Desenvolvimento puberal em meninas tratadas de LLA

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Monteiro I.M.M.

1998-01-01

Full Text Available OBJETIVO: Com o objetivo de avaliar o desenvolvimento puberal após o tratamento de leucemia linfóide aguda (LLA na infância, foi realizado um estudo retrospectivo, em meninas tratadas de janeiro de 1980 a janeiro de 1991, no Centro de Investigações Hematológicas "Dr. Domingos A. Boldrini", em Campinas-SP. CASUÍSTICA E MÉTODO: Foram selecionadas 42 meninas, tratadas antes da puberdade com quimioterapia sistêmica e intratecal e radioterapia cranial, utilizando doses de 18 ou 24 Grays (Gy. RESULTADOS: As idades médias da telarca, pubarca e menarca foram inferiores às do grupo-controle, embora com significância estatística apenas para a idade da telarca. Não houve diferenças entre os grupos tratados com 18 ou 24Gy. As meninas tratadas antes dos cinco anos de idade apresentaram idade média da menarca estatisticamente inferior àquelas tratadas após cinco anos e em relação ao grupo-controle. CONCLUSÃO: Os resultados mostraram que o desenvolvimento puberal em meninas tratadas de LLA na infância foi mais precoce que o de meninas saudáveis.

Facial symmetry evaluation after experimentally displaced condylar process fracture in methotrexate treated rats Avaliação da simetria facial após fratura experimental com desvio do processo condilar em ratos tratados com metotrexato

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Samantha Cristine Santos Xisto Braga Cavalcanti

2012-03-01

Full Text Available PURPOSE: To investigate the facial symmetry of high and low dose methotrexate (MTX treated rats submitted to experimentally displaced mandibular condyle fracture through the recording of cephalometric measurements. METHODS: One hundred male Wistar rats underwent surgery using an experimental model of right condylar fracture. Animals were divided into four groups: A - saline solution (1mL/week; B - dexamethasone (DEX (0,15mg/Kg; C - MTX low dose (3 mg/Kg/week; D - MTX high dose (30 mg/Kg. Animals were sacrificed at 1, 7, 15, 30 and 90 days postoperatively (n=5. Body weight was recorded. Specimens were submitted to axial radiographic incidence, and cephalometric mensurations were made using a computer system. Linear measurements of skull and mandible, as well as angular measurements of mandibular deviation were taken. Data were subjected to statistical analyses among the groups, periods of sacrifice and between the sides in each group (α=0.05. RESULTS: Animals regained body weight over time, except in group D. There was reduction in the mandibular length and also changes in the maxilla as well as progressive deviation in the mandible in relation to the skull basis in group D. CONCLUSION: Treatment with high dose methotrexate had deleterious effect on facial symmetry of rats submitted to experimentally displaced condylar process fracture.OBJETIVO: Avaliar a simetria facial de ratos tratados com metotrexato (MTX, em dose alta e baixa, submetidos à fratura experimental do processo condilar com desvio por meio de mensurações cefalométricas. MÉTODOS: Cem ratos Wistar machos foram submetidos a procedimento cirúrgico utilizando modelo experimental de fratura de côndilo do lado direito. Os animais foram distribuídos em quatro grupos: A - soro fisiológico (1mL/semana; B - dexametasona (DEX (0,15mg/Kg; C - MTX baixa dose (3mg/Kg/semana; D - MTX alta dose (30mg/Kg. Os períodos de sacrifício foram de 1, 7, 15, 30 e 90 dias de pós-operatório (n=5

Tratamento das fraturas do processo odontóide Treatment of odontoid fractures

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Pedro Augusto Pontin

2011-01-01

Full Text Available OBJETIVO: Este artigo faz a avaliação retrospectiva clínica e radiológica das fraturas do odontóide de 20 pacientes atendidos no IOT-HCFMUSP, durante o período de 2004-2010. MÉTODOS: Foi realizado a estratificação destas fraturas segundo sua classificação (AO/Anderson e D'Alonzo, perfil epidemiológico, tipo de tratamento, tempo de consolidação e complicações. RESULTADOS: Observou-se maior número de casos da fratura do odontóide em pacientes do sexo masculino (4:1, com idade entre 3ª e 4ª década de vida (60%, vítimas de quedas de altura (60% e acidentes automobilísticos (25% como principais mecanismos de trauma, e 15% dos casos apresentaram-se com déficit neurológico. A fraturas do odontóide de maior prevalência foram as do tipo II (55%, seguidas pelas fraturas do tipo III (40%. Os tratamentos mais empregados nas fraturas do tipo II e III foram, respectivamente, o cirúrgico (73% e conservador (87,5%. A consolidação ocorreu em até 16 semanas para 87,5% dos casos de tratamento cirúrgico e para 54,5% dos tratados conservadoramente. Não houve casos de pseudoartrose. CONCLUSÃO: O tratamento cirúrgico das fraturas do odontóide do tipo II apresentou resultados satisfatórios em relação ao tempo consolidação e baixa incidência de complicações, bem como o tratamento conservador destinado às fraturas do tipo III.Nivel de Evidência IV, série de casos.OBJECTIVE: This article describes a clinical and radiologic retrospective analysis of odontoid fractures in20 patients accompanied byThe IOT-HCFMUSP,from 2004 to 2010. METHODS: These fractures were stratified according to their classification (AO/Anderson andD'Alonzo, epidemiologic profile, type of treatment, time to consolidation of the fracture, and complications. RESULTS: It was observed that there was a higher number of odontoid fractures in males (4:1, between the third and fourth decades of life (60%, and that the main causes of the trauma were falling from

Correlação entre tempo para o tratamento cirúrgico e mortalidade em pacientes idosos com fratura da extremidade proximal do fêmur Correlation between time until surgical treatment and mortality among elderly patients with fractures at the proximal end of the femur

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Gustavo Gonçalves Arliani

2011-04-01

Full Text Available OBJETIVO: O objetivo primário do estudo é analisar a possível associação entre o atraso para a realização do tratamento cirúrgico e mortalidade em pacientes idosos com fratura da extremidade proximal do fêmur. MÉTODOS: Foram estudados 269 pacientes com fraturas da extremidade proximal do fêmur (fraturas do colo do fêmur e fraturas intertrocanterianas, tratadas cirurgicamente no Hospital São Paulo - Unifesp-SP, no período de janeiro de 2003 a dezembro de 2007. Foram analisados e comparados com a literatura referente ao assunto os seguintes atributos: sexo, idade, tipo de fratura, classificação da mesma, lado acometido, síntese utilizada, mecanismo de trauma, tempo de internação, tempo para cirurgia, comorbidades associadas, hemograma de entrada, tipo de anestesia, necessidade de transfusão sanguínea, dia da semana e estação do ano da fratura. RESULTADOS: O estudo apresentou correlação entre maior número de comorbidades clínicas, maior tempo de internação e utilização de anestesia geral na cirurgia com maior mortalidade dos pacientes. CONCLUSÃO: Não houve associação entre tempo para realização da cirurgia e mortalidade.OBJECTIVE: The primary aim of this study was to analyze the possible association between delay in receiving surgical treatment and mortality among elderly patients with fractures at the proximal end of the femur. METHODS: 269 patients with fractures at the proximal end of the femur (femur neck and intertrochanteric fractures who were treated surgically at Hospital São Paulo, UNIFESP, São Paulo, between January 2003 and December 2007, were studied. Sex, age, type of fracture, classification of the fracture, affected side, synthesis used, trauma mechanism, length of hospitalization, length of surgery, associated comorbidities, hemogram at admission, type of anesthesia, need for blood transfusion, day of the week and season of the year of the fracture were analyzed and compared with the literature

Fratura supracondiliana de úmero em crianças: fixação com dois fios de Kirschner cruzados Supracondylar fracture of the humerus in children: fixation with two crossed Kirschner wires

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Roni Azevedo Carvalho

2012-01-01

Full Text Available OBJETIVO: Analisar e apresentar os resultados de fraturas supracondilianas instáveis de úmero em crianças, tratadas cirurgicamente com redução e fixação percutânea com dois fios de Kirschner cruzados. MÉTODOS: Foi realizado estudo transversal com 20 crianças, considerando sexo, idade na época da fratura e no momento da análise, lateralidade, tipo e mecanismo de fratura, complicações pós-operatórias, variáveis radiográficas e clínicas. RESULTADOS: Observaram-se 10 fraturas à esquerda e 10 à direita. A idade na fratura variou de dois a 13 anos (média 5,9 anos ± 2,48. Três fraturas foram classificadas como tipo II e 17 do tipo III. O tempo de seguimento variou de quatro meses a três anos. O ângulo de Baumann variou de 69 a 100 (média 78,3, sendo observada a presença de cúbito varo em quatro pacientes (com valores variando de 84 a 100. Segundo os critérios de Flynn modificados, obtiveram-se 20 casos satisfatórios, 17 excelentes (85%, dois bons (10% e um regular (5%. Dois pacientes apresentaram déficit da amplitude de movimento, dois parestesia no território cubital e uma criança apresentou neuropraxia transitória do nervo ulnar por seis semanas. CONCLUSÃO: A fixação percutânea com dois fios de Kirschner cruzados, quando realizada com visualização direta e isolamento do nervo ulnar, permite bons resultados.OBJECTIVE: To analyze and present the surgical results from unstable supracondylar fractures of the humerus in children, treated by means of reduction and percutaneous fixation using two crossed Kirschner wires. METHODS: A cross-sectional study was conducted on 20 children, taking into consideration sex, age at the time of the fracture, age at the time of the assessment, side affected, type and mechanism of trauma, postoperative complications and radiographic and clinic variables. RESULTS: Ten fractures were observed in the left arm and ten in the right arm. The age at the time of the fracture ranged from 2

Riego subsuperficial con aguas residuales tratadas

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Crespi, Raúl; Camacho, Emilio; Polo, María José

2009-01-01

La reutilización de aguas residuales tratadas para riego por goteo subsuperficial (RGS) de cultivos extensivos, es una práctica reconocida mundialmente, siendo la obturación de emisores un serio problema en la operación de estos sistemas. Durante el ciclo agrícola 2002/03, se realizó un ensayo experimental usando dos tipos de agua: limpia (AL) y residual tratada (AR) en un sistema mixto combinando un reactor biológico con laguna de maduración y tres tipos de protectores del emisor: micro dosi...

Terapêutica interdisciplinar para fratura cominutiva de côndilo por projétil de arma de fogo: enfoque miofuncional Interdisciplinary approach for comminuted condyle fracture of by firearms: myofunctional focus

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Esther Mandelbaum Gonçalves Bianchini

2010-10-01

Full Text Available TEMA: ferimentos causados por projéteis de arma de fogo apresentam alta incidência na região da cabeça e face. A articulação temporomandibular pode estar envolvida, além de estruturas anatômicas importantes como o nervo facial, necessitando de equipe multidisciplinar para efetuar tratamento adequado. PROCEDIMENTOS: apresentação de caso clínico de fratura condilar cominutiva causada por projétil de arma de fogo tratado de forma não-cirúrgica associado à terapia miofuncional orofacial. Paciente encaminhado para avaliação e procedimentos fonoaudiológicos após conduta da equipe de cirurgia bucomaxilofacial, sem remoção do projétil, alojado superficialmente, próximo da origem do músculo esternocleidomastóideo à direita, com fratura condilar cominutiva e lesão do nervo facial. Foram aspectos observados em avaliação: mordida aberta anterior, importante redução da amplitude dos movimentos mandibulares com desvios para o lado acometido, ausência de lateralidade contralateral, dor muscular, paralisia e parestesia em terço médio e superior da hemiface direita. Realizadas sessões de terapia miofuncional seguindo protocolo específico para traumas de face constando de: drenagem de edema; manipulações na musculatura levantadora da mandíbula ipsilateral; ampliação e correção dos movimentos mandibulares; procedimentos específicos referentes à paralisia facial e reorganização funcional direcionada. RESULTADOS: após oito semanas de terapia os resultados obtidos mostram restabelecimento de amplitude e da simetria dos movimentos mandibulares, reorganização da mastigação, adequação da deglutição e fala, remissão da sintomatologia dolorosa e remissão da paralisia do terço médio. CONCLUSÃO: o tratamento conservador da fratura por meio da terapia miofuncional orofacial resultou na reabilitação funcional da mandíbula e face dirigindo os movimentos e estimulando a adequação das funções estomatogn

Ultra-som pulsado de baixa intensidade em fraturas diafisárias: aplicação clínica em cães Low-intensity pulsed ultrasound in diaphyseal fractures: clinical application in dogs

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Valéria Lima de Sousa

2008-08-01

Full Text Available Os efeitos da estimulação ultra-sônica sobre a consolidação óssea têm sido demonstrados por trabalhos experimentais e clínicos. Este estudo teve por objetivo investigar a aplicação clínica do ultra-som pulsado de baixa intensidade como tratamento adjuvante de fraturas diafisárias em cães. Foram utilizados 16 cães de raças variadas, com faixa etária entre sete meses e seis anos, peso corpóreo entre 2,5 e 43kg, portadores de fraturas diafisárias fechadas recentes localizadas no rádio e ulna, fêmur ou tíbia e fíbula, estabilizadas por procedimentos de osteossíntese (fixação esquelética externa, pinos intramedulares ou a associação desses métodos. Os cães foram divididos em dois grupos: fraturas estabilizadas tratadas por ultra-som de baixa intensidade (grupo tratado, n=8; fraturas estabilizadas, não tratadas por estimulação ultra-sônica, (grupo controle, n=8. Os animais foram avaliados por exames clínicos e radiográficos nos períodos pré-operatório, pós-operatório imediato e a cada 30 dias posteriores aos procedimentos cirúrgicos. Realizou-se tratamento com ultra-som pulsado (sinal senoidal com freqüência de 1,5MHz, largura de pulso de 200µs e freqüência de repetição de 1kHz de baixa intensidade (30mW cm-2, aplicado de modo estacionário no foco de fratura. A terapia ultra-sônica foi realizada 20 minutos por dia, durante 21 dias consecutivos, a partir do período compreendido entre o 1° e o 9° dia pós-operatório. O teste t de Student, empregado na análise estatística, mostrou diferença significante (PThe effects of ultrasound stimulation on bone healing have been demonstrated in experimental and clinical studies. The purpose of this study was to investigate the clinical application of low-intensity pulsed ultrasound as an adjuvant for the treatment of diaphyseal fractures in dogs. Sixteen dogs of different breeds, ages ranging from seven months to six years, weighing from 2.5 to 43kg, were

Epidemiologia das fraturas zigomáticas: uma análise de 10 anos = Zygomatic fractures epidemiology: a 10-year-analysis

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Gondola, Abdiel Ortega

2006-01-01

Full Text Available Devido a sua localização e projeção no complexo maxilofacial, o osso zigomático apresenta elevado índice de fratura comparando-o às demais fraturas dos ossos da face. Estudos epidemiológicos sempre são de grande importância para o cirurgião BucoMaxiloFacial, pois fornecem dados pelos quais se pode traçar o perfil das fraturas faciais e analisar a efetividade dos métodos de tratamento empregados. No presente trabalho foi realizado um levantamento epidemiológico retrospectivo de 10 anos dos pacientes atendidos no Hospital Infantil Maria Lucinda que apresentavam fratura do complexo zigomático. A amostra foi composta por 153 pacientes portadores de fratura do complexo zigomático, onde foram analisados comparativamente os indicadores gênero, faixa etária, etiologia do trauma e localização topográfica da fratura. Os resultados obtidos mostraram o gênero masculino como o mais acometido (83,6%, a faixa etária de 21 a 40 anos (71,2% mais freqüente, tendo como causa principal a queda da própria altura (39,9% e o osso zigomático esquerdo como a localização mais afetada (49,7%

Fratura extra-articular da extremidade medial da clavícula associada à luxação acromioclavicular tipo IV: relato de caso

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Correa, Mário Chaves; Gonçalves, Lucas Braga Jacques; Vilela, Jose Carlos Souza; Leonel, Igor Lima; Costa, Lincoln Paiva; Andrade, Ronaldo Percopi de

2011-01-01

Ocorrendo isoladamente, as fraturas da clavícula e as luxações acromioclaviculares são lesões muito comuns. A combinação de uma luxação acromioclavicular e de uma fratura do terço lateral da clavícula não é rara. Entretanto, existem muito poucos casos descritos de luxações acromioclaviculares associadas a fraturas do terço médio da clavícula; aquelas associadas a fraturas do terço medial são ainda mais raras. Nós reportamos o caso de um indivíduo adulto do sexo masculino que sofreu uma luxaçã...

CARACTERÍSTICAS CLÍNICAS E PADRÃO DE FRATURAS NO MOMENTO DO DIAGNÓSTICO DE OSTEOGÊNESE IMPERFEITA EM CRIANÇAS

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Evelise Brizola

Full Text Available RESUMO Objetivo: Caracterizar o padrão de fraturas e a história clínica no momento do diagnóstico de osteogênese imperfeita. Métodos: Neste estudo retrospectivo, foram incluídos todos os pacientes com osteogênese imperfeita de ambos os sexos, com idades entre 0 e 18 anos, que realizaram tratamento entre 2002 e 2014. Os prontuários médicos foram revisados para coleta de dados clínicos, incluindo presença de escleras azuladas, dentinogênese imperfeita, história familiar positiva para a doença e locais das fraturas, além de achados radiográficos no momento do diagnóstico. Resultados: Foram incluídos no estudo 76 pacientes (42 do sexo feminino, com idade, no momento do diagnóstico, entre 0 e 114 meses [mediana (p25-p75 de idade de 38 (6-96 meses]. Escleras azuladas estavam presentes em 93,4% dos pacientes, dentinogênese imperfeita foi observada em 27,6% e ossos wormianos em 29,4%. O número de fraturas ao diagnóstico variou entre 0 e 17, com uma mediana de 3 (2-8 fraturas. Em 40 (57% pacientes, as fraturas eram de membros superiores e inferiores no momento do diagnóstico e, em 9 pacientes também havia fratura vertebral. O diagnóstico foi realizado ao nascimento em 85,7% dos pacientes com o tipo 3 e em 39,3% daqueles com tipo 4/5 da doença. Conclusões: Osteogênese imperfeita é uma doença genética com características clínicas distintas, tais como fragilidade óssea, fraturas recorrentes, escleras azuladas e dentinogênese imperfeita. É importante saber identificar essas características, facilitando o diagnóstico, otimizando o tratamento e diferenciando de outras doenças que também podem causar fraturas.

Fraturas do planalto tibial Tibial plateau fractures

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Maurício Kfuri Júnior

2009-01-01

Full Text Available As fraturas do planalto tibial são lesões articulares cujos princípios de tratamento envolvem a redução anatômica da superfície articular e a restauração funcional do eixo mecânico do membro inferior. Contribuem para a tomada de decisões no tratamento dessas fraturas o perfil do paciente, as condições do envelope de tecidos moles, a existência de outros traumatismos associados e a infraestrutura disponível para abordagens cirúrgicas. Para as fraturas de alta energia, o tratamento estagiado, seguindo o princípio do controle de danos, tem como prioridade a manutenção do alinhamento do membro enquanto se aguarda a resolução das más condições de tecidos moles. Já nos traumas de baixa energia, desde que os tecidos moles não sejam um fator adverso, o tratamento deve ser realizado em tempo único, com osteossíntese definitiva. Fixação estável e movimento precoce são variáveis diretamente relacionadas com os melhores prognósticos. Desenvolvimentos recentes, como os implantes com estabilidade angular, substitutos ósseos e imagens tridimensionais para controle intraoperatório, deverão contribuir para cirurgias menos invasivas e melhores resultados.Tibial plateau fractures are joint lesions that require anatomical reduction of joint surface and functional restoration of mechanical axis of a lower limb. Patient profile, soft tissue conditions, presence of associated injuries and the available infrastructure for the treatment all contribute to the decision making about the best treatment for these fractures. High-energy fractures are usually approached in a staged manner respecting the principle of damage control, and are primarily targeted to maintain limb alignment while the resolution unfavorable soft tissue conditions is pending. Low-energy trauma can be managed on a single-stage basis, provided soft tissues are not an adverse factor, with open reduction and internal f-ixation. Stable fixation and early painless joint

Tratamento cirúrgico das fraturas do odontóide tipo II com parafuso anterior: análise de 15 casos

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Dantas Fernando Luiz Rolemberg

2002-01-01

Full Text Available Apresentamos estudo retrospectivo dos resultados de 15 pacientes consecutivos, com fratura do odontóide tipo II P (fratura com traço oblíquo e deslocamento posterior e II N (fratura com traço horizontal na base do odontóide, segundo a classificação de Roy-Camille , que foram submetidos a fixação anterior direta do odontóide com parafuso. A série é composta por 13 homens e 2 mulheres, com idade variando entre 14 a 74 anos e período de acompanhamento de 6 a 36 meses (média 20 meses. Tivemos apenas uma complicação relacionada com a técnica cirúrgica: um parafuso mal posicionado necessitando de uma reoperação para ser reposicionado. Não houve óbito. Não houve saída nem quebra de parafuso. Obteve-se 94% de fusão óssea. Propomos que seja utilizada a classificação de Roy-Camille na seleção dos casos cirúrgicos de fraturas do odontóide, pois ela fornece uma abordagem cirúrgica específica para cada tipo de fratura.

Fraturas do anel pélvico: estudo epidemiológico Pelvic ring fractures: epidemiological study

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Alceu Gomes Chueire

2004-03-01

Full Text Available De fevereiro de 2000 a setembro de 2001, 84 pacientes apresentando fratura do anel pélvico foram avaliados, segundo determinado protocolo aplicado. Houve predomínio do sexo masculino (67%, a maioria dos pacientes eram brancos (86% e a idade média foi de 37 anos. Quanto ao tipo de acidente, os mais freqüentes foram os relacionados ao trânsito (58% - carro, moto e atropelamento - pacientes vítimas de traumas de alta energia. As fraturas foram classificadas de acordo com Tile(13 em estáveis, em 55% (fraturas do tipo A; rotacionalmente instáveis, em 30% (fraturas do tipo B e rotacional e verticalmente instáveis, em 15% (fraturas do tipo C. A fratura mais freqüentemente encontrada foi a dos ramos isquiopúbicos. O tratamento cirúrgico foi realizado em 29% dos pacientes. Houve necessidade de transfusão sangüínea em 20% dos pacientes, utilizando-se uma média de cinco unidades de sangue total; exceto dois pacientes (2,4% com lesão arterial intra pélvica que necessitaram mais de 10 unidades de sangue nas primeiras 48 horas. A mortalidade foi de sete por cento tendo relação significativa com traumas extra pélvicos.From February 2000 to September 2001, 84 patients with pelvic fractures were assessed, using a determined protocol. There were more men (67% than women. Most of the patients were white (86% and the average was 37 years of age. The most frequent accident was reported to have been traffic accidents (58% such as motor vehicle, motorcycle and running over - victims of high-energy injuries. The pelvic ring fractures were classified according to Tile (13 as stable in 55% (type A injury, as rotationally unstable in 30% (type B injury and as unstable in translation in 15% (type C injury. The most frequent lesion affecting the pelvic girdle was the isquiopubic bones fracture (transpubic instability. The overall rate of operative stabilization was 29%. An average of five units of total blood transfusion was required in 20% of the

Diferenças sazonais de quedas e fraturas em idosos gaúchos

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Iride Cristofoli Caberlon

2015-12-01

Full Text Available Resumo Quedas e fraturas em pessoas idosas representam um problema relevante de saúde pública. Ambas vêm associadas a elevados índices de morbimortalidade, redução da capacidade funcional, institucionalização do idoso e óbito precoce. O objetivo deste estudo foi investigar quedas e fraturas em idosos, residentes em municípios da região metropolitana e serra gaúcha do Rio Grande do Sul, analisando fatores associados, sazonalidade e gravidade. Trata-se de estudo transversal, retrospectivo, descritivo-analítico, quantitativo, com dados secundários, em idosos atendidos por queda entre primeiro de janeiro a 31 de dezembro de 2010, em unidades de Atendimento de Urgência e Emergência do SUS. A amostra foi de 6.556 idosos atendidos por queda, dos quais 71% eram mulheres, 26,8% dos atendimentos ocorreram no inverno, 30% dos que caíram fraturaram, sendo 32% em mulheres contra 28% em homens (p < 0,0001. O local da queda foi registrado somente em 17,2% dos boletins, sendo 58% fora do domicílio. O inverno foi a estação do ano com 34% de fraturas confirmadas (p = 0,0002, sendo 26,3% com gravidade severa. Como a maioria das quedas e suas consequências podem ser prevenidas e evitadas, urge criar programas e ações multifatoriais de intervenção.

FRATURA DO ARCO ZIGOMÁTICO NO PERÍODO DE CRESCIMENTO: ESTUDO EXPERIMENTAL EM RATOS

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GOULART Alan Cruvinel

1998-01-01

Full Text Available O comportamento da fratura do arco zigomático no período de crescimento foi avaliado através de mensurações cefalométricas. Fratura com desvio medial no lado direito foi realizada em ratos com um mês de idade. Foi verificada tendência de retorno do arco fraturado à sua posição original, porém, com diferença estatisticamente significante para a profundidade da fossa infratemporal. Entretanto, não houve diferença significante para a distância entre o arco zigomático e a mandíbula, o que pode ser explicado pela presença de desvio significante da mandíbula.

Perfil funcional, sociodemográfico e epidemiológico de idosos hospitalizados por fratura proximal de fêmur

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Danielle Ferreira Santana

2015-05-01

Full Text Available A fratura proximal de fêmur (FPF está relacionada a altos índices de morbidade e a grande impacto sobre a capacidade funcional do idoso. O objetivo do estudo foi traçar o perfil funcional de pacientes idosos hospitalizados por FPF, analisando os tipos de fraturas, o mecanismo causal, e as características físicas e funcionais prévias ao evento. Trata-se de um estudo do tipo observacional, quantitativo, de corte transversal, cujos participantes eram pacientes hospitalizados por FPF. Foi utilizada uma Ficha de Registro para coletar os dados sociodemográficos. O grau de independência funcional e a capacidade de marcha prévia à FPF foram avaliados respectivamente pelo Índice de Barthel, o Questionário de Pfeffer e a Classificação Funcional da Marcha Modificada. A amostra foi constituída por 32 idosos com média de idade de 79 (± 9,5 anos e uma predominância do sexo feminino (71,8%, de cor parda (43,8% e baixa escolaridade. A maioria não morava sozinho e faziam uso de algum medicamento. Os idosos participantes, previamente à fratura, eram independentes para as atividades básicas da vida diária (ABVD, dependentes para as atividades instrumentais da vida diária (AIVD e não utilizam dispositivos para locomoção. A queda foi a principal causa da FPF, sendo as mais prevalentes a fratura de colo de fêmur (FCF e a fratura transtrocantérica (FTT. As comorbidades, os medicamentos, os fatores sociodemográficos, o deficit de marcha e a dependência funcional, podem estar associados à ocorrência de FPF em idosos.  

Análise isocinética e cinética de corredores e triatletas com e sem histórico de fratura por estresse

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Natália Mariana Silva Luna

2015-08-01

Full Text Available INTRODUÇÃO: A associação da fadiga muscular com o aumento da força vertical de reação do solo representa risco de fratura por estresse de tíbia em esportes como a corrida de longa distância e o triatlo. Objetivo: Analisar e comparar parâmetros do componente vertical das forças de reação do solo e parâmetros musculares isocinéticos da flexão plantar (FP e dorsiflexão (DF do tornozelo entre grupos de corredores de longa distância e triatletas com e sem histórico de fratura por estresse de tíbia.MÉTODOS: Setenta e cinco atletas de corrida de longa distância e triatletas do sexo masculino, com média de idade de 30,26 ± 6,51 anos foram divididos de acordo com a história pregressa de fratura por estresse de tíbia em: grupo fratura (GF, composto por 12 indivíduos com história de fratura por estresse da tíbia, e grupo não-fratura (GNF, composto por 37 indivíduos sem história de fratura por estresse de tíbia. Os parâmetros cinéticos foram medidos durante a corrida por meio de uma plataforma de força AMTI, e os parâmetros isocinéticos por meio de dinamômetro isocinético Biodex (System 3.RESULTADOS: Para todas as variáveis isocinéticas e cinéticas, não houve diferenças entre GF e GNF.CONCLUSÃO: Ainda que não se tenha identificado uma diferença de desempenho entre os grupos estudados, o perfil cinético (impacto e isocinético (atividade muscular mostra que o treinamento da corrida com déficits em cuidados com a condição muscular e o controle de fatores extrínsecos pode criar uma situação de risco de ocorrência de fraturas por estresse.

Fratura periprotética da tíbia combinada com fratura de fadiga da haste tibial de artroplastia total do joelho Tibial periprosthetic fracture combined with tibial stem stress fracture from total knee arthroplasty

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Fernando Fonseca

2011-01-01

Full Text Available As complicações das artroplastias totais do joelho relacionadas com o próprio material são muito raras, exceto o desgaste do polietileno. Neste artigo os autores reportam o caso de uma paciente do sexo feminino de 58 anos referenciada ao pronto-socorro do nosso hospital por uma fratura periprotética tibial (tipo I da classificação da Mayo Clinic. Uma observação mais cuidadosa mostrou a presença concomitante da referida fratura da tíbia associada à fratura de fadiga da haste tibial. A prótese com a haste foi remetida a um laboratório de biomecânica independente onde foi avaliada e efetuada uma reconstrução com uso de sistema de elementos finitos em CAD de modo a verificar a existência de algum defeito de fabricação e as eventuais causas para o sucedido. Depois de avaliadas diversas hipóteses, concluiu-se que a fratura do material foi provocada por uma sobrecarga na zona de transição prato/haste secundária à falência óssea prévia (fratura. Da avaliação do caso ressalta-se novamente a necessidade de efetuar uma avaliação adequada da mineralização óssea e, em caso de dúvida, utilizar uma haste longa.Total knee arthroplasty complications related to the prosthetic material are very rare, except for polyethylene wear. We report the case of a 58-year-old woman who came to the emergency service of our hospital with a periprosthetic tibial fracture (Mayo Clinic type I. Careful examination showed that this fracture was concomitantly associated with a tibial stem fatigue fracture. The prosthesis and the stem were sent to an independent biomechanics laboratory for evaluation. A finite-element CAD system was used to make a reconstruction, so as to ascertain whether there had been any manufacturing defect and what the causes of the event might have been. After evaluation of several hypotheses, it was concluded that the fracture in the prosthetic material had been caused by overloading at the plate/stem transition zone

Demência como fator de risco para fraturas graves em idosos

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Carvalho Aline de Mesquita

2002-01-01

Full Text Available INTRODUÇÃO: As quedas entre pessoas idosas constituem importante problema de saúde pública devido à sua alta incidência, às complicações para a saúde e aos altos custos assistenciais. O estudo realizado visa a estimar a associação entre demência e ocorrência de quedas e fraturas entre idosos. MÉTODOS: Foi conduzido estudo caso-controle de 404 indivíduos com 60 ou mais anos de idade, da cidade do Rio de Janeiro, Brasil. Casos e controles foram pareados por idade, sexo e hospital. Os dados foram coletados por meio de entrevista estruturada com os idosos. Foram considerados portadores de quadro demencial idosos cuja pontuação no questionário BOAS fosse superior a dois. Foram obtidos odds ratios (OR ajustados por fatores potenciais de confusão, utilizando-se regressão logística condicional. RESULTADOS: As quedas distribuíram-se igualmente entre os períodos da manhã, tarde e noite, havendo uma redução em sua freqüência durante a madrugada. Acidentaram-se dentro de casa 78% dos idosos com demência, contra 55% daqueles sem essa doença. O OR não-ajustado para a associação entre demência e fratura grave foi de 2,0 (IC95%, 1,23-3,25. Após o ajuste por fatores de confusão, houve uma pequena redução dessa associação (OR=1,82, 1,03-3,23. CONCLUSÃO: Idosos com quadro demencial apresentam maior risco de caírem e ser hospitalizados por fratura do que idosos sem demência. Tal fato implica a necessidade de cuidados especiais com esses indivíduos, visando a minimizar o risco desses acidentes.

Avaliação de sensibilidade objetiva versus sensibilidade subjetiva após fraturas de zigoma

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Jean Francisco KIPPER

Full Text Available Resumo Introdução Cirurgiões bucomaxilofaciais frequentemente tratam fraturas do complexo zigomaticofacial e, com isso, os sinais e sintomas auxiliam o profissional a estabelecer o diagnóstico e a conduta frente a cada caso. A presença de alteração de sensibilidade é um sintoma frequente neste tipo de trauma. Objetivo Avaliar comparativamente a presença e as alterações de sensibilidade subjetiva e sensibilidade objetiva após fraturas de zigoma. Metodologia Foram selecionados 14 pacientes com fraturas unilaterais de zigoma. A sensibilidade subjetiva foi avaliada por meio de um questionário e a sensibilidade objetiva, mensurada por meio do monofilamento de Semmes-Weinstein. Resultado Os resultados mostraram alteração de sensibilidade em 13 pacientes (92,84%; destes, oito pacientes (57,13% apresentaram alterações de ordem subjetiva e dez (71,42%, de ordem objetiva. Alterações concomitantes de sensibilidade subjetiva e sensibilidade objetiva foram encontradas em cinco pacientes (35,71%. Afetados exclusivamente por um tipo de alteração de sensibilidade somaram oito pacientes (57,13%; destes, cinco pacientes (35,71% apresentaram somente alterações objetivas e três pacientes (21,42%, apenas alterações subjetivas. A única queixa de sensibilidade subjetiva encontrada foi a hipoestesia, com sete casos (50%. Conclusão As alterações de sensibilidade são frequentemente encontradas após fraturas de zigoma, existindo uma forte correlação entre a perda da percepção subjetiva e a perda da sensibilidade objetiva; porém, ocorre predominância de alterações de ordem objetiva.

Estudo retrospectivo de radiografias com fraturas rádio e ulna em cães

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Robson Fortes Giglio

2007-12-01

Full Text Available Foram analisadas 528 radiografias simples de fraturas de rádio e ulna do arquivo do Serviço de Diagnostico por Imagem do Departamento de Cirurgia junto ao Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo realizadas no período de julho de 1999 a dezembro de 2005, selecionando-se os meses para análise de forma randomizada. Os principais resultados encontrados foram: Fraturas de rádio e ulna representam 20,9% do total encontradas, destas o tipo mais observado foi a transversal, tanto no rádio (75,5% quanto na ulna (76,6%. 87,1% das fraturas acometeram o rádio e a ulna. O terço distal foi o mais acometido foi o distal, tanto do rádio quanto da ulna (72,9% e 70,1%, respectivamente. Esquírolas ósseas foram observadas em 13,8% e desvio de eixo ósseo em 94,9% dos casos. 40,2% dos cães não possuíam raça definida. 34,3% dos cães possuíam idade entre seis meses a um ano.

Bases tratadas con cemento, en California

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Chinchilla, M.

1962-05-01

Full Text Available El uso de bases tratadas con cemento para autopistas se inició en el Estado de California en 1938, empleándose para carreteras con determinadas condiciones de tráfico. Inicialmente, se especificó el uso obligatorio de plantas mezcladoras para asegurar el debido control de las proporciones adecuadas.

Estudo epidemiológico das fraturas femorais diafisárias pediátricas Epidemiological study of children diaphyseal femoral fractures

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Cassiano Ricardo Hoffmann

2012-04-01

Full Text Available OBJETIVO: Avaliar as características pessoais, das fraturas e do tratamento e suas complicações em pacientes com fraturas femorais diafisárias pediátricas atendidos no Serviço de Ortopedia Pediátrica do Hospital Infantil Joana de Gusmão. MÉTODOS: Trata-se de estudo retrospectivo e transversal com população composta por pacientes com fraturas diafisárias de fêmur, com idade entre o nascimento e 14 anos e 11 meses, divididos em quatro grupos etários. As informações foram obtidas nos prontuários e transferidas para o questionário de pesquisa que apresentava variáveis pessoais, das fraturas e do tratamento e suas complicações. RESULTADOS: A população do estudo foi composta por 96 pacientes. A média de idade encontrada foi de 6,8 anos. Houve predomínio no sexo masculino, fratura fechada, lado direito, 1/3 médio e traço simples. Quanto à etiologia das fraturas, houve predomínio na amostra global de acidentes de trânsito. A maioria dos pacientes (74-77,1% apresentou fratura de fêmur como lesão isolada. Houve predomínio do tratamento conservador na faixa etária menor que seis anos e do tratamento cirúrgico na faixa etária de seis anos a 14 anos e 11 meses. As complicações observadas até a união óssea foram: discrepância, infecção e limitação de movimento. O tempo médio de consolidação foi de 9,6 ± 2,4 semanas, variando com a idade. CONCLUSÃO: As características das fraturas estudadas foram semelhantes às citadas na literatura e o tratamento empregado apresentou bom resultado. O Hospital Infantil Joana de Gusmão (HIJG tem utilizado o tratamento proposto pela literatura nas fraturas femorais diafisárias pediátricas.OBJECTIVE: To evaluate the personal, fracture, treatment and complication characteristics among patients with pediatric femoral shaft fractures attended at the pediatric orthopedic service of the Joana de Gusmão Children's Hospital. METHODS: This was a retrospective cross-sectional study

Uma Metodologia para a avaliação dos gradientes de tenacidade à fratura ao longo da camada cementada do aço SAE 5115

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Sandor,Leonardo Taborda; Ferreira,Itamar

2006-01-01

Este trabalho propõe um modelo para avaliar pontualmente as variações de tenacidade à fratura ao longo da camada cementada de um aço SAE 5115. A pequena espessura dessas camadas impede a retirada de corpos de prova nas dimensões especificadas pelas normas de ensaios de tenacidade à fratura. Assim, para simular uma camada cementada retirou-se corpos-de-prova de tração e de tenacidade à fratura de amostras de aços SAE 5115, 5140, 5160 e 52100 assumindo a influência local apenas da variação do t...

