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Sample records for mandibular anterior region

  1. Relevance of anterior mandibular body ostectomy in mandibular prognathism

    PubMed Central

    Bansal, Pankaj; Singh, Virender; Anand, S. C.; Bansal, Sumidha

    2013-01-01

    Purpose: We tried to find out the relevance of anterior mandibular body ostectomy in deformities of the mandible specially prognathism, which is primarily limited to anterior part only. Patients and Methods: Ten patients with skeletal deformity along with malocclusion, which was limited to anterior body of mandible were selected. Selected patients had proper molar interdigitation (even if class 3) and in general had anterior crossbite (except one). All patients had crossed their growth spurts and had no hormonal influence on facial deformity. Specific protocol, including cephelometric analysis cephalometry for orthognathic surgery, prediction tracing and model surgeries were devised. Pre and post-surgical orthodontics and body ostectomy were performed in all patients along with 18-month post-op follow-up. Results: There was significant reduction in prognathism and horizontal dysplasia in all ten patients. Anterior crossbite as well as axis of incisiors over mandibular plane was corrected in all patients due to decrease in length of mandibular body. All patients showed decreased facial height and better lip competence with intact posterior occlusion and no (negligible or transient) sensory loss. Conclusions: Our study could confirm that people whose deformity is limited to the anterior part of mandible with reasonable occlusion posteriorly can get satisfactory cosmetic and functional results through body ostectomy alone rather than going for surgical procedure in the ramal area, which is liable to cause sensory and occlusal disturbances. PMID:24163554

  2. Dynamic relationships of the mandibular anterior segment.

    PubMed

    Braun, S; Hnat, W P

    1997-05-01

    The hyperbolic cosine function is shown to be an accurate representation of the form of the mandibular anterior teeth from the canine/first premolar contact on one side around the perimeter to the opposite side (r = 0.951). On the basis of this mathematical function, the changes in canine width, anterior segment depth, arch perimeter, and their related incisor angular alterations are forecastable. This knowledge will allow the clinician to predict the effects on various aspects of the anterior segment arch form as one or more of these variables are altered without resorting to trial and error or performing a wax-up. For example, the clinician can predict the change in the anterior segment arch depth and incisor angulation that would occur with alterations in canine width.

  3. 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

  4. 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

  5. An overlay partial denture to restore worn mandibular anterior teeth.

    PubMed

    Samant, Asha; DeSciscio, Peter

    2014-01-01

    Restoring worn anterior mandibular teeth is a challenge, especially when teeth are small, esthetics are a concern, the long-term prognosis is questionable, and/or patient finances are an issue. This article describes an alternate treatment for a patient with a collapsed bite, missing posterior mandibular teeth, an ill-fitting complete maxillary denture with poor esthetics, and irregular, worn mandibular anterior teeth.

  6. 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

  7. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    PubMed Central

    Nejaim, Yuri; de Freitas, Deborah Queiroz; de Oliveira Santos, Christiano

    2016-01-01

    Purpose The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Materials and Methods Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. Results In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. Conclusion CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region. PMID:27672611

  8. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    PubMed Central

    Nejaim, Yuri; de Freitas, Deborah Queiroz; de Oliveira Santos, Christiano

    2016-01-01

    Purpose The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Materials and Methods Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. Results In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. Conclusion CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region.

  9. [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

  10. [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.

  11. Anesthetic efficacy of infiltrations in mandibular anterior teeth.

    PubMed Central

    Yonchak, T.; Reader, A.; Beck, M.; Clark, K.; Meyers, W. J.

    2001-01-01

    The purpose of this prospective, randomized, double-blind study was to measure the degree of anesthesia obtained with a labial infiltration of either 2% lidocaine with 1:50,000 or 2% lidocaine with 1:100,000 epinephrine in mandibular anterior teeth. Another objective was to measure the degree of anesthesia obtained with a lingual infiltration of 2% lidocaine with 1:100,000 epinephrine in mandibular anterior teeth. Through use of a repeated-measures design, 40 subjects randomly received a labial infiltration at the lateral incisor apex of either 1.8 mL of 2% lidocaine with 1:100,000 epinephrine or 1.8 mL of 2% lidocaine with 1:50,000 epinephrine at 2 separate appointments. An additional 40 subjects received a lingual infiltration at the lateral incisor apex of 1.8 mL of 2% lidocaine with 1:100,000 epinephrine. The mandibular anterior teeth were blindly pulp tested at 4-minute cycles for 60 minutes postinjection. No response from the subject to the maximum output (80 reading) of the pulp tester was used as the criterion for pulpal anesthesia. Anesthesia was considered successful when 2 consecutive 80 readings were obtained. For the 3 infiltrations, success rates for the lateral incisor ranged from 43 to 50%. Adjacent teeth had success rates of 27 to 63%. There was no significant difference (P > 0.05) in success between the labial infiltration of 2% lidocaine with 1:100,000 epinephrine and 2% lidocaine with 1:50,000 epinephrine or the lingual infiltration of 2% lidocaine with 1:100,000 epinephrine when compared with the labial infiltration of 2% lidocaine with 1:100,000 epinephrine. Duration of pulpal anesthesia declined steadily for all solutions over the 60 minutes. In conclusion, the success rate of 43-50% and declining duration of pulpal anesthesia over an hour indicates that a labial infiltration of 1.8 mL of either 2% lidocaine with 1:100,000 epinephrine or 1: 50,000 epinephrine or a lingual infiltration of 2% lidocaine with 1:100,000 epinephrine over the

  12. Segmental resection of the anterior mandibular arch with fibular microvascular reconstruction.

    PubMed

    Dierks, E J; Karakourtis, M H

    1997-09-01

    Segmental mandibular resection should be undertaken if there is a demonstrable invasion by cancer or if such invasion is suspected. Before the advent of microvascular free flaps, immediate osseous reconstruction of the anterior mandible was technically demanding and unreliable. Mandibular reconstruction with microvascular free flaps is no longer a novelty, nor is it reserved for unusually large resections. It has become the method of choice for the immediate reconstruction of defects resulting from mandibular cancer. This technique is particularly well-suited for defects of the anterior mandibular arch.

  13. Esthetic and functional rehabilitation of crowded mandibular anterior teeth using ceramic veneers: a case report.

    PubMed

    de Andrade, Oswaldo Scopin; Ferreira, Luiz Alves; Hirata, Ronaldo; Rodrigues, Flavia Pires; D'Alpino, Paulo Henrique Perlatti; Di Hipolito, Vinicius

    2012-09-01

    The use of ceramic veneers to restore crowded teeth in the maxilla has been widely discussed in the literature. However, the use of this technique in the mandible has received little attention. Therefore, this case report describes the treatment of crowded mandibular anterior teeth using ceramic veneers. The primary treatment challenge in this region is the reduced tooth structure available for rehabilitation. Proper communication between the clinician and dental technician is required to achieve clinical success. This article presents a straightforward treatment plan and restorative technique that includes both the clinical and laboratory sequences necessary for predictable and stable postoperative outcomes.

  14. 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

  15. 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

  16. 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.

  17. 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

  18. Clinical evaluation of inferior alveolar nerve block by injection into the pterygomandibular space anterior to the mandibular foramen.

    PubMed Central

    Takasugi, Y.; Furuya, H.; Moriya, K.; Okamoto, Y.

    2000-01-01

    The conventional inferior alveolar nerve block (conventional technique) has potential risks of neural and vascular injuries. We studied a method of inferior alveolar nerve block by injecting a local anesthetic solution into the pterygomandibular space anterior to the mandibular foramen (anterior technique) with the purpose of avoiding such complications. The insertion angle of the anterior technique and the estimation of anesthesia in the anterior technique were examined. The predicted insertion angle measured on computed tomographic images was 60.1 +/- 7.1 degrees from the median, with the syringe end lying on the contralateral mandibular first molar, and the insertion depth was approximately 10 mm. We applied the anterior technique to 100 patients for mandibular molar extraction and assessed the anesthetic effects. A success rate of 74% was obtained. This is similar to that reported for the conventional technique but without the accompanying risks for inferior alveolar neural and vascular complications. Images Figure 2 PMID:11432177

  19. Comparative anatomic study of mandibular growth in rats after bilateral resections of superficial masseter, posterior temporal, and anterior digastric muscles.

    PubMed

    Lifshitz, J

    1976-01-01

    Bilateral resections of the superficial masseter, posterior temporal, and anterior digastric muscles of rats were done to determine their effects on mandibular growth. The macroscopic findings support the functional matrix theory of mandibular growth. The analysis of body weight and the statistical two-way analysis of variance done suggest that malnutrition was the main factor that caused the mandibles of rats in the experimental groups of remain undersized.

  20. 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

  1. 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

  2. The evaluation of direct composite restorations for the worn mandibular anterior dentition - clinical performance and patient satisfaction.

    PubMed

    Poyser, N J; Briggs, P F A; Chana, H S; Kelleher, M G D; Porter, R W J; Patel, M M

    2007-05-01

    This prospective split-mouth clinical trial evaluated the performance and patient satisfaction of 168 Herculite XRV direct composite restorations bonded to the worn anterior dentition of 18 patients with localized anterior tooth surface loss. One hundred and six of these restorations were placed on the mandibular anterior teeth. The restorations increased the anterior occlusal vertical dimension between 0.5 and 5 mm and the posterior occlusal contacts were restored after a mean duration of 6.2 months (range: 3-13 months) in 14 out of the 15 'Dahl' sub-group patients. The restorations were evaluated after 2.5 years of service by five examiners. Four patients and 23 mandibular restorations were lost to follow-up. Multiple clinical and restorative variables were assessed to determine their influence on restoration performance. Complete failure occurred in 6% of the restorations. Circumferential preparation and height of the restorative addition did not influence the performance of the restorations. A Visual Analogue Scale (VAS) was used to assess the patient's opinion regarding sensitivity, aesthetics, longevity and function of the worn mandibular anterior teeth. A statistically significant difference (95% CI) was found between the pre-operative and 1-month review VAS responses for aesthetics and longevity and this was maintained at the 2.5-year review. Direct composite restorations placed at an increased occlusal vertical dimension are a simple and time-efficient method of managing the worn mandibular anterior dentition. Patient's acceptance and adaptation to the technique is good and the results are accompanied with a high level of patient satisfaction that is maintained for the medium-term.

  3. Anesthetic efficacy of an infiltration in mandibular anterior teeth following an inferior alveolar nerve block.

    PubMed Central

    Clark, Kenneth; Reader, Al; Beck, Mike; Meyers, William J.

    2002-01-01

    The purpose of this prospective, randomized, blinded study was to measure the degree of pulpal anesthesia obtained with an inferior alveolar nerve (IAN) block followed by an infiltration in mandibular anterior teeth. Through use of a repeated-measures design, 40 patients randomly received 3 injection combinations at 3 separate appointments: an IAN block followed by a mock lingual infiltration and a mock labial infiltration, an IAN block followed by a mock lingual infiltration and a labial infiltration, and an IAN block followed by a mock labial infiltration and a lingual infiltration. Each IAN block used 3.6 mL of 2% lidocaine with 1:100,000 epinephrine, and each infiltration used 1.8 mL of 2% lidocaine with 1:100,000 epinephrine administered over the lateral incisor apex. Mandibular anterior teeth were blindly pulp tested at 2-minute cycles for 60 minutes following the IAN-infiltration injections. No response from the patient to the maximum output (80 reading) of the pulp tester was used as the criterion for pulpal anesthesia. Anesthesia was considered successful when 2 consecutive 80 readings were obtained within 15 minutes and the 80 reading was sustained for 60 minutes. Anesthesia was considered a failure if 2 consecutive 80 readings were not obtained during the 60 minutes. The results of this study showed that 100% of the patients had lip numbness with all IAN blocks. For the lateral incisor, the success rate of the IAN block alone was 40% and the failure rate was 30%. For the IAN block plus labial infiltration, the success rate was 62% and the failure rate was 12% for the lateral incisor. There was a significant difference (P < .05) between the IAN block alone and the IAN block plus labial infiltration. In conclusion, a labial infiltration, over the lateral incisor apex, of 1.8 mL of 2% lidocaine with 1:100,000 epinephrine following an IAN block significantly improved pulpal anesthesia for the lateral incisor compared with the IAN block alone. PMID:15384292

  4. Biomechanical Evaluation of Different Fixation Methods for Mandibular Anterior Segmental Osteotomy Using Finite Element Analysis, Part One: Superior Repositioning Surgery.

    PubMed

    Kilinç, Yeliz; Erkmen, Erkan; Kurt, Ahmet

    2016-01-01

    The aim of the current study was to comparatively evaluate the mechanical behavior of 3 different fixation methods following various amounts of superior repositioning of mandibular anterior segment. In this study, 3 different rigid fixation configurations comprising double right L, double left L, or double I miniplates with monocortical screws were compared under vertical, horizontal, and oblique load conditions by means of finite element analysis. A three-dimensional finite element model of a fully dentate mandible was generated. A 3 and 5 mm superior repositioning of mandibular anterior segmental osteotomy were simulated. Three different finite element models corresponding to different fixation configurations were created for each superior repositioning. The von Mises stress values on fixation appliances and principal maximum stresses (Pmax) on bony structures were predicted by finite element analysis. The results have demonstrated that double right L configuration provides better stability with less stress fields in comparison with other fixation configurations used in this study.

  5. 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.

  6. 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. PMID:27630964

  7. Angiosarcoma of Anterior Mandibular Gingiva Showing Recurrence - A Case Report with Immunohistochemistry.

    PubMed

    Hunasgi, Santosh; Koneru, Anila; Vanishree, M; Manvikar, Vardendra

    2016-07-01

    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 17(th) case report of angiosarcoma arising in anterior mandiblular gingiva. PMID:27630964

  8. Regional odontodysplasia: Report of an unusual case involving mandibular arch

    PubMed Central

    Babu, N. S. Venkatesh; Smriti, R. Jha; Pratima, D. Bang

    2015-01-01

    Regional odontodysplasia (RO) is a rare developmental anomaly involving both mesodermal and ectodermal components in primary or permanent dentition. It affects the maxilla and the mandible or both; however, maxilla is more commonly involved. This article reports the case of 33-month-old boy who came with the chief complaint of delayed eruption of mandibular teeth. Findings of clinical and radiographic examination were consistent with those of RO. Maxillary dentition was unaffected. Clinical and radiographic features and treatment options are discussed. PMID:26097362

  9. Mandibular Range of Movement and Pain Intensity in Patients with Anterior Disc Displacement without Reduction

    PubMed Central

    Alajbeg, Iva Z.; Gikić, Marijana; Valentić-Peruzović, Melita

    2015-01-01

    Objective Temporomandibular disorders (TMD) are the most common source of orofacial pain of a non-dental origin. The study was performed to investigate the therapeutic effect of the conventional occlusal splint therapy and the physical therapy. The hypothesis tested was that the simultaneous use of occlusal splint and physical therapy is an effective method for treatment of anterior disc displacement without reduction. Materials and Methods Twelve patients (mean age =30.5 y) with anterior disc displacement without reduction (according to RDC/TMD and confirmed by magnetic resonance imaging) were randomly allocated into 2 groups: 6 received stabilization splint (SS) and 6 received both physical therapy and stabilization splint (SS&PT). Treatment outcomes included pain-free opening (MCO), maximum assisted opening (MAO), path of mouth opening and pain as reported on visual analogue scale (VAS). Results At baseline of treatment there were no significant differences among the groups for VAS scores, as well as for the range of mandibular movement. VAS scores improved significantly over time for the SS&PT group (F=28.964, p=0.0001, effect size =0.853) and SS group (F=8.794, p=0.001, effect size =0.638). The range of mouth opening improved significantly only in the SS&PT group (MCO: F=20.971, p=0.006; MAO: F=24.014, p=0.004) (Figure 2). Changes in path of mouth opening differ significantly between the groups (p=0.040). Only 1 patient in SS&PT group still presented deviations in mouth opening after completed therapy while in the SS group deviations were present in 5 patients after completed therapy. Conclusion This limited study gave evidence that during the treatment period lasting for 6 months, the simultaneous use of stabilization splint and physical therapy was more efficient in reducing deviations and improving range of mouth opening than the stabilization splint used alone. Both treatment options were efficient in reducing pain in patients with anterior disc

  10. Single implant in the mandibular molar region of edentulous patient.

    PubMed

    Zhai, Jun-Jiang; Wen, Cai; Teng, Ming-Hua; Liang, Xing

    2013-09-01

    Implant-retained overdentures are a valid treatment option for edentulous patients, especially for patients with severe alveolar ridge atrophy. A central single implant is considered adequate to retain an overdenture in the edentulous mandible. However, for some patients, there is no sufficient bone height, or width in the interforaminal region of the mandible for insertion of the implant. This case report illustrates that the insertion of a single implant in the mandibular molar region might stabilize the prosthesis, and might improve the oral health-related quality of life and chewing function. A Locator attachment was used in this case to retain the overdenture. The one-year clinical results are promising. However, long-term clinical results and randomized clinical trials are needed before this method can be widely used in clinical application.

  11. Class I malocclusion treatment: influence of a missing mandibular incisor on anterior guidance.

    PubMed

    Barros, Sérgio Estelita C; Janson, Guilherme; Torres, Fernando César; de Freitas, Marcos Roberto; de Almeida, Renato Rodrigues

    2010-07-01

    This case report describes the orthodontic treatment of a patient with a deep-overbite Angle Class I malocclusion, agenesis of a mandibular central incisor, and 2 supernumerary teeth, which caused impaction of the mandibular first premolars. The 15-year-old patient also had a convex profile, maxillary dentoalveolar protrusion, and deficiency of space for the correct alignment of teeth. Therefore, treatment consisted of fixed appliance therapy, cervical headgear, extraction of the supernumeraries and the mandibular and maxillary first premolars, and mesiodistal reduction of the maxillary incisors to solve the arch perimeter discrepancy as much as possible with interproximal stripping. This method of treatment significantly improved the patient's facial and dental esthetics and provided a good functional occlusion, despite the absence of a mandibular incisor, which generally impairs achieving adequate incisal guidance.

  12. 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

  13. Supplemental mandibular mesiodens: a diagnostic challenge.

    PubMed

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

    2013-12-01

    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

  14. Root and canal symmetry in the mandibular anterior teeth of patients attending a dental clinic: CBCT study.

    PubMed

    Kayaoglu, Guven; Peker, Ilkay; Gumusok, Mustafa; Sarikir, Cigdem; Kayadugun, Aylin; Ucok, Ozlem

    2015-01-01

    The aims of this study were to evaluate the number of roots/root canals in the mandibular anterior teeth of a Turkish population, to assess the relationship between gender or age and the frequency of two canals in a single root, and to determine the symmetry in root/root canal numbers between contralateral sides among patients. Cone-beam computed tomography images (n = 1128; 6253 teeth) taken at the Department of Dentomaxillofacial Radiology of the Faculty of Dentistry of Gazi University were examined by three observers and a supervisor, all of whom were blinded to patient gender and age. Axial, sagittal, and cross-sectional slices with a thickness of 1 mm were used. Numbers of roots and canals for each type of tooth were recorded. Most teeth had a single root and single root canal. Roots with two canals were more frequent in the incisors (14.9%, 17.2%, and 6.1% of the central incisors, lateral incisors, and canines, respectively). Teeth with two roots were more frequent in the canines (3.1% vs. 0% or 0.1%). Females more often had canines with double root canals (p < 0.001). When at least one tooth had two root canals, bilateral symmetry between contralateral teeth was found in 45.0%, 29.0%, and 28.0% of cases for central incisors, lateral incisors, and canines, respectively. Patients older than 56 years had fewer teeth with double root canals (p ≤ 0.001). A small proportion of the mandibular anterior teeth had two roots or root canals. Double root canals were mostly unilateral. Age and gender were associated with the number of root canals.

  15. Evaluation of the Root and Canal Morphology of Mandibular Permanent Anterior Teeth in an Iranian Population by Cone-Beam Computed Tomography

    PubMed Central

    Aminsobhani, Mohsen; Sadegh, Mona; Meraji, Naghmeh; Razmi, Hasan; Kharazifard, Mohamad Javad

    2013-01-01

    Objective: To evaluate differences in the root and canal configurations of mandibular permanent anterior incisors and canines in an Iranian population by means of Cone Beam CT (CBCT) images. Materials and Methods: Four hundred CBCT images of mandibular permanent incisors and canines that met the inclusion criteria were evaluated. Vertucci’s classification was used to evaluate the number of roots, number of root canals, root lengths, root curvatures and canal types. Results: Totally 632 central incisors, 614 lateral incisors and 608 canines were evaluated. The average length of the mandibular central, lateral incisors and canines was 21.3±0.10, 21.9± 0.13 and 25.1± 0.11 mm, respectively. All of the mandibular central and lateral incisors had one root, but the incidence of single-rooted mandibular canines and two-rooted mandibular canines was 96.3% and 4.7%, respectively. The majority of mandibular central, lateral incisors and canines had one canal (72.7%, 70.6% and 71.8%, respectively). Five types of Vertucci canal configurations were seen in the evaluated teeth. Type 1 Vertucci configuration was the most prevalent configuration (72.3%, 70.6% and 71.8% for the central, lateral incisors and canines, respectively)), and type 5 Vertucci canal configuration was the least prevalent type seen (3.3%, 3.2% and 2.3% for the central, lateral incisors and canines, respectively). The most frequent root curvatures in these teeth were distally and buccally. No significant difference was seen between male and female patients regarding any of the parameters evaluated in this study (p>0.05). Conclusion: More attention should be given to the detection of additional canals and the recognition of canal curvature in Iranian patients. PMID:24396355

  16. 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

  17. Cone beam computed tomographic evaluation of two access cavity designs and instrumentation on the thickness of peri-cervical dentin in mandibular anterior teeth

    PubMed Central

    Varghese, Vinny Sara; George, John V.; Mathew, Sylvia; Nagaraja, Shruthi; Indiresha, H. N.; Madhu, K. S.

    2016-01-01

    Background and Objectives: The aim of the study was to determine the effect of two access cavity designs on the peri-cervical dentin thickness before and after instrumentation using cone beam computed tomography (CBCT). Materials and Methods: Sixty mandibular anterior teeth were divided into two groups of thirty teeth each: Group I: conventional access cavity preparation, where access was prepared just above the cingulum and Group II: incisal access cavity preparation, where access was prepared in proximity to the incisal edge. CBCT scans were taken preoperatively, following access cavity preparation and post instrumentation. 200 μm thick slices were obtained 4mm apical and coronal to the cemento-enamel junction. The peri-cervical dentin thickness was calculated on the facial, lingual, mesial, and distal for all the three obtained scans. Results: The analysis showed that access cavity preparation and instrumentation resulted in a significant loss of tooth structure in Group I on all surfaces, but in Group II, there was a significant loss of tooth structure only in the mesial, lingual, and distal surfaces (P < 0.05). Conclusion: Incisal access cavity preparation resulted in lesser loss of dentin in the peri-cervical region.

  18. Cone beam computed tomographic evaluation of two access cavity designs and instrumentation on the thickness of peri-cervical dentin in mandibular anterior teeth

    PubMed Central

    Varghese, Vinny Sara; George, John V.; Mathew, Sylvia; Nagaraja, Shruthi; Indiresha, H. N.; Madhu, K. S.

    2016-01-01

    Background and Objectives: The aim of the study was to determine the effect of two access cavity designs on the peri-cervical dentin thickness before and after instrumentation using cone beam computed tomography (CBCT). Materials and Methods: Sixty mandibular anterior teeth were divided into two groups of thirty teeth each: Group I: conventional access cavity preparation, where access was prepared just above the cingulum and Group II: incisal access cavity preparation, where access was prepared in proximity to the incisal edge. CBCT scans were taken preoperatively, following access cavity preparation and post instrumentation. 200 μm thick slices were obtained 4mm apical and coronal to the cemento-enamel junction. The peri-cervical dentin thickness was calculated on the facial, lingual, mesial, and distal for all the three obtained scans. Results: The analysis showed that access cavity preparation and instrumentation resulted in a significant loss of tooth structure in Group I on all surfaces, but in Group II, there was a significant loss of tooth structure only in the mesial, lingual, and distal surfaces (P < 0.05). Conclusion: Incisal access cavity preparation resulted in lesser loss of dentin in the peri-cervical region. PMID:27656065

  19. Inferior alveolar nerve block by injection into the pterygomandibular space anterior to the mandibular foramen: radiographic study of local anesthetic spread in the pterygomandibular space.

    PubMed Central

    Okamoto, Y.; Takasugi, Y.; Moriya, K.; Furuya, H.

    2000-01-01

    We studied the spread of local anesthetic solution in the inferior alveolar nerve block by the injection of local anesthetic solution into the pterygomandibular space anterior to the mandibular foramen (anterior technique). Seventeen volunteers were injected with 1.8 mL of a mixture containing lidocaine and contrast medium utilizing the anterior technique. The course of spread was traced by fluoroscopy in the sagittal plane, and the distribution area was evaluated by lateral cephalograms and horizontal computed tomography. The results indicate that the contrast medium mixture spreads rapidly in the pterygomandibular space to the inferior alveolar nerve in the subjects who exhibited inferior alveolar nerve block effect. We concluded that the anesthetic effect due to the anterior technique was produced by the rapid distribution of anesthetic solution in the pterygomandibular space toward the mandibular foramen, and individual differences in the time of onset of analgesia may be due to differences in the histologic perineural tissues. Images Figure 1 Figure 2 Figure 3 PMID:11432178

  20. 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

  1. 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

  2. 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

  3. Capillary Hemangioma in Maxillary Anterior Region: A Case Report

    PubMed Central

    Bhat, Manohar; Maganur, Prabhadevi C; Shah, Parth; Biradar, Vijay

    2014-01-01

    ABSTRACT Hemangiomas are relatively common benign proliferative lesion of vascular tissue origin. They are often present at birth and may become more apparent throughout life. They are seen on facial skin, tongue, lips, buccal mucosa and palate as well as muscles. Hemangiomas occur more common in females than males. This case report presents a case of capillary hemangioma in maxillary anterior region in a 10-year-old boy. How to cite this article: Satish V, Bhat M, Maganur PC, Shah P, Biradar V. Capillary Hemangioma in Maxillary Anterior Region: A Case Report. Int J Clin Pediatr Dent 2014;7(2):144-147. PMID:25356016

  4. 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

  5. Anterior-posterior regionalized gene expression in the Ciona notochord

    PubMed Central

    Veeman, Michael

    2014-01-01

    Background In the simple ascidian chordate Ciona the signaling pathways and gene regulatory networks giving rise to initial notochord induction are largely understood and the mechanisms of notochord morphogenesis are being systematically elucidated. The notochord has generally been thought of as a non-compartmentalized or regionalized organ that is not finely patterned at the level of gene expression. Quantitative imaging methods have recently shown, however, that notochord cell size, shape and behavior vary consistently along the anterior-posterior (AP) axis. Results Here we screen candidate genes by whole mount in situ hybridization for potential AP asymmetry. We identify 4 genes that show non-uniform expression in the notochord. Ezrin/radixin/moesin (ERM) is expressed more strongly in the secondary notochord lineage than the primary. CTGF is expressed stochastically in a subset of notochord cells. A novel calmodulin-like gene (BCamL) is expressed more strongly at both the anterior and posterior tips of the notochord. A TGF-β ortholog is expressed in a gradient from posterior to anterior. The asymmetries in ERM, BCamL and TGF-β expression are evident even before the notochord cells have intercalated into a single-file column. Conclusions We conclude that the Ciona notochord is not a homogeneous tissue but instead shows distinct patterns of regionalized gene expression. PMID:24288133

  6. 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

  7. Evaluating residual dentin thickness following various mandibular anterior tooth preparations for zirconia full-coverage single crowns: an in vitro analysis.

    PubMed

    Borelli, Bruna; Sorrentino, Roberto; Goracci, Cecilia; Amato, Massimo; Zarone, Fernando; Ferrari, Marco

    2015-01-01

    The objective of this study was to evaluate the residual dentin thickness (RDT) after different tooth preparations. Ninety mandibular anterior teeth were divided into three groups: central incisors, lateral incisors, and canines. Specimens were prepared for single-crown coverage with shoulder, slight chamfer, and knife-edge finish lines. Specimens were sectioned and divided into four subgroups according to measurement areas: (1) buccal, (2) distal, (3) lingual, and (4) mesial. The RDT was analyzed statistically by means of one-way analysis of variance and Tukey post hoc test (P = .05). Significant differences were found for shoulder but not for slight chamfer and knife-edge finish lines. The interproximal areas wound up being critical due to thin RDT, potentially interfering with the structural and biologic integrity of teeth.

  8. 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

  9. 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

  10. Multiple mandibular exostoses: a rare case report.

    PubMed

    Bansal, Mansi; Rastogi, Sanjay; Sharma, Anamika

    2013-08-01

    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.

  11. 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

  12. 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.

  13. Antimicrobial prophylaxis in open reduction and internal fixation of compound mandibular fractures: a collaborative regional audit of outcome.

    PubMed

    Singh, Rabindra P; Carter, Lachlan M; Whitfield, Paul H

    2013-07-01

    We conducted a regional 2-stage prospective audit involving 5 different maxillofacial units in the Yorkshire region of the UK to evaluate the effectiveness of perioperative antimicrobial prophylaxis in the treatment of mandibular fractures. In the first stage (145 patients) we surveyed current practice concerning antimicrobial prophylaxis and found out the current infection rate after open reduction and internal fixation (ORIF) of mandibular fractures. In the second stage (157 patients) we implemented a common antimicrobial protocol in all units and recorded the infection rates using the new regimen. In the first stage a wide range of antimicrobial prophylaxis was used in different units. The agreed perioperative antimicrobial protocol in the second stage was to begin amoxicillin or clarithromycin and metronidazole intravenously on admission and include 2 postoperative doses. The infection rates were 10.3% and 8.9%, respectively, and the difference between the two groups was not significant (χ(2)=0.051, df=1, p=0.83). The infection rate in the Yorkshire region was similar to results from other centres. We recommend short perioperative antimicrobial prophylaxis with a maximum of 2 postoperative doses after ORIF of mandibular fractures.

  14. Finite element analysis of stresses in the maxillary and mandibular dental arches and TMJ articular discs during clenching into maximum intercuspation, anterior and unilateral posterior occlusion.

    PubMed

    Pileicikiene, Gaivile; Surna, Algimantas; Barauskas, Rimantas; Surna, Rimas; Basevicius, Algidas

    2007-01-01

    The objective of this study was to investigate distribution of stresses in the human TMJ discs, generated during clenching into various occlusal positions. The work presents a biomechanical finite element model of interaction of mandibular and maxillary dental arches and the TMJ discs of a particular person, based on real geometrical data obtained from spiral computed tomography two-dimensional images. 3D contour coordinates - point clouds were collected from these images and solid model was created. The system under investigation consisted of eight basic parts: two rigid structures representing the mandibular and maxillary dental arches, two mandibular condyles, two mandibular fossae of temporal bone, and solid models of two articular discs. The model of maxillary dental arch was fixed in space. The model of the mandibular dental arch was able to move in space synchronically with the mandibular condyles under action of applied forces, which were considered as prescribed and known at insertion points of masticatory muscles. The motion of the mandible was constrained by interdental contact interactions and contact interaction with articular discs, which were situated in between mandibular condyles and mandibular fossae of temporal bone. The model was implemented by using LS-DYNA finite element software. The obtained results presented a 3D view of stresses exhibited in the articular discs, as well as the real contact points of dental interactions at given masticatory geometry of a particular subject and the values of interaction forces. The expected practical value of the developed model is the facilitation of biomechanical evaluations of the influence of tolerances of teeth shapes and occlusal areas together with the supporting areas on the final stress distribution in the dental arches and articular discs.

  15. Mandibular nerve entrapment in the infratemporal fossa.

    PubMed

    Piagkou, Maria N; Demesticha, T; Piagkos, G; Androutsos, G; Skandalakis, P

    2011-05-01

    The posterior trunk of the mandibular nerve (V(3)) comprises of three main branches. Various anatomic structures may entrap and potentially compress the mandibular nerve branches. A usual position of mandibular nerve (MN) compression is the infratemporal fossa (ITF) which is one of the most difficult regions of the skull base to access surgically. The anatomical positions of compression are: the incomplete or complete ossified pterygospinous (LPs) or pterygoalar (LPa) ligament, the large lamina of the lateral plate of the pterygoid process and the medial fibres of the lower belly of the lateral pterygoid (LPt). A contraction of the LPt, due to the connection between nerve and anatomic structures (soft and hard tissues), might lead to MN compression. Any variations of the course of the MN branches can be of practical significance to surgeons and neurologists who are dealing with this region, because of possibly significant complications. The entrapment of the MN motor branches can lead to paresis or weakness in the innervated muscle. Compression of the sensory branches can provoke neuralgia or paraesthesia. Lingual nerve (LN) compression causes numbness, hypoesthesia or even anaesthesia of the mucous of the tongue, anaesthesia and loss of taste in the anterior two-thirds of the tongue, anaesthesia of the lingual gums, as well as pain related to speech articulation disorders. Dentists should be very suspicious of possible signs of neurovascular compression in the region of the ITF.

  16. 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

  17. Rare courses of the mandibular canal in the molar regions of the human mandible: a cadaveric study.

    PubMed

    Sato, Iwao; Ueno, Ryuji; Kawai, Taisuke; Yosue, Takashi

    2005-11-01

    The inferior alveolar artery, vein and nerve send some branches to the molar teeth via the mandibular canal to the mental foramen. The present study attempted to define the presence and course of the mandibular canal in the mandible with the alveolar process by macroscopic cadaveric dissection and computerized tomography (CT) in order to provide information that might prevent injuries to vessels and nerves at risk during root canal treatment. We identified the position of the mandibular canal within a 30% ratio of the distance from inferior border of mandible to the apices of the root for 39 out of 131 sides (mesial root of first molar, 20%; distal root of first molar, 22.6%; mesial root of second molar, 27.8% and distal root of second molar, 47%) on panoramic X-ray observation. In one cadaver (male, 64 years old), the root apex of the second molar was in close proximity to the upper bony mandibular canal. Macroscopic dissection and computerized tomography showed that the main trunks of the inferior alveolar artery, vein, and nerve were in tight contact with the apex of the second molar. These observations of the anatomic course of the mandibular canal will be important to consider during root canal treatment of mandibular teeth. PMID:16350422

  18. Estimation of coronary reserve in left anterior descending and circumflex coronary arteries by regional thermodilution technique.

    PubMed

    Kurita, A; Azorin, J; Granier, A; Bourassa, M G

    1982-09-01

    The present study was attempted to determine whether a reduction in regional venous maximal coronary flow can indicate the presence of significant coronary stenosis. The great cardiac vein flow and the coronary sinus outflow were measured simultaneously in 8 open-chest dogs by a continuous thermodilution technique using a triple thermister catheter or two separate thermister catheters. The left anterior descending and circumflex coronary inflows were recorded using electromagnetic flow probes. Successive 70% coronary arterial stenosis maximal coronary flow and coronary reserve decreased significantly in the great cardiac vein and the coronary sinus. Significant correlations were found between the flows in the left anterior descending artery and in the great cardiac vein (r = 0.81) and between those in the circumflex artery and in the coronary sinus minus the great cardiac vein (r = 0.79) throughout the periods of preocclusion, occlusion and reactive hyperemic response. There were no significant changes in heart rate and hemodynamics. Using continuous thermodilution techniques, the inflows of the left anterior descending and the circumflex coronary arteries at a stenosis greater than 70% could be estimated from the changes in regional venous outflows.

  19. Salivary duct carcinoma in the mandibular anterior region: The role of immunohistochemical markers in its definitive diagnosis

    PubMed Central

    Chandrasekar, Chetana; Salati, Naser; Rao, Lakshmi; Radhakrishnan, Raghu

    2016-01-01

    Salivary duct carcinoma (SDC) is a high-grade adenocarcinoma arising from the ductal epithelium of salivary glands which rarely involves the minor salivary glands. The varied histological presentation in the minor salivary gland tumors makes them the most heterogeneous group of neoplasms, making the diagnosis a challenge. This report highlights the importance of immunohistochemical markers in the definitive diagnosis of SDC. PMID:27721618

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

    PubMed Central

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

    2015-01-01

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

  1. Crumbs Affects Protein Dynamics In Anterior Regions Of The Developing Drosophila Embryo

    PubMed Central

    Firmino, João; Tinevez, Jean-Yves; Knust, Elisabeth

    2013-01-01

    Maintenance of apico-basal polarity is essential for epithelial integrity and requires particular reinforcement during tissue morphogenesis, when cells are reorganised, undergo shape changes and remodel their junctions. It is well established that epithelial integrity during morphogenetic processes depends on the dynamic exchange of adherens junction components, but our knowledge on the dynamics of other proteins and their dynamics during these processes is still limited. The early Drosophila embryo is an ideal system to study membrane dynamics during morphogenesis. Here, morphogenetic activities differ along the anterior-posterior axis, with the extending germband showing a high degree of epithelial remodelling. We developed a Fluorescence Recovery After Photobleaching (FRAP) assay with a higher temporal resolution, which allowed the distinction between a fast and a slow component of recovery of membrane proteins during the germband extension stage. We show for the first time that the recovery kinetics of a general membrane marker, SpiderGFP, differs in the anterior and posterior parts of the embryo, which correlates well with the different morphogenetic activities of the respective embryonic regions. Interestingly, absence of crumbs, a polarity regulator essential for epithelial integrity in the Drosophila embryo, decreases the fast component of SpiderGFP and of the apical marker Stranded at Second-Venus specifically in the anterior region. We suggest that the defects in kinetics observed in crumbs mutant embryos are the first signs of tissue instability in this region, explaining the earlier breakdown of the head epidermis in comparison to that of the trunk, and that diffusion in the plasma membrane is affected by the absence of Crumbs. PMID:23555600

  2. 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

  3. 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

  4. 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

  5. A Combined Intradural Presigmoid-Transtransversarium-Transcondylar Approach to the Whole Clivus and Anterior Craniospinal Region

    PubMed Central

    Ammirati, Mario; Ma, Jianya; Canalis, Rinaldo; Martin, Neil; Black, Keith; Cheatham, Mel; Bloch, Joseph; Becker, Donald

    1993-01-01

    Surgical exposure of the clivus is difficult because of its proximity to vital neurovascular structures. The anatomic bases of a new surgical approach to this area are discussed. A supra-auricular skin incision is extended toward the posterior border of the sternocleidomastoid muscle. The vertebral artery is exposed from C2 to the occiput unroofing the foramen transversarium of C1. The bone removal consists of a posterior temporal craniotomy, a suboccipital craniectomy, including mastoidectomy with sigmoid sinus unroofing, removal of the lateral margin of the foramen magnum, of the medial third of the occipital condyle, and retrolabyrinthine petrous drilling. Posterior retraction of the vertebral artery facilitates occipital condyle drilling. Intradural exposure of the petroclival region is achieved by L-shaped cutting of the dura with the long branch placed infratentorially anterior to the sigmoid sinus. Intradural exposure of the craniospinal/upper cervical areas is achieved by cutting of the dura medial to the distal sigmoid sinus and by longitudinal cutting of the dura anterior to the vertebral artery. This approach allows multiple ports of entry to the clivus with full control of the vertebrobasilar system, and of the dural sinuses, and is anatomically suited for controlled removal of tumors located in these areas. This approach, or segments of it, has been used successfully in the treatment of large neoplasms of the craniovertebral junction. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10Figure 11 PMID:17170911

  6. Irradiated mandibular autografts

    SciTech Connect

    Hamaker, R.C.; Singer, M.I.; Shockley, W.W.; Pugh, N.; Shidnia, H.

