaths are sternal outgrowths and not limbs.

    PubMed

    Wolff, Carsten; Scholtz, Gerhard

    2006-01-01

    The question of arthropod head segmentation has become one of the central issues in Evolutionary Developmental Biology. The number of theories pertaining to head segments progressively enlarges, old concepts have been revitalized, and nearly every conceivable composition of the arthropod head has at some point received discussion. One contentious issue involves a characteristic mouthpart in crustaceans--the lower lips or the so-called paragnaths. The paragnaths build the posterior border of the mouth region antagonistic to the upper lip--the labrum. We show here the development of the appendage-like structures in the mandibular region of the amphipod crustacean Orchestia cavimana at a high level of cellular resolution. The embryos are examined during development of the mouthparts using in vivo labeling. An invariant cell division pattern of the mandibular segment was detected by 4D-microscopy and a preliminary model for pattern of the first cleavages in the mandibular region created. With this indispensable precondition single ectodermal cells of the grid-like pattern were labeled with DiI--a lipophilic fluorescent dye--to trace cell lineages and determine the clonal composition of the developing mouthparts, especially the mandibular segment. From our data it is evident that the paragnaths are sternal outgrowths of the mandible segment. The assumption of the limb nature of paragnaths and the presence of an additional head segment between the mandibular and the second antennal segments are clearly refuted by our data. Our results show the power of cell lineage and clonal analyses for inferences on the nature, origin and thus homology of morphological structures. With this kind of investigation morphological and gene expression data can be complemented. We discuss notable similarities of paragnath anlagen to those of the hypopharynx complex in myriapods and hexapods. The fact that both structures grow out as two lateral buds in the same region of the mandibular

  9. Does the presence of an unerupted lower third molar influence the risk of mandibular angle and condylar fractures?

    PubMed

    Antic, S; Saveljic, I; Nikolic, D; Jovicic, G; Filipovic, N; Rakocevic, Z; Djuric, M

    2016-05-01

    It has been suggested that unerupted lower third molars (M3) increase the fragility of the mandibular angle and simultaneously decrease the risk of condylar fracture. However, it is unknown whether this applies regardless of the direction and point of impact of the traumatic force. The aim of this study was to investigate the impact of an unerupted M3 on the fragility of the angle and condyle in terms of a force acting from different directions and affecting different regions of the mandible. Computed tomography scans of a human mandible and finite element methodology were used to obtain two three-dimensional models: a model with, and the other without an unerupted M3. A force of 2000N was applied to three different regions of the models: the symphysis, ipsilateral body, and contralateral body, respectively. When the force was applied to the mandibular body, the results revealed increased angle fragility in cases with unerupted M3. When the force was applied to the symphysis, the condyle region showed higher fragility, irrespective of the presence of an unerupted M3. In summary, fragility of the angle and condyle regions depends on the presence of an unerupted M3 and on the direction and point of impact of the force. PMID:25448405

  10. Mandibular Angle Fractures: Comparison of One Miniplate vs. Two Miniplates

    PubMed Central

    Yazdani, Javad; Taheri Talesh, Kourosh; Kalantar Motamedi, Mohammad Hosein; Khorshidi, Reza; Fekri, Sasan; Hajmohammadi, Saeed

    2013-01-01

    Background Monocortical miniplate fixation is an accepted and reliable method for internal fixation of mandibular angle fractures. Although placement of a second miniplate may theoretically provide more stability; however, the clinical importance of this issue remains controversial. Objectives The present study assessed the postoperative complications and outcomes associated with the fixation of mandibular angle fractures using 1 and 2 miniplates in patients with favorable mandibular angle fractures. Patients and Methods A prospective study of 87 patients (73 males, 14 females) with favorable mandibular angle fractures was done. In the first group, a 4-hole miniplate was placed at the superior border through an intraoral approach. In group 2, patients were treated with 2 miniplates, one placed at the superior border (similar to group 1) and the other on the lateral aspect of the angle at the inferior border through an intraoral and transcutaneous approach using a trocar. Postoperative complications including malocclusion, malunion and sensory disturbances associated with surgery, additional maxillomandibular fixation (MMF) by means of an arch bar and wires for a longer period (for delayed union) and infection were assessed in patients of both groups up to 12 months postoperatively. The data were analyzed using the chi-square test. Results In the single miniplate group, 25 patients showed lip numbness associated with surgery (55.6%), 22 patients required additional use of MMF (48.9%) and 3 patients developed infections (6.7%). In the double miniplate group 20 patients showed lip numbness associated with surgery (47.6%), 18 patients required additional use of MMF (42.9%) and 1 patient developed infection (2.4%). None of the patients in either group showed malocclusion or malunion. No significant difference was observed between the groups regarding overall complication rate. Conclusions In this study, use of one miniplate or two miniplates for treatment of favorable

  11. Effects of different mandibular fracture patterns on the stability of miniplate screw fixation in angle mandibular fractures.