Efeito do laser de baixa potência (AsGa, 904 ηm na reparação óssea de fraturas em ratos Effect of low-level laser (GaAs, 904 ηm for bone repair on fractures in rats

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Jorge Alfredo Léo

2012-04-01

Full Text Available OBJETIVO: Analisar os efeitos do laser de baixa potência, AsGa - 904 ηm, no reparo ósseo de fraturas de tíbias em ratos. MÉTODOS: 40 ratos divididos em quatro grupos de 10 animais: grupo controle, sem fratura (GC; grupo com fratura, sem tratamento (GE II; grupo com fratura tratado com laser a 10J/cm² (GE III e grupo com fratura tratado com laser a 15J/cm² (GE IV. A fratura foi realizada cirurgicamente e o tratamento teve duração de 45 dias, realizado em dias alternados. Finalizado o tratamento, os ratos foram submetidos à eutanásia e as tíbias tratadas foram radiografadas e submetidas a ensaios mecânicos de flexão em três pontos para avaliar a força máxima (N para ruptura. RESULTADOS: Os valores observados de força máxima (N foram: grupo controle (GC de 51,5N ± 7,9N; GE II de 17,2N ± 7,8N; GE III de 16,6N ± 12,1N e GE IV de 30,3N ± 7,8N. Foram observadas diferenças estatisticamente significantes entre o grupo controle e os grupos experimentais e também entre o grupo experimental IV e os grupos experimentais II e III. Em relação às radiografias, foi observada a formação de calo ósseo em todos os grupos fraturados, indicando que passaram pelo processo normal de reparo tecidual. CONCLUSÃO: O grupo GE IV, submetido à terapia laser com dosagem de 15J/cm² obteve o maior valor para força máxima (N entre os grupos experimentais, indicando a influência da maior dosagem do laser no reparo ósseo.OBJECTIVE: To analyze the effects of low-level laser therapy (GaAs, 904 nm for bone repair on tibial fractures in rats. METHODS: Forty rats were divided into four groups of 10 animals: control group without fracture (CG; fracture group without treatment (EG II; fracture group treated with laser at 10 J/cm² (EG III; and fracture group treated with laser at 15 J/cm² (EG IV. The fracture was produced surgically and the treatment lasted 45 days, done on alternate days. After treatment completion, the rats were sacrificed. The

Estudo do tratamento das fraturas da cabeça do fêmur Study of the treatment of femoral head fractures

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Rodrigo Pereira Guimarães

2010-01-01

Full Text Available OBJETIVO: Estabelecer diretrizes para o tratamento das fraturas da cabeça femoral e determinar a melhor via de acesso nos casos tratados cirurgicamente. MÉTODOS: Avaliamos os resultados clínicos e radiográficos de 13 pacientes (13 fraturas tratados cirurgicamente entre maio de 1986 e julho de 1996 no Departamento de Ortopedia e Traumatologia da Santa Casa de Misericórdia de São Paulo (SCMSP, Pavilhão "Fernandinho Simonsen". RESULTADOS: Entre as seis fraturas Pipkin 1, cinco foram submetidas à ressecção do fragmento, o que nos levou a quatro resultados excelentes e um bom, sendo este com fixação do fragmento. Três pacientes apresentaram fraturas Pipkin 2 e todas foram fixadas, observados dois excelentes resultados e um regular. Dois pacientes Pipkin 3 foram submetidos à artroplastia primária. Dos dois pacientes com lesão Pipkin 4, um foi tratado com redução e osteossíntese da fratura do acetábulo, sem abordar o fragmento da cabeça que estava bem reduzido e resultou em artrose precoce, e o outro foi submetido à artroplastia total como tratamento primário. CONCLUSÃO: Concluímos após comparação da revisão da literatura com a análise dos nossos casos, que o tratamento da fratura da cabeça femoral deve ser cirúrgico e a escolha da via de acesso vai depender do tipo de fratura.OBJECTIVE: To establish guidelines for the treatment of femoral head fractures and to determine the best form of access in cases treated surgically. METHODS: We evaluated the clinical and radiological results of 13 patients (13 fractures treated surgically, between May 1986 and July 1996, at the Department of Orthopedics and Traumatology at the Santa Casa de Misericórdia de São Paulo (SCMSP, Fernandinho Simonsen Pavillion. RESULTS: Among six Pipkin 1 fractures, five had resection of the fragment, resulting in four excellent and one good result. The good result had fixation of the fragment. All three Pipkin 2 fractures had fixation of the fragment

Fratura toracolombar tipo explosão: comparação do tratamento conservador em pacientes com e sem fratura do arco vertebral posterior Thoracolumbar burst fracture: comparing conservative treatment in patients with and without fracture of the posterior vertebral arch

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Osmar Avanzi

2008-06-01

Full Text Available OBJETIVO: Comparar clínica e radiologicamente os resultados a longo prazo do tratamento conservador da fratura explosão toracolombar, em pacientes com e sem fratura do arco vertebral posterior, com o propósito de avaliar eventuais diferenças na evolução destes dois tipos de lesão. MÉTODOS: Foram avaliados, retrospectivamente, os prontuários e exames de imagem (radiografias e tomografias computadorizadas de 25 pacientes sem déficit neurológico, com fratura toracolombar tipo explosão tratados não cirurgicamente e comparados o grau de progressão da cifose entre os casos com fratura da lâmina (grupo 1 e sem fratura posterior (grupo 2. Desses, 13 pacientes foram submetidos à avaliação comparativa por meio da escala visual analógica de dor (VAS, da escala de dor e trabalho de Denis e do questionário de qualidade de vida SF-36. RESULTADOS: Foram analisados 25 pacientes (36% do grupo A e 74% do grupo B com tempo médio de seguimento de 111,64 meses. Não houve diferença em relação ao grau de progressão da cifose durante o seguimento entre os grupos A e B (5,22º x 4,63º - p = 0,650. Dos 13 pacientes analisados funcionalmente, 46% eram do grupo A e 54% do grupo B. Nesta avaliação, apesar da VAS pior (1,83 x 5,00 - p = 0,015 nos pacientes sem fratura posterior (grupo B, não houve diferença em relação à escala de Denis (4,00 x 5,71 - p > 0,05 e SF-36 (98,60 x 90,83 - p = 0,168 entre os dois grupos. CONCLUSÃO: A fratura do arco posterior, isoladamente, parece não ser indicativo de instabilidade ou de mau prognóstico nas fraturas toracolombares tipo explosão.OBJECTIVE: To make a clinical and radiological comparison of long term results of the conservative treatment of thoracolumbar burst fractures, in patients with and without fracture in the posterior vertebral arch, in order to assess possible differences in the evolution of the two types of lesion. METHODS: A retrospective analysis was made of the clinical records and

IMOBILIZAÇÃO DE FRATURAS DISTAIS DO ÚMERO EM CÃES ATRAVÉS DE TRANSFIXAÇÃO ÓSSEA

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Isabela Schmitt

1993-04-01

Full Text Available Fraturas distais do úmero, em cinco cães, foram imobilizadas através de transfixação esquelética com pinos de Steinmann estabilizados com barras de acrílico autopolimerizável, O artifício foi adaptado no sentido craneo-caudal com imobilização do cotovelo. Três dos cães apresentaram fratura unilateral, outro bilateral e o quinto unilateral com osteomielite. A metodologia adotada permitiu rápida recuperação dos pacientes sendo indicado como opção eficiente e de baixo custo.

Locating Mandibular Foramen in Children with Mandibular Retrognathism in Mixed Dentition

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Mehrsa Paryab

2015-06-01

Full Text Available Background and aims. One of the most common reasons forthe inferior alveolar nerve block anesthesia failure is the variation in mandibular foramen location. The aim of this study was to assess the location of mandibular foramen in chil-dren with mandibular retrognathism in comparison to children with normal skeletal occlusion in the mixed dentition. Materials and methods. One hundred and twenty panoramic radiographs of patients in mixed dentition period, undergo-ing orthodontic treatment, were selected based on inclusion criteria, skeletal occlusion and stage of dental development. The radiographs were divided into two groups: I: 60 panoramic radiographs of patients with normal skeletal occlusion (15 in each of the Hellman dental age stages; II: 60 panoramic radiographs of patients with mandibular retrognathism (15 in each of the Hellman dental age stages. The radiographs were traced and the linear distance from the mandibular foramen to the borders of the mandibular ramus and its angular position were identified. The measurements were compared between the two groups and among the four dental age groups by t-test, ANOVA and post hoc tests. Results. No statistically significant differences werefound between the patients with normal skeletal occlusion and patients with mandibular retrognathism (P>0.05. Statistical tests showed significant differences in the vertical location of mandibu-lar foramen and gonial angle between the four dental age groups (P<0.05. Conclusion. Mandibular retrognathism does not have a significant impact on the location of the mandibular foramen in the mixed dentition period. The child’s dental age would be considered in the localization of the mandibular foramen.

Redução fechada e fixação esquelética externa tipo I para tratamento de fraturas de tibiotarso em pombos domésticos (Columba livia

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Alievi M.M.

2002-01-01

Full Text Available Estudaram-se a redução fechada e a fixação esquelética externa tipo I para o tratamento de fraturas de tibiotarso em 10 pombos domésticos (Columba livia adultos. As aves foram anestesiadas com a associação de xilazina e cetamina e em seguida foi realizada fratura do tibiotarso direito por pressão digital sobre a diáfise do membro. Quatro pinos de Kirschner, dois proximais e dois distais à linha da fratura, foram inseridos percutaneamente através de ambas as corticais ósseas e, após redução fechada da fratura, conectados externamente por uma barra de acrílico autopolimerizável na face lateral do membro. Em três aves foi observado radiograficamente desvio ósseo angular, porém, a função do membro não foi afetada. O tempo médio e o desvio-padrão para a cicatrização óssea foram 23,4± 3,0 dias. Os resultados demonstram que a redução fechada e a aplicação de fixador esquelético externo tipo I é um método efetivo para o tratamento de fraturas de tibiotarso em pombos domésticos (Columba livia.

Resultados do tratamento das fraturas da diáfise do fêmur ipsilaterais às do colo ou transtrocantérica Outcomes in treatment of diaphiseal femur fractures ipsilateral to the neck or transtrocanteric fracture

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Nelson Astur Neto

2010-01-01

Full Text Available OBJETIVO: Avaliação radiográfica, funcional e das complicações do tratamento cirúrgico das fraturas diafisárias do fêmur associadas à fratura transtrocantérica ou do colo do mesmo fêmur. MÉTODOS: De 2002 a 2007 foram tratados 17 pacientes. Eram masculinos 88% e a idade média foi de 31 anos e três meses. Dez (59% apresentavam associação com fratura do colo do fêmur e sete (41% com a fratura transtrocantérica. Foram avaliados a dor residual e a amplitude de movimento articular do quadril e joelho, a consolidação radiográfica e o tipo de implante utilizado, pela avaliação atual e retrospectivamente pelo prontuário, com um seguimento médio de 48 meses. RESULTADOS: Todas as fraturas transtrocantéricas evoluíram para consolidação sem deformidade residual. Das fraturas do colo, três (30% apresentaram retardo da consolidação, e duas consolidaram em varo. Dois pacientes apresentaram retardo de consolidação da fratura diafisária. Todas as fraturas associadas trans-diáfise apresentaram resultado funcional excelente ou bom. Das associadas colo-diáfise, sete (70% apresentaram resultado funcional excelente ou bom, dois regular e um ruim. CONCLUSÃO: As fraturas associadas da diáfise do fêmur com fratura transtrocantérica apresentaram melhor resultado radiográfico e funcional com menos complicações que a associação da fratura diafisária com a fratura do colo do fêmurOBJECTIVE: To perform a radiographic and functional evaluation of the complications of diaphyseal fractures of the femur associated with ipsilateral fractures of the trochanter or the neck of the femur. METHODS: From 2002 to 2007, seventeen patients were treated, of which 88% were men, with a mean age of thirty-one years and three months. Ten (59% had associated fractures of the femoral neck and seven (41% had associated trochanteric fractures. The final range of motion of the hip and knee, the radiographic fracture consolidation, and the type of

Facial fractures: a 1-year retrospective study in a hospital in Belo Horizonte Fraturas de face: um estudo retrospectivo de 1 ano em um hospital de Belo Horizonte

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Bruno Ramos Chrcanovic

2004-12-01

Full Text Available A retrospective study was performed to assess facial fractures in patients treated at a public hospital in Belo Horizonte, in 2000. The data collected included age, gender, etiology, distribution of maxillofacial trauma considering day of the week and month, anatomic site of the fracture, and treatment. The analyses involved descriptive statistics and chi-squared test, Bonferroni test and analysis of variance. A total of 1,326 facial fractures were found in 911 patients. Most fractures occurred in adults with age ranging from 21 to 30 years. Men were more affected than women, with a male-female ratio of 4.69:1. Accidents causing facial fractures occurred predominantly on weekends. Bicycle and motorcycle accidents were the major cause of trauma, followed by interpersonal violence, automobile accidents, and falls. When the relation between the gender and the etiology of facial fractures was analyzed, a significant relation was noted between these variables (p Um estudo retrospectivo foi realizado para avaliar fraturas faciais em pacientes atendidos no ano de 2000 em um hospital público de Belo Horizonte. As informações coletadas incluíam idade, sexo, etiologia, distribuição do trauma de acordo com o dia da semana e o mês, o local anatômico da fratura e o tratamento. As análises envolveram estatísticas descritivas, teste qui-quadrado, teste Bonferroni e análise de variância. Foram encontradas 1.326 fraturas de face em 911 pacientes. A maioria das fraturas ocorreu em adultos na faixa etária de 21 a 30 anos. Os homens foram mais acometidos do que as mulheres, numa proporção homem:mulher de 4,69:1. Os traumas causadores de fraturas faciais ocorreram predominantemente nos fins de semana. Os acidentes de moto e bicicleta foram a maior causa de trauma, seguidos por violência interpessoal, acidentes automobilísticos e quedas. Quando analisada a relação entre o gênero e a etiologia das fraturas de face, observou-se uma associa

Radiologic study of mandibular foramen of mandibular prognathism by three-dimensional computed tomography

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Lee, Seung Hun; Moon, Cheol Hyun; Im, Jeong Soo; Seo, Hwa Jeong [Graduate School of Public Health and Social Welfare, Gachon University of Medicine and Science, Incheon (Korea, Republic of)

2010-06-15

This study is aimed to evaluate the position of mandibular foramen of mandibular prognathism patients using 3-dimensional CT images in order to reduce the chance of an anesthetic failure of the mandibular nerve and to prevent the damage to the inferior alveolar nerve during the orthognathic surgery. The control group consist of 30 patients with class I occlusion. The experimental group consist of 44 patients with class III malocclusion. Three-dimensional computed tomography was used to evaluate the position of the mandibular foramina. The distance between mandibular plane and mandibular foramen, class I was 25.385 mm, class III was 23.628 mm. About the distance between occlusal plane and mandibular foramen, class I was 1.478 mm, class III was 5.144 mm. The distance between posterior border plan of mandibular ramus and mandibular foramen had not statistically significant. About the distance between sagittal plane of mandible and mandibular foramen did not also showed statistically significant. The result of this study could help the clinicians to apprehend more accurate anatomical locations of the foramina on the mandible with various facial skeletal types. Thereby to perform more accurate block anesthesia of the mandibular nerve and osteotomy with minimal nerve damage. In addition, this study could provide fundamental data for any related researches about the location of the mandibular foramina for other purposes.

Radiologic study of mandibular foramen of mandibular prognathism by three-dimensional computed tomography

International Nuclear Information System (INIS)

Lee, Seung Hun; Moon, Cheol Hyun; Im, Jeong Soo; Seo, Hwa Jeong

2010-01-01

This study is aimed to evaluate the position of mandibular foramen of mandibular prognathism patients using 3-dimensional CT images in order to reduce the chance of an anesthetic failure of the mandibular nerve and to prevent the damage to the inferior alveolar nerve during the orthognathic surgery. The control group consist of 30 patients with class I occlusion. The experimental group consist of 44 patients with class III malocclusion. Three-dimensional computed tomography was used to evaluate the position of the mandibular foramina. The distance between mandibular plane and mandibular foramen, class I was 25.385 mm, class III was 23.628 mm. About the distance between occlusal plane and mandibular foramen, class I was 1.478 mm, class III was 5.144 mm. The distance between posterior border plan of mandibular ramus and mandibular foramen had not statistically significant. About the distance between sagittal plane of mandible and mandibular foramen did not also showed statistically significant. The result of this study could help the clinicians to apprehend more accurate anatomical locations of the foramina on the mandible with various facial skeletal types. Thereby to perform more accurate block anesthesia of the mandibular nerve and osteotomy with minimal nerve damage. In addition, this study could provide fundamental data for any related researches about the location of the mandibular foramina for other purposes.

Fatores predisponentes para infecção em pacientes portadores de fraturas expostas e criação de escore

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Lima, Lucynara Gomes

2013-01-01

Os principais objetivos do tratamento ortopédico das fraturas expostas são a prevenção de infecção, estabilização da lesão óssea e restauração da função do membro. A prevenção da infecção, entretanto, representa a principal medida para que os outros objetivos possam ser alcançados. Objetivo. Identificar os fatores de risco associados à infecção em pacientes acometidos por fraturas expostas, utilizando a força de associação destes fatores para propor um escore que possibilite a estratificação ...

Lifestyle changes after osteoporotic fractures in elderly women Mudanças dos hábitos de vida após fratura por osteoporose em mulheres idosas

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Marcelo Medeiros Pinheiro

2003-10-01

Full Text Available OBJECTIVE: health promotion and disease prevention activities directed to osteoporosis might help to reduce the rate of osteoporotic fractures among elderly people. METHODS: in order to check whether osteoporotic women modify their habits after the fracture, 518 postmenopausal white Brazilian elderly women were recruited from the outpatient clinic of the Rheumatology Division (122 of them with fracture and were followed for one year. Questionnaire of evaluation was based on the European Vertebral Osteoporosis Study (EVOS and inquiries about topics related to falls, bone mass and fracture. Lateral thoracic and lumbar radiographs were taken according to a standard protocol in order to verify vertebral fracture. Bone mineral density was measured using a bone densitometer (Lunar DPX, Madison, WI. Women's behavior was analyzed before and after the fracture. RESULTS: before the fracture, 34% of them had poor health perception, 40.2% walked at least half an hour per day, 14.7% used canes, 56.6% complained of dizziness, 59.6% scattered rugs, 78.9% used public transportation, 21.1% used car, and 36.8% wore leather instead of rubber sole. After the fracture, 66.4% of those women had worse health perception; 69.7% became more sedentary, 27.9% used more canes, 63.4% complained of more dizziness, 38.3% removed rugs, 68.1% changed from public to private car transportation, and 55.7% modified their shoes from leather to rubber sole. Risk factors related to bone mass did not change before and after the fractures. CONCLUSIONS: these findings suggested that women modify only lifestyle habits related to falls but not those related to bone mass after osteoporotic fracture. Further research is needed in order to check which intervention strategies may lead to better results in preventing osteoporotic fractures.OBJETIVO: atividades de promoção de saúde e prevenção direcionadas para osteoporose podem ajudar a reduzir a taxa de fraturas osteoporóticas na popula

Influence of root embedment material and periodontal ligament simulation on fracture resistance tests Influência do material de inclusão e da simulação do ligamento periodontal nos ensaios de resistência à fratura

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Carlos José Soares

2005-03-01

Full Text Available The aim of this study was to evaluate the influence of the embedment material and periodontal ligament simulation on fracture resistance of bovine teeth. Eighty bovine incisor teeth were randomized into 8 groups (n = 10, embedded in acrylic or polystyrene resin using 4 types of periodontal ligament simulation: 1 - absence of the ligament; 2 - polyether impression material; 3 - polysulfide impression material; 4 - polyurethane elastomeric material. The specimens were stored at 37°C and 100% humidity for 24 hours. Specimens were submitted to tangential load on the palatal surface at 0.5 mm/minute crosshead speed until fracture. The fracture modes were analyzed as follows: 1 - coronal fracture; 2 - cemento-enamel junction fracture; 3 - partial root fracture; 4 - total root fracture. Statistical analyses by two-way ANOVA and Tukey's test were applied (p O objetivo deste estudo foi avaliar a influência do material de inclusão e da simulação de ligamento periodontal na resistência à fratura de dentes bovinos. Oitenta incisivos bovinos foram divididos em 8 grupos (n = 10 e, então, incluídos em cilindros com dois materiais, resina acrílica ou resina de poliestireno, usando-se quatro tipos de simulação do ligamento periodontal: 1 - ausência do ligamento; 2 - material de moldagem à base de poliéter; 3 - material de moldagem à base de polissulfeto; e 4 - material elastomérico à base de poliuretano. As amostras foram armazenadas em 100% de umidade a 37°C por 24 horas e então submetidas a carregamento tangencial na superfície palatina com velocidade de 0,5 mm/minuto até a fratura. Os padrões de fratura foram analisados de acordo com: 1 - fraturas coronais; 2 - fratura da junção esmalte-cemento; 3 - fratura parcial da raiz; 4 - fratura radicular total. A análise estatística empregou análise de variância fatorial e teste de Tukey (p < 0,05. Os resultados mostram que o método de inclusão e a simulação do ligamento periodontal

Fratura extra-articular da extremidade medial da clavícula associada à luxação acromioclavicular tipo IV: relato de caso Extra-articular fracture of the medial end of the clavicle associated with type IV acromioclavicular dislocation: case report

OpenAIRE

Mário Chaves Correa; Lucas Braga Jacques Gonçalves; Jose Carlos Souza Vilela; Igor Lima Leonel; Lincoln Paiva Costa; Ronaldo Percopi de Andrade

2011-01-01

Ocorrendo isoladamente, as fraturas da clavícula e as luxações acromioclaviculares são lesões muito comuns. A combinação de uma luxação acromioclavicular e de uma fratura do terço lateral da clavícula não é rara. Entretanto, existem muito poucos casos descritos de luxações acromioclaviculares associadas a fraturas do terço médio da clavícula; aquelas associadas a fraturas do terço medial são ainda mais raras. Nós reportamos o caso de um indivíduo adulto do sexo masculino que sofreu uma luxaçã...

Avaliação epidemiológica das fraturas da coluna torácica e lombar dos pacientes atendidos no Serviço de Ortopedia e Traumatologia do Hospital Getúlio Vargas em Recife/PE

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Pereira,André Flávio Freire; Portela,Luiz Eduardo Duque; Lima,Guilherme Didier de Andrade; Carneiro,Wagner Cabral Gomes; Ferreira,Marcus André Costa; Rangel,Túlio Albuquerque de Moura; Santos,Ricardo Barreto Monteiro dos

2009-01-01

INTRODUÇÃO: as fraturas da coluna torácica e lombar estão se tornando mais frequentes, devido ao aumento dos acidentes de alta energia. Elas apresentam um elevado índice de morbidade e mortalidade, acarretando grandes prejuízos socioeconômicos. OBJETIVO: analisar a epidemiologia das fraturas torácicas e lombares de pacientes atendidas no Serviço de Ortopedia e Traumatologia do Hospital Getúlio Vargas em Recife (PE). MÉTODOS: este estudo é uma análise epidemiológica dos pacientes com fraturas ...

Resultados do tratamento de fraturas crônicas pela via anterior em pacientes com osteoporose Resultados del tratamiento de fracturas crónicas por la via anterior en pacientes con osteoporosis Results of treatment of chronic fractures by anterior approach in patients with osteoporosis

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Fabio Leme de Oliveira Pinto

2011-01-01

Full Text Available OBJETIVO: Analisar os resultados da cirurgia de corpectomia e artrodese por via anterior nos pacientes com fratura tipo explosão da coluna toracolombar e com osteoporose, que foram submetidos a tratamento conservador prévio por no mínimo sete meses, sem melhora importante do quadro doloroso. MÉTODOS: Foram tratadas seis pacientes idosas com fratura-explosão da coluna toracolombar em um único nível, depois de, no mínimo, sete meses do trauma, pela via anterior, com corpectomia, uso de enxerto autólogo de costela e fixação com parafusos pediculares nos níveis adjacentes. A dor foi avaliada pela EVA no pré-operatório, três semanas, três meses, seis meses e um anos após a cirurgia. RESULTADO: As pacientes apresentaram melhora significativa da dor pós-operatória, com diminuição substancial do uso de medicação analgésica. CONCLUSÕES: Os autores recomendam a via anterior isolada como método de tratamento para fraturas tipo explosão crônicas em pacientes com osteoporose pela baixa taxa de complicações e pelos resultados satisfatórios encontrados.OBJECTIVO: Analizar los resultados de la cirugía de corpectomía y artrodesis por la vía anterior, en pacientes con fracturas tipo explosión de la columna toracolumbar y, con osteoporosis, que habían sido sometidos a tratamiento conservador previo por lo menos durante siete meses, sin mejora importante del cuadro de dolor. MÉTODOS: fueron tratadas seis pacientes ancianas del sexo femenino con la fractura-explosión de la columna toracolumbar en solamente un nivel, después de, como mínimo, siete meses del traumatismo, a través de la vía anterior, con corpectomía, utilización del injerto autólogo de costilla y fijaci��n con tornillos pediculares en los niveles adyacentes. El dolor fue evaluado con EVA en pre-operatorio, tres semanas, tres meses, seis meses y un año después de la cirugía. RESULTADO: Las pacientes presentaron mejoría significativa del dolor

The effects of orthognathic surgery on mandibular movements in patients with mandibular prognathism

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Sinobad Vladimir

2012-01-01

Full Text Available Introduction. Mandibular prognathism, one of the most severe dentofacial deformities, affects the person’s appearance, psychological health and the quality of life in the most sensitive age period. Objective. The aim of this study was to evaluate the effects of sagittal split ramus osteotomy on the range of mandibular border movements in the early postoperative period. Methods. The study was conducted on 20 patients, of mean age 20.8 years, with mandibular prognathism. All patients included in this study were operated on by bilateral sagittal spliting ramus osteotomy according to Obwegeser and Dal Pont followed by mandibular immobilization during eight weeks. In all patients mandibular border movements were recorded before and six months after surgery using the computerized pantograph Arcus-Digma (KaVo EWL GmbH, Leutkirch, Germany. Results. The analysis of the chosen kinematic parameters revealed that sagittal split ramus osteotomy followed by eight weeks of mandibular immobilization had severe effects on the mouth opening. Six months after surgery the range of maximal mouth opening decreased for approximately 13.9 mm in relation to the preoperative stage. On the contrary, the ranges of maximal protrusion and the border of laterotrusive excursions increased significantly after surgery. Conclusion. In patients with mandibular prognathism where enormous mandibular growth was the main causal factor of the deformity, the sagittal split ramus osteotomy yielded good results. The rigid fixation of bone fragments and reduced period of mandibular immobilization followed by appropriate physical therapy could considerably contribute to a more rapid recovery of mandibular kinematics in the postoperative period.

Surgical management of axis' traumatic spondylolisthesis (Hangman's frature Tratamento cirúrgico para a espondilolistese traumática do áxis (fratura do enforcado

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José Luiz Romeo Boullosa

2004-09-01

ções de fixação com "halo vest" devido a traumatismo crânio-encefálico importante. MÉTODO: De junho de 1998 a abril de 2002, foram operados dez pacientes com espondilolistese traumática do áxis. Nove foram vítimas de acidentes automobilísticos e um sofreu queda de cavalo. Quatro pacientes tinham sido submetidos a tratamento clínico, e apresentavam sinais de pseudoartrose, com dor intensa à movimentação da coluna cervical. Dois apresentavam traumatismo crânio-encefálico moderado com múltiplas fraturas de crânio. Um foi submetido a tratamento cirúrgico de hematoma extradural agudo. Três apresentavam deslocamento importante de C2 sobre C3. Os pacientes foram submetidos a artrodese das fraturas com dois parafusos de rosca parcial colocados nos pedículos de C2, atravessando-se as fraturas, o que permitiu melhor aproximação das fraturas com alinhamento de C2-C3. Em dois pacientes foi necessária a fixação adicional com placa lateral fixa nas massas laterais de C3. RESULTADOS: Nove pacientes tiveram boa evolução pós-operatória com consolidação satisfatória das fraturas, e desaparecimento dos sintomas. Um paciente teve boa evolução com consolidação das fraturas, mas permanece com dores cervicais aos esforços. CONCLUSÃO: A fixação da espondilolistese traumática do áxis com o uso de parafusos de rosca parcial, nos pedículos de C2 e através dos traços de fratura é uma boa opção para o tratamento de pacientes que apresentarem pseudoartrose após tratamento clínico, ou apresentam contraindicações para o uso do "halo vest", como fraturas da calota craniana, ou grandes lacerações de couro cabeludo.

EFICIENCIA DEL TRATAMIENTO QUÍMICO EN LA PREVENCIÓN DEL TAPONAMIENTO DE GOTEROS APLICANDO AGUA RESIDUAL SANITARIA TRATADA

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RAFAEL OLIVEIRA BATISTA

2009-01-01

Full Text Available El objetivo de este trabajo fue el de verificar la eficiencia del tratamiento químico en la prevención del taponamiento de los sistemas de goteo, cuando se usa aguas residuales sanitarias tratadas. Para la realización del ensayo experimental fue construida una plataforma de ensayos con la finalidad de abastecer cuatro unidades de irrigación por goteo con aguas residuales sanitarias, tratada y filtradas mediante un filtro de disco de 120 mesh. Fueron ensayados tres modelos de goteros (M1, M2 y M3 durante un período de 560 horas. En el tratamiento químico fueron ensayadas las concentraciones de cloro residual libre de 0; 0,4; 1,0 y 1,9 mg L-1. A partir de los resultados obtenidos se tienen las siguientes conclusiones: el agua residual sanitaria, tratada por aplicación vía sistema de irrigación por goteo propicio la formación de un biofilme en los goteros, resultante de la interacción entre colonias de bacterias y algas. La aplicación de cloro en el agua residual sanitaria tratada, minimizó el desarrollo del biofilme en el interior de los goteros y de las líneas laterales de irrigación; además, se encontró que los goteros con mayor diámetro en el laberinto y con mas de un filtro secundario (M2 y M3, son mas susceptibles al taponamiento cuando trabajan con aguas residuales tratadas. La concentración de cloro residual libre de 0,4 mg L-1 fue mas sustentable en la prevención de taponamiento por biofilme en sistemas de riego por goteo que operan con agua residual domestica tratada.

Surgical Repair of an Olecranon Fracture in a Horse / Reparação Cirúrgica de Fratura de Olécrano em Eqüino

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Josmari Pirolo

2010-04-01

Full Text Available Olecranon fractures are frequently encountered in horses especially in foals. External trauma due to kicks or falls is the most common cause of the fracture. Treatment modalities of olecranon fractures including prolonged stall rest and surgical reconstruction of the different types of fractures have been proposed with different outcomes. This article describes a successful surgical reconstruction of an olecranon fracture in an adult horse repaired with a dynamic compression plate. The horse regained complete soundness and performed his job normally for additional 7 years. Information regarding the history, clinical signs, diagnosis, surgical treatment and long-term prognosis is discussed and compared with the current literature.As fraturas de olécrano ocorrem freqüentemente em eqüinos, especialmente em potros jovens. A causa mais comum da fratura relaciona-se ao trauma externo originado, principalmente, por coices ou quedas. Modalidades distintas de tratamento incluindo o repouso prolongado ou a reparação cirúrgica dos variados tipos de fratura têm sido executadas com diferentes resultados. Este trabalho tem por objetivo a descrição de um caso de fratura de olécrano em um eqüino adulto reparada cirurgicamente por meio de placa e parafusos ortopédicos. O animal apresentou recuperação plena da função locomotora desempenhando normalmente suas funções por mais 7 anos. Informações relativas ao histórico, sinais clínicos, diagnóstico, tratamento cirúrgico e prognóstico são discutidas e comparadas com a literatura.

Epidemiologia das fraturas de face em crianças num pronto-socorro de uma metrópole tropical Epidemiology of children's facial fractures in the emergency room of a tropical metropolis

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Daniel Falbo Martins de Souza

2010-01-01

Full Text Available OBJETIVO: Realizar um estudo epidemiológico das fraturas de face em crianças em um serviço de urgência. MÉTODOS: Estudo retrospectivo de quarenta e dois pacientes com idades variando entre zero a 17 anos, portadores de fraturas de face, tratados no Setor de Cirurgia Buco-Maxilo-Facial da Santa Casa de São Paulo, no período de janeiro de 2000 a dezembro de 2003. Os dados foram tabulados através das informações colhidas dos prontuários dos pacientes, tais como: idade, gênero, tipo de fratura, etiologia e sazonalidade. RESULTADOS: Entre os resultados encontrados, houve predominância do gênero masculino com 81% da casuística, a fratura de mandíbula foi a mais prevalente, com mais de 70% dos casos, os acidentes de trânsito e as quedas foram os agentes etiológicos que mais causaram fraturas. O verão foi a época do ano com mais casos de fratura e mais de 80% destas necessitaram de intervenção cirúrgica para o seu tratamento. CONCLUSÃO: É necessária uma política de prevenção com uma atenção especial aos acidentes de trânsito e às quedas, que foram os agentes etiológicos que mais causaram fraturas faciais.OBJECTIVE: To conduct an epidemiological study of facial fractures in children in an emergency room. METHODS: A retrospective study of forty-two patients, aged zero to 17 years, with facial fractures treated at the Department of Oral and Maxillofacial Surgery, Santa Casa de São Paulo, from January 2000 to December 2003. The data were tabulated from information retrieved from patient files, such as age, gender, type of fracture, etiology and season of occurrence. RESULTS: Among the results were a predominance of males, accounting for 81% of all cases; jaw fracture was the most prevalent, constituting more than 70% of cases; and traffic accidents and falls were the etiologic agents that caused the most fractures. Summer was the season with the greatest number of cases of fracture and more than 80% required surgical

Mandibular tori are associated with mechanical stress and mandibular shape.

Science.gov (United States)

Cortes, Arthur Rodriguez Gonzalez; Jin, Zhaoyu; Morrison, Matthew Daniel; Arita, Emiko Saito; Song, Jun; Tamimi, Faleh

2014-11-01

The influence of mechanical stimulation on the formation of torus mandibularis (TM) is still poorly understood. We sought to understand the etiology of TMs by investigating the role of parafunctional activity and mandibular morphology on the formation of TMs. We designed a case-control study for patients attending the dental clinic of the present study (University of São Paulo School of Dentistry, São Paulo, SP, Brazil). Patients presenting with TMs were defined as cases, and those without TMs were defined as controls. Finite element analysis (FEA) was used in 3-dimensional mandibular models to examine the stress distribution in the mandibles with and without TMs. In addition, the associations of mandibular arch shape, mandibular cortical index, and parafunctional activity with the presence of T were assessed using odds ratio analysis. A total of 10 patients with TMs and 37 without TMs were selected (22 men and 25 women, mean age 54.3 ± 8.4 years). FEA showed a stress concentration in the region in which TMs form during simulation of parafunctional activity. The radiographic assessment showed that those with TMs were more likely to have a square-shaped mandible with sharp angles (P = .001) and a normal mandibular cortex (P = .03). The subjects without TMs had a round-shaped mandible with obtuse angles and an eroded mandibular cortex. Parafunctional activity could be causing the formation of TMs by concentrating mechanical stress in the region in which TMs usually form. Thus, mandibular geometries that favor stress concentration, such as square-shaped mandibles, will be associated with a greater prevalence of TMs. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Fixação pedicular percutânea de fraturas vertebrais toracolombares sem compromisso neurológico

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Luís Miguel Pinheiro da Silva

2013-01-01

Full Text Available OBJETIVO: Avaliar a eficácia e a segurança da fixação pedicular percutânea em fraturas toraco-lombares, sem compromisso neurológico. MÉTODOS: Foram incluídos no estudo os pacientes com idade compreendida entre os 18 e 70 anos com fratura toracolombar AO tipo (A.3, cifose> 30º ou redução da altura do corpo vertebral> 50% ou compressão do canal vertebral >50% que foram submetidos a tratamento cirúrgico com fixação pedicular percutânea. Foram avaliados os parâmetros radiológicos: ângulo de Cobb, colapso vertebral, acunhamento anterior e compressão do canal vertebral no pré-operatório, pós-operatório e no fim do seguimento. O resultado funcional e clínico foi avaliado pelo Oswestry Disability Index (ODI. RESULTADOS: O tempo operatório médio foi de 81 minutos (Mín. 69, Máx. 95 min. O volume médio de perda sanguínea intraoperatória foi de 85 ml (Mín. 75 e Máx. 155 ml. O seguimento médio foi de sete meses (Min. três meses, Máx. 14 meses. Apresentaram um ODI médio final de 18% (excelente. CONCLUSÕES: Os resultados clínicos sugerem que a fixação pedicular percutânea pode ser uma técnica cirúrgica alternativa para o tratamento das fraturas toracolombares AO tipo (A.3, sem défices neurológicos. Esta técnica demonstrou ser eficaz e segura, apresentando as vantagens de uma abordagem minimamente invasiva.