    1983-09-15

    The cosmetic and functional disability associated with mandibular resection has been a major problem to the patient with direct invasion of the mandible by oral cancer. Marginal resections with combined postoperative radiation therapy have frequently been substituted for the more preferred segmental resections and resultant deformities. Presented are 15 cases of oral cavity cancer involving resection of the mandible, immediate radiation to 10,000 rad, and primary reconstruction as irradiated mandibular autografts. The longest following is 4 years and 3 months, with a success rate of 66%. Morbidity is minimal as compared to autogenous bone grafting. Tumor size, previous radiation, or use of regional flaps have not been a factor in the success of this method in reconstruction of the mandible primarily.

  7. 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

  8. 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

  9. Surgical management of a large complex odontoma of the mandibular angle-ramus region through intra-oral buccal approach--A case report.

    PubMed

    Ogunlewe, M O; Adeyemo, W L; Ladeinde, A L; Bamgbose, B O; Ajayi, O F

    2005-12-01

    Large complex odontomas of the jaws are rare. A report of a large complex odontoma of the mandibular angle-ramus region enucleated through intra-oral buccal approach is presented. A review of the literature on different modalities of treatment is also undertaken. A large expansile complex odontoma of the angle-ramus region of the mandible was excised through an intraoral buccal approach under general anaesthesia. Recovery and immediate post-operative period were uneventful. There was no altered sensation in the distribution of the inferior alveolar nerve and lingual nerve; and wound healing was satisfactory. Post-operative radiograph 2 years after the operation showed satisfactory bone regeneration. Intraoral buccal approach to large complex odontomas of the angle-ramus region of the mandible is a relatively safe procedure with minimal complication.

  10. Digital orthopantomograms in osteoporosis detection: mandibular density and mandibular radiographic indices as skeletal BMD predictors

    PubMed Central

    Savic Pavicin, I; Jukic, T; Badel, T; Badanjak, A

    2014-01-01

    Objectives: To determine the correlation of skeletal bone mineral density (BMD) with mandibular density and mandibular radiographic indices estimated on digital panoramic radiographs. Methods: Study comprised 112 female subjects older than 45 years. Digital panoramic radiographs were taken, and patients were referred to densitometric measuring (dual energy X-ray absorptiometry) of BMD in the hip bones and lumbar spine regions (L1–L4). On the radiographs, mandibular bone density was estimated and the following indices were measured by the DIGORA® software (Soredex, Tuusula, Finland): mental index (MI), gonial index (GI), antegonial index (AI), panoramic mandibular index (PMI) and alveolar crest resorption degree (M/M). Mandibular cortical index (MCI) was visually estimated. Results: Mandibular density and visual index MCI are significant predictors of hip and spine BMD. Mandibular density was marked by a significant square trend: it decreased until the age of 54 years and remained constant until the age of 64 years when it started to increase. Significant correlations were found between MI, AI and PMI values and BMD in the hip but not in the lumbar spine region. The GI and M/M values did not show statistically significant correlations with BMD of either region. Conclusions: Mandibular bone density and mandibular radiographic indices are useful in detecting patients with decreased BMD. The applicability of orthopantomograms in diagnosing osteoporosis/osteopenia should be recognized as the potential greatest benefit of this everyday diagnostic method in dental practice. PMID:24969554

  11. Resistance exercise induces region-specific adaptations in anterior pituitary gland structure and function in rats.

    PubMed

    Kraemer, William J; Flanagan, Shawn D; Volek, Jeff S; Nindl, Bradley C; Vingren, Jakob L; Dunn-Lewis, Courtenay; Comstock, Brett A; Hooper, David R; Szivak, Tunde K; Looney, David P; Maresh, Carl M; Hymer, Wesley C

    2013-12-01

    The anterior pituitary gland (AP) increases growth hormone (GH) secretion in response to resistance exercise (RE), but the nature of AP adaptations to RE is unknown. To that end, we examined the effects of RE on regional AP somatotroph GH release, structure, and relative quantity. Thirty-six Sprague-Dawley rats were assigned to one of four groups: 1) no training or acute exercise (NT-NEX); 2) no training with acute exercise (NT-EX); 3) resistance training without acute exercise (RT-NEX); 4) resistance training with acute exercise (RT-EX). RE incorporated 10, 1 m-weighted ladder climbs at an 85° angle. RT groups trained 3 days/wk for 7 wk, progressively. After death, trunk blood was collected, and each AP was divided into quadrants (ventral-dorsal and left-right). We measured: 1) trunk plasma GH; 2) somatotroph GH release; 3) somatotroph size; 4) somatotroph secretory content; and 5) percent of AP cells identified as somatotrophs. Trunk GH differed by group (NT-NEX, 8.9 ± 2.4 μg/l; RT-NEX, 9.2 ± 3.5 μg/l; NT-EX, 15.6 ± 3.4 μg/l; RT-EX, 23.4 ± 4.6 μg/l). RT-EX demonstrated greater somatotroph GH release than all other groups, predominantly in ventral regions (P < 0.05-0.10). Ventral somatotrophs were larger in NT-EX and RT-NEX compared with RT-EX (P < 0.05-0.10). RT-NEX exhibited significantly greater secretory granule content than all other groups but in the ventral-right region only (P < 0.05-0.10). Our findings indicate reproducible patterns of spatially distinct, functionally different somatotroph subpopulations in the rat pituitary gland. RE training appears to induce dynamic adaptations in somatotroph structure and function.

  12. Crown lengthening in the maxillary anterior region: a 6-month prospective clinical study.

    PubMed

    Deas, David E; Mackey, Scott A; Sagun, Ruben S; Hancock, Raymond H; Gruwell, Scott F; Campbell, Casey M

    2014-01-01

    The purpose of this study was to assess osseous parameters and stability of maxillary anterior teeth following crown lengthening surgery. Thirty-six patients requiring facial crown lengthening of 277 maxillary anterior and first premolar teeth were included. Presurgical and intraoperative clinical measurements were recorded at baseline and 1, 3, and 6 months postsurgery at midfacial, mesiofacial, and distofacial line angles. The data presented here suggest that when crown lengthening anterior maxillary teeth, the distance between the desired gingival margin and alveolar crest is usually insufficient to allow for biologic width. In addition, there is significant tissue rebound that may stabilize by 6 months. Tissue rebound appears related to flap position relative to the alveolar crest at suturing. These findings suggest that clinicians should establish proper anterior crown length with osseous resection.

  13. Anterior thalamic nuclei lesions in rats disrupt markers of neural plasticity in distal limbic brain regions

    PubMed Central

    Dumont, J.R.; Amin, E.; Poirier, G.L.; Albasser, M.M.; Aggleton, J.P.

    2012-01-01

    In two related experiments, neurotoxic lesions were placed in the anterior thalamic nuclei of adult rats. The rats were then trained on behavioral tasks, immediately followed by the immunohistochemical measurement of molecules linked to neural plasticity. These measurements were made in limbic sites including the retrosplenial cortex, the hippocampal formation, and parahippocampal areas. In Experiment 1, rats with unilateral anterior thalamic lesions explored either novel or familiar objects prior to analysis of the immediate-early gene zif268. The lesions reduced zif268 activity in the granular retrosplenial cortex and postsubiculum. Exploring novel objects resulted in local changes of hippocampal zif268, but this change was not moderated by anterior thalamic lesions. In Experiment 2, rats that had received either bilateral anterior thalamic lesions or control surgeries were exposed to novel room cues while running in the arms of a radial maze. In addition to zif268, measurements of c-AMP response element binding protein (CREB), phosphorylated CREB (pCREB), and growth associated protein43 (GAP-43) were made. As before, anterior thalamic lesions reduced zif268 in retrosplenial cortex and postsubiculum, but there were also reductions of pCREB in granular retrosplenial cortex. Again, the hippocampus did not show lesion-induced changes in zif268, but there were differential effects on CREB and pCREB consistent with reduced levels of hippocampal CREB phosphorylation following anterior thalamic damage. No changes in GAP-43 were detected. The results not only point to changes in several limbic sites (retrosplenial cortex and hippocampus) following anterior thalamic damage, but also indicate that these changes include decreased levels of pCREB. As pCREB is required for neuronal plasticity, partly because of its regulation of immediate early-gene expression, the present findings reinforce the concept of an ‘extended hippocampal system’ in which hippocampal function is

  14. Cone beam computed tomographic analyses of alveolar bone anatomy at the maxillary anterior region in Chinese adults.

    PubMed

    Zhou, Zhixuan; Chen, Wu; Shen, Ming; Sun, Chao; Li, Jun; Chen, Ning

    2014-11-01

    To provide an anatomical basis for clinical implant esthetics, we evaluated the morphology of the nasopalatine canal (NPC) and analyzed labial and interproximal bone anatomy at the maxillary anterior region. We sought to investigate the effect of maxillary protrusion and tooth labiolingual inclination on labial bone anatomy in Chinese adults. Three dimensional (3D) images were reconstructed using cone-beam computed tomography (CBCT) images from 80 Chinese subjects and by SimPlant 11.04. The dimensions of the NPC, the thickness and profile of the labial bone, the width and height of the interproximal bone, angle sella-nasion-subspinale (SNA) and angle upper central incisor-nasion,subspinale (U1-NA) were measured. The incisive foramen of the NPC was markedly wider than its nasal foramen. The dimension of its labial bone wall demonstrated an increasing width from the crestal to apical measurements. The labial bone at the maxillary anterior region was rather thin, especially at 3 mm below the cemento-enamel junction (CEJ) and the mid-root level; the profile of the labial bone was more curved at the central incisor, and the interproximal bone became wider and shorter posteriorly. There were significant relationships between maxillary protrusion and labial bone profile, tooth labiolingual inclination and labial bone thickness (P < 0.02). To achieve optimal esthetic outcome of implant, bone augmentation is necessary at the maxillary anterior region. For immediate or early placement at the maxillary anterior region, the implant should be located palatally to reduce labial bone resorption and marginal recession; its apex should be angulated palatally to avoid labial perforation at the apical region. To protect the NPC, implants at the central incisor region should be placed away from NPC. PMID:25469120

  15. 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

  16. Occlusal force, electromyographic activity of masticatory muscles and mandibular flexure of subjects with different facial types

    PubMed Central

    CUSTODIO, William; GOMES, Simone Guimarães Farias; FAOT, Fernanda; GARCIA, Renata Cunha Matheus Rodrigues; DEL BEL CURY, Altair Antoninha

    2011-01-01

    Objective The aim of this study was to evaluate whether vertical facial patterns influence maximal occlusal force (MOF), masticatory muscle electromyographic (EMG) activity, and medial mandibular flexure (MMF). Material and Methods Seventy-eight dentate subjects were divided into 3 groups by Ricketts's analysis: brachyfacial, mesofacial and dolychofacial. Maximum occlusal force in the molar region was bilaterally measured with a force transducer. The electromyographic activities of the masseter and anterior temporal muscles were recorded during maximal voluntary clenching. Medial mandibular flexure was calculated by subtracting the intermolar distance of maximum opening or protrusion from the distance in the rest position. The data were analyzed using ANOVA followed by Tukey's HSD test. The significance level was set at 5%. Results Data on maximum occlusal force showed that shorter faces had higher occlusal forces (P<0.0001). Brachyfacial subjects presented higher levels of masseter electromyographic activity and medial mandibular flexure, followed by the mesofacial and dolychofacial groups. Additionally, dolychofacial subjects showed significantly lower electromyographic temporalis activities (P<0.05). Conclusion Within the limitations of the study, it may be concluded that maximum occlusal force, masticatory muscle activity and medial mandibular flexure were influenced by the vertical facial pattern. PMID:21655772

  17. Traumatic impaction of foreign body in the mucobuccal fold of lower anterior region in the oral cavity: A chance finding

    PubMed Central

    Vinayagam, Ramya; Gita, Bagavad; Chandrasekaran, Sajja; Nazer, Afreena Imami

    2015-01-01

    Foreign bodies may be ingested, inserted or deposited in the oral cavity. Iatrogenic foreign bodies such as impression material, amalgam, broken instruments, needles etc., are commonly encountered. These foreign bodies are generally symptomatic and show signs of inflammation pain and purulent discharge. An unusual case of asymptomatic traumatic foreign body (stone) impacted in the lower anterior region due to an accident 3 years back, which was diagnosed during routine oral examination is reported. PMID:26229280

  18. Mandibular condylar pseudocyst: an introduction to the orthodontist.

    PubMed

    Yitschaky, Oded; Friedlander-Barenboim, Silvina; Friedman, Menahem; Tzur-Gadassi, Liat; Zadik, Yehuda

    2013-10-01

    The aims of this article are to introduce mandibular condylar pseudocysts to orthodontists, present 2 relevant case reports, and discuss possible differential diagnoses. Condylar pseudocyst is a radiologic variant of pterygoid fovea, which is the site of insertion of the lateral pterygoid muscle to the head of the mandibular condyle. A pathognomonic picture of a solitary well-defined radiolucency with radiopaque borders, located on the anterior aspect of the condyle in an asymptomatic orthodontic patient, is characteristic. PMID:24075670

  19. Biomechanical Response in Mandibular Bone due to Mastication Loading on 3-Unit Fixed Partial Dentures

    PubMed Central

    Field, Clarice; Li, Qing; Li, Wei; Swain, Michael

    2010-01-01

    An understanding of functional responses in oral bone is a crucial component of dental biomechanics. The purpose of this study was to investigate the potential biological remodelling response during mastication on the mandibular pre- and post-insertion of a fixed partial denture (FPD). A series of three-dimensional (3D) finite element analysis (FEA) models were presented pre- and postextraction to determine the biomechanical responses to masticatory loading in the anterior mandible. Equivalent strains were analysed at lingual/buccal and mesial/distal areas of the premolar to molar region and quantified to anticipate bone remodelling response. Mandibular bone incorporating an FPD experienced substantially greater stress/strain magnitudes than that prior to placement of fixed prosthodontics, which is suggestive of engagements of bone remodelling. The results suggest similar outcomes to those reported clinically. Developing a simulation reflecting the outcomes of restorative treatment can provide meaningful insight into restorative treatment planning, clinical outcomes, and fixed prosthodontics designs. PMID:20981154

  20. Biomechanical Response in Mandibular Bone due to Mastication Loading on 3-Unit Fixed Partial Dentures.

    PubMed

    Field, Clarice; Li, Qing; Li, Wei; Swain, Michael

    2010-01-01

    An understanding of functional responses in oral bone is a crucial component of dental biomechanics. The purpose of this study was to investigate the potential biological remodelling response during mastication on the mandibular pre- and post-insertion of a fixed partial denture (FPD). A series of three-dimensional (3D) finite element analysis (FEA) models were presented pre- and postextraction to determine the biomechanical responses to masticatory loading in the anterior mandible. Equivalent strains were analysed at lingual/buccal and mesial/distal areas of the premolar to molar region and quantified to anticipate bone remodelling response. Mandibular bone incorporating an FPD experienced substantially greater stress/strain magnitudes than that prior to placement of fixed prosthodontics, which is suggestive of engagements of bone remodelling. The results suggest similar outcomes to those reported clinically. Developing a simulation reflecting the outcomes of restorative treatment can provide meaningful insight into restorative treatment planning, clinical outcomes, and fixed prosthodontics designs.

  1. 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

  2. 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.

  3. Difficult laryngoscopy caused by massive mandibular tori.

    PubMed

    Takasugi, Yoshihiro; Shiba, Mayuka; Okamoto, Shinji; Hatta, Koji; Koga, Yoshihisa

    2009-01-01

    Mandibular tori, defined as bony protuberances located along the lingual aspect of the mandible, are a possible cause of difficult intubation. We describe a case of mandibular tori that resulted in difficult intubation. A 62-year-old woman who had speech problems was diagnosed with mandibular tori, and was scheduled for surgical resection. On physical assessment, the patient had a class II Mallampati view and bilateral mandibular tori. Preoperative computed tomography images demonstrated that the bilateral mandibular tori arose from the lingual aspects of the second incisor to the first molar regions of the mandibular corpus, and occupied the floor of the mouth. In the operating room, anesthesia was induced with remifentanil and propofol. After complete paralysis was achieved, laryngoscopy was attempted several times with Macintosh blades. The massive tori prevented insertion of the tip of the blade into the oropharynx, and neither the epiglottis nor the arytenoids could be visualized, i.e., Cormack and Lehane grade IV. Blind nasotracheal intubation was successful and the surgery proceeded uneventfully. The anesthesiologist should examine any space-occupying lesion of the oral floor and should be vigilant for speech problems in order to detect mandibular tori that might impede intubation. PMID:19444571

  4. Incremental enamel development in modern human deciduous anterior teeth.

    PubMed

    Mahoney, Patrick

    2012-04-01

    This study reconstructs incremental enamel development for a sample of modern human deciduous mandibular (n = 42) and maxillary (n = 42) anterior (incisors and canines) teeth. Results are compared between anterior teeth, and with previous research for deciduous molars (Mahoney: Am J Phys Anthropol 144 (2011) 204-214) to identify developmental differences along the tooth row. Two hypotheses are tested: Retzius line periodicity will remain constant in teeth from the same jaw and range from 6 to 12 days among individuals, as in human permanent teeth; daily enamel secretion rates (DSRs) will not vary between deciduous teeth, as in some human permanent tooth types. A further aim is to search for links between deciduous incremental enamel development and the previously reported eruptionsequence. Retzius line periodicity in anterior teeth ranged between 5 and 6 days, but did not differ between an incisor and molar of one individual. Intradian line periodicity was 12 h. Mean cuspal DSRs varied slightly between equivalent regions along the tooth row. Mandibular incisors initiated enamel formation first, had the fastest mean DSRs, the greatest prenatal formation time, and based upon prior studies are the first deciduous tooth to erupt. Relatively rapid development in mandibular incisors in advance of early eruption may explain some of the variation in DSRs along the tooth row that cannot be explained by birth. Links between DSRs, enamel initiation times, and the deciduous eruption sequence are proposed. Anterior crown formation times presented here can contribute toward human infant age-at-death estimates. Regression equations for reconstructing formation time in worn incisors are given.

  5. 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

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

    PubMed

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

    2003-12-01

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

  7. 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

  8. Technetium-99m bone scintigraphy and mandibular condylar hyperplasia.

    PubMed

    Henderson, M J; Wastie, M L; Bromige, M; Selwyn, P; Smith, A

    1990-06-01

    Radionuclide skeletal scintigraphy has been successfully used in the assessment of mandibular condylar hyperplasia (condylar hyperplasia) causing mandibular asymmetry to identify the presence of continued active growth in the condylar region. This study reviews 14 cases of mandibular asymmetry and concludes that symmetrical radionuclide uptake in the condylar regions on the bone scintigram excludes a continuing asymmetrical growth focus. Unilateral increased radionuclide uptake may often indicate an abnormally active condylar growth focus but false positive results may be encountered in patients with associated temporo-mandibular joint disease. PMID:2383957

  9. Fused primary first mandibular macromolar with a unique relation to its permanent successors: A rare tooth anomaly

    PubMed Central

    Dhindsa, Abhishek; Garg, Shalini; Damle, S. G.; Opal, Shireen; Singh, Tavleen

    2013-01-01

    Dental anomalies of number and forms may occur in the primary and permanent dentition. Various terms have been used to describe dental twinning anomalies: Germination, fusion, concrescence, double teeth, conjoined teeth, twinned teeth, geminifusion, and vicinifusion. Fused tooth is a developmental anomaly that is seen more frequently in the primary than the permanent dentition. Double tooth involving deciduous anterior teeth is found mostly in the mandible. Very few cases of nonsyndromic double primary molar have been reported in the literature. The succeeding permanent tooth is often found missing congenitally in the same region. This article reports a very rare unilateral occurrence of an anomalous, primary mandibular first macromolar formed by fusion with a dysmorphic premolar like supernumerary tooth in deciduous dentition period. Instead of agenesis of succedaneous tooth, the double tooth has been succeeded by normally developing mandibular first premolar in the same region. PMID:24883034

  10. 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

  11. 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

  12. 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

  13. Mandibular destructive radiolucent lesion: The first sign of multiple myeloma

    PubMed Central

    Fregnani, Eduardo-Rodrigues; Leite, Amanda-Almeida; Parahyba, Claudia-Joffily; Nesrallah, Ana-Cristina-Alo; Ramos-Perez, Flávia-Maria-de Moraes

    2016-01-01

    The occurrence of a mandibular lesion as the first sign of multiple myeloma (MM) is uncommon. This report describes a case of MM diagnosed because of a mandibular lesion. A 62-year-old woman presented a destructive radiolucent lesion in the right mandibular ramus. The lesion caused rupture of the anterior cortical bone and extended from the retromolar area to the coronoid process. An incisional biopsy was performed. Histopathological examination revealed numerous pleomorphic plasma cells, some with binucleated nuclei. The tumor cells showed kappa light-chain restriction. Bone marrow biopsy showed findings of massive infiltration of neoplastic plasma cells, besides lesions in the vertebrae. The diagnosis of MM was established. The patient underwent autologous hematopoietic stem-cell transplantation. Currently, the patient is under regular follow up after 40 months of initial treatment. In conclusion, MM should be considered in the differential diagnosis of destructive mandibular lesions. Key words:Mandible, multiple myeloma, radiolucent lesion. PMID:27703618

  14. Mandibular reconstruction using an axially vascularized tissue-engineered construct

    PubMed Central

    2011-01-01

    Background Current reconstructive techniques for continuity defects of the mandible include the use of free flaps, bone grafts, and alloplastic materials. New methods of regenerative medicine designed to restore tissues depend mainly on the so-called extrinsic neovascularization, where the neovascular bed originates from the periphery of the construct. This method is not applicable for large defects in irradiated fields. Methods We are introducing a new animal model for mandibular reconstruction using intrinsic axial vascularization by the Arterio-Venous (AV) loop. In order to test this model, we made cadaveric, mechanical loading, and surgical pilot studies on adult male goats. The cadaveric study aimed at defining the best vascular axis to be used in creating the AV loop in the mandibular region. Mechanical loading studies (3 points bending test) were done to ensure that the mechanical properties of the mandible were significantly affected by the designed defect, and to put a base line for further mechanical testing after bone regeneration. A pilot surgical study was done to ensure smooth operative and post operative procedures. Results The best vascular axis to reconstruct defects in the posterior half of the mandible is the facial artery (average length 32.5 ± 1.9 mm, caliber 2.5 mm), and facial vein (average length 33.3 ± 1.8 mm, caliber 2.6 mm). Defects in the anterior half require an additional venous graft. The defect was shown to be significantly affecting the mechanical properties of the mandible (P value 0.0204). The animal was able to feed on soft diet from the 3rd postoperative day and returned to normal diet within a week. The mandible did not break during the period of follow up (2 months). Conclusions Our model introduces the concept of axial vascularization of mandibular constructs. This model can be used to assess bone regeneration for large bony defects in irradiated fields. This is the first study to introduce the concept of axial

  15. 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

  16. Regional wall motion abnormality in apical ballooning syndrome (Takotsubo/stress cardiomyopathy): importance of biplane left ventriculography for differentiating from spontaneously aborted anterior myocardial infarction.

    PubMed

    Patel, Sandeep M; Lennon, Ryan J; Prasad, Abhiram

    2012-04-01

    Understanding the precise distribution of the regional wall motion abnormality (RWMA) in apical ballooning syndrome (ABS) is important because the cardiomyopathy can mimic an acute anterior ST-elevation myocardial infarction (STEMI). The aim of the study was to quantify the severity and distribution of RWMA in ABS, compare it to anterior STEMI, and correlate with clinical features. RWMA (normal = 1, hypokinetic = 2, akinetic = 3) was quantified from the biplane left ventriculogram using a nine-segment model in 95 ABS and 17 anterior STEMI patients at the time of their presentation. Regional wall motion score index (RWMSI) was higher in ABS [2.1 (1.9, 2.1)] compared to anterior STEMI [2.0 (1.8, 2.0)], P = 0.024]. The region that most clearly differentiated ABS from anterior STEMI was the posterolateral segment (sensitivity 81% and specificity 100%) which was hypocontractile in 81% of ABS, but none of the STEMI patients (P < 0.001). RWMSI in ABS had a modest positive correlation with the troponin T levels (r = 0.23, P = 0.029). Patients with ABS with ST-segment elevation had the highest RWMSI [2.1(2.0, 2.2)], while those with non specific changes had the lowest [1.9 (1.8, 2.1)] (P = 0.007). In conclusion, patients with ABS have greater and more diffuse RWMA compared to anterior STEMI. The presence of systolic dysfunction in the posterolateral segment in the left anterior oblique projection of the left ventriculogram most accurately distinguishes ABS from an anterior STEMI highlighting the utility of biplane angiography for this purpose. The severity of RWMA correlates with the extent of troponin release and ECG abnormality.

  17. Primate experiments on mandibular growth direction.

    PubMed

    Tomer, B S; Harvold, E P

    1982-08-01

    Induced oral respiration in eight growing monkeys led to a lowering of the chin, a steeper mandibular plane angle, and an increase in the gonial angle as compared with eight control animals. The posterior border of the mandible maintained its normal inclination relative to the skull. The mandible underwent a posterior rotation in the experimental animals and an anterior rotation in the controls. The findings suggest that the position of the chin and the inclination of the mandibular plane are controlled by the balance between the suprahyoid and the orofacial muscles. Since the posterior border of the ramus undergoes gradual remodeling and maintains its normal inclination, it is assumed that the masticatory muscles are not significantly affected by the altered respiratory function. It is therefore concluded that the ramus with the masticatory muscles and the chin with its suprahyoid and orofacial muscles represent two relatively independent systems.

  18. Direct Physiologic Evidence of a Heteromodal Convergence Region for Proper Naming in Human Left Anterior Temporal Lobe

    PubMed Central

    Rhone, Ariane E.; Nourski, Kirill V.; Kawasaki, Hiroto; Oya, Hiroyuki; Griffiths, Timothy D.; Howard, Matthew A.; Tranel, Daniel

    2015-01-01

    Retrieving the names of friends, loved ones, and famous people is a fundamental human ability. This ability depends on the left anterior temporal lobe (ATL), where lesions can be associated with impaired naming of people regardless of modality (e.g., picture or voice). This finding has led to the idea that the left ATL is a modality-independent convergence region for proper naming. Hypotheses for how proper-name dispositions are organized within the left ATL include both a single modality-independent (heteromodal) convergence region and spatially discrete modality-dependent (unimodal) regions. Here we show direct electrophysiologic evidence that the left ATL is heteromodal for proper-name retrieval. Using intracranial recordings placed directly on the surface of the left ATL in human subjects, we demonstrate nearly identical responses to picture and voice stimuli of famous U.S. politicians during a naming task. Our results demonstrate convergent and robust large-scale neurophysiologic responses to picture and voice naming in the human left ATL. This finding supports the idea of heteromodal (i.e., transmodal) dispositions for proper naming in the left ATL. PMID:25632128

  19. [Correction of a mandibular alveolar protrusion using maxillary miniscrew anchorage in the treatment of a Class II division 1 malocclusion].

    PubMed

    Haiim, Frederic

    2011-12-01

    This article describes a relatively simple method of reducing a mandibular alveolar protrusion without compensatory extraction of mandibular bicuspids or advancement of anterior teeth in the treatment of a Class II division 1 malocclusion. The use of well-planned skeletal anchorage specifically adapted to each specific situation is also well elucidated.

  20. Mandibular osteonecrosis due to bisphosphonate use.

    PubMed

    Şalvarcı, Ahmet; Altınay, Serdar

    2015-03-01

    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 3(rd) 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

  1. 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

  2. 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

  3. 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.

  4. Intra-mandibular adenoid cystic carcinoma.

    PubMed

    Bouaichi, A; Aimad-Eddine, S; Mommers, X-A; Ella, B; Zwetyenga, N

    2014-04-01

    Intra-mandibular localization of adenoid cystic carcinoma is rare. This tumor is characterized by progressive local, regional, and distant aggressiveness. We reviewed the latest data on this rare type of cancer with a small number of reported cases, alack of consensus for its treatment, and its bad prognosis.

  5. 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

  6. Complications of mandibular fractures.

    PubMed

    Zweig, Barry E

    2009-03-01

    Before any definitive treatment of mandibular fractures, the patient needs to be evaluated for more potentially life-threatening injuries. Complications can and do occur with treatment of mandibular fractures and can occur during any of the phases of treatment. The development of an accurate diagnosis and appropriate treatment plan is vital in achieving optimal success and decreasing complications. Knowledge of the anatomy and the principles of bone healing is also an important factor in preventing complications. To limit long-term untoward effects, complications should be recognized early and the appropriate treatment should be started before a minor complication becomes a complex one that is more difficult to manage.

  7. 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.

  8. Orthodontic treatment of a mandibular incisor extraction case with invisalign.

    PubMed

    Zawawi, Khalid H

    2014-01-01

    Mandibular incisor extraction for orthodontic treatment is considered an unusual treatment option because of the limited number of patients that meet the criteria for such treatment. Accurate diagnosis and treatment planning is essential to achieve the desired results. Adult orthodontic patients are increasingly motivated by esthetic considerations and reject the idea of conventional fixed appliances. In recent years, Invisalign appliances have gained tremendous attention for orthodontic treatment of adult patients to meet their esthetic demands. In this case report, a case of Class I malocclusion was treated with mandibular incisor extraction using the Invisalign appliance system. Successful tooth alignment of both arches was achieved. The use of Invisalign appliance is an effective treatment option in adult patients with Class I malocclusion that requires incisor extraction due to moderate to severe mandibular anterior crowding.

  9. Orthodontic Treatment of a Mandibular Incisor Extraction Case with Invisalign

    PubMed Central

    Zawawi, Khalid H.

    2014-01-01

    Mandibular incisor extraction for orthodontic treatment is considered an unusual treatment option because of the limited number of patients that meet the criteria for such treatment. Accurate diagnosis and treatment planning is essential to achieve the desired results. Adult orthodontic patients are increasingly motivated by esthetic considerations and reject the idea of conventional fixed appliances. In recent years, Invisalign appliances have gained tremendous attention for orthodontic treatment of adult patients to meet their esthetic demands. In this case report, a case of Class I malocclusion was treated with mandibular incisor extraction using the Invisalign appliance system. Successful tooth alignment of both arches was achieved. The use of Invisalign appliance is an effective treatment option in adult patients with Class I malocclusion that requires incisor extraction due to moderate to severe mandibular anterior crowding. PMID:25024852

  10. 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

  11. A Correlational Study of Scoliosis and Trunk Balance in Adult Patients with Mandibular Deviation

    PubMed Central

    Yang, Yang; Wang, Na; Wang, Wenyong; Ding, Yin; Sun, Shiyao

    2013-01-01

    Previous studies have confirmed that patients with mandibular deviation often have abnormal morphology of their cervical vertebrae. However, the relationship between mandibular deviation, scoliosis, and trunk balance has not been studied. Currently, mandibular deviation is usually treated as a single pathology, which leads to poor clinical efficiency. We investigated the relationship of spine coronal morphology and trunk balance in adult patients with mandibular deviation, and compared the finding to those in healthy volunteers. 35 adult patients with skeletal mandibular deviation and 10 healthy volunteers underwent anterior X-ray films of the head and posteroanterior X-ray films of the spine. Landmarks and lines were drawn and measured on these films. The axis distance method was used to measure the degree of scoliosis and the balance angle method was used to measure trunk balance. The relationship of mandibular deviation, spine coronal morphology and trunk balance was evaluated with the Pearson correlation method. The spine coronal morphology of patients with mandibular deviation demonstrated an “S” type curve, while a straight line parallel with the gravity line was found in the control group (significant difference, p<0.01). The trunk balance of patients with mandibular deviation was disturbed (imbalance angle >1°), while the control group had a normal trunk balance (imbalance angle <1°). There was a significant difference between the two groups (p<0.01). The degree of scoliosis and shoulder imbalance correlated with the degree of mandibular deviation, and presented a linear trend. The direction of mandibular deviation was the same as that of the lateral bending of thoracolumbar vertebrae, which was opposite to the direction of lateral bending of cervical vertebrae. Our study shows the degree of mandibular deviation has a high correlation with the degree of scoliosis and trunk imbalance, all the three deformities should be clinically evaluated in the

  12. Time-varying Brain Potentials and Interhemispheric Coherences of Anterior and Posterior Regions during Repetitive Unimanual Finger Movements

    PubMed Central

    Meng, Ling-Fu; Lu, Chiu-Ping; Chan, Hsiao-Lung

    2007-01-01

    Previous brain electrophysiological research has studied the interregional connectivity during the tapping task and found that inter-hemispheric alpha coherence was more significant under bimanual task conditions than that under unilateral conditions, but the interregional connectivity situation in the unilateral tapping condition was not explored clearly. We have designed a unilateral repetitive finger-tapping task to delineate the anterior and posterior cortex contributions to unilateral finger movement. Sixteen right handed college students participated in this study. Event related potentials (ERPs) and the strength of event related coherence (ERCoh) were analyzed to examine the antero-postero dominance of cortical activity in the phase of early visual process (75-120ms), pre-execution (175-260ms), execution (310-420ms) and post-execution (420-620ms). Results showed that the occipital (Oz, O1 and O2), frontal (Fz, F3, and F4), fronto-central (Fz, Cz, F3 and C3), and parietal regions were the most pronounced in the early visual, pre-execution, execution, and post-execution phases, respectively. Moreover, among four inter-hemispheric pairs only the Coh (C3 and C4) was significantly correlated to reaction time (RT) of tapping in the execution phase. In conclusion, the aforementioned variability of electrophysiological data (ERPs and coherence) and the change of antero-postero regional dominance with time reflect the relative importance of different mechanisms in different phases. The mechanisms of visual processing, motor planning, motor execution and feedback reward were operational, respectively.

  13. Three-dimensional assessment of mandibular advancement 1 year after surgery

    PubMed Central

    de Assis Ribeiro Carvalho, Felipe; Cevidanes, Lucia Helena Soares; Motta, Alexandre Trindade Simões da; de Oliveira Almeida, Marco Antonio; Phillips, Ceib

    2010-01-01

    Introduction This prospective observational study evaluated changes in the 3-dimensional position and remodeling of the mandibular rami, condyles, and chin at splint removal and 1 year after mandibular advancement surgery. Methods Presurgery, splint removal (4–6 weeks postsurgery), and 1-year postsurgery cone-beam computed tomography scans of 27 subjects were used. Superimposition on the cranial base was used to assess positional or remodeling changes in the anatomic regions of interest. Surface distance displacements were visually displayed and quantified by 3-dimensional color maps. A 1-sample t test was used to assess the average postsurgical changes of each region of interest. The level of significance was set at 0.05. Results After antero-inferior chin displacement with surgery (mean, 6.81 ± 3.2 mm at splint removal), the average 1-year post-surgery displacement was not statistically significant (P = 0.44). Postsurgical adaptations greater than 2 mm were observed in 48% of the patients: 16% with an additional anterior-inferior displacement of the chin of 2 to 4 mm, and 4% with ≥4 mm; 20% had postero-superior movement of 2 to 4 mm, and 8% had postero-superior movement of ≥4 mm. The condyles tended to move, on average, ≤2 mm supero-posteriorly with surgery, and this small positional displacement was maintained 1 year postsurgery (right condyle, P = 0.58; left, P = 0.88). The rami exhibited outward (lateral) movements with surgery, with greater displacement of the inferior part of the rami (≥2 mm in 65% of the subjects). This torque of the ramus with surgery was stable 1 year postsurgery. Conclusions Three-dimensional assessment of skeletal changes with mandibular advancement surgery shows that nearly half of the patients have >2 mm change in chin position from splint removal to the 1-year follow-up, with approximately equal chances of anterior and posterior movement. Torque of the rami usually occurs with mandibular advancement surgery. PMID:20381760

  14. Mandibular metastasis of cholangiocarcinoma: A case report

    PubMed Central

    You, Tae Min; Kim, Kee-Deog; Jeong, Ho-Gul

    2015-01-01

    Tumors metastasizing from distant regions to the oral and maxillofacial region are uncommon, comprising only 1%-2% of all malignancies. Cholangiocarcinoma is a malignancy that arises from cholangiocytes, which are epithelial cells that line the bile ducts. These cancers are difficult to diagnose and have a poor prognosis. In this paper, we report a rare case of mandibular metastasis of cholangiocarcinoma diagnosed at the primary site and discuss the radiographic findings observed in this case. PMID:26730373

  15. 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

  16. Multidisciplinary treatment of peripheral osteoma arising from mandibular condyle in patient presenting with facial asymmetry.