    PubMed

    Pektas, Z O; Bayram, B; Balcik, C; Develi, T; Uckan, S

    2012-03-01

    The aim of the present study was to evaluate the effects of horizontally favourable and unfavourable mandibular fracture patterns on the fixation stability of titanium plates and screws by simulating chewing forces. Favourable and unfavourable mandibular fractures on 22 sheep hemimandibles were fixed with 4-hole straight titanium plates and 2.0mm×7mm titanium screws according to the Champy technique. Hemimandibles were mounted with a fixation device in a servohydraulic testing unit for compressive testing. Displacement values under 20, 60, 100, 120, 150, 200N, maximum displacements, and maximum forces the model could resist before breakage were recorded and compared. The authors found no statistically significant differences between the groups for the displacement values in the force range 60-200N (60, 100, 120, 150 and 200N). Statistically significant differences for maximum displacement values (displacement values at the breaking forces) between the groups were found (P<0.05). There was no evidence for the need to apply different treatment modalities to mandibular fractures regardless of whether the factures are favourable or not. PMID:22178275

  12. 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

  13. 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

  14. [Ultrasound imaging of the anterior cruciate ligament. Possibilities and limits].

    PubMed

    Kelsch, G; Ulrich, C; Bickelhaupt, A

    1996-02-01

    We carried out sonography of the femoral origin of the anterior cruciate ligament in the dorsal cross section with a 7.5-MHz linear scanner in 25 test subjects with healthy knee joints. A physiological difference between the sides in the size of the hypoechoic region of the origin could be defined on the basis of the measurements obtained in both knee joints. Values outside a reference range which could be evaluated from this difference were rated as pathological in terms of an anterior cruciate ligament rupture. The reliability of this method in definitively diagnosing an anterior cruciate ligament rupture was analysed statistically as compared to the golden standard of arthroscopy on 65 patients by means of the two-by-two frequency table test. The femoral origin of the cruciate ligament in 25 test subjects had a median width of 3.1 mm (range 1.7-5.8 mm) on the right and 3.4 mm (range 1.7-4.4 mm) on the left. The median difference between the sides is 0.4 mm (range 0-1.8 mm). If the 3rd to the 97th percentile is selected as the reference range, our data show a physiological difference between the sides of 0-1.5 mm. The median age of the 65 patients was 31 years (range 14-74 years). Two thirds of all patients were men. A rupture of the anterior cruciate ligament was diagnosed sonographically in 19 patients. The result was confirmed arthroscopically in 15 patients. In 4 patients, there was a false positive sonographic finding. Forty-six patients did not fulfil the sonographic criteria of a rupture of the anterior cruciate ligament. Of these, 38 showed an intact anterior cruciate ligament on arthroscopy. Eight patients had a false-negative sonographic finding. The corresponding statistical analysis showed sensitivity of 65%, specificity of 90% and precision of 79%. Accordingly, the diagnostic reliability of knee joint sonography in diagnosing a rupture of the anterior cruciate ligament appears to be unsatisfactory, since old ruptures, above all, cannot be imaged with

  15. Assessing the feasibility of yttria-stabilized zirconia in novel designs as mandibular anterior fixed lingual retention following orthodontic treatment

    NASA Astrophysics Data System (ADS)

    Stout, Matthew

    The purpose of this study is to explore the feasibility of yttria-stabilized zirconia (Y-TZP) in fixed lingual retention as an alternative to stainless steel. Exploratory Y-TZP specimens were milled to establish design parameters. Next, specimens were milled according to ASTM standard C1161-13 and subjected to four-point flexural test to determine materials properties. Finite Element (FE) Analysis was employed to evaluate nine novel cross-sectional designs and compared to stainless steel wire. Each design was analyzed under the loading conditions to determine von Mises and bond stress. The most promising design was fabricated to assess accuracy and precision of current CAD/CAM milling technology. The superior design had a 1.0 x 0.5 mm semi-elliptical cross section and was shown to be fabricated reliably. Overall, the milling indicated a maximum percent standard deviation of 9.3 and maximum percent error of 13.5 with a cost of $30 per specimen. Y-TZP can be reliably milled to dimensions comparable to currently available metallic retainer wires. Further research is necessary to determine the success of bonding protocol and clinical longevity of Y-TZP fixed retainers. Advanced technology is necessary to connect the intraoral scan to an aesthetic and patient-specific Y-TZP fixed retainer.