Radiological study of the mandibular fractures

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Kim, Ju Won; Kim, Kyoung A; Koh, Kwang Jun [Department of Oral and Maxillofacial Radiology, School of Dentistry, and Institute of Oral Bio Science, Chonbuk National University, Jeonju (Korea, Republic of)

2009-06-15

To classify and evaluate mandibular fractures. The author classified mandibular fractures of 284 patients who were referred to the Chonbuk National University Dental Hospital during the period from March 2004 to June 2007. This study was based on the conventional radiographs as well as computed tomographs which were pertained to the 284 patients who have had the mandibular fractures including the facial bone fractures. And mandibular fractures were classified with respect to gender, age, site and type of the fractures. More frequently affected gender with mandibular fracture was male with the ratio of 3.3 : 1. The most frequently affected age with mandibular fracture was third decade (38%), followed by fourth decade (16%), second decade (15%), fifth decade (11%), sixth decade (7%), seventh decade (5%), eighth decade (4%), first decade (4%), and ninth decade (0.3%). The most frequent type of mandibular fracture was single fracture (58%), followed by double fracture (39%), triple fracture (3%). The most common site of mandibular fracture was mandibular condyle as 113 cases (27.7%) and the next was mandibular symphysis as 109 cases (26.7%), mandibular angle as 103 cases (25.3%), mandibular body as 83 cases (20.3%) in order. The sum of fracture sites were 408 sites and there were 1.4 fracture sites per one patient. The number of mandible fractures accompanied with facial bone fractures were 41 cases (14.4%). The results showed the most frequent type and common site of mandibular fracture was single fracture and mandibular condyle respectively.

Radiological study of the mandibular fractures

International Nuclear Information System (INIS)

Kim, Ju Won; Kim, Kyoung A; Koh, Kwang Jun

2009-01-01

To classify and evaluate mandibular fractures. The author classified mandibular fractures of 284 patients who were referred to the Chonbuk National University Dental Hospital during the period from March 2004 to June 2007. This study was based on the conventional radiographs as well as computed tomographs which were pertained to the 284 patients who have had the mandibular fractures including the facial bone fractures. And mandibular fractures were classified with respect to gender, age, site and type of the fractures. More frequently affected gender with mandibular fracture was male with the ratio of 3.3 : 1. The most frequently affected age with mandibular fracture was third decade (38%), followed by fourth decade (16%), second decade (15%), fifth decade (11%), sixth decade (7%), seventh decade (5%), eighth decade (4%), first decade (4%), and ninth decade (0.3%). The most frequent type of mandibular fracture was single fracture (58%), followed by double fracture (39%), triple fracture (3%). The most common site of mandibular fracture was mandibular condyle as 113 cases (27.7%) and the next was mandibular symphysis as 109 cases (26.7%), mandibular angle as 103 cases (25.3%), mandibular body as 83 cases (20.3%) in order. The sum of fracture sites were 408 sites and there were 1.4 fracture sites per one patient. The number of mandible fractures accompanied with facial bone fractures were 41 cases (14.4%). The results showed the most frequent type and common site of mandibular fracture was single fracture and mandibular condyle respectively.

Haste bloqueada "Faculdade de Medicina de Ribeirão Preto": experiência clínica no tratamento das fraturas femorais Ribeirão Preto school of medicine locking nail: clinical experience in the femoral fractures treatment

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Fernando Mendes Paschoal

2000-12-01

Full Text Available Uma série de 103 casos de fraturas diafisárias complexas do fêmur foram tratadas com a haste intramedular bloqueada FMRP, no período de maio de 1987 a dezembro 1995. Das 103 fraturas, 67 eram cominutivas, 12 bifocais (segmentar, 4 espirais, 13 proximais e 21 distais, instáveis, rotacionalmente, da diáfise femoral. Do total dos casos, constatou-se 97 bloqueios estáticos e 6 dinâmicos. Dessas 97 estáticas, 7 foram dinamizadas durante a evolução. Clínica e radiográficamente a consolidação ocorreu em 97,09% dos casos, com média de 16,72 semanas e em 3 casos não houve consolidação. Houve 4 casos de infecção suspeita e 3 estabelecidas que foram debeladas e evoluíram para consolidação. Houve 81 casos de encurtamentos que variaram entre 0,5 a 4 cm com média de 1 cm. O encurtamento menor ou igual a 2 cm ocorreu em 73 casos. Desvio de alinhamento em qualquer plano acima de 10 º e igual a 15º foi observado em 8 pacientes. Houve 10 casos de deformidades rotacionais, porém nenhum caso acima de 10º. A incidência de infecção foi baixa e a de consolidação alta. A estabilização dessas fraturas complexas permitiu imediata mobilização do paciente, reabilitação precoce do membro e diminuição da permanência hospitalar, excetuando os politraumatizados. A haste FMRP permitiu o tratamento dessas fraturas sem o uso de intensificador de imagens e de fresas flexíveis com baixo custo operacional. Os resultados foram semelhantes aos obtidos com as hastes intramedulares bloqueadas que necessitam de aparelhagem técnica mais sofisticada, porém com vantagens para o paciente e a equipe cirúrgica.A series of 103 cases of complex femoral fracture were treated with FMRP (Faculdade de Medicina de Ribeirão Preto nail. These fractures were treated from May 1987 until December 1995. From the 103 fractures, 67 were cominutive, 12 bifocal (segmental, 4 spiral, 13 proximal e 21 distal and unstable rotationaly. From the total of cases, 97

Utilização da distração osteogênica mediana sagital para tratamento da atresia mandibular Mid-sagital mandibular distraction osteogenesis for treatment of lower arch crowding

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Luiz Guilherme Martins Maia

2007-06-01

Full Text Available OBJETIVO: relatar o tratamento de uma paciente com apinhamento severo decorrente de uma atresia maxilomandibular, tratada por meio da Distração Osteogênica da Sínfise Mandibular (DOSM. RESULTADOS: neste caso, observamos bom engrenamento dentário, diminuição do corredor bucal escuro, correção do apinhamento, boa forma de arcos e boa estética facial, num período de tempo bastante satisfatório, sem trazer dano ao tecido periodontal adjacente. CONCLUSÃO: pacientes com arcos atrésicos e apinhamento dentário podem ser beneficiados com a DOSM que, quando bem indicada, surge como uma nova forma de tratamento para casos limítrofes de apinhamento dentário, nos quais as alternativas convencionais oferecem limitações, tais como o achatamento do perfil facial, o aumento do corredor bucal e a instabilidade.OBJECTIVE: To report the treatment of a patient with severe dental crowding resulting from a maxillary mandibular atresia, treated by the osteogenic extraction of the mandible symphysis (DOSM. RESULTS: In this case there was good dental engagement, a reduction of the dark oral aisle, a correction of the crowding, good dental arch form and good facial esthetics, in a very satisfactory period of time without causing damage to the adjacent periodontal tissues. CONCLUSION: Patients with atresia arches and dental crowding can be benefited by a DOSM that when well indicated, appears as a new form of treatment in cases of maximum borderline dental crowding, in which the conventional alternatives have limitations such as flattening of the facial profile, increase in the oral aisle and instability.

Evolution of Brazilian elderly with hip fracture secondary to a fall Evolução de idosos brasileiros com fratura de colo de femur secundária à queda

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Rosamaria Garcia

2006-01-01

Full Text Available OBJECTIVE: To contribute to fall prevention by studying the epidemiological profile, mortality, and functional evolution of elderly persons with hip fracture, in Brazil, in the year following a fracture. METHOD: Fifty-six elderly patients aged 60 years and over with hip fracture secondary to a fall and admitted in 2000 were included. In addition to the medical record data, patients or their guardians filled a form providing information regarding personal data, history of fall and fracture, physical evaluation, and ability to perform basic and instrumental activities of daily living prior to and 1 year after their fracture, using Katz's Index and Lawton's Index, respectively. RESULTS: Fractures were more common among Caucasian widowed women, and most falls occurred at home. General mortality within 1 year after the occurrence of fracture was 30.35% and was associated with sex and age. There was an increase in the inability to walk and in the use of a supporting device. A significant reduction in the functional ability to perform basic and instrumental activities of daily living was found. CONCLUSION: The evolution of hip fracture in the year following it is related to high mortality and to a decrease in functional ability, with age and male sex being the factors associated with a worse prognosis, emphasizing the need for special follow-up care of these groups during the immediate and late postoperative periods.OBJETIVO: Estudar o perfil epidemiológico, mortalidade e a evolução funcional, no primeiro ano após a fratura, de idosos com fratura de quadril visando a contribuir para a prevenção de quedas. CASUÍSTICA E MÉTODO: Foram estudados 56 pacientes idosos, com 60 anos ou mais, com fratura de quadril decorrente de queda, internados em 2000. Alem dos dados de prontuário, os pacientes ou responsáveis responderam a um questionário, fornecendo informações sobre os dados pessoais, história da queda e da fratura, avaliação física e da

Técnica de Doyle na correção de fratura completa em úmero de tucano (Ramphastos toco: relato de caso

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D.B.C. Lima

2014-12-01

Full Text Available O objetivo deste trabalho foi relatar a realização de osteossíntese no úmero esquerdo de uma ave silvestre utilizando-se a técnica de Doyle. Um tucano (Ramphastos toco sofreu uma fratura transversa completa no terço proximal do úmero esquerdo. Após avaliação clínica e procedimentos pré-operatórios, a ave foi submetida à osteossíntese. A técnica cirúrgica utilizada permitiu uma perfeita coaptação dos fragmentos ósseos, ocasionando a formação de calo ósseo e recuperação do membro afetado em um período curto de tempo, apresentando-se como opção eficaz na correção de fraturas do úmero em aves de médio porte.

Roentgenographic study of the mandibular canal

International Nuclear Information System (INIS)

Ahn, Hyung Kyu

1980-01-01

The mandibular canal must be considered carefully during the surgical treatment, especially surgical extraction of the impacted tooth and intraosseous implant, because it contains the important inferior alveolar nerve and vessels. The author investigated the curvature of the mandibular canal and its relation to the mandibular molars and positional relation between the mental foramen and the mandibular premolars in orthopantomogram. The materials consisted of 441 orthopantomograms divided four groups; Group I consisted of 56 males and 44 females from 1 to 6 years of age, Group II consisted of 58 males and 45 females from 7 to 12 years of age, Group III consisted of 65 males and 33 females from 13 to 18 years of age, Group IV consisted of 86 males and 54 females over 19 years of age. The results were as followings; 1. The curvature of mandibular canal was 144.50 .deg. in Group II, 148.11 .deg. in Group III, 147.33 .deg. in Group IV. 2. The curvature of mandibular canal was located most frequently on the area between mandibular 1st molar and mandibular 2nd molar in Group I (42%) and on the mandibular 2nd molar area in Group II (54%), Group III (59%), Group IV (53%). 3. The position of mental foramen was most frequently below the mandibular 1st premolar in Group I (58%), between the mandibular 1st premolar and the 2nd premolar in Group II (62%), Group III (47%), and below the mandibular 2nd premolar in Group IV (58%).

Estudo observacional comparativo de fraturas em crianças e adolescentes Epidemiologic comparative study of fractures in children and adolescents

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Roberto Guarniero

2011-01-01

Full Text Available Objetivos: 1 Analisar comparativamente a incidência de fraturas na criança e no adolescente em três centros universitários de atendimento. 2 Estudar o acometimento segundo a faixa etária, o sexo, o tipo de acidente, a localização anatômica, a localização no osso, o tipo de fratura, a associação com outras lesões e o tratamento. 3 Em relação ao tipo de fratura e seu tratamento, avaliar se os programas de ensino e treinamento desenvolvidos atualmente, tanto na graduação como na pós-graduação Lato sensu (residência médica e especialização estão condizentes com as necessidades do médico para o atendimento diário nos diferentes serviços de emergência de nosso País. Métodos: Estudo prospectivo transversal e observacional. Estudados os prontuários de 543 pacientes, no grupo etário de um dia de vida a 19 anos, atendidos em um período de três meses em três hospitais universitários, com uma ficha especialmente idealizada para determinar as características gerais das fraturas nesta série de pacientes. Resultados: Observamos a incidência de 531 fraturas (isoladas e 12 luxações nos 543 pacientes, sendo, em relação ao sexo, 394 meninos (72,5% e 149 meninas (27,4%. Segundo a etiologia dos traumatismos, o episódio “queda da própria altura” foi o que apresentou a maior incidência, seguido pela “queda de altura”, caracterizando um traumatismo mais grave. Observamos o maior acometimento dos membros superiores em relação aos membros inferiores, sendo 404 fraturas nos superiores (com 11 luxações, representando 76,08% das fraturas e 127 nos inferiores, que representam 23,91%. Conclusões: 1 Em função da casuística estudada, podemos concluir que campanhas educativas devem ser realizadas com conteúdo que enfatize as causas e a prevenção da “queda da própria altura”. 2 Os programas de treinamento do especialista devem enfatizar a maior ocorrência dos traumatismos e lesões dos membros superiores, bem

Complaints related to mandibular function impairment after closed treatment of fractures of the mandibular condyle

NARCIS (Netherlands)

Niezen, E. T.; Bos, R. R. M.; de Bont, L. G. M.; Stegenga, B.; Dijkstra, P. U.

This study analysed the relationship between complaints and mandibular function after closed treatment of fractures of the mandibular condyle in a prospective study. In a I-year follow-up, complaints were assessed during physical examination and function was assessed using the mandibular function

[Mandibular-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia with rapid prototyping technology].

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Gao, Quan-Wen; Song, Hui-Feng; Xu, Ming-Huo; Liu, Chun-Ming; Chai, Jia-Ke

2013-11-01

To explore the clinical application of mandibular-driven simultaneous maxillo-mandihular distraction to correct hemifacial microsomia with rapid prototyping technology. The patient' s skull resin model was manufactured with rapid prototyping technology. The osteotomy was designed on skull resin model. According to the preoperative design, the patients underwent Le Fort I osteotomy and mandibular ramus osteotomy. The internal mandible distractor was embedded onto the osteotomy position. The occlusal titanium pin was implanted. Distraction were carried out by mandibular-driven simultaneous maxillo-mandihular distraction 5 days after operation. The distraction in five patients was complete as designed. No infection and dysosteogenesis happened. The longest distance of distraction was 28 mm, and the shortest distance was 16 mm. The facial asymmetry deformity was significantly improved at the end of distraction. The ocelusal plane of patients obviously improved. Rapid prototyping technology is helpful to design precisely osteotomy before operation. Mandibular-driven simultaneous maxillo-mandibular distraction can correct hemifacial microsomia. It is worth to clinical application.

Radiological classification of mandibular fractures

International Nuclear Information System (INIS)

Mihailova, H.

2009-01-01

Mandibular fractures present the biggest part (up to 97%) of the facial bone fractures. Method of choice for diagnosing of mandibular fractures is conventional radiography. The aim of the issue is to present an unified radiological classification of mandibular fractures for the clinical practice. This classification includes only those clinical symptoms of mandibular fracture which could be radiologically objectified: exact anatomical localization (F1-F6), teeth in fracture line (Ta,Tb), grade of dislocation (D I, D II), occlusal disturbances (O(+), O(-)). Radiological symptoms expressed by letter and number symbols are systematized in a formula - FTDO of mandibular fractures similar to TNM formula for tumours. FTDO formula expresses radiological diagnose of each mandibular fracture but it doesn't include neither the site (left or right) of the fracture, nor the kind and number of fractures. In order to express topography and number of fractures the radiological formula is transformed into a decimal fraction. The symbols (FTD) of right mandible fracture are written in the numerator and those of the left site - in the denominator. For double and multiple fractures between the symbols for each fracture we put '+'. Symbols for occlusal disturbances are put down opposite, the fractional line. So topographo-anatomical formula (FTD/FTD)xO is formed. In this way the whole radiological information for unilateral, bilateral, single or multiple fractures of the mandible is expressed. The information in the radiological topography anatomic formula, resp. from the unified topography-anatomic classification ensures a quick and exact X-ray diagnose of mandibular fracture. In this way contributes to get better, make easier and faster X-ray diagnostic process concerning mandibular fractures. And all these is a precondition for prevention of retardation of the diagnosis mandibular fracture. (author)

Composição corporal de pacientes acamados por fraturas do quadril Body composition in bed-ridden adult patients by hip fracture

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Francisco José Berral

2008-01-01

Full Text Available As fraturas do quadril são a maior causa de hospitalização da terceira idade, e constituem um considerável encargo econômico e social. A taxa de mortalidade atual após um ano de fratura é acima de 33%, e o risco de morte é maior do quarto ao sexto mês após a fratura. O objetivo deste estudo foi de avaliar alterações na composição corporal de pacientes idosos, durante sua hospitalização por fraturas fêmur proximal, através de métodos antropométricos e análise dos valores fisiológicos de gasto energético. Foi realizado um estudo prospectivo utilizando-se 45 pacientes consecutivos com diagnóstico de fratura do quadril. Em todos os casos, foram obtidas medidas diretas e avaliações antropométricas indiretas baseadas em estimativas, nas primeiras 24 horas e repetidas após uma semana de admissão hospitalar. Após uma semana de internação houve diminuição da média do perímetro do braço (0,73 cm, p=0.0052 e da espessura da prega tricipital (1.41 mm, p=0.0181, sem haver modificação das outras variáveis estudadas. A avaliação antropométrica como um meio de se fazer um mapa da composição corporal, em conjunto com as estimativas indiretas sugeridas neste estudo, podem ajudar a determinar o estado nutricional e necessidades calóricas de pacientes idosos.Hip fractures are a major cause of hospitalization among the elderly, and constitute a considerable social and economic burden. The current mortality rate one year after hip fracture is over 33%, the risk of death is greatest 4 to 6 months after fracture. The objective of this study was to use anthropometric methods and physiological energy-expenditure values to assess changes in body composition during hospitalization, in elderly patients admitted for fractures of the proximal femur. A prospective study was performed using a consecutive sequence of 45 patients with diagnosed hip fracture. In all cases, direct measurements and indirect estimate-based anthropometric

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

Science.gov (United States)

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.

Observation of positional relation between mandibular third molars and the mandibular canal on limited cone beam computed tomography

International Nuclear Information System (INIS)

Hashizume, Atsuko; Nakagawa, Yoichi; Ishii, Hisako; Kobayashi, Kaoru

2004-01-01

We describe the preoperative use of limited cone beam computed tomography (CT) with a dental CT scanner for the assessment of mandibular third molars before extraction. Cone beam CT provides 42.7-mm-high and 30-mm-wide rectangular solid images, with a resolution of less than 0.2 mm. The positional relationship between the mandibular third molars and the mandibular canal was examined by dental CT. Sixty-eight lower third molars of 62 patients whose teeth were superimposed on the mandibular canal on periapical or panoramic radiographs were studied. Dental CT scans clearly demonstrated the positional relationship between the mandibular canal and the teeth. The mandibular canal was located buccally to the roots of 16 teeth, lingually to the roots of 27 teeth, inferiorly to the roots of 23 teeth, and between the roots of 2 teeth. The presence of bone between the mandibular canal and the teeth was not noted in 7 of 16 buccal cases, 24 of 27 lingual cases, and 10 of 23 inferior cases on dental CT scans, suggesting that the canal was in contact with the teeth. Fifty-nine of the 68 mandibular third molars were surgically removed, and postoperative transient hypoesthesia occurred in 4 patients. Dental CT scans showed no bone between the mandibular canal and the teeth in all 4 patients. Hypoesthesia was not related to the bucco-lingual location of the mandibular canal or to the extent of bone loss between the canal and the teeth. However, hypoesthesia did not occur in patients with bone between the mandibular canal and the teeth. Thus, information on the distance between the canal and teeth on dental CT scans was useful for predicting the risk of inferior alveolar nerve damage. Because of its high resolution and low radiation dose, cone beam CT was useful for examination before mandibular third molar surgery. (author)

Overview of Mandibular Condyle Fracture

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Su-Seong Park

2012-07-01

Full Text Available The mandibular condyle is a region that plays a key role in the opening and closing ofthe mouth, and because fracture causes functional and aesthetic problems such as facialasymmetry, it is very important to perform accurate reduction. Traditionally, there has beendisagreement on how to manage fracture of the mandibular condyle. This review exploresthe misunderstanding of mandibular condyle fracture treatment and modern-day treatmentstrategies.

Fixação externa em fratura completa de metacarpo em potros External fixation in complete metacarpal fracture in foals

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Marcelo Jorge Cavalcanti de Sá

1997-08-01

Full Text Available A regeneração de fraturas nos membros de eqüinos é complexa pelas características da espécie. Baseado em estudo biomecânico prévio, dez potros com fratura iatrogênica experimental do metacarpo tiveram redução pelo método de transfixação óssea. Cada animal foi avaliado mediante exames clínico, laboratorial e radiográfico até a recuperação. As complicações não foram significativas, exceto em um potro que requereu eutanásia. O método mostrou-se adequado e oferece estabilidade suficiente para cicatrização.The fracture healing in equine legs is a complex process due to species characteristics. Based in previous biomechanical study ten horses had iatrogenic metacarpal fractures reduced by external bone fixation. Each animal was evaluated by clinical, laboratorial and radiografic examination till complete recovery. No significant complication were observed, except one animal which was submitted to euthanasia. The method offers appropriate stability for bone healing.

Overview of Mandibular Condyle Fracture

OpenAIRE

Park, Su-Seong; Lee, Keun-Cheol; Kim, Seok-Kwun

2012-01-01

The mandibular condyle is a region that plays a key role in the opening and closing of the mouth, and because fracture causes functional and aesthetic problems such as facial asymmetry, it is very important to perform accurate reduction. Traditionally, there has been disagreement on how to manage fracture of the mandibular condyle. This review explores the misunderstanding of mandibular condyle fracture treatment and modern-day treatment strategies.

Overview of Mandibular Condyle Fracture

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Su-Seong Park

2012-07-01

Full Text Available The mandibular condyle is a region that plays a key role in the opening and closing of the mouth, and because fracture causes functional and aesthetic problems such as facial asymmetry, it is very important to perform accurate reduction. Traditionally, there has been disagreement on how to manage fracture of the mandibular condyle. This review explores the misunderstanding of mandibular condyle fracture treatment and modern-day treatment strategies.

Relationship between fracture of mandibular condyle and absence of unerupted mandibular third molar-a retrospective study.

Science.gov (United States)

Rajan, Ritesh; Verma, Dinesh Kumar; Borle, R M; Yadav, Abhilasha

2016-06-01

The purpose of the present study was to find, if there exists, a co-relation between presence of unerupted mandibular third molar and fracture of mandibular condyle. A retrospective, multicenter study was done collecting the data of all mandibular condyle fractures treated from November 2006 till August 2015. Data was collected from the patient's records and radiographs for the following information: age, sex, etiology of fracture, presence and state of lower third molars, and associated fracture. The results were subjected to statistical analysis. Out of 180 patients of condylar fracture, unerupted third molars were present in 35 (19.44 %) cases compared to 145 (80.55 %) cases of condylar fracture where the unerupted third molars were not present. The difference was statistically significant (p fracture was seen in 4 (11.4 %) cases, bilateral condylar fracture associated with other mandibular fractures in 9 (25.7 %) cases, isolated unilateral condylar fracture in 0 (0.0 %) cases, and unilateral condylar fracture associated with other mandibular fractures in 17 (48.5 %) cases and condylar fracture associated with mid face fractures in 5 (14.2 %) cases. In the unerupted third molar absent group, isolated bilateral condylar fracture was seen in 5 (3.4 %) cases, bilateral condylar fracture associated with other mandibular fractures in 30 (20.6 %) cases, isolated unilateral condylar fracture in 24 (16.5 %) cases, unilateral condylar fracture associated with other mandibular fractures in 73 (50.34 %) cases, and condylar fracture associated with mid face fractures in 13(8.96 %) cases. The difference between the groups was statistically significant (p = 0.032). This study suggests that the fractures of mandibular condylar region have a significantly higher incidence in patients without an unerupted mandibular third molar.

Análise de fraturas diafisárias do fêmur em crianças menores de 3 anos de idade Femoral shaft fractures: an assessment in children younger than 3 years old

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João Paulo Machado Bergamaschi

2007-01-01

Full Text Available Este estudo consiste na reavaliação ortopédica e psicossocial de crianças que sofreram fratura do fêmur até a idade dos três anos e objetiva a análise de suas causas prováveis e detecção de indícios de ocorrência de Síndrome de Maus Tratos. Trinta e cinco crianças menores de três anos de idade sofreram fratura diafisária de fêmur e foram atendidas no Pronto Socorro do Serviço de Ortopedia e Traumatologia da Santa Casa de São Paulo, no período de janeiro de 1996 a agosto de 2002, sendo que 18 compareceram para reavaliação. Como causa relatada das fraturas observamos: queda em 13 (72,2% casos, queda de objetos sobre o membro em três (16,7% e fratura no parto em dois (11,1%. Constatamos suspeita de Síndrome dos Maus Tratos em nove (maus tratos físicos em seis [33,3%] e negligência em três [16,7%] casos, fratura patológica em quatro (22,2%, causa acidental em três (16,7%, e outras causas em dois (11,1% casos. Maus tratos constituem uma importante causa a ser investigada nos casos de fratura do fêmur em crianças com menos de três anos de idade, sendo o provável mecanismo responsável por metade das fraturas aqui estudadas.This study consists of an orthopaedic and psychosocial re-evaluation of children who experienced femur fractures as young as 3 years old and aims to analyze potential causes and detect Child Abuse rates. Thirty-five children under the age of three years who experienced femoral shaft fractures received care at the Emergency Department of the Orthopaedics and Traumatology Service of Santa Casa de São Paulo within the period ranging from January, 1996 to August, 2002. Eighteen patients returned to the hospital for re-evaluation. The reported causes for fractures were: fall in 13 cases (72.2%, object fall on the limb in 2 cases (11.1%. Child abuse was suspected in 9 cases (physical abuse in 6 cases (33.3%, negligence in 3 cases (16.7%, pathological fracture in 4 cases (22.2%, accidental causes in 3

Fratura supracondiliana do fêmur durante salto após reconstrução artroscópica do ligamento cruzado anterior Supracondylar emur fracture during jump after anterior cruciate ligament arthroscopic reconstruction

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Thiago Yukio Fukuda

2009-04-01

Full Text Available CONTEXTUALIZAÇÃO: A fratura distal do fêmur é uma das possíveis complicações no período pós-operatório de reconstrução de LCA, porém, de incidência rara. RELATO DE CASO: Descreve-se o caso de um atleta de 34 anos, gênero masculino, no quinto mês de pós-operatório de reconstrução de LCA. O caso evoluía normalmente de acordo com o protocolo estabelecido; o paciente apresentava bom controle e estabilidade sensoriomotora, quando sofreu fratura supracondiliana do fêmur ao realizar um salto durante atendimento fisioterápico. A reconstrução ligamentar foi realizada com enxerto dos músculos flexores do joelho e a fratura, ocasionada posteriormente, reduzida e fixada com placa e parafuso. Dez meses após a redução aberta e fixação interna da fratura, apresenta função regular na escala Lysholm, amplitude de movimento normal e força muscular grau V em flexores e extensores da coxa. DISCUSSÃO: Poucos relatos de caso semelhantes ao presente foram encontrados na literatura; a maioria apresentou fratura do fêmur após a reconstrução do LCA com tendão patelar. Este caso mostra-se relevante pela associação da fratura supracondiliana do fêmur com reconstrução ligamentar com tendões dos flexores, visto que apenas um trabalho seguiu tal direção. Dentre as prováveis causas dessa fratura, destacam-se uma fragilidade óssea por desuso e túnel ósseo femoral de diâmetro maior que o padrão, apesar de não haver consenso em relação a essas alterações. Uma hipótese sugerida pelos autores deste relato é de que o túnel ósseo de fixação do enxerto pode ter sido um intensificador de estresse sobre o local da fratura.BACKGROUND: Distal femoral fracture is one of the possible complications on the post operative period of the ACL reconstruction; however, with rare incidence. CASE REPORT: This study reports a male 34 year-old athlete, five months after ACL reconstruction surgery. The case developed normally in accordance

Novo Parafuso (Acutrak® No tratamento cirúrgico de jogadores de futebol de elite com fraturas do quinto metatarso New screw (Acutrak® in the surgical treatment of elite football players with fifth metatarsal

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Hayati Ozturk

2009-01-01

Full Text Available OBJETIVO: Há uma variabilidade considerável na literatura no que tange ao tratamento ideal de fraturas do quinto metatarso. O objetivo deste estudo é apresentar os resultados da fixação cirúrgica de fraturas do quinto metatarso usando o parafuso Acutrak® em jogadores de futebol de elite. MATERIAL E MÉTODOS: Três casos de fratura do quinto metatarso em jogadores de futebol de elite são apresentados. A média de idade dos pacientes era de 24 anos (18-26 anos. Tratamos as três fraturas do quinto metatarso em jogadores de futebol de elite. Os casos em nosso estudo consistiam de uma fratura diafisiária do quinto metatarso e duas fraturas de Jones. As fraturas ocorreram durante a participação nos jogos. Aplicamos fixação interna utilizando um parafuso Acutrak® percutâneo sob anestesia local com o auxílio de um fluoroscópio. Os pacientes foram clinica e radiograficamente avaliados. RESULTADOS: O restabelecimento clínico foi obtido em 10 semanas após a cirurgia. A consolidação radiográfica ocorreu em 8 semanas de pós-operatório, sendo que os pacientes retornaram a seus níveis prévios de atividade em 11 semanas de pós-operatório. Não foi relatada nenhuma complicação pósoperatória. Não se observou nenhuma irritação de pele devido à ausência de cabeça do parafuso Acutrak®. CONCLUSÃO: Os resultados sugerem que Acutrak® pode ser usado em jogadores de futebol com fraturas do quinto metatarso. Apesar de fatores como facilidade de implante, o custo e a resistência a inclinação também devem ser considerados.OBJECTIVE: There is considerable variability in the literature concerning the optimal treatment of fifth metatarsal fracture. The purpose of this study is to report the outcome of surgical fixation of fifth metatarsal fractures using Acutrak® screw in elite football players. MATERIAL AND METHOD: Three cases of fifth metatarsal fracture in elite football players. The mean age was 24 years old (18-26 years. We

GESSO SINTÉTICO E PINOS TRANSCORTICAIS NA REDUÇÃO DE FRATURA DE TÍBIA EM UMA BEZERRA FIBERGLASS CAST AND TRANSCORTICAL PINS IN TIBIAL FRACTURE REDUCTION IN A CALF

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Edivaldo Aparecido Nunes Martins

2001-02-01

Full Text Available Relata-se um caso de fratura de tíbia em uma bezerra de sete meses de idade, 200kg de peso, apresentando fratura fechada, cominutiva em diáfise. A fixação externa foi preferida como método de imobilização óssea, utilizando-se pinos transcorticais e gesso sintético. Obteve-se eficiente imobilização da fratura, com rápida recuperação do animal, dispendendo-se pouco tempo para o pós-operatório (52 dias. A técnica demonstrou ser de fácil realização e passível de ser executada a campo.A case of tibial fracture in a 7-month-old calf is reported, with closed comminuted diaphysial fracture. It has been given preference to external fixation as means of fracture immobilization, and transcortical pins and fiberglass cast have been used. Effective immobilization of the fracture and fast recovering of the animal as well as less time consuming toward the postoperative have been obtained. This technique has showed feasible to be done in the field.

The role of simultaneous gap arthroplasty and distraction osteogenesis in the management of temporo-mandibular joint ankylosis with mandibular deformity in children.

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Rao, Krishna; Kumar, Sudhir; Kumar, Vijay; Singh, Arun Kumar; Bhatnagar, Sudhir Kumar

2004-02-01

Temporo-mandibular joint ankylosis is a common cause of acquired deformity in children. Surgical correction of the ankylosis only leaves the patient with an uncorrected mandibular deformity. This study was to evaluate the use of distraction osteogenesis for simultaneous correction of the mandibular deformity. This study was done on six children with temporo-mandibular joint ankylosis and mandibular deformity. Uniaxial double pin distractors with Schanz pins were used in this study. The patients underwent simultaneous gap arthroplasty and mandibular osteotomy (retromolar) with distractor insertion. Distraction was started on the fifth post-operative day. The patients were put on dynamic temporo-mandibular joint exercises on the first post-operative day. All patients had a satisfactory mouth opening on follow-up. Satisfactory cosmetic correction of the mandibular deformity was also achieved in all these patients. Some degree of malocclusion resulted from treatment due to which the patients were placed on orthodontic treatment. Distraction osteogenesis can be used simultaneously with gap arthroplasty in patients with temporo-mandibular ankylosis, for the correction of the mandibular deformity.

Miniplate 1.5 fixation for the repair of mandibular osteotomies in cats Fixação interna de osteotomias mandibulares com miniplacas 1.5 em gatos

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Adelina Maria da Silva

2011-02-01

Full Text Available Purpose: To evaluate the application of the maxillofacial miniplate 1.5 in the repair of unilateral mandibular osteotomies in cats. Methods: Twelve adult cats were divided into two groups. In group 1 (n=6, the osteotomy was performed in the body of the mandible, behind the 1st molar. In group 2 (n=6, the osteotomy was performed between the 4th premolar and 1st molar. The osteotomy was fixed with a titanium miniplate 1.5. Oral alimentation was reinitiated 24 hours after surgery. Cats were euthanized at 12 weeks postoperative. Results: Radiographs taken 1 week after surgery showed a radiolucent line. The osteotomy line was not more visible on the radiographs taken at 12 weeks postoperative. Macroscopic examination confirmed alignment and bone union of operated hemimandibles. Histological examination showed formation of woven bone within the osteotomy line. The percentage of bone tissue at these areas was measured by the histometry. There was no statistically significant difference between the values of group 1(75.07 ± 5.99 and group 2 (74.76 ± 8.54 (Mann-Whitney's test p= 0.469. Conclusion: We concluded that the use of miniplate 1.5 for the fixation of mandibular osteotomy in cats provided the main goals in the treatment of mandibular fractures: bone union, normal dental occlusion and immediate return to oral alimentation.Objetivo: Avaliar a fixação de osteotomias mandibulares unilaterais com miniplacas 1.5 em gatos. Métodos: Foram utilizados 12 gatos adultos divididos em dois grupos de seis animais cada. No grupo 1, a osteotomia foi realizada caudalmente ao 1º molar e no grupo 2, entre o 4º pré-molar e 1º molar. A osteotomia foi fixada com uma miniplaca 1.5 de titânio. A alimentação oral foi reiniciada 24 horas após a cirurgia. Os animais foram submetidos a eutanásia 12 semanas após a cirurgia. Resultados: A osteotomia pode ser notada como uma linha de radiolucência nas radiografias realizadas uma semana após a cirurgia. Essa

Thin-plate spline analysis of mandibular growth.

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Franchi, L; Baccetti, T; McNamara, J A

2001-04-01

The analysis of mandibular growth changes around the pubertal spurt in humans has several important implications for the diagnosis and orthopedic correction of skeletal disharmonies. The purpose of this study was to evaluate mandibular shape and size growth changes around the pubertal spurt in a longitudinal sample of subjects with normal occlusion by means of an appropriate morphometric technique (thin-plate spline analysis). Ten mandibular landmarks were identified on lateral cephalograms of 29 subjects at 6 different developmental phases. The 6 phases corresponded to 6 different maturational stages in cervical vertebrae during accelerative and decelerative phases of the pubertal growth curve of the mandible. Differences in shape between average mandibular configurations at the 6 developmental stages were visualized by means of thin-plate spline analysis and subjected to permutation test. Centroid size was used as the measure of the geometric size of each mandibular specimen. Differences in size at the 6 developmental phases were tested statistically. The results of graphical analysis indicated a statistically significant change in mandibular shape only for the growth interval from stage 3 to stage 4 in cervical vertebral maturation. Significant increases in centroid size were found at all developmental phases, with evidence of a prepubertal minimum and of a pubertal maximum. The existence of a pubertal peak in human mandibular growth, therefore, is confirmed by thin-plate spline analysis. Significant morphological changes in the mandible during the growth interval from stage 3 to stage 4 in cervical vertebral maturation may be described as an upward-forward direction of condylar growth determining an overall "shrinkage" of the mandibular configuration along the measurement of total mandibular length. This biological mechanism is particularly efficient in compensating for major increments in mandibular size at the adolescent spurt.