    PubMed

    Nojima, Kunihiko; Niizuma-Kosaka, Fumiko; Nishii, Yasushi; Sueishi, Kenji; Yamakura, Daiki; Ikumoto, Hideyuki; Ohata, Hitoshi; Inoue, Takashi

    2014-01-01

    While osteomas often occur in the orofacial area, it is relatively rare for one to occur in the temporomandibular joint area. Here, we report a patient who underwent multidisciplinary treatment including high condylectomy for peripheral osteoma arising in the left mandibular condyle. The patient was a 46-year-old woman with the chief complaint of facial asymmetry. Cephalometric analysis revealed skeletal anterior crossbite due to anterior deviation of the mandible, with chin deviation of 10 mm to the right. A computed tomography scan revealed bone hyperplasia in the mesiodistal and inner areas of the left mandibular condyle, which exhibited outward anterior displacement. Bone scintigraphy showed a circular area of strong radioisotope accumulation with indistinct boundaries, consistent with the lesion in the left mandibular condyle. The above findings led to a diagnosis of skeletal mandibular prognathism with facial asymmetry due to peripheral osteoma originating in the left mandibular condyle. After orthodontic treatment and surgical resection of the tumor and mandibular condyle, preservation and prosthetic treatment were undertaken. A well-balanced facial appearance and good occlusion were achieved.

  17. 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.

  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. Distraction osteogenesis for correction of post ankylosis mandibular deformities

    PubMed Central

    Khan, Ahmed; Fareed, Wamiq Musheer; Tandon, Parul; Zafar, Muhammad Sohail

    2015-01-01

    Abstract Temporomandibular joint ankylosis, a debilitating disease mainly affecting children, is characterized by progressive restriction of mouth opening and maxilla-mandibular developmental deformities. Craniofacial distraction osteogenesis has been developed as a standard surgical strategy for rectification of craniofacial deformities. The purpose of this study was to assess mono-planar distraction devices for the correction of various mandibular asymmetries in patients with unilateral temporomandibular joint ankylosis who developed restricted mouth opening and mandibular retrognathia. All patients were treated using one-stage distraction osteogenesis followed by temporalis fascia interpositional arthroplasty under general anesthesia. A significant increase in mandibular ramus and base length was observed. Although an increase in anterior lower facial height was observed, it was not significant statistically. A decrease in posterior lower facial height and corpus was observed. Oblique distraction with angular osteotomy allowed lengthening of both the ramus and corpus, yielding satisfactory results and hence eliminating the need of secondary surgery. In conclusion, univector internal distractors are effective for correction of multi-planar mandibular deficiencies by optimizing its placement through meticulous planning. PMID:26243521

  20. 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.

  1. Double mandibular osteotomy with segmental mandibular swing approach to parapharyngeal space.

    PubMed

    Satpathy, Shouvanik; Dam, Aniruddha; Hossain, Mollah Arafat; Chatterjee, Jayanta

    2014-01-01

    Surgical removal of benign tumors of the Parapharyngeal space (PPS) is the treatment of choice. PPS tumors may remain undetected for long periods of time and large tumors in the PPS can extend into the Retropharyngeal Space or into the Infra-Temporal Fossa. Anatomically, the mandible represents a significant obstacle to successful PPS surgery. Except for very small tumors, it is difficult to remove larger tumors from this region without some form of mandibular retraction. The standard mandibular "swing" approach involves splitting of the lower lip and a single parasymphysis osteotomy for retraction of the mandible laterally to expose the PPS. However, the morbidity associated with midline lip split and anesthesia of the hemi-labial region caused by the severing of the mental nerve is an unwanted complication of this approach. In this article, we describe an easier double mandibular osteotomy (Segmental Mandibular Swing Approach) which avoids the morbidity associated with lip splitting or intra-oral mucosal incision but allows excellent exposure of the superior and lateral aspect of PPS for easier removal of large tumors in this region.

  2. Facial pressure sore complicated by mandibular osteomyelitis.

    PubMed

    Taylor, J; Obisesan, O

    1999-10-01

    A case is reported of an 85-year-old woman with mandibular osteomyelitis secondary to a submental pressure sore. The main aetiological factors in the development of the pressure sore were dementia and severe senile kyphosis. Pressure sores are rare in the head and neck region and, though osteomyelitis is a common complication at other anatomical sites, it has not been previously reported in the mandible.

  3. 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

  4. Long-term three-dimensional stability of mandibular advancement surgery

    PubMed Central

    Franco, Alexandre A.; Cevidanes, Lucia Helena S.; Phillips, Ceib; Rossouw, Paul Emile; Turvey, Timothy A.; Carvalho, Felipe de Assis R.; de Paula, Leonardo K.; Quintão, Cátia Cardoso A.; Almeida, Marco Antonio O.

    2013-01-01

    PURPOSE To evaluate the three-dimensional changes in the position of the condyles, rami, and chin from 1 to 3 years after mandibular advancement surgery. METHOD This prospective observational study used pre and postoperative CBCT scans of 27 subjects with skeletal Class II jaw relationship and normal or deep overbite. An automatic technique of cranial base superimposition was used to assess positional and/or bone remodeling changes that were visually displayed and quantified using 3D color maps. An analysis of covariance with presence of genioplasty, age at the time of surgery, and sex as explanatory variables was used to estimate and test the adjusted mean changes for each region of interest. RESULTS The chin rotated downward and backwards between the 1 and 3 years post-surgery. Changes ≥ 2mm were observed in 17% of the cases. The mandibular condyles presented displacements and/or bone remodeling ≥ 2mm on the anterior surface (21% of the cases on the left and 13% on the right side), superior surfaces (8% on both sides) and lateral poles (17% on the left and 4% on the right side). The posterior borders of the rami exhibited symmetric lateral or rotational displacements in 4% of the cases. CONCLUSION In the hierarchy of surgical stability, mandibular advancement surgery is considered one of the most stable surgical procedures However, between 1 and 3 years post-surgery approximately 20% of the patients had 2-4 mm changes in the horizontal and vertical chin position, and/or changes in condylar position and adaptive bone remodeling. PMID:23769460

  5. 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

  6. Identification of the mandibular landmarks in a pediatric population

    PubMed Central

    Sekerci, Ahmet E.; Miloglu, Ozkan; Buyuk, Suleyman K.

    2014-01-01

    Objectives: The aim of this study was to determine and compare the reliability to accomplish of common mandibular landmarks and to determine the incidence of incisive canals, anterior looping, and lingual foramina in children from panoramic and CBCT images. Study Design: Panoramic and CBCT images from 100 children and adolescent patients were randomly selected. In order to grade the visibility of mandibular anatomical landmarks, a four-point rating scale was used. Results: In panoramic images, the mandibular canal could be observed in 92.5% of cases, with good visibility in 12.0%. The mental foramen could be observed in 44.5% of cases, while none had good visibility. Anterior looping of the mental nerve was present in 16.5% of the cases, and none had good visibility. An incisive canal could be identified in 22.5% of cases, with only 1.5% showing good visibility. The lingual foramen could be visualized in 61.0% of cases, with good visibility in 6%. In CBCT images, the mandibular canal, the mental foramen, and the lingual foramen could be observed in 100% of the cases, with good visibility in 51.0%, 98.5%, and 45.0% of cases, respectively. Anterior looping of the mental nerve was present in 26% of cases, with 2% having good visibility. An incisive canal could be identified in 49.5% of cases, with only 75% showing good visibility. Conclusions: This study confirms the applicability of CBCT images to visualize critical structures in children. Key words:Panoramic radiography, cone beam computed tomography, anatomical landmark. PMID:24121905

  7. Topography of descending projections from anterior insular and medial prefrontal regions to the lateral habenula of the epithalamus in the rat.

    PubMed

    Kim, Uhnoh; Lee, Taehee

    2012-04-01

    The epithalamic lateral nucleus of the habenula (LHb) plays a key role in regulating firing of dopamine and serotonin neurons in the midbrain and is thereby involved in various cognitive and affective behaviors. It is not yet clear, however, from where the LHb receives cognitive and affective information relevant to its regulation of the midbrain monoaminergic systems. The prefrontal cortex would be among the ideal sources. Here, using anterograde and retrograde tracer injections in the rat brain, we characterized the topography of the corticohabenular projections. Following injections of cholera toxin subunit B into the LHb, retrogradely labeled neurons were produced in the anterior insular, cingulate, prelimbic and infralimbic cortices. Consistent with this retrograde tracing, injections of biotinylated dextran amine (BDA) into these cortical regions labeled robust terminals in the LHb. Our quantification of the BDA-impregnated varicosities revealed that projections from the anterior insula terminated mainly in the intersection regions of the lateral and ventral two-thirds of the LHb, while projections from the cingulate cortex terminated mainly in the lateral two-thirds of the LHb. By comparison, BDA-labeled terminals originating from the medial prefrontal regions were contained mainly in the medial plus ventral one-third of LHb. Based on these data, we hypothesize that LHb provides a link for conveying cognitive and affective information from prefrontal and insular regions to the midbrain monoaminergic centers.

  8. 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

  9. [A device for mandibular advancement in respiratory disorders of sleep. Clinical study].

    PubMed

    Bacon, W; Tschill, P; Sforza, E; Krieger, J

    2000-12-01

    This study describes the technical steps for the making of a mandibular advancement device for sleep disordered patients (apnea index < 10). In a second part of the study, a group of 21 patients with sleep disordered breathing treated successfully with a mandibular advancement device is compared to a homologous control group. The experimental group showed cephalometric characteristics approaching those seen in patients with sleep apnea syndrome. The mandibular advancement device moved the mandibule forward (SNB angle increases by 1.7 degrees) and downward (mandibular plane angle increases by 3 degrees, which can be related to the 7.4 mm anterior vertical height increase). The hyoid bone adopted a more distant position from the cervical vertebrae. Important individual variations were seen among the patients for the optimal repositioning of the mandible.

  10. Manual reduction of articular disc after traumatic extraction of mandibular third molar: a case report

    PubMed Central

    Camino, Rubens; Manzi, Marcello Roberto; de Carvalho, Matheus Furtado; Luz, João Gualberto de Cerqueira; Pimentel, Angélica Castro; Deboni, Maria Cristina Zindel

    2015-01-01

    Introduction: Disc displacement without reduction with limited opening is an intracapsular biomechanical disorder involving the condyle-disc complex. With the mouth closed, the disc is in an anterior position in relation to the condylar head and does not reduce with mouth opening. This disorder is associated with persistent limited mandibular opening. Case report: The patient presented severe limitation to fully open the mouth, interfering in her ability to eat. Clinical examination also revealed maximum assisted jaw opening (passive stretch) with less than 40 mm of maximum interincisal opening. Magnetic resonance imaging was the method of choice to identify the temporomandibular disorders. Conclusion: By means of reporting this rare case of anterior disc displacement without reduction with limited opening, after traumatic extraction of a mandibular third molar, in which manual reduction of temporomandibular joint articular disc was performed, it was possible to prove that this technique is effective in the prompt restoration of mandibular movements. PMID:26560828

  11. Number and localization of the implants for the fixed prosthetic reconstructions: on the strain in the anterior maxillary region.

    PubMed

    Bölükbaşı, Nilüfer; Yeniyol, Sinem

    2015-04-01

    Resorption following tooth loss and poor bone quality affect the success of implants in the anterior maxilla. Inappropriate planning can cause implant loss and aesthetics problems that are difficult to resolve. There is a limited literature on the optimum number and location of implants in anterior maxilla for fabricating fixed prosthesis in biomechanical terms. This study investigated the effect of dental implant localizations in anterior maxilla on the strain values around implants using a three dimensional finite elements analysis method. Obtained strain values were compared to the data in Frost's mechanostat theory. The entire totally edentulous maxilla was modeled using computer tomography images and five models were prepared representing different implant localizations. The distribution of implants in the models was as follows: two canines in the first model, two canines and one central incisor in the second model, two canines and central incisor in the third model, two canines and one lateral incisor in the fourth model and two canines and two lateral incisors in the fifth model. Anatomic abutments with a gingival height of 2 mm and angle of 15° were used as the abutments to fabricate one piece cemented metal fused to porcelain restoration. A chewing strength of 100 N was applied to the cingulum of all crowns at a 45° angle. Maximum strain values in all models were measured in cortical bone in implant necks. The highest strain value was measured in the first model at the cortical bone area (3037 microstrain). Except the first model, all models showed micro strain values within 1000-3000 microstrain. The fifth model was the least risky method in biomechanical terms. The results of this study should be compared with different clinical scenarios (for example different implant designs and sizes). Due to the limitations of three-dimensional finite elements analysis studies, the findings of the study need to be supported by clinical studies.

  12. Molarization of mandibular second premolar.

    PubMed

    Mangla, Neha; Singh Khinda, Vineet Inder; Kallar, Shiminder; Singh Brar, Gurlal

    2014-05-01

    Macrodontia (megadontia, megalodontia, mac rodontism) is a rare shape anomaly that has been used to describe dental gigantism. Mandibular second premolars show an elevated variability of crown morphology, as are its eruptive potential and final position in the dental arch. To date, only eight cases of isolated macrodontia of second premolars have been reported in the literature. This case report presents clinical and radiographic findings of unusual and rare case of isolated unilateral molarization of left mandibular second premolar. How to cite this article: Mangla N, Khinda VIS, Kallar S, Brar GS. Molarization of Mandibular Second Premolar. Int J Clin Pediatr Dent 2014;7(2):137-139. PMID:25356014

  13. [Statistical study of mandibular resections].

    PubMed

    Sidibe, C A; Dichamp, J; Razouk, O; Bertrand, J C; Guilbert, G

    1994-01-01

    A retrospective study of mandibular resections performed from 1980 to 1984 was conducted to evaluate age, sex, aetiology, etc. The number of mandibular resections appears to have declined at the Institute of Stomatology and Maxillofacial Surgery of the Pitié-Salpêtrière Hospital. Different factors are involved included early diagnosis, improved surgical techniques and better patient follow-up. Partial mandibular resections are increasingly performed (52% of the cases) compared with total resections. Finally, a better understanding of the pathologies involved, especially tumours, has led to an adaptation of the resection techniques to avoid extensive mutilations.

  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. 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

  16. 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

  17. Fetal and infant growth patterns of the mandibular symphysis in modern humans and chimpanzees (Pan troglodytes).

    PubMed

    Coquerelle, Michael; Bookstein, Fred L; Braga, José; Halazonetis, Demetrios J; Weber, Gerhard W

    2010-11-01

    Comparison of the early development of the mandibular symphysis between primates and modern humans is of particular interest in human palaeontology. Using geometric morphometric methods, we explored and compared the ontogenetic shape changes of 14 chimpanzee mandibles (Pan troglodytes) against 66 human CT-scanned mandibles over the age range from fetal life to the complete emergence of the deciduous dentition in a visualization incorporating the deciduous tooth arrangement. The results reveal that the symphysis is anteriorly inclined in the youngest chimpanzee fetuses but develops an increasingly vertical orientation up until birth. At the same time, the anterior teeth reorient before a vertical emergence, and a symphyseal tuber appears on the labial side. When the deciduous canine emerges, the symphysis inclines anteriorly again, exhibiting the adult characteristic slope. These two phases are characterized by a repositioning of the simian shelf. Unlike chimpanzees, the human symphysis remains vertical throughout fetal development. However, the combination of morphological changes observed in chimpanzee fetuses is similar to that of modern humans after birth, as the mental region projects forward. By elongating the alveolar process, the inclination of the chimpanzee symphysis could be a key event for emergence of the deciduous canine, as space is lacking at the alveolar ridge in a vertical symphysis once the deciduous incisors and molars have emerged. The repositioning of the simian shelf suggests that the suprahyoid muscles have a significant influence on the anterior growth of the symphysis. The anteroposterior positioning of the basal symphysis in both species may be related to hyoid bone position during ontogeny.

  18. Fetal and infant growth patterns of the mandibular symphysis in modern humans and chimpanzees (Pan troglodytes)

    PubMed Central

    Coquerelle, Michael; Bookstein, Fred L; Braga, José; Halazonetis, Demetrios J; Weber, Gerhard W

    2010-01-01

    Comparison of the early development of the mandibular symphysis between primates and modern humans is of particular interest in human palaeontology. Using geometric morphometric methods, we explored and compared the ontogenetic shape changes of 14 chimpanzee mandibles (Pan troglodytes) against 66 human CT-scanned mandibles over the age range from fetal life to the complete emergence of the deciduous dentition in a visualization incorporating the deciduous tooth arrangement. The results reveal that the symphysis is anteriorly inclined in the youngest chimpanzee fetuses but develops an increasingly vertical orientation up until birth. At the same time, the anterior teeth reorient before a vertical emergence, and a symphyseal tuber appears on the labial side. When the deciduous canine emerges, the symphysis inclines anteriorly again, exhibiting the adult characteristic slope. These two phases are characterized by a repositioning of the simian shelf. Unlike chimpanzees, the human symphysis remains vertical throughout fetal development. However, the combination of morphological changes observed in chimpanzee fetuses is similar to that of modern humans after birth, as the mental region projects forward. By elongating the alveolar process, the inclination of the chimpanzee symphysis could be a key event for emergence of the deciduous canine, as space is lacking at the alveolar ridge in a vertical symphysis once the deciduous incisors and molars have emerged. The repositioning of the simian shelf suggests that the suprahyoid muscles have a significant influence on the anterior growth of the symphysis. The anteroposterior positioning of the basal symphysis in both species may be related to hyoid bone position during ontogeny. PMID:20807267

  19. 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.

  20. 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

  1. Mandibular condylectomy in a horse.

    PubMed

    Patterson, L J; Shappell, K K; Hurtig, M B

    1989-07-01

    Mandibular condylectomy was effective in improving mastication and stopping weight loss in a horse. The horse had a history of intermittent purulent drainage from a facial wound and unilateral ankylosis of the temporomandibular joint. PMID:2759880

  2. Mandibular shape and skeletal divergency.

    PubMed

    Ferrario, V F; Sforza, C; De Franco, D J

    1999-04-01

    Pre-treatment lateral cephalograms of 41 skeletal Class I girls aged 11 to 15 were divided according to MP-SN angle: lower than 28 degrees (hypodivergent, 10 girls), between 31 and 34 degrees (normodivergent, 18 girls), or larger than 37 degrees (hyperdivergent, 13 girls). The mandibular outlines were traced and digitized, and differences in shape were quantified using the elliptic Fourier series. Size differences were measured from the areas enclosed by the mandibular outlines. Shape differences were assessed by calculating a morphological distance (MD) between the size-independent mean mathematical reconstructions of the mandibular outlines of the three divergency classes. Mandibular shape was different in the three classes: large variations were found in hyperdivergent girls versus normodivergent girls (MD = 4.61), while smaller differences were observed in hypodivergent girls (MD versus normodivergent 2.91). Mean size-independent mandibular shapes were superimposed on an axis passing through the centres of gravity of the condyle and of the chin. Normodivergent and hyperdivergent mandibles differed mostly at gonion, the coronoid process, sigmoid notch, alveolar process, posterior border of the ramus, and along the mandibular plane. A significant size effect was also found, with smaller mandibles in the hyperdivergent girls.

  3. 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

  4. 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

  5. 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

  6. Golden proportion assessment between maxillary and mandibular teeth on Indian population

    PubMed Central

    Kumar, Vaikunth Vijay; Rangarajan, Vedantham

    2012-01-01

    PURPOSE This study evaluated the existence of golden proportion between the widths of the maxillary and mandibular anterior teeth in Indian population. MATERIALS AND METHODS The clinical tooth width measurements were recorded with the digital vernier calipers on 576 patients of both sexes in the age group of 21 - 30 years. Flexible ruler was used to determine the width of maxillary and mandibular anterior teeth on the patients by the same operator. The data obtained was statistically analyzed using paired student t-test (α=.05). RESULTS The golden proportion was not found between the width of the right central and lateral incisors in 53% of women and 47% of men. The results revealed the golden percentage was rather inconstant in terms of relative tooth width. CONCLUSION The golden proportion is an inappropriate method to relate the successive widths of the maxillary anterior teeth in Indian population. PMID:22737310

  7. 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

  8. Treatment of mandibular prognathism.

    PubMed

    Chang, Hong-Po; Tseng, Yu-Chuan; Chang, Hsin-Fu

    2006-10-01

    Mandibular prognathism (MP) or skeletal Class III malocclusion with a prognathic mandible is one of the most severe maxillofacial deformities. Facial growth modification can be an effective method of resolving skeletal Class III jaw discrepancies in growing children with dentofacial orthopedic appliances including the chincup, face mask, maxillary protraction combined with chincup traction and the Fränkel functional regulator III appliance. Orthognathic surgery in conjunction with orthodontic treatment is required for the correction of adult MP. The two most commonly applied surgical procedures to correct MP are sagittal split ramus osteotomy (SSRO) and intraoral vertical ramus osteotomy. Both procedures are suitable for patients in whom a desirable occlusal relationship can be obtained with a setback of the mandible, and each has its own advantages and disadvantages. In bilateral SSRO, the intentional ostectomy of the posterior part of the distal segment can offer long-term positioned stability. This may be attributable to reduction of tension in the pterygomasseteric sling that applies force in the posterior mandible. While various environmental factors have been found to contribute to the development of MP, heredity plays a substantial role. The relative contributions of genetic and environmental components in the etiology of MP are unclear. The recent identification of the genetic susceptibilities to MP constitutes the first step toward understanding the molecular pathogenesis of MP. Further studies in molecular biology are needed to identify the gene-environment interactions associated with the phenotypic diversity of MP and the heterogenic developmental mechanisms thought to be responsible for them.

  9. Osteochondroma of Bilateral Mandibular Condyle with Review of Literature.

    PubMed

    Kamble, Vijaya; Rawat, Jitesh; Kulkarni, Ameya; Pajnigara, Nilufer; Dhok, Avinash

    2016-08-01

    Osteochondroma (OC) is a common slow growing tumour of bone. This lesion is frequently seen in the axial skeleton and is relatively uncommon in oral and maxillofacial region. In facial bones, it usually affects the mandibular condyle followed by coronoid process. Very few cases of condylar osteocondroma have been reported in the literature. The aim of this article was to present an atypical case of osteochondroma of bilateral mandibular condyle in an asymptomatic patient and facilitate making an exact diagnosis of it. To the best of our knowledge this is the 2(nd) case of this type reported in literature. PMID:27656529

  10. Osteochondroma of Bilateral Mandibular Condyle with Review of Literature

    PubMed Central

    Kamble, Vijaya; Kulkarni, Ameya; Pajnigara, Nilufer; Dhok, Avinash

    2016-01-01

    Osteochondroma (OC) is a common slow growing tumour of bone. This lesion is frequently seen in the axial skeleton and is relatively uncommon in oral and maxillofacial region. In facial bones, it usually affects the mandibular condyle followed by coronoid process. Very few cases of condylar osteocondroma have been reported in the literature. The aim of this article was to present an atypical case of osteochondroma of bilateral mandibular condyle in an asymptomatic patient and facilitate making an exact diagnosis of it. To the best of our knowledge this is the 2nd case of this type reported in literature. PMID:27656529

  11. 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

  12. 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

  13. Adenocarcinoma metastatic to the mandibular condyle.

    PubMed

    Webster, K

    1988-07-01

    Two cases of metastatic lesions presenting in the mandibular condyle as Temporo-Mandibular Joint Pain Dysfunction Syndrome are presented with a discussion on the mechanisms of tumour metastases to bone.

  14. 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

  15. 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.

  16. The effect of maxillary first premolar extraction and incisor retraction on mandibular position: testing the central dogma of "functional orthodontics".

    PubMed

    Luecke, P E; Johnston, L E

    1992-01-01

    It has been argued by a vocal coterie of disaffected dentists that premolar extraction, incisor retraction, and "backward-pulling" mechanics conspire to "distalize" the condyles and, pari passu, to produce craniomandibular dysfunction. Given the gravity of this conjecture, it seemed appropriate to test the predictions it generates in a sample of patients of the type most often said to be at risk: 42 "edgewise" patients with Class II, Division 1 malocclusions, treated in conjunction with the extraction of two maxillary first premolars. Regional and anterior cranial-base cephalometric superimpositions were used to quantify the individual components of the molar and overjet corrections, to measure both at the chin and condyles the mandibular displacement seen during treatment, and to examine the extent to which this displacement is related to the correction of maxillary incisor protrusion. Although the present patients underwent marked upper incisor retraction (on average, about 5 mm), lip retraction was much less pronounced, and 70% of the sample showed a net forward displacement of mandibular basal bone. Significantly, changes in condylar position were not correlated with incisor retraction, as the "functional orthodontists" would have it, but rather with the changes in the buccal occlusion and the growth of the maxilla. Thus, 30% of the patients who showed evidence of distal displacement were generally nongrowing patients who underwent more than average anchorage loss in the mandible and less than average loss in the maxilla.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. 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

  18. 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

  19. Overwhelming hypercalcaemia in mandibular ameloblastoma

    PubMed Central

    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

  20. Accuracy of perioperative mandibular positions in orthognathic surgery.

    PubMed

    Borba, A M; Ribeiro-Junior, O; Brozoski, M A; Cé, P S; Espinosa, M M; Deboni, M C Z; Miloro, M; Naclério-Homem, M G

    2014-08-01

    Mandibular position is an important parameter used for the diagnosis of dentofacial deformities, as well as for orthognathic surgery planning and execution. Centric relation (anterior and superior relationship of the mandibular condyles interposed by the thinnest portion of their disks against the articular eminencies), centric occlusion (when lower teeth contact upper teeth at centric relation), and maximal intercuspation (complete interdigitation of lower and upper teeth) are not often addressed as factors that influence the results of orthognathic surgery, although these relationships are critical to ensure accuracy during the surgery. The present study assessed occlusal measurements taken before and after the induction of general anaesthesia from consecutive orthognathic surgery subjects. The variables assessed included the differences between these occlusal measurements, patient age, gender, type of deformity, and type of proposed orthognathic surgical procedure. The results demonstrated statistically significant differences for mandibular retrusion from maximal intercuspation to centric occlusion position, whereas the mandible appeared not to change significantly from centric occlusion after the induction of general anaesthesia. Patient age and the type of deformity appeared to influence the results. While in most instances centric occlusion can be adequately reproduced under general anaesthesia, for some specific orthognathic cases more accurate results might be obtained if the mandible-first sequence is used.

  1. Closed reduction of the mandibular fracture.

    PubMed

    Blitz, Meredith; Notarnicola, Kurt

    2009-03-01

    The search for the ideal method of treatment for mandibular fractures has continued for thousands of years. These injuries have unique and problematic features for adequate reliable wound healing. Oral and maxillofacial surgeons must learn and master several techniques for mandibular fracture treatment. The age-old successful management of these injuries using closed reduction techniques always should be considered when mandibular trauma presents. The closed reduction remains a mainstay of mandibular fracture treatment. An adequate knowledge of anatomy, multiple closed reduction techniques, and the physiology of fracture healing must be adequately understood and technically mastered by the oral and maxillofacial surgical team for the present and future of mandibular fracture management.

  2. Facial talon cusp on mandibular incisor: a rare case report with review of literature.

    PubMed

    Sachdeva, Suresh K; Verma, Pradhuman; Dutta, Sanjay; Verma, Kanika Gupta

    2014-01-01

    Talon cusp is a relatively rare developmental dental anomaly thought to arise as a result of evagination on the surface of a tooth crown before calcification has occurred. It is characterized by cusp-like projections from the cingulum area, or cemento-enamel junction of maxillary or mandibular anterior teeth, in both the primary and permanent dentition, usually observed on the lingual surface of the affected tooth. The cusp may or may not contain an extension of the pulp. The etiology remains unknown. The incidence is 0.04-8%. Any tooth may have a talon cusp but most of the cases involve maxillary lateral incisors. The anomaly has been reported to be rare especially when it occurs on mandibular teeth. This article reports a case of talon cusp on permanent mandibular central incisor that too on facial aspect which makes it a rare entity. PMID:25099002

  3. Nonsurgical correction of a Class III malocclusion in an adult by miniscrew-assisted mandibular dentition distalization.

    PubMed

    Jing, Yan; Han, Xianglong; Guo, Yongwen; Li, Jingyu; Bai, Ding

    2013-06-01

    This article reports the successful use of miniscrews in the mandible to treat a 20-year-old Mongolian woman with a chief complaint of anterior crossbite. The patient had a skeletal Class III malocclusion with a mildly protrusive mandible, an anterior crossbite, and a deviated midline. In light of the advantages for reconstruction of the occlusal plane and distal en-masse movement of the mandibular arch, we used a multiloop edgewise archwire in the initial stage. However, the maxillary incisors were in excessive labioversion accompanied by little retraction of the mandibular incisors; these results were obviously not satisfying after 4 months of multiloop edgewise archwire treatment. Two miniscrews were subsequently implanted vertically in the external oblique ridge areas of the bilateral mandibular ramus as skeletal anchorage for en-masse distalization of the mandibular dentition. During treatment, the mandibular anterior teeth were retracted about 4.0 mm without negative lingual inclinations. The movement of the mandibular first molar was almost bodily translation. The maxillary incisors maintained good inclinations by rotating their brackets 180° along with the outstanding performance of the beta-titanium wire. The patient received a harmonious facial balance, an attractive smile, and ideal occlusal relationships. The outcome was stable after 1 year of retention. Our results suggest that the application of miniscrews in the posterior area of the mandible is an effective approach for Class III camouflage treatment. This technique requires minimal compliance and is particularly useful for correcting Class III patients with mild mandibular protrusion and minor crowding. PMID:23726338

  4. 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.

  5. Brodie bite with an extracted mandibular first molar in a young adult: a case report.

    PubMed

    Chugh, Vinay K; Sharma, Vijay P; Tandon, Pradeep; Singh, Gyan P

    2010-05-01

    Total buccal crossbites are rare, but, when they occur, they can be extremely difficult to correct, even with surgery and orthodontics. In most patients with in-locking crossbites, the maxillary teeth erupt past their mandibular antagonists, creating severe occlusal difficulties. This article presents an adult patient with scissors-bite or partial telescoping bite bilaterally in the posterior region and an extracted mandibular first molar on the right side. She was treated with expansion of the mandibular arch, and the subsequent open bite was closed with the help of masticatory muscle exercises and high-pull headgear. The second and third molars were uprighted and moved mesially to close the extraction spaces.

  6. Functional anatomy of the mandibular nerve: consequences of nerve injury and entrapment.

    PubMed

    Piagkou, Maria; Demesticha, Theano; Skandalakis, Panayiotis; Johnson, Elizabeth O

    2011-03-01

    Various anatomic structures including bone, muscle, or fibrous bands may entrap and potentially compress branches of the mandibular nerve (MN). The infratemporal fossa is a common location for MN compression and one of the most difficult regions of the skull to access surgically. Other potential sites for entrapment of the MN and its branches include, a totally or partially ossified pterygospinous or pterygoalar ligament, a large lamina of the lateral plate of the pterygoid process, the medial fibers of the lower belly of the lateral pterygoid muscle and the inner fibers of the medial pterygoid muscle. The clinical consequences of MN entrapment are dependent upon which branches are compressed. Compression of the MN motor branches can lead to paresis or weakness in the innervated muscles, whereas compression of the sensory branches can provoke neuralgia or paresthesia. Compression of one of the major branches of the MN, the lingual nerve (LN), is associated with numbness, hypoesthesia, or even anesthesia of the tongue, loss of taste in the anterior two thirds of the tongue, anesthesia of the lingual gums, pain, and speech articulation disorders. The aim of this article is to review, the anatomy of the MN and its major branches with relation to their vulnerability to entrapment. Because the LN expresses an increased vulnerability to entrapment neuropathies as a result of its anatomical location, frequent variations, as well as from irregular osseous, fibrous, or muscular irregularities in the region of the infratemporal fossa, particular emphasis is placed on the LN.

  7. Application of the functionally generated path technique to restore mandibular molars in bilateral group function occlusion.

    PubMed

    DuVall, Nicholas B; Rogers, Paul M

    2013-04-01

    The functionally generated path (FGP) is a static representation of the opposing cusps' dynamic eccentric movements from a centric position to achieve optimal articulation and occlusal harmony. When understood and appreciated, use of the FGP technique is a straightforward and practical method to achieve harmonious occlusal anatomy of restorations with the anterior determinant/anterior guidance, the posterior determinant/condylar guidance, existing occlusal and cuspal anatomy, and the neuromuscular system. Although the FGP technique is normally used in the fabrication of maxillary posterior indirect restorations, it is described and applied here in the fabrication of mandibular posterior restorations that maintained the patient's bilateral group function occlusion while eliminating the nonworking side and protrusive interferences. This novel procedure involved the use of a stone crib to intraorally construct a stone core that captured the FGP recording while simultaneously indexing to the contralateral and ipsilateral mandibular dentition. This technique lends additional stability to the stone core to minimize error during the mounting process.

  8. 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.

  9. Effects of experimental unilateral condylectomy followed by altered mandibular function on the maxilla and zygoma.

    PubMed

    Spyropoulos, M N; Tsolakis, A I; Katsavrias, E; Alexandridis, K

    1997-04-01

    The effect of protruded mandibular function on the maxilla and zygoma was studied in young unilaterally condylectomized growing rats. Forty-eight-4-week-old rats were divided into two experimental and two control groups as follows: group A, 12 animals unilaterally condylectomized on the right side; the mandible was allowed to function normally; group B, 12 animals unilaterally condylectomized on the right side; the mandible was protracted forwards immediately by means of an appliance; group C, 12 animals sham-operated on the right side; no condylectomy or mandibular protraction; and group d, 12 control animals not subjected to any operation or mandibular protraction. The mandibular protraction was achieved by an appliance consisting of an acrylic collar brace fitted to the animal's neck and supporting rubber bands pulling on an intraoral part cemented on the animal's lower incisors. Twenty-five grams of pulling force and protrusion to a clinically and radiographically testes anterior crossbite was exercised for 12 hours per day. The experimental period was 30 days. Lateral and dorsoventral radiographs were taken on days 1 and 30 following condylectomies and mandibular protraction. Cephalometric analysis was performed for each animal with measurements evaluating the maxilla and zygoma. Statistical analysis and comparison of the findings in the four groups of animals can be summarized as follows: (i) condylectomy and altered mandibular function may produce remote skeletal reactions in other parts of the cranial complex; and (ii) the ipsilateral maxilla is affected by condylectomy of the mandible, but altered mandibular function by protraction compensates for the results of condylectomy. PMID:9183070

  10. 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

  11. Osteochondroma of the mandibular condyle: Report of two surgical approaches.

    PubMed

    Lim, William; Weng, Lye Kok; Tin, Goh Bee

    2014-01-01

    Osteochondromas are common tumors of the long bones, but are rare in the craniofacial region. We detailed two different management of osteochondroma of the mandibular condyle treated utilizing three-dimensional (3D) imaging and computer-assisted planning. Simultaneous open temporomandibular joint and orthognathic surgeries were done to treat both the pathology and secondary facial asymmetry. An osteochondroma that presented as a bony mass at the lateral aspect of the left mandibular condyle of a 24-year-old Chinese female was treated with simultaneous orthognathic surgery and conservative excision. No recurrence was detected 7 months postsurgery. An osteochondroma that presented as a generalized enlargement of the right mandibular condyle of a 25-year-old Chinese male was treated with simultaneous orthognathic surgery and condylectomy. There were no significant issues 3 years postsurgery. Simultaneous orthognathic and temporomandibular joint surgeries are a viable option for the management of osteochondroma of the mandibular condyle. The availability of 3D imaging enabled better presurgical examination of the lesion, which directed treatment toward condylectomy or conservative excision.

  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.

  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. [Bone regeneration over plastic implants after mandibular resection breaking the continuity].

    PubMed

    Utz, W

    1977-04-01

    In young patients, bone regeneration may start from the region of the temporo-mandibular joint and from the peripheral mandibular stump in cases of continuity defects of the mandible. A resin graft implanted for soft tissue reconstruction is collar-like surrounded by bone which is developing into a functionally and anatomically full regenerate over many years, in correspondence to periosteal and desmal growth stimuli. In adults, regeneration is minimal.

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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

  20. Changes in NMDA receptor subunits and interacting PSD proteins in dorsolateral prefrontal and anterior cingulate cortex indicate abnormal regional expression in schizophrenia.

    PubMed

    Kristiansen, L V; Beneyto, M; Haroutunian, V; Meador-Woodruff, J H

    2006-08-01

    Abnormal expression of the N-methyl-D-Aspartate (NMDA) receptor and its interacting molecules of the postsynaptic density (PSD) are thought to be involved in the pathophysiology of schizophrenia. Frontal regions of neocortex including dorsolateral prefrontal (DLPFC) and anterior cingulate cortex (ACC) are essential for cognitive and behavioral functions that are affected in schizophrenia. In this study, we have measured protein expression of two alternatively spliced isoforms of the NR1 subunit (NR1C2 and NR1C2') as well as expression of the NR2A-D subunits of the NMDA receptor in DLPFC and ACC in post-mortem samples from elderly schizophrenic patients and a comparison group. We found significantly increased expression of NR1C2' but not of NR1C2 in ACC, suggesting altered NMDA receptor cell membrane expression in this cortical area. We did not find significant changes in the expression of either of the NR1 isoforms in DLPFC. We did not detect changes of any of the NR2 subunits studied in either cortical area. In addition, we studied expression of the NMDA-interacting PSD molecules NF-L, SAP102, PSD-95 and PSD-93 in ACC and DLPFC at both transcriptional and translational levels. We found significant changes in the expression of NF-L in DLPFC, and PSD-95 and PSD-93 in ACC; increased transcript expression was associated with decreased protein expression, suggesting abnormal translation and/or accelerated protein degradation of these molecules in schizophrenia. Our findings suggest abnormal regional processing of the NMDA receptor and its associated PSD molecules, possibly involving transcription, translation, trafficking and protein stability in cortical areas in schizophrenia.