  16. A Modified Method of Proximal Segment Alignment After Sagittal Split Ramus Osteotomy for Patients With Mandibular Asymmetry

    PubMed Central

    Xia, James J.; Wang, Xudong

    2015-01-01

    Purpose The purpose of this study was to evaluate a modified method of aligning the proximal segment after bilateral sagittal split ramus osteotomy (BSSO) in the treatment of patients with facial asymmetry. Patients and Methods Eleven patients with mandibular excess and facial asymmetries were enrolled in this prospective study. The surgery was planned according to a computer-aided surgical simulation protocol. In addition, the proximal segment on the hypoplastic side was intentionally flared out after the distal segment was rotationally set back. If the gap between the proximal and distal segments was too wide, then bone grafts were used. The surgery was completed according to the computerized plan. The proximal segment on the hypoplastic side was fixed with bicortical lag screws, and the proximal segment on the hyperplastic side was fixed with a 4-hole titanium miniplate. Postoperative evaluation was performed 6 months after surgery. Statistical analyses were performed. Results All surgeries were completed uneventfully. Of the 11 patients, 4 also underwent genioplasty and 3 underwent bone grafting to fill in the gap and smooth the anterior step. The physicians and patients were satisfied with the surgical outcomes. Only 1 patient underwent a secondary revision using an onlay hydroxyapatite implant. Results of statistical analyses showed that the computerized surgical plan could be accurately transferred to the patients at the time of surgery and the surgical outcomes achieved with this modified method were better than with the routine method of aligning the proximal and distal segments in maximal contact. Conclusion The present modified method of aligning the proximal segment for BSSO can effectively correct mandibular asymmetry and obviate a secondary revision surgery. PMID:26026710

  17. Panoramic-Based Mandibular Indices and Bone Mineral Density of Femoral Neck and Lumbar Vertebrae in Women

    PubMed Central

    Marandi, S.; Bagherpour, A.; Imanimoghaddam, M.; Hatef, MR.; Haghighi, AR.

    2010-01-01

    Objective: The aim of this cross-sectional analytic study was to evaluate the diagnostic efficacy of panoramic-based indices of the mandible (Mental Index-MI, Mandibular Cortical Index-MCI and Panoramic Mandibular Index-PMI) and to determine their correlation with bone mineral density (BMD) of the femoral neck and lumbar vertebrae (L2-L4) in order to assess the possibility of using these parameters as indicators of osteoporosis. Materials and Methods: The mandibular indices of 67 women over 35 years old were measured from panoramic radiographs, and bone densitometry was performed in the femoral neck and lumbar vertebrae (L2-L4), using DXA (Dual Energy X-ray Absorptiometry) technique. The patients were divided into three categories of normal, osteopenic and osteoporotic in each skeletal region. One-way ANOVA and ROC curve analyses were applied. The results were considered statistically significant when the P-value was less than 0.05. Results: Comparing the mean BMD in the femoral neck in women between C1 and C3 subgroups of MCI, a significant difference was detected (P=0.04). The mean PMI in the three skeletal subgroups was not different according to the skeletal region (P>0.05). We found a significant difference in mean MI between normal and osteopenic subgroups in the femoral neck (P=0.042). Conclusion: Using radiomorphometric indices of the mandible (MCI-MI) may be useful in determining the skeletal status of the patients, but is not sufficient for precise evaluation. PMID:21998782

  18. The anterior insular and anterior cingulate cortices in emotional processing for self-face recognition.

    PubMed

    Morita, Tomoyo; Tanabe, Hiroki C; Sasaki, Akihiro T; Shimada, Koji; Kakigi, Ryusuke; Sadato, Norihiro

    2014-05-01

    Individuals can experience embarrassment when exposed to self-feedback images, depending on the extent of the divergence from the internal representation of the standard self. Our previous work implicated the anterior insular cortex (AI) and the anterior cingulate cortex (ACC) in the processing of embarrassment; however, their exact functional contributions have remained uncertain. Here, we explored the effects of being observed by others while viewing self-face images on the extent of embarrassment, and the activation and connectivity patterns in the AI and ACC. We conducted functional magnetic resonance imaging hyperscanning in pairs of healthy participants using an interaction system that allowed an individual to be observed by a partner in real time. Being observed increased the extent of embarrassment reported when viewing self-face images; a corresponding increase in self-related activity in the right AI suggested that this region played a direct role in the subjective experience. Being observed also increased the functional connectivity between the caudal ACC and prefrontal regions, which are involved in processing the reflective self. The ACC might therefore serve as a hub, integrating information about the reflective self that is used in evaluating perceptual self-face images. PMID:23377900

  19. The anterior insular and anterior cingulate cortices in emotional processing for self-face recognition

    PubMed Central

    Morita, Tomoyo; Tanabe, Hiroki C.; Sasaki, Akihiro T.; Shimada, Koji; Kakigi, Ryusuke

    2014-01-01

    Individuals can experience embarrassment when exposed to self-feedback images, depending on the extent of the divergence from the internal representation of the standard self. Our previous work implicated the anterior insular cortex (AI) and the anterior cingulate cortex (ACC) in the processing of embarrassment; however, their exact functional contributions have remained uncertain. Here, we explored the effects of being observed by others while viewing self-face images on the extent of embarrassment, and the activation and connectivity patterns in the AI and ACC. We conducted functional magnetic resonance imaging hyperscanning in pairs of healthy participants using an interaction system that allowed an individual to be observed by a partner in real time. Being observed increased the extent of embarrassment reported when viewing self-face images; a corresponding increase in self-related activity in the right AI suggested that this region played a direct role in the subjective experience. Being observed also increased the functional connectivity between the caudal ACC and prefrontal regions, which are involved in processing the reflective self. The ACC might therefore serve as a hub, integrating information about the reflective self that is used in evaluating perceptual self-face images. PMID:23377900