Exposição humana a trialometanos presentes em água tratada

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Maria Y Tominaga

1999-08-01

Full Text Available Realizou-se uma revisão bibliográfica do período de 1974-1998, no MEDLINE, sobre compostos orgânicos halogenados derivados de hidrocarbonetos denominados de trialometanos. Muitos deles, reconhecidamente carcinogênicos para diferentes espécies animais, podem ser encontrados freqüentemente, inclusive entre nós, em águas tratadas e enviadas à população urbana. É o caso de compostos como o clorofórmio, bromodiclorometano, clorodibromometano e bromofórmio, resultantes da halogenação de precursores, principalmente substâncias húmicas e fúlvicas presentes na água que será tratada (clorada. Assim, descreve-se sua formação, fontes de exposição humana bem como os aspectos toxicológicos de maior importância: disposição cinética e espectro dos efeitos tóxicos (carcinogênicos, mutagênicos e teratogênicos decorrentes de exposições a longo prazo e baixas concentrações. Níveis seguros de exposição propostos são também fornecidos.

Exposição humana a trialometanos presentes em água tratada

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Tominaga Maria Y

1999-01-01

Full Text Available Realizou-se uma revisão bibliográfica do período de 1974-1998, no MEDLINE, sobre compostos orgânicos halogenados derivados de hidrocarbonetos denominados de trialometanos. Muitos deles, reconhecidamente carcinogênicos para diferentes espécies animais, podem ser encontrados freqüentemente, inclusive entre nós, em águas tratadas e enviadas à população urbana. É o caso de compostos como o clorofórmio, bromodiclorometano, clorodibromometano e bromofórmio, resultantes da halogenação de precursores, principalmente substâncias húmicas e fúlvicas presentes na água que será tratada (clorada. Assim, descreve-se sua formação, fontes de exposição humana bem como os aspectos toxicológicos de maior importância: disposição cinética e espectro dos efeitos tóxicos (carcinogênicos, mutagênicos e teratogênicos decorrentes de exposições a longo prazo e baixas concentrações. Níveis seguros de exposição propostos são também fornecidos.

MORPHOMETRIC ANALYSIS OF MANDIBULAR FORAMEN AND INCIDENCE OF ACCESSORY MANDIBULAR FORAMINA IN ADULT HUMAN MANDIBLES OF AN INDIAN POPULATION. Análisis morfométrico del foramen mandibular e incidencia de la foramina mandibular accesoria en mandíbulas adult

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Prajna Paramita Samanta

2016-03-01

Full Text Available El foramen mandibular es un importante hito anatómico. Para procedimientos como el bloqueo alveolar inferior del nervio, el tratamiento con implantes y osteotomías mandibulares, un profundo conocimiento de la ubicación del foramen mandibular (MF y el foramen mandibular accesorio (AMF es un requisito previo. Hay pocas referencias en la literatura con respecto a la localización anatómica exacta del foramen mandibular. Por lo tanto, el presente estudio tuvo como objetivo identificar la ubicación exacta de la MF y la incidencia de la AMF alrededor MF en una población india. Sesenta (60 mandíbulas humanas adultas fueron estudiadas para determinar la distancia del LV de la los anteriores, bordes posteriores de la rama mandibular, maxilar inferior categoría y el ángulo de la mandíbula. AMF todo el MF también fueron estudiados por su presencia y números. La distancia media de MF del borde anterior de rama mandibular fue 15,72 ±2,92 mm(lado derecho, 16,23 ±2,88 mm(lado izquierdo, de borde posterior fue 13,29 ±1,74 mm(lado derecho y 12,73 ±2,04 mm(a la izquierda lado. La MF se encuentra 22,70 ±3 mm(lado derecho y 22, 27 ± 2,62 mm(lado izquierdo de la muesca mandibular. La distancia de MF de ángulo de la mandíbula fue 21,54 ±2,92 mm(lado derecho y 21,13 ±3.43 mm(lado izquierdo. AMF estuvieron presentes en el 16, 66% de las mandíbulas. En 10% de las mandíbulas una sola AMF estaba presente y en el 6,66% hubo dos agujeros presentes. La ubicación del MF y AMF es importante para evitar compli-caciones como hemorragia y parestesia durante los procedimientos quirúrgicos orales y también para los radioterapeutas en la planificación de la radioterapia.  The mandibular foramen is an important anatomical land mark. For procedures like inferior alveolar nerve block, implant treatment and mandibular osteotomies, a thorough knowledge of the location of the mandibular foramen (MF and accessory mandibular foramina (AMFs is a prerequisite

Measuring mandibular ridge reduction

International Nuclear Information System (INIS)

Steen, W.H.A.

1984-01-01

This thesis investigates the mandibular reduction in height of complete denture wearers and overdenture wearers. To follow this reduction in the anterior region as well as in the lateral sections of the mandible, an accurate and reproducible measuring method is a prerequisite. A radiologic technique offers the best chance. A survey is given of the literature concerning the resorption process after the extraction of teeth. An oblique cephalometric radiographic technique is introduced as a promising method to measure mandibular ridge reduction. The reproducibility and the accuracy of the technique are determined. The reproducibility in the positioning of the mandible is improved by the introduction of a mandibular support which permits a precise repositioning of the edentulous jaw, even after long periods of investigation. (Auth.)

Mandibular canal branches supplying the mandibular third molar observed on cone beam computed tomographic images: Reports of four cases

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Lee, Jae Seo; Yoon, Suk Ja; Kang, Byung Cheol [Department of Oral and Maxillofacial Radiology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju (Korea, Republic of)

2009-12-15

Bifid mandibular canal can be an anatomic variation. This condition can lead to complication when performing mandibular anesthesia or during extraction of lower third molar, placement of implants and surgery in the mandible. Four patients underwent preoperative imaging for extraction of third molars using CBCT (CB Mercuray, Hitachi, Japan). The axial images were processed with CBworks program 2.1 (CyberMed Inc., Seoul, Korea). The branches for supplying the lower third molar were identified mainly on cross-sectional and panoramic images of CBCT. Since the location and configuration of mandibular canal variations are important in any mandibular surgical procedures, we report 4 cases of bifid mandibular canal with panoramic and the CBCT images.

[Orthodontic treatment of Class III patients with mandibular asymmetry].

Science.gov (United States)

Duan, Yin-Zhong; Huo, Na; Chen, Lei; Chen, Xue-Peng; Lin, Yang

2008-12-01

To investigate the treatment outcome of Class III patients with dental, functional and mild skeletal mandibular asymmetry. Thirty-five patients (14 males and 21 females) with dental, functional and mild skeletal mandibular asymmetry were selected. The age range of the patients was 7 - 22 years with a mean age of 16.5 years. Dental mandibular asymmetry was treated with expansion of maxillary arch to help the mandible returning to normal position. Functional mandibular asymmetry was treated with activator or asymmetrical protraction and Class III elastics. Mild skeletal mandibular asymmetry was treated with camouflage treatment. Good occlusal relationships were achieved and facial esthetics was greatly improved after orthodontic treatment in patients with dental and functional mandibular asymmetry. However, patients with skeletal mandibular asymmetry should be treated with both extraction and genioplasty. Orthodontic treatment was suitable for patients with dental and functional mandibular asymmetry, while combined orthodontics and surgery could get good results in patients with skeletal mandibular asymmetry.

Seating position, seat belt wearing, and the consequences in facial fractures in car occupants Posição no veículo, uso de cinto de segurança e suas conseqüências nas fraturas de face em ocupantes de carros

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Alexandre Siqueira Franco Fonseca

2007-01-01

fractures, not being effectively protected by the seat belt, although the wearing of seat belts seems to have a protective role against the occurrence of facial fractures in front-seat passengers. It was not possible to evaluate the wearing of seat belts among rear-seat passengers, even though the high incidence of fractures in this group showed its high susceptibility to the occurrence of facial fractures, which highlights the need of taking protective measures against this situation.INTRODUÇÃO: Os traumatismos devidos a acidentes de trânsito estão entre as principais etiologias na ocorrência de fraturas de face em todo o mundo. No entanto os mecanismos de trauma são diferentes, conforme o local onde o estudo foi realizado, devido a condições de desenvolvimento, legislação e cultura 1, 2, 3, 4. Com o objetivo de se conhecer a epidemiologia e os mecanismos envolvidos na ocorrência de fraturas de face em ocupantes de automóveis na região metropolitana de São Paulo, foi realizado um estudo retrospectivo entre Fevereiro de 2001 e Julho de 2006. MÉTODO: Foram coletados dados de 297 pacientes admitidos com fraturas de face na sala de emergência do HC-FMUSP. Destes, 151 indivíduos estiveram envolvidos em acidentes de trânsito sendo que 56 (37,08% estavam dentro de automóveis. Estes últimos foram agrupados baseados na posição em que estavam sentados no veículo no momento do acidente e no uso de cintos de segurança. Dados referentes ao número e localização dos traços de fratura foram obtidos nos diferentes grupos e um Índice Fraturas/Paciente (IF/P foi idealizado para comparar e avaliar o impacto nesses grupos, e para posteriormente serem analisados e discutidos. RESULTADO: Ocorreram 323 traços de fraturas nos 56 pacientes ocupantes de carros. Aplicando-se o IF/P obtivemos maiores valores no grupo de passageiros do banco traseiro sem cinto de segurança (7,23 fraturas/ paciente, seguido pelo grupo de motoristas sem cinto de segurança (6,33 fraturas

21 CFR 872.3960 - Mandibular condyle prosthesis.

Science.gov (United States)

2010-04-01

... (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 to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the human...

Prevalência de osteoporose e fraturas vertebrais em mulheres na pós-menopausa atendidas em serviços de referência Prevalence of osteoporosis and vertebral fractures in postmenopausal women attending reference centers

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Francisco Bandeira

2007-03-01

Full Text Available Este estudo tem por objetivo verificar a prevalência de osteoporose e a presença de fraturas vertebrais em mulheres na pós-menopausa. Foram estudadas, em serviços de referências, 627 mulheres com idade acima de 50 anos, com média de idade de 63,9 ± 8,3 anos, tempo de menopausa de 16,2 ± 8,6 anos, e índice de massa corpórea de 26,6 ± 4.3 Kg/m2. A prevalência de osteoporose foi de 28,8% na coluna lombar e de 18,8% no colo do fêmur. Esta foi maior nas pacientes que apresentaram história de fraturas quando jovens. Na faixa entre 60 a 69 anos, 33,2% tinham osteoporose na coluna lombar e entre 70 e 79 anos, 38,2%. Das pacientes com mais de 80 anos 54,5% apresentam osteoporose na coluna lombar e 72,7% no colo do fêmur. Trinta e sete por cento tinham fraturas, sendo que 9% apresentam fraturas grau I, e 10,9% fraturas severas. Considerando-se os diversos grupos etários, a prevalência de fraturas vertebrais foi de 20% entre 50 e 59 anos, 25,6% entre 60 e 69 anos, 58,3% entre 70 e 79 anos, e 81,8% entre 80 e 89 anos. Em mulheres na pós-menopausa, a maioria sem sintomas clínicos, verificamos uma alta taxa de prevalência de osteoporose, e fraturas vertebrais.The aim of this study was to determine the prevalence of osteoporosis and vertebral fractures in postmenopausal women. We studied 627 women, aged 50 years and over in reference centers (mean age 63.9±8.3 years, 16.2 ± 8.6 mean years since menopause, and mean body mass index 26.6 ± 4.3 Kg/m2. The prevalence of osteoporosis was 28.8% for lumbar spine and 18.8% for femoral neck. The prevalence was higher in patients who had had a fracture during youth. In the 60-69 year-old group, 32.2% had lumbar spine osteoporosis and 17.4% femoral neck osteoporosis. In the 70-79 year-old group, 38.2% had lumbar spine osteoporosis and 34% femoral neck osteoporosis. In the 80 years and over age group, 54.5% had lumbar spine osteoporosis and 72.7% femoral neck osteoporosis. Thirty-seven percent had

Mandibular ameloblastomas

International Nuclear Information System (INIS)

Masip, M.J.; Arana, E.; Beltran, J.; Garcia, J.L.; Cifrian, C.; Aparisi, F.

1995-01-01

We present a retrospective review of 39 cases of mandibular ameloblastoma that were assessed in terms of patient age and sex, duration and clinical signs at the time of diagnosis. The associated plain radiology, CT and MR signs are also reviewed. It usually presented as a slowly growing, painless mass. According to radiological findings, most of the ameloblastomas studied were extensive, involving the mandibular branch, angle and molar area; the lesions were expanding, unilocular or multilocular, with erosion of the dental apex. CT disclosed cystic areas of low attenuation. The images of the three patients studied by MR presented low signal intensity in T1-weighed sequences and hyperintense signal in t2-weighted sequences. 9 refs

Tratamento cirúrgico das fraturas dos metatársicos laterais com técnica percutânea anterógrada: descrição técnica e resultados clínicos

OpenAIRE

Baumfeld,Daniel; Macedo,Benjamim Dutra; Nery,Caio; Esper,Leonardo Elias; Baldo Filho,Marco Aurelio

2012-01-01

OBJETIVO: O objetivo deste trabalho é avaliar os resultados obtidos com a técnica de fixação anterógrada percutânea para o tratamento das fraturas do colo e diáfise dos metatársicos laterais. MÉTODOS: Realizamos avaliação prospectiva de 14 pacientes operados no período de 2003 a 2008, em que foram levados em consideração a topografia das fraturas, o mecanismo de trauma, as comorbidades associadas e o escore AOFAS para o antepé. RESULTADOS: A região anatômica mais atingida foi o colo dos metat...

Rotational Distraction for the Treatment of Severe Mandibular Retrognathia.

Science.gov (United States)

Ito, Osamu; Mitsugi, Masaharu; Alcalde, Rafael E; Yano, Tomoyuki; Uemura, Noriko; Okazaki, Mutsumi

2015-07-01

The main problem with intraoral distraction of the mandible is the inability to achieve the three-dimensional mandibular correction as planned preoperatively. We developed a technique that allows spontaneous changes in the direction of mandibular elongation using an intraoral distractor. After mandibular osteotomy, the distractor is fixed to the distal segment of the mandible using a single bicortical screw, allowing anterior-posterior, vertical and limited lateromedial changes in the vector of distraction. Mandibular lengthening is performed while keeping the maxilla and mandible in class I occlusion with intermaxillary fixation. As the distraction device is activated allowing mandibular elongation, the proximal segment, guided by the surrounding soft tissues, moves and rotates posterosuperiorly. Mandibular lengthening is continued until the condylar head reaches an adequate position in the mandibular fossa as confirmed clinically and radiographically. Thirty-three patients with mandibular retrognathia received this treatment and good results were obtained.

Fratura tipo explosão da coluna torácica e lombar: correlação entre o segmento biomecânico sagital acometido e as alterações estruturais da vértebra fraturada

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Matheus Luís da Silva

2013-01-01

Full Text Available OBJETIVO: Analisar as fraturas tipo explosão da coluna torácica e lombar e fazer a correlação entre o segmento biomecânico sagital acometido e as alterações estruturais da vértebra fraturada. MÉTODOS: Estudo retrospectivo de 72 pacientes com fraturas tipo explosão da coluna torácica e lombar. O estreitamento do canal vertebral, o colapso vertebral e a cifose local foram avaliados em três segmentos distintos: torácico, transição toracolombar e lombar. RESULTADOS: Houve diferença estatística significativa (p < 0,05 dos valores do estreitamento do canal vertebral e cifose local nos diferentes segmentos da coluna vertebral avaliados. CONCLUSÃO: As fraturas tipo explosão da coluna torácica e lombar, embora apresentem características semelhantes, independentemente do local de ocorrência, sofrem influência direta do segmento biomecânico sagital no que diz respeito às alterações estruturais que ocorrem na vértebra fraturada.

Anquilosis mandibular: una frecuente secuela por Noma Mandibular ankylosis: a Noma frequent sequel

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R. Fernández García-Guilarte

2009-12-01

Full Text Available Conocemos poco sobre el Noma o Enfermedad Cancrum Oris. Esta entidad afecta a niños con malnutrición crónica, poca higiene oral, poco desarrollo sanitario y enfermedades concurrentes debilitantes. Existe un consenso general sobre que el Noma empieza como una gingivitis; en su fase aguda, puede haber respuesta al tratamiento antibiótico, no obstante, las secuelas tras su curación incluyen daños estéticos y funcionales variables, que pueden requerir cirugía reconstructiva. Presentamos 3 casos de anquilosis mandibular que en el examen preoperatorio presentaron dimorfismo mandibular, fusión de hueso maxilar y mandibular y anquilosis de la articulación témporomandibular. La ortopantografía y la Tomografía Axial Computerizada (TAC fueron muy útiles en la planificación de la cirugía. El tratamiento quirúrgico consistió en todos los casos en la resección del hueso anquilótico y la reconstrucción con injerto condrocostal en uno de los casos. En el postoperatorio se siguió fisioterapia intensiva. Clínicamente todos los pacientes mostraron una gran mejoría en la masticación, la alimentación y el habla, obviamente debido a una buena oclusión. El problema más común fue la baja colaboración en la rehabilitación mandibular por parte de los pacientes.Little is known about Noma or Cancrum Oris Disease. This entity affects to children with chronic malnutrition, poor oral hygiene, poor environmental sanitation and debilitating concurrent illness. There is general consensus that noma starts as gingivitis. The acute stage responds readily to antibiotic treatment. The sequelae after healing include variable functional and aesthetic impairments, which require reconstructive surgery. We report 3 cases of mandibular ankylosis. Preoperative examination revealed mandibular dismorphism, fusion of maxilla and mandible and ankylosis of the temporomandibular joint. Orthopantography and Computed Thomography scan (TCS were very useful in planning

Desenho de placa em forma de borboleta para tratamento de fraturas do calcâneo Design of butterfly-shaped plate and its application in treatment for calcaneal fractures

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Guangrong Yu

2012-12-01

Full Text Available OBJETIVO: Apresentar um desenho de placa em forma de borboleta e sua aplicação no tratamento de fraturas do calcâneo e discutir suas indicações clínicas, vantagens e desvantagens. MÉTODOS: De fevereiro de 2008 a abril de 2010, 22 pacientes com 26 fraturas intra-articulares do calcâneo foram tratados com redução a céu aberto e fixação interna com placa em forma de borboleta. Dezesseis pacientes eram homens e 6 eram mulheres, com média de idade de 36,8 anos. Onze eram pés esquerdos e 15, direitos. De acordo com a classificação de Sanders, 12 eram fraturas de calcâneo Tipo II (inclusive 3 Tipo IIa, 7 Tipo IIb e 2 Tipo IIc e 14 eram Tipo III (inclusive cinco do Tipo IIIab, 7 Tipo IIIac e duas do Tipo IIIbc. RESULTADOS: Dezessete pacientes (21 pés foram submetidos a acompanhamento por em média 19,2 meses. Os desfechos funcionais foram avaliados com o sistema Maryland Foot Score. Entre os nove pés com fraturas Tipo II, sete receberam escore excelente e dois, bom. Entre as 12 fraturas Tipo III, seis tiveram escore excelente, cinco, bom e uma, razoável. CONCLUSÃO: A placa em forma de borboleta é aplicável ao tratamento de fraturas do calcâneo do Tipo II e Tipo III de Sanders, com a vantagem de garantir fixação confiável, facilitar a cirurgia, produzir menos complicações pós-operatórias e produzir melhores desfechos clínicos gerais. Nível de Evidência IV, Série de casos.OBJECTIVE: To introduce the design of butterfly-shaped plate and its application in treatment for calcaneal fractures, and to discuss its clinical indications, advantages and disadvantages. METHODS: From February 2008 to April 2010, 22 patients with 26 intra-articular calcaneal fractures were treated by open reduction and internal fixation with butterfly-shape plate. Sixteen patients were male and 6 patients were female, with a mean age of 36.8 years. Eleven were left feet and 15, right. According to Sanders classification, 12 were Type II (including 3

Possibility of estimating three-dimensional mandibular morphology by cephalogram analysis

International Nuclear Information System (INIS)

Kim, S.; Motegi, Etsuko; Kikuchi, Yu; Yamaguchi, Hideharu; Takaki, Takashi; Shibahara, Takahiko

2007-01-01

The purpose of this study was to investigate the possibility of a surmise of three-dimensional mandibular morphology by two-dimensional cephalogram analysis. The materials were three-dimensional CT and cephalogram of 20 female mandibular prognathism patients (average age: 25.20±7.49) before there orthognathic surgery. Mandibular bone volume and sponge bone width were calculated from three-dimensional images constructed from CT images using imaging software (Real Intage, KGT inc.). There was a positive correlation (r=0.72) between mandibular volume value and mandibular ramus width. There was a positive correlation between sponge bone width at the site of the mandibular cuspid and mandibular ramus width and SNB angle (r=0.80), and between sponge bone width at the site of the mandibular molar and symphysis height and mandibular ramus width (r=0.81). It was thought that these results will be useful for a surmise of three-dimensional mandibular morphology by cephalogram analysis. (author)

Pharyngeal airway changes following mandibular setback surgery

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Babu Ramesh

2005-01-01

Full Text Available Treatment of dentofacial deformities with jaw osteotomies has an effect on airway anatomy and therefore mandibular setback surgery has the potential to diminish airway size. The purpose of this study was to evaluate the effect of mandibular setback surgery on airway size. 8 consecutive patients were examined prospectively. All patients underwent mandibular setback surgery. Cephalometric analysis was performed preoperatively and 3 months post operatively with particular attention to pharyngeal airway changes. Pharyngeal airway size decreased considerably in all, patients thus predisposing to development of obstructive sleep apnea. Therefore, large anteroposterior discrepancies should be corrected by combined maxillary and mandibular osteotomies.

Biomechanical considerations in mandibular incisor extraction cases.

Science.gov (United States)

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

2015-01-01

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

Estudo de prevalência das fraturas bucomaxilofaciais na região de Pelotas = Study of prevalence of the bucomaxilofacial fractures in Pelotas region

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Portolan, Moacir

2005-01-01

Full Text Available Analisamos 745 casos de fraturas bucomaxilofaciais registrados no SAME (Serviço de Arquivo Médico Estatístico da Santa Casa de Misericórdia de Pelotas e no Centro de Estudos e Reabilitação Bucomaxilofacial de Pelotas (CERBMF, no período de 10 de janeiro de 1996 a 31 de dezembro de 2000. Os dados formam colhidos e anotados em fichas, as quais totalizaram 745 casos de pacientes submetidos à cirurgia. O nariz foi o local mais atingido, seguido pelo osso zigomático e mandíbula. As agressões foram as principais causas de fraturas, seguidas por acidentes de trânsito e quedas. O gênero masculino foi o mais atingido, numa proporção de 8/2 em relação ao feminino. A faixa etária mais atingida foi a de 21 a 30 anos de idade, seguida pela de 31 a 40 anos de idade e 11 a 20 anos de idade

Fratura tipo explosão da coluna torácica e lombar: correlação entre o segmento biomecânico sagital acometido e as alterações estruturais da vértebra fraturada

OpenAIRE

Silva,Matheus Luís da; Tisot,Rodrigo Arnold; Vieira,Juliano Silveira Luiz; Santos,Renato Tadeu dos; Tisot,Orley Fauth

2013-01-01

OBJETIVO: Analisar as fraturas tipo explosão da coluna torácica e lombar e fazer a correlação entre o segmento biomecânico sagital acometido e as alterações estruturais da vértebra fraturada. MÉTODOS: Estudo retrospectivo de 72 pacientes com fraturas tipo explosão da coluna torácica e lombar. O estreitamento do canal vertebral, o colapso vertebral e a cifose local foram avaliados em três segmentos distintos: torácico, transição toracolombar e lombar. RESULTADOS: Houve diferença estatística si...

Anterior mandibular apical base augmentation in the surgical orthodontic treatment of mandibular retrusion.

Science.gov (United States)

Brusati, R; Giannì, A B

2005-12-01

The authors describe a surgical technique alternative to traditional pre-surgical orthodontics in order to increase the apical base in mandibular retrusion (class II, division I). This subapical osteotomy, optimizing inferior incisal axis without dental extractions and a long orthodontic treatment, associated to genioplasty permits to obtain an ideal labio-dento-mental morphology. This procedure avoids in some cases the need of a mandibular advancement and, if necessary, it reduces his entity with obvious advantages.

Physiological responses in the banana plantlets treateds with strobilurinsRespostas fisiológicas em mudas de banananeira tratadas com estrobilurinas

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Sivia Helena Modenese-Gorla da Silva

2012-04-01

âmetro do pseudocaule e a massa da matéria seca da parte aérea de plantas tratadas com estrobilurinas foram superiores às de plantas não tratadas. O efeito do tratamento com fungicidas foi diferenciado, sendo mais pronunciado nas plantas tratadas com piraclostrobina do que nas plantas tratadas com azoxistrobina. Plantas tratadas com piraclostrobina apresentaram área foliar, atividade da redutase do nitrato e teor de clorofila a e de nitrogênio total foliar superiores às plantas tratadas com azoxistrobina e água, que não diferiram entre si. As estrobilurinas afetaram a fisiologia das mudas de bananeira, com destaque para a piraclostrobina.

A patient with mandibular deviation and 3 mandibular incisors treated with asymmetrically bent improved superelastic nickel-titanium alloy wires.

Science.gov (United States)

Ikeda, Yuhei; Kokai, Satoshi; Ono, Takashi

2018-01-01

Skeletal and dental discrepancies cause asymmetric malocclusions in orthodontic patients. It is difficult to achieve adequate functional occlusion and guidance in patients with congenital absence of a mandibular incisor due to the tooth-size discrepancy. Here, we describe the orthodontic treatment of a 22-year-old woman with an asymmetric Angle Class II malocclusion, mandibular deviation to the left, and 3 mandibular incisors. The anterior teeth and maxillary canines were crowded. We used an improved superelastic nickel-titanium alloy wire (Tomy International, Tokyo, Japan) to compensate for the asymmetric mandibular arch and an asymmetrically bent archwire to move the maxillary molars distally. A skeletal anchorage system provided traction for intermaxillary elastics, and extractions were not needed. We alleviated the crowding and created an ideal occlusion with proper overjet, overbite, and anterior guidance with Class I canine and molar relationships. This method of treatment with an asymmetrically bent nickel-titanium alloy wire provided proper Class I occlusion and anterior guidance despite the mandibular deviation to the left and 3 mandibular incisors, without the need for extractions. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Mandibular reconstruction in adults: a review.

NARCIS (Netherlands)

Goh, B.T.; Lee, S.; Tideman, H.; Stoelinga, P.J.W.

2008-01-01

Mandibular defects may result from trauma, inflammatory disease and benign or malignant tumours. Mastication, speech and facial aesthetics are often severely compromised without reconstruction. The goal of mandibular reconstruction is to restore facial form and function, implying repair of

Assessment of the relationship between the mandibular third molar and the mandibular canal using panoramic radiograph and cone beam computed tomography

International Nuclear Information System (INIS)

Jung, Yun Hoa; Nah, Kyung Soo; Cho, Bong Hae

2008-01-01

The purpose of this study is to evaluate the position of the mandibular canal in relation to the mandibular third molar by cone beam CT in cases showing a close relationship between the third molar and the mandibular canal on the panoramic radiograph. The panoramic images and cone beam CT scans of 87 impacted mandibular third molars in 60 patients were evaluated to assess the tooth relationship to the mandibular canal. The clearness of the canal wall and the vertical depth of the lower third molar were evaluated on panoramic radiographs. The lower third molars were assessed using cone beam CT to determine the proximity and position of the canal relative to the roots. In the 66 cases where the canal wall was unclear on the panoramic radiographs, 58 (87.9%) of the third molars had contact between the canal and root; 34 (51.5%) canals were showed an inferior position and 22 (33.3%) showed a linguoinferior position on cone beam CT. Interruption of the canal wall on panoramic radiographs was highly predictive of contact between the mandibular canal and the third molar. Cross sectional CT may be indicated for localization of the mandibular canal in such cases.

Mandibular condyle position in cone beam computed tomography

Energy Technology Data Exchange (ETDEWEB)

Hwang, Hyoung Joo; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [Kyung Hee Univ. School of Dentistry, Seoul (Korea, Republic of)

2006-06-15

To evaluate position of the mandibular condyle within articular fossa in an asymptomatic population radiographically by a cone beam computed tomography. Cone beam computed tomography of 60 temporomandibular joints was performed on 15 males and 15 females with no history of any temporomandibular disorders, or any other orthodontic or photoconductors treatments. Position of mandibular condyle within articular fossa at centric occlusion was evaluated. A statistical evaluation was done using a SPSS. In the sagittal views, mandibular condyle within articular fossa was laterally located at central section. Mandibular condyles in the right and left sides were showed asymmetric positional relationship at medial, central, and lateral sections. Mandibular condyle within articular fossa in an asymptomatic population was observed non-concentric position in the sagittal and coronal views.

[Stereomodel-assisted fibula free flap harvest and mandibular reconstruction: A technical note. Literature review of CAS and CAM applied to mandibular reconstruction.

Science.gov (United States)

Pauchot, J; Lachat, J; Floret, F; Badet, J-M; Tavernier, L; Aubry, S

2013-08-05

Mandibular reconstruction with fibula free flap harvest is currently the reference technique. Various preoperative processes have been developed to optimize this reconstruction. We report our experience with a simple, inexpensive, preoperative technique requiring a 3D printer, a device for maintaining mandibular reduction, a paper-cutting guide. Stereomodels of the mandible were obtained from computed tomography scan data and printed 3D in ABS. It allowed planning mandibular osteotomies, determine the angle between two bone fragments, and preoperatively modeling the osteosynthesis plate. A paper-cutting guide, and a simple device for maintaining mandibular reduction were also built. Two patients were operated on with this technique, with follow-up at 6 and 8 months. Reconstructions were successful with good clinical outcome in terms of mandibular contour and reconstructed segments positions. Preoperative planning of reconstruction may be used for mandibular osteotomies, fibular osteotomies, maintaining mandibular reduction, osteosynthesis, or placing implants for dental rehabilitation. The most complex procedures can virtually plan all these steps, but they are expensive and long to implement. Nevertheless, such procedures are quite expansive and require time not always compatible with carcinoma. Using a mandibular stereomodel is fast, easy, and cheap. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Reliability of mandibular canines as indicators for sexual dichotomy.

Science.gov (United States)

Hosmani, Jagadish V; Nayak, Ramakant S; Kotrashetti, Vijayalakshmi S; S, Pradeep; Babji, Deepa

2013-02-01

Amongst the various calcified structures in the human body, teeth have gained lot of popularity in estimating the sex of an individual as they are highly resistant to destruction and decomposition. Using permanent mandibular canines many researchers have predicted a high level of accuracy in identifying the sex correctly. The purpose of our study was to gauge the effectiveness of mandibular canines in discerning sex. Fifty dental casts each of males and females were utilized for the study. Mesio-distal dimension and inter-canine distance of mandibular right and left canine was recorded using digital vernier caliper and mandibular canine index was calculated. The mean value of mesio-distal dimensions of right and left mandibular canine was slightly greater in males compared to females. The mandibular canine index was equal in both sexes. Inter-canine distance was marginally higher in males compared to females. Despite of higher values in males none of the parameters were statistically significant. The results herein bolster contemporary studies that mesio-distal dimensions of mandibular canines and mandibular canine index do not reflect sexual dimorphism and that its application should be discontinued in sex prediction among Indian populations. How to cite this article: Hosmani J V, Nayak R S, Kotrashetti V S, Pradeep S, Babji D. Reliability of Mandibular Canines as Indicators for Sexual Dichotomy. J Int Oral Health 2013; 5(1):1-7.

A new method for classifying distal radius fracture: the IDEAL classification Um novo método de classificação para as fraturas da extremidade distal do rádio – a classificação IDEAL

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João Carlos Belloti

2013-01-01

Full Text Available OBJECTIVES: To describe the new IDEAL method from classifying distal radius fractures. METHODS: IDEAL classification system is based on the most important literature evidences about clinical and radiographic characteristics that influence in the treatment and prognosis for patients that suffered from a distal radius fractures. In this method, we classify the fracture in patients first consultation, in which we collect demographical (age and trauma energy and radiographic characteristics ( fracture deviation, articular fracture, and associated lesions. For each feature a score is attributed for grouping purposes. Group I - Stable fractures, good prognosis; Group II - potentially unstable fractures, commonly treated by surgical methods. Prognosis depends on surgeons' success after method choice. Group III - complex and instable fractures, poor outcome is expected. CONCLUSION: IDEAL classification staging rationale was presented, which is based on the best available evidence. The evidence of its scientific plausibility will be settled with the assessment of the classification reliability and its capacity to aid in therapeutical decisions and as a tool to predict prognosis. Further studies are under development to support these properties. OBJETIVOS: Descrição do método de Classificação IDEAL - para as fraturas da extremidade distal do rádio. MÉTODOS: O sistema de classificação IDEAL fundamenta-se nas principais evidências da literatura sobre fatores clínicos e radiográficos que influenciam o tratamento e prognóstico das fraturas do rádio distal. Classificamos as fraturas no atendimento inicial do paciente mediante a verificação de dois dados epidemiológicos e três dados radiográficos: Idade do paciente, energia do trauma, desvio dos fragmentos, incongruência articular e lesões associadas. RESULTADOS: Conforme a pontuação obtida, agrupamos os casos em três grupos: Grupo I - fraturas estáveis com bom prognóstico, Grupo II

Emprego de fixador externo circular no tratamento de complicações de fraturas do rádio e ulna em cães de raças pequenas Use of circular external fixator in the treatment of fracture complications of radius and ulna in small breed dogs

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Sheila Canevese Rahal

2005-10-01

Full Text Available O objetivo deste estudo foi avaliar o método de Ilizarov no tratamento de complicações de fraturas do rádio e ulna em cães de raças pequenas. Um fixador de Ilizarov miniatura composto por anéis de alumínio e hastes de aço foi usado em três cães da raça poodle miniatura (casos 1, 2 e 3 e em um pinscher (caso 4. Os cães 1 e 4 apresentavam consolidação atrasada das porções médio-distal e distal, respectivamente, devido a prévio tratamento com tala externa. Foi aplicada uma montagem constituída por dois anéis proximais e um distal. Ambas as fraturas consolidaram, sendo que a do poodle apresentou leve desvio cranial das extremidades fraturadas. Os outros dois casos (2 e 3 consistiam de fraturas previamente tratadas por procedimento cirúrgico. O caso 2 apresentava rotação lateral do membro torácico e não-união do aspecto distal da diáfise radial com presença de pino intramedular e dois fios de cerclagem. O pino intramedular e um dos fios de cerclagem foram removidos e realizou-se a derrotação do foco da fratura. O aparelho foi montado como nos casos 1 e 4. A consolidação da fratura foi obtida com moderado desvio caudal do eixo ósseo. No caso 3, havia reabsorção óssea na diáfise do rádio e ulna devido ao emprego inadequado de fixador externo resina-pino. Empregou-se o transporte ósseo com o fixador de Ilizarov para induzir a regeneração óssea. Entretanto, este foi interrompido por falta de resposta. Manteve-se o fixador e o defeito ósseo foi tratado com enxerto esponjoso autólogo e biomateriais. A ulna ocupou parte do defeito segmentar do rádio. Foi possível concluir que o método de Ilizarov pode ser usado no tratamento de consolidação atrasada e não-união, mas o fixador externo circular é de difícil aplicação em cães de raças pequenas.The aim of this study was to evaluate the Ilizarov’s method for treating complications of radius and ulna fractures in small breed dogs. A miniature Ilizarov�

Fratura de órbita por queda de cavalo e correção de estrabismo Orbit fracture by horse fall and strabismus correction

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Abelardo de Souza Couto Junior

2010-06-01

Full Text Available Descreve-se uma paciente com fratura orbitária grave causada por queda de cavalo. Relato do seu tratamento cirúrgico com correção do estrabismo e tentativa de correção da enoftamia.Description of a patient with orbital fracture cause by a horse fall. Follow-up the surgical treatment of the strabismus and the enophtlamos.