  1. Exostosis of the mandibular coronoid process.

    PubMed

    Michel, R G; Hudson, W R; Drawbaugh, E J; Baylin, G J

    1977-01-01

    Abnormal enlargement of one or both mandibular coronoid processes may lead to a limited mandibular excursion. A case of unilateral coronoid process exostosis severely limiting mandibular function is described. A review of the literature pertinent to this uncommon abnormality is presented. The various entities of coronoid process osteochondroma, osteoma, exostosis, hypertrophy and developmental anomaly, all producing a similar picture of coronoid process enlargement are discussed. The proper use of the available radiographic techniques simplifies the diagnosis of these uncommon maladies, as long as a coronoid process abnormality is considered in the differential diagnosis of restricted mandibular movement.

  2. Centric relation registration using an anterior deprogrammer in dentate patients.

    PubMed

    Hunter, B D; Toth, R W

    1999-03-01

    A technique is described for registering centric relation in dentate patients using an anterior deprogrammer to prevent muscle splinting. Properly executed, the patient is able to close into centric relation unassisted, eliminating the possibility of operator-induced error associated with commonly accepted manipulative techniques. Verification is possible visually when articulating casts by confirming the precise alignment of the mandibular incisors with occlusal markings on the deprogrammer attached to the maxillary cast.

  3. 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

  4. Treatment of anterior dental crossbite using bonded resin-composite slopes: case reports.

    PubMed

    Bayrak, Sule; Tunc, Emine Sen

    2008-10-01

    Anterior crossbite is the term used to describe an abnormal labiolingual relationship between one or more maxillary and mandibular incisor teeth. Different techniques have been used to correct anterior crossbite. This paper describes the use of bonded resin-composite slopes for the management of anterior crossbite in children in early mixed dentition.In each of the cases presented here, dental crossbite was corrected by applying a 3-4 mm bonded resin-composite slope to the incisal edge of the mandibular incisor with an angle 45 degrees to the longitudinal axis of the tooth. Correction was achieved within 1-2 weeks with no damage to either the tooth or the marginal periodontal tissue. The procedure is a simple and effective method for treating anterior dental crossbite.

  5. Relationship between disease course in the temporomandibular joints and mandibular growth rotation in patients with juvenile idiopathic arthritis followed from childhood to adulthood

    PubMed Central

    2010-01-01

    Objective To investigate the relationship between radiographic JIA disease course in the TMJs and mandibular growth rotation, compared with growth in healthy individuals. Methods From a larger series of JIA patients followed from childhood to adulthood, 26 were included; 11 without and 15 with bilateral radiographic TMJ involvement. Joint morphology and function were assessed at baseline, 2-, 4-, 6- and 27 years follow-up. Mandibular growth rotation (anterior, posterior or none) was assessed from cephalometric evaluations at childhood and adulthood, with observations from 16 healthy individuals as controls. TMJ disease course and mandibular growth rotation were assessed independently and their relationship analysed. Non-parametric statistical methods were applied to test differences between groups. Results In the normal TMJ group of JIA patients the joint morphology was similar at the follow-ups and all patients had good function both in childhood and in adulthood. The mandibular growth rotation was similar to that of healthy controls, i.e. predominantly in anterior direction. In the abnormal TMJ group different JIA TMJ disease courses were observed and associated with changes in the mandibular growth rotation (p = 0.007). Progressing JIA TMJ disease course was related to posterior mandibular growth rotation and improving disease course to anterior mandibular growth rotation. Conclusion A relationship was found between JIA disease course in the TMJs and mandibular growth rotation, suggesting that a favourable growth could be regained in patients with improvement in TMJ morphology and/or TMJ function. To confirm this, further research on larger patient series is needed. PMID:20412568

  6. A rare presentation of dens in dente in the mandibular third molar with extra oral sinus

    PubMed Central

    Bansal, Monika; Singh, NN; Singh, Anand Pratap

    2010-01-01

    The unusual case of dense in dente in mandibular molar area with extra oral sinus in a 30-year-old female is presented. The chief complaint of the patient was wound formation and pus discharge from the right side of lower jaw for many years. Clinical examination revealed extra oral sinus and mild swelling in vestibular region opposite the right mandibular molars. On radiographical examination, right mandibular third molar had bulbous root associated with periapical radiolucency. It appeared that there was a tooth within a tooth and the invagination extended nearly to the root apex. A clinical diagnosis of dense in dente Type III was confirmed by stereomicroscopy of ground section of the tooth. Extra oral sinus healed after extraction of the mandibular third molar within a month. PMID:21731269

  7. Mandibular periostitis ossificans in immature large breed dogs: 5 cases (1999-2006).

    PubMed

    Blazejewski, Stanley W; Lewis, John R; Gracis, Margherita; Woodward, Tony M; LeVan, Laura M; Ross, Donald L; Reiter, Alexander M

    2010-01-01

    This case series describes clinical, radiographic, and histopathological features of mandibular swellings in 5 immature, large breed dogs. The dogs originated from different regions of the United States. In each case, intraoral dental radiography of the jaw swelling revealed a two-layered (double) ventral mandibular cortex. Biopsy was performed in 4 of the 5 puppies, revealing periosteal new bone formation. Resolution of the mandibular swelling was spontaneous in the 4 dogs available for follow-up examination. The authors postulate that the clinical, radiographic, and histopathological presentation of mandibular swelling in these 5 dogs is a distinct pathological entity consistent with an inflammatory condition of the maturing human mandible known as periostitis ossificans.

  8. 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

  9. Correction of a mandibular asymmetry after fibula reconstruction using a custom-made polyetheretherketone (PEEK) onlay after implant supported occlusal rehabilitation.

    PubMed

    Berrone, M; Aldiano, C; Pentenero, M; Berrone, S

    2015-10-01

    This study describes an unusual case of mandibular asymmetry after fibula free flap reconstruction in a young man following major facial trauma that was corrected using a custom-made polyetheretherketone prosthesis. There is little information in the literature on the use of alloplasts to correct mandibular asymmetry as interest in 'aesthetic re-modelling' has traditionally focused on nasal, zygomatic and chin regions. This report demonstrates that this technique can be used successfully to address selected cases of mandibular asymmetry.

  10. Correction of a mandibular asymmetry after fibula reconstruction using a custom-made polyetheretherketone (PEEK) onlay after implant supported occlusal rehabilitation.

    PubMed

    Berrone, M; Aldiano, C; Pentenero, M; Berrone, S

    2015-10-01

    This study describes an unusual case of mandibular asymmetry after fibula free flap reconstruction in a young man following major facial trauma that was corrected using a custom-made polyetheretherketone prosthesis. There is little information in the literature on the use of alloplasts to correct mandibular asymmetry as interest in 'aesthetic re-modelling' has traditionally focused on nasal, zygomatic and chin regions. This report demonstrates that this technique can be used successfully to address selected cases of mandibular asymmetry. PMID:26824216

  11. Effects of altered mandibular function on mandibular growth after condylectomy.

    PubMed

    Tsolakis, A I; Spyropoulos, M N; Katsavrias, E; Alexandridis, K

    1997-02-01

    The purpose of this study was to investigate the effect of protruded mandibular function on bilaterally condylectomized mandibles of growing rats. Sixty 4-week-old rats were divided into three experimental and two control groups each consisting of 12 animals as follows: (A) bilateral condylectomy was performed and the mandible was left to function normally; (B) the mandible was protracted forward without any condylectomy; (C) after bilateral condylectomy, the mandible was forced to function in a protruded position; (D) the animals were used as controls without any operation or appliance; and (E) a sham operation was performed in the condylar area but no appliance was used. Mandibular protraction was achieved by means of a specific appliance acting via rubber bands pulling the mandible in a straight, forward direction with a force of 25 g for 12 hours/day. The experimental period was 30 days. Lateral and dorsoventral radiographs were taken and vital dyes were administered on days 1 and 30 for all animals. Cephalometric analysis included 10 measurements. Findings resulting from statistical analysis of measurements in the five groups are summarized as follows: (i) between group A and groups D and E, less growth was found in group A; (ii) between group B and groups D and E, more growth was found in group B; (iii) between group A and group B, more growth was found in group B; (iv) between group A and group C, more growth was found in group C; and (v) between group B and group C, more growth was found in group B. These findings support the conclusion that although mandibular propulsion enhances growth even after condylectomy, the condyle seems to be an essential element for normal growth and development. PMID:9071041

  12. An In-Vivo Correlation Analysis of the Distance Between Lingual Frenal Attachment and Mandibular Incisal Edge Position as an Aid in Establishing Mandibular Occlusal Plane in South Indian Population

    PubMed Central

    Balasubramanian, R; Raj, Krishna

    2015-01-01

    Statement of problem: The aim of the study is to find the reliability in measuring the distance between the anterior attachment of the lingual frenum and the incisal edge of the mandibular central incisor on casts to be used as a pre-extraction record. Purpose: The objective of this study is to give a range of numerical values from anterior attachment of lingual frenum to mandibular central incisors in a class I ridge relation in south Indian population, which may be used in establishing the vertical dimension of the edentulous patient and also to locate the mandibular incisors in teeth arrangement of complete denture fabrication. Materials and Methods: One hundred subjects (50 males and 50 females) under the age group of 21-28y, with class I dental relationship and who have never undergone orthodontic treatment were selected. Two models were made for each subject using irreversible hydrocolloid impression material and type III gypsum product to obtain an average value for each subject. The distance between the incisal edges of the lower central incisor and the anterior attachment of the lingual frenum is measured using a divider and digital vernier caliper. Statistical Analysis: Mean and Standard deviation using descriptive statistics tool using SPSS software version 18. Result: The distance between the anterior attachment of the lingual frenum and incisal edges of mandibular central incisors among the 100 subjects was 14.50mm ± 2.2245 mm. Conclusion: The value obtained aided in establishing the vertical dimension easier by making a pre-determined height of mandibular occlusal rim. PMID:25859527

  13. Reinforced composite restoration following trauma to a mandibular tooth: technique and follow-up treatment.

    PubMed

    Smidt, Ami; Sharon, Eldad; Adler, Mordekhai Lipovetsky

    2012-10-01

    The loss of an entire tooth in the anterior region is accompanied by impairment of esthetics, function, phonetics, and self-esteem. It is common knowledge that treatment with implants during childhood or early adolescence is not an option. Splinting of adjacent teeth during growth and development may interfere with the independent process of teeth realignment and repositioning during that phase of life. Other creative solutions must be offered, such as free-standing composite buildup restorations on compromised broken teeth or single wing/cantilevered restorations adhered to one neighboring tooth during the growth period. The positive effects of reinforced composite materials were researched and presented in the literature. Their use is clearly indicated for interim and economical restorations. Long-term follow-up on a mandibular incisor that experienced trauma, losing its clinical crown and vitality when the patient was 12 years of age, is discussed with all the various aspects of material selection, future considerations, and long-term follow-up to adulthood, when a conventional crown was prepared and delivered.

  14. 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

  15. 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

  16. Mandibular facial talon cusp: a rare case report.

    PubMed

    Prabhu, Rv; Chatra, L; Shenai, P; Kishore, S; Nithin, S; Savitha, D; Prabhu, V

    2014-03-01

    Talon cusp (TC) is a relatively uncommon developmental anomaly characterized by cusp-like projections from the cemento-enamel junction to a variable distance toward the incisal edge of an anterior tooth. It usually presents on palatal/lingual surface of the anterior teeth. Studies have revealed that it consists of enamel, dentine and a variable amount of pulp tissue. Presence of this cusp on the facial surface of an anterior tooth is a rare finding with very few cases being reported in the literature. The effects of TCs are mainly aesthetic and functional. The management requires a sufficient knowledge of the present clinical entity and the problems associated with it. Early detection and treatment plays a very vital role in avoiding the future complications. The present case reports a 25-year-old male patient with a facial TC on the mandibular left central incisor in which a prophylactic enameloplasty was carried out to avoid the stagnation of debris and stain. PMID:25031904

  17. 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

  18. Teeth in the line of mandibular fractures.

    PubMed

    Spinnato, Gaetano; Alberto, Pamela L

    2009-03-01

    Many mandibular fractures occur through tooth sockets. The treatment plan for teeth in the line of fracture has evolved through the years because of the development of new antibiotics and fixation techniques. In this article we review the history and current studies and discuss treatment protocols for teeth in the line of mandibular fractures.

  19. 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

  20. 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.

  1. Mandibular histology and growth of the nonmammaliaform cynodont Tritylodon

    PubMed Central

    Jasinoski, Sandra C; Chinsamy, Anusuya

    2012-01-01

    An investigation of bone microstructure of nonmammalian therapsids has revealed distinctive signals pertaining to their ontogenetic growth and biology. Until now, histological studies of the nonmammaliaform cynodonts have focused only on postcranial material. Through the examination of micro-computed tomography (micro-CT) scans and serial thin sections, the current study provides a novel perspective on the structure and growth of the mandible of Tritylodon, a derived herbivorous cynodont from southern Africa. By tracking histological features across the serial thin sections, trends in relocation and modelling are documented for the growing Tritylodon mandible. For example, during growth, localized changes in the cross-sectional shape of the mandible occurred. Localized deposits of new lamellar and fibrolamellar bone on the lateral edge indicate widening of the mandible during different episodes of growth. The presence of radial channels indicates the deepening of the mandible at its anterior and posterior ends. The relocation of the paired mental foramina suggests that the mandibular body lengthened mainly in the posterior direction. The medial movement of a posterior postcanine tooth during growth and eruption is recorded in the histology. This histological assessment also documents the presence of Sharpey’s fibres in the cellular cementum of the first incisor, providing novel and unequivocal evidence that it was attached to the Tritylodon jaw by a periodontal ligament. This is the first comprehensive study that uses histological analysis to document the growth dynamics of the mandible of a nonmammalian therapsid, thus providing a unique perspective of localized mandibular growth in a fossil animal.

  2. Conservative condylectomy for management of osteochondroma of the mandibular condyle.

    PubMed

    de Melo, Willian Morais; Pereira-Santos, Darklilson; Sonoda, Celso Koogi; de Moura, Walter Leal; de Paulo-Cravinhos, Julio César

    2013-05-01

    Osteochondroma is one of the most common benign tumors of the skeleton. This tumor is rare in the craniofacial region, with the most common sites of occurrence being the coronoid process of the mandible and the mandibular condyle. Traditionally, the treatments of these lesions include total condylectomy or local resection of the lesion. Conservative condylectomy procedure with reshaping of the remaining condylar neck and repositioning of the articular disk has been suggested. This article aimed to describe a 35-year-old woman with osteochondroma in the left mandibular condyle who was treated by conservative condylectomy. The patient has been free of recurrence for 2 years, showing good aesthetic and functional stability. PMID:23714962

  3. 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.

  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.

  5. 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

  6. Geometric morphometric analysis of mandibular shape diversity in Pan.

    PubMed

    Robinson, Chris

    2012-07-01

    The aim of this research is to determine whether geometric morphometric (GM) techniques can provide insights into how the shape of the mandibular corpus differs between bonobos and chimpanzees and to explore the potential implications of those results for our understanding of hominin evolution. We focused on this region of the mandible because of the relative frequency with which it has been recovered in the hominin fossil record. In addition, no previous study had explored in-depth three-dimensional (3D) mandibular corpus shape differences between adults of the two Pan species using geometric morphometrics. GM methods enable researchers to quantitatively analyze and visualize 3D shape changes in skeletal elements and provide an important compliment to traditional two-dimensional analyses. Eighteen mandibular landmarks were collected using a Microscribe 3DX portable digitizer. Specimen configurations were superimposed using Generalized Procrustes analysis and the projections of the fitted coordinates to tangent space were analyzed using multivariate statistics. The size-adjusted corpus shapes of Pan paniscus and Pan troglodytes could be assigned to species with approximately 93% accuracy and the Procrustes distance between the two species was significant. Analyses of the residuals from a multivariate linear regression of the data on centroid size suggested that much of the shape difference between the species is size-related. Chimpanzee subspecies and a small sample of Australopithecus specimens could be correctly identified to taxon, at best, only 75% of the time, although the Procrustes distances between these taxa were significant. The shape of the mandibular symphysis was identified as especially useful in differentiating Pan species from one another. This suggests that this region of the mandible has the potential to be informative for taxonomic analyses of fossil hominoids, including hominins. The results also have implications for phylogenetic hypotheses of

  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. [The temporo-mandibular articulation].

    PubMed

    Dargaud, J; Vinkka-Puhakka, H

    2004-04-01

    The standing posture of humans has created both morphological and functional adaptations in the temporo-mandibular joint and the masticatory function. This biped state is the one of the most important characteristic of human evolution. It is furthermore the agent determining most of the functional changes in the whole body. This survey will be carried out in several levels including, a descriptive anatomy, biomechanics, radiological imaging, functioning in the articulation of TMJ. The descriptive anatomic picture will be obtained by the traditional dissection techniques. 20 TMJ joints are dissected from 10 cadavers: 7 cadavers, 65-75 year old, 3 cadavers, 60-65 year old. The x-rays are lateral view and the subjects of the radiological imaging are young's, adults and olds: 1, 3 y-old Male; 1, 7 y-old Female; 1, 14 y-old Female; 10, 19-23 y-old Male; 1, 26 y-old Female; 1, 34 y-old Male; 1, 75 y-old Female. The anatomic elements in the TMJ well resembled the ones described in the literature of the capsule, the ligament, the masticator muscles (masseter, temporal, medial and lateral pterygoids). The temporo-mandibular ligament proved to be difficult to separate from the capsule in some of the specimens. Sometimes it was not always found after a dissection.

  9. [Surgical correction of mandibular cyst and tumour defects (author's transl)].

    PubMed

    Raveh, J

    1979-01-01

    The various surgical techniques for the repair of mandibular defects following ablative surgery are discussed. The methods used in the treatment of large mandibular cysts are described and a modification of the osteoplastic technique is presented. The importance of reconstruction and functional rehabilitation with so caused mandibular defects and temporo-mandibular joint substitutions are stressed.

  10. 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.

  11. 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

  12. 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.

  13. Management of malunited mandibular condylar fractures.

    PubMed

    Rubens, B C; Stoelinga, P J; Weaver, T J; Blijdorp, P A

    1990-02-01

    The non-surgical treatment of mandibular condylar fractures, may occasionally result in articular imbalance and temporomandibular joint dysfunction. This may be attributed to condylar head displacement and resorption, resulting in a shortened vertical ramus and lost posterior vertical facial height. Restoring the vertical ramus height is essential in the treatment of such dysfunction, and may be accomplished by unilateral, or bilateral ramus osteotomies. Four examples of patients treated with mandibular ramus osteotomies to restore vertical ramus height, with subsequent improvement in occlusal balance and function are presented. The use of the sagittal split mandibular osteotomy and the external vertical ramus osteotomy, stabilized with small osseous plates, and monocortical screws, is discussed.

  14. 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

  15. 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

  16. Congenital and acquired mandibular asymmetry: Mapping growth and remodeling in 3 dimensions

    PubMed Central

    Solem, R. Christian; Ruellas, Antonio; Miller, Arthur; Kelly, Katherine; Ricks-Oddie, Joni L.; Cevidanes, Lucia

    2016-01-01

    Introduction Disordered craniofacial development frequently results in definitive facial asymmetries that can significantly impact a person's social and functional well-being. The mandible plays a prominent role in defining facial symmetry and, as an active region of growth, commonly acquires asymmetric features. Additionally, syndromic mandibular asymmetry characterizes craniofacial microsomia (CFM), the second most prevalent congenital craniofacial anomaly (1:3000 to 1:5000 live births) after cleft lip and palate. We hypothesized that asymmetric rates of mandibular growth occur in the context of syndromic and acquired facial asymmetries. Methods To test this hypothesis, a spherical harmonic-based shape correspondence algorithm was applied to quantify and characterize asymmetries in mandibular growth and remodeling in 3 groups during adolescence. Longitudinal time points were automatically registered, and regions of the condyle and posterior ramus were selected for growth quantification. The first group (n = 9) had a diagnosis of CFM, limited to Pruzansky-Kaban type I or IIA mandibular deformities. The second group (n = 10) consisted of subjects with asymmetric, nonsyndromic dentofacial asymmetry requiring surgical intervention. A control group (n = 10) of symmetric patients was selected for comparison. A linear mixed model was used for the statistical comparison of growth asymmetry between the groups. Results Initial mandibular shape and symmetry displayed distinct signatures in the 3 groups (P < 0.001), with the greatest asymmetries in the condyle and ramus. Similarly, mandibular growth had unique patterns in the groups. The dentofacial asymmetry group was characterized by significant asymmetry in condylar and posterior ramal remodeling with growth (P < 0.001). The CFM group was characterized by asymmetric growth of the posterior ramus (P < 0.001) but relatively symmetric growth of the condyles (P = 0.47). Conclusions Forms of CFM are characterized by active and

  17. 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

  18. Integrated three-dimensional digital assessment of accuracy of anterior tooth movement using clear aligners

    PubMed Central

    Zhang, Xiao-Juan; He, Li; Tian, Jie; Bai, Yu-Xing; Li, Song

    2015-01-01

    Objective To assess the accuracy of anterior tooth movement using clear aligners in integrated three-dimensional digital models. Methods Cone-beam computed tomography was performed before and after treatment with clear aligners in 32 patients. Plaster casts were laser-scanned for virtual setup and aligner fabrication. Differences in predicted and achieved root and crown positions of anterior teeth were compared on superimposed maxillofacial digital images and virtual models and analyzed by Student's t-test. Results The mean discrepancies in maxillary and mandibular crown positions were 0.376 ± 0.041 mm and 0.398 ± 0.037 mm, respectively. Maxillary and mandibular root positions differed by 2.062 ± 0.128 mm and 1.941 ± 0.154 mm, respectively. Conclusions Crowns but not roots of anterior teeth can be moved to designated positions using clear aligners, because these appliances cause tooth movement by tilting motion. PMID:26629473

  19. Parotid sialocele and fistula after mandibular osteotomy.

    PubMed

    Dierks, E J; Granite, E L

    1977-04-01

    Two cases are presented that show the progression to sialocele or salivary fistula, or both, after a modified Risdon approach is used for mandibular subcondylar osteotomy. Use of antisialogogues and conservative management is recommended.

  20. 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.

  1. 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

  2. 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

  3. 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

  4. Mandibular adaptations following total maxillary osteotomy in adolescent monkeys.

    PubMed

    Nanda, R; Sugawara, J

    1983-06-01

    The purpose of this study was to investigate the growth and remodeling changes of the mandible following superior anterior surgical repositioning (Le Fort I) of the maxilla in adolescent Macaca fascicularis monkeys. Eight adolescent monkeys served as controls, and seven monkeys underwent surgical procedures. All monkeys received tantalum implants on both sides of certain facial bones for stereometric and conventional cephalometry. The animals were followed up to 24 months postoperatively. Analysis of cephalometric head films taken at monthly intervals shows that both the maxillas and the mandibles of the experimental monkeys grew harmoniously, although the amount and direction of growth showed significant changes compared to the controls. The mandibles of experimental monkeys that underwent autorotation immediately following the surgical procedures showed 36 to 60 percent less growth as measured from condylion to menton, condylion to gonion, and gonion to menton. Similarly, the anterior dental-alveolar-symphyseal height showed 75 percent less increase as compared to the controls. The results show that, although the surgical procedure was performed on the maxilla, the mandibular growth showed significant modulation to adapt to the surgically changed maxillary environment. The role of occlusion and function is discussed in the context of the present findings.

  5. Mandibular growth following Le Fort I osteotomy in adolescent monkeys.

    PubMed

    Nanda, R; Bouayad, O; Topazian, R G

    1987-06-01

    Le Fort I osteotomy with anterior and superior repositioning of the maxilla was performed on adolescent Macaca fascicularis monkeys to study its effect on the subsequent growth and remodeling changes of the mandible. Six adolescent Macaca fascicularis monkeys were randomly divided into two surgical groups and eight others served as controls. Group I animals underwent a Le Fort I advancement and Group II animals experienced a Le Fort I advancement and impaction. All monkeys received tantalum implants in the anterior part of the cranial base, on opposite sides of craniofacial sutures and in multiple sites of the maxilla and mandible. The immediate postsurgical occlusion of all experimental animals was a Class II molar relationship. The animals were followed for up to 12 months postoperatively. Analysis of cephalometric head films taken at monthly intervals showed that both the maxilla and the mandible of all experimental monkeys grew in a coordinated fashion, although the amount, rate, and direction of growth varied between control and experimental animals as well as between Group I and Group II animals. The largest increments and rates of growth were observed in the control animals, Group I animals, and Group II animals, respectively. This study indicates that the growth changes in both maxilla and mandible are related to the extent of injury caused by maxillary surgery. The results also showed that although the surgical procedures were performed in the maxilla, mandibular growth was significantly modulated by the surgically changed maxillary environment.

  6. Consideration of QRS complex in addition to ST-segment abnormalities in the estimation of the "risk region" during acute anterior or inferior myocardial infarction.

    PubMed

    Vervaat, F E; Bouwmeester, S; van Hellemond, I E G; Wagner, G S; Gorgels, A P M

    2014-01-01

    The myocardial area at risk (MaR) is an important aspect in acute ST-elevation myocardial infarction (STEMI). It represents the myocardium at the onset of the STEMI that is ischemic and could become infarcted if no reperfusion occurs. The MaR, therefore, has clinical value because it gives an indication of the amount of myocardium that could potentially be salvaged by rapid reperfusion therapy. The most validated method for measuring the MaR is (99m)Tc-sestamibi SPECT, but this technique is not easily applied in the clinical setting. Another method that can be used for measuring the MaR is the standard ECG-based scoring system, Aldrich ST score, which is more easily applied. This ECG-based scoring system can be used to estimate the extent of acute ischemia for anterior or inferior left ventricular locations, by considering quantitative changes in the ST-segment. Deviations in the ST-segment baseline that occur following an acute coronary occlusion represent the ischemic changes in the transmurally ischemic myocardium. In most instances however, the ECG is not available at the very first moments of STEMI and as times passes the ischemic myocardium becomes necrotic with regression of the ST-segment deviation along with progressive changes of the QRS complex. Thus over the time course of the acute event, the Aldrich ST score would be expected to progressively underestimate the MaR, as was seen in studies with SPECT as gold standard; anterior STEMI (r=0.21, p=0.32) and inferior STEMI (r=0.17, p=0.36). Another standard ECG-based scoring system is the Selvester QRS score, which can be used to estimate the final infarct size by considering the quantitative changes in the QRS complex. Therefore, additional consideration of the Selvester QRS score in the acute phase could potentially provide the "component" of infarcted myocardium that is missing when the Aldrich ST score alone is used to determine the MaR in the acute phase, as was seen in studies with SPECT as gold

  7. Association between mandibular posterior alveolar morphology and growth pattern in a Chinese population with normal occlusion*

    PubMed Central

    Han, Min; Wang, Rong-yang; Liu, Hong; Zhu, Xiu-juan; Wei, Fu-lan; Lv, Tao; Wang, Na-na; Hu, Li-hua; Li, Guo-ju; Liu, Dong-xu; Wang, Chun-ling

    2013-01-01

    Objective: To investigate the relationship between growth patterns and mandibular posterior tooth-alveolar bone complex morphology in a Chinese population with normal occlusion. Methods: Forty-five patients with normal occlusion (23 males, 22 females) were included in this study. Among these patients, 20 displayed the vertical growth pattern, and 20 had the horizontal growth pattern, while the remaining patients displayed the average growth pattern. All of the patients underwent dental cone beam computed tomography (CBCT), which included the region of the mandibular posterior teeth and the alveolar. A linear regression analysis and a correlation analysis between the facial height index (FHI) and the alveolar bone morphology were performed. Results: The inclination of the molars, the thickness of the cortical bone, and the height of the mandibular bone differed significantly between patients with the horizontal growth pattern and those with the vertical growth pattern (P<0.05). Significant positive correlations were found between: the FHI and the inclination of the molars; the FHI and the thickness of the cortical bone; and the FHI and the height of the mandibular bone. Conclusions: The mandibular posterior tooth-alveolar bone complex morphology may be affected by growth patterns. PMID:23303628

  8. Unilateral mandibular condylectomy in lambs.

    PubMed

    Miyamoto, H; Matsuura, H; Jones, R H; Kurita, K; Goss, A N

    2001-08-01

    The purpose of this experimental study was to investigate the degree of regeneration of the mandibular condyle after unilateral condylectomy in 10-week-old lambs. The lambs were killed three months after the operation, and the joints examined radiologically and histologically. Scoring systems were used to assess the radiological changes and histological regeneration of the condyle. All joints showed regeneration of the condylar head postoperatively. The maximum degree of regeneration occurred on the medial side rather than the central or lateral areas. There was a significant correlation among the medial, central, and lateral planes (P<0.05). The reformed articular cartilage was irregular and thin (P<0.01), and the disc was thick in the central plane (P<0.01) compared with the control joints. The temporal bone was normal. This study shows that unilateral condylectomy in the growing period results in some condylar regeneration particularly on the medial side and reformation of some irregular and thin articular cartilage. PMID:11437430

  9. 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

  10. 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

  11. 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.

  12. Subway mandibular buccal defect blocked with two part prosthesis unified by Earth magnets.

    PubMed

    Punjani, Shikha; Arora, Aman; Upadhyaya, Viram

    2013-03-01

    This clinical report describes the fabrication of a two-piece obturator used to close the mandibular buccal defect. Two-piece obturator prosthesis was fabricated with clear heat cure acrylic resin to be used during the healing period following the marsupialization of odontogenic keratocyst which had lead to the loss of portions of the mandibular buccal region. The prosthesis fabricated in two parts was joined by the rare earth magnets. Retention was increased by lining the prosthesis with tissue conditioner material engaging the undercut. PMID:24431709

  13. 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

  14. Subway mandibular buccal defect blocked with two part prosthesis unified by Earth magnets.

    PubMed

    Punjani, Shikha; Arora, Aman; Upadhyaya, Viram

    2013-03-01

    This clinical report describes the fabrication of a two-piece obturator used to close the mandibular buccal defect. Two-piece obturator prosthesis was fabricated with clear heat cure acrylic resin to be used during the healing period following the marsupialization of odontogenic keratocyst which had lead to the loss of portions of the mandibular buccal region. The prosthesis fabricated in two parts was joined by the rare earth magnets. Retention was increased by lining the prosthesis with tissue conditioner material engaging the undercut.

  15. 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

  16. Replacement of Missing Anterior Teeth in a Patient with Temporomandibular Disorder

    PubMed Central

    Haralur, Satheesh B.; Saeed Al-Shahrani, Omar

    2014-01-01

    The loss of anterior teeth leads to extreme psychological trauma, along with functional and esthetic debilitations. Healthy anterior teeth play an important role of protecting the posterior teeth during excursive mandibular movement. Loss of anterior teeth induces posterior interference with extended disocclusion time. Posterior disocclusion is critical to remove the harmful force on the teeth temporomandibular joint and eliminate muscle hypertonicity. Occlusal interference is considered as contributing factor to temporomandibular disorder (TMD) symptoms. Prosthesis design should eliminate deleterious tooth contacts. Establishing optimum anterior guidance is a key to establishing harmonious functional occlusion in addition to the correction of the esthetic and phonetic disabilities. This case report explains the steps involved in the rehabilitation of the TMD patient with loss of maxillary anterior teeth. PMID:24715993

  17. Replacement of missing anterior teeth in a patient with temporomandibular disorder.

    PubMed

    Haralur, Satheesh B; Saeed Al-Shahrani, Omar

    2014-01-01

    The loss of anterior teeth leads to extreme psychological trauma, along with functional and esthetic debilitations. Healthy anterior teeth play an important role of protecting the posterior teeth during excursive mandibular movement. Loss of anterior teeth induces posterior interference with extended disocclusion time. Posterior disocclusion is critical to remove the harmful force on the teeth temporomandibular joint and eliminate muscle hypertonicity. Occlusal interference is considered as contributing factor to temporomandibular disorder (TMD) symptoms. Prosthesis design should eliminate deleterious tooth contacts. Establishing optimum anterior guidance is a key to establishing harmonious functional occlusion in addition to the correction of the esthetic and phonetic disabilities. This case report explains the steps involved in the rehabilitation of the TMD patient with loss of maxillary anterior teeth. PMID:24715993

  18. 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

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

    PubMed Central

    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

  20. 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

  1. Bilateral Anterior Shoulder Dislocation

    PubMed Central

    Siu, Yuk Chuen; Lui, Tun Hing

    2014-01-01

    Introduction: Unilateral anterior shoulder dislocation is one of the most common problems encountered in orthopedic practice. However, simultaneous bilateral anterior dislocation of the shoulders is quite rare. Case Presentation: We report a case of a 75-year-old woman presented with simultaneous bilateral anterior shoulder dislocation following a trauma, complicated with a traction injury to the posterior cord of the brachial plexus. Conclusions: Bilateral anterior shoulder dislocation is very rare. The excessive traction force during closed reduction may lead to nerve palsy. Clear documentation of neurovascular status and adequate imaging before and after a reduction should be performed. PMID:25685749

  2. 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.

  3. 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

  4. Implant installation with bone augmentation and transmucosal healing with demineralized human cortical bone in the maxillary anterior region: report of 3 cases.

    PubMed

    Park, Jun-Beom

    2012-12-01

    It is well known that a decrease in vertical height and in horizontal width is seen after tooth extraction. Immediate implant placement, originally thought to prevent buccal wall resorption, showed little or no evident decrease of the resorption rate or pattern in animal experiments or clinical studies. Thus, the need for bone augmentation with immediate implantation has been suggested. However, until recently, simultaneous bone augmentation with immediate implant placement was thought to be possible only in a submerged environment. In this report, the harmony of soft and hard tissue was achieved in 3 patients by immediate implant placement and bone augmentation with transmucosal healing in esthetically challenging situations. Further evaluation is needed to monitor hard- and soft-tissue changes on a long-term basis. Implant placement and bone augmentation with transmucosal healing using demineralized bone matrix may be an option in the treatment of the loss of anterior teeth. PMID:21126168

  5. 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

  6. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mandibular condyle prosthesis. 872.3960 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw...

  7. 21 CFR 872.4770 - Temporary mandibular condyle reconstruction plate.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... device that is intended to stabilize mandibular bone and provide for temporary reconstruction of the... surgical procedures requiring removal of the mandibular condyle and mandibular bone. This device is not intended for treatment of temporomandibular joint disorders. (b) Classification. Class II (special...

  8. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant facial prosthesis. (a) Identification. A mandibular implant facial prosthesis is a device that is intended to be implanted for use in the functional reconstruction of mandibular deficits. The device...

  9. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant facial prosthesis. (a) Identification. A mandibular implant facial prosthesis is a device that is intended to be implanted for use in the functional reconstruction of mandibular deficits. The device...

  10. 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

  11. Dens invaginatus (dilated odontome) in mandibular canine

    PubMed Central

    Halawar, Sangamesh S; Satyakiran, GVV; Krishnanand, PS; Prashanth, R

    2014-01-01

    Dens invaginatus is a developmental malformation of teeth related to shape of the teeth. Affected teeth show a deep infolding of enamel and dentin starting from the tip of the cusps and may extend deep into the root. It results from the invagination of the enamel organ into the dental papilla before calcification has occurred. Teeth most affected are maxillary lateral incisors. The presence of dens invaginatus in mandibular canine is extremely rare. The tooth was symptomatic in that it was mobile and was oriented horizontally. This article presents a case of symptomatic dens invaginatus in mandibular canine. PMID:25364169

  12. 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

  13. 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.

  14. Risk factors for breakage of biodegradable plate systems after bilateral sagittal split mandibular setback surgery.

    PubMed

    Yoshioka, Izumi; Igawa, Kaori; Nagata, Jyunko; Yoshida, Maho; Baba, Takashi; Ichiki, Takeshi; Kondoh, Yudai; Takamori, Koichi; Kashima, Koji; Sakoda, Sumio

    2013-06-01

    The aim of this retrospective study was to evaluate the risk factors associated with breakage of biodegradable plate systems after bilateral sagittal split mandibular setback. We studied 169 Japanese adults (62 men, 107 women; age range 16-53 years) with deformities of the jaw diagnosed as mandibular prognathism. All patients were treated by bilateral sagittal split osteotomy (BSSO) with 2 biodegradable fixation plates and screws at the anterior mandibular ramus. We collected the following data from the medical records and radiological findings: sex; age; degree of setback; presence of asymmetry; presence of open bite; operation; design of the plate; operating time; and blood loss. Multiple logistic regression analysis was used to find the factors that were independently associated with the dependent variable: breakage of the biodegradable plate system. In 10 of the 169 patients (6%) the biodegradable plate system for the BSSO broke. Factors that influenced whether or not the biodegradable plate system fractured were if they were asymmetrical (odds ratio (OR) 5.35; P=0.02) and had an open bite (OR 5.20; P=0.02). Asymmetry or open bite was significantly associated with breaks in the biodegradable plate system. Biodegradable plates should be used only when loading is minimal.