  20. Mandibular Symphyseal/Parasymphyseal Fracture with Incisor Tooth Loss: Preventing Lower Arch Constriction.

    PubMed

    Rahpeyma, Amin; Khajehahmadi, Saeedeh; Abdollahpour, Somayeh

    2016-03-01

    Mandibular fractures are the second most common fractures of the face after the nasal bone. Mandibular symphyseal/parasymphyseal fracture comprises 15.6 to 29.3% of mandibular fractures. Tooth loss in the fracture line is a known phenomenon, but space loss has not been evaluated comprehensively in the literature. In a retrospective study, patients with mandibular symphyseal/parasymphyseal fractures, who had been treated from 2012 to 2013 in Mashhad University, Iran, Emdadi Hospital, were recalled. Patients with mandibular incisor tooth/teeth loss were included in the study. Space loss, the technique used to replace the lost tooth/teeth, upper and lower dental midline relationship, combination fracture or fractures in other facial skeleton, and type of treatment were evaluated. Of 98 patients with mandibular symphyseal/parasymphyseal fractures, 22.5% had incisor tooth/teeth loss. In this group, 73% had space loss. Only four patients had replaced the lost tooth/teeth. Dental midlines did not match each other in patients whose feature was evaluated. Open reduction and internal fixation with miniplates were used in symphyseal/parasymphyseal fractures except one. Space loss after mandibular symphyseal/parasymphyseal fracture with incisor tooth loss is a common error. The most important factor to prevent complications related to space loss following mandibular symphyseal/parasymphyseal fracture accompanying incisor tooth loss is space preservation. PMID:26889343

  1. Unusual Cases of the Transmigrated Mandibular Canines: Report of 4 Cases

    PubMed Central

    Aktan, Ali Murat; Kara, Sami; Akgunlu, Faruk; Isman, Eren; Malkoc, Siddik

    2008-01-01

    The canine impaction is not uncommon in dental literature, but the transmigration of mandibular canine is a rare phenomenon, and some of them are far more extreme than others. In this study, we aimed to present the more extreme cases of the four transmigrated mandibular canine cases with special emphasis on their classification. PMID:19212522

  2. Electron microscopic study of the mandibular glands of Kalotermes flavicollis fabr. (isoptera; calotermitidae).

    PubMed

    Cassier, P; Fain-Maurel, M A; Lebrun, D

    1977-08-26

    The mandibular glands of Kalotermes were examined in different castes. They show sexual dimorphism in the soldiers and primary reproductives, Moreover, in female soldiers and queens, mandibular gland cells contained numerous crystalline structures of mitochondrial origin. The role of these glands (secretion of saliva or pheromone) is discussed. PMID:922809

  3. Complete denture covering mandibular tori using three base materials: a case report.

    PubMed

    Abrams, S

    2000-10-01

    The torus mandibularis presents many challenges when fabricating a complete denture. The mucosa tends to be thin and will not tolerate normal occlusal loads on a denture. Large mandibular tori can prevent complete seating of impression trays and denture. To address this problem, we fabricated a new mandibular complete denture incorporating a combination of soft acrylic flanges and liners. PMID:11070628

  4. Congenital deformities and developmental abnormalities of the mandibular condyle in the temporomandibular joint.

    PubMed

    Kaneyama, Keiseki; Segami, Natsuki; Hatta, Toshihisa

    2008-09-01

    The temporomandibular joint (TMJ) consists of the mandibular condyle and the articular eminence of the temporal bone. The morphological development of the TMJ during prenatal life lags behind other joints in terms of both the timing of its appearance and its progress. At birth, the joint is still largely underdeveloped. There are many causes of the various growth disturbances and abnormalities of the mandibular condyle and related structures. Growth disturbances in the development of the mandibular condyle may occur in utero late in the first trimester and may result in disorders such as aplasia or hypoplasia of the mandibular condyle. Meanwhile, hyperplasia of the mandibular condyle is not visible at birth and seems to be gradually acquired during growth. In the present review article, the congenital abnormalities of the mandibular condyle are classified morphologically into three major groups and two subgroups from a clinical standpoint: (1) hypoplasia or aplasia of the mandibular condyle, including (i) primary condylar aplasia and hypoplasia, (ii) secondary condylar hypoplasia; (2) hyperplasia; and (3) bifidity. In addition, the molecular-based etiology of anomalies of the mandibular condyle is also discussed. PMID:18778456