Mandibular Deformity Correction by Distraction Osteogenesis

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Md Asaduzzaman

2011-02-01

Full Text Available Distraction osteogenesis (DO is a biological process of new bone formation. It could be used as an alternative treatment method for the correction of mandibular hypoplastic deformity. Modern distraction osteogenesis evolved primarily from the work of Gavriel llizarov. DO has been first applied to craniofacial region since McCarthy et al. In this case report, the patient was 17 years old male with bird face deformity due to hypoplasia of mandible resulted from bilateral TMJ ankylosis due to the fracture of both condyle at the age of 4 years. Patient’s intraincisal opening was absent 1 year back. He underwent condylectomy in both sides to release the ankylosis and to increase intraincisal opening. His mandibular length was markedly short. To increase his mandibular antero-posterior length, mandibular body distraction was done in Oral and Maxillofacial Surgery department, BSMMU. Through this procedure length of the body of mandibule was increased by 10 mm, occlusion was edge to edge and his lower facial appearance increased markedly. Mandibular body distraction osteogenesis was considerably effective when performed in a hypoplastic mandible to facilitate post-operative functional and esthetic restoration. Long term follow-up is necessary to evaluate relapse and complications. DOI: 10.3329/bsmmuj.v3i2.7061BSMMU J 2010; 3(2: 103-106

Pseudo-aneurisma de artéria subclávia pós fratura de clavícula: relato de caso

OpenAIRE

ROSÁRIO, Ricardo Costa Val; RIOS, Adriana Vaggiani; FIGUEIREDO JÚNIOR, Fernando de Assis; CHRISTO, Sérgio Figueiredo Campos; SIMÃO FILHO, Charles; CHRISTO, Marcelo Campos

1997-01-01

Os autores descrevem a formação de um pseudo-aneurisma de artéria subclávia esquerda após trauma contuso seguido de fratura de clavícula esquerda. Comentários e uma breve revisão da literatura são mencionadosThe authors describe the left subclavian artery pseudo-aneurysm formation after blunt trauma followed by left clavicular fracture. Comments and a brief review of the literature are also mentioned.

Fratura extra-articular da extremidade medial da clavícula associada à luxação acromioclavicular tipo IV: relato de caso Extra-articular fracture of the medial end of the clavicle associated with type IV acromioclavicular dislocation: case report

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Mário Chaves Correa

2011-10-01

Full Text Available Ocorrendo isoladamente, as fraturas da clavícula e as luxações acromioclaviculares são lesões muito comuns. A combinação de uma luxação acromioclavicular e de uma fratura do terço lateral da clavícula não é rara. Entretanto, existem muito poucos casos descritos de luxações acromioclaviculares associadas a fraturas do terço médio da clavícula; aquelas associadas a fraturas do terço medial são ainda mais raras. Nós reportamos o caso de um indivíduo adulto do sexo masculino que sofreu uma luxação acromioclavicular (tipo IV associada a uma fratura extra-articular desviada da extremidade medial da clavícula (grupo 3 de Almann em um acidente ciclístico. O paciente foi tratado na fase aguda com redução aberta e fixação interna das duas lesões. Na avaliação clínica, 12 meses após a cirurgia, o paciente apresentava-se assintomático, com mobilidade ativa e passiva completa, força e resistência normais e simetria das cinturas escapulares. As radiografias e a tomografia computadorizada tridimensional mostravam subluxação posterossuperior persistente da articulação acromioclavicular e consolidação anatômica da fratura clavicular.Fractures of the clavicle and acromioclavicular dislocations are very common injuries when they occur separately. The combination of an acromioclavicular dislocation and a fracture of the lateral third of the clavicle is not rare. However, there are very few reported cases of acromioclavicular dislocations associated with fractures of the middle third of the clavicle; those associated with fractures of the medial third are even rarer. We report the case of an adult male who suffered an acromioclavicular dislocation (type IV associated with a displaced extra-articular fracture of the medial end of the clavicle (Almann group 3 in a cycling accident. The patient was treated during the acute phase with open reduction and internal fixation of the two lesions. At the clinical evaluation 12

Malignant mandibular tumors: two case reports of rare mandibular ...

African Journals Online (AJOL)

Arun Kumar Agnihotri

2014-02-26

Feb 26, 2014 ... present two cases of rare malignant mandibular tumors in a single institution. KEY WORDS: .... Spiculated osteoblastic periosteal reaction was noted with mild ... displacement of right 2nd premolar and 2nd molar teeth were ...

Avaliação da qualidade de vida em pacientes idosos um ano após o tratamento cirúrgico de fraturas transtrocanterianas do fêmur Functional outcomes and quality of life one year after surgical management of trochanteric fractures

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Fernanda de Aquino Moraes Guimarães

2011-01-01

Full Text Available OBJETIVO: Avaliar o impacto que as fraturas transtrocanterianas produzem sobre a qualidade de vida de pacientes idosos, tratados cirurgicamente, durante o período de um ano de acompanhamento. MATERIAL E MÉTODO: Foram selecionados 73 idosos com fratura transtrocanterina, com idade igual ou superior a 65 anos de ambos os sexos. Foi aplicado questionário padronizado, para se obter informações quanto aos hábitos de vida, atividade física, funcionalidade, deambulação e estado cognitivo. Foram excluídos os óbitos ocorridos durante o estudo, pacientes que não deambulavam, com doenças neurológicas ou fraturas patológicas. RESULTADOS: A média de idade foi 80,17 ± 7,2, sendo 75% do sexo feminino. Ao comparar as somatórias das atividades de vida diária (p=0,04 e instrumentais da vida diária (p=0,004, obtidas na pré e pós-fratura, os pacientes tornaram-se mais dependentes pós-fratura. Atividades de vida diária que apresentaram piora pós-fratura foram: tomar banho (p=0,04, ir ao banheiro (p=0,02 e vestir-se (p=0,04. Todas as atividades instrumentais da vida diária apresentaram diferença significativa, apresentando maior dependência funcional pós-fratura, assim como aumento da necessidade de auxílio a deambulação (p=0,00002, idade avançada (p=0,01 e não realizar atividades domésticas (p=0,01. A baixa pontuação no teste Minimental estava associada com uma maior dependência para realizar as atividades da vida diária na pré-fratura (p=0,00002 e pós-fratura (p=0,01. CONCLUSÃO: Após um ano, as atividades de vida diária que dependiam dos membros inferiores pioraram significativamente, todas as atividades instrumentais de vida diária apresentaram piora significativa em mais de 50% dos pacientes e mais da metade dos pacientes que andavam sem apoio perderam esta capacidade.OBJECTIVE: Evaluate the impact that trochanteric hip fractures produce on life quality of elderly patients, treated surgically, during one year of

The efficacy of supplemental intraosseous anesthesia after insufficient mandibular block

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Samir Prohić

2005-02-01

Full Text Available It is a well-known scientific fact that only a small percentage of infiltration of inferior alveolar nerve is clinically proven to be efficient. The objective of this study was to determine the anesthetic efficacy of supplemental intraosseous injection, used after the insufficient classical mandibular block that didn't provide deep pulp anesthesia of mandibular molar planed for extraction. The experimental teeth consisted of 98 mandibular molars with clinical indication for extraction. Based on the history of disease, we indicated the extraction of the tooth. After that each tooth was tested with a electric pulp tester P1. We tested the pulp vitality and precisely determined the level of vitality. After that, each patient received classical mandibular block, and the pulp vitality was tested again. If the pulp tester indicated negative vitality for the certain mandibular molar, and the patient didn't complain about pain or discomfort during the extraction, the molar was extracted and the result was added to anesthetic success rate for the classical mandibular block. If, five minutes after receiving the mandibular block, the pulp tester indicated positive vitality (parameters of vitality or the patient complained about pain or discomfort (parameters of pain and discomfort, we used the Stabident intraosseous anesthesia system. Three minutes after the application of supplemental intraosseous injection the molar was tested with the pulp tester again. The anesthetic solution used in both anesthetic techniques is lidocaine with 1:100.000 epinephrine. The results of this study indicate that the anesthetic efficacy of the mandibular block is 74.5%, and that supplemental intraosseous anesthesia, applied after the insufficient mandibular block, provides pulpal anesthesia in 94.9% of mandibular molars. The difference between anesthetic efficacy of the classical mandibular block and anesthetic efficacy of the supplemental intraosseous anesthesia, applied

The efficacy of supplemental intraosseous anesthesia after insufficient mandibular block.

Science.gov (United States)

Prohić, Samir; Sulejmanagić, Halid; Secić, Sadeta

2005-02-01

It is a well-known scientific fact that only a small percentage of infiltration of inferior alveolar nerve is clinically proven to be efficient. The objective of this study was to determine the anesthetic efficacy of supplemental intraosseous injection, used after the insufficient classical mandibular block that didn't provide deep pulp anesthesia of mandibular molar planed for extraction. The experimental teeth consisted of 98 mandibular molars with clinical indication for extraction. Based on the history of disease, we indicated the extraction of the tooth. After that each tooth was tested with a electric pulp tester P1. We tested the pulp vitality and precisely determined the level of vitality. After that, each patient received classical mandibular block, and the pulp vitality was tested again. If the pulp tester indicated negative vitality for the certain mandibular molar, and the patient didn't complain about pain or discomfort during the extraction, the molar was extracted and the result was added to anesthetic success rate for the classical mandibular block. If, five minutes after receiving the mandibular block, the pulp tester indicated positive vitality (parameters of vitality) or the patient complained about pain or discomfort (parameters of pain and discomfort), we used the Stabident intraosseous anesthesia system. Three minutes after the application of supplemental intraosseous injection the molar was tested with the pulp tester again. The anesthetic solution used in both anesthetic techniques is lidocaine with 1:100.000 epinephrine. The results of this study indicate that the anesthetic efficacy of the mandibular block is 74.5%, and that supplemental intraosseous anesthesia, applied after the insufficient mandibular block, provides pulpal anesthesia in 94.9% of mandibular molars. The difference between anesthetic efficacy of the classical mandibular block and anesthetic efficacy of the supplemental intraosseous anesthesia, applied after the

Topographical evaluation of the mandibular canal through panoramic radiograph

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Ingrid Macedo Oliveira

2016-10-01

Full Text Available The mandibular canal is located inside the body of the mandible and may have anatomical variations. The topographic knowledge of the mandibular canal by the Dental surgeons is fundamental to achieving success in surgical planning, anesthetics and clinical interventions involving the jaw. To study the anatomy of the mandibular canal through panoramic radiographs. A retrospective descriptive study, developed after review and approval by the Ethics and Research Committee with the number of opinion 431095. Were analyzed 252 panoramic radiographs of patients of male and female attended in dental clinics UNINOVAFAPI University Center, Teresina-Pi, Brazil. The radiographs were analyzed with the aid of a light box and each antimere the jaw was observed separately. The classification of Nortjé and Langlais for description of the topography of the mandibular canal were used. Descriptive statistical analysis was performed with SPSS version 18.0. There was a prevalence of 38.89% in both antimeres, of mandibular channel the Type II. The type IV was present in 25.4% in the right hemi-arch and 26.6% on the left. Mandibular canal with unilateral bifurcation was observed in 0.77% of the sample and molar straight channel has not been identified. We observed anatomical variations as for the number and path, of the mandibular canal with the highest prevalence of Types II and IV, and the absence of bifurcations. Most was mandibular channels showed no bifurcation. The panoramic radiograph showed up an aid important to identify the mandibular canal and its variations.

Prosthodontic management of mandibular deviation using palatal ramp appliance

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Prince Kumar

2012-08-01

Full Text Available Segmental resection of the mandible generally results in deviation of the mandible to the defective side. This loss of continuity of the mandible destroys the balance of the lower face and leads to decreased mandibular function by deviation of the residual segment toward the surgical site. Prosthetic methods advocated to reduce or eliminate mandibular deviation include intermaxillary fixation, removable mandibular guide flange, palatal ramp, implant-supported prosthesis and palatal guidance restorations which may be useful in reducing mandibular deviation and improving masticatory performance and efficiency. These methods and restorations would be combined with a well organized mandibular exercise regimen. This clinical report describes the rehabilitation following segmental mandibulectomy using palatal ramp prosthesis.

Avaliação do torque para inserção, remoção e fratura de diferentes mini-implantes ortodônticos Evaluation of insertion, removal and fracture torques of different orthodontic mini-implants in bovine tibia cortex

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Maria Fernanda Prates da Nova

2008-10-01

Full Text Available OBJETIVO: avaliar, em mini-implantes de diferentes dimensões, os seguintes fatores: (a torque de inserção, (b torque de remoção, (c torque de fratura, (d tensão cisalhante, (e tensão normal e (f tipo de fratura. METODOLOGIA: foram utilizados 20 mini-implantes autoperfurantes, 10 da marca SIN e 10 da Neodent com, respectivamente, 8 e 7mm de comprimento, todos com 1,6mm de diâmetro. Dos 10 mini-implantes de cada marca, 5 não possuíam perfil transmucoso e 5 tinham perfil de 2mm, formando 4 grupos: SIN sem perfil (SSP, SIN com perfil (SCP, Neodent sem perfil (NSP e Neodent com perfil (NCP. Todos os mini-implantes foram inseridos em cortical óssea e removidos com micromotor acoplado a um torquímetro. Os mini-implantes foram, também, submetidos ao ensaio de fratura. Os torques de inserção, remoção e fratura, assim como a tensão cisalhante e normal calculadas, foram comparados entre todos os grupos pela ANOVA. O tipo de fratura foi avaliado em microscópio eletrônico de varredura. RESULTADOS: verificou-se que o grupo NCP apresentou torque de inserção significativamente maior que os demais grupos, porém todos fraturaram durante a inserção (n = 2 ou remoção (n = 3. Não houve diferença entre os grupos para o torque de remoção. Para o grupo NSP, o torque de fratura foi significativamente menor do que todos os outros grupos. Todos os mini-implantes sofreram fratura do tipo dúctil. CONCLUSÃO: uma vez que não houve diferença na resistência mecânica de ambas as marcas, variando apenas a forma, conclui-se que a resistência à fratura pode ser afetada por esta variável.AIM: The purpose of this study was to evaluate mini-implants with different dimensions for the following factors: (a insertion torque, (b removal torque, (c fracture torque, (d shear tension, (e normal tension and (f type of fracture. METHODS: Twenty self-drilling mini-implants were used, 10 from SIN and 10 from Neodent, with 1.6mm in diameter and with 8 and 7

Skeletal maturity assessment using mandibular canine calcification stages

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Vildana Džemidžić

2016-11-01

Full Text Available Objective. The aims of this study were: to investigate the relationship between mandibular canine calcification stages and skeletal maturity; and to evaluate whether the mandibular canine calcification stages may be used as a reliable diagnostic tool for skeletal maturity assessment. Materials and methods. This study included 151 subjects: 81 females and 70 males, with ages ranging from 9 to 16 years (mean age: 12.29±1.86 years. The inclusion criteria for subjects were as follows: age between 9 and 16 years; good general health without any hormonal, nutritional, growth or dental development problems. Subjects who were undergoing or had previously received orthodontic treatment were not included in this study. The calcification stages of the left permanent mandibular canine were assessed according to the method of Demirjian, on panoramic radiographs. Assessment of skeletal maturity was carried out using the cervical vertebral maturation index (CVMI, as proposed by the Hassel-Farman method, on lateral cephalograms. The correlation between the calcification stages of mandibular canine and skeletal maturity was estimated separately for male and female subjects. Results. Correlation coefficients between calcification stages of mandibular canine and skeletal maturity were 0.895 for male and 0.701 for female subjects. Conclusions. A significant correlation was found between the calcification stages of the mandibular canine and skeletal maturity. The calcification stages of the mandibular canine show a satisfactory diagnostic performance only for assessment of pre-pubertal growth phase.

Fraturas proximais do fêmur em idosos: qual o melhor tratamento? Proximal fracture of the femur on the elderly: what's the best treatment?

Directory of Open Access Journals (Sweden)

Lygia Paccini Lustosa

2009-01-01

Full Text Available As fraturas proximais do fêmur em idosos representam um sério problema dentro do contexto da saúde pública, devido aos elevados custos econômicos para o tratamento e as suas consequências, assim como pela alta taxa de morbidade e mortalidade. O objetivo desse estudo foi discutir quais os tratamentos mais indicados para esse tipo de fratura, em idosos, por meio de uma revisão da literatura. As bases de dados pesquisadas foram MEDLINE, COCHRANE e PEDro. Os critérios de inclusão foram estudos publicados nos últimos sete anos; nos idiomas português, inglês e espanhol; realizados em seres humanos, sem distinção de gênero e com idade maior que 60 anos; estudos com desenho metodológico de ensaios clínicos, ensaios clínicos aleatorizados e revisões sistemáticas com e sem meta-análise. Foram encontrados sete artigos e após a análise pode se afirmar que não existe um tratamento específico para as fraturas proximais do fêmur em idosos. O tratamento normalmente indicado na maioria dessas fraturas é cirúrgico e requer envolvimento fisioterápico para uma reabilitação adequada. Apesar da dificuldade de comparação entre os estudos, foi observado que uma equipe de profissionais da saúde parece promover uma reabilitação mais efetiva, além de prevenir complicações.The proximal fractures of the femur on the elderly represent a serious problem inside the public health context, because of the high economic costs needed for the treatment and it's consequence, as the high taxes of morbidity and mortality. The goal of this study was to discuss, through a literature revision, which is the most indicated treatment for the proximal fractures of the femur, on the elderly. The researched data bases were MEDLINE, COCHRANE and PEDro. The inclusion criterions were published studies on the last seven years, only on the Portuguese, English and Spanish languages, accomplished on human beings, with no genre distinction and with ages above 60

Ultrasound and multidetector computed tomography of mandibular ...

African Journals Online (AJOL)

Because of local invasivity and high metastatic potential, preoperative imaging evaluation of mandibular region and tumoral staging is essential along with biopsy sampling. The present manuscript describes the ultrasound and computed tomographic imaging findings of mandibular gland adenocarcinoma in two dogs and ...

Influence of mandibular length on mouth opening

NARCIS (Netherlands)

Dijkstra, PU; Hof, AL; Stegenga, B; De Bont, LGM

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

Fratura bilateral de primeira costela em mergulho com colete salva-vidas Bilateral first rib fracture in a dive with life vest

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Pietro de Almeida Sandri

2010-06-01

Full Text Available As fraturas de primeira costela são incomuns e geralmente associadas a grandes traumas torácicos a ponto de servirem como associação com a gravidade do trauma. As fraturas isoladas bilaterais de primeira costela sem grandes traumas torácicos são raramente descritas na literatura. Os sintomas podem passar despercebidos e serem minimizados dificultando o diagnóstico desta condição. O presente relato mostra um trauma direto sobre a região supraclavicular com sintomas de contusão do plexo braquial numa queda de jet ski com uso de salva-vidas. É feita uma revisão da literatura mostrando as diversas faces do problema discutindo-se o tratamento desta condição.First rib fractures are uncommon and are generally related to major thoracic traumas, so much so that they indicate the severity of the trauma. Isolated bilateral first rib fractures without major thoracic trauma are rarely described in the literature. Symptoms may go unnoticed and could be minimal, making diagnosis of this condition difficult. The present report presents a direct trauma of the supraclavicular region with symptoms of contusion of the brachial plexus, caused by a fall from a jet ski using a life vest. A review was done of literature indicating the various facets of the problem and discussing treatment of this condition.

Incidence and characteristics of mandibular accessory canals: A radiographic investigation.

Science.gov (United States)

Borgonovo, Andrea Enrico; Taschieri, Silvio; Vavassori, Virna; Re, Dino; Francetti, Luca; Corbella, Stefano

2017-11-01

The aim of the present study was to explore, through tridimensional reconstructions of cone-beam computed tomography (CBCT) scans, the presence and the characteristics of mandibular accessory canals. For each included participant, the presence of accessory canals was recorded. The diameter of the canal, as well as the distance between the canal walls and the walls of the mandibular bone (lingual, buccal, cranial and caudal), were measured and recorded. Mandibular accessory canals could be found in 8.8% of participants. Retromolar canals were the most frequently found accessory mandibular canals. Accessory mandibular canals were found in a relatively high number of participants through the examination of CBCT scans and tridimensional reconstruction. The presence of such structures should be considered cautiously when planning and performing surgical interventions in mandibular area. © 2017 John Wiley & Sons Australia, Ltd.

Evaluation of the relationship between mandibular third molar and mandibular canal by different algorithms of cone-beam computed tomography.

Science.gov (United States)

Mehdizadeh, Mojdeh; Ahmadi, Navid; Jamshidi, Mahsa

2014-11-01

Exact location of the inferior alveolar nerve (IAN) bundle is very important. The aim of this study is to evaluate the relationship between the mandibular third molar and the mandibular canal by cone-beam computed tomography. This was a cross-sectional study with convenience sampling. 94 mandibular CBCTs performed with CSANEX 3D machine (Soredex, Finland) and 3D system chosen. Vertical and horizontal relationship between the mandibular canal and the third molar depicted by 3D, panoramic reformat view of CBCT and cross-sectional view. Cross-sectional view was our gold standard and other view evaluated by it. There were significant differences between the vertical and horizontal relation of nerve and tooth in all views (p < 0.001). The results showed differences in the position of the inferior alveolar nerve with different views of CBCT, so CBCT images are not quite reliable and have possibility of error.

Split-Framework in Mandibular Implant-Supported Prosthesis

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Danny Omar Mendoza Marin

2015-01-01

Full Text Available 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.

Pediatric mandibular fractures treated by rigid internal fixation.

Science.gov (United States)

Wong, G B

1993-09-01

Mandibular fractures in the pediatric patient population are relatively uncommon. These patients present with their own unique treatment requirements. Most fractures have been treated conservatively by dental splints. Closed reduction techniques with maxillomandibular fixation (MMF) in very young children can pose several concerns, including cooperation, compliance and adequate nutritional intake. Rigid internal fixation of unstable mandibular fractures using miniplates and screws circumvents the need for MMF and allows immediate jaw mobilization. At major pediatric trauma institutions, there has been an increasing trend toward the use of this treatment when open reduction is necessary. This article presents a report of a five-year-old child who presented with bilateral mandibular fractures and was treated by rigid internal fixation and immediate mandibular mobilization.

Bifid mandibular canal: a rare or underestimated entity?

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Ibrahim Nasseh

2016-10-01

Full Text Available 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.

Avaliação do emprego da haste femoral curta na fratura trocantérica instável do fêmur Evaluating the use of a proximal femoral nail in unstable trochanteric fracture of the femur

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João Antonio Matheus Guimarães

2008-09-01

Full Text Available OBJETIVO: Identificar a taxa de consolidação da fratura trocantérica instável submetida a osteossíntese com haste femoral curta (PFN® - AO/ASIF, em pacientes operados entre novembro de 1999 e março de 2004. MÉTODOS: Foram analisados 45 pacientes com idades entre 60 e 93 anos, portadores de fratura trocantérica instável do fêmur, submetidos à osteossíntese com PFN® curto, mediante redução indireta em mesa de tração e auxílio de radioscopia. As fraturas foram classificadas de acordo com a classificação AO/OTA. A qualidade óssea foi avaliada através do índice de Singh, na rotina radiográfica pré-operatória. A qualidade da redução obtida e o posicionamento do implante foram avaliados pela radiografia pós-operatória em ântero-posterior e perfil do fêmur proximal, com análise do ângulo cervicodiafisário e a distância entre a ponta do parafuso deslizante e o centro da cabeça femoral, o chamado tip apex distance (TAD. RESULTADOS: A média de idade dos pacientes estudados foi de 80,8 anos (60-93. O sexo feminino foi predominante, com 37 casos (82,2%. O lado direito foi acometido em 22 casos (48,89% e o esquerdo em 23 (51,1%. Todas as fraturas eram instáveis, sendo 22 do tipo 31A2 (48,8% e 23 do tipo 31A3 (51,1%. O tempo médio de utilização da radioscopia foi de 102,4 segundos (61-185. A diferença entre o tempo de radioscopia para a redução e fixação dos dois grupos de fraturas estudados não foi significativa (p = 0,62. Com relação à qualidade óssea, 82,2% dos pacientes apresentavam índice de Singh menor que IV, caracterizando perda da arquitetura óssea normal. Quanto à consolidação da fratura, 44 casos evoluíram com êxito com tempo médio de 3,2 meses, variando entre dois e sete meses. Em sete casos ocorreu a necessidade de novo procedimento cirúrgico, sendo quatro para a retirada de material de síntese, devido a migração dos parafusos proximais da haste. Um caso de fratura do tipo 31A2

Mandibular incisor apicoectomy in a Canadian Beaver.

Science.gov (United States)

Steenkamp, Gerhard; Venter, Leon; Crossley, David; Buss, Peter

2009-01-01

A 52-month-old Canadian beaver was presented for treatment of lip trauma resulting from overgrowth of the right mandibular incisor tooth following earlier loss of the right maxillary incisor tooth. Extraction of the affected tooth was considered, but rejected due to the length of the embedded portion of rodent mandibular incisor teeth. The lip injury was managed by crown reduction (odontoplasty) of the overgrowing incisor tooth pending a more permanent treatment plan. A 2-cm apicoectomy of the right mandibular incisor tooth was performed to arrest growth of the tooth when the beaver was 82-months-old. The remainder of the tooth continued to erupt and was completely expelled during a 9-month period with one additional odontoplasty being required. The beaver continued to feed normally with just the left maxillary and mandibular incisor teeth until its death at 118-months, with odontoplasty performed twice on the remaining incisor teeth during the 30-months following exfoliation.

Evaluation of mandibular morphology in different facial types

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Rajat Mangla

2011-01-01

Full Text Available The purpose of this study was to evaluate mandibular morphology in different facial types using various parameters. This study was conducted on lateral cephalograms of a total of 110 subjects, which included 55 males and 55 females between the age of 18-25 years having a mean of 22.3 years for males and 21.5 years for females. The sample was divided into normodivergent, hypodivergent, and hyperdivergent subgroups based on Jarabak′s ratio. Symphysis height, depth, ratio (height/depth and angle, antegonial notch depth, ramal height and width, mandibular depth, upper, lower, and total gonial angle, and mandibular arc angle were analyzed statistically and graphically. It was found that the mandible with the vertical growth pattern was associated with a symphysis with large height, small depth, large ratio, small angle, decreased ramus height and width, smaller mandibular depth, increased gonial angle, and decreased mandibular arc angle in contrast to mandible with a horizontal growth pattern. Sexual dichotomy was found with mean symphysis height and depth in the female sample being smaller than in the male sample, but symphysis ratio was larger in the female sample; males having greater ramus height and width, mandibular depth than females. The mandible seemed to have retained its infantile characteristics with all its processes underdeveloped in hyperdivergent group.

Relationship between cervical vertebral maturation and mandibular growth.

Science.gov (United States)

Ball, Gina; Woodside, Donald; Tompson, Bryan; Hunter, W Stuart; Posluns, James

2011-05-01

The cervical vertebrae have been proposed as a method of determining biologic maturity. The purposes of this study were to establish a pattern of mandibular growth and to relate this pattern to the stages of cervical vertebral maturation. Cephalometric radiographs, taken annually from ages 9 to 18 years, were evaluated for 90 boys from the Burlington Growth Center, Toronto, Ontario, Canada. Mandibular lengths were measured from articulare to gnathion, and incremental growth was determined. Cervical vertebral maturation stages were assessed by using a 6-stage method. Advanced, average, and delayed maturation groups were established. The prepubertal mandibular growth minimum velocity occurred during cervical stages 1 through 4 (P = 0.7327). Peak mandibular growth velocity occurred most frequently during stage 4 in all 3 maturation groups, with a statistical difference in the average and delayed groups (P cervical stages 1 through 6 does not occur annually; time spent in each stage varies depending on the stage and the maturation group. Cervical vertebral maturation stages cannot accurately identify the mandibular prepubertal growth minimum and therefore cannot predict the onset of the peak in mandibular growth. The cervical vertebral maturation stages should be used with other methods of biologic maturity assessment when considering both dentofacial orthopedic treatment and orthognathic surgery. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Impacted mandibular third molars and their influence on mandibular angle and condyle fractures--a retrospective study.

Science.gov (United States)

Gaddipati, Rajasekhar; Ramisetty, Sudhir; Vura, Nandagopal; Kanduri, Rajeev Reddy; Gunda, Vinay Kumar

2014-10-01

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. A retrospective cohort was designed for patients reported to the Department of Oral and Maxillofacial Surgery from January 2011 till June 2013. The study variables are presence or absence of third molar, if it is present, their position, classified using the Pell and Gregory system; angulation, classified using Shiller's method. The outcome variables were angle and condyle fractures. Hospital records and panoramic radiographs were used to determine and classify these variables. The study sample comprised of 118 mandibular angle and condyle fractures in 110 patients. Database was constructed and analysed using SPSS version 10.0. This present retrospective study concluded that the presence of impacted third molar predisposes the angle to fracture and reduces the risk of a concomitant condylar fracture. However absence of impacted third molar increases the risk of condylar fracture. The highest incidence of angle fracture was observed in position A impacted mandibular third molars. And there is no significant relationship, concerning ramus position and angulation of impacted mandibular third molars with the angle fracture. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Resolution of neurosensory deficit after mandibular orthognathic surgery: A prospective longitudinal study.

Science.gov (United States)

Alolayan, Albraa Badr; Leung, Yiu Yan

2017-05-01

To investigate the longitudinal resolution of neurosensory deficit (NSD) and the possible risk factors that might contribute to NSD following mandibular orthognathic procedures. A prospective longitudinal observational study on patients who had mandibular orthognathic procedures was performed. Standardized neurosensory assessments were performed. The 2 years longitudinal resolution and risk factors of NSD including patients' age and gender, specific mandibular procedures and surgeons' experience were analyzed. 66 patients (44 females) with 132 sides of mandibular procedures were enrolled in the study. Surgical procedures included mandibular ramus surgery, anterior mandibular surgery, or the combination of the two. The overall occurrences of subjective NSD improved from 78.8% at postoperative 2 weeks to 13.8% at post-operative 2 years. Combinations of ramus surgery and anterior mandibular surgery increased the risk of NSD at the first three post-operative months (p orthognathic surgery. The occurrence of NSD after mandibular orthognathic procedures reduced progressively within the post-operative 2 years. Combination of mandibular ramus surgery and anterior mandibular surgery increased the risk of NSD in the early post-operative period. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Morphometric study on mandibular foramen and incidence of accessory mandibular foramen in mandibles of south Indian population and its clinical implications in inferior alveolar nerve block.

Science.gov (United States)

Shalini, R; RaviVarman, C; Manoranjitham, R; Veeramuthu, M

2016-12-01

The mandibular foramen is a landmark for procedures like inferior alveolar nerve block, mandibular implant treatment, and mandibular osteotomies. The present study was aimed to identify the precise location of the mandibular foramen and the incidence of accessory mandibular foramen in dry adult mandibles of South Indian population. The distance of mandibular foramen from the anterior border of the ramus, posterior border of the ramus, mandibular notch, base of the mandible, third molar, and apex of retromolar trigone was measured with a vernier caliper in 204 mandibles. The mean distance of mandibular foramen from the anterior border of ramus of mandible was 17.11±2.74 mm on the right side and 17.41±3.05 mm on the left side, from posterior border was 10.47±2.11 mm on the right side and 9.68±2.03 mm on the left side, from mandibular notch was 21.74±2.74 mm on the right side and 21.92±3.33 mm on the left side, from the base of the ramus was 22.33±3.32 mm on the right side and 25.35±4.5 mm on the left side, from the third molar tooth was 22.84±3.94 mm on the right side and 23.23±4.21 mm on the left side, from the apex of retromolar trigone was 12.27±12.13 mm on the right side and 12.13±2.35 mm on the left side. Accessory mandibular foramen was present in 32.36% of mandibles. Knowledge of location mandibular foramen is useful to the maxillofacial surgeons, oncologists and radiologists.

Terapêutica interdisciplinar para fratura cominutiva de côndilo por projétil de arma de fogo: enfoque miofuncional

OpenAIRE

Bianchini,Esther Mandelbaum Gonçalves; Moraes,Rogério Bonfante; Nazario,Daniella; Luz,João Gualberto de Cerqueira

2010-01-01

TEMA: ferimentos causados por projéteis de arma de fogo apresentam alta incidência na região da cabeça e face. A articulação temporomandibular pode estar envolvida, além de estruturas anatômicas importantes como o nervo facial, necessitando de equipe multidisciplinar para efetuar tratamento adequado. PROCEDIMENTOS: apresentação de caso clínico de fratura condilar cominutiva causada por projétil de arma de fogo tratado de forma não-cirúrgica associado à terapia miofuncional orofacial. Paciente...

Mandibular advancement appliance for obstructive sleep apnoea

DEFF Research Database (Denmark)

Petri, Niels; Svanholt, Palle; Solow, Beni

2008-01-01

The aim of this trial was to evaluate the efficacy of a mandibular advancement appliance (MAA) for obstructive sleep apnoea (OSA). Ninety-three patients with OSA and a mean apnoea-hypopnoea index (AHI) of 34.7 were centrally randomised into three, parallel groups: (a) MAA; (b) mandibular non...

Occlusal plane rotation: aesthetic enhancement in mandibular micrognathia.

Science.gov (United States)

Rosen, H M

1993-06-01

Patients afflicted with extreme degrees of mandibular micrognathia typically have vertically deficient rami as well as sagittally deficient mandibular bodies. This results in deficient posterior facial height, an obtuse gonial angle, excessively steep occlusal and mandibular planes, and a compensatory increase in anterior facial height. The entire maxillomandibular complex is overrotated in a clockwise direction. Standard orthognathic surgical correction fails to address this rotational deformity. As a consequence, the achieved projection of the lower face is inadequate, posterior facial height is further reduced, and occlusal and mandibular planes remain steep. Eleven patients with severe mandibular micrognathia underwent a surgical correction involving occlusal plane rotation to its normal orientation relative to Frankfort horizontal. This was accomplished by Le Fort I osteotomy to shorten the anterior maxilla (creating open bites in seven patients and making preexisting open bites worse in four patients) and sagittal split ramus osteotomies to advance and rotate the mandibular body counterclockwise, thus closing the surgically produced open bite. Counterclockwise rotation of the mandible afforded significantly greater sagittal displacement at the B point (mean 17 mm) than at the first molar (mean 10 mm) and produced adequate degrees of projection of the lower face when accompanied by a modest sliding genioplasty (mean 6.9 mm). Total advancement at the pogonion was a mean of 25.2 mm. In addition, posterior facial height was preserved, and mandibular and occlusal planes were normalized to mean angles of 27 and 10 degrees, respectively. At follow-up, which ranged from 9 to 24 months with a mean of 14.1 months, the mean sagittal relapse at the B point was 1.9 mm. Although heretofore considered unstable and therefore not clinically accepted, maxillomandibular counterclockwise rotation to normalize the occlusal plane rotational deformity provides stable, aesthetically

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

Science.gov (United States)

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.

Mandibular Condyle Fractures and Treatment Modalities

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Halil ibrahim Kisa

2014-08-01

Full Text Available Maxillofacial injuries are most commonly associated with falls, motor and vehicle accidents, sports-related trauma, and interpersonel violence. The complexity of mandibular condyle region and its anatomic proximity to other craniofacial structures complicate diagnosis and treatment. Thus, treatment approaches of mandibular condyle fracture are still controversial. In the literature, different success rates are reported about observation versus treatment, closed reduction versus open reduction and fixation methods. In the present article, controversial issues related to mandibular condyle fractures were reviewed under the light of current literature. In conclusion, the simplest way that can be done with the least risk of complication should be chosen during treatment planning. In addition, current adjunctive treatment methods accelerating healing of fracture should be considered. [Archives Medical Review Journal 2014; 23(4.000: 658-671

A new technique for mandibular osteotomy

Directory of Open Access Journals (Sweden)

Puricelli Edela

2007-03-01

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

Quedas e fraturas entre residentes de instituições de longa permanência para idosos Falls and fractures among older adults living in long-term care

Directory of Open Access Journals (Sweden)

Giovâni Firpo Del Duca

2013-03-01

Full Text Available OBJETIVO: Investigar a ocorrência de quedas e fraturas no último ano e fatores associados entre residentes de instituições de longa permanência para idosos (ILPI. MÉTODOS: Estudo transversal exploratório, a partir de um censo realizado em ILPI localizadas em Pelotas, Rio Grande do Sul, em 2008. As quedas e fraturas decorrentes dessas foram investigadas a partir de autorrelato referente ao último ano. Sexo, idade, escolaridade, incapacidade funcional para atividades básicas da vida diária, tipo de financiamento da instituição e hospitalização no último ano foram coletados como potencias fatores associados à ocorrência de queda no último ano. Empregou-se o teste qui-quadrado para heterogeneidade e tendência linear e, na análise ajustada, a regressão de Poisson com variância robusta. RESULTADOS: Nas 24 ILPI incluídas no estudo, coletaram-se dados de 466 indivíduos. A prevalência de quedas no último ano foi de 38,9% (IC95%: 34,5 - 43,4. Dentre aqueles que caíram, as fraturas acometeram 19,2%. As fraturas mais frequentes foram: fêmur/quadril (43,3% e punho (10%. Na análise ajustada, o avanço da idade, apresentar incapacidade funcional em uma a cinco atividades da vida diária, residir em instituições públicas/filantrópicas e ter sido hospitalizado no último ano associaram-se à queda no último ano. CONCLUSÃO: A alta ocorrência de quedas e fraturas entre residentes de instituições de longa permanência para idosos revela a fragilidade da população avaliada. Atenção específica deve ser destinada a indivíduos mais velhos e hospitalizados no último ano. OBJECTIVE: To investigate the prevalence of falls and fractures over the past 12 months and associated factors among older adults living in long-term care. METHODS: Census of all long-term care located in the city of Pelotas, Brazil, in 2008. Falls over the past 12 months were assessed using the following question: "Over the last 12 months, have you fallen

Maxillary-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia.