  15. 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

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

    PubMed

    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.

  17. The effects of extraction and nonextraction treatment on the mandibular position.

    PubMed

    Yamaguchi, K; Nanda, R S

    1991-11-01

    Decisions on extraction of teeth as an aid in orthodontic treatment depend on dental and skeletal discrepancies concerning sagittal and vertical relationships. The purpose of this study was to assess the effects of extraction and nonextraction procedures on the posterior rotation of the mandible and the position of gnathion. Forty-eight nonextraction patients and seventy-three extraction patients treated in the orthodontic department were selected. The patients were from 11 to 15 years old, with a mean age of 12 years 2 months. The lateral cephalometric radiographs taken before and after treatment were traced and measured. Eleven variables reflecting the mandibular rotation were selected on the basis of factor analysis. Before treatment, total arch circumferential discrepancy and the 11 selected measurements showed significant differences between the extraction and nonextraction groups. In the extraction group, the lower anterior facial height was larger, ramus height was smaller, and the difference between vertical position of both maxillary and mandibular first molars and posterior facial height was greater than in the nonextraction group. Consequently, the mandible showed posterior rotation and was in retruded position in the extraction group. In the nonextraction group, the type of force application had no significant effect on the changes in skeletal and dental measurements. In the extraction group, however, the type of force application had a significant effect (p less than 0.05) on the changes in total anterior facial height, the horizontal distance of the maxillary first molar to a perpendicular line to the S-N plane passing through point S, the vertical distance of the maxillary molar to the S-N plane, the vertical distance of the maxillary and mandibular first molars to the S-N plane, the difference between the vertical position of the first molars and posterior facial height, and the difference between the vertical position of the first molar and

  18. An experimental study on mandibular movement and osteoporosis.

    PubMed

    Shimahara, M; Ono, K; Hashiguchi, N; Yoshida, Y; Kono, K; Dote, T

    1991-12-01

    In order to clarify the relationship between mandibular movement and osteoporosis, the authors secured the temporo-mandibular joints of 8-week-old rats to immobilize their jaws; then conducted histologic studies chronologically, up to the fifth week. After three weeks, an expansion of the marrow cavity and a reduction of the trabecular were observed in the mandibular process and mandibular fossa. During the fifth week, an osteoporosis-like state was clearly observed. Further, an irregularity in the form of mandibular process was recognized, as well as a remarkable disturbance caused by cartilaginous ossification of the articular cartilage of the condyle.

  19. Functional and morphological correlates of mandibular symphyseal form in a living human sample.

    PubMed

    Holton, Nathan E; Franciscus, Robert G; Ravosa, Matthew J; Southard, Thomas E

    2014-03-01

    Variation in recent human mandibular form is often thought to reflect differences in masticatory behavior associated with variation in food preparation and subsistence strategies. Nevertheless, while mandibular variation in some human comparisons appear to reflect differences in functional loading, other comparisons indicate that this relationship is not universal. This suggests that morphological variation in the mandible is influenced by other factors that may obscure the effects of loading on mandibular form. It is likely that highly strained mandibular regions, including the corpus, are influenced by well-established patterns of lower facial skeletal integration. As such, it is unclear to what degree mandibular form reflects localized stresses incurred during mastication vs. a larger set of correlated features that may influence bone distribution patterns. In this study, we examine the relationship between mandibular symphyseal bone distribution (i.e., second moments of area, cortical bone area) and masticatory force production (i.e., in vivo maximal bite force magnitude and estimated symphyseal bending forces) along with lower facial shape variation in a sample of n = 20 living human male subjects. Our results indicate that while some aspects of symphyseal form (e.g., wishboning resistance) are significantly correlated with estimates of symphyseal bending force magnitude, others (i.e., vertical bending resistance) are more closely tied to variation in lower facial shape. This suggests that while the symphysis reflects variation in some variables related to functional loading, the complex and multifactorial influences on symphyseal form underscores the importance of exercising caution when inferring function from the mandible especially in narrow taxonomic comparisons.

  20. 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

  1. Anterior open-bite orthodontic treatment in an adult patient: A clinical case report.

    PubMed

    Gracco, Antonio; Siviero, Laura; de Stefani, Alberto; Bruno, Giovanni; Stellini, Edoardo

    2016-06-01

    A 45-year-old woman presented with an anterior open-bite complaining chiefly of her unpleasant smile esthetics and masticatory and speech problems. Treatment included speech therapy initiated immediately after bonding. Lingual spurs were positioned on the mandibular incisors in order to help tongue rehabilitation. During the working phase, temporary anchorage devices (TADs) were used at the mandibular anterior segment to intrude the lower left premolars. A splint was used to ensure retention in the upper and lower arches; an enveloppe linguale nocturne (ELN) was provided. Non-surgical open-bite treatment could offer a valid alternative to orthognanthic surgery when cephalometric evaluation shows no vertical growth pattern; patient compliance is essential to prevent relapse. PMID:27080595

  2. Deciduous Mandibular Second Molar with Supernumerary Roots and Root Canals Associated with Missing Mandibular Permanent Premolar

    PubMed Central

    Shafi, Shabina; Gambhir, Natasha; Rehani, Usha

    2011-01-01

    Morphological variations like additional roots and root canals in human deciduous dentition are rare. Knowledge of the morphology, variation of root and root canals of deciduous teeth are useful for successful endodontic treatment and exodontia. Presented here is a case report of the supernumerary roots and additional root canals of deciduous mandibular second molar (85) with congenitally bilateral missing of mandibular permanent second premolar (35 and 45) tooth bud.

  3. Mandibular two-implant telescopic overdentures.

    PubMed

    Heckmann, Siegfried M; Schrott, Alexander; Graef, Friedrich; Wichmann, Manfred G; Weber, Hans-Peter

    2004-10-01

    To stabilize mandibular overdentures in edentulous patients, various connector types which can be attached to between two and four implants placed in the anterior mandible are possible. Treatment using non-rigid telescopic connectors on two interforaminal implants for overdenture stabilization began in 1989. The objective of this study is to investigate soft- and hard-tissue conditions as well as prosthesis function after a period of 10 years. This also involved an evaluation of correlations between radiographic and clinical parameters. Twenty-three subjects with 46 interforaminal implants (ITI solid screw implants, 12 mm in length, 4.1 mm in diameter; 10.4 years in situ, range, 8-12.8 years) were investigated. Modified plaque index (mPI), sulcus fluid flow rate (SFFR), modified sulcus bleeding index (mBI), probing depth (PD), distance from implant crown margin to the coronal border of the peri-implant mucosa (DIM), attachment level (AL), width of keratinized mucosa (KM), Periotest values (PTVs) and prosthesis function were evaluated. In the radiographic evaluation, the distance between implant shoulder and first crestal bone-implant contact (DIB) in mm and the horizontal bone loss (HBL) in mm were measured. The relatively high mPI scores (mean, 0.82; score, 0 in 44.4%; SD, 0.83) did not result in increased SFFR scores (mean, 12; min, 3, max, 38; SD, 7.43) or higher mBI scores (mean, 0.35; score, 0 in 70.8%; SD, 0.59), which was commensurate with healthy peri-implant mucosa. A mean PD value of 2.15 mm (min, 1 mm; max, 5 mm; SD, 0.96) and a mean DIM value of 0.28 mm (min, 0 mm; max, 2 mm; SD, 0.52) were measured. The implants were stable, showing a mean Periotest value of -1.91 (max, 02, min, -6; SD, 1.76). A mean DIB of 3.19+/-0.95 mm (range, 1.3-5.16 mm) and a mean HBL of 1.6+/-1.52 mm (range, 0.28-8.33 mm) were calculated. A correlation was found between DIB and the parameters SFFR (P=0.060), DIM (P=0.042), AL (P=0.050) and especially PTV (P<0.01), leading to the

  4. Outcomes and stability in patients with anterior open bite and long anterior face height treated with temporary anchorage devices and a maxillary intrusion splint

    PubMed Central

    Scheffler, Nicole R.; Proffit, William R.; Phillips, Ceib

    2015-01-01

    Introduction Temporary skeletal anchorage devices now offer the possibility of closing anterior open bites and decreasing anterior face height by intruding maxillary posterior teeth, but data for treatment outcomes are lacking. This article presents outcomes and posttreatment changes for consecutive patients treated with a standardized technique. Methods The sample included 33 consecutive patients who had intrusion of maxillary posterior teeth with a maxillary occlusal splint and nickel-titanium coil springs to temporary anchorage devices in the zygomatic buttress area, buccal and apical to the maxillary molars. Of this group, 30 had adequate cephalograms available for the period of treatment, 27 had cephalograms including 1-year posttreatment, and 25 had cephalograms from 2 years or longer. Results During splint therapy, the mean molar intrusion was 2.3 mm. The mean decrease in anterior face height was 1.6 mm, less than expected because of a 0.6-mm mean eruption of the mandibular molars. During the postintrusion orthodontics, the mean change in maxillary molar position was a 0.2-mm extrusion, and there was a mean 0.5-mm increase in face height. Positive overbite was maintained in all patients, with a slight elongation (<2 mm) of the incisors contributing to this. During the 1 year of posttreatment retention, the mean changes were a further eruption of 0.5 mm of the maxillary molars, whereas the mandibular molars intruded by 0.6 mm, and there was a small decrease in anterior face height. Changes beyond 1 year posttreatment were small and attributable to growth rather than relapse in tooth positions. Conclusions Intrusion of the maxillary posterior teeth can give satisfactory correction of moderately severe anterior open bites, but 0.5 to 1.5 mm of reeruption of these teeth is likely to occur. Controlling the vertical position of the mandibular molars so that they do not erupt as the maxillary teeth are intruded is important in obtaining a decrease in face height

  5. 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

  6. Repair of Bovine and Equine Mandibular Fractures

    PubMed Central

    Murch, K. M.

    1980-01-01

    Clinical findings, surgical repair and postsurgical care of a unilateral fracture of the mandible of a bull and of a bilateral mandibular fracture in a horse are described. Compression plating limited the pain suffered by the animals and resulted in a quick return to function of the mandibles. ImagesFigure 1.Figure 1.Figure 3.Figure 4.Figure 5.Figure 6. PMID:7363268

  7. Significance of localization of mandibular foramen in an inferior alveolar nerve block

    PubMed Central

    Thangavelu, K.; Kannan, R.; Kumar, N. Senthil; Rethish, E.; Sabitha, S.; SayeeGanesh, N.

    2012-01-01

    Background: The mandibular foramen (MF) is an opening on the internal surface of the ramus for divisions of the mandibular vessels and nerve to pass. The aim of this study is to determine the position of the MF from various anatomical landmarks in several dry adult mandibles. Materials and Methods: A total of 102 human dry mandibles were examined, of which 93 were of dentulous and 9 were of edentulous. The measurements were taken from the anterior border of the ramus (coronoid notch) to the midportion of the MF and then from the midportion of the MF to the other landmarks such as internal oblique ridge, inferior border, sigmoid notch, and condyle were measured and recorded. Results: The data were compared using Student's t-test. The MF is positioned at a mean distance of 19 mm (with SD 2.34) from coronoid notch of the anterior border of the ramus. Superio-inferiorly from the condyle to the inferior border MF is situated 5 mm inferior to the midpoint of condyle to the inferior border distance (ramus height). Conclusion: We conclude that failures in the anesthesia of the inferior alveolar nerve are due to the operator error and not due to the anatomical variation. PMID:23225978

  8. Evaluation of Interforaminal Mandible Region of Individuals With Pierre Robin Sequence and Treacher Collins Syndrome Through the Cone-Beam Computed Tomography.

    PubMed

    Tucunduva, Rosana Mara Adami; Imada, Thaís Sumie Nozu; Lopes, Ivna Albano; Rubira-Bullen, Izabel Regina Fischer; de Carvalho, Izabel Maria Marchi

    2016-01-01

    The Pierre Robin sequence (PRS) and the Treacher Collins syndrome (TCS) are conditions that cause significant abnormalities of jaw. This study was conducted in anticipation of evaluating the morphology of interforaminal region and identify the anatomic variations: anterior loop and mandibular incisive canal, in individuals with PRS and TCS by cone-beam computed tomography and compare them with individuals without craniofacial anomalies. By applying the t-test, the results showed no statistically significant difference, allowing to infer that there are no significant differences in interforaminal mandible morphology between groups and indicated that the prevalence and location of the studied anatomic variations are consistent with those described in literature.

  9. 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.

  10. Anterior knee pain

    MedlinePlus

    ... as running, jumping or twisting, skiing, or playing soccer). You have flat feet. Anterior knee pain is ... to the kneecap Runners, jumpers, skiers, bicyclists, and soccer players who exercise often Teenagers and healthy young ...

  11. Effects of hypodontia on craniofacial structures and mandibular growth pattern

    PubMed Central

    2011-01-01

    Introduction This study was performed to examine craniofacial structures in persons with hypodontia and to reveal any differences, that may occur, when agenetic teeth are only found in the maxilla, the mandible or in both jaws. The groups consistent of 50 children (33 girls, 17 boys) aged between 9 and 13.5 years were analyzed and assigned to three subgroups. Group 1 = upper jaw hypodontia. Group 2 = lower jaw hypodontia. Group 3 = hypodontia in both jaws. Materials and methods Eleven angular and three index measurements from lateral encephalographs and two linear measurements from dental blaster casts were calculated. All data was statistically analyzed, parameters with p < 5% were investigated for each subgroup respectively. Results In comparison with standards the study group showed bimaxillary retrognathism and a reduction of the lower anterior facial height. Moreover both overbite and overjet significantly increased. Other values laid within the normal ranges. Evaluating results of the subgroups, differences in the means of SNA, SNB and overjet between the groups were observed. Analysis of the mandibular growth pattern revealed, that neither vertical nor horizontal patterns are dominant in hypodontia patients. Conclusions In certain dentofacial parameters differences between persons with hypodontia and such with full dentition exist. According to our findings agenetic teeth may have a negative influence on the saggital development of a jaw and the lower face and may be responsible for increased overbites. This should receive attention in orthodontic treatment of hypodontia patients. PMID:22142280

  12. Three-unit bridge construction in anterior single-pontic areas using a metal-free restorative.

    PubMed

    Narcisi, E M

    1999-02-01

    A new glass-ceramic material, IPS Empress 2, is revolutionizing esthetic restorative dentistry by allowing metal-free, three-unit bridge construction in anterior and premolar single-pontic areas. The case discussed in this article illustrates the material's application in the dual-arch restoration of a young woman with congenitally missing teeth. The material was used as an alternative to single-tooth implant restorations to place two maxillary three-unit bridges, one mandibular three-unit bridge, and two mandibular porcelain veneers. IPS Empress 2 provides an esthetic alternative to porcelain-fused-to-metal restorations by facilitating attractive, functional tooth restoration.

  13. Quality of Life Following Early Orthodontic Therapy for Anterior Crossbite: Report of Cases in Twin Boys

    PubMed Central

    Piassi, Eluza; Antunes, Leonardo Santos; Andrade, Marcia Rejane Thomas Canabarro

    2016-01-01

    Anterior crossbite (AC) refers to a condition in which the maxillary anterior teeth are placed lingually in their relationship with the mandibular anterior teeth. This dental condition results in visible incisor differences that are associated with higher levels of dissatisfaction with appearance and have potential to negatively impact on oral health-related quality of life (OHRQoL) of the children. The aim of this paper was to report two cases of interceptive orthodontic treatment of twin children with anterior crossbite and its impact on OHRQoL of these children. Although AC affects negatively psychosocial aspects of OHRQoL of the children, the interceptive orthodontic treatment of children with AC was essential to improve their OHRQoL. PMID:27738533

  14. 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

  15. 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

  16. Regional odontodysplasia.

    PubMed

    Mehta, D N; Bailoor, D; Patel, B

    2011-01-01

    Regional odontodysplasia is an unusual developmental anomaly in which ectodermal and mesodermal tooth components are affected. We present a rare case of a developmental anomaly called regional odontodysplasia or 'ghost teeth' in a 12-year-old Indian girl. The anomaly affected right maxillary permanent teeth. The mandibular teeth were unaffected. The clinical, radiographic and histological features are reviewed. The management of affected patients is discussed.

  17. Maxillary versus mandibular arch form differences in human permanent dentition assessed by Euclidean-distance matrix analysis.

    PubMed

    Ferrario, V F; Sforza, C; Miani, A; Tartaglia, G

    1994-02-01

    Euclidean-distance matrix analysis (EDMA) was used to analyse the dental arch form in 50 men and 45 women aged 20-27 yr with sound dentitions. Fourteen landmarks, corresponding to the centres of gravity (centroids) of the occlusal surfaces of all permanent teeth (right second molar to left second molar), were identified on the dental casts of subjects. All the possible linear distances between pairs of teeth were computed and maxillary/mandibular arch differences within sex were tested by EDMA. In both sexes, the maxillary arch was larger than the mandibular arch; arch shape was also significantly different. All teeth contributed to the shape difference between arches regardless of gender. EDMA also separated the influence of anterior and posterior teeth in the determination of upper/lower arch characteristics.

  18. 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.

  19. [Temporo-mandibular joint. Morpho-functional considerations].

    PubMed

    Scutariu, M D; Indrei, Anca

    2004-01-01

    The temporo-mandibular joint is distinguished from most other synovial joints of the body by two features: 1. the two jointed components carry teeth whose position and occlusion introduce a very strong influence on the movements of the temporo-mandibular joint and 2. its articular surfaces are not covered by hyaline cartilage, but by a dense, fibrous tissue. This paper describes the parts of the temporo-mandibular joint: the articular surfaces (the condylar process of the mandible and the glenoid part of the temporal bone), the fibrocartilaginous disc which is interposed between the mandibular and the temporal surface, the fibrous capsule of the temporo-mandibular joint and the ligaments of this joint. All these parts present a very strong adaptation at the important functions of the temporo-mandibular joint.

  20. In vivo bioreactors for mandibular reconstruction.

    PubMed

    Tatara, A M; Wong, M E; Mikos, A G

    2014-12-01

    Large mandibular defects are difficult to reconstruct with good functional and aesthetic outcomes because of the complex geometry of craniofacial bone. While the current gold standard is free tissue flap transfer, this treatment is limited in fidelity by the shape of the harvested tissue and can result in significant donor site morbidity. To address these problems, in vivo bioreactors have been explored as an approach to generate autologous prefabricated tissue flaps. These bioreactors are implanted in an ectopic site in the body, where ossified tissue grows into the bioreactor in predefined geometries and local vessels are recruited to vascularize the developing construct. The prefabricated flap can then be harvested with vessels and transferred to a mandibular defect for optimal reconstruction. The objective of this review article is to introduce the concept of the in vivo bioreactor, describe important preclinical models in the field, summarize the human cases that have been reported through this strategy, and offer future directions for this exciting approach.

  1. Mandibular mass in a child on hemodialysis.

    PubMed

    Youssef, Doaa M; Mohammed, Faten F; Adham, Tamer

    2016-01-01

    We here with report a 13-year-old female patient on regular hemodialysis for the past five years who presented with a large mandibular mass. This was detected to be a brown tumor due to severe renal osteodystrophy as a complication of secondary hyperparathyroidism. The tumor did not regress even with intensive treatment with intravenous active vitamin D and needed surgical removal. PMID:26787582

  2. 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

  3. Anterior skull base oncocytoma.

    PubMed

    López, Fernando; Vivanco, Blanca; Suárez, Carlos; Llorente, José L

    2013-03-01

    Oncocytic neoplasms are tumors composed of oncocytes (ie, epithelial cells with a large cytoplasm that is rich in mitochondria). Most cases are benign and originate from the salivary glands. Although there have been a few reported cases of oncocytomas being found in the sinonasal tract, most if not all cases seem not to involve the anterior skull base. We report a rare case of oncocytoma involving the anterior skull base occurring in a 44-year-old male patient. Preoperative carotid angiography and selective embolization was performed. The patient underwent an expanded endoscopic endonasal anterior craniofacial resection, which allowed complete resection of the tumor, with a low morbidity. The pathological diagnosis was oncocytoma. At 36 months after the initial treatment, the patient is free of disease. Based on our literature search, this may be the first such reported case. A brief review of the available literature examining the known body of knowledge regarding these neoplasms is presented.

  4. Bifid Mandibular Canal: A Rare or Underestimated Entity?

    PubMed Central

    Nasseh, Ibrahim; Aoun, Georges

    2016-01-01

    One of the rare anatomical variations that can be of significant importance for the dentist is the bifid mandibular canal. Many complications can occur from this condition such as failure of anesthesia when performing inferior alveolar nerve block, difficulties during the surgical extraction of the third mandibular molar, and during implants placement. Therefore, good knowledge of this condition is essential. In this report, we describe the radiographic finding of a unilateral bifid mandibular canal. PMID:27777715

  5. Malignant mixed salivary tumor presenting as a mandibular metastasis.

    PubMed

    Mellor, T K; Scott, J

    1985-11-01

    A rare case of a central mandibular metastatic mixed salivary gland tumor is reported which presented following a 45-year history of recurrent benign mixed salivary gland tumor of the parotid gland on the same side. The mandibular tumor included a predominantly benign mixed salivary gland component as well as frankly invasive adenocarcinoma. The clinicopathologic features of the mandibular and residual parotid tumors suggested that the metastatic event may have occurred prior to the development of frank carcinoma in the parotid tumor.

  6. 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

  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

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

    2013-04-01

    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. Anterior tibial striations.

    PubMed

    Daffner, R H

    1984-09-01

    Radiolucent horizontal striations of the anterior cortex of the tibia were seen in 10 athletes who were evaluated for "shin-splints." There were seven basketball players, two professional dancers, and one hurdler. Each patient's history included vigorous leaping in performance of athletic feats. All the lesions were similar in location and appearance and were accompanied by thickening of the anterior tibial cortex. These striations are considered stress fractures and were not observed in a group of runners who were evaluated for shin-splints.

  10. 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

  11. [Mandibular reconstruction in benign tumors of the mandible].

    PubMed

    Kadiri, F; Raji, A; Touhami, M; Chekkoury, I A; Benchakroun, Y

    1996-01-01

    The authors report ten cases of reconstruction in the mandibular interrupter substance wast after excision of the large benign tumors which dominated by ameloblastoma. The reparation is realised by free no vascularized bone graft, of ten with the iliac crest, rarely with costochondral graft. The lateral mandibular interrupter substance waste concerning the temporo-mandibular joint (type III) is frequent. The reparation often immediate, is realised by the iliac crest graft fixed to mandibular stump with miniatures plaques and intermaxillar blocking. The fonctioning and morphology results in majority is qualified to be mean with a follow-up between 14 and 24 months.

  12. 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

  13. 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

  14. 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

  15. Three-dimensional assessment of mandibular and glenoid fossa changes after bone-anchored Class III intermaxillary traction

    PubMed Central

    De Clerck, Hugo; Nguyen, Tung; de Paula, Leonardo Koerich; Cevidanes, Lucia

    2013-01-01

    Introduction Conventional treatment for young Class III patients involves extraoral devices designed to either protract the maxilla or restrain mandibular growth. The use of skeletal anchorage offers a promising alternative to obtain orthopedic results with fewer dental compensations. Our aim was to evaluate 3-dimensional changes in the mandibles and the glenoid fossae of Class III patients treated with bone-anchored maxillary protraction. Methods Twenty-five consecutive skeletal Class III patients between the ages of 9 and 13 years (mean age, 11.10 ± 1.1 year) were treated with Class III intermaxillary elastics and bilateral miniplates (2 in the infrazygomatic crests of the maxilla and 2 in the anterior mandible). The patients had cone-beam computed tomography images taken before initial loading and at the end of active treatment. Three-dimensional models were generated from these images, registered on the anterior cranial base, and analyzed by using color maps. Results Posterior displacement of the mandible at the end of treatment was observed in all subjects (posterior ramus: mean, 2.74 ± 1.36 mm; condyles: mean, 2.07 ± 1.16 mm; chin: mean, −0.13 ± 2.89 mm). Remodeling of the glenoid fossa at the anterior eminence (mean, 1.38 ± 1.03 mm) and bone resorption at the posterior wall (mean, −1.34 ± 0.6 mm) were observed in most patients. Conclusions This new treatment approach offers a promising alternative to restrain mandibular growth for Class III patients with a component of mandibular prognathism or to compensate for maxillary deficiency in patients with hypoplasia of the midface. Future studies with long-term follow-up and comparisons with facemask and chincup therapies are needed to better understand the treatment effects. PMID:22748987

  16. 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

  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. Regulated expression of chimaeric genes containing the 5'-flanking regions of human growth hormone-related genes in transiently transfected rat anterior pituitary tumor cells.

    PubMed Central

    Cattini, P A; Eberhardt, N L

    1987-01-01

    The expression and hormonal regulation of chimaeric genes containing the 5'-flanking regions of the normal human growth hormone (hGH-1), the variant hGH (hGH-2) and chorionic somatomammotropin (hCS-1) genes fused to the chloramphenicol acetyl transferase (CAT) gene has been examined after transient transfection into cultured rat pituitary (GC), and non-pituitary (HeLa and Rat 2) tumor cells. As assessed by levels of CAT activity, the hGH-1 and hCS-1 gene hybrids were expressed at 5- to 25-fold higher levels in GC cells than in HeLa or Rat 2 cells. The hGH-2 gene hybrid was expressed at very low levels in all 3 cell types. Triiodothyronine treatment of transiently transfected GC cells had little effect on CAT activity from the hGH-1 gene hybrid but increased CAT activity from the hCS-1 gene hybrid. A slight but significant increase in CAT expression was detected with both genes after dexamethasone treatment. The data indicate that elements present on the hGH-1 and hCS-1 genes' 5'-flanking DNA are required for the efficient expression of these genes in GC cells. Images PMID:3644237

  19. 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.

  20. Anaplastic Transformation in Mandibular Metastases of Follicular Variant of Papillary Thyroid Carcinoma: A Case Report and Review of the Literature.

    PubMed

    Ambelil, Manju; Sultana, Sadia; Roy, Suvra; Gonzalez, Maria M

    2016-09-01

    Anaplastic transformation of well-differentiated thyroid carcinomas at distant metastatic sites is a rare condition. Most cases described in the literature have occurred in the thyroid or regional lymph nodes. We report a case of anaplastic transformation of the follicular variant of papillary thyroid carcinoma in mandibular metastases. A 76-year-old female presented with a painful and enlarging mandibular mass. She had been treated in the past for the follicular variant of papillary thyroid carcinoma. A palliative hemi-mandibulectomy was performed. Histology revealed a metastatic papillary thyroid carcinoma, follicular variant, with an unusual finding of solid pleomorphic epithelioid and spindle cell areas, consistent with anaplastic transformation. PMID:27650625

  1. A questionnaire study to investigate custom and practice of imaging methods for the anterior region of the mandible prior to dental implant placement

    PubMed Central

    Shelley, AM; Wardle, L; Goodwin, M; Brunton, P; Horner, K

    2013-01-01

    Objectives: To investigate the custom and practice of private dental implant practitioners in the north-west of England when planning imaging methods prior to implant placement in the symphyseal region of the edentulous mandible. To gain an understanding of decision-making when prescribing imaging methods. Methods: A web-based questionnaire presented two realistic clinical scenarios. Both were of edentulous patients for whom implant-retained lower complete dentures were planned. A mixed mode survey methodology was employed. Results: 169 dentists were surveyed with an 80% response rate. The results showed no agreement on prescription of imaging methods. Those in the 0–10 years qualified group were significantly associated with the prescription of three-dimensional (3D) imaging. Implant practitioners who place more than 100 implants per year were significantly associated with the non-use of imaging guides and prescription of the same view for both cases. The sample as a whole, however, changed their prescription according to the case difficulty. Those who have a cone beam CT machine available were more likely to use 3D imaging regardless of the difficulty of the case. Conclusions: Existing guidelines are open to interpretation and could be construed to support a range of imaging choices. Training in dental implantology may leave dentists to make their own judgements about selection criteria. The idiosyncratic nature of independent dental practice may be an important factor in the chaotic pattern of prescriptions. There is a need for widely disseminated, evidence-based selection criteria for imaging prior to dental implantology which are clear and specific. PMID:23439687

  2. Treatment selection for anterior endodontically involved teeth.

    PubMed

    Rifkin, Robert; McLaren, Ed

    2004-09-01

    Innovations in material science and clinical techniques have expanded the number of treatment options available for nonvital anterior teeth. These options include the use of composite to fill the access opening with no additional treatment, crown placement, orthodontic extrusion, crown lengthening with or without orthodontic extrusion, dowel restorations with crown placement, and fixed bridge or implant therapy when extraction is necessary. Clinicians need to understand the benefits and limitations of each option in order to provide their patients with optimum function and aesthetics. Using case presentations, this article describes predictable approaches for the diagnosis, treatment planning, and restoration or replacement of endodontically treated teeth in the anterior region.

  3. 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

  4. Harmonization of free mandibular movements by orthodontic-surgical treatment of patients with mandibular retrognathism.

    PubMed

    Schwestka-Polly, R; Kubein-Meesenburg, D; Nägerl, H

    2000-01-01

    The aim of the following study was to investigate whether adult patients with mandibular retrognathism combined with a dental Class II relationship without craniomandibular pain show a characteristic structure of free mandibular movements caused by the neuromuscular system compared to patients with neutral skeletal and dental relationships. The authors also analyzed whether these characteristic structures changed following orthodontic-surgical treatment. To record the spatial movement of the mandible, an ultrasound measurement system was chosen and diagnostic software was developed for computer analysis of the recorded movements based on physical and biomechanical concepts. Clinically complaint-free, adult patients with mandibular retrognathism and distal bite exhibited a structure of mandibular movement that was markedly displaced as compared to patients with neutral skeletal and dental alignment. After completion of orthodontic and surgical treatment, it is apparent that the entire neuromuscular system of movement was transformed from one characterized by massive dysco-ordination to one of harmonized, coordinated motion, as is seen in patients with nonpathologic, neutral relation.

  5. Primary mandibular xanthoma: case report.

    PubMed

    de Araujo, Melissa Rodrigues; Scariot, Rafaela; Uetanabaro, Lucas; Luvison Gomes da Silva, Larissa; Giovanini, Allan Fernando

    2015-10-01

    Xanthoma is a very rare bone tumor, especially in the mandible, that can be associated with metabolic diseases such as hyperlipidemia. A 14-year-old girl presented with a non-corticated unilocular radiolucent lesion observed on panoramic radiography. The lesion was located between the roots of the left first and second premolar teeth, extending from the cervical to the apical region, measuring approximately 1 cm in greatest dimension. An excisional biopsy revealed foam cells and occasional nonfoamy mononuclear macrophage-like cells spread among a discrete fibrous stroma. Immunohistochemically, the xanthomatous cells were CD68 and vimentin positive, focally positive for S100, CD1a, and CD3 and negative for AE1/AE3, CD20, CD117, and HMB45. Hematologic and biochemical investigations ruled out systemic disease.

  6. Esthetic crown lengthening for maxillary anterior teeth.

    PubMed

    Sonick, M

    1997-08-01

    In the maxillary anterior region, the gingival labial margin position is an important parameter in the achievement of an ideal smile. The relationship between the periodontium and the restoration is critical if gingival health and esthetics are to be achieved. Periodontal therapy is a necessary and useful adjunct when any anterior restoration is undertaken. Anterior surgical crown lengthening may be undertaken to avoid restorative margin impingement on the biologic width. Crown lengthening is also used to alter the gingival labial profiles. This article discusses the esthetic parameters of ideal gingival labial positions and presents a classification of crown-lengthening procedures and the procedure for a two-stage crown-lengthening technique. The two-stage crown-lengthening technique is surgically precise because healing is predictable.

  7. 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

  8. 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

  9. 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...

  10. 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...

  11. 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...

  12. Cerebro-costo-mandibular syndrome: Report of two cases.

    PubMed

    Abdalla, Wael; Panigrahy, Ashok; Bartoletti, Stefano C

    2011-01-01

    Cerebro-costo-mandibular syndrome (CCMS) is a rare syndrome that includes a constellation of mandibular hypoplasia and posterior rib defects as its basic features. Additional features can include hearing loss, tracheal cartilage abnormalities, scoliosis, elbow hypoplasia, and spina bifida. Here we report two cases of CCMS and discuss the reported long-term outcome of the disease.

  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. [Surgical anatomy of the anterior mediastinum].

    PubMed

    Biondi, Alberto; Rausei, Stefano; Cananzi, Ferdinando C M; Zoccali, Marco; D'Ugo, Stefano; Persiani, Roberto

    2007-01-01

    The mediastinum is located from the thoracic inlet to the diaphragm between the left and right pleural cavities and contains vital structures of the circulatory, respiratory, digestive, and nervous system. Over the years, since there are no fascial or anatomic planes, anatomists and radiologists have suggested various schemes for subdividing the mediastinum and several anatomical and radiological classifications of the mediastinum are reported in the literature. The most popular of these scheme divides medistinum, for purposes of description, into two parts: an upper portion, above the upper level of the pericardium, which is named the superior mediastinum; and a lower portion, below the upper level of the pericardium. For clinical purposes, the mediastinum may be subdivided into three major areas, i.e. anterior, middle, and posterior compartments. The anterior mediastinum is defined as the region posterior to the sternum and anterior to the heart and brachiocephalic vessels. It extends from the thoracic inlet to the diaphragm and contains the thymus gland, fat, and lymph nodes. This article will review surgical anatomy of the anterior mediastinum and will focus on the surgical approch to anterior mediastinum and thymic diseases.

  15. Predictors of treatment preference for mandibular fracture

    PubMed Central

    Der-Martirosian, Claudia; Gironda, Melanie W.; Black, Edward E.; Belin, Thomas R.; Atchison, Kathryn A.

    2016-01-01

    Background Patient treatment preferences do not necessarily remain stable over time. Objective This study focuses on predictors of patient treatment choice and on the extent to which patients are willing to take risks by choosing surgical versus non-surgical treatment for mandibular fracture. Methods Surveys of African-American and Hispanic adults receiving treatment at King/Drew Medical Center for either a mandibular fracture (n = 98) or third-molar removal (n = 105) were used to investigate patterns of patient preference over the course of a 4-month study period using generalized estimating equations controlling for age, gender, income, and fracture versus third-molar patient. The study examined the effects of symptom rating and a “standard gamble” measure reflecting a patient’s willingness to accept scarring or nerve damage. This analysis is based on 169 patients who participated in four waves of data collection. Results The most salient predictor of patient treatment was the standard gamble measure at 1-month follow-up. Subjects with higher risk tolerance were more likely to select surgery versus jaw wiring. A higher likelihood of choosing surgery was associated with higher income and greater symptom severity. Fracture patients were more likely to select surgery compared with third-molar patients. Conclusions The significance of symptom severity 1-month post-surgery raises an important issue regarding the healing process. Moreover, the significance of standard gamble as a predictor of treatment choice for mandibular fracture should encourage other researchers to use this measure of willingness to accept risk when studying acute conditions such as jaw fracture. PMID:19694938

  16. Effects of mandibular advancement on growth after condylectomy.

    PubMed

    Nakano, M; Fujita, T; Ohtani, J; Kawata, T; Kaku, M; Motokawa, M; Tsuka, N; Hayashi, H; Tanne, K

    2009-03-01

    Previous studies have indicated that an injured condyle during adolescence is a causative factor for reduced mandibular growth and resulting asymmetry of the mandible. The aim of this study was to examine the nature of mandibular growth after unilateral condylectomy and to elucidate the effects of mandibular advancement. Sixty growing mice were subjected to unilateral condylectomy, and then one-half of them underwent treatment with a functional appliance. After 4 wks, a unilateral condylectomy produced reduced growth of the mandible and a subsequent lateral shift to the affected side. However, reduced growth and a lateral shift of the mandible were eliminated by a functional appliance, and prominent regeneration of the condyle was also demonstrated. It was shown that mandibular advancement provides for the regeneration of cartilaginous tissues on injured condyles and recovery of reduced mandibular growth, leading to correction of the lateral shift of the mandible. PMID:19329461

  17. Mandibular kinematics after orthognathic surgical treatment a pilot study.

    PubMed

    Sforza, Chiarella; Ugolini, Alessandro; Rocchetta, Davide; Galante, Domenico; Mapelli, Andrea; Giannì, Aldo Bruno

    2010-03-01

    We recorded three-dimensional mandibular movements, while the mouth was being opened and closed, using an optoelectronic motion analyser in 14 patients (5 skeletal Class II, 9 skeletal Class III) who were being assessed 7-49 months after orthognathic operations, and in 44 healthy subjects. All 14 patients had satisfactory healing on clinical examination, and function had been restored. Mandibular movement was divided into its rotational and translational components. On maximum mouth opening, the patients had significantly less total displacement of the mandibular interincisor point (p=0.05), and more mandibular movement that was explained by pure condylar rotation (p=0.006), than control subjects. There was no significant relation between maximum mouth opening and percentage rotation. While mandibular motion was well restored clinically by orthognathic surgery, the kinematics of the joint were modified. Larger studies and longitudinal investigations are necessary to appreciate the clinical relevance of the variations in condylar rotational and translational components.

  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. [Temporo-mandibular joints and orthognathic surgery].

    PubMed

    Bouletreau, P

    2016-09-01

    Temporo-Mandibular Joints (TMJ) and orthognathic surgery are closely linked. In the past, some authors have even described (with mixed results) the correction of some dysmorphosis through direct procedures on the TMJs. Nowadays, performing orthognathic surgery involves the TMJ in three different occasions: (1) TMJ disorders potentially responsible for dento-maxillary dysmorphosis, (2) effects of orthognathic surgery on TMJs, and (3) condylar positioning methods in orthognathic surgery. These three chapters are developed in order to focus on the close relationships between TMJ and orthognathic surgery. Some perspectives close this article.