  5. Split-frame implant prosthesis designed to compensate for mandibular flexure: a clinical report.

    PubMed

    Paez, Carmen Yamily; Barco, Thomas; Roushdy, Sally; Andres, Carl

    2003-04-01

    When an edentulous mandible is restored with 4 or more implants connected by a metal bar and retained with screws, mandibular flexure may cause screw loosening and unnecessary stresses and strains on the prosthesis and implants. Separating the prosthesis at the midline can relieve these stresses and strains. This article describes the separation of a hybrid mandibular denture at the midline. PMID:12690344

  6. The mechanical significance of morphological variation in the macaque mandibular symphysis during mastication.

    PubMed

    Panagiotopoulou, Olga; Cobb, Samuel N

    2011-10-01

    Catarrhine symphyseal morphology displays considerable variation. Although this has been related to dentition, phylogeny, sexual dimorphism, and facial orientation, most emphasis has been given to the functional significance of the symphysis to mechanical loading during mastication. The current state of knowledge regarding the mechanical significance of the symphysis is based on a combination of in vivo experimental and comparative studies on Macaca fascicularis. These approaches have provided considerable insight into the stereotypical patterns of loading in the symphyseal region during chewing and hypotheses related to the associated symphyseal morphologies. Finite element analysis (FEA) was used to assess how in silico manipulation translates into the mechanical loading hypotheses previously proposed experimentally. In particular, this study tests the form-function relationship of the symphysis of an adult M. fascicularis mandible during lateral transverse bending and dorsoventral shear of the mandibular symphysis, and a series of modified hypothetical morphologies including absence/presence of tori and variation in the inclination and depth of the symphysis. FEA results of this study support previous findings that stresses associated with lateral transverse bending and dorsoventral shear of the mandibular symphysis can be minimized via an increased labio-lingual thickness in the superior transverse torus, an oblique symphyseal inclination, and/or an increased symphyseal depth. The finding that reduction of strains related to lateral transverse bending and dorsoventral shear can be achieved through a number of different morphologies contributes to our understanding of the influence of morphological and/or developmental constraints, such as dental development, on symphyseal form. PMID:21826640

  7. A three-dimensional analysis of soft and hard tissue changes after a mandibular setback surgery.

    PubMed

    Kim, Nam-Kug; Lee, Cheol; Kang, Suk-Ho; Park, Jae-Woo; Kim, Myung-Jin; Chang, Young-Il

    2006-09-01

    This paper is concerned with a three-dimensional (3D) analysis on soft and hard tissue changes after mandibular setback surgery. For comparing with previous two-dimensional (2D) cephalometric data, we proposed a three-dimensional registration and analysis method based on the cephalometric knowledge. The 3D changes of bone, soft tissue and the ratio of soft tissue to bony movement were investigated in eight skeletal class III mandibular prognathism patients. CT scans of each patient were taken at pre- and post-operative states. Each scan was registered to a universal 3D coordinate system defined by cephalometric landmarks. A grid, parallel to the coronal plane, was also designed for the comparison of the changes. The bone and soft tissue was intersected by the projected line from each point on the grid. The coordinate values of intersected point were measured and compared between the pre- and post-operative models. In addition, the reproducibility of the universal coordinate system and the grid was evaluated. The facial surface changes after setback surgery occurred not only in the mandible but also in the mouth corner region. The soft tissue changes of the mandible were measured relatively by the proportional ratios to the bone changes. The ratios at the mid-sagittal plane were 77-102% (p<0.05). The ratios at all other sagittal planes had similar patterns to the mid-sagittal plane with decreased values. All the results conformed to the previous 2D based clinical knowledge and instinct of orthodontists. It is expected that the proposed approach would be applicable to other oral and maxillofacial surgeries as well as plastic surgeries. PMID:16919839

  8. Treatment of extensive comminuted mandibular fracture between both mandibular angles with bilateral condylar fractures using a reconstruction plate: a case report

    PubMed Central

    Lee, Kwonwoo; Yoon, Kyuho; Cheong, Jeongkwon; Shin, Jaemyung; Bae, Jungho; Ko, Inchan; Park, Hyungkoo

    2014-01-01

    This following case report describes the open reduction, internal fixation and the reconstruction of an extensive comminuted mandibular fracture with bilateral condylar fractures in a 19-year-old male patient with an intellectual disability and autistic disorder. He suffered fall trauma, resulting in shattered bony fragments of the alveolus and mandibular body between both mandibular rami, the fracture of both condyles and the avulsion or dislocation of every posterior tooth of the mandible. The patient underwent open reduction and internal fixation between both mandibular rami using a reconstruction plate, open reduction and internal fixation of the shattered fragments using miniplates and screws, and the closed reduction of the bilateral condylar fractures. PMID:25045641

  9. Pamidronate Affects the Mandibular Cortex of Children with Osteogenesis Imperfecta

    PubMed Central

    Apolinário, A.C.; Figueiredo, P.T.; Guimarães, A.T.; Acevedo, A.C.; Castro, L.C.; Paula, A.P.; Paula, L.M.; Melo, N.S.; Leite, A.F.