Science.gov (United States)

Nakajima, Hideo; Sakamoto, Yoshiaki; Tamada, Ikkei; Ogata, Hisao; Kishi, Kazuo; Sakamoto, Teruo

2011-12-01

We treat hemifacial microsomia with a combination of surgery and orthodontic treatment during the growth period, resulting in early improvement in facial asymmetry and the induction of normal growth. We previously used gradual distraction of the mandibular ramus for Pruzansky's type II classification (Pruzansky, 1969). In type II cases, the maxilla should also be treated actively as, using this technique, improvement of the occlusal plane is difficult to achieve, resulting in a cross bite and difficulties in post-operative orthodontic treatment-especially in older patients. Morphologically, the mandibular angle region of the operative side is flat, and the angle of the mouth remains elevated. We performed mandibular-driven simultaneous maxillo-mandibular distraction while the occlusion was maintained using intermaxillary anchorage. However, mandibular-driven distraction tended to elongate the face because the mandible only elongated downwards and the mandibular ramus did not reach the glenoid. Furthermore, external distraction devices produce significant distress for patients until removal of the device and cause scars on the face. We developed a new internal distraction device with a variable angle and performed maxillary-driven simultaneous maxillo-mandibular distraction using this device. The result was morphologically satisfactory and solved the above problems. Because the patient was in the growth period, careful follow-up and induction to normal growth were important while the inferior growth of the affected side was monitored. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Radiologic study of mandibular third molar of Korean youths

International Nuclear Information System (INIS)

Ahn, Hyung Kyu

1982-01-01

The author has made a study on the classification of the mandibular 3rd molars of Korean youths through dental radiography by means of Pell and Gregory's classification and on the prevalence of the dental caries of distal surface of the mandibular 2nd molar adjacent to the mandibular 3rd molars turned anteriorly. The results are as follow; 1. It was found that the largest case number was class I (272 cases, 52.9%) in the relation of the tooth to the ramus of the mandible and 2nd molar. 2. The mesio-angular position was the largest number (239 cases, 46.5%) in the relation of the long axis of the impacted mandibular 3rd molar to the long axis of the 2nd molar. 3. The mesio-angular position of class I was the largest number (140 cases, 27.2%) in the relation of the tooth to the ramus of the mandible and 2nd molar and the long axis of the impacted mandibular 3rd moral to the long axis of the 2nd molar. 4. The average angle of the long axis of mandibular 3rd molar in mesioangular position or horizontal position to the occlusal plane was 143 W 5. Mandibular 3rd molar with lesion such as dental cries or pericoronitis was 73 cases (14.2). 6. The caries incidence rate of the distal surface of the 2nd molar was about 3.1%.

Osteochondroma involving mandibular condyle

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Latika Bachani

2017-01-01

Full Text Available Osteochondroma is defined as an osteocartilagenous exostosis with cartilage capped exophytic lesion that arises from the bone cortex. It is a slow growing benign tumor that is rarely seen in the maxillofacial region. Osteochondroma of the mandibular condyle is a relatively rare condition that causes a progressive enlargement of the condyle, usually resulting in facial asymmetry, temporomandibular joint (TMJ dysfunction and malocclusion. Radiographically, there is a unilaterally enlarged condyle usually with an exophytic growth of the tumor from the condylar head. The treatment of osteochondroma is primarily surgical resection of the tumor. This paper reports a case of osteochondroma of the right mandibular condyle presenting as a painless restricted mouth opening.

Relação entre qualidade de vida e fratura vertebral em mulheres idosas residentes no Sul do Brasil Relationship between quality of life and vertebral fractur in older women living in Southern Brazil

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Patrícia Pereira de Oliveira

2011-05-01

Full Text Available OBJETIVO: Verificar a relação entre qualidade de vida e fratura vertebral em mulheres com mais de 60 anos em uma cidade do Sul do Brasil. MÉTODOS: Realizado estudo caso-controle com aplicação do questionário WHOQOL-bref em 100 mulheres residentes na cidade Chapecó (SC, com idade superior a 60 anos, na pós-menopausa de raça branca ou caucasoide, sem prejuízo cognitivo importante ou história pessoal doenças que sabidamente afetem o metabolismo ósseo ou neoplasias malignas. A população foi dividida em dois grupos dependendo da existência ou não de fraturas vertebrais na radiografia de coluna. Foram analisadas variáveis relacionadas à historia médica atual e pregressa, hábitos de vida e história familiar de fraturas, e os domínios e facetas que compõe o WHOQOL-bref. RESULTADOS: Observou-se que as mulheres com fratura tinham maior média de idade do que as sem fraturas (p0,05. Na avaliação dos domínios que compõem o WHOQOL-bref, a maior média deste grupo foi no psicológico (..=63,6±13,0, e a menor no meio ambiente (..=58,8±9,3. No grupo sem fratura, a maior média também ocorreu no domínio psicológico (..=67,2±9,3, já a menor ocorreu no das relações sociais (..=57,5±7,7. A análise estatística não mostrou correlação significativa entre as médias das facetas que compõem os domínios entre os grupos com e sem fraturas. CONCLUSÃO: Este estudo sugere não haver prejuízo na qualidade de vida de idosas com fratura vertebral, mas sua relação com o tempo de ocorrência e gravidade das fraturas deve ser melhor avaliada. Ambos grupos tiveram escores mais elevados no domínio psicológico, mostrando que as entrevistadas se apóiam em crenças pessoais, espiritualidade e religião, aceitam sua aparência física mantendo a autoestima e a capacidade de pensar, aprender e concentrar-se, independentemente da existência do agravo. Não houve diferença estatisticamente significativa entre os grupos, e nem entre os

Mandibular kinematics after orthognathic surgical treatment a pilot study.

Science.gov (United States)

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.

Fixation of zygomatic and mandibular fractures with biodegradable plates

OpenAIRE

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 sc...

Conseqüências no crescimento de maxila e mandíbula de defeito ósseo cirúrgico no ramo da mandíbula de ratos Consequences on the growth of maxilla and mandible of surgical bone defect on mandibular ramus of rats

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Lucimar Rodrigues

2004-10-01

Full Text Available OBJETIVO: Analisar as conseqüências no crescimento de maxila e mandíbula de defeito ósseo cirúrgico simulando fratura no ramo da mandíbula. MÉTODOS: Foram utilizados 25 ratos Wistar com um mês de idade. Sob anestesia geral e por meio de incisão submandibular. Foi realizada osteotomia vertical no ramo da mandíbula do lado direito com emprego de motor cirúrgico. Após período de dois meses os animais foram sacrificados, os tecidos moles retirados e as hemimandíbulas desarticuladas. Foram realizadas incidências radiográficas axiais para o crânio e laterais para as hemimandíbulas. A seguir, por intermédio de um sistema de computador foram obtidas medidas lineares da maxila e das hemimandíbulas. Foi empregado o teste "t" de Student para verificação da significância da diferença entre os lados experimental e controle. RESULTADOS: A diferença foi significante para a altura do ramo (p=0,010 e comprimento da mandíbula referente ao côndilo (p=0,015 e ao ângulo (pPURPOSE: To analyse the consequences on the growth of maxilla and mandible of a surgical bone defect that simulates a mandibular ramus fracture. METHODS: A group of 25 one-month-old Wistar rats were used in this study. Under general anesthesia, and through a submandibular incision, a vertical osteotomy on the right side of the mandibular ramus was made using a surgical drill. The animals were sacrificed after two months, soft tissues removed, and the mandible disarticulated. The skull was submitted to axial radiograph and the hemimandibles to a lateral radiograph. With these, cephalometric mensurations were made through a computer system, and the obtained values submitted to Student's t-test. RESULTS: The height of the mandibular ramus presented significant difference (p=0,010 as well as the length of mandible, both to the condyle (P=0,015 and the angle (p=0,001. There was no significant difference to the mensurations of the maxilla. CONCLUSION: The consequences of the

Algorithm of imaging modalities in cases of mandibular fractures

International Nuclear Information System (INIS)

Mihailova, H.

2009-01-01

Mandibular fracture is the most common bone fracture of maxillo-facial trauma. Up to now the main method for examination of the mandible is radiography. The aim of the issue is to present an algorithm of imaging modalities for investigation of patients in cases of mandibular trauma. It consists of series of X ray techniques and views of the facial skull named mandibulo-facial. This standardizes mandibulo-facial series includes exactly determined four projections done by conventional X ray techniques: posterior-anterior view of skull (PA or AP), oblique view of the left mandible; oblique view of the right mandible; occipito-mental view. Using these four planned radiograms is obligatory for each mandibular trauma. Panoramic X-ray is obligatory in cases of apparatus availability; this abolish only oblique views (left and right). Occipito-mental view of the skull gives anatomically better the coronoid process of the mandible, the zygoma complex, the orbital edges and maxillar sinus than Waters projection. So mandibulo-facial series of four planned radiograms is not only for diagnostic of mandibular fractures, but as a screening of mandibulo-facial trauma too. Thus using algorithm of imaging modalities in cases of mandibular fracture leads to optimization of diagnostic process in patients with mandibular trauma. (author)

Chincup treatment modifies the mandibular shape in children with prognathism.

Science.gov (United States)

Alarcón, José Antonio; Bastir, Markus; Rosas, Antonio; Molero, Julia

2011-07-01

Although chincups are the preferred treatment for growing children with mandibular prognathism, the mechanism by which chincups improve this condition remains unclear. The aim of this study was to use geometric morphometrics to evaluate changes in the shape of the mandible of prognathic children treated with a chincup. Geometric morphometrics were used to evaluate the short-term mandibular shape changes in 50 prognathic children treated with chincups compared with 40 untreated matched controls. Twenty-one 2-dimensional mandibular landmarks from cephalograms taken before and after 36 months of treatment or observation were analyzed by Procrustes superimposition and thin plate spline. Permutation tests of the treated patients showed highly significant differences in the mandibular shapes before and after treatment, and compared with the control group after the observation period. The thin plate spline grid deformations indicated more rectangular mandibular configuration, forward condyle orientation, condyle neck compression, gonial area compression, and symphysis narrowing. Early chincup treatment widely modifies the mandibular shape of prognathic children to improve Class III malocclusion. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Rediseño de una lavadora de bidones para envasado de agua tratada

OpenAIRE

Martinez Lozano, Ernesto Rolando

2009-01-01

El objetivo de esta tesis es aplicar los conocimientos adquiridos, para realizar el rediseño de una lavadora manual para bidones de una empresa de tratamiento de agua, se establecerán las condiciones de diseño optimo para disminuir el tiempo en el proceso de lavado de los bidones que son utilizados en el proceso de envasado del agua tratada el cual es realizado manualmente, en donde los tiempos de lavado varían entre 40 y 60 botellas por hora; queriendo llegar a obtener un tiempo estándar de ...

Augmented mandibular bone structurally adapts to functional loading

NARCIS (Netherlands)

Verhoeven, J. W.; Ruijter, J. M.; Koole, R.; de Putter, C.; Terlou, M.; Cune, M. S.

2013-01-01

Long-term changes in trabecular bone structure during the 10 years following onlay grafting with simultaneous mandibular implant placement were studied. Extraoral radiographs of both mandibular sides in eight patients were taken regularly. Bone structure was analysed using a custom-written image

Diagnostic ability of panoramic radiography for mandibular fractures

International Nuclear Information System (INIS)

Lee, Ji Hyun; Jung, Yun Hoa; Cho Bong Hae; Hwang, Dae Seok

2010-01-01

The purpose of this study was to evaluate the diagnostic efficacy of panoramic radiographs for detection of mandibular fractures. The sample was comprised of 65 patients (55 fractured, 10 non-fractured) with 92 fracture sites confirmed by multi-detector computed tomography (CT). Panoramic radiographs were evaluated for mandibular fractures by six examiners; two oral and maxillofacial radiologists (observer A and B), two oral and maxillofacial surgeons (observer C and D), and two general dentists (observer E and F). Sensitivity of panoramic radiography for mandibular fractures was 95.7% in observer A and B, 93.5% in observer C and D and 80.4% in observer E and F. The lowest sensitivity was shown in symphyseal/parasymphyseal areas, followed by subcondylar/condylar regions. Panoramic radiography is adequate for detection of mandibular fractures. However, additional multidetector CT is recommended to ascertain some indecisive fractures of symphysis and condyle, and in complicated fractures.

Diagnostic ability of panoramic radiography for mandibular fractures

Energy Technology Data Exchange (ETDEWEB)

Lee, Ji Hyun; Jung, Yun Hoa; Cho Bong Hae; Hwang, Dae Seok [School of Dentistry, Pusan National University, Pusan (Korea, Republic of)

2010-03-15

The purpose of this study was to evaluate the diagnostic efficacy of panoramic radiographs for detection of mandibular fractures. The sample was comprised of 65 patients (55 fractured, 10 non-fractured) with 92 fracture sites confirmed by multi-detector computed tomography (CT). Panoramic radiographs were evaluated for mandibular fractures by six examiners; two oral and maxillofacial radiologists (observer A and B), two oral and maxillofacial surgeons (observer C and D), and two general dentists (observer E and F). Sensitivity of panoramic radiography for mandibular fractures was 95.7% in observer A and B, 93.5% in observer C and D and 80.4% in observer E and F. The lowest sensitivity was shown in symphyseal/parasymphyseal areas, followed by subcondylar/condylar regions. Panoramic radiography is adequate for detection of mandibular fractures. However, additional multidetector CT is recommended to ascertain some indecisive fractures of symphysis and condyle, and in complicated fractures.

Autotransplantation of Mandibular Third Molar: A Case Report

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Pabbati Ravi kumar

2012-01-01

Full Text Available 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.

Eosinophilic granuloma of the mandibular condyle

International Nuclear Information System (INIS)

Huh, Kyung Hoe; Yi, Won Jin; Oh, Sung Won; Lee, Sam Sun; Choi, Mun Kyung

2008-01-01

The present study reports a case of eosinophilic granuloma of the mandibular condyle. Eosinophilic granulomas on the mandibular condyle are very rare, but there are several common clinical and radiographic presentations. The clinical presentations involve swelling on preauricular area, limitation of opening, TMJ pain, etc. The radiographic presentations involve radiolucent lytic condylar lesion with or without pathologic fracture. Sometimes new bone formations are observed. The purpose of the article is to add new cases to the literatures.

Eosinophilic granuloma of the mandibular condyle

Energy Technology Data Exchange (ETDEWEB)

Huh, Kyung Hoe; Yi, Won Jin; Oh, Sung Won; Lee, Sam Sun [Department of Oral and Maxillofacial Radiology, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of); Choi, Mun Kyung [Department of Oral and Maxillofacial Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Seoul (Korea, Republic of)

2008-03-15

The present study reports a case of eosinophilic granuloma of the mandibular condyle. Eosinophilic granulomas on the mandibular condyle are very rare, but there are several common clinical and radiographic presentations. The clinical presentations involve swelling on preauricular area, limitation of opening, TMJ pain, etc. The radiographic presentations involve radiolucent lytic condylar lesion with or without pathologic fracture. Sometimes new bone formations are observed. The purpose of the article is to add new cases to the literatures.

Mandibular fracture cases in Pelotas, Rio Grande do Sul, Brazil

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Rafael Silva da Silva

2009-10-01

Full Text Available Objectives: To analyze the data in the literature, which show a high incidence of mandibular fractures. The aim of this research was to elucidate the context in which these fractures occur among patients attended at the first aid center of “Pronto Socorro Municipal de Pelotas”, Rio Grande do Sul, Brazil. Methods: From the records referring to the period of June, 2001 to August, 2007, there were 1 345 patients with facial fractures. Of this total, 116 patients with mandibular fracture were selected for this study and the items analysed were: age, gender, mandibular fracture site, etiology and period of the year. Results: It was found that 86.2% of the sample were men. The most prevalent age was 20 to 29 years old representing 36.2%, and the most affected mandibular sites were the body, with 29 cases (25%, and the condyle, with 26 cases (22.4%. The most common cause of fractures was the physical aggression representing 37.1%. The period of the year with the highest incidence of mandibular fractures was the summer, with 38 cases (32.8%. Conclusion: It was therefore observed that the patients with mandibular fracture assisted at Pronto-Socorro Municipal de Pelotas, Rio Grande do Sul, Brazil, were generally men, 20 to 29 years old with mandibular body fracture and they were victims of physical aggression.

Early Loaded Single Implant Reinforced Mandibular Overdenture

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K. Nischal

2016-01-01

Full Text Available 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.

Intraoperative monitoring of marginal mandibular nerve during neck dissection.

Science.gov (United States)

Tirelli, Giancarlo; Bergamini, Pier Riccardo; Scardoni, Alessandro; Gatto, Annalisa; Boscolo Nata, Francesca; Marcuzzo, Alberto Vito

2018-05-01

The purpose of this study was to assess the efficacy of intraoperative nerve integrity monitoring (NIM) to prevent marginal mandibular nerve injuries during neck dissection. This prospective study compared 36 patients undergoing NIM-assisted neck dissection from July 2014 to March 2015 to a cohort of 35 patients subjected to neck dissection over an identical period of time before the technique was introduced. We also assessed possible correlations between marginal mandibular nerve injuries and other factors, such as anthropometric measurements, presence of clinical neck metastases, type of neck dissection, and site of primary tumor. The incidence of marginal mandibular nerve paralyses was significantly lower among the group of patients undergoing NIM-assisted neck dissection (P = .021). There was no significant difference in the duration of the procedure, and the technique resulted in a limited increase of cost. No other factor seemed to influence the onset of marginal mandibular nerve palsy. In our opinion, NIM is a valuable aid for preventing marginal mandibular nerve injuries during neck dissection. © 2018 Wiley Periodicals, Inc.

Radiographic Localization of the Mental Foramen and Mandibular Canal

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Farzaneh Afkhami

2013-01-01

Full Text Available Objective: Accurately localizing the mental foramen and mandibular canal is important when administering local anesthesia and performing surgery; therefore, knowing the normal range of the possible locations is essential. Our purpose was to assess the location of the mental foramen and mandibular canal in an Iranian population using panoramic radiography.Materials and Methods: Standard panoramic radiographies were performed. The positions of 100 mental foramens were evaluated. The distances from the center of the mental foramen to the superior and inferior borders of the mandible and to the apexes of the first and second premolar were measured. The distance of the mental foramens from the mandibular midline and the diameter of the mandibular canal in the mental foramen connection were also measured.Results: Among 100 mental foramens, 6% were positioned under the first premolar, 24% were between the first and second premolars, 67% were under the second premolar, and the remaining 3% were behind the second premolar. The mean distance from the mental foramen to the mandibular midline was 27.77±3.20 mm. The mean diameter of the mandibular canal in the mental foramen connection was 3.09±0.69mm.Conclusion: The mental foramen was near the second premolar and the inferior border of the mandible. This information can be used to perform safer mental nerve blocks in surgical interventions.

21 CFR 874.3695 - Mandibular implant facial prosthesis.

Science.gov (United States)

2010-04-01

... made of materials such as stainless steel, tantalum, titanium, cobalt-chromium based alloy... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mandibular implant facial prosthesis. 874.3695... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant...

Penetration of flomoxef into human maxillary and mandibular bones.

Science.gov (United States)

Igawa, H H; Sugihara, T; Yoshida, T; Kawashima, K; Ohura, T

1995-09-01

Penetration of flomoxef into the maxillary and mandibular bones was assayed clinically to provide data about its usefulness for the prevention of postoperative infection after maxillofacial surgery. Twenty-one patients undergoing maxillofacial surgery at our department were given flomoxef 2 g dissolved in 20 ml of physiological saline intravenously over 3 minutes during operation, and the serum, maxillary and mandibular concentrations were measured 1, 3, and 6 hours after injection by the band culture method using Escherichia coli 7437 as the indicator strain. The mean concentrations were 53.4, 16.1, and 2.6 micrograms/ml, respectively, in the serum, 17.6, 7.8, and 1.0 micrograms/g in maxillary bone, and 16.4, 4.2, and 0.9 micrograms/g in mandibular bone. The mean bone:serum ratios at 1, 3, and 6 hours were 33.0%, 48.2%, and 36.8%, respectively, for maxillary bone, and 30.7%, 26.2%, and 35.7% for mandibular bone. When compared with previously reported data on the bone:serum ratios in jaw of various other intravenous antibiotics, our results show that penetration of flomoxef into maxillary and mandibular bone is extremely high. As all the intramaxillary and intramandibular concentrations exceed its MIC80 values against clinical isolates of bacteria frequently isolated in cases of infection in the oral and maxillofacial region, it is apparent that one intravenous shot of flomoxef 2 g allows penetration of the drug into the maxillary and mandibular bones at effective concentrations. Flomoxef is therefore potentially useful for the prevention and treatment of infections in the oral and maxillofacial region, as it has excellent penetration into the maxillary and mandibular bones.

Inducción de la brotación in vitro de microplántulas de nogal (Juglans neotropica) tratadas con Thidiazuron (TDZ) y 6-Bencilaminnopurina (BAP)

OpenAIRE

Peña Tapia, Denisse Fabiola; Rocano Curillo, Melida Noemi; Salazar, Jazmin M.; Torres, Carlos S.; Universidad de Cuenca; Dirección de Investigación de la Universidad de Cuenca; DIUC

2014-01-01

El nogal (Juglans neotropica) es una especie de gran potencial para proyectos de conservación y agro-productivos en la eco-región Andina. No obstante, su baja capacidad germinativa limita su propagación para reforestación. El objetivo de este estudio fue determinar el efecto del tratamiento con Thidiazuron (TDZ) y 6-Bencilaminopurina (BAP) en la inducción in vitro de brotes de J. neotropica. Las microplántulas tratadas con BAP produjeron más brotes que aquellas tratadas con TDZ. Las microplán...

Intermaxillary Fixation Screw Morbidity in Treatment of Mandibular Fractures

DEFF Research Database (Denmark)

Florescu, Vlad-Andrei; Kofod, Thomas; Pinholt, Else Marie

2016-01-01

Purpose The aim of the present retrospective study was to investigate the morbidity of screws used for intermaxillary fixation (IMF) in the treatment of mandibular fractures. A review of the published data was also performed for a comparison of outcomes. Our hypothesis was that the use of screws...... for IMF of mandibular fractures would result in minimal morbidity. Materials and Methods Patients treated for mandibular fractures from 2007 to 2013, using screws for IMF, using the international diagnosis code for mandibular fracture, DS026, were anonymously selected (Department of Oral and Maxillofacial...... Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark). The fracture type, radiographic findings, treatment modality, screw type and number, and root damage were recorded. For the outcome comparison, a review of the published data regarding iatrogenic dental root damage caused...

[A toddler with a mandibular fracture].

Science.gov (United States)

van der Linden, E L; Bun, R J; van Os, E

2017-01-01

Mandibular fractures are rare in children. Symptoms of these fractures include preauricular pain and swelling, trismus and pain when opening the mouth, and they are often preceded by a fall on the chin. If the diagnosis is missed they may have serious consequences for the growth and development of the jaw. A 3-year-old boy was referred with a swelling in his left cheek, fever and vomiting. Two days earlier he had fallen on his chin. At physical examination he had severe preauricular pain on palpation and a trismus. The patient was admitted because of suspicion of a viral parotitis and the threat of dehydration. After discharge, he went to the dentist for examination of a molar that was painful to the touch. The dentist performed an orthopantomogram and discovered a fracture of the left mandibular collum. Any child with trauma to the chin should be observed for symptoms of a mandibular fracture, and if it seems necessary non-invasive radiographic examination should be performed.

Trigeminocardiac reflex by mandibular extension on rat pial microcirculation: role of nitric oxide.

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Dominga Lapi

Full Text Available In the present study we have extended our previous findings about the effects of 10 minutes of passive mandibular extension in anesthetized Wistar rats. By prolonging the observation time to 3 hours, we showed that 10 minutes mandibular extension caused a significant reduction of the mean arterial blood pressure and heart rate respect to baseline values, which persisted up to 160 minutes after mandibular extension. These effects were accompanied by a characteristic biphasic response of pial arterioles: during mandibular extension, pial arterioles constricted and after mandibular extension dilated for the whole observation period. Interestingly, the administration of the opioid receptor antagonist naloxone abolished the vasoconstriction observed during mandibular extension, while the administration of Nω-Nitro-L-arginine methyl ester, a nitric oxide synthase inhibitor, abolished the vasodilation observed after mandibular extension. Either drug did not affect the reduction of mean arterial blood pressure and heart rate induced by mandibular extension. By qRT-PCR, we also showed that neuronal nitric oxide synthase gene expression was significantly increased compared with baseline conditions during and after mandibular extension and endothelial nitric oxide synthase gene expression markedly increased at 2 hours after mandibular extension. Finally, western blotting detected a significant increase in neuronal and endothelial nitric oxide synthase protein expression. In conclusion mandibular extension caused complex effects on pial microcirculation involving opioid receptor activation and nitric oxide release by both neurons and endothelial vascular cells at different times.

Coronal views of the paediatric mandibular condyle on ...

African Journals Online (AJOL)

This article highlights the importance of routinely reviewing the mandibular condyle on computerised tomography brain studies in a trauma setting, that often extends to involve the mandibular condyles in the scan parameters. We discuss 4 cases seen over the last 18 months at our institution, and review the relevant ...

Osteochondroma of the mandibular condyle

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Ashish Kumar

2011-01-01

Full Text Available Osteochondroma (OC of the mandibular condyle is a relatively rare condition that causes a progressive enlargement of the condyle, usually resulting in facial asymmetry, temporomandibular joint (TMJ dysfunction, and malocclusion. Radiographically, there is a unilaterally enlarged condyle usually with an exophytic outgrowth of the tumor from the condylar head. We present a case of a left mandibular condylar OC that created a major facial asymmetry, malocclusion, and TMJ dysfunction. Discussion includes the rationale for treatment and the method used in this case. In actively growing OCs, surgical intervention is indicated to remove the tumor stopping the benign growth process and improve facial symmetry, occlusion, and jaw function.

Orthodontic Extraction of High-Risk Impacted Mandibular Third Molars in Close Proximity to the Mandibular Canal: A Systematic Review.

Science.gov (United States)

Kalantar Motamedi, Mahmood Reza; Heidarpour, Majid; Siadat, Sara; Kalantar Motamedi, Alimohammad; Bahreman, Ali Akbar

2015-09-01

Extraction of mandibular third molars (M3s) in close proximity to the mandibular canal has some inherent risks to adjacent structures, such as neurologic damage to teeth, bone defects distal to the mandibular second molar (M2), or pathologic fractures in association with enlarged dentigerous cysts. The procedure for extrusion and subsequent extraction of high-risk M3s is called orthodontic extraction. This is a systematic review of the available approaches for orthodontic extraction of impacted mandibular M3s in close proximity to the mandibular canal and their outcomes. The PubMed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), DOAJ, Google Scholar, OpenGrey, Iranian Science Information Database (SID), Iranmedex, and Irandoc databases were searched using specific keywords up to June 2, 2014. Studies were evaluated based on predetermined eligibility criteria, treatment approaches, and their outcomes. Thirteen articles met the inclusion criteria. A total of 123 impacted teeth were extracted by orthodontic extraction and 2 cases were complicated by transient paresthesia. Three types of biomechanical approaches were used: 1) using the posterior maxillary region as the anchor for orthodontic extrusion of lower M3s, 2) simple cantilever springs attached to the M3 buttonhole, and 3) cantilever springs tied to a bonded orthodontic bracket on the M3 plus multiple-loop spring wire for distal movement of the M3. Osteo-periodontal status of M2s also improved uneventfully. Despite the drawbacks of orthodontic extraction, removal of deeply impacted M3s using the described techniques is safe with regard to mandibular nerve injury and neurologic damage. Orthodontic extraction is recommended for extraction of impacted M3s that present a high risk of postoperative osteo-periodontal defects on the distal surface of the adjacent M2 and those associated with dentigerous cysts. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by

Avaliação de seis anos de fraturas cervicais subaxiais Evaluación de seis años de fracturas cervicales subaxiales Evaluation of six years of cervical sub-axial fractures

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Leonardo Franco Pinheiro Gaia

2013-01-01

Full Text Available OBJETIVO: Avaliar retrospectivamente os fatores relacionados ao trauma cervical, segundo o tipo de fratura baseado na classificação AO. Levando-se em consideração aspectos etiológicos e epidemiológicos do evento. MÉTODOS: Foram analisados retrospectivamente prontuários de pacientes com fratura cervical, no período de 2004 a 2009. Estudou-se as fraturas subaxiais (C3-C7, por se enquadrarem em apenas uma classificação (AO. Usou-se radiografias frente e perfil, e tomografias para dividir as fraturas em A (compressão, B (distração e C (rotação, de acordo com o padrão apresentado. Analisou-se os seguintes parâmetros: sexo, idade, classificação AO, mecanismo de trauma, presença de déficit neurológico, e tratamento cirúrgico ou conservador. RESULTADOS: Foram analisados 264 prontuários, sendo 216 pacientes do sexo masculino e 48 femininos. A média de idade destes pacientes foi de 38,55 anos. O mecanismo de trauma mais comum das fraturas cervical subaxiais foi o acidente automobilístico com 84 casos. Quanto ao tipo de fratura pela classificação AO, a mais frequente foi do tipo B. Dos casos avaliados, 136 pacientes apresentaram déficit neurológico, parcial ou completo. O tratamento cirúrgico foi realizado em 166 casos. CONCLUSÃO: Os dados apresentados demonstram que as fraturas cervicais representam um importante problema para a saúde no Brasil, pública e privada. A prevenção das fraturas cervicais apresenta a melhor relação custo benefício na abordagem destas lesões.OBJETIVO: Evaluar retrospectivamente los factores relacionados al trauma cervical, según el tipo de fractura, basándose en la clasificación AO, considerandose los aspectos etiológicos y epidemiológicos del evento. MÉTODOS: Fueron analizadas retrospectivamente las historias clínicas de pacientes con fractura cervical, desde el 2004 hasta el 2009. Se estudiaron las fracturas subaxiales (C3-C7, ya que éstas se encuadran en apenas una clasificaci

O emprego de hastes intramedulares bloqueadas no tratamento das fraturas diafisárias do úmero Use of blocked intramedullary shaft for the treatment of humeral diaphyseal fractures

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Fernando Baldy dos Reis

2005-01-01

Full Text Available Estudamos os resultados clínicos e radiográficos de 31 pacientes portadores de fraturas diafisárias do úmero que foram operados com hastes intramedulares. Destes quatro apresentaram fraturas no local da inserção da haste e foram tratados com outro método. Dos 27 pacientes restantes o índice de consolidação foi de 96,1 % e que durou em média de 63,4 dias. Cinco queixaram-se de dor no ombro e em apenas um apresentou limitação da abdução. Paralisia temporária do nervo radial foi constatada em dois pacientes e pseudartrose em um que após 5 meses da cirurgia foi submetido a nova intervenção cirúrgica com o emprego de placa e enxerto ósseo autólogo. Concluímos que embora o emprego de hastes intramedulares bloqueadas apresentou alto índice de a via de acesso retrógrada pode levar a fraturas no seu ponto de entrada e via anterógrada com violação do manguito rotador pode gerar dores no ombro.Clinical and radiographic outcomes of 31 patients with humeral diaphyseal fractures submitted to surgery with intramedullary shafts were studied. From these, four patients presented fractures at the shaft insertion site and were treated using a different method. From the 27 patients left, the healing rate was 96.1%, with an average duration of 63.4 days. Five of them complained of pain in the shoulder and only one presented abduction limitation. Temporary palsy of the radial nerve was found in two patients and pseudoarthrosis in one of them, who was submitted to a new surgical intervention with plate and autologous bone graft, after 5 months. It was concluded that, although blocked intramedullary shafts presents a high incidence of the retrograde access port leading to fractures in its insertion site and the anterograde port causing pain in the shoulder.

Experimental occlusal interferences. Part V. Mandibular rotations versus hemimandibular translations.

Science.gov (United States)

Christensen, L V; Rassouli, N M

1995-12-01

Frontal plane mandibular rotations and corresponding hemimandibular translations were studied in vitro by using direct observations of a human cadaver mandible and in vivo by using the indirect observations of rotational electrognathography. A comparison between the two methods showed that rotational electrognathography erred in measuring the clinically relevant hemimandibular translations resulting from mandibular rotations having a unilateral molar point (simulated occlusal interference) as the pivot of frontal plane torque. In vitro frontal plane rotations about a unilateral mandibular molar tooth (simulated occlusal interference) suggested that the resulting hemimandibular upward translations of the lateral portion of the mandibular condyle, contralateral to the molar tooth, would cause considerable compressive loading of the temporomandibular joint disc.

Toxicidad por dosis repetidas de la solución CM-95 tratada magnéticamente en ratas Sprague Dawley

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Clara E. Martínez

2008-08-01

Full Text Available En este trabajo se realizó la evaluación toxicológica a dosis repetidas por el método de test límite del candidato a inmunopotenciador, la solución CM-95 tratada magnéticamente, acorde con las regulaciones de la Organización para la Colaboración Económica y el Desarrollo, incluida en la Guía 407. El objetivo fue establecer las posibles lesiones orgánicas y funcionales ocasionadas por la solución CM-95, tratada magnéticamente con la máxima inducción magnética permisible (0,16 T, para la obtención del candidato a inmunopotenciador. Se emplearon tres grupos: Experimental, Control y Satélite. Como Biomodelo experimental se utilizaron ratas Sprague Dawley machos y hembras con pesos de 150 a 200 g. Durante el estudio no se registraron signos clínicos de toxicidad ni muertes en ninguno de los animales de los grupos tratados, ni en los controles. No hubo afectación del peso corporal durante el ensayo. Aunque hubo variaciones en los valores de algunos parámetros hematológicos y bioquímicos, estos no tuvieron significación biológica. No se encontraron lesiones macroscópicas, ni microscópicas; solo se observaron efectos proliferativos en el tejido linfoide de timo y bazo, relacionados con la respuesta del sistema inmune. La solución CM-95 tratada magnéticamente, no mostró toxicidad en el modelo animal y nivel de dosis utilizado, y bajo las condiciones experimentales ensayadas.

Predicting pathology in impacted mandibular third molars

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Aveek Mukherji

2017-01-01

Full Text Available Introduction: The rising incidence of the impacted mandibular third molars and their association with pathologies is now considered a public health problem. Aims and Objectives: The objective of this study was to assess the position of impacted mandibular third molars that are prone to developing pathologies and to determine the frequency and type of pathological conditions associated with these impacted teeth to facilitate planning for their prophylactic removal. Materials and Methods: Consecutive panoramic radiographs and clinical examination of 300 patients with impacted mandibular third molars were collected. They were segregated according to Pell and Gregory’s classification, Winter’s classification, and according to their state of eruption. These were correlated with associated pathologies based on clinical and radiological criteria. Statistical Analysis Used: Descriptive statistics included computation of percentages, mean, and standard deviations. The statistical test applied for the analysis was Pearson’s Chi-square test (χ2. For this test, confidence interval and P value were set at 93% and ≤0.03, respectively. Results: The pathology most commonly associated with impacted third molars was pericoronitis, which had the highest frequency of occurrence in partially erupted, distoangular, and IA positioned (as per Pell and Gregory classification impacted teeth. Impacted mandibular third molars, which were in IA position, placed mesially, and partially erupted, were prone to develop pathologies such as dental caries and periodontitis. Conclusion: The clinical and radiographical features of impacted third molar may be correlated to the development of their pathological complications. The partially impacted mandibular third molars with mesioangularly aligned in IA position have the highest potential to cause pathological complications.