  20. 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

  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. The skeletal stability after maxillo-mandibular osteotomy with a "physiological positioning strategy".

    PubMed

    Ohba, Seigo; Nakao, Noriko; Nakatani, Yuya; Kawasaki, Takako; Minamizato, Tokutarou; Koga, Takamitsu; Kohara, Haruka; Yoshida, Noriaki; Asahina, Izumi

    2014-12-01

    The aim of this study was to estimate skeletal and dental stability after maxillomandibular osteotomy with physiological positioning. Ten patients (7 men and 3 women) with skeletal mandibular prognathism were treated by conventional Le Fort I osteotomy for the maxilla and unfixed short lingual osteotomy for the mandible together with physiological positioning. We used cephalometric analysis to evaluate the skeletal and dental stability preoperatively, immediately after maxillomandibular osteotomy, and more than 1 year later. The immediately postoperative measurements for the SNA and the SN-palatal planes were 0.15° (p=0.67) and 1.0° (p=0.17), respectively. The positions of the anterior nasal spine, posterior nasal spine, and A point showed minimal changes 1 year postoperatively. The postoperative difference for SNB was 0.76° (p=0.04). Dental stability was apparent postoperatively. We conclude that reliable stability of both the maxilla and the mandible was achieved after maxillomandibular osteotomy with physiological positioning in patients with mandibular prognathism.

  3. Complications of mandibular distraction osteogenesis for developmental deformities: a systematic review of the literature.

    PubMed

    Verlinden, C R A; van de Vijfeijken, S E C M; Tuinzing, D B; Jansma, E P; Becking, A G; Swennen, G R J

    2015-01-01

    A systematic review of English and non-English articles on the complications of mandibular distraction osteogenesis (MDO) for patients with developmental deformities was performed, in accordance with the PRISMA statement. Search terms expressing distraction osteogenesis were used in 'AND' combination with search terms comprising 'mandible' and terms for complication, failure, and morbidity. A search using PubMed (National Library of Medicine, NCBI), EMBASE, and Cochrane Controlled Trials Register yielded 644 articles published between 1966 and mid October 2013. Clinical articles that reported complications related to MDO in developmental deformities were included. Two hundred and fifty articles were eligible and were screened in detail. A total of 32 articles reporting the cases of 565 patients were finally included. Patients underwent mandibular lengthening and transverse widening. A total of 211 complications were reported (37.4%); these were classified according to an index that indicates the clinical impact. Inferior alveolar nerve (IAN) neurosensory disturbances, minor infection, device failure, anterior open bite, permanent dental damage, and skeletal relapse were most represented. Complications that resolved spontaneously (type I) were seen in 11.0%, medically or technically manageable complications, without hospitalization, were seen in 10.8% (type II), and permanent complications (type VI) were seen in 9.6%.

  4. Modified Interim Mandibular Advancement (MIMA) Appliance for Symptomatic Correction of Obstructive Sleep Apnea

    PubMed Central

    Singh, Harpreet; Mishra, Harsh Ashok; Gupta, Ankur

    2016-01-01

    Obstructive Sleep Apnea (OSA) is a chronic, progressive, multifactorial, life-threatening disorder that causes significant impact on patient’s life. Patients with OSA [Apnea/Hypopnea Index (AHI)>30] who cannot tolerate Continuous Positive Airway Pressure (CPAP) therapy or are not surgical candidates may benefit from oral appliances. This paper describes interim appliance devised from existing Hawley’s retainer in patients with OSA. A 38-year-old man of athletic built with history of orthodontic treatment six months back due to esthetic concerns and wearing upper Hawley’s retainer, reported with chief complaint of frequent nocturnal awakening along with excessive daytime somnolence. Based on diagnostic aids, he was diagnosed with Class II Division 1 malocclusion with severe mandibular retrusion. Sleep test revealed AHI score of 34, suggestive of severe OSA. With ENT and Oral surgeon concurrence, mandibular advancement of 7mm with Bilateral Sagital Split Osteotomy (BSSO) with distraction was contemplated as a viable functional and curative stable treatment plan. Because of non-adherence and non-compliance with CPAP therapy and on request of patient, an interim anterior positioning appliance was devised to facilitate comfortable sound sleep till the time surgery is impending. After three months of wearing this customized appliance, improved quality of sleep was discernible; both subjectively as reported by patient and objectively using sleep test (AHI=9.8). PMID:27656589

  5. Modified Interim Mandibular Advancement (MIMA) Appliance for Symptomatic Correction of Obstructive Sleep Apnea.

    PubMed

    Maurya, Rajkumar; Singh, Harpreet; Mishra, Harsh Ashok; Gupta, Ankur

    2016-08-01

    Obstructive Sleep Apnea (OSA) is a chronic, progressive, multifactorial, life-threatening disorder that causes significant impact on patient's life. Patients with OSA [Apnea/Hypopnea Index (AHI)>30] who cannot tolerate Continuous Positive Airway Pressure (CPAP) therapy or are not surgical candidates may benefit from oral appliances. This paper describes interim appliance devised from existing Hawley's retainer in patients with OSA. A 38-year-old man of athletic built with history of orthodontic treatment six months back due to esthetic concerns and wearing upper Hawley's retainer, reported with chief complaint of frequent nocturnal awakening along with excessive daytime somnolence. Based on diagnostic aids, he was diagnosed with Class II Division 1 malocclusion with severe mandibular retrusion. Sleep test revealed AHI score of 34, suggestive of severe OSA. With ENT and Oral surgeon concurrence, mandibular advancement of 7mm with Bilateral Sagital Split Osteotomy (BSSO) with distraction was contemplated as a viable functional and curative stable treatment plan. Because of non-adherence and non-compliance with CPAP therapy and on request of patient, an interim anterior positioning appliance was devised to facilitate comfortable sound sleep till the time surgery is impending. After three months of wearing this customized appliance, improved quality of sleep was discernible; both subjectively as reported by patient and objectively using sleep test (AHI=9.8). PMID:27656589

  6. Is the late Neandertal mandibular sample from Vindija Cave (Croatia) biased?

    PubMed

    Kesterke, Matthew J; Ahern, James C M

    2007-06-01

    The late Neandertal sample from Vindija (Croatia) has been described as transitional between the earlier Central European Neandertals from Krapina (Croatia) and modern humans. However, the morphological differences indicating this transition may rather be the result of different sex and/or age compositions between the samples. This study tests the hypothesis that the metric differences between the Krapina and Vindija mandibular samples are due to sample bias. Mandibles are the focus of this paper because past studies have posited this region as particularly indicative of the Vindija sample's transitional nature. The results indicate that the metric differences between the Krapina and Vindija mandibular samples are not due to sample bias. This conclusion is consistent with an earlier analysis of sample bias for the Vindija supraorbital sample.

  7. 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

  8. Osteochondroma of the mandibular condyle. Report of a case with 5-year follow-up.

    PubMed

    Friedrich, Reinhard E; Scheuer, Hanna A; Fuhrmann, Andreas; Hagel, Christian; Zustin, Jozef

    2012-10-01

    In the current case, a 31-year-old patient who presented with a painful unilateral malocclusion and an unclear mass in the region of the right temporo-mandibular joint (TMJ) is reported. The malocclusion had been noticed by the patient a few months earlier. Chewing on the right side had become severely impaired and painful. The patient had no history of trauma to the TMJ. Plain radiographs and computed-tomographic scans depicted an enlarged and deformed mandibular condyle. A condylectomy was performed. The histological investigation of the specimen revealed an osteochondroma. The tumour did not express insulin-like growth factor-1 receptor. Five years following the surgical intervention, there has been no local recurrence and dental occlusion was re-established, without further treatment.

  9. Metastatic transitional cell carcinoma of the urinary bladder presenting as a mandibular gingival swelling.

    PubMed

    de Courten, A; Irle, C; Samson, J; Lombardi, T

    2001-05-01

    Oral cavity metastases mostly originate from the breasts, lungs, or kidneys. Transitional cell carcinoma (TCC), the most frequent malignant tumor of the urinary bladder, rarely metastasizes to the jaws. To the best of our knowledge, only 8 cases of bladder carcinoma have been reported in the English literature to metastasize to the jawbones. A new case of mandibular metastasis of urinary bladder TCC with extension to the gingiva is presented in a 64-year-old white man. The patient was referred for a periodontal infection of the upper right first molar. The clinical examination also showed a gingival swelling located in the lower left premolar region with a hypoasthesia of the left side of the lower lip. The gingival mass was biopsied, and the microscopy showed a mandibular metastatic TCC of the urinary bladder extending to the gingiva. Periodontists should be aware that, although gingival metastases are rare, when they occur they may mimic other local benign pathological conditions. PMID:11394406

  10. Myositis ossificans circumscripta of the buccinator muscle: First report of a rare complication of mandibular third molar extraction

    PubMed Central

    Wiggins, Raymond L.; Thurber, David; Abramovitch, Kenneth; Bouquot, Jerry; Vigneswaran, Nadarajah

    2008-01-01

    Myositis ossificans is a self-limiting ossifying process that most often develops following mechanical trauma to skeletal musculature. It chiefly affects the skeletal muscles of extremities of young athletically active adult males. Myositis ossificans is rare in children except for children affected by heritable disorder known as progressive myositis ossificans (fibrodysplasia ossificans progressiva). Children with this disorder develop ossification of muscles and associated soft tissue in early childhood without prior history of trauma. Traumatic form of myositis ossificans also known as myositis ossificans circumscripta (MOC) is rarely encountered in the head and neck musculature. We report a case of MOC within the buccinator which developed as a postoperative complication of mandibular third molar surgery. During extraction of a left mandibular third molar in a 16-year old male, a tooth fragment was accidently displaced into the adjacent soft tissue. Retrieval of this tooth fragment caused significant soft tissue trauma. Eighteen months after his third molar surgery, the patient continued to have pain and tenderness anterior to the left mandibular ramus. Radiographic imaging revealed a well-defined ovoid radiopaque mass within the left buccinator muscle. The lesion was surgically removed and the post-surgical course of the patient was uneventful. Histological findings of the mass were characteristic for myositis ossificans. PMID:18718410

  11. Cone Beam Computed Tomographic Analysis of the Shape, Height, and Location of the Mandibular Lingula in a Population of Children

    PubMed Central

    Sekerci, Ahmet Ercan; Cantekin, Kenan; Aydinbelge, Mustafa

    2013-01-01

     Objectives. This is the first study to identify and classify the different morphological shapes of the mandibular lingula (ML) in children using cone-beam computed tomography (CBCT). Material and Methods. A retrospective study was performed to evaluate the shape, height, and location of the ML in relation to the surrounding structures using CBCT images of mandibles obtained from 269 children. The shape of the ML was classified into triangular, truncated, nodular, or assimilated types. The location was determined by five distances. The height of the lingula was also measured from the lingular tip to the mandibular foramen. Results. A nodular shape of the ML was most commonly found (48.3%, n = 260) followed by truncated (23.4%, n = 126), assimilated (14.4%, n = 78), and triangular (13.7%, n = 74). The mean distance of ML from the anterior and posterior borders of mandibular ramus was 13.3 ± 2.3 mm and 10.2 ± 1.6 mm, respectively. In the majority of the mandibles studied, the ML was located above the occlusal plane. Conclusion. The present study provides new information to the literature concerning the shape, height, and location of the lingula in a Turkish pediatric population. This finding may assist clinicians to localize the lingula and avoid intraoperative complications. PMID:24490173

  12. Evaluation of location and dimensions of mandibular lingual canals: a cone beam computed tomography study.

    PubMed

    Wang, Y-M; Ju, Y-R; Pan, W-L; Chan, C-P

    2015-09-01

    This retrospective study evaluated the presence, location, and diameter of the mandibular lingual canals in a Taiwanese population using cone beam computed tomography (CBCT), to help improve the safety of mandibular surgical procedures. A total of 101 patients (46 men and 55 women), with a mean age of 55 years, were enrolled. Cross-sectional CBCT images of the mandible were used to define the orifice and diameter of each lingual canal detected. The relevance of all data for both sexes was assessed and analyzed statistically using non-paired t-tests. The canals were categorized as median (MLC) and lateral lingual canals (LLC) based on the position of the mandible. The midline of the symphysis showed the highest frequency of lingual canals (97.0%), and all patients exhibited at least one lingual perforating bone canal in the mandible. The lingual canal diameter ranged from 0.25 to 1.90 mm (mean 0.61 mm) in the midline region and from 0.25 to 1.60mm (mean 0.58 mm) in the lateral region. Significant differences in diameter were observed between the sexes in the MLC and LLC groups (men>women). The results suggest that mandibular lingual vascular canals are common and detected regularly using CBCT. PMID:25890920

  13. 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.

  14. Closed reduction of mandibular condyle fractures using C-arm fluoroscopy: a technical note.

    PubMed

    Imai, Tomoaki; Michizawa, Masahiro; Yamamoto, Naofumi; Kai, Tatsuro

    2013-01-01

    We describe a C-arm technique for mandibular condylar fractures in an anatomic study using a model skull and show its feasibility in a clinical case. The C-arm allowed posterior-anterior visualization of the condylar process. The X-ray axis was canted ∼15 degrees cranially to the Frankfort horizontal line. The skull's sagittal plane was rotated ∼15 degrees ipsilaterally to the X-ray axis. This technique facilitates clear visualization of the condylar neck with easy, flexible, and timely adjustments. In selected cases, this method would convert the clinical settings of the condylar fracture pattern to that which would not be amenable to an open approach, making possible minimally invasive surgical procedures.

  15. 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

  16. An in situ hybridization study of Runx2, Osterix, and Sox9 in the anlagen of mouse mandibular condylar cartilage in the early stages of embryogenesis.

    PubMed

    Shibata, Shunichi; Yokohama-Tamaki, Tamaki

    2008-09-01

    Mandibular condylar cartilage is the best-studied mammalian secondary cartilage, differing from primary cartilage in that it originates from alkaline phosphatase-positive progenitor cells. We previously demonstrated that three transcription factors related to bone and cartilage formation, namely Runx2, Osterix and Sox9, are simultaneously expressed in the anlage of mandibular condylar cartilage (condylar anlage) at embryonic day (E)14. In this study, expression of these transcription factors was investigated in the anlagen of mandibular bone (mandibular anlagen) from E11.0 to 14.0. Runx2 mRNA was first expressed in the mandibular anlage at E11.5. Osterix mRNA was first expressed at E12.0, and showed a different expression pattern from that of Runx2 from E12.5 to E14.0, confirming that Osterix acts downstream of Runx2. Sox9 mRNA was expressed in Meckel's cartilage and its anlagen throughout the experimental period, but not clearly in the mandibular anlagen until E13.0. At E13.5, the condylar anlage was morphologically identified at the posterior end of the mandibular anlage, and enhanced Sox9 mRNA expression was detected here. At this stage, Runx2 and Osterix mRNA were simultaneously detected in the condylar anlage. These results indicate that the Sox9 mRNA-expressing condylar anlage is derived from Runx2/Osterix mRNA-expressing mandibular anlage, and that upregulation of Sox9 in this region acts as a trigger for subsequent condylar cartilage formation.

  17. Direct restoration of worn maxillary anterior teeth with a combination of composite resin materials: a case report.

    PubMed

    Soares, Carlos José; Pizi, Eliane Cristina Gava; Fonseca, Rodrigo Borges; Martins, Luis Roberto Marcondes; Neto, Alfredo Júlio Fernandes

    2005-01-01

    Tooth loss, alterations on tooth structure, and reduced vertical dimension are known to severely compromise the stomatognathic system. This case report describes the treatment of a patient who presented with an extremely worn maxillary anterior dentition with a loss of posterior support owing to the loss of almost all the posterior teeth, except the mandibular premolars. Provisional removable partial dentures were used to create an optimum maxillomandibular relationship and to provide restorative space prior to the restoration of the remaining teeth. This restoration was accomplished with a combination of layered hybrid and microfilled composite materials, which restored the maxillary anterior teeth to optimum esthetics and function.

  18. In Vivo Bioreactors for Mandibular Reconstruction

    PubMed Central

    Tatara, A.M.; Wong, M.E.; Mikos, A.G.

    2014-01-01

    Large mandibular defects are difficult to reconstruct with good functional and aesthetic outcomes because of the complex geometry of craniofacial bone. While the current gold standard is free tissue flap transfer, this treatment is limited in fidelity by the shape of the harvested tissue and can result in significant donor site morbidity. To address these problems, in vivo bioreactors have been explored as an approach to generate autologous prefabricated tissue flaps. These bioreactors are implanted in an ectopic site in the body, where ossified tissue grows into the bioreactor in predefined geometries and local vessels are recruited to vascularize the developing construct. The prefabricated flap can then be harvested with vessels and transferred to a mandibular defect for optimal reconstruction. The objective of this review article is to introduce the concept of the in vivo bioreactor, describe important preclinical models in the field, summarize the human cases that have been reported through this strategy, and offer future directions for this exciting approach. PMID:25139360

  19. 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

  20. Spatial relationship between the mental foramen and mandibular developing teeth in modern humans, chimpanzees, and hamadryas baboons.

    PubMed

    Fukase, Hitoshi

    2014-08-01

    The mental foramen (MF) of adult human mandibles is characterized by its high position and posterosuperior opening orientation, compared with that of nonhuman primates. In this study, to examine when and how such interspecies variations in MF position/orientation are manifested in the context of dental development, positional relationships between the MF and nearby forming teeth (dc, dm1, C, P3) were assessed using CT-scanned growth-series mandibles of the following three species with various MF positions and anterior dental sizes: modern humans, chimpanzees, and hamadryas baboons. Results showed that modern humans have more antero-superiorly located MF and dc than the two nonhuman samples during growth, whereas the MF and dm1 of hamadryas baboons are the most inferiorly positioned. Considering that the mandibular canal generally reaches the dc/dm1 position during infancy, the species differences in MF position can be attributed largely to the positions where the anterior deciduous teeth first appear. Specifically, the distinctive dental position of modern humans should stem eventually from the comparatively small anterior dental size. Furthermore, human MF position shifted slightly upwards with alveolar development, unlike in the nonhuman samples, accompanied by strong curvature and vertical elongation of the anterior mandibular canal. Meanwhile, the human MF shifted from a forward to a lateral/backward orientation in association with human-specific growth-related alveolar recession. The findings of this study, thus, collectively indicate that taxonomic variations in adult MF position/orientation can be interpreted partly by the positions of the surrounding developing teeth.

  1. 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

  2. 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

  3. Backward distraction osteogenesis in a patient with severe mandibular micrognathia.

    PubMed

    Mitsukawa, Nobuyuki; Morishita, Tadashi; Saiga, Atsuomi; Akita, Shinsuke; Kubota, Yoshitaka; Satoh, Kaneshige

    2013-09-01

    Maxillary skeletal prognathism can involve severe mandibular micrognathia with marked mandibular retrognathism or hypoplasia. For patients with such a condition, a conventional treatment is mandibular advancement by sagittal split ramus osteotomy (SSRO). This procedure has problems such as insufficient advancement, instability of jaw position, and postoperative relapse. Thus, in recent years, mandibular distraction osteogenesis has been used in some patients. Mandibular distraction has many advantages, but an ideal occlusion is difficult to achieve using this procedure. That is, 3-dimensional control cannot be attained using an internal device that is unidirectional. This report describes a case of severe mandibular micrognathia in a 14-year-old girl treated using backward distraction osteogenesis. This procedure was first reported by Ishii et al (Jpn J Jaw Deform 2004; 14:49) and involves a combination of SSRO and ramus distraction osteogenesis. In the present study, intermaxillary fixation in centric occlusion was performed after osteotomy, and proximal bone segments were distracted in a posterosuperior direction. This procedure is a superior surgical technique that avoids the drawbacks of SSRO and conventional mandibular distraction. However, it applies a large load to the temporomandibular joints and requires thorough management. Thus, careful evaluation needs to be made of the indication for backward distraction osteogenesis.

  4. 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

  5. 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.

  6. [Congenital malformations of the temporo-mandibular joint and the mandibular ramus: Grafting vs distraction osteogenesis].

    PubMed

    Gallucci, A; Graillon, N; Foletti, J M; Chossegros, C; Cheynet, F

    2016-09-01

    Congenital deformities of the mandibular ramus and of the temporo-mandibular joint are treated by surgery since the early 20th century. However, morphological and functional results are often disappointing, accounting for iterative operations. Today, a clear consensus concerning the type of intervention to be proposed, and at what age it should be carried out does not yet exist. For mild cases, "conventional" orthognathic or osteogenic distraction procedures seem to work well, especially if they are carried out at the end of growth. In severe cases, it is often necessary to proceed in several surgical steps, usually starting with a chondrocostal graft, especially when interceptive surgery, performed before the end of growth, is preferred in order to improve the patient's quality of life.

  7. Percutaneous radiofrequency thermocoagulation for trigeminal neuralgia using neuronavigation-guided puncture from a mandibular angle

    PubMed Central

    Ding, Weihua; Chen, Shuping; Wang, Rong; Cai, Jun; Cheng, Yuan; Yu, Liang; Li, Qinghua; Deng, Fang; Zhu, Shengmei; Yu, Wenhua

    2016-01-01

    Abstract Percutaneous radiofrequency thermocoagulation (RFT) of the Gasserian ganglion is an effective treatment for primary trigeminal neuralgia (pTN). Currently Hartel anterior approach is the most commonly used method to access the Gasserian ganglion. However, this approach is associated with high recurrence rate and technical difficulties in certain patients with foramen ovale (FO) anatomical variations. In the present study, we assessed the feasibility of accessing the Gasserian ganglion through the FO from a mandibular angle under computed tomography (CT) and neuronavigation guidance. A total of 108 patients with TN were randomly divided into 2 groups (Group G and Group H) using a random number table. In Group H, Hartel anterior approach was used to puncture the FO; whereas in Group G, a percutaneous puncture through a mandibular angle was used to reach the FO. In both groups, procedures were guided by CT imaging and neuronavigation. The success rates, therapeutic effects, complications, and recurrence rates of the 2 groups were compared. The puncture success rates in Group H and Group G were 52/54 (96.30%) and 49/54 (90.74%), respectively (P = 0.24). The 2 procedural failures in Group H were rescued by using submandibular trajectory, and the 5 failures in Group G were successfully reapproached by Hartel method. Therapeutic effects as measured by Barrow Neurological Institute (BNI) pain scale (P = 0.03) and quality of life (QOL) scores (P = 0.04) were significantly better in Group G than those in Group H at 36 months posttreatment. Hematoma developed in 1/54 (1.85%) cases in Group H, and no cases of hematoma were observed in Group G (P = 0.33). In Group H, RFT resulted in injury to the unintended trigeminal nerve branches and motor fibers in 27/52 (51.92%) cases; in Group G, it resulted in the same type of injury in 7/49 cases (14.29%) (P < 0.01). In Group H, the 24- and 36-month recurrence rates were 12/51 (23.53%) and 20/51 (39

  8. 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

  9. Mandibular first molar with single root and single root canal

    PubMed Central

    Munavalli, Anil; Kambale, Sharnappa; Ramesh, Sachhi; Ajgaonkar, Nishant

    2015-01-01

    Mandibular molars demonstrate considerable anatomic complexities and abnormalities with respect to number of roots and root canals. Clinicians should be aware that there is a possibility of the existence of a fewer number of roots and root canals than the normal root canal anatomy. Mandibular first molar with a single root and single canal was diagnosed with the aid of dental operating microscope and multiple angled radiographs. This case report presents a rare case of successful endodontic management of mandibular first molar with a single root and root canal. PMID:26180424

  10. Clinical trial of pantomography for the evaluation of mandibular trauma.

    PubMed

    Johnston, C C; Doris, P E

    1980-08-01

    A trial study was conducted comparing the standard "four view" mandibular series and pantomography for th evaluation of mandibular trauma. During the six-month trial period a series of 17 patients with a total of 24 mandibular fractures was compiled. The pantomographs were more easily interpreted than the standard views because overlapping structures were blurred and spatial orientation was clear. In eight of the 17 patients the fractures were more clearly visualized by pantomography. Because the entire mandibule was seen so well on the pantomographs, no special views were required. Eleven patients had single fractures, which are in fact quite common.

  11. Endothelin-A receptor-dependent and -independent signaling pathways in establishing mandibular identity

    PubMed Central

    Ruest, Louis-Bruno; Xiang, Xilin; Lim, Kim-Chew; Levi, Giovanni; Clouthier, David E.

    2009-01-01

    Summary The lower jaw skeleton is derived from cephalic neural crest (CNC) cells that reside in the mandibular region of the first pharyngeal arch. Endothelin-A receptor (Ednra) signaling in crest cells is crucial for their development, as Ednra−/− mice are born with severe craniofacial defects resulting in neonatal lethality. In this study, we undertook a more detailed analysis of mandibular arch development in Ednra−/− embryos to better understand the cellular and molecular basis for these defects. We show that most lower jaw structures in Ednra−/− embryos undergo a homeotic transformation into maxillary-like structures similar to those observed in Dlx5/Dlx6−/− embryos, though lower incisors are still present in both mutant embryos. These structural changes are preceded by aberrant expansion of proximal first arch gene expression into the distal arch, in addition to the previously described loss of a Dlx6/Hand2 expression network. However, a small distal Hand2 expression domain remains. Although this distal expression is not dependent on either Ednra or Dlx5/Dlx6 function, it may require one or more GATA factors. Using fate analysis, we show that these distal Hand2-positive cells probably contribute to lower incisor formation. Together, our results suggest that the establishment of a ‘mandibular identity’ during lower jaw development requires both Ednra-dependent and -independent signaling pathways. PMID:15306564

  12. Relationship between Frontal Gap and Postoperative Stability in the Treatment of Mandibular Prognathism

    PubMed Central

    Tseng, Yu-Chuan; Hsu, Kun-Jung; Wu, Ju-Hui

    2016-01-01

    Objectives. To investigate the correlation between frontal gaps and skeletal stability after intraoral vertical ramus osteotomy (IVRO) for correction of mandibular prognathism. Materials and Methods. Thirty-three patients with frontal gaps after IVRO-based mandibular prognathism correction were included. Three lateral and frontal cephalometric radiographs were obtained: preoperatively (T1), immediately postoperatively (T2), and 2 years postoperatively (T3). Two linear measurements (menton [Me] and frontal gap) were compared from T1 to T3 (T21: immediate surgical changes; T32: postoperative stability; T31: 2-year surgical change). Data were analyzed using Pearson's correlation coefficient and multiple linear regression. Results. The T21 mean surgical horizontal change in the Me position was 12.4 ± 4.23 mm. Vertically, the mean downward Me movement was 0.6 ± 1.73 mm. The mean frontal gaps were 4.7 ± 2.68 mm and 4 ± 2.48 mm in the right and left gonial regions, respectively. Postoperative stability (T32) significantly correlated with the amount of setback. Frontal gaps did not have a significant effect on postoperative stability. However, multiple regression model (R2 = 0.341, P = 0.017) showed value predictability, especially in the amount of setback. Conclusion. Frontal gaps occur after IVRO but have no significant effect on long-term postoperative skeletal stability. The primary risk factor for postoperative relapse remains the amount of mandibular setback. PMID:27774457

  13. Wound ballistics of the pig mandibular angle: a preliminary finite element analysis and experimental study.

    PubMed

    Chen, Yubin; Miao, Yingyun; Xu, Chuan; Zhang, Gang; Lei, Tao; Tan, Yinghui

    2010-04-19

    To study wound ballistics of the mandibular angle, a combined hexahedral-tetrahedral finite element (FE) model of the pig mandible was developed to simulate ballistic impact. An experimental study was carried out by measuring impact load parameters from 14 fresh pig mandibles that were shot at the mandibular angle by a standard 7.62 mm M43 bullet. FE analysis was executed through the LS-DYNA code under impact loads similar to those obtained from the experimental study. The resulting residual velocity, the transferred energy from the bullet to the mandible, and the surface area of the entrance wound had no statistical differences between the FE simulation and the experimental study. However, the mean surface area of the exit wounds in the experimental study was significantly larger than that in the simulation. According to the FE analysis, the stress concentrated zones were mainly located at the region of impact, condylar neck, coronoid process and mandibular body. The simulation results also indicated that trabecular bone had less stress concentration and a lower speed of stress propagation compared with cortical bone. The FE model is appropriate and conforms to the basic principles of wound ballistics. This modeling system will be helpful for further investigations of the biomechanical mechanisms of wound ballistics.

  14. 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

  15. 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

  16. The effect of diabetes mellitus on rat mandibular bone formation and microarchitecture.

    PubMed

    Abbassy, Mona A; Watari, Ippei; Soma, Kunimichi

    2010-08-01

    The aim of this study was to assess the effect of type 1 diabetes mellitus (DM) on the structure of mandibular bone and on the changes of alveolar/jaw bone formation. Experimental DM was induced in 3-wk-old male Wistar rats by a single dose of 60 mg/kg body weight of streptozotocin. All rats were injected with calcein on days 21 and 28. The rats were killed when 8 wk of age. Bone structure was analyzed by bone histomorphometry, microcomputed tomography (micro-CT), and histological section. Histomorphometric analysis showed that the mineral apposition and the bone formation rates in most of the mandibular regions were significantly decreased in the DM group compared with the control group. Micro-CT analysis showed significant deterioration of the bone quality in rats with DM. For a histometric measure of bone resorption, the number of osteoclasts along the distal surface of the alveolar wall was counted. The number of osteoclasts was significantly lower in the rats with DM than in the controls. These findings suggest that uncontrolled DM decreases mandibular bone formation, reduces the rate of bone turnover in the alveolar wall surrounding the root, and affects the quality of bone structure resulting in retardation of its skeletal development.

  17. 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.

  18. Impact of impacted mandibular third molars in mandibular angle and condylar fractures.

    PubMed

    Thangavelu, A; Yoganandha, R; Vaidhyanathan, A

    2010-02-01

    Previous retrospective analyses prove that impacted mandibular third molars (M3s) increase the risk of angle fractures and decrease the risk of concomitant fractures to the condyle. The authors have attempted to verify these relationships and identify the underlying mechanism of injury. A retrospective cohort was designed for patients attending the Division of Oral and Maxillofacial Surgery from January 2001 till October 2008. The primary predictor variable was M3. The secondary predictor variables were: M3 position, classified using the Pell and Gregory system; angulation, classified using Shiller's method; and the number of visible dental roots. The outcome variables were angle and condyle fractures. Hospital charts and radiographs were used to determine and classify these variables. The study sample comprised 1102 mandibular fractures in 600 patients. For patients injured by moderate traumatic force resulting in two fractures of the mandible, the presence/absence of impacted M3s played an important role in angle/condylar fractures. Patients with impacted M3s were three times more likely to develop angle fractures and less likely to develop condylar fractures than those without impacted M3s. This study provides clinical evidence to suggest that the removal of unerupted mandibular third molars predisposes the mandible to condyle fractures.

  19. 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

  20. 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

  1. 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

  2. An analysis of postoperative complications and efficacy of 3-D miniplates in fixation of mandibular fractures

    PubMed Central

    Gokkulakrishnan, Sadhasivam; Singh, Sanjay; Sharma, Ashish; Shahi, Ashish Kumar

    2012-01-01

    Background: Recently, various modifications in transorally placed miniplates for direct fixation of the mandibular fracture are gaining popularity. The modifications have various advantages like more rigidity, less foreign material, less time in application, etc. Among the various modifications of miniplates, three-dimensional (3-D) plating system is also gaining popularity. Thus, in the present study, we tried to evaluate the efficacy and postoperative complications of 3-D titanium miniplates in the treatment of mandibular fractures. Materials and Methods: A prospective study was conducted on 40 patients with non-comminuted mandibular fractures. They were treated using a 2-mm 3-D titanium miniplate through intraoral approach. All patients were systematically monitored 6 months postoperatively. Outcome parameters like infection, hardware failure, wound dehiscence, sensory disturbance of the inferior alveolar nerve, occlusion, and 3-D plate stability were recorded. The statistical tests used in study were mean, standard deviation, and Chi-square test. P values less than 0.05 were considered significant and values less than 0.001 were considered very highly significant. Results: Two patients had a postoperative infection with no consequences. All patients had normal sensory function 3 months after surgery. Plate fracture had not occurred in any patient. Occlusal was normal and wound dehiscence was not reported. 3-D plate was stable in all the patients. Conclusions: It was seen that 3-D titanium miniplates were effective in the treatment of mandibular fractures and overall complication rates were lesser. In symphysis and parasymphysis regions, 3-D plating system uses lesser foreign material than the conventional miniplates using Champy's principle. PMID:23162581

  3. Hypnotic induction decreases anterior default mode activity.

    PubMed

    McGeown, William J; Mazzoni, Giuliana; Venneri, Annalena; Kirsch, Irving

    2009-12-01

    The 'default mode' network refers to cortical areas that are active in the absence of goal-directed activity. In previous studies, decreased activity in the 'default mode' has always been associated with increased activation in task-relevant areas. We show that the induction of hypnosis can reduce anterior default mode activity during rest without increasing activity in other cortical regions. We assessed brain activation patterns of high and low suggestible people while resting in the fMRI scanner and while engaged in visual tasks, in and out of hypnosis. High suggestible participants in hypnosis showed decreased brain activity in the anterior parts of the default mode circuit. In low suggestible people, hypnotic induction produced no detectable changes in these regions, but instead deactivated areas involved in alertness. The findings indicate that hypnotic induction creates a distinctive and unique pattern of brain activation in highly suggestible subjects. PMID:19782614

  4. Paediatric mandibular fractures: report of a case.

    PubMed

    Qadri, Ghalib Walid; Mokhtar, Sarimah Mohd

    2008-12-01

    The conservative approach in the treatment of maxillofacial trauma in children has been widely adopted. The type of fracture and its presence within the growing facial skeleton along with the presence of tooth buds may result in different management strategies to that employed in adults. An understanding of conservative treatment options is essential to make informed choices which will best manage these injuries, and an example is presented in this paper. This case report describes a 14-year-old boy who sustained trauma to the chin as a result of a fall, causing a mandibular symphyseal fracture. He was successfully treated by the means of applying direct interdental wiring combined with an acrylic splint.

  5. Reconstruction of mandibular defects in irradiated patients

    SciTech Connect

    Klotch, D.W.; Gump, J.; Kuhn, L. )

    1990-10-01

    In this prospective study, mandibular reconstruction using titanium plates was evaluated in 31 patients treated between July 1988 and January 1990. Sixteen patients had prior surgery; 13 had prior radiotherapy. In 11 patients, prior radiation and surgery had failed. Sixteen patients received postoperative radiotherapy either in standard or accelerated fractions. Twelve patients had complications of either intraoral (8), extraoral (5), or combined (1) plate exposure or fistula formation (2). Factors significantly related to complications were poor nutrition, accelerated radiation, and recurrence. Sixty-one percent of all patients healed uneventfully. When patients with complications secondary to recurrence who subsequently died were excluded, the success rate was 73%. Only one patient had an unacceptable result that produced a cosmetic and functional deformity despite secondary repair.

  6. 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

  7. Mandibular coronoid hyperplasia in pediatric patients.

    PubMed

    Jaskolka, Michael S; Eppley, Barry L; van Aalst, John A

    2007-07-01

    Bilateral coronoid hyperplasia is a relatively rare condition in the pediatric population and yet may be an unrecognized cause of limited mouth opening in children. There are multiple theories as to the causes of the hyperplasia, which include temporalis hyperactivity, hormonal stimulus, and genetic inheritance. The resulting excess growth of the coronoids results in impingement on the zygomatic processes leading to mandibular hypomobility. The diagnosis is confirmed with plain films and computed tomography scans. Treatment involves bilateral coronoidectomies to relieve impingement on the zygoma. Postoperative physical therapy is crucial for success; the therapy focuses on maintaining the mouth opening achieved at the time of surgery. Outcome reports have been variable despite good physical therapy, suggesting that the exact pathology of the condition is not well understood.

  8. Spring-mediated mandibular distraction osteogenesis.

    PubMed

    Mofid, Mehrdad M; Inoue, Nozomu; Tufaro, Anthony P; Vander Kolk, Craig A; Manson, Paul N

    2003-09-01

    Successful performance of distraction osteogenesis requires rigorous patient compliance with a daily activation regimen of a percutaneous screw. Previous clinical studies have found that failure of patient compliance with this regimen is the most common complication leading to technical failure of the distraction process. The authors have developed an internalized spring-mediated device for mandibular distraction osteogenesis that can potentially abrogate the risks associated with patient compliance by allowing for automated distraction across an osteotomy. Twenty adult New Zealand White rabbits underwent unilateral mandibular osteotomy. A segment of nickel-titanium shape memory alloy reinforced at both ends with a pinball was fashioned into an inferiorly based arc and secured to the mandible with stainless steel wire. On postoperative day 12, spring activation commenced by cutting a wire binding the two pinballs to one another. Animals were observed for 6 weeks before they were killed. Radiographic studies and decalcified histologic analysis were performed on extracted mandibles. Temperature- and displacement-dependent properties of the shape memory alloy were also examined. Five animals were excluded from the study due to infection, nonunion, or device failure. A mean distraction of 1.2 mm in the distracted hemimandible relative to the nonoperated hemimandible was found (P <.001, two-tailed paired t test). The maximum distraction achieved in an experimental specimen using the spring distractor was 3.7 mm. There were no other histologic or radiographic differences found between study specimens and specimens subjected to traditional distraction methods. Biomechanical testing of the shape memory alloy revealed a temperature-dependent increase in force at body temperature compared with room temperature and a reduction in force with increased displacement of the spring. This study demonstrates the feasibility of spring-mediated distraction osteogenesis across an

  9. Anterior endoscopic correction of scoliosis.

    PubMed

    Picetti, George D; Ertl, Janos P; Bueff, H Ulrich

    2002-04-01

    Our technique of anterior endoscopic scoliosis correction demonstrates the ability to perform an anterior approach through a minimally invasive technique with minimal disruption of the local biology. The initial results appear to equal curve correction and fusion rates to those of a formal open anterior approach. Additional benefits are: 1) shortened operative time, 2) lower blood loss, 3) shortened rehabilitation time, 4) less pain, and 5) shortened hospital stays. Endoscopic technique shows great promise in the management of scoliosis curves; however, this is a technically demanding procedure that requires cross-training in endoscopic discectomy and scoliosis management as well as familiarity with the anterior approach anatomy. PMID:12389288

  10. 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

  11. 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

  12. 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

  13. 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

  14. Intra-mandibular canalicular adenoma: report of a rare case.

    PubMed

    Dayisoylu, Ezher Hamza; Pampu, Ali Alper; Mungan, Sevdegul; Taskesen, Fatih

    2012-11-01

    Canalicular adenomas are uncommon benign salivary gland neoplasms of the oral cavity. They are typically located on the upper lip, buccal mucosa and infrequently found on the palate and derived from minor salivary glands. Intra-mandibular localization of canalicular adenoma is extremely rare. Due to benign character of the tumour, canalicular adenomas rarely present with bone erosion. Histologically, trabecular type of basal cell adenoma, pleomorphic adenoma and polymorphous low-grade adenocarcinoma should be discriminated from canalicular adenomas. A-56- year old female patient with asymptomatic intra-mandibular canalicular adenoma was presented. The lesion was managed surgically under local anesthesia and 2 year's follow up was uneventful. Only two other intra-mandibular canalicular adenoma cases have been reported up till now. This case report describes the third intra-mandibular canalicular adenoma, and reviews the literature.