    2015-01-01

    We hypothesized that mandibular cortical width (MCW) is smaller in children with osteogenesis imperfecta (OI) than in healthy children and that pamidronate can improve the cortical mandibular thickness. The aim of this study was to assess changes in the MCW on dental panoramic radiographs (DPRs) of children with normal bone mineral density (BMD) and with OI. We also compared the MCW of children with different types of OI regarding the number of pamidronate cycles and age at the beginning of treatment. MCW measurements were retrospectively obtained from 197 DPRs of 66 children with OI types I, III, and IV who were in treatment with a comparable dosage of cyclical intravenous pamidronate between 2007 and 2013. The control group had 92 DPRs from normal BMD children. Factorial analysis of variance was used to compare MCW measurements among different age groups and between sexes and also to compare MCW measurements of children with different types of OI among different pamidronate cycles and age at the beginning of treatment. No significant differences in results were found between male and female subjects in both OI and healthy children, so they were evaluated altogether (P > 0.05). There was an increase of MCW values related to aging in all normal BMD and OI children but on a smaller scale in children with OI types I and III. Children with OI presented lower mean MCW values than did children with normal BMD at the beginning of treatment (P < 0.05). A linear model estimated the number of pamidronate cycles necessary to achieve mean MCW values equivalent to those of healthy children. The thinning of the mandibular cortex depended on the number of pamidronate cycles, the type of OI, and the age at the beginning of treatment. DPRs could thus provide a way to identify cyclic pamidronate treatment outcomes in patients with OI. PMID:25608973

  10. Asymmetric muscle function in patients with developmental mandibular asymmetry.

    PubMed

    Dong, Y; Wang, X M; Wang, M Q; Widmalm, S E

    2008-01-01

    The aim was to test the hypothesis that developmental mandibular asymmetry is associated with increased asymmetry in muscle activity. Patients with mandibular condylar and/or ramus hyperplasia having unilateral cross-bite were compared with healthy subjects with normal occlusion. Muscle activity was recorded with surface electrodes in the masseter, suprahyoid, sternocleidomastoid muscle (SCM) and upper trapezius areas during jaw opening-closing-clenching, head-neck flexion-extension, and elevation-lowering of shoulders. Root mean square (RMS) and mean power frequency (MPF) values were calculated and analysed using anova and t-tests with P < 0.05 chosen as significance level. The SCM and masseter muscles showed co-activation during jaw and head movements, significantly more asymmetric in the patients than in the healthy subjects. The RMS and MPF values were higher in the patients than in the controls in the SCM and suprahyoid areas on both sides during jaw opening-closing movement. The results indicate that the ability to perform symmetric jaw and neck muscle activities is disturbed in patients with developmental mandibular asymmetry. This is of clinical interest because asymmetric activity may be an etiologic factor in temporomandibular joint and cervical pain. The results support that co-activation occurs between jaw and neck muscles during voluntary jaw opening and indicate that postural antigravity reflex activity occurs in the masseter area during head extension. Further studies, where EMG recordings are made from the DMA patients at early stages are motivated to verify activity sources and test if the asymmetric activity is associated with muscle and joint pain in the jaw and cervical areas. PMID:18190358

  11. Attachment systems for mandibular implant overdentures: a systematic review

    PubMed Central

    Kim, Ha-Young; Lee, Jeong-Yol; Bryant, S. Ross

    2012-01-01

    PURPOSE The aim of this systematic review was to address treatment outcome according to attachment systems for mandibular implant overdentures in terms of implant survival rate, prosthetic maintenance and complications, and patient satisfaction. MATERIALS AND METHODS A systematic literature search was conducted using PubMed and hand searching of relevant journals considering inclusion and exclusion criteria. Clinical trial studies on mandibular implant overdentures until August, 2010 were selected if more than one type of overdenture attachment was reported. Twenty four studies from 1098 studies were finally included and the data on implant survival rate, prosthetic maintenance and complications, patient satisfaction were analyzed relative to attachment systems. RESULTS Four studies presented implant survival rates (95.8 - 97.5% for bar, 96.2 - 100% for ball, 91.7% for magnet) according to attachment system. Ten other studies presented an implant survival rate ranging from 93.3% to 100% without respect to the attachment groups. Common prosthetic maintenance and complications were replacement of an assay for magnet attachments, and activation of a matrix or clip for ball or bar attachments. Prosthetic maintenance and complications most commonly occurred in the magnet groups. Conflicting findings were found on the rate of prosthetic maintenance and complications comparing ball and bar attachments. Most studies showed no significant differences in patient satisfaction depending upon attachment systems. CONCLUSION The implant survival rate of mandibular overdentures seemed to be high regardless attachment systems. The prosthetic maintenance and complications may be influenced by attachment systems. However patient satisfaction may be independent of the attachment system. PMID:23236571