Fractografia de compósito estrutural aeronáutico submetido ao ensaio de tenacidade à fratura interlaminar em Modo II

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Geraldo Maurício Cândido

2014-01-01

Full Text Available A fractografia consiste no estudo detalhado da morfologia da superfície de fratura de materiais. Para isto, a técnica de microscopia eletrônica de varredura (MEV é usualmente utilizada para determinar a causa de falha e a relação do modo de falha com a microestrutura do material em análise. Essas informações permitem estabelecer analogia entre estrutura, propriedade e processamento do material com a iniciação e a propagação da falha. Neste estudo, a análise fractográfica é utilizada para investigar os aspectos que caracterizaram a falha por delaminação em Modo II de laminados poliméricos de uso estrutural. Para isto, espécimes com um inserto de Teflon® introduzido no plano médio de uma das extremidades do laminado (End-Notched foram submetidos ao ensaio de carregamento em flexão em quatro pontos. Os espécimes foram preparados a partir de um laminado fabricado em autoclave, com camadas (0º, 90º de material pré-impregnado de tecido bidirecional em estilo plain weave de fibras de carbono IM7/resina epóxi M21. Os resultados da análise mostram que a superfície de fratura é muito irregular, com a visualização de fibras e impressões de fibras na matriz. Aspectos fractográficos de cúspides e formatos de concha, originados durante o cisalhamento da matriz polimérica, são também observados.

Pediatric mandibular fractures: a free hand technique.

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Davison, S P; Clifton, M S; Davison, M N; Hedrick, M; Sotereanos, G

2001-01-01

The treatment of pediatric mandibular fractures is rare, controversial, and complicated by mixed dentition. To determine if open mandibular fracture repair with intraoral and extraoral rigid plate placement, after free hand occlusal and bone reduction, without intermaxillary fixation (IMF), is appropriate and to discuss postoperative advantages, namely, maximal early return of function and minimal oral hygiene issues. A group of 29 pediatric patients with a mandibular fracture were examined. Twenty pediatric patients (13 males and 7 females) with a mean age of 9 years (age range, 1-17 years) were treated using IMF. All patients were treated by the same surgeon (G.S.). Surgical time for plating was reduced by 1 hour, the average time to place patients in IMF. The patients who underwent open reduction internal fixation without IMF ate a soft mechanical diet by postoperative day 3 compared with postoperative day 16 for those who underwent IMF. Complication rates related to fixation technique were comparable at 20% for those who did not undergo IMF and 33% for those who did. We believe that free hand reduction is a valuable technique to reduce operative time for pediatric mandibular fractures. It maximizes return to function while minimizing the oral hygiene issues and hardware removal of intermaxillary function.

Forced extrusion for removal of impacted third molars close to the mandibular canal Extrusión forzada para extraer los terceros molares impactados cerca del canal mandibular

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Dennis Flanagan DDS

2012-03-01

Full Text Available Impacted mandibular third molars can be located in close proximity to the mandibular canal. This creates a risk for the nerve or artery injury. These are contained in the canal. However, the impacted third molar can be moved coronally by orthodontic means, after removal of overlying bone, and safely extracted. The orthodontic intervention slowly moves the tooth apex away from the mandibular canal and reduces the potential for a neural injury. This method may be useful for older patients with root apices that approximate or are actually located in the mandibular canal. This technique needs further study. There is a theoretical potential for neural or arterial injury from physical contact of the tooth apex as it moves by or through the mandibular canal.Los terceros molares inferiores impactados pueden localizarse muy cerca del canal mandibular. Esto constituye un riesgo de lesión del nervio o la arteria, que se localizan dentro del canal. No obstante, el tercer molar impactado puede desplazarse en dirección coronal con ortodoncia, tras ostectomía del hueso suprayacente, y extraerse sin riesgos. La intervención ortodóncica desplaza lentamente el ápice del diente fuera del canal mandibular y reduce la posibilidad de lesión neural. Este método puede ser útil para pacientes de edad avanzada con ápices dentales que se aproximan o en realidad se localizan en el canal mandibular. La técnica necesita un estudio adicional. Hay la posibilidad teórica de lesión neural o arterial a partir del contacto físico del ápice del diente a medida que se desplaza a través del canal mandibular.

Radiographic evaluation of the course and visibility of the mandibular canal

International Nuclear Information System (INIS)

Jung, Yun Hoa; Cho, Bong Hae

2014-01-01

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). 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 visibility of the canal on panoramic radiographs was compared with that on CBCT images. 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. 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.

Mandibular ramus fractures: a rarity.

Science.gov (United States)

Kale, Tejraj Pundalik; Kotrashetti, S M; Louis, Archana; Lingaraj, J B; Sarvesh, B U

2013-01-01

To determine the incidence of mandibular ramus fractures in KLE's PK Hospital and to analyze the outcome of open reduction and internal fixation of these fractures. Using a retrospective study design, records of all trauma patients who reported to the Department of Oral and Maxillofacial Surgery, KLE's PK Hospital Belgaum, between the years January 2006 to October 2011 was obtained from the medical records office. The data variables that were analyzed were the name, age, sex, cause of injury, pretreatment occlusion, treatment given, period of MMF and post-treatment occlusion. Total number of mandibular fracture cases was 298. Ramus fractures were 10 in number which accounted for 3.3% of fractures. The age range of these 10 patients was seen to be between 20 to 80 years with the average age being 35.6 years. Of these 10 patients, 9 were male and 1 was female and 7 patients were treated by open reduction and internal fixation and the remaining 3 by closed reduction. The average period of MMF was 3 days for the patients who underwent open reduction and internal fixation. There was improvement in occlusion in all 10 patients post-treatment and there was no complication reported in any of the cases. Ramus fractures accounted for 3.3% of all mandibular fractures. Open reduction and internal fixation of ramus fractures ensures adequate functional and anatomic reduction. This study makes an attempt to throw a light on the increasing incidence of ramus fractures and a successful management of these fractures by open reduction and internal fixation. How to cite this article: Kale TP, Kotrashetti SM, Louis A, Lingaraj JB, Sarvesh BU. Mandibular Ramus Fractures: A Rarity. J Contemp Dent Pract 2013;14(1):39-42. Source of support: Nil Conflict of interest: None declared.

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

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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.

Pearls of mandibular trauma management.

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

2010-11-01

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

Experimental occlusal interferences. Part III. Mandibular rotations induced by a rigid interference.

Science.gov (United States)

Rassouli, N M; Christensen, L V

1995-10-01

A rigid intercuspal interference (minimum mean height of 0.24 mm) was placed on either the right or left mandibular second premolar and first molar of 12 subjects. During brisk and forceful biting on the interference, rotational electrognathography measured maximum torque of the right and left mandibular condyles in the frontal and horizontal planes of orientation. All subjects showed frontal plan upward rotation (mean of 0.7 degrees) of the mandibular condyle contralateral to the interference. In 33% of the subjects there was no horizontal plane backward rotation. In 58% of the subjects there was horizontal plane backward rotation (mean of 0.5 degrees) of the mandibular condyle ipsilateral to the interference, and in one subject (8%) there was backward horizontal plane rotation (0.1 degree) of the mandibular condyle contralateral to the interference. It was inferred that the masseter muscle, ipsilateral to the interference, generated negative work in order to decelerate frontal plane 'unseating' of the mandibular condyle ipsilateral to the interference. It was inferred that the masseter muscle, contralateral to the interference, produced positive work in order to accelerate frontal plane 'seating' of the mandibular condyle contralateral to the interference. Finally, it was speculated that the impact forces of frontal plane 'seating' of the mandibular condyle, contralateral to the interference, might lead to 'vacuum sticking' of the temporomandibular joint disc because of the formation of negative hydrostatic pressures.

Maxillary advancement for mandibular prognathism: indications and rationale.

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Rosen, H M

1991-05-01

The surgical correction of mandibular prognathism has traditionally involved posterior repositioning of the mandibular body. This treatment approach corrects the skeletal disproportion at the expense of reducing facial skeletal volume and can unpredictably result in inadequately supported soft tissues with loss of skeletal definition. In an effort to avoid these sequelae of mandibular reduction, 18 patients diagnosed as having mandibular prognathism were treated with maxillary advancement surgery at the Le Fort I level. Mean patient SNB angle was 85.2 degrees, as compared with a normal 79 +/- 3 degrees. Maxillae were documented to be in normal position relative to both cranial base and Frankfort horizontal. The mean maxillary advancement was 6.9 mm, with a range of 4.5 to 8.8 mm. All patients required genioplasty to reduce vertical chin height and/or to laterally shift the chin. At the time of follow-up (mean 16.2 months), all patients retained cephalometric data suggestive of enlarged mandibles and excessive anterior facial divergence. However, maxillomandibular harmony and facial convexity had been restored without sacrificing skeletal volume. Treatment results demonstrated these faces to be skeletally well proportioned despite lower face protrusion that was beyond "normal." Postoperative appearances were characterized by a well-supported soft-tissue envelope and a highlighted skeletal foundation, creating angular, well-defined lower faces. These findings support the credibility of maxillary advancement as the procedure of choice in selected individuals with mandibular prognathism. Indications and an aesthetic rationale for this surgical approach are presented.

Mandibular pseudocarcinomatous hyperplasia.

Science.gov (United States)

Warter, A; Walter, P; Meyer, C; Barrière, P; Galatir, L; Wilk, A

2000-08-01

Three unusual cases of pseudocarcinomatous (pseudoepitheliomatous) hyperplasia (PH) affecting chronic osteomyelitic mandibular sequestra are reported to highlight the differences with the various squamous neoplasms which occur in that site. In two patients carrying a mandibular graft following the excision of an ameloblastoma, mucosal ulcers resulted in chronic osteomyelitis. In a third patient, an apical dental infection was associated with fistulated osteomyelitis. Histology of the three sequestra showed an intraosseous squamous proliferation. It was characterized by a peripheral involvement of medullary spaces, the more mature epithelial layer covering the bone trabeculae without intervening stroma, and the basal type epithelial layer surrounding a central fibrovascular core. There were no histological or cytological signs of malignancy. PH shows an inverted pattern when compared with the centro-medullary tumoural islands seen in the various oral or odontogenic squamous neoplasms which occur in the jaws. The lack of signs of malignancy distinguish PH from common squamous cell carcinomas. A short clinical course is an important feature in the distinction of PH from the well differentiated squamous cell carcinomas which may develop in fistulated chronic osteomyelitis.

Distracción mandibular y articulación temporomandibular Mandibular distraction and the temporomandibular joint

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F. Monje Gil

2004-08-01

Full Text Available Los pacientes con deformidades craneofaciales requieren generalmente multiples y, a veces, complejos procedimientos quirurgicos para reconstruir tejidos blandos y duros alterados. Un avance importante en cirugía reconstructiva es el alargamiento de la mandibula por distracción que tiene la ventaja de una cirugía menos agresiva que determinados tipos de osteotomías. Con esta técnica una osteotomía bicortical se hace en distintas zonas de la mandibula colocandose el distractor hasta alcanzar los efectos deseados. Aunque las fuerzas aplicadas se han mostrado eficaces para alargar la mandíbula, sus efectos en segmentos proximales y distales, incluyendo la articulación temporomandibular no han sido analizados sistemáticamente. En este artículo se repasa trabajos experimentales y clínicos en los que se detalla la relación entre distracción mandibular y articulación temporomandibular.Abstract: Patients with severe craniofacial abnormalities often require multiple and complex surgical procedures to reconstruct maldeveloped hard and soft tissues of the maxillofacial complex. An important advance in reconstructive surgery is mandibular lengthening by gradual distraction, which takes advantage to be less agressive surgery than some osteotomies. With this technique, a bicortical osteotomy is made at the angle of the deficient mandible, and an expansion appliance is placed across the osteotomy line. Although the applied forces have been shown to lengthen the mandible effectively in the region of the application, their effects on the proximal and distal mandibular segments, including the temporomandibular joint region, have not been analyzed systematically. In this article, we study several experimental and clinical papers where it describes the relationship between mandibular distraction and temporomandibular joint.

Mandibular marginal contouring in oriental aesthetic surgery: refined surgical concept and operative procedure.

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Satoh, Kaneshige; Mitsukawa, Nobuyuki

2014-05-01

In aesthetic mandibular contouring surgery, which is often conducted in Asians, the operative procedure is thought to deliver a more aesthetic mandibular shape by means of contouring conducted as a whole from the ramus to the symphysis. The authors describe the refined concept and operative procedures of mandibular marginal contouring. For the 7-year period from 2004 to 2011, mandibular marginal contouring has been used in 57 consecutive series of Japanese subjects. Patient ages ranged from 18 to 33 years, and the subjects included 15 men and 42 women. The surgery was carried out by cutting off the protruding deformed mandibular margin from the ramus to the symphysis. In 53 of 57 cases, the focus was on angle contouring. Concomitant genioplasty by horizontal osteotomy of the chin was conducted in 42 of 57 cases (recession, advancement, shortening, elongation, and correction of the shift variously). In 22 materials exhibiting bulk around the mandibular, the ramus to the body was excised sagittally and thinned. In all the patients, mandibular marginal contouring from the ramus to the symphysis was completed. Partial masseter muscle resection was conducted in 11 of 57 cases. Mandibular contouring effectively achieved a highly satisfactory result in all cases. The upper portion of the peripheral branch of the trunk of the mental nerve was dissected by an electric scalpel in 1 case but sutured immediately using an 8-0 nylon stitch. Transient palsy of the mental nerve was noticed in a few cases but subsided in 1 to 2 months. No particular complications were encountered. No secondary revision was required in this series. In mandibular angle plasty, mandibular marginal contouring from the ramus to the symphysis should be carried out by cutting off the angle keeping in mind the entire mandibular shape. This concept and the procedure can deliver greater patient satisfaction.

Mandibular asymmetry and the fourth dimension.

Science.gov (United States)

Kaban, Leonard B

2009-03-01

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

Thin-plate spline graphical analysis of the mandible in mandibular prognathism.

Science.gov (United States)

Chang, Hsin-Fu; Chang, Hong-Po; Liu, Pao-Hsin; Chang, Chih-Han

2002-11-01

The chin cup has been used to treat skeletal mandibular prognathism in growing patients for 200 years. The pull on the orthopedic-force chin cup is oriented along a line from the mandibular symphysis to the mandibular condyle. Various levels of success have been reported with this restraining device. The vertical chin cup produces strong vertical compression stress on the maxillary molar regions when the direction of traction is 20 degrees more vertical than the chin-condyle line. This treatment strategy may prevent relapse due to counter-clockwise rotation of the mandible. In this report, we describe a new strategy for using chin-cup therapy involving thin-plate spline (TPS) analysis of lateral cephalometric roentgenograms to visualize transformation of the mandible. The actual sites of mandibular skeletal change are not detectable with conventional cephalometric analysis. A case of mandibular prognathism treated with a chin cup and a case of dental Class III malocclusion without orthodontic treatment are described. The case analysis illustrates that specific patterns of mandibular transformation are associated with Class III malocclusion with or without orthopedic therapy, and that visualization of these deformations is feasible using TPS graphical analysis.

Surgical-prosthetic treatment of large mandibular cysts

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Džambas Ljubiša D.

2003-01-01

Full Text Available This paper presents a combined surgical-prosthetic procedure of reconstructing mandibular bone defect in a 53 year old patient, following enucleation of a mandibular cyst (Cystectomy Partsch II. After a thorough diagnostic evaluation, a surgical procedure was planned with the particular attention to the nature of the disease, patient’s condition, size and extension of the cyst, tissue loss, and the possibilities of prosthetic management of a mandibular bone defect with partial postresection dental prosthesis. It is of great importance to point to the significance of teamwork of a maxillofacial surgeon and a specialist in prosthodontics. This kind of cooperation provided very effective and less risky soft tissue, as well as bone tissue regeneration (osteogenesis. The patient’s recovery was fast, and he could return to his daily activities and work without significant changes regarding quality of life after surgery and prosthetic treatment.

Prospective audit of mandibular fractures at the Charlotte Maxeke ...

African Journals Online (AJOL)

Objective. This study was a prospective cross-sectional clinical audit of patients with mandibular fractures at the Charlotte Maxeke Johannesburg Academic Hospital. Methods. Between 1 March and 31 August 2004, patients with mandibular fractures seen by one clinician had their details recorded. Results. The female:male ...

Combined surgical management of mandibular angle prominence and microgenia

International Nuclear Information System (INIS)

Portelles Masso, Ayelen Maria; Berger Kohn, Carlos

2010-01-01

Chin play a very important role in facial aesthetics. Different deformities of volume and of position may occur at this level and it is the microgenia one of the more frequent. Treatment options include the use of silicone, alloplasty materials and autologous bone graft. Authors report the use of the bone removed from mandibular angle to increase the chin. This is the case of a white female patient aged 18 seen by the Orthognathics Multidisciplinary Staff of 'V. I. Lenin' Hospital due to its uncommon face width. The corresponding physical examination as well as the complementary ones diagnosed a bilateral prominence of mandibular angle associated with a microgenia. Surgery carried out was of remodeling type of both mandibular angles and genioplasty of height increase and a discrete advancement using the bone removed from the gonion. There were satisfactory aesthetic results without evidence of bone reabsorption. We conclude that use of autologous graft of mandibular angle is an effective treatment alternative for correction of microgenia. (author)

Pinos transcorticais e gesso associados à aplicação local de plasma rico em plaquetas no tratamento de fratura do III metatarsiano em potro

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Marcos Jun Watanabe

2015-03-01

Full Text Available Em potros até um ano de idade, as fraturas do III osso metacarpiano (McIII ou III metatarsiano (MtIII são principalmente atribuídas ao trauma. A redução aberta e a imobilização do foco com implantes constituem o tratamento cirúrgico recomendado. Uma potra com três meses de idade e 150kg, da raça Quarto de Milha, que apresentava umafratura diafisária multifragmentar em cunha do MtIII direito foi submetida à osteossíntese através datransfixação externa e gesso, associada com a aplicação intralesional deplasma rico em plaquetas (PRP. Após dois anos do tratamento, o animal iniciou programa de treinamento para corrida e, após seis meses do treinamento, correu o primeiro páreo oficial. A escolha dos métodos terapêuticos para o tratamento de fraturas em equinos deve ser baseada naquela que promova reparação precoce e de melhor qualidade, com menores riscos de complicações. Sendo assim, a associação terapêutica adotada foi considerada favorável, já que possibilitou o completo reestabelecimento da locomoção da paciente, podendo inclusive competir na sua modalidade esportiva

Sorción de hidrolizados proteicos en lana tratada con bisulfito sódico: influencia en las propiedades químicas y físico-mecánicas.

OpenAIRE

Gómez de Paula, Ma Nieves; Naik Kardile, Arun; Juliá Ferrés, Ma. Rosa; Erra Serrabasa, Pilar

1997-01-01

La sorción de hidrolizados proteicos en fibras queratinicas provoca una mejora en las propiedades físicas y quimicas de fibras dañadas. En este trabajo se presentan los resultados de las modificaciones de estas propiedades en lana tratada con bisulfito sódico e hidrolizado proteico bien de colágeno o de queratina o de sus respectivos derivados anfifílicos cuaternizados y se comparan con las obtenidas para lana tratada sólo con bisulfito sódico. The sorption of protein hydrolisates in kerat...

Variant Root Morphology of Third Mandibular Molar in Normal and ...

African Journals Online (AJOL)

isaac kipyator

2017-11-12

Nov 12, 2017 ... ABSTRACT. The mandibular third molar poses a challenge to dental surgeons due to it's unpredictable morphology ... treatment in the School of Dental Sciences since 2010. ... mandibular third molar include presence of three.

Quiste óseo aneurismático mandibular

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Denia Morales Navarro

Full Text Available El quiste óseo aneurismático es definido como una lesión osteolítica expansiva que consiste en espacios llenos de sangre y canales divididos por tabiques de tejido conectivo, los cuales contienen tejido osteoide y células gigantes multinucleadas. El objetivo es presentar un caso clínico poco común de un quiste óseo aneurismático de la región del cuerpo mandibular. Se trata de una paciente femenina de 39 años de edad que acudió a consulta externa del Servicio de Cirugía Maxilofacial del Hospital Universitario "General Calixto García" por aumento de volumen en región mandibular derecha y dolor intenso de 1 mes de evolución. Radiográficamente se detectó un área radiolúcida unilocular de bordes bien definidos; se realizó curetaje de la cavidad, y estudio histopatológico de la lesión que informó la presencia de un quiste óseo aneurismático. Se concluye que el quiste óseo aneurismático es más común en los huesos largos y en la región del ángulo mandibular en el esqueleto facial, por lo que la presentación de este en el cuerpo mandibular resulta de interés.

Mastication markedly affects mandibular condylar cartilage growth, gene expression, and morphology.

Science.gov (United States)

Enomoto, Akiko; Watahiki, Junichi; Nampo, Tomoki; Irie, Tarou; Ichikawa, Yuuta; Tachikawa, Tetsuhiko; Maki, Koutaro

2014-09-01

Mandibular growth is believed to be strongly related to mastication. Furthermore, mandibular condylar cartilage is known to be derived from neural crest cells. We examined whether the degree of chewing affects condylar cartilage growth of the mandible. Mice were fed diets with varying hardness. Genes specific to neural crest-derived cells were measured by real-time polymerase chain reaction to compare the expression changes between the mandibular and tibia cartilages. The mandibular condylar cartilage was then evaluated histologically, and proliferation was evaluated using proliferating cell nuclear antigen. Immunostaining was conducted for osteopontin, type X collagen, and Musashi1, and real-time polymerase chain reaction was used to assess the expression levels of osteopontin and type X collagen. Markers including P75, Wnt-1, Musashi1, and Nestin were upregulated in the mandibular condylar cartilage as compared with the tibial cartilage. Histologic assessment of the mandibular cartilage showed that the hypertrophic chondrocyte zone was statistically significantly thicker in mice fed a hard diet. Chondrocyte proliferation and Musashi1 expression were lower in mice fed a hard diet. After 4 weeks, numerous osteopontin and type X collagen-positive cells were observed in mice fed a mixed diet. Mastication affects the balance between differentiation and proliferation in the mandibular condylar cartilage. This phenomenon might be attributed to the presence of neural crest-derived cells. Copyright © 2014 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Parafusos bioabsorvíveis na reparação de fraturas experimentais de sesamóides proximais em eqüinos Bioabsorbable screws in the healing of experimentally induced fractures of the proximal sesamoid bone in horses

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Marcelo Damas Pyles

2007-10-01

Full Text Available Avaliou-se a eficácia dos implantes bioabsorvíveis de ácido polilático na fixação interna de fraturas induzidas no osso sesamóide proximal de eqüinos. Osteossínteses foram realizadas em oito eqüinos, distribuídos em dois grupos de quatro animais conforme o implante: aqueles que receberam implantes bioabsorvíveis formaram o grupo GI e os que receberam implantes metálicos do grupo GII. O monitoramento radiográfico foi realizado no 30° dia (D30, no 60° dia (D60, no 90° dia (D90 e no 120o dia (D120 pós-operatório. Ao exame radiográfico no D30, observou-se preenchimento do foco de fratura de aspecto radiopaco, porém com densidade reduzida nos animais do grupo GII. Tal preenchimento às análises clínica e radiográfica apresentou qualidade superior no grupo GI, quando comparado com o grupo GII. No D120, observou-se, nos animais de ambos os grupos, ao exame radiográfico, o preenchimento do foco de fratura por tecido radiopaco, indicando a reparação da fratura em sua quase totalidade. Contudo, no GI, observaram-se pontos de esclerose ao redor do implante bioabsorvível e, ao exame físico, ausência de claudicação e, nos animais do GII, diminuição da flexão metacarpo-falangeana e claudicação de grau I. Os implantes bioabsorvíveis de PLLA mostram-se eficazes na fixação interna de fraturas induzidas dos ossos sesamóides proximais de eqüinos; os animais submetidos à redução da fratura com implantes bioabsorvíveis apresentaram ao final do experimento grau de claudicação menor quando comparados com os animais que receberam implantes metálicos. À análise radiográfica, os implantes bioabsorvíveis de PLLA possibilitaram remodelamento ósseo de melhor qualidade, quando comparados com os implantes metálicos.This study evaluated the efficacy of bioabsorbable polylactic acid implants in internal fixation of induced fractures of the proximal sesamoid bone in horses. Eight horses underwent osteosynthesis; four

Radiographic analysis of odontogenic cysts showing displacement of the mandibular canal

International Nuclear Information System (INIS)

Cho, Bong Hae

2003-01-01

To assess the radiographic findings of odontogenic cysts showing displacement of the mandibular canal using computed tomographic (CT) and panoramic images. CT and panoramic images of 63 odontogenic cysts (27 dentigerous, 16 odontogenic keratocysts, and 20 radicular cysts) were analyzed to evaluate the following parameters: the dimension and shape of the cysts, and the effect of the cysts on the mandibular canal and cortical plates. Of the 63 cysts examined in the study, 35 (55.6%) showed inferior displacement of the mandibular canal and 46 (73.0%) showed perforation of the canal. There were statistically significant differenced between CT and panoramic images in depicting displacement and perforation of the mandibular canal. Cortical expansion was seen in 46 cases (73.0%) and cortical perforation in 23 cases (36.5%). The radicular cysts showed cortical expansion and perforation less frequently than the other cyst groups. Large cysts of mandible should be evaluated by multiplanar CT images in order to detect the mandibular canal and cortical bone involvement.

Deoxycholic Acid and the Marginal Mandibular Nerve: A Cadaver Study.

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Blandford, Alexander D; Ansari, Waseem; Young, Jason M; Maley, Bruce; Plesec, Thomas P; Hwang, Catherine J; Perry, Julian D

2018-06-04

One of the rare but serious complications observed with deoxycholic acid administration is damage to the marginal mandibular nerve. In this study, we evaluated if deoxycholic acid directly induces histologic damage to fresh cadaveric marginal mandibular nerve. A segment of marginal mandibular nerve was harvested from 12 hemifaces of 6 fresh cadavers. The nerve specimen was exposed to either 0.9% sterile saline for 24 h, deoxycholic acid (10 mg/ml) for 20 min, or deoxycholic acid (10 mg/ml) for 24 h. The nerve specimens were then fixed in glutaraldehyde for a minimum of 24 h. Toluidine blue stained sections were evaluated for stain intensity using light microscopy and color deconvolution image analysis. Supraplatysmal fat was harvested as a positive control and exposed to the same treatments as the marginal mandibular nerve specimens, then evaluated using transmission electron microscopy. Toluidine blue staining was less in the marginal mandibular nerve exposed to deoxycholic acid when compared to saline. The specimen exposed to deoxycholic acid for 24 h showed less toluidine blue staining than that of the nerve exposed to deoxycholic acid for 20 min. Transmission electron microscopy of submental fat exposed to deoxycholic acid revealed disruption of adipocyte cell membrane integrity and loss of cellular organelles when compared to specimens only exposed to saline. Deoxycholic acid (10 mg/ml) damages the marginal mandibular nerve myelin sheath in fresh human cadaver specimens. Direct deoxycholic acid neurotoxicity may cause marginal mandibular nerve injury clinically. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Congenitally missing mandibular second premolars: clinical options.

Science.gov (United States)

Kokich, Vincent G; Kokich, Vincent O

2006-10-01

Congenital absence of mandibular second premolars affects many orthodontic patients. The orthodontist must make the proper decision at the appropriate time regarding management of the edentulous space. These spaces can be closed or left open. If the space will be left open for an eventual restoration, the keys during orthodontic treatment are to create the correct amount of space and to leave the alveolar ridge in an ideal condition for a future restoration. If the space will be closed, the clinician must avoid any detrimental alterations to the occlusion and the facial profile. Some early decisions that the orthodontist makes for a patient whose mandibular second premolars are congenitally missing will affect his or her dental health for a lifetime. Therefore, the correct decision must be made at the appropriate time. In this article, we present and discuss various treatment alternatives for managing orthodontic patients with at least 1 congenitally missing mandibular second premolar.

The Psychological Status of Patients with Acute Mandibular Injury

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A. N. Pudov

2012-01-01

Full Text Available Objective: to define the specific features of the psychological status of patients with acute mandibular injury, to compare a psychological reaction to injury in different age groups and in persons with signs of alcohol addiction. Subjects and methods. The study enrolled 37 patients of both sexes over 15 years of age. The patients were distributed by age and chronic alcohol intoxication. Psychological parameters were determined using personality questionnaires: Spielberg-Hanin, Zung, GHQ-28, and Wein ones. Results. The patients with mandibular injury were found to have higher levels of situational and personality anxiety. A state of depression as a response to acute mandibular injury of reactive genesis was found in 29.8% of cases. Autonomic dysfunction occurred in 62.2% of the patients with mandibular fractures. Occult pathopsychological states were detected in 35.1% of the study group patients. Conclusion. The main found peculiarities of the psychological status of the patients with acute mandibular injury were high anxiety and the considerable incidence of autonomic dysfunction syndrome. There were no great age differences in psychological status and the direction of reactions. The patients with chronic alcohol intoxication more frequently developed a depressive state, but the autonomic dysfunction syndrome was just less often encountered and pathopsychological states were less frequently found. Key words: acute low anxiety depression alcohol abuse, psychological status.

Bone changes of mandibular condyle using cone beam computed tomography

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Lee, Ji Un; Kim, Hyung Seop; Song, Ju Seop; Kim, Kyoung A; Koh, Kwang Joon [Chonbuk National Univ., Chonju (Korea, Republic of)

2007-09-15

To assess bone changes of mandibular condyle using cone beam computed tomography (CBCT) in temporomandibualr disorder (TMD) patients. 314 temporomandibular joints (TMJs) images of 163 TMD patients were examined at the Department of Oral and Maxillofacial Radiology, Chonbuk National University. The images were obtained by PSR9000N (Asahi Roentgen Co., Japan) and reconstructed by using Asahivision software (Asahi Roentgen Co., Japan). The CBCT images were examined three times with four weeks interval by three radiologists. Bone changes of mandibular condyle such as flattening, sclerosis, erosion and osteophyte formation were observed in sagittal, axial, coronal and 3 dimensional images of the mandibular condyle. The statistical analysis was performed using SPSS 12.0. Intra-and interobserver agreement were performed by 3 radiologists without the knowledge of clinical information. Osteopathy (2.9%) was found more frequently on anterior surface of the mandibular condyle. Erosion (31.8%) was found more frequently on anterior surface of the mandibular condyle. The intraobserver agreement was good to excellent (k=0.78{sub 0}.84), but interobserver agreement was fair (k=0.45). CBCT can provide high qualified images of bone changes of the TMJ with axial, coronal and 3 dimensional images.

Bone changes of mandibular condyle using cone beam computed tomography

International Nuclear Information System (INIS)

Lee, Ji Un; Kim, Hyung Seop; Song, Ju Seop; Kim, Kyoung A; Koh, Kwang Joon

2007-01-01

To assess bone changes of mandibular condyle using cone beam computed tomography (CBCT) in temporomandibualr disorder (TMD) patients. 314 temporomandibular joints (TMJs) images of 163 TMD patients were examined at the Department of Oral and Maxillofacial Radiology, Chonbuk National University. The images were obtained by PSR9000N (Asahi Roentgen Co., Japan) and reconstructed by using Asahivision software (Asahi Roentgen Co., Japan). The CBCT images were examined three times with four weeks interval by three radiologists. Bone changes of mandibular condyle such as flattening, sclerosis, erosion and osteophyte formation were observed in sagittal, axial, coronal and 3 dimensional images of the mandibular condyle. The statistical analysis was performed using SPSS 12.0. Intra-and interobserver agreement were performed by 3 radiologists without the knowledge of clinical information. Osteopathy (2.9%) was found more frequently on anterior surface of the mandibular condyle. Erosion (31.8%) was found more frequently on anterior surface of the mandibular condyle. The intraobserver agreement was good to excellent (k=0.78 0 .84), but interobserver agreement was fair (k=0.45). CBCT can provide high qualified images of bone changes of the TMJ with axial, coronal and 3 dimensional images

Mandibular incisive canal in relation to periapical surgery

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Kani Bilginaylar

2016-01-01

Full Text Available 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.

Fraturas vertebrais em grandes animais: estudo retrospectivo de 39 casos (1987-2002 Vertebral fractures in large animals: retrospective study of 39 cases (1987-2002

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A.S. Borges

2003-04-01

Full Text Available Realizou-se estudo retrospectivo (1987-2002 dos aspectos clínicos das fraturas vertebrais em eqüinos, bovinos, ovinos, caprinos e suínos atendidos no hospital veterinário da FMVZ-Unesp de Botucatu. Todos os casos tiveram confirmação radiográfica ou post-mortem. Segundo a espécie, a ordem de acometimento foi: bovina, eqüina, ovina, caprina e suína. As lesões ocorreram desde os 12 dias de idade até os 10 anos, com maior freqüência até os 12 meses. O segmento torácico foi o mais comprometido seguido dos segmentos lombar, cervical e sacral. As fraturas vertebrais devem fazer parte da lista de diagnósticos diferenciais de animais em decúbito, independente da espécie, sexo ou idade.It was performed a retrospective study (1987-2002 of clinical features of spinal fractures in the equine, bovine, ovine, caprine and swine referred to the Veterinary Hospital - FMVZ-Unesp in Botucatu, SP, Brazil. All the cases were confirmed by necropsy or radiographic evaluation. Bovines were the most affected species, followed by horses, sheep, goats and swines, and lesions occurred from 12 days to 10 years of age, being more frequent up to 12 months of age. Thoracic vertebrae were the most affected, followed by lumbar, cervical and sacral segments. Vertebral fractures should be included for differential diagnosis of recumbent animals, independently on species, sex or age.

Reduced mandibular range of motion in Duchenne Muscular Dystrophy: predictive factors.

Science.gov (United States)

van Bruggen, H W; Van Den Engel-Hoek, L; Steenks, M H; Bronkhorst, E M; Creugers, N H J; de Groot, I J M; Kalaykova, S I

2015-06-01

Patients with Duchenne muscular dystrophy (DMD) experience negative effects upon feeding and oral health. We aimed to determine whether the mandibular range of motion in DMD is impaired and to explore predictive factors for the active maximum mouth opening (aMMO). 23 patients with DMD (mean age 16.7 ± 7.7 years) and 23 controls were assessed using a questionnaire about mandibular function and impairments. All participants underwent a clinical examination of the masticatory system, including measurement of mandibular range of motion and variables related to mandibular movements. In all patients, quantitative ultrasound of the digastric muscle and the geniohyoid muscle and the motor function measure (MFM) scale were performed. The patients were divided into early and late ambulatory stage (AS), early non-ambulatory stage (ENAS) and late non-ambulatory stage (LNAS). All mandibular movements were reduced in the patient group (P < 0.001) compared to the controls. Reduction in the aMMO (<40 mm) was found in 26% of the total patient group. LNAS patients had significantly smaller mandibular movements compared to AS and ENAS (P < 0.05). Multiple linear regression analysis for aMMO revealed a positive correlation with the body height and disease progression, with MFM total score as the strongest independent risk factor (R(2) = 0.71). Mandibular movements in DMD are significantly reduced and become more hampered with loss of motor function, including the sitting position, arm function, and neck and head control. We suggest that measurement of the aMMO becomes a part of routine care of patients with DMD. © 2015 John Wiley & Sons Ltd.

Regenerative approach to bilateral rostral mandibular reconstruction in a case series of dogs

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Boaz eArzi

2015-03-01

Full Text Available Extensive rostral mandibulectomy in dogs typically results in instability of the mandibles that may lead to malocclusion, difficulty in eating and drinking, food prehension, and pain of the temporomandibular joint. Large rostral mandibular defects are challenging to reconstruct due to the complex geometry of this region. In order to restore mandibular continuity and stability following extensive rostral mandibulectomy, we developed a surgical technique using a combination of intraoral and extraoral approaches, a locking titanium plate and a compression resistant matrix (CRM infused with rhBMP-2. Furthermore, surgical planning that consisted of computed tomographic (CT scanning and 3D model printing were utilized. We describe a regenerative surgical technique for immediate or delayed reconstruction of critical-size rostral mandibular defects in 5 dogs. Three dogs had healed with intact gingival covering over the mandibular defect and had immediate return to normal function and occlusion. Two dogs had the complication of focal plate exposure and dehiscence, which was corrected with mucosal flaps and suturing; these dogs have since healed with intact gingival covering over the mandibular defect. Mineralized tissue formation was palpated clinically within 2 weeks and solid bone formation within 3 months. Computed tomography findings at 6 months postoperatively demonstrated that the newly regenerated mandibular bone had increased in mineral volume with evidence of integration between the native bone, new bone and CRM compared to the immediate postoperative CT. We conclude that rostral mandibular reconstruction using a regenerative approach provides an excellent solution for restoring mandibular continuity and preventing mandibular instability in dogs.