  15. 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

  16. 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

  17. 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

  18. [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.

  19. [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

  20. Computer-assisted individual osteotomy design for mandibular reconstruction

    NASA Astrophysics Data System (ADS)

    Zeilhofer, Hans-Florian U.; Sader, Robert; Horch, Hans-Henning; Wunderlich, Arthur P.; Kirsten, Rainer; Gerhardt, H. C. P.

    1994-04-01

    The complex structure and functional capacity of the mandible places high demands on the design for mandibular reconstructions for graft or transplant purposes. When using the crista iliac as a basis for grafts to bridge large defects, the graft is empirically shaped by the operator according to this experience, whereby it is often necessary to dissect and reconstruct it numerous times. A 3-D computer tomogram of the lower jaw and ilium is carried out on patients undergoing a planned mandible reconstruction. The 3-D CT data are processed in a workstation using a medical image analysis system. The ala of the ilium is superimposed over the region of the lower jaw which is to be replaced. This enables a coincidence of the structure of the lower jaw and the structure of the ilium crest to be formed to within an accuracy of one voxel - despite the complex three dimensional structure and distortions in all three spatial planes. In accordance with the computer simulation, the applicably shaped ilium crest is placed on the individually calculated donor site and transplanted in the resected section of the lower jaw. An exact reconstruction of the lower jaw bone is made possible using computer assisted individual osteotomy design, resulting in complete restoration regarding shape and functionality.

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. The Gow-Gates mandibular block. Evaluation after 4,275 cases.

    PubMed

    Malamed, S F

    1981-05-01

    The Gow-Gates mandibular block, introduced in the United States in 1973, represents the first new approach to intraoral regional anesthesia in many years. The technique is being taught at most United States dental schools. This article presents a clinical evaluation of the Gow-Gates technique after 5 years of application and more than 4,000 cases. Advantages of this technique over the conventional inferior alveolar nerve block include a greater success rate, decreased positive aspiration rate, and fewer postinjection problems.

  8. 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

  9. The interposition of Lyodura in operations for ankylosis of the temporo-mandibular joint. An experimental study using pigs.

    PubMed

    Timmel, R; Grundschober, F

    1982-11-01

    Experimental investigations using domestic pigs were carried out in order to study the subject of resorption of lyophilized Dura (Lyodura) interposed in the region of the temporo-mandibular joint after operations for ankylosis. The condyle of the mandible was partially resected on one or both sides, the joint capsule and disc excised and the mandibular fossa stripped of cartilage. Lyodura was interposed between the surfaces of the bones and intravital sequential labelling of the bones was carried out using fluorochromes. The animals were sacrificed after 18, 36, 50 and 120-130 days and the joint region excised. Undecalcified microtome (5-8 mu) and ground sections were prepared and contact microradiographs made. It was found that the Lyodura remained in place in spite of the mechanical loading until it was assimilated by a foreign body reaction and replaced by largely collagenous, endogenous connective tissue. Spaces similar to the joint cavity and lined with pseudosynovia were found after 120-130 days.

  10. [Anterior pituitary hypersecretion syndromes].

    PubMed

    Gómez, F; Steinhäuslin, F; Crottaz, B; Temler, E

    1987-01-17

    Anterior pituitary hypersecretion can be due to abnormal hypothalamic regulation, decreased peripheral hormone feedback or pituitary tumor. In some cases hypersecretion gives rise to a typical clinical syndrome involving acromegaly, hyperprolactinemia, and excess corticotropin (ACTH). The etiology of acromegaly is a growth hormone (GH)-secreting pituitary tumor in the vast majority of cases. Hyperprolactinemia and excess cortisol, however, may be due to many causes among which prolactin (PRL)- and ACTH-secreting pituitary tumors are not frequent. Glycoprotein-secreting pituitary tumors, especially gonadotropin (LH and FSH) and free subunits usually do not cause a typical excess hormone syndrome. Perhaps for this reason they are seldom recognized clinically, although histopathological studies are increasingly disclosing the gonadotrope nature of many pituitary tumors. Mixed hormonal secretions are common. When pituitary hormone secretion can be selectively suppressed by medical therapy, a significant reduction of tumor size is by no means rare. In other cases, pituitary irradiation or surgery, or even treatment aimed at a peripheral target gland, may be necessary. PMID:3029861

  11. Examination of the relationship between mandibular position and body posture.

    PubMed

    Sakaguchi, Kiwamu; Mehta, Noshir R; Abdallah, Emad F; Forgione, Albert G; Hirayama, Hiroshi; Kawasaki, Takao; Yokoyama, Atsuro

    2007-10-01

    The purpose of this study was to evaluate the effect of changing mandibular position on body posture and reciprocally, body posture on mandibular position. Forty-five (45) asymptomatic subjects (24 males and 21 females, ages 21-53 years, mean age 30.7 years) were included in this study and randomly assigned to one of two groups, based on the table of random numbers. The only difference between group I and group II was the sequence of the testing. The MatScan (Tekscan, Inc., South Boston, MA) system was used to measure the result of changes in body posture (center of foot pressure: COP) while subjects maintained the following 5 mandibular positions: (1) rest position, (2) centric occlusion, (3) clinically midlined jaw position with the labial frena aligned, (4) a placebo wax appliance, worn around the labial surfaces of the teeth and (5) right eccentric mandibular position. The T-Scan II (Tekscan, Inc., South Boston, MA) system was used to analyze occlusal force distribution in two postural positions, with and without a heel lift under the right foot. Total trajectory length of COP in centric occlusion was shorter than in the rest position (p < 0.05). COP area in right eccentric mandibular position was larger than in centric occlusion (p < 0.05). When subjects used a heel lift under the right foot, occlusal forces shifted to the right side compared to no heel lift (p < 0.01). Based on these findings, it was concluded that changing mandibular position affected body posture. Conversely, changing body posture affected mandibular position.

  12. Rehabilitation of Edentulous Atrophic Anterior Mandible – The Role of Vertical Alveolar Distraction Osteogenesis

    PubMed Central

    Rao, Latha P; Sequiera, Joyce; Rao, B H Sripathi; Chandra, Jagadish; Rai, Gunachandra

    2014-01-01

    The rehabilitation of patients with edentulous alveolar ridge is always a challenge, more so in case of a long standing atrophic mandible. Mandible, the largest movable bone in the maxillofacial skeleton is associated with many soft tissue attachments which imparts dislodging forces to prosthesis. In addition to this, the rate of resorption of the mandibular ridge is four times that of the maxilla. These factors make the environment of the mandibular arch less favorable to complete denture stability and retention. An ideal solution would be to augment the atrophic alveolar ridge with native bone of the individual which shall eliminate the possible complications, associated with conventional ridge augmentation procedures. With advent of modern technology, and increased biological understanding, the principles of distraction osteogenesis are increasingly being applied to the craniofacial skeleton and have been found to be a viable option in augmenting the native alveolar bone in the mandible. Here the application of an indigenous stainless steel vertical alveolar distraction device to augment atrophic anterior mandibular ridge is assessed in six patients. PMID:25584344

  13. Combining traditional techniques to correct anterior open bite and posterior crossbite.

    PubMed

    Menezes, Luciane Macedo de; Ritter, Daltro Eneas; Locks, Arno

    2013-03-01

    The treatment of anterior open bite often requires the use of skeletal anchorage to prevent excessive eruption of the posterior teeth and consequent downward rotation of the mandible. However, this procedure might not always be accomplished. This article reports the successful treatment of an anterior open bite and a posterior crossbite in a young boy, combining traditional techniques and involving high-pull maxillary traction to help growth to correct the skeletal Class II malocclusion without skeletal anchorage. The vertical dentoalveolar contribution of maxillary growth was also favorable to close the bite, whereas cross-elastics corrected the axial inclination of the mandibular posterior teeth, eliminating the inverted posterior crossbite. The open bite was completely closed with edgewise appliances, which also achieved normal overjet, intercuspation, and incisor exposure on smiling. Traditional mechanics for the treatment of open bite and crossbite remain a useful alternative when patients do not accept skeletal anchorage.

  14. Anterior crossbite correction in primary and mixed dentition with removable inclined plane (Bruckl appliance).

    PubMed

    Jirgensone, Irena; Liepa, Andra; Abeltins, Andris

    2008-01-01

    Anterior crossbite correction in early mixed dentition is highly recommended as this kind of malocclusion do not diminish with age. Uncorrected anterior crossbite may lead to abnormal wear of the lower incisors, dental compensation of mandibular incisors leading to thinning of labial alveolar plate and/or gingival recession. There are several methods for solving this problem. In this article we would like to describe removable inclined plane. This is a removable simple functional appliance on the lower arch (jaw), which works as inclined plane. One of the advantage of the Bruckl appliance is that it can also be used as retention appliance after active treatment as well as it is possible to add acrylic teeth if necessary. Therefore it can be used as a removable partial denture in lower jaw in case where there is a premature loss of the primary teeth. The use of this appliance is illustrated with three cases.

  15. 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

  16. 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

  17. Asymmetry of normal mandibular condylar shape.

    PubMed

    Ferrario, V F; Sforza, C; Miani, A; Sigurtà, D

    1997-01-01

    Morphological studies of the facial skeleton in human beings are usually made from radiographs (frontal and lateral projections and orthopantomographs). The conventional linear and angular measurements provide quantitative information only about size, and fail to define the shape and form of the skeletal features and their variations. Mathematical methods such as the Fourier series allow a correct quantitative analysis of the shape and its variations. The outlines of the mandibular condyles in the orthopantomographs of 20 men and 20 women (mean age 29 years) were traced and digitized. All subjects had a good dentition, no temporomandibular joint problems, and were referred to a dental surgery for periodontal problems. A Fourier analysis of the outlines was performed. Fourier coefficients and reconstructed outlines were compared to analyze the condylar symmetry of shape on an intra- and intersubject basis. A significant condylar asymmetry for shape as distinct from size was found on an intrasubject basis, i.e. the left and right condyles of a single individual had a different shape with a large interindividual variability. Conversely, the mean condyle shape of the male and female groups was symmetric.

  18. Use of a modified anterior inclined plane in the treatment on the dentoskeletal Class II division 2 patient.

    PubMed

    Rao, S A; Thomas, A M; Chopra, S

    2010-01-01

    Class II malocclusions are seen due to the underdevelopment of the mandible in most of the cases. To compensate for the mandible retrusive position, there is flaring of the lower anterior teeth or retroclination of the central incisors as a compensatory mechanism seen in Class II division 2 type of malocclusion. This case report evaluates the skeletal and dental changes when a 12-year-old female patient with Class II div 2 malocclusion was treated with a modified anterior inclined plane. The postreatment data suggested that there were no significant changes in the vertical skeletal parameters. The upper central incisors were significantly realigned by proclination along with retroclination of the lateral incisors. There was significant increase in the mandibular length. The results revealed that the modified anterior inclined plane showed good results in the treatment of a case of Class II div 2 malocclusion.

  19. 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

  20. 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.

  1. 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

  2. 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

  3. [Treatment of mandibular condylar hyperplasia in developmental age. Clinical case].

    PubMed

    Silvestri, A; Incisivo, V; Mariani, G

    2000-10-01

    A case of hyperplasia of the mandibular condyle in a growing-up subject, observed at the Department of Maxillo-Facial Surgery of the University of Rome "La Sapienza", is described. Hyperplasia of the mandibular condyle is a facial asymmetry due to the unilateral overdevelopment of the mandibular bone. In this study the authors underline how bone scintigraphy, 3D tomography and electrognatographic analysis, associated with standard radiography and cephalometry, are important methods of diagnosis in order to make an early diagnosis of hyperplasia of the mandibular condyle and differential diagnosis with other pathologies. In particular, bone scintigraphy is a useful screening procedure to detect if the pathology is in an active phase or not. The 3D tomography is used in pre-surgery to evaluate precisely morphological and structural alterations of the craniofacial bones on a tridimentional base. Finally, the electrognatographic test records the mandibular activity both in physiological and pathological conditions. All these instrumental techniques allow to make a diagnosis and lead to a possible therapeutical approach. PMID:11268938

  4. Mandibular asymmetry in patients with the crouzon or apert syndrome.

    PubMed

    Elmi, P; Reitsma, J H; Buschang, P H; Wolvius, E B; Ongkosuwito, E M

    2015-05-01

    The aim of this study was to describe directional and fluctuating mandibular asymmetry over time in children with Crouzon or Apert syndrome. Mandibular asymmetry of children between 7.5 and 14 years of age with Crouzon syndrome (n = 35) and Apert syndrome (n = 24) were compared with controls (n = 327). From panoramic radiographs, mandibular directional and fluctuating asymmetry was determined for the three groups. Multilevel statistical techniques were used to describe mandibular asymmetry changes over time. Patients with Crouzon and Apert syndromes showed statistically significant more fluctuating asymmetry for mandibular measures than did controls. Between the Crouzon and Apert syndromes groups, no statistical differences were found in directional and fluctuating asymmetry. The control group showed statistically significantly more directional asymmetry than did patients with Crouzon or Apert syndrome. The controls showed no change over time for the directional asymmetry of condylar-ramal height; however, the directional asymmetry of the gonial angle increased. Patients with Crouzon syndrome showed side dominance for only condylar-ramal height; whereas, patients with Apert syndrome did not show dominance for any of the measurements. Apert and Crouzon syndromes showed developmental instability, in contrast to the controls. No statistically significant longitudinal differences were found for either the directional or the fluctuating asymmetry between Crouzon and Apert syndromes. Findings for fluctuating and directional asymmetry for both syndromes may indicate an inability to cope with genetic and environmental stress during development and treatment, compared with untreated nonsyndromic individuals. PMID:24878346

  5. Expression of Superficial Zone Protein in Mandibular Condyle Cartilage

    PubMed Central

    Ohno, S; Schmid, T; Tanne, Y; Kamiya, T; Honda, K; Ohno-Nakahara, M; Swentko, N; Desai, T A; Tanne, K; Knudson, CB; Knudson, W

    2011-01-01

    Objective Superficial zone protein (SZP) has been shown to function in the boundary lubrication of articular cartilages of the extremities. However, the expression of SZP has not been clarified in mandibular cartilage which is a tissue that includes a thick fibrous layer on the surface. This study was conducted to clarify the distribution of SZP on the mandibular condyle and the regulatory effects of humoral factors on the expression in both explants and fibroblasts derived from mandibular condyle. Methods The distribution of SZP was determined in bovine mandibular condyle cartilage, and the effects of IL-1β and TGF-β on SZP expression were examined in condyle explants and, fibroblasts derived from the fibrous zone of condyle cartilage. Results SZP was highly distributed in the superficial zone of intact condyle cartilage. The SZP expression was up-regulated by TGF-β in both explants and cultured fibroblasts, whereas the expression was slightly down-regulated by IL-1β. A significant increase in accumulation of SZP protein was also observed in the culture medium of the fibroblasts treated with TGF-β. Conclusions These results suggest that SZP plays an important role in boundary lubrication of mandible condylar cartilage, is synthesized locally within the condyle itself and, exhibits differential regulation by cell mediators relevant to mandibular condyle repairing and pathologies. PMID:16563813

  6. 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

  7. 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. PMID:27555722

  8. The Relevance of the Use of Radiographic Planning in Order to Avoid Complications in Mandibular Implantology: A Retrospective Study.

    PubMed

    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.

  9. 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

  10. 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)

  11. Conjoint activity of anterior insular and anterior cingulate cortex: awareness and response

    PubMed Central

    Critchley, Hugo D.

    2010-01-01

    There is now a wealth of evidence that anterior insular and anterior cingulate cortices have a close functional relationship, such that they may be considered together as input and output regions of a functional system. This system is typically engaged across cognitive, affective, and behavioural contexts, suggesting that it is of fundamental importance for mental life. Here, we review the literature and reinforce the case that these brain regions are crucial, firstly, for the production of subjective feelings and, secondly, for co-ordinating appropriate responses to internal and external events. This model seeks to integrate higher-order cortical functions with sensory representation and autonomic control: it is argued that feeling states emerge from the raw data of sensory (including interoceptive) inputs and are integrated through representations in conscious awareness. Correspondingly, autonomic nervous system reactivity is particularly important amongst the responses that accompany conscious experiences. Potential clinical implications are also discussed. PMID:20512367

  12. 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

  13. 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.

  14. 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.

  15. Size and placement of developing anterior teeth in immature Neanderthal mandibles from Dederiyeh Cave, Syria: implications for emergence of the modern human chin.

    PubMed

    Fukase, Hitoshi; Kondo, Osamu; Ishida, Hajime

    2015-03-01

    Evolutionary and functional significance of the human chin has long been explored from various perspectives including masticatory biomechanics, speech, and anterior tooth size. Recent ontogenetic studies have indicated that the spatial position of internally forming anterior teeth partially constrains adult mandibular symphyseal morphology. The present study therefore preliminarily examined the size and placement of developing anterior teeth in immature Neanderthal mandibles of Dederiyeh 1 and 2, compared with similarly-aged modern humans (N = 16) and chimpanzees (N = 7) whose incisors are comparatively small and large among extant hominids, respectively. The Dederiyeh 1 mandible is described as slightly presenting a mental trigone and attendant mental fossa, whereas Dederiyeh 2 completely lacks such chin-associated configurations. Results showed that, despite symphyseal size being within the modern human range, both Dederiyeh mandibles accommodated overall larger anterior dentition and displayed a remarkably wide bicanine space compared to those of modern humans. Dederiyeh 2 had comparatively thicker deciduous incisor roots and more enlarged permanent incisor crypts than Dederiyeh 1, but both Dederiyeh individuals exhibited a total dental size mostly intermediate between modern humans and chimpanzees. These findings potentially imply that the large deciduous/permanent incisors collectively distended the labial alveolar bone, obscuring an incipient mental trigone. It is therefore hypothesized that the appearance of chin-associated features, particularly of the mental trigone and fossa, can be accounted for partly by developmental relationships between the sizes of the available mandibular space and anterior teeth. This hypothesis must be, however, further addressed with more referential samples in future studies.

  16. Mandibular condylectomy in a cow with a chronic luxation of the temporomandibular joint

    PubMed Central

    Sparks, Holly D.; Roquet, Imma; MacKay, Angela; Barber, Spencer

    2014-01-01

    A cow, presented after being struck by a motor vehicle, continued to have difficulty eating after mandibular fracture repair. Imaging showed a temporomandibular luxation and a mandibular condylectomy was performed. Mastication improved greatly but the cow was euthanized due to infection. This is the first report of mandibular condylectomy in cattle. PMID:24891643

  17. Mandibular condylectomy in a cow with a chronic luxation of the temporomandibular joint.

    PubMed

    Sparks, Holly D; Roquet, Imma; MacKay, Angela; Barber, Spencer

    2014-06-01

    A cow, presented after being struck by a motor vehicle, continued to have difficulty eating after mandibular fracture repair. Imaging showed a temporomandibular luxation and a mandibular condylectomy was performed. Mastication improved greatly but the cow was euthanized due to infection. This is the first report of mandibular condylectomy in cattle. PMID:24891643

  18. Clinical application of autogenous mandibular bone grafts. Analysis of 166 cases.

    PubMed

    Hong, M; Chen, Z H; Sun, H; Bu, R F; Chen, M J; Xie, G C; Wang, Y M; Wang, X S

    1989-10-01

    Of the 166 patients receiving autogenous mandibular bone grafts during 1972-1987, 55 were used for repair of mandibular bone defect, 67 for correction of maxillofacial malformation and 44 for reconstruction of temporo-mandibular joint. Follow-up showed that 155 patients had satisfactory results after operation.

  19. Cephalometric predictors of treatment outcome with mandibular advancement devices in adult patients with obstructive sleep apnea: a systematic review

    PubMed Central

    Ippolito, Daniela Rita; Bartolucci, Maria Lavinia; D'Antò, Vincenzo; Incerti-Parenti, Serena

    2015-01-01

    Objective The efficacy of mandibular advancement devices (MADs) in the treatment of obstructive sleep apnea (OSA) ranges between 42% and 65%. However, it is still unclear which predictive factors can be used to select suitable patients for MAD treatment. This study aimed to systematically review the literature on the predictive value of cephalometric analysis for MAD treatment outcomes in adult OSA patients. Methods The MEDLINE, Google Scholar, Scopus, and Cochrane Library databases were searched through December 2014. Reference lists from the retrieved publications were also examined. English language studies published in international peer-reviewed journals concerning the predictive value of cephalometric analysis for MAD treatment outcome were considered for inclusion. Two review authors independently assessed eligibility, extracted data, and ascertained the quality of the studies. Results Fifteen eligible studies were identified. Most of the skeletal, dental, and soft tissue cephalometric measurements examined were widely recognized as not prognostic for MAD treatment outcome; however, controversial and limited data were found on the predictive role of certain cephalometric measurements including cranial base angle, mandibular plane angle, hyoid to mandibular plane distance, posterior nasal spine to soft-palate tip distance, anterior nasal spine to epiglottis base distance, and tongue/oral cross sectional area ratio thus justifying additional studies on these parameters. Conclusions Currently available evidence is inadequate for identification of cephalometric parameters capable of reliably discriminating between poor and good responders to MAD treatment. To guide further research, methodological weaknesses of the currently available studies were highlighted and possible reasons for their discordant results were analyzed. PMID:26629477

  20. Three Cases of Elongated Mandibular Coronoid Process with Different Presentations

    PubMed Central

    Ilguy, Mehmet; Kursoglu, Pinar; Ilguy, Dilhan

    2014-01-01

    Abnormal elongation of the mandibular coronoid process is rare and its etiology is not yet elucidated. The aim of this report is to demonstrate and discuss the relationship between elongated mandibular coronoid process and limitation of mouth opening with cone beam computed tomography. Although the clinical characteristic of elongation of the coronoid process is mandibular limitation, in this report, one case had problem with mouth opening. Axial scans revealed that the distance between the coronoid process and the inner face of the frontal part of the zygomatic bone may cause limitation in mouth opening. In conclusion, instead of the length, the distance between the coronoid process and the inner face of the frontal part of the zygomatic bone may be the actual reason for limitation of mouth opening. This may prevent misdiagnosis. PMID:24693298

  1. Osteochondroma of mandibular condyle: A clinic-radiographic correlation

    PubMed Central

    More, Chandramani B.; Gupta, Swati

    2013-01-01

    Osteochondroma (OC) of temporo mandibular joint is a rare, slow growing, benign tumor that causes a progressive enlargement of the condyle, usually resulting in facial asymmetry, temporo mandibular joint (TMJ) dysfunction, limited mouth opening and malocclusion. Pain is rarely associated with this tumor. OC is composed of cartilaginous and osseous tissues. Radiographically, there is unilaterally enlarged condyle usually with an exophytic outgrowth of the tumor from the condylar head. We present a rare case of osteochondroma of right mandibular condyle in a 45-year-old male who reported with painless swelling over TMJ area and progressive limited mouth opening. Panoramic radiograph and computed tomography (CT) was performed for better evaluation of the pathological condition. This paper describes the clinico-radiographic features and differential diagnosis of OC. PMID:24082753

  2. Cementoblastoma Relating to Right Mandibular Second Primary Molar

    PubMed Central

    Manepalli, Swapna; Mohapatra, Abinash

    2016-01-01

    Cementoblastoma is a benign lesion of the odontogenic ectomesenchymal origin. It rarely occurs in primary dentition. This report describes a case of a cementoblastoma relating to the right mandibular second primary molar in a 7-year-old girl. Her panoramic radiograph revealed a well-defined radiopaque lesion with a radiolucent border extending from the distal surface of the mandibular right first primary molar to the distal surface of mandibular second primary molar. The tumor was attached to the mesial root of primary second molar and was excised along with the teeth involved and sent for histopathological evaluation, which showed irregular trabeculae of mineralized tissue interspersed with fibrovascular connective tissue, trabeculae of mineralized tissue with prominent reversal lines, and peripheral rimming of the mineralized tissue with blast cells. On a six-month follow-up, there has been no recurrence of the lesion. PMID:27738532

  3. Mandibular prognathism caused by acromegaly – a surgical orthodontic case

    PubMed Central

    Gosau, Martin; Vogel, Corinna; Moralis, Antonios; Proff, Peter; Kleinheinz, Johannes; Driemel, Oliver

    2009-01-01

    A 22-year-old man presented for orthodontic surgery because of mandibular prognathism. Clinical symptoms suggested acromegaly, and diagnosis was verified by an endocrinologist as well as by radiograph. Bilateral mandibular prognathism often represents the first and most striking physical characteristic of acromegaly; usually, it is also the main reason why patients seek help from orthodontists or maxillo-facial surgeons. This case report recapitulates the clinical and histopathological findings in pituitary growth hormone (GH) adenomas and emphasises their importance in surgical orthodontic planning. Mandibular prognatism, macroglossia and abnormal growth of hands and feet represent strong indicators for the diagnosis of acromegaly. This disease and its complications not only affect the entire body but increase mortality if the pituitary gland tumour remains untreated. PMID:19660127

  4. Mandibular prognathism caused by acromegaly - a surgical orthodontic case.

    PubMed

    Gosau, Martin; Vogel, Corinna; Moralis, Antonios; Proff, Peter; Kleinheinz, Johannes; Driemel, Oliver

    2009-01-01

    A 22-year-old man presented for orthodontic surgery because of mandibular prognathism. Clinical symptoms suggested acromegaly, and diagnosis was verified by an endocrinologist as well as by radiograph. Bilateral mandibular prognathism often represents the first and most striking physical characteristic of acromegaly; usually, it is also the main reason why patients seek help from orthodontists or maxillo-facial surgeons. This case report recapitulates the clinical and histopathological findings in pituitary growth hormone (GH) adenomas and emphasises their importance in surgical orthodontic planning. Mandibular prognatism, macroglossia and abnormal growth of hands and feet represent strong indicators for the diagnosis of acromegaly. This disease and its complications not only affect the entire body but increase mortality if the pituitary gland tumour remains untreated.

  5. Microbiology of the pericoronal pouch in mandibular third molar pericoronitis.

    PubMed

    Leung, W K; Theilade, E; Comfort, M B; Lim, P L

    1993-10-01

    The microorganisms associated with mandibular third molar pericoronitis were investigated using direct microscopy and anaerobic culture method. The pericoronal pouch was sampled with paper points in A) 8 patients without mandibular third molar pericoronitis and B) 6 patients with mandibular third molar pericoronitis. Under the microscope, the microflora was found to be a complex mixture comprising gram-positive and gram-negative cocci, rods and filaments (including fusiform and curved rods), motile rods and spirochetes. Significantly higher proportions of motile, gram-negative rods were found in group B than in group A. The predominant cultivable microflora of 9 samples: A (4) and B (5) comprised several species of facultative and obligate anaerobic bacteria, namely Peptostreptococcus, Streptococcus, Actinomyces, Eubacterium, Propionibacterium, Veillonella, Porphyromonas, Prevotella, Bacteriodes, Fusobacterium, Campylobacter, Staphylococcus, Stomatococcus, Lactobacillus, Neisseria, Capnocytophaga, Haemophilus, Selenomonas and Centipeda species. The microflora in pericoronitis appeared similar to that of diseased periodontal pockets.

  6. 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

  7. Neonatal mandibular distraction in a patient with Treacher Collins syndrome.

    PubMed

    Brevi, Bruno Carlo; Leporati, Massimiliano; Sesenna, Enrico

    2015-01-01

    The purpose of this study was to analyze a case of mandibular distraction in a case of Treacher Collins syndrome. Mandibular distraction is an adequate surgical treatment of patients with Pierre Robin sequence and represents an alternative to tracheostomy. In severe hypoplastic cases or when three-dimensional vector control or gonial angle control is necessary, extraoral bidirectional or multidirectional devices have an advantage over intraoral devices. The anchorage obtained with transfixing Kirschner wires fixed in the mandibular distal segment and symphysis is crucial in neonates for the stability of the devices. Moreover, with the use of a second pin for each bone segment, the extraoral devices allow to modify the vector orientation and consequently the shape of the newly formed mandible.

  8. [Differential radiodiagnosis of odontogenic mandibular osteomyelitis accompanied by trigeminal neuropathy].

    PubMed

    Solonskaia, N S; Zorina, I S

    2011-01-01

    This paper deals with the results of radiation examination in 43 patients with clinical manifestations of mandibular osteomyelitis. In 13 of them, the disease was accompanied by trigeminal neuropathy. The radiation semiotics of the changes occurring in the mandibular bone and its adjacent soft tissues in different phases of osteomyelitis is described. Comparative analysis of orthopantomograms and the images obtained by multislice spiral computed tomography has revealed the advantage of the latter in identifying insignificant changes in bone tissue and damages to the mandibular canal. Ultrasound study is of more informative value in detecting soft tissue changes in this area. High-technology radiodiagnostic techniques play a leading role in the differentiation of odontogenic and non-odontogenic trigeminal neuropathies.

  9. 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

  10. Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Arcuri, Francisco; Barclay, Fernando; Nacul, Ivan

    2015-01-01

    Introduction: The most recent advances in ACL reconstruction try to reproduce the anatomic femoral and tibial footprints as close as possible. Creating independent tunnels would allow an optimal of the entry point and the femoral tunnel obliquity, and together with an adequate reamer diameter they wouldreproduce with greater certainty the anatomy. Objective: To compare the radiographic parameters of the femoral and tibial tunnel positions in two groups of patients, one operated with a transtibial and other with transportal anatomic techniques. Materials and Methods: From December 2012 to December 2013, 59 patients with a primary ACL reconstruction divided in two groups, a trans tibial technique (TT), 19 patients, and an transportal one (TP) with 40 patients were prospectively evaluated with AP and lateral X-rays. The femoral tunnel angle, the insertion site with respect of the Blumensaat line, the trans osseous distance, the tibial tunnel position as a percentage of the tibial plateau in the AP and lateral views. And finally the tibial tunnel angle in the AP and Lateral views. Results: The femoral tunnel angle was in the TP group of 45,92º and in the TT one 24,53º, p 0,002. The insertion site percentage of the Blumensaat line was of 20,96 in TP and 20,74 in the TT, p 0,681.Trans osseous distance was in the TP of 3,43 cm and in the TT of 4,79 cm, p <0,000. The tibial tunnel position as a percentage in the AP tibial plateau was of 44,35 in TP and of 40,80 TT with a p of 0,076. The tibial tunnel position as a percentage of the lateral tibial plateau was of 28,70 in TP and 34,53 in TT with a p 0,367. Tibial tunnel angle in the AP was of 73,48º in TP and 62,81 in TT with a p of 0,002, and in the lateral plateau of 114,69º in TP and 112,79º in TT with a p of 0,427. Conclusion: It is possible to create tibial and femoral tunnel in optimal positions but not equal between both groups. Creating independent tunnels allow a more anterior and vertical tibial tunnel

  11. 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

  12. The influence of masseter activity on rat mandibular growth.

    PubMed

    Yonemitsu, Ikuo; Muramoto, Takeshi; Soma, Kunimichi

    2007-05-01

    Many studies have shown that mandibular and condylar growth is affected by compressive forces on mandibular bone and the condyle. It has been reported that chondroblastic differentiation and proliferation in chondrocytes play important roles in condylar growth. However, the influence of reduced compressive force on chondroblastic proliferation and mandibular bone formation is not fully understood. Thirty-six 3-week-old male Wistar rats were used in this study. In the experimental group, the masseter muscles were bilaterally resected to evaluate the influence of masticatory force on mandibular and condylar bone morphology. Six weeks after the operation, while the rats were in the pubertal growth stage, lateral X-rays were taken to analyze the skeletal pattern of the mandible. The form of the condyle and the thickness of the chondroblastic layers were evaluated by toluidine blue staining. Chondroblastic proliferation was identified by insulin-like growth factor-1 receptor (IGF-1r) immunostaining and bone resorption of the condyle was assessed by measuring tartrate-resistant acid phosphatase (TRAP) activity. Lateral X-rays of the mandible showed that rats in the experimental group tended to have large mandibular plane angles. The chondroblastic layer in the condyles of the experimental group rats was thinner than in the control group. The expression of IGF-1r immunopositive cells in the experimental group was significantly lower than in the control chondrocytes, and the number of TRAP-positive cells was significantly higher in the condylar bone of the experimental group. We conclude that masseter muscle activity is closely related to mandibular morphology during growth.

  13. 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

  14. Evaluation of aural manifestations in temporo-mandibular joint dysfunction.

    PubMed

    Sobhy, O A; Koutb, A R; Abdel-Baki, F A; Ali, T M; El Raffa, I Z; Khater, A H

    2004-08-01

    Thirty patients with temporo-mandibular joint dysfunction were selected to investigate the changes in otoacoustic emissions before and after conservative treatment of their temporo-mandibular joints. Pure tone audiometry, transient-evoked otoacoustic emissions (TEOAE), distortion-product otoacoustic emissions (DPOAE) as well as a tinnitus questionnaire were administered to all patients before and after therapy. Therapy was conservative in the form of counselling, physiotherapy, anti-inflammatory agents, muscle relaxants, and occlusal splints. Results indicated insignificant changes in the TEOAEs, whereas there were significant increases in distortion product levels at most of the frequency bands. These results were paralleled to subjective improvement of tinnitus.

  15. Use of porous space maintainers in staged mandibular reconstruction.

    PubMed

    Henslee, Allan M; Spicer, Patrick P; Shah, Sarita R; Tatara, Alexander M; Kasper, F Kurtis; Mikos, Antonios G; Wong, Mark E

    2014-05-01

    The success of mandibular reconstructions depends not only on restoring the form and function of lost bone but also on the preservation of the overlying soft tissue layer. In this case study, 5 porous polymethylmethacrylate space maintainers fabricated via patient-specific molds were implanted initially to maintain the vitality of the overlying oral mucosa during staged mandibular reconstructions. Three of the 5 patients healed well; the other 2 patients developed dehiscences, likely due to a thin layer of soft tissue overlying the implant. The results presented provide evidence that a larger investigation of space maintainers fabricated using this method is warranted.

  16. A new look at mandibular growth--a preliminary report.

    PubMed

    Miller, S; Kerr, W J

    1992-04-01

    Cephalometric radiographs of 42 growth study subjects (21 males, 21 females) were the basis of an investigation into the longitudinal growth of the mandible from 5 to 20 years using a digitizer program capable of generating curved outlines through groups of four points. In this presentation mean plots for all subjects at 5, 10, 15, and 20 years of age, variously superimposed, confirmed the previous theories of Björk and Skieller (1983) with regard to mandibular rotation and provide a visual representation of the processes of mandibular growth.

  17. Temporospatial cell interactions regulating mandibular and maxillary arch patterning.

    PubMed

    Ferguson, C A; Tucker, A S; Sharpe, P T

    2000-01-01

    The cellular origin of the instructive information for hard tissue patterning of the jaws has been the subject of a long-standing controversy. Are the cranial neural crest cells prepatterned or does the epithelium pattern a developmentally uncommitted population of ectomesenchymal cells? In order to understand more about how orofacial patterning is controlled we have investigated the temporal signalling interactions and responses between epithelium and mesenchymal cells in the mandibular and maxillary primordia. We show that within the mandibular arch, homeobox genes that are expressed in different proximodistal spatial domains corresponding to presumptive molar and incisor ectomesenchymal cells are induced by signals from the oral epithelium. In mouse, prior to E10, all ectomesenchyme cells in the mandibular arch are equally responsive to epithelial signals such as Fgf8, indicating that there is no pre-specification of these cells into different populations and suggesting that patterning of the hard tissues of the mandible is instructed by the epithelium. By E10.5, ectomesenchymal cell gene expression domains are still dependent on epithelial signals but have become fixed and ectopic expression cannot be induced. At E11 expression becomes independent of epithelial signals such that removal of the epithelium does not affect spatial ectomesenchymal expression. Significantly, however, the response of ectomesenchyme cells to epithelial regulatory signals was found to be different in the mandibular and maxillary primordium. Thus, whereas both mandibular and maxillary arch epithelia could induce Dlx2 and Dlx5 expression in the mandible and Dlx2 expression in the maxilla, neither could induce Dlx5 expression in the maxilla. Reciprocal cell transplantations between mandibular and maxillary arch ectomesenchymal cells revealed intrinsic differences between these populations of cranial neural crest-derived cells. Research in odontogenesis has shown that the oral epithelium

  18. The role of the lateral pterygoid muscle in the sagittal fracture of mandibular condyle (SFMC) healing process.

    PubMed

    Liu, Chng-Kui; Liu, Ping; Meng, Fan-Wen; Deng, Bang-Lian; Xue, Yang; Mao, Tian-Qiu; Hu, Kai-Jin

    2012-06-01

    The aim of this study was to examine the role of the lateral peterygoid muscle in the reconstruction of the shape of the condyle during healing of a sagittal fracture of the mandibular condyle. Twenty adult sheep were divided into 2 groups: all had a unilateral operation on the right side when the anterior and posterior attachments of the discs were cut, and an oblique vertical osteotomy was made from the lateral pole of the condyle to the medial side of the condylar neck. Ten sheep had the lateral pterygoid muscle cut, and the other 10 sheep did not. Sheep were killed at 4 weeks (n=2 from each group), 12 weeks (n=4), and 24 weeks (n=4) postoperatively. Computed tomograms (CT) were taken before and after operations. We dissected the joints, and recorded with the naked eye the shape, degree of erosion, and amount of calcification of the temporomandibular joint (TMJ). In the group in which the lateral peterygoid muscle had not been cut the joints showed overgrowth of new bone and more advanced ankylosis. Our results show that the lateral pterygoid muscle plays an important part in reconstructing the shape of the condyle during the healing of a sagittal fracture of the mandibular condyle, and combined with the dislocated and damaged disc is an important factor in the aetiology of traumatic ankylosis of the TMJ.