  12. Mandibular nerve schwannoma resection using sagittal split ramus osteotomy.

    PubMed

    Mahmood, Laith; Demian, Nagi; Weinstock, Yitzchak E; Weissferdt, Annikka

    2013-11-01

    A case is presented of a unique presentation and treatment of a mandibular nerve schwannoma. Its uniqueness stems from the fact that it consisted of 2 distinct tumors along the same nerve: one within the body of the mandible and the other within the ipsilateral pterygomandibular space. Rather than the standard approach of lip split and hemimandibulectomy, a unique approach of a sagittal split ramus osteotomy was used that allowed access to the 2 lesions and avoided the added morbidity of the former approach. The 2 portions of the lesion were successfully removed and the patient was satisfied with the result. Recurrence has not been detected after 6 months. PMID:23891013

  13. Tuberculous osteomyelitis of mandibular condyle: A rare encounter.

    PubMed

    Kumar, Sanjay; Mohan, S; Lav, Rupali; John, Bobby

    2015-01-01

    Tuberculosis (TB), one of the oldest known microbial infectious diseases affecting humans has continued to burden our healthcare system over generations. Conventionally, primary TB usually manifests as a pulmonary infection. However, the last decade has witnessed increasing reports of extrapulmonary infections. It's often atypical clinical presentations require a high degree of clinical suspicion, especially in the developing countries with a high incidence of this infectious disease. In this report, we present one such case of tuberculous osteomyelitis of the mandibular condyle where the patient reported with the complaint of swelling on the left side of the face with no apparent systemic manifestation. PMID:27390500

  14. MANDIBULAR SQUAMOUS CELL CARCINOMA IN A BOBCAT (LYNX RUFUS).

    PubMed

    Sladakovic, Izidora; Burnum, Anne; Blas-Machado, Uriel; Kelly, Lisa S; Garner, Bridget C; Holmes, Shannon P; Divers, Stephen J

    2016-03-01

    A 23-yr-old female spayed bobcat (Lynx rufus) presented with a 1-wk history of hypersalivation. On examination, the right mandible was markedly thickened, the right mandibular dental arcade was missing, and the oral mucosa over the right mandible was ulcerated and thickened. Skull radiographs and fine needle aspirate cytology were supportive of squamous cell carcinoma. The bobcat was euthanized as a result of its poor prognosis. Necropsy confirmed a diagnosis of oral squamous cell carcinoma of the mandible. To the authors' knowledge, this is the first report of oral squamous cell carcinoma in a bobcat. PMID:27010306

  15. Mandibular Movements Identify Respiratory Effort in Pediatric Obstructive Sleep Apnea

    PubMed Central

    Martinot, Jean-Benoît; Senny, Fréderic; Denison, Stéphane; Cuthbert, Valérie; Gueulette, Emmanuelle; Guénard, Hervé; Pépin, Jean-Louis

    2015-01-01

    Study Objectives: Obstructive sleep apnea-hypopnea (OAH) diagnosis in children is based on the quantification of flow and respiratory effort (RE). Pulse transit time (PTT) is one validated tool to recognize RE. Pattern analysis of mandibular movements (MM) might be an alternative method to detect RE. We compared several patterns of MM to concomittant changes in PTT during OAH in children with adenotonsillar hypertrophy. Methods: Participants: 33 consecutive children with snoring and symptoms/signs of OAH. Measurements: MMs were measured during polysomnography with a magnetometer device (Brizzy Nomics, Liege, Belgium) placed on the chin and forehead. Patterns of MM were evaluated representing peak to peak fluctuations > 0.3 mm in mandibular excursion (MML), mandibular opening (MMO), and sharp MM (MMS), which closed the mouth on cortical arousal (CAr). Results: The median (95% CI) hourly rate of at least 1 MM (MML, or MMO, or MMS) was 18.1 (13.2–36.3) and strongly correlated with OAHI (p = 0.003) but not with central apnea-hypopnea index (CAHI; p = 0.292). The durations when the MM amplitude was > 0.4 mm and PTT > 15 ms were strongly correlated (p < 0.001). The mean (SD) of MM peak to peak amplitude was larger during OAH than CAH (0.9 ± 0.7 mm and 0.2 ± 0.3 mm; p < 0.001, respectively). MMS at the termination of OAH had larger amplitude compared to MMS with CAH (1.5 ± 0.9 mm and 0.5 ± 0.7 mm, respectively, p < 0.001). Conclusions: MM > 0.4 mm occurred frequently during periods of OAH and were frequently terminated by MMS corresponding to mouth closure on CAr. The MM findings strongly correlated with changes in PTT. MM analysis could be a simple and accurate promising tool for RE characterization and optimization of OAH diagnosis in children. Citation: Martinot JB, Senny F, Denison S, Cuthbert V, Gueulette E, Guénard H, Pépin JL. Mandibular movements identify respiratory effort in pediatric obstructive sleep apnea. J Clin Sleep Med 2015;11(5):567–574. PMID

  16. Histological evaluation of mandibular third molar roots retrieved after coronectomy.

    PubMed

    Patel, Vinod; Sproat, Chris; Kwok, Jerry; Beneng, Kiran; Thavaraj, Selvam; McGurk, Mark

    2014-05-01

    There is a resurgence of interest in coronectomy for the management of mandibular third molars because it has a low risk of injury to the inferior dental nerve. However, there is concern that the root that is left in place will eventually become a source of infection. We describe the histological evaluation of 26 consecutive symptomatic coronectomy roots in 21 patients. All roots had vital tissue in the pulp chamber and there was no evidence of periradicular inflammation. Persistent postoperative symptoms related predominantly to inflammation of the soft tissue, which was caused by partially erupted roots or failure of the socket to heal. PMID:24684971

  17. Anaplastic mandibular carcinoma in a meerkat (Suricata suricatta).

    PubMed

    Dadone, Liza I; Garner, Michael M; Klaphake, Eric; Johnston, Matthew S; Han, Sushan

    2014-06-01

    An 8-yr-old female slender-tailed meerkat (Suricata suricatta) presented with a necrotic sublingual mass and osteolysis of the mandible. After 1 mo of palliative care, the meerkat was euthanized. The mass was diagnosed histologically as an anaplastic carcinoma with extensive rostral mandibular destruction. Immunohistochemistry for vimentin and cytokeratin was validated in this nontypical species and showed that neoplastic cells expressed both mesenchymal and epithelial characteristics, suggestive of a primitive and poorly differentiated tumor. A review of 150 adult slender-tailed meerkat histopathology reports showed a 2% prevalence of orofacial neoplasia, suggesting that oral neoplasms are uncommon in meerkats. PMID:25000710

  18. Taxonomic and functional implications of mandibular scaling in early hominins.

    PubMed

    Wood, B; Aiello, L C

    1998-04-01

    Body mass estimates for fossil hominin taxa can be obtained from suitable postcranial and cranial variables. However, the nature of the taphonomic processes that winnow the mammalian fossil record are such that these data are usually only available for the minority of the specimens that comprise the hypodigm of a species. This study has investigated the link between species mean body mass and the height and width of the mandibular corpus in a core sample of 23 species of extant simians. The slopes of the least-squares regressions for the whole sample and for the hominoid subset are similar. However, the intercepts differ so that for a given body mass, a hominoid will generally have a smaller mandible than a generalized simian. The same mandibular measurements were taken on 75 early hominin mandibles assigned to eight species groups. When mandibular corpus height- and width-derived estimates of body mass for the fossil taxa were compared with available postcranial and cranial-derived body mass estimates, the eight early hominin species sort into four groups. The first, which includes A. afarensis and A. africanus, has mandibles which follow a "generalized simian" scaling relationship. The second group, which comprises the two "robust" australopithecine species, P. boisei and P. robustus, has mandibles which scale with body mass as if they are "super-simians," for they have substantially larger mandibles than a simian with the same body mass. The two "early Homo" species, H. habilis sensu stricto and H. rudolfensis, make up the third group. It has mandibular scaling relationships that are intermediate between that of the comparative simian sample and that of the hominoid subsample. The last of the four groups comprises H. ergaster and H. erectus; their mandibles scale with body mass as if they were hominoids, so that of the four groups they have the smallest mandibles per unit body mass. These results are related to comparable information about relative tooth size

  19. Incidental Anterior Cruciate Ligament Calcification: Case Report

    PubMed Central

    Hayashi, Hisami; Fischer, Hans

    2016-01-01

    The calcification of knee ligaments is a finding noted only in a handful of case reports. The finding of an anterior cruciate ligament calcification has been reported once in the literature. Comparable studies involving the posterior cruciate ligament, medial collateral ligament and an ossicle within the anterior cruciate ligament are likewise discussed in reports of symptomatic patients. We report a case of incidentally discovered anterior cruciate ligament calcification. We discuss the likely etiology and clinical implications of this finding. PMID:27200163

  20. Zygomatic Anterior Subtemporal Approach for Lesions in the Interpeduncular Cistern

    PubMed Central

    Deda, Haluk; Ugur, Hasan Çaglar

    2001-01-01

    The interpeduncular cistern is a difficult region to approach through conventional methods due to its deep location and important adjacent neurovascular structures. Therefore, it is usually difficult to expose the region sufficiently. Technical problems associated with various surgical approaches have led to emergence of combined approaches and their modifications (i.e., the removal of the zygomatic arch). In addition, a frontotemporal craniotomy is reported to provide a wide exposure of the anterior temporal base, thus allowing oblique access to the interpeduncular cistern with minimal brain retraction. This study describes clinicians' experience and the surgical results of 24 patients who underwent a zygomatic anterior subtemporal approach. ImagesFigure 1Figure 2 PMID:17167628