  19. 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

  20. 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.

  1. 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

  2. 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

  3. Longitudinal evaluation of jaw muscle activity and mandibular kinematics in young patients with Class II malocclusion treated with the Teuscher activator

    PubMed Central

    Cuevas, Maria J.; Cacho, Alberto; Alarcón, Jose A.

    2013-01-01

    Objectives: A longitudinal study was performed to evaluate the jaw muscle activity and mandibular kinematics after Teuscher activator treatment and at 2 years after orthodontic treatment completion. Material and Methods: Twenty-seven children with Class II division 1 malocclusion were evaluated before treatment (T0; mean: 11.6 years), after functional treatment (T1; mean: 12.8 years), and 2 years after orthodontic treatment (T2; mean: 18 years). Bilateral surface electromyographic activities of the anterior temporalis, posterior temporalis, masseter, and suprahyoid muscle areas were analyzed at rest and during clenching, swallowing, and mastication. Kinematic recordings of the mandibular maximum opening, lateral shift, right and left lateral excursions, and protrusion were evaluated. Results: Compared to T0, the left masseter activity during clenching was decreased at T1 but increased at T2, similar to the other evaluated muscles. The suprahyoid activity during swallowing was increased at T1 but decreased at T2. The masseter activity during mastication was increased at T1 and further increased at T2. The left and right lateral excursions and protrusion did not show significant changes throughout the experiment. Conclusions: Teuscher activator and subsequent fixed orthodontic treatment improved jaw muscle function; however, a long period was needed to attain complete neuromuscular adaptation. Key words:Class II malocclusion, jaw muscles, mandibular kinematics, sEMG, Teuscher activator. PMID:23385506

  4. Cephalometric analysis of modifications of the pharynx due to maxillo-mandibular advancement surgery in patients with obstructive sleep apnea.

    PubMed

    Faria, A C; Xavier, S P; Silva, S N; Trawitzki, L V Voi; de Mello-Filho, F V

    2013-05-01

    Cephalometry has been used to measure hard and soft facial tissues, as well as the pharyngeal air space for the diagnosis of obstructive sleep apnea (OSA). The changes occurring in the pharynx due to maxillo-mandibular advancement (MMA) have not been established or quantified. The objective of this study was to identify the anatomical changes of the pharynx and of hard tissues that occur in patients with OSA after MMA. 19 patients with a polysomnographic diagnosis of OSA were submitted to cephalometric analysis before and 6 months after surgery in order to evaluate the changes produced by MMA in the pharynx and soft tissues. Cephalometry was standardized in order to obtain descriptive measurements of the dimensions of the airways, the position of the hyoid bone, and maxilla-mandibular relations. The modifications of the pharynx due to MMA showed a significant relation obtained by cephalometry. For each millimeter of maxillary and mandibular bone advancement there was a 0.76mm increase in the retropalatal region and a 1.2mm increase in the pharynx in the retrolingual region. In addition, MMA promoted a significant repositioning of the hyoid bone in the cranial direction.

  5. 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

  6. Concomitant reconstruction of mandibular basal and alveolar bone with a free fibular flap.

    PubMed

    Lee, J H; Kim, M J; Choi, W S; Yoon, P Y; Ahn, K M; Myung, H; Hwang, S J; Seo, B M; Choi, J Y; Choung, P H; Kim, S M

    2004-03-01

    Repair of long-span mandibular defects with a free fibular flap is now a routine procedure. However, the bone height of the neo-mandible after reconstruction with a fibular flap is about half that of the dentulous mandible. When a fibular graft is placed only at the inferior border of the mandible, the resulting vertical discrepancy between the graft segment and the occlusal plane can adversely affect implant mechanics or denture stability and retention. To overcome these problems, we developed a technique for two-strut type mandibular reconstruction. A vascularized fibular segment is used to reconstruct the inferior basal portion of the neo-mandible, while a non-vascularized residual fibular segment is used to simulate the superior alveolar portion. We used this technique in 22 patients. Graft survival, graft resorption, and the ability to place implants were assessed as compared with those after the conventional one-strut type technique. The fibular segment grafted to the alveolar region was removed in one patient with intraoral wound dehiscence and in two with postoperative infection. All vascularized fibular flaps were successful. The resorption rate was 13.6+/-7.2% for non-vascularized segments and 3.0+/-3.7% for vascularized segments. Dental implants were placed in five of our 22 patients. The crown:fixture length ratio was improved to 1:1.7, as compared with a ratio of 1:1.21 with use of a conventional fibular flap. We conclude that our technique is very easy and safe and provides substantially improved lower-lip and cheek support and implant-prosthetic mechanics than conventional procedures for the repair of long-span mandibular defects. PMID:15050071

  7. 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

  8. Mandibular corpus bone strain in goats and alpacas: implications for understanding the biomechanics of mandibular form in selenodont artiodactyls.

    PubMed

    Williams, Susan H; Vinyard, Christopher J; Wall, Christine E; Hylander, William L

    2009-01-01

    The goal of this study is to clarify the functional and biomechanical relationship between jaw morphology and in vivo masticatory loading in selenodont artiodactyls. We compare in vivo strains from the mandibular corpus of goats and alpacas to predicted strain patterns derived from biomechanical models for mandibular corpus loading during mastication. Peak shear strains in both species average 600-700 microepsilon on the working side and approximately 450 microepsilon on the balancing side. Maximum principal tension in goats and alpacas is directed at approximately 30 degrees dorsocaudally relative to the long axis of the corpus on the working side and approximately perpendicular to the long axis on the balancing side. Strain patterns in both species indicate primarily torsion of the working-side corpus about the long axis and parasagittal bending and/or lateral transverse bending of the balancing-side corpus. Interpretation of the strain patterns is consistent with comparative biomechanical analyses of jaw morphology suggesting that in goats, the balancing-side mandibular corpus is parasagittally bent whereas in alpacas it experiences lateral transverse bending. However, in light of higher working-side corpus strains, biomechanical explanations of mandibular form also need to consider that torsion influences relative corpus size and shape. Furthermore, the complex combination of loads that occur along the selenodont artiodactyl mandibular corpus during the power stroke has two implications. First, added clarification of these loading patterns requires in vivo approaches for elucidating biomechanical links between mandibular corpus morphology and masticatory loading. Second, morphometric approaches may be limited in their ability to accurately infer masticatory loading regimes of selenodont artiodactyl jaws.

  9. Immediately loaded implants in a patient with involuntary mandibular movements: a clinical report.

    PubMed

    Shek, Justin W; Plesh, Octavia; Curtis, Donald A

    2014-07-01

    Immediately loaded implant prostheses have been used to successfully rehabilitate completely edentulous arches. Risk factors for successful treatment have not included involuntary mandibular movements. The treatment was completed on a patient with a history of neuroleptic medications who had remaining mandibular teeth extracted and then developed involuntary mandibular movements. The patient was dissatisfied with a mandibular removable prosthesis and wanted a fixed prosthesis. The immediate implant loading of a complete arch fixed prosthesis was delivered, and the patient lost 3 of the 6 implants. The patient continued to have problems with her definitive prostheses as the symptoms of her involuntary mandibular movements worsened.

  10. Immediately loaded implants in a patient with involuntary mandibular movements: a clinical report.

    PubMed

    Shek, Justin W; Plesh, Octavia; Curtis, Donald A

    2014-07-01

    Immediately loaded implant prostheses have been used to successfully rehabilitate completely edentulous arches. Risk factors for successful treatment have not included involuntary mandibular movements. The treatment was completed on a patient with a history of neuroleptic medications who had remaining mandibular teeth extracted and then developed involuntary mandibular movements. The patient was dissatisfied with a mandibular removable prosthesis and wanted a fixed prosthesis. The immediate implant loading of a complete arch fixed prosthesis was delivered, and the patient lost 3 of the 6 implants. The patient continued to have problems with her definitive prostheses as the symptoms of her involuntary mandibular movements worsened. PMID:24393329

  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. An algorithm for the treatment of noncondylar mandibular fractures.

    PubMed

    Ellis, Edward

    2014-05-01

    An algorithm for the treatment of noncondylar mandibular fractures is presented based on outcomes from studies that have been performed during the past 30 years. It is designed to assist clinicians in formulating a treatment plan that can be expected to provide the patient with a predictable outcome.

  13. Reinforcement of a mandibular complete denture with internal metal framework.

    PubMed

    Balch, J Heath; Smith, Pamela D; Marin, Mark A; Cagna, David R

    2013-03-01

    Metal framework reinforcement is used in complete dentures to improve the fracture resistance, dimensional stability, accuracy, weight, and retention of a definitive prosthesis. A novel technique for suspending a metal framework within the denture base of mandibular complete dentures is described.

  14. Bilateral metastatic spread of testicular teratoma to mandibular condyles.

    PubMed

    Porter, S R; Chaudhry, Z; Griffiths, M J; Scully, C; Kabala, J; Whipp, E

    1996-09-01

    The clinical and radiological features of a patient with metastatic spread of testicular teratoma to both mandibular condyles are presented. It is suggested that in patients with known systemic malignancy, a local metastatic deposit should be considered as a possible cause of unexplained pain in the temporomandibular joints.

  15. Management of the edentulous/atrophic mandibular fracture.

    PubMed

    Aziz, Shahid R; Najjar, Talib

    2009-03-01

    Edentulous or atrophic mandible fractures are rare and potentially problematic for the oral and maxillofacial surgeon. With the loss of teeth, atrophy of the alveolar bony apparatus ensues, creating a mandible more prone to fracture. This article describes the management of edentulous/atrophic mandibular fractures.

  16. Minimally invasive mandibular bone augmentation using injectable hydrogels.

    PubMed

    Martínez-Sanz, Elena; Varghese, Oommen P; Kisiel, Marta; Engstrand, Thomas; Reich, Karoline M; Bohner, Marc; Jonsson, Kenneth B; Kohler, Thomas; Müller, Ralph; Ossipov, Dmitri A; Hilborn, Jöns

    2012-12-01

    Hyaluronic acid-based hydrogels are proven biocompatible materials and excellent carriers of bone morphogenetic protein-2 (BMP-2) that have been successfully tested for bone generation in vivo. Different formulations, with or without nanohydroxyapatite, have shown promise for craniofacial applications. In this study, 28 rats were used to investigate whether it is possible to achieve mandibular bone augmentation upon injection of novel hyaluronic acid-based hydrogels containing nanohydroxyapatite and different concentrations of BMP-2 (0, 5 and 150 µg/ml). The biomaterials were injected subperiosteally through fine needles into the innate mandibular diastema, imitating a clinical procedure for resorbed mandibles. No incisions, flaps or sutures were necessary. After 8 weeks the mandibles were evaluated by peripheral quantitative computed tomography (pQCT), micro-computed tomography (μCT), histology, immunohistochemistry and fluorochrome labelling. As a result, engineered bone was observed in all treated mandibles, with a statistically significant increase in mandibular bone volume correlated with the amount of BMP-2 loaded in the hydrogel formula. We therefore demonstrated that minimally invasive mandibular bone augmentation is possible upon injection in rats, when using the appropriate injectable scaffolds. This represents an attractive clinical alternative for oral implantology patients.

  17. 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

  18. Temporo-mandibular joint changes in renal osteodystrophy.

    PubMed

    Cappelini, G; Pavlica, P; Stasi, G; Tonti, R; Viglietta, G

    1978-01-01

    The radiologic study of temporo-mandibular joints in patients undergoing long-term haemodialysis has led to documentation of osteodystrophic changes in 6 patients: 2 were asymptomatic and 4 had referred to pain. The roentgenologic picture of this unusual abnormally varies from a simple decrease of bone density to resorption of the condylar head.

  19. Computed tomography of the temporo-mandibular joint.

    PubMed

    Avrahami, E; Horowitz, I; Cohn, D F

    1984-01-01

    Computed tomography (CT) of the temporo-mandibular joint (TMJ) has only been occasionally reported. As CT techniques improve, more detailed information is available. Though conventional radiography of the TMJ can supply sufficient diagnostic detail, it may well be replaced by CT as a preliminary examination, as it is able to offer more information with less radiation and minimal patient discomfort.

  20. 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

  1. 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...

  2. 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

  3. Osteochondritis dissecans affecting the temporo-mandibular joint.

    PubMed

    Olley, S F; Leopard, P J

    1978-07-01

    A case of a single loose body occurring in the temporo-mandibular joint is described. It is probable that this case represents the degenerative process of osteochondritis dissecans, a condition not previously described in this joint. The essential features of this condition are noted as a comparison to the condition of synovial chondromatosis.

  4. [The Helkimo index for assessing treatment results after mandibular fractures].

    PubMed

    Härtel, J; Hellmuth, M; Hellmuth, K O

    1991-01-01

    Based on the Helkimo index we assessed the success of conservative and conservative-surgical forms of treatment for mandibular fractures in a total of 166 patients. The control group consisted of 50 probands. The Helkimo dysfunction index, which is based on various criteria, showed dysfunction in 81.9% of the patients with only slight functional impairment in 57.2% of these cases. 18.1% of the patients were clinically symptom-free. A comparison with the probands revealed no major differences in dysfunction between the two groups. Significant differences were observed only in the case of 2 isolated criteria (maximum mandibular protrusion, muscle pain). Severe dysfunction, however, was more common in the fracture patients. Based on the Helkimo occlusion index disorder were noted in 91.7% of the patients, while severe occlusion disorder were observed particularly in patients with combined mandibular body and condyle fractures (40.0%). In the control group a more favorable occlusion index was found to be due mainly to the greater number of present and/or occluding teeth. The Helkimo index, particularly the dysfunctionindex, is a very useful instrument for assessing the success of treatment measures in mandibular fracture cases. It should be more commonly used to improve the possibilites of objective comparisons between patients from different hospitals.

  5. Effect of methotrexate on the mandibular development of arthritic rabbits

    PubMed Central

    Meyer, Philipp; Rafayelyan, Smbat; Minden, Kirsten; Jost-Brinkmann, Paul-Georg

    2015-01-01

    Summary Introduction: Juvenile idiopathic arthritis affecting the temporomandibular joint (TMJ) can cause severe disturbances of the mandibular development. Methotrexate (MTX) is often administered as a common used remission-inducing agent to treat this disease. The aim of this study was to investigate the effect of low dose MTX on the mandibular growth in arthritic rabbits. Subjects and methods: Eighteen 10-week-old female New Zealand white rabbits were randomly assigned to three groups with six animals in each group. After being sensitized to ovalbumin (OA), the first and the second group received intra-articular injections with OA. The first group remained untreated, the second was treated by weekly injections of MTX. Cephalograms were taken from each animal at 10, 13, 16, 19, and 22 weeks of age and six mandibular distances measured. Results: All distances showed an increase between 10 and 20 per cent, whereas growth was more accentuated in the sagittal dimension. Significant differences in the overall growth could be observed between the arthritic and the control animals and less accentuated between the arthritic and the MTX animals. In contrast, existing differences between the groups were not significant during the intervals, but time had the greatest influence on mandibular growth. Conclusions: MTX seems to have a positive impact on growth in rabbits suffering from experimental arthritis of the TMJ. PMID:25518996

  6. GMP-level adipose stem cells combined with computer-aided manufacturing to reconstruct mandibular ameloblastoma resection defects: Experience with three cases

    PubMed Central

    Wolff, Jan; Sándor, George K.; Miettinen, Aimo; Tuovinen, Veikko J.; Mannerström, Bettina; Patrikoski, Mimmi; Miettinen, Susanna

    2013-01-01

    Background: The current management of large mandibular resection defects involves harvesting of autogenous bone grafts and repeated bending of generic reconstruction plates. However, the major disadvantage of harvesting large autogenous bone grafts is donor site morbidity and the major drawback of repeated reconstruction plate bending is plate fracture and difficulty in reproducing complex facial contours. The aim of this study was to describe reconstruction of three mandibular ameloblastoma resection defects using tissue engineered constructs of beta-tricalcium phosphate (β-TCP) granules, recombinant human bone morphogenetic protein-2 (rhBMP-2), and Good Manufacturing Practice (GMP) level autologous adipose stem cells (ASCs) with progressively increasing usage of computer-aided manufacturing (CAM) technology. Materials and Methods: Patients’ three-dimensional (3D) images were used in three consecutive patients to plan and reverse-engineer patient-specific saw guides and reconstruction plates using computer-aided additive manufacturing. Adipose tissue was harvested from the anterior abdominal walls of three patients before resection. ASCs were expanded ex vivo over 3 weeks and seeded onto a β-TCP scaffold with rhBMP-2. Constructs were implanted into patient resection defects together with rapid prototyped reconstruction plates. Results: All three cases used one step in situ bone formation without the need for an ectopic bone formation step or vascularized flaps. In two of the three patients, dental implants were placed 10 and 14 months following reconstruction, allowing harvesting of bone cores from the regenerated mandibular defects. Histological examination and in vitro analysis of cell viability and cell surface markers were performed and prosthodontic rehabilitation was completed. Discussion: Constructs with ASCs, β-TCP scaffolds, and rhBMP-2 can be used to reconstruct a variety of large mandibular defects, together with rapid prototyped reconstruction

  7. 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. PMID:27555721

  8. Features extraction in anterior and posterior cruciate ligaments analysis.

    PubMed

    Zarychta, P

    2015-12-01

    The main aim of this research is finding the feature vectors of the anterior and posterior cruciate ligaments (ACL and PCL). These feature vectors have to clearly define the ligaments structure and make it easier to diagnose them. Extraction of feature vectors is obtained by analysis of both anterior and posterior cruciate ligaments. This procedure is performed after the extraction process of both ligaments. In the first stage in order to reduce the area of analysis a region of interest including cruciate ligaments (CL) is outlined in order to reduce the area of analysis. In this case, the fuzzy C-means algorithm with median modification helping to reduce blurred edges has been implemented. After finding the region of interest (ROI), the fuzzy connectedness procedure is performed. This procedure permits to extract the anterior and posterior cruciate ligament structures. In the last stage, on the basis of the extracted anterior and posterior cruciate ligament structures, 3-dimensional models of the anterior and posterior cruciate ligament are built and the feature vectors created. This methodology has been implemented in MATLAB and tested on clinical T1-weighted magnetic resonance imaging (MRI) slices of the knee joint. The 3D display is based on the Visualization Toolkit (VTK).

  9. Overexpressed TGF-β in subchondral bone leads to mandibular condyle degradation.

    PubMed

    Jiao, K; Zhang, M; Niu, L; Yu, S; Zhen, G; Xian, L; Yu, B; Yang, K; Liu, P; Cao, X; Wang, M

    2014-02-01

    Emerging evidence has implied that subchondral bone plays an important role during osteoarthritis (OA) pathology. This study was undertaken to investigate whether abnormalities of the condylar subchondral bone lead to temporomandibular joint (TMJ) OA. We used an osteoblast-specific mutant TGF-β1 transgenic mouse, the CED mouse, in which high levels of active TGF-β1 occur in bone marrow, leading to abnormal bone remodeling. Subchondral bone changes in the mandibular condyles were investigated by micro-CT, and alterations in TMJ condyles were confirmed by histopathological and immunohistochemical analysis. Abnormalities in the condylar subchondral bone, characterized as fluctuant bone mineral density and microstructure and increased but uncoupled activity of osteoclasts and osteoblasts, were apparent in the 1- and 4-month CED mouse groups, while obvious cartilage degradation, in the form of cell-free regions and proteoglycan loss, was observed in the 4-month CED group. In addition, increased numbers of apoptotic chondrocytes and MMP9- and VEGF-positive chondrocytes were observed in the condylar cartilage in the 4-month CED group, but not in the 1-month CED group, compared with their respective age-matched controls. This study demonstrated that progressive degradation of mandibular condylar cartilage could be induced by the abnormal remodeling of the underlying subchondral bone during TMJOA progression. PMID:24309371

  10. Histological study of the human temporo-mandibular joint and its surrounding muscles.

    PubMed

    Bravetti, P; Membre, H; El Haddioui, A; Gérard, H; Fyard, J P; Mahler, P; Gaudy, J F

    2004-10-01

    This is a histological study of the human temporo-mandibular joint and its surrounding muscles. Using a microscopic study of serial sections from anatomical specimens from six subjects, the detailed anatomy of the joint is presented with particular regard to the histology. This study has allowed, in particular, the description of the ligaments and capsule as well as the insertions of the masticatory muscles (temporalis, masseter, lateral pterygoid) on this joint. These observations are then compared with the anatomical and histological data already reported on this subject. This study shows that the bulk of the muscular fibres of the lateral pterygoid passes under the foot of the disc is attached over the whole height of the condylar, unite and extend as far as the medial pole of the joint under the insertion of the articular disc. An insertion of the temporo-masseter musculo-tendinous complex on the anterior and lateral capsulo-discal structures was observed. The lateral pterygoid is composed of a succession of tendinous and fleshy fibres. This study confirms the thickening of the lateral capsule that corresponds to a lateral collateral ligament, and the absence of a medial collateral ligament. Medial stability is conferred by the lateral ligament of the contralateral joint.

  11. Synovial chondromatosis of the temporo-mandibular joint. Report of three cases and a review of the literature.

    PubMed

    Blankestijn, J; Panders, A K; Vermey, A; Scherpbier, A J

    1985-01-15

    Synovial chondromatosis of the temporo-mandibular joint is a rare affection, characterized by the formation of cartilage particles in the synovial membrane. These particles can break through and enter the joint compartments. The diagnosis must be considered for patients who complain of slowly progressive swelling, pain, and crepitus in the region of the temporo-mandibular joint. When the changes are not visible on plain X-rays due to absence of ossification, important diagnostic information can be obtained by a technetium 99m (99m Tc) bone scan and a computerized tomography (CT) sialogram. The diagnosis can be established only by histopathologic examination of surgically removed particles or resected synovial membrane. Discussed are 25 cases of histopathologically verified chondromatosis of the temporo-mandibular joint reported in the literature, as well as 3 new cases seen and treated at the University Hospital Groningen since 1970. A good clinical result can be obtained by removal of all particles and synovectomy. Condylectomy is seldom required.

  12. Light- and electron-microscopic observations on the mandibular condylar cartilages in growing rats on a low-calcium diet.

    PubMed

    Matsumoto, F; Miyamoto, Y; Nagayama, M

    1991-01-01

    In order to obtain more insight into the physiologic mechanism of endochondral ossification, histological changes occurring in the mandibular condylar cartilage of growing rats fed on a low-calcium diet were investigated by light and electron microscopy. Twenty-three-day-old rats were fed on a normal diet or a low-calcium diet for 8 weeks. For the histological observations the mandibular condyles were dissected from each animal at 1, 2, 4, 5 and 8 weeks after the initiation of the experiment. Histological changes occurring in the mandibular condylar cartilages of the rats fed on a low-calcium diet were as follows: (1) narrow proliferative and mature cell zones and a wide hypertrophic cell zone, (2) inhibition of development of cell organelles in the mature chondrocytes, (3) decrease in dead cells in the proliferative zone, (4) decrease in glycogen accumulation in the chondrocytes and (5) inhibition of calcification in the extracellular matrix of the hypertrophic cell zone. Additionally at the end of the experimental period, the following findings were observed: (1) appearance of small light cells in the mature cell zone and the hypertrophic cell zone and (2) decrease in proteoglycan granules and appearance of large collagen fibrils in the pericellular region of the hypertrophic cell zone.

  13. Effect of low-intensity pulsed ultrasound (LIPUS) on mandibular condyle growth in rats analyzed with micro-CT.

    PubMed

    Sasaki, Kyozo; Motoyoshi, Mitsuru; Horinuki, Eri; Arai, Yoshinori; Shimizu, Noriyoshi

    2016-01-01

    This study examined the effects of a bite-jumping appliance combined with low-intensity pulsed ultrasound (LIPUS) stimulation on the mandibular condyle of growing rats using micro CT (mCT) and histological examinations. Twelve Wistar rats were divided into three groups of four individuals each: Group 1 was an untreated control group, Group 2 received bite-jumping appliances, and Group 3 received bite-jumping appliances and LIPUS stimulation (15 min/day, 2 weeks) to the temporomandibular region. We measured the length and three-dimensional bone volume of each rat's mandibular condyle using mCT. The condylar cartilage was observed after the rats had been sacrificed. There was no significant difference in condylar sagittal width among the groups. The bite-jumping appliance combined with LIPUS stimulation increased the condylar major axis, mandibular sagittal length and condylar bone volume to a greater degree than use of the bite-jumping appliance alone. Histological examination demonstrated hypertrophy of the condylar cartilage layers, the fibrous layer and hypertrophic cell layer of the rats treated with bite-jumping appliances combined with LIPUS stimulation in comparison to rats treated with bite-jumping appliances alone. (J Oral Sci 58, 415-422, 2016). PMID:27665982

  14. Comparative analysis between direct Conventional Mandibular nerve block and Vazirani-Akinosi closed mouth Mandibular nerve block technique

    NASA Astrophysics Data System (ADS)

    Mishra, Sobhan; Tripathy, Ramanupam; Sabhlok, Samrat; Panda, Pankaj Kumar; Patnaik, Satyabrata

    2012-11-01

    Introduction: Over the years different techniques have been developed for achieving mandibular nerve anaesthesia. The main aim of our study was to carry out comparison and clinical efficacy of mandibular nerve anaesthesia by Direct Conventional technique with that of Vazirani-Akinosi mandibular nerve block technique.Materials and Methods: 50 adult patients requiring surgical extraction of premolars, mandibular first, second and third molars were selected randomly to receive Direct Conventional technique and Vazirani- Akinosi technique for nerve block alternatively.Results: No statistically significant differences were observed regarding complete lip anaesthesia at 5 minutes and 10 minutes, nerves anaesthetized with single injection, effectiveness of anaesthesia, supplementary injections and complications in both the techniques. However, onset of lip anaesthesia was found to be faster in Vazirani-Akinosi technique, patients experienced less pain during the Vazirani-Akinosi technique as compared to the Direct Conventional technique. Post injection complication complications were less in the VaziraniAkinosi Technique.Conclusions: Except for faster onset of lip anaesthesia, less pain during injection and fewer post injection complications in Vazirani-Akinosi technique all other parameters were of same efficacy as Direct Conventional technique. This has strong clinical applications as in cases with limited mouth opening, apprehensive patients Vazirani-Akinosi technique is the indicated technique of choice.

  15. 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

  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.

  17. 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

  18. 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

  19. Anterior cruciate ligament - updating article.

    PubMed

    Luzo, Marcus Vinicius Malheiros; Franciozi, Carlos Eduardo da Silveira; Rezende, Fernando Cury; Gracitelli, Guilherme Conforto; Debieux, Pedro; Cohen, Moisés

    2016-01-01

    This updating article on the anterior cruciate ligament (ACL) has the aim of addressing some of the most interesting current topics in this field. Within this stratified approach, it contains the following sections: ACL remnant; anterolateral ligament and combined intra and extra-articular reconstruction; fixation devices; and ACL femoral tunnel creation techniques. PMID:27517015

  20. Anterior cruciate ligament - updating article.

    PubMed

    Luzo, Marcus Vinicius Malheiros; Franciozi, Carlos Eduardo da Silveira; Rezende, Fernando Cury; Gracitelli, Guilherme Conforto; Debieux, Pedro; Cohen, Moisés

    2016-01-01

    This updating article on the anterior cruciate ligament (ACL) has the aim of addressing some of the most interesting current topics in this field. Within this stratified approach, it contains the following sections: ACL remnant; anterolateral ligament and combined intra and extra-articular reconstruction; fixation devices; and ACL femoral tunnel creation techniques.

  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

    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

  2. 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.

  3. 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

  4. Cystic olfactory schwannoma of the anterior cranial base.

    PubMed

    Daglioglu, E; Okay, Onder; Dalgic, Ali; Albayrak, Ahmet Levent; Ergungor, Fikret

    2008-10-01

    Olfactory groove schwannomas are extremely uncommon and less than 30 cases are reported in the literature. We report a 21-year-old developmentally-retarded boy who experienced severe headache and aggressive behaviour for 5 months. Imaging showed a cystic mass in the subfrontal region, which was removed by craniotomy. The lesion had a vascular supply from the anterior ethmoidal arteries and it was noted to be attached to the right olfactory nerve. It was removed completely and histology showed it to be a schwannoma. Olfactory groove schwannomas are rare lesions and should be differentiated from meningiomas, neuroblastomas and dural-based metastatic lesions of the anterior cranial base.

  5. 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

  6. Alveolar regions of the mandible for the installation of immediate-implant fixtures and bone screws of alveolar distractors.

    PubMed

    Kim, Da-Hye; Park, Man-Soo; Won, Sung-Yoon; Hu, Kyung-Seok; Han, Dong-Hoo; Kim, Hee-Jin

    2011-05-01

    The purposes of this study were to elucidate the anatomic relationship between the dental roots and surrounding tissues and to identify the optimal sites at which to install dental surgical devices including immediate-implant fixtures and alveolar distractors. We made 5 types of measurements on horizontal cross sections obtained at 1-mm intervals from 20 Korean mandibles. The following results were obtained: (1) the mandibular facial plate was thinnest at the canine (0.5-0.7 mm) and became thicker toward the molar region; (2) the thicknesses of the facial and lingual cortical bone in the interdental region increased from anterior to posterior and from coronal to apical aspects; (3) in each section, the buccolingual root was narrower than 4 mm at depths greater than 8 and 9 mm in the central and lateral incisors, respectively, and the maximum mesiodistal root widths were 3.0 and 3.3 mm; (4) the interroot distance increased from anterior to posterior and from coronal to apical aspects; and (5) on the sections of the first and second molars, the diameter of the septal bone ranged from 4.2 to 7.9 mm buccolingually and from 1.3 to 3.3 mm mesiodistally. Achieving successful placements of implant fixtures and bone screws requires an accurate understanding of the anatomic structure at the installation site. The reported anatomic data might facilitate successful treatments and provide crucial information for use when planning and performing placements of dental surgical devices.

  7. 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

  8. 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.

  9. 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...

  10. Role of fusiform and anterior temporal cortical areas in facial recognition.

    PubMed

    Nasr, Shahin; Tootell, Roger B H

    2012-11-15

    Recent fMRI studies suggest that cortical face processing extends well beyond the fusiform face area (FFA), including unspecified portions of the anterior temporal lobe. However, the exact location of such anterior temporal region(s), and their role during active face recognition, remain unclear. Here we demonstrate that (in addition to FFA) a small bilateral site in the anterior tip of the collateral sulcus ('AT'; the anterior temporal face patch) is selectively activated during recognition of faces but not houses (a non-face object). In contrast to the psychophysical prediction that inverted and contrast reversed faces are processed like other non-face objects, both FFA and AT (but not other visual areas) were also activated during recognition of inverted and contrast reversed faces. However, response accuracy was better correlated to recognition-driven activity in AT, compared to FFA. These data support a segregated, hierarchical model of face recognition processing, extending to the anterior temporal cortex.

  11. Removal of Deeply Impacted Mandibular Molars by Sagittal Split Osteotomy.

    PubMed

    Cansiz, Erol; Isler, Sabri Cemil; Gultekin, B Alper

    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.

  12. [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

  13. Anatomy and clinical applications of the mandibular nerve.

    PubMed

    Somayaji, S Krishnaraj; Acharya, S Rashmi; Mohandas, K G; Venkataramana, V

    2012-01-01

    A thorough anatomical knowledge is very essential for clinical practice and any surgical procedure. Unfortunately anatomical variations can lead to hazards in medical and dental diagnosis and treatment. Such knowledge is very essential even in effective local anesthesia which is an essential part of treatment in patients with many oral disorders. Therefore a normal anatomy and its possible variations are utmost important aspects also in dentistry. One of the structures that dentists very often deal with is the mandibular nerve which therefore needs a thorough review. However, there are not many consolidated literature reviews available regarding its variations and clinical applications. Keeping this in mind, in this article, the authors have brought together available literature on various aspects of mandibular nerve. The final review will be of benefit to clinicians (Fig. 2, Ref. 63).

  14. Functional anatomy of the temporo-mandibular joint (II).

    PubMed

    Sava, Anca; Scutariu, Monica

    2012-01-01

    Jaw movement is analyzed as an action between two rigid components jointed together in a particular way, the movable mandible against the stabilized cranium. Opening and closing movements are symmetrical; that is, both sides of the cranio-mandibular articulation are making the same movements. Protrusive and retrusive movements may also be symmetrical. The mandibular muscles determine all the complicated postures and-movements of the jaw. Their behavior can be greatly clarified by restating certain fundamentals crucial to purposive muscular activity. The joint derives its arterial supply from the superficial temporal artery and the maxillary artery. Branches of the auriculo-temporal and masseteric nerves and postganglionic sympathetic nerves supply the tissues associated with the capsular ligament and the looser posterior bilaminar extension of the disc.

  15. Patients' Priorities and Attitudes Towards Their Temporo-Mandibular Disorders.

    PubMed

    Kelleher, Martin; Ray-Chaudhuri, Arijit; Khawaja, Noman

    2015-08-01

    The diagnosis and appropriate management of temporo-mandibular disorders (TMDs) remains controversial. Current scientific evidence highlights the importance of psychosocial factors in sufferers and the reducing emphasis on occlusal or dental/prosthetic factors. This paper describes the findings of a survey of 211 patients reporting pain from their temporo-mandibular joint area and associated structures. This article offers busy primary dental care practitioners a cost effective questionnaire for obtaining relevant information from patients about the history of their condition and highlights what patients hope to achieve through the management of their disorder. It also emphasises the importance of communicating effectively with patients and offers practical tips for the management of TMDs in primary care.

  16. Bilateral elongated mandibular coronoid process in an Anatolian skull

    PubMed Central

    Çorumlu, Ufuk; Demir, Mehmet Tevfik; Pirzirenli, Mennan Ece

    2016-01-01

    Elongation or hyperplasia of coronoid process of mandible is rare condition characterized by abnormal bone development which cause malocclusion and the limited mouth opening. In this study, in an Anatolian skull, a case of bilateral elongation of mandibular coronoid process was presented. Levandoski panographic analysis was performed on the panoramic radiographie to determine the hyperplasia of the coronoid process. The right condylar process was exactly hyperplastic. The measurements of Kr-Go/Cd-Go were 95.10 mm/79.03 mm on right side and 97.53 mm/87.80 mm on left side. The ratio of Kr-Go/Cd-Go on the right side was 1.20. Elongated coronoid process is one of the factors cause mandibular hypomobility, it as reported here might lead to limited mouth opening. The knowledge of this variation or abnormality can be useful for the radiologist and surgeons and prevent misdiagnosis. PMID:27722017

  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. 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.

  19. 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

  20. Fixation of zygomatic and mandibular fractures with biodegradable plates

    PubMed Central

    Degala, Saikrishna; Shetty, Sujeeth; Ramya, S

    2013-01-01

    Context: In this prospective study, 13 randomly selected patients underwent treatment for zygomatic–complex fractures (2 site fractures) and mandibular fractures using 1.5 / 2 / 2.5-mm INION CPS biodegradable plates and screws. Aims: To assess the fixation of zygomatic-complex and mandibular fractures with biodegradable copolymer osteosynthesis system. Materials and Methods: In randomly selected 13 patients, zygomatic-complex and mandibular fractures were plated using resorbable plates and screws using Champy's principle. All the cases were evaluated clinically and radiologically for the type of fracture, need for the intermaxillary fixation (IMF) and its duration, duration of surgery, fixation at operation, state of reduction at operation, state of bone union after operation, anatomic reduction, paresthesia, occlusal discrepancies, soft tissue infection, immediate and late inflammatory reactions related to biodegradation process, and any need for the removal of the plates. Statistical Analysis Used: Descriptives, Frequencies, and Chi-square test were used. Results: In our study, the age group range was 5 to 55 years. Road traffic accidents accounted for the majority of patients six, (46.2%). Postoperative occlusal discrepancies were found in seven patients as mild to moderate, which resolved with IMF for 1-8 weeks. There were minimal complications seen and only as soft tissue infection. Conclusions: Use of biodegradable osteosynthesis system is a reliable alternative method for the fixation of zygomatic-complex and mandibular fractures. The biodegradable system still needs to be refined in material quality and handling to match the stability achieved with metal system. Biodegradable plates and screws is an ideal system for pediatric fractures with favorable outcome. PMID:23662255