Risk factors for osteoporotic fractures and low bone density in pre and postmenopausal women Factores de riesgo para fractura por osteoporosis y baja densidad ósea en mujeres en la pre y post menopausia Fatores de risco para fratura por osteoporose e baixa densidade óssea em mulheres na pré e pós-menopausa

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Marcelo M Pinheiro

2010-06-01

Full Text Available OBJECTIVE: To estimate the prevalence and analyze risk factors associated to osteoporosis and low-trauma fracture in women. METHODS: Cross-sectional study including a total of 4,332 women older than 40 attending primary care services in the Greater São Paulo, Southeastern Brazil, between 2004 and 2007. Anthropometrical and gynecological data and information about lifestyle habits, previous fracture, medical history, food intake and physical activity were obtained through individual quantitative interviews. Low-trauma fracture was defined as that resulting from a fall from standing height or less in individuals 50 years or older. Multiple logistic regression models were designed having osteoporotic fracture and bone mineral density (BMD as the dependent variables and all other parameters as the independent ones. The significance level was set at pOBJETIVO: Estimar la prevalencia y analizar los factores de riesgo asociados con osteoporosis y fractura por bajo impacto entre mujeres. MÉTODOS: Estudio transversal realizado con 4.332 mujeres encima de 40 años de edad provenientes de atención primaria de salud en el área metropolitana de la gran Sao Paulo, SP, entre 2004 2007. Datos antropométricos y ginecológico y relativos a hábitos de vida, fractura previa, antecedentes personales, ingestión alimentaria y actividad física fueron evaluados por medio de entrevista individual y cuantitativa. Fractura por bajo impacto fue definida como decurrente de caída de la propia altura o menos en individuos con más de 50 años de edad. Modelos de regresión multivariada y logística analizaron, respectivamente, la densidad ósea y la fractura por osteoporosis, como variables dependientes y todas las otras como independientes. El nivel de significancia estadística establecido fue pOBJETIVO: Estimar a prevalência e analisar os fatores de risco associados com osteoporose e fratura por baixo impacto entre mulheres. MÉTODOS: Estudo transversal realizado

Mandibular osteosynthesis in a Boa constrictor snake

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Jorge Luiz Costa Castro

2014-02-01

Full Text Available Nowadays are observed an increase in the finding of certain wild animals in urban areas, due to environmental changes caused by deforestation and economic use of natural areas. It causes disappearance of usual prey and forces these animals, including snakes, to migrate to urban areas, becoming vulnerable to injuries caused by aggressions, car accidents and capture. Mandibular and maxillar fractures are common in many animal species, representing about 3-6% of all bone fractures in dogs and cats. Mandibular trauma usually occurs as a result of fights, car accidents and improper handling and/or restraint, and fractures can be closed or open, clean or contaminated. The jaw is a flat bone with differences from the long bones that should be taken into consideration for successful treatment, being minimal muscle coverage and need to maintain occlusion factors that influence the definition of the best ostheosynthesis method. The methods of stabilization include using intramedullary pins, wires, external skeletal fixation, bone plate, and acrylic resin. Conventional bone plates are efficient but related to some complications, such as the necessity of muscular elevation and high risk of injuries to mandibular structures. This article describes the successful results of the application of plate and screws in the ostheosynthesis of a mandibular fracture in a female Boa constrictor snake with weight of 8.0 kg and length of 1.80 m, at the RIOZOO Foundation (Rio de Janeiro, RJ, Brazil.

Mandibular second molar with 3 mesial canals and a radix paramolaris

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N Ragavendran

2014-01-01

Full Text Available Mandibular first molar commonly has two roots, the mesial and the distal root. Surprisingly in some mandibular first molar has an unusual extra third root in between mesial and distal root. This extra root is the most commonly seen in lingual side and is called as radix entomolaris. If this extra root is seen on the buccal side, it is termed as radix paramolaris (RP, which is a very rare phenomenon. Recently, various case report studies has shown the presence of third canal in the mesial and distal roots of mandibular molars. They are named as middle mesial and middle distal canal, respectively. Here, we present a case report of mandibular second molar showing three canals in the mesial root and a RP.

Restricted Mandibular Movement Attributed to Ossification of Mandibular Depressors and Medial Pterygoid Muscles in Patients With Fibrodysplasia Ossificans Progressiva: A Report of 3 Cases.

Science.gov (United States)

Okuno, Tetsuko; Suzuki, Hitoshi; Inoue, Akio; Kusukawa, Jingo

2017-09-01

Fibrodysplasia ossificans progressiva (FOP) is an extremely rare genetic condition characterized by congenital malformation and progressive heterotopic ossification (HO) caused by a recurrent single nucleotide substitution at position 617 in the ACVR1 gene. As the condition progresses, HO leads to joint ankylosis, breathing difficulties, and mouth-opening restriction, and it can shorten the patient's lifespan. This report describes 3 cases of FOP confirmed by genetic testing in patients with restricted mouth opening. Each patient presented a different onset and degree of jaw movement restriction. The anatomic ossification site of the mandibular joint was examined in each patient using reconstructed computed tomographic (CT) images and 3-dimensional reconstructed CT (3D-CT) images. A 29-year-old woman complained of jaw movement restriction since 13 years of age. 3D-CT image of the mandibular joint showed an osseous bridge, formed by the mandibular depressors that open the mouth, between the hyoid bone and the mentum of the mandible. A 39-year-old man presented with jaw movement restriction that developed at 3 years of age after a mouth injury. 3D-CT image of the jaw showed ankylosis of the jaw from ossification of the mandibular depressors that was worse than in patient 1. CT images showed no HO findings of the masticatory muscles. To the authors' knowledge, these are the first 2 case descriptions of the anatomic site of ankylosis involving HO of the mandibular depressors in the jaw resulting from FOP. In contrast, a 62-year-old bedridden woman with an interincisal distance longer than 10 mm (onset, 39 years of age) had no HO of the mandibular depressors and slight HO of the medial pterygoid muscle on the right and left sides. These findings suggest that restricted mouth opening varies according to the presence or absence of HO of the mandibular depressors. Copyright © 2017. Published by Elsevier Inc.

A correlational study of scoliosis and trunk balance in adult patients with mandibular deviation.

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Shuncheng Zhou

Full Text Available 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, p1°, 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 management of mandibular deviation.

Fratura epifisiolise da extremidade proximal do úmero com luxação intratorácica: relato de caso Epiphysiolysis fracture of the proximal end of the humerus with intrathoracic dislocation: a case report

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Jaime Guiotti Filho

2008-02-01

Full Text Available A fratura da extremidade proximal do úmero com luxação intratorácica foi relatada em 1949 por West, em que a fratura era, somente, do tubérculo maior. Desde então, poucos casos foram relatados na literatura, a maioria constituída por pessoas idosas, prevalecendo como indicação terapêutica artroplastia parcial. Os autores relatam o caso de um adolescente de 14 anos de idade, sexo masculino, que apresentou fratura epifisiolise da extremidade proximal do úmero com luxação intratorácica em decorrência de acidente ciclístico e que foi submetido a tratamento cirúrgico com redução, osteossíntese e reinserção do manguito rotador. A recuperação da cabeça do úmero totalmente desvitalizada e o acompanhamento do processo de necrose e revas cularização durante seis anos, em paciente adolescente, parece não terem sido previamente relatados.Fracture of the proximal end of the humerus with intrathoracic dislocation was reported in 1949 by West, and the fracture was only a fracture of the greater tubercle. Few cases have since been published, and most of them in elderly individuals, partial arthroplasty prevailing as the therapy indication. The authors report the case of a 14 year old boy who presented with an epiphysiolysis fracture of the proximal end of the humerus with intrathoracic dislocation resulting from a bicycle accident. The boy was submitted to surgical treatment with reduction, osteosynthesis, and reinsertion of the rotator cuff. The totally devitalized humeral head recovery and the monitoring of the necrosis and revascularization process for a period of six years in a teenager patient seems to have never been reported before.

Mandibular ramus: A predictor for sex determination - A digital radiographic study

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Kotya Naik Maloth

2017-01-01

Full Text Available Aim: To evaluate mandibular ramus linear measurements on digital panoramic radiographs and to assess the usefulness of mandibular ramus in sex determination. Material and Methods: A retrospective study was conducted on 100 patients (50 males and 50 females using digital panoramic radiographs of Khammam population with age ranging from 20 to 50 years. Standard digital panoramic radiographs were taken without any errors by Sirona, ORTHOPHOS XG 5 machine. The following five mandibular linear measurements were performed in cm such as upper ramus breadth, lower ramus breadth, condylar ramus height, projective ramus height, and coronoid ramus height. The obtained data were analyzed with the software SPSS 13.0 for statistical analysis using discriminate methods. Results: In the present study, all the linear measurements of mandibular ramus on digital panoramic radiographs showed a statistically significant difference between the genders. Conclusion: We conclude that the use of mandibular ramus is recommended as an aid for sex determination in forensic science due to their unique feature of sexual dimorphism.

Clinical importance of median mandibular flexure in oral rehabilitation: a review.

Science.gov (United States)

Sivaraman, K; Chopra, A; Venkatesh, S B

2016-03-01

The mandible has a property to flex inwards around the mandibular symphysis with change in shape and decrease in mandibular arch width during opening and protrusion of the mandible. The mandibular deformation may range from a few micrometres to more than 1 mm. The movement occurs because of the contraction of lateral pterygoid muscles that pulls mandibular condyles medially and causes a sagittal movement of the posterior segments. This movement of mandible can have a profound influence on prognosis and treatment outcome for various restorative, endodontics, fixed, removable and implant-related prosthesis. The review unfolds the causes, importance and clinical implications of median mandibular flexure in oral rehabilitation. This review also highlights the appropriate preventive measures and techniques that should be adopted by clinicians to minimise the effect of flexural movement of the jaw during oral rehabilitation. This would not only help clinicians to achieve a good prosthesis with accurate fit and longevity but also maintain the health of the surrounding periodontal or periimplant gingival tissues and bone. © 2015 John Wiley & Sons Ltd.

Mandibular growth changes and cervical vertebral maturation. a cephalometric implant study.

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Gu, Yan; McNamara, James A

2007-11-01

To evaluate mandibular dimensional changes and regional remodeling occurring during five intervals of circumpubertal growth. This investigation evaluated a unique sample of subjects in whom tantalum implants were placed into the craniofacial complex during childhood. The sample was obtained from the Mathews and Ware implant study originally conducted at the University of California San Francisco in the 1970s, with longitudinal cephalometric records of 20 subjects (13 female, 7 male) available for evaluation. Cephalograms at six consecutive stages of cervical vertebral maturation (CS1 through CS6) were analyzed. Peak mandibular growth was noted during the interval from CS3 to CS4. Forward rotation of the mandible was due to greater mandibular growth posteriorly than anteriorly. Progressive closure of the condylar-ramus-occlusal (CRO) angle resulted in a forward and upward orientation of the ramus relative to the corpus of the mandible due to increased vertical growth of the condyle. A peak in mandibular growth at puberty was substantiated. Mandibular remodeling and condylar rotation continue to occur after the growth spurt.

Tenacidade à fratura translaminar dinâmica de um laminado híbrido metal-fibra para uso em elevadas temperaturas Translaminar dynamic fracture toughness of a hybrid fiber-metal laminate devised to high-temperature applications

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José R. Tarpani

2010-01-01

Full Text Available A tenacidade à fratura translaminar dinâmica do laminado híbrido metal-fibra titânio-grafite com matriz termoplástica foi determinada sob as velocidades de impacto de 2,25 e 5,52 m/s, no intervalo de temperaturas de -196 a +180 °C, e comparada à de laminados compósitos convencionais de fibras de carbono e resina epóxi. Constatou-se que o laminado híbrido exibe uma tenacidade à iniciação da fratura inferior à dos compósitos tradicionais com fibras na forma de fita unidirecional, porém superior à dos laminados convencionais com fibras na forma de tecido bidirecional. Os ensaios de impacto revelaram que, comparativamente ao desempenho mecânico dos laminados carbono-epóxi, o emprego do laminado híbrido metal-fibra se justifica mais pela sua resistência à propagação do que à iniciação da fratura dinâmica.The translaminar dynamic fracture toughness of titanium-graphite hybrid fiber-metal laminate with thermoplastic matrix has been determined at the impact velocities of 2.25 and 5.52 m/s, within the temperature range from -196 to +180 ºC, and compared to that of conventional carbon-epoxy composite laminates. The hybrid laminate exhibits lower initiation fracture toughness than traditional unidirectional tape composites though it is tougher than conventional woven fabric laminates. Impact tests revealed that, if compared to the mechanical performance of conventional carbon-epoxy laminates, the fiber-metal laminate application must rely on its resistance to dynamic fracture propagation rather than on fracture initiation.

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

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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. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Lower molar and incisor displacement associated with mandibular remodeling.

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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.

Peripheral Osteoma of the Mandibular Notch: Report of a Case

International Nuclear Information System (INIS)

Iwai, Toshinori; Izumi, Toshiharu; Baba, Junichi; Maegawa, Jiro; Mitsudo, Kenji; Tohnai, Iwai

2013-01-01

Osteoma is a benign, slow-growing osteogenic tumor that sometimes arises from the craniomaxillofacial region, such as the sinus, temporal or jaw bones. Osteoma consists of compact or cancellous bone that may be peripheral, central or extraskeletal type. Peripheral osteoma arises from the periosteum and is commonly a unilateral, pedunculated mushroom-like mass. Peripheral osteoma of the mandible is relatively uncommon, and peripheral osteoma of the mandibular notch is extremely rare, although many cases arise from the mandibular body, angle, condyle, or coronoid process. We report here an unusual peripheral osteoma of the mandibular notch in a 78-year-old nonsyndromic female

Fraturas de odontoide tipo III com necessidade de tratamento cirúrgico: estudo de série de casos e revisão de literatura Fracturas de odontoides tipo III con necesidad de tratamiento quirúrgico: estudio de série de casos y revisión de la literatura Type III odontoid fractures requiring surgical treatment: a case series study and literature review

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Alan Robert Wieczorek

2011-01-01

Full Text Available OBJETIVO: Analisar uma série de pacientes com fraturas de odontoide do tipo III, instáveis, tratados cirurgicamente. MÉTODOS: Análise retrospectiva de uma série de 5 casos consecutivos de pacientes com fratura de odontoide do tipo III, submetidos a tratamento cirúrgico. RESULTADOS: Três pacientes foram tratados inicialmente com halo-veste e, nos casos de falha, foram submetidos a osteossíntese cirúrgica. Dois pacientes, um com grande instabilidade radiológica em flexão e compressão medular e outro com comprometimento neurológico, foram submetidos a tratamento cirúrgico primário. A técnica cirúrgica foi individualizada para cada caso. Não ocorreram complicações graves; quatro pacientes evoluíram assintomáticos e somente um paciente desenvolveu dor cervical não incapacitante. A tomografia computadorizada (TC mostrou consolidação da fratura em 2 casos, os demais não realizaram TC de controle. O seguimento médio foi de 1,9 anos. CONCLUSÕES: Fraturas de odontoide do tipo III nem sempre são lesões benignas, sendo importante individualizar seu tratamento sempre que alguma característica incomum for identificada. Existem critérios de instabilidade e indicação de tratamento cirúrgico para pacientes com este tipo de lesão.OBJETIVO: Analizar los casos de una serie de pacientes con fracturas de odontoides del tipo III inestables, tratadas quirúrgicamente. MÉTODOS: Análisis retrospectiva de una serie de 5 casos consecutivos de pacientes con fractura de odontoides del tipo III, sometidos a tratamiento quirúrgico. RESULTADOS: Tres pacientes fueran tratados al comienzo con halo veste y, en la falla de este, se sometieron a osteosíntesis quirúrgica. Dos pacientes, uno con inestabilidad radiológica importante en flexión y compresión medular y otro con déficit neurológico se sometieron a tratamiento quirúrgico primario. La técnica quirúrgica se individualizó para cada uno de los casos. No ocurrieron complicaciones

Maxillary palatal ramp prosthesis: A prosthodontic solution to manage mandibular deviation following surgery

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Sampa Ray (Bhattacharya

2015-01-01

Full Text Available Mandibular resection following surgical treatment for neoplastic lesions of the oral cavity leads to numerous complications including altered mandibular movements, disfigurement, difficult in swallowing, impaired speech and articulation, and deviation of the mandible towards the resected site. Various prosthetic methods are employed to reduce or minimize mandibular deviation and improve and restore the lost functions and esthetic, like maxillomandibular fixation, implant supported prosthesis, removable mandibular guide flange prosthesis, and palatal based guidance restoration. This clinical report describes the rehabilitation of a patient following segmental mandibulectomy using palatal ramp prosthesis.

[Trigeminal motor paralysis and dislocation of the temporo-mandibular joints].

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Ohkawa, S; Yoshida, T; Ohsumi, Y; Tabuchi, M

1996-07-01

A 64-year-old woman with diabetes mellitus was admitted to our hospital with left hemiparesis of sudden onset. A brain MRI demonstrated a cerebral infarction in the ventral part of the right lower pons. When left hemiparesis worsened, she had dislocation of the temporo-mandibular joints repeatedly. Then, her lower jaw deviated to the right when she opened her mouth. Also, there was decreased contraction of the right masseter when she clenched her teeth. These findings suggest that there was trigeminal motor paralysis on the right side resulting from involvement of the intrapontine trigeminal motor nerve. She has no history of dislocation of the temporo-mandibular joints. An X-ray film showed that the temporo-mandibular joints were intact. Thus, it is possible that deviation of the lower jaw was the cause of this dislocation. We suspect that dislocation of the temporo-mandibular joints may occur as a complication of unilateral trigeminal motor paralysis. This has not been reported to our knowledge.

[Bruxism, temporo-mandibular dysfunction and botulinum toxin].

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Chikhani, L; Dichamp, J

2003-07-01

Tooth grinding and tooth clenching are unvoluntary mainly nocturnal habits that result in an hypertrophy of masseter and temporalis muscles with an unbalance between opening and closing muscles of the jaw and lead to an alteration of mandibular condyles movements and to hyper pressure in the temporo-mandibular joints (TMJ) which can generate severe pain. Intra muscular injections of botulinum toxin permit to restablish the balance between closing and opening muscles, to relieve pain, to treat masseteric hypertrophy with improvement of face outline and to recover a normal cinetic of temporo-mandibular joints. Moreover, botulinum toxin injections permit to quit habits of tooth grinding and clenching and one single session of injections is curative for 2/3 of the patients. There are no side effects apart from slight diffusion to superficial muscles of the face resulting in a "fixed" smile for about 6 to 8 weeks. So injections of botulinum toxin in masseter and temporalis muscles are an efficient treatment of bruxism and TMJ dysfunction, cheap with no lasting side effect.

Evaluation of Recurring Esthetic Dental Proportion in Natural Mandibular Anterior Dentition

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Dipti S Shah

2015-01-01

Results: After calculating proportions in mandibular anterior teeth, P value was found to be statistically insignificant (P > 0.05. Conclusion: Within the limitations of the study, RED proportion was not seen in mandibular natural dentition.

Cementoblastoma Relating to Right Mandibular Second Primary Molar

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Sivakumar Nuvvula

2016-01-01

Full Text Available 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.

[Inferior hemiarthroplasty of the temporo-mandibular joint with articulated condylar prosthesis type Stryker].

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Bucur, A; Dincă, O; Totan, C; Ghită, V

2007-01-01

The optimal reconstruction of the mandible and of the temporo-mandibular joint after mandibular hemi-resection with disarticulation is still controversial in literature. This paperwork presents our experience on four cases in the reconstruction of the mandible together with the inferior arthroplasty of the temporo-mandibular joint, after the resection of extended benign tumors of the mandible, based on fibular free vascularized grafts having attached a Stryker titanium condylar prosthesis reconstructing the inferior segment of the temporo-mandibular joint. Our results for the this technique were excellent, with a functional rehabilitation very close to normal. After reviewing the various techniques and their arguments in literature, with accent on the TMJ reconstruction, we consider this method to be optimal for the reconstruction of mandibular defects in patients with neoplastic conditions.

Study of pulp chamber morphology of primary mandibular molars using spiral computed tomography.

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Selvakumar, Haridoss; Kavitha, Swaminathan; Vijayakumar, Rajendran; Eapen, Thomas; Bharathan, Rajendran

2014-11-01

The purpose of this study was to evaluate the pulp chamber morphology in primary mandibular molars using spiral computed tomography (SCT). Sixty extracted primary mandibular molars were scanned using SCT for the (i) distance between the central fissure to furcation, (ii) distance between the central fissure to the floor of the pulp chamber, (iii) height of the pulp chamber (roof-floor), (iv) distance between the floor of the pulp chamber to the furcation. The mean and standard deviation was analyzed using statistical package for the social sciences (SPSS) program. The results of this study show that the average mean distance from the central fissure to the floor of the pulp chamber is 5.07 mm in first mandibular primary molar and 5.54 mm in second mandibular primary molar. It can be concluded that the greatest depth to which a bur can go during access opening without perforating the furcation in first primary mandibular molar is 5.07 mm and 5.54 mm in second primary mandibular molar.

Influence of mastication and edentulism on mandibular bone density.

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Chou, Hsuan-Yu; Satpute, Devesh; Müftü, Ali; Mukundan, Srinivasan; Müftü, Sinan

2015-01-01

The aim of this study was to demonstrate that external loading due to daily activities, including mastication, speech and involuntary open-close cycles of the jaw contributes to the internal architecture of the mandible. A bone remodelling algorithm that regulates the bone density as a function of stress and loading cycles is incorporated into finite element analysis. A three-dimensional computational model is constructed on the basis of computerised tomography (CT) images of a human mandible. Masticatory muscle activation involved during clenching is modelled by static analysis using linear optimisation. Other loading conditions are approximated by imposing mandibular flexure. The simulations predict that mandibular bone density distribution results in a tubular structure similar to what is observed in the CT images. Such bone architecture is known to provide the bone optimum strength to resist bending and torsion during mastication while reducing the bone mass. The remodelling algorithm is used to simulate the influence of edentulism on mandibular bone loss. It is shown that depending on the location and number of missing teeth, up to one-third of the mandibular bone mass can be lost due to lack of adequate mechanical stimulation.

Does the titanium plate fixation of symphyseal fracture affect mandibular growth?

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Bayram, Burak; Yilmaz, Alev Cetinsahin; Ersoz, Esra; Uckan, Sina

2012-11-01

The effect of metallic fixation on growth is a major concern in children and is not yet clear. The aim of this study was to evaluate the effect of metallic fixation of mandibular symphyseal fracture on mandibular growth.Eighteen 90-day-old growing white New Zealand rabbits weighing 1.6 to 2.5 kg were included in this study and divided into 2 groups of 9 subjects. In the experimental group, animals underwent mandibular osteotomy, simulating a symphyseal fracture on the midline of mandibular symphysis. The bone segments were fixed with microplates and microscrews (1.6 mm).In the control group, the same surgical incision without performing symphyseal osteotomy was conducted, and 2 screws were inserted on each side of the symphyseal midline.Digital cephalometric and submentovertex radiographs were taken before the operation and at postoperative 6 months for each animal in 2 groups, and cephalometric measurements were performed. The distance between the centers of the head of 2 screws measured at the end of surgery in the control group was compared with measurements at 6 months after surgery. Obtained data were statistically analyzed.There is no statistically significant difference between the 2 groups for growth amount of both sides of the mandible. Difference of ANS-Id (the most anterior points of nasal bone, the most anterior point on the alveolar bone between the lower incisors) and Cd-Id (the uppermost and most distal point of the mandibular condyle, the most anterior point on the alveolar bone between the lower incisors) values of the 2 groups is not statistically significant (P > 0.05).The distance between the 2 screws at the first application significantly increased at the postoperative sixth month (P mandibular symphyseal fracture does not affect the vertical and sagittal mandibular growth in growing rabbits.

Preliminary optical coherence tomography investigation of the temporo-mandibular joint disc

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Mărcăuteanu, Corina; Demjan, Enikö; Sinescu, Cosmin; Negrutiu, Meda; Motoc, Adrian; Lighezan, Rodica; Vasile, Liliana; Hughes, Mike; Bradu, Adrian; Dobre, George; Podoleanu, Adrian G.

2010-02-01

Aim and objectives. The morphology and position of the temporo-mandibular disc are key issues in the diagnosis and treatment of arthrogenous temporo-mandibular disorders. Magnetic resonance imaging and arthroscopy are used today to identify: flattening of the pars posterior of the disc, perforation and/or adhesions in the pars intermedia of the disc and disc displacements. The present study proposes the investigation of the temporo-mandibular joint disc by optical coherence tomography (OCT). Material and methods. 8 human temporo-mandibular joint discs were harvested from dead subjects, under 40 year of age, and conserved in formalin. They had a normal morphology, with a thicker pars posterior (2,6 mm on the average) and a thinner pars intermedia (1mm on the average). We investigated the disc samples using two different OCT systems: an en-face OCT (time domain (TD)-OCT) system, working at 1300 nm (C-scan and B-scan mode) and a spectral OCT system (a Fourier domain (FD)-OCT) system , working at 840 nm (B-scan mode). Results. The OCT investigation of the temporo-mandibular joint discs revealed a homogeneous microstructure. The longer wavelength of the TD-OCT offers a higher penetration depth (2,5 mm in air), which is important for the analysis of the pars posterior, while the FD-OCT is much faster. Conclusions: OCT is a promising imaging method for the microstructural characterization of the temporo-mandibular disc.

Glenoid fossa position in Class II malocclusion associated with mandibular retrusion.

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Giuntini, Veronica; De Toffol, Laura; Franchi, Lorenzo; Baccetti, Tiziano

2008-09-01

To assess the position of the glenoid fossa in subjects with Class II malocclusion associated with mandibular retrusion and normal mandibular size in the mixed dentition. A sample of 30 subjects (16 male, 14 female), age 9 years +/- 6 months, with skeletal and dental Class II malocclusion associated with mandibular retrusion, normal skeletal vertical relationships, and normal mandibular dimensions, was compared with a matched group of 37 subjects (18 male, 19 female) with skeletal and dental Class I relationships. The comparisons between the Class II group and the control group on the cephalometric measures for the assessment of glenoid fossa position were performed by means of a nonparametric test for independent samples (Mann-Whitney U-test, P < .05). Subjects with Class II malocclusion presented with a significantly more distal position of the glenoid fossa, when compared with the control group as measured by means of three parameters (GF-S on FH, GF-Ptm on FH, and GF-FMN). A posteriorly displaced glenoid fossa is a possible diagnostic feature of Class II malocclusion associated with mandibular retrusion. An effective cephalometric measurement to evaluate glenoid fossa position is the distance from the glenoid fossa to the frontomaxillonasal suture (GF-FMN).

Mandibular Two Mini Implants Overdenture Using Magnetic Attachments: A Case Report

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Anna Miyayasu

2017-12-01

Full Text Available Many patients with an edentulous mandible struggle to use complete dentures. The instability of such dentures caused by the lack of retention, often causes discomfort, as well as functional and psychosocial problems, which can be signifcantly improved using implant overdentures with retentive attachments. This case report describes a successful case of a mandibular implant overdenture using two mini implants and magnetic attachments for an elderly edentulous patient. Case Report: A 62-year-old female with a thin mandibular bone ridge presented with complaints of pain caused by an unstable and unretentive complete mandibular denture. This patient received two mini implants (diameter: 2.6 mm; length: 12 mm with magnetic attachments. After three months, magnetic assemblies with magnetic attraction of 400 gf were incorporated into the intaglio surface of her mandibular overdenture. At 11 months, magnetic attraction was changed from 400 gf to 600 gf to provide a stronger magnetic force for improving the retention of this denture. Conclusion: Based on a two-year follow-up period, the mandibular two mini implants overdenture with magnetic attachments was successful in improving the patient’s general satisfaction with her dentures

Signaling pathways regulating the expression of Prx1 and Prx2 in the Chick Mandibular Mesenchyme

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Doufexi, Aikaterini-El; Mina, Mina

2009-01-01

Prx1 and Prx2 are members of the aristaless-related homeobox genes shown to play redundant but essential roles in morphogenesis of the mandibular processes. To gain insight into the signaling pathways that regulate expression of Prx genes in the mandibular mesenchyme, we used the chick as a model system. We examined the patterns of gene expression in the face and the roles of signals derived from the epithelium on the expression of Prx genes in the mandibular mesenchyme. Our results demonstrated stage-dependent roles of mandibular epithelium on the expression of Prx in the mandibular mesenchyme and provide evidence for positive roles of members of the fibroblast and hedgehog families derived from mandibular epithelium on the expression of Prx genes in the mandibular mesenchyme. Our studies suggest that endothelin-1 signaling derived from the mesenchyme is involved in restricting the expression of Prx2 to the medial mandibular mesenchyme. PMID:18942149

Fraturas supracondilares tipo III do úmero em crianças: tratamento com braço reto Type III supracondylar fractures of the humerus in children: straight-arm treatment

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Jamish Gandhi

2010-01-01

Full Text Available INTRODUÇÃO: As fraturas supracondilares de Gartland tipo III são as lesões comuns em crianças. Apresentamos um método de redução manipulativa, imobilização e fixação usando gesso-de-Paris, com o cotovelo em extensão total (braço reto. MÉTODO: Estudo retrospectivo analisando todos os pacientes com fraturas supracondilares de Gartland tipo III no Wellington Public Hospital, durante o período de fevereiro de 1999 a março de 2007. Os sete pacientes foram tratados pela técnica do braço reto, e os desfechos clínicos foram revisados neste estudo. RESULTADO: Todos os pais ficaram satisfeitos com os resultados. Usando os critérios de Flynn,6 seis pacientes atingiram excelentes resultados e um teve resultado bom quando se analisou o ângulo de alinhamento. Ao verificar a amplitude de movimento, quatro pacientes tiveram resultados bons, um moderado e dois, ruim. CONCLUSÃO: O tratamento com braço reto das fraturas supracondilares de Gartland tipo III parece ser uma alternativa não-invasiva e segura da fixação com fio K.OBJECTIVE: Gartland type III supracondylar fractures are a common injury in children. We present a method of manipulative reduction, immobilization and fixation using Plaster of Paris with the elbow in full extension (straight-arm. METHOD: Retrospective study analyzing all patients with Gartland type III supracondylar fractures at the Wellington Public Hospital during the period from February 1999 to March 2007. The seven patients had been treated with the straight-arm technique, and the clinical outcomes are reviewed in this study. RESULT: All the parents were satisfied with the results. Using the Flynn criteria6, six patients achieved excellent results and one good, in relation to the carrying angle. With regard to the range of motion, four patients had good results, one fair, and two poor. CONCLUSION: Straight-arm treatment of Gartland type III supracondylar fractures appears to be a non-invasive and safe

Management of periodontally compromised mandibular molar with Hemisectioning: A case report

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Bandu Napte

2014-01-01

Full Text Available Introduction: Hemisection involves sectioning of a periodontally involved mandibular molar so as to remove the involved root and save the remaining tooth. This procedure helps in saving a tooth which otherwise would have been deemed for extraction. Hemisection refers to removal or separation of root with its accompanying crown portion of two-rooted teeth, most commonly mandibular molars. Method: In this case report, an advanced Endo-Perio lesion on a left mandibular first molar was successfully treated by root-canal treatment and hemisection. This procedure helps preserve the tooth structure, alveolar bone and promote cost savings over other treatment options. Conclusion: Hemisection is a treatment option for saving a mandibular molar which is in advanced stage of periodontal disease of one root. Removal of the affected root will help in retaining the remaining tooth structure.

Evaluation of mandibular condyles in children with unilateral posterior crossbite.

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Illipronti-Filho, Edson; Fantini, Solange Mongelli de; Chilvarquer, Israel

2015-01-01

The relationship of mandibular condyle dimensions and its association with unilateral posterior crossbite (UPXB) has been suggested in the literature. The purpose of this prospective study was to evaluate mandibular condyles on the left and right sides and between crossed and non-crossed sides in the sagittal and coronal planes, using cone-beam computed tomography (CBCT). Twenty CBCT images of 40 temporo mandibular joints (TMJs) in individuals in mixed dentition phase, which included 9 males (mean 7.9 years) and 11 females (mean 8.2 years), with unilateral posterior crossbite without premature contacts and functional mandibular shifts and with transverse maxillary deficiency. The criteria for sample exclusion included the presence of painful symptoms, facial trauma history, systemic diseases such as juvenile rheumatoid arthritis, mouth opening limitation (anomalies, and skeletal asymmetries that may result in TMJ disorders. Dimensional measurements of the condyles between the right and left sides and crossed and non-crossed sides in sagittal and coronal view were made. There was no significant difference between the measurements of the crossed and non-crossed sides in both sagittal and coronal view. These findings suggest that the presence of unilateral posterior crossbite in children with UPXB did not result in changes between the mandibular condyles in the right and left sides or between the crossed and non-crossed sides in the coronal or sagittal plane.

Mandibular Symmetrical Bilateral Canine-Lateral Incisors Transposition: Its Early Diagnosis and Treatment Considerations.

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Shapira, Yehoshua; Finkelstein, Tamar; Kadry, Rana; Schonberger, Shirley; Shpack, Nir

2016-01-01

Bilateral mandibular tooth transposition is a relatively rare dental anomaly caused by distal migration of the mandibular lateral incisors and can be detected in the early mixed dentition by radiographic examination. Early diagnosis and interceptive intervention may reduce the risk of possible transposition between the mandibular canine and lateral incisor. This report illustrates the orthodontic management of bilateral mandibular canine-lateral incisor transposition. Correct positioning of the affected teeth was achieved on the left side while teeth on the right side were aligned in their transposed position. It demonstrates the outcome of good alignment of the teeth in the dental arch.

Influência do componente protéico na consolidação de fraturas: trabalho experimental em ratos Influence of the protein component upon fracture healing: an experimental study in rats

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Roberto Guarniero

2003-12-01

Full Text Available Os autores estudaram a influência da nutrição protéica na consolidação de fraturas em 40 ratos Lewis divididos em 4 grupos de 10. Durante 6 semanas os grupos 1, 2 e 3 receberam respectivamente dietas com 0, 19% e 36% de proteínas. O grupo 4 recebeu dieta sem proteínas durante as 2 primeiras semanas e com 36% de proteínas nas 4 semanas seguintes. Foram realizadas fraturas nas tíbias esquerdas ao final de 2 semanas e após 4 semanas das fraturas os animais foram sacrificados para estudo dos calos ósseos. Para a avaliação dos resultados foram utilizadas medidas clínicas, bioquímicas, radiográficas, densitométricas, e histomorfométricas. Concluiu-se que a dieta hiperprotéica alterou a consolidação óssea produzindo um calo maior e mais resistente, mas não alterou a qualidade em concentração de cálcio e em porcentagem a quantidade de tecido ósseo.The authors investigated the influence of a protein diet on fracture healing in 40 Lewis rats divided into four groups of ten. During 6 weeks, Groups 1, 2 and 3 were fed diets containing, respectively, 0.19% and 36% protein. Group 4 was fed a proteinless diet during the first two weeks and a 36%-protein diet during the next 4 weeks. At two weeks, fractures were performed in the left tibias; all animals were killed 4 weeks later so that the bone calluses could be investigated. Clinical, biochemical, radiographic, densitometry and histomorphometry measurements were performed to evaluate the findings. The conclusion was that the hyperprotein diet altered bone healing by producing a larger, more resistant callus, although it did not change quality as regards calcium levels and the percentage amount of bone tissue.

Root canal morphology and variations of mandibular premolars by clearing technique: an in vitro study.

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Parekh, Vaishali; Shah, Nimisha; Joshi, Hardik

2011-07-01

The aim of this study was to compare internal anatomy between first and second mandibular premolars and to study different percentage variations of root canal morphology of mandibular premolars in Gujarat population based on Vertucci's classification by clearing technique. A total of 80 extracted intact permanent mandibular premolars (40 each mandibular first premolar and mandibular second premolar) with fully formed apices were collected. Access cavity was prepared with endo access kit, all samples were placed in 2.5% sodium hypochlorite for 48 hours, after that all samples were washed in running water for 2 hours. After washing, all samples were transferred to 5% nitric acid, for decalcification, for 72 hours, with the acid being changed every 24 hours and stirred once every 8 hours. All samples were washed in running water and dehydrated using ascending grades (70%, 80%, 90% and 100%) of isopropyl alcohol for 2 days. Finally, they were rendered transparent by immersion in methyl salicylate for 15 minutes and then India ink dye was injected into the access cavity. The anatomy of the root canal was observed and classified based on the Vertucci's classification. Parametric Z-test was used to compare the variation between mandibular first and second premolars. In mandibular first premolar, type 1 was found in 20%, type 2 was 5%, type 3 was 5%, type 4 was 25%, type 5 was 12.5% and type 6 was 2.5% of total samples. Whereas, in mandibular second premolar, type 1 was found in 80% out of all samples, type 4 was 2.5%, type 5 was 17.5%. Type 2, type 3, type 6, type 7 and type 8 were not found in this study. Mandibular first premolar showed higher variation (75%) compared to mandibular second premolar (37.5%). The knowledge of variations in the root canal morphology of the mandibular premolars can enhance the level of endodontic treatment of mandibular premolars. Root canal morphology, Vertucci's classification, Clearing technique. How to cite this article: Parekh V, Shah N

Management of mandibular body fractures in pediatric patients: a case report with review of literature.

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John, Baby; John, Reena R; Stalin, A; Elango, Indumathi

2010-10-01

Mandibular fractures are relatively less frequent in children when compared to adults, which may be due to the child's protected anatomic features and infrequent exposure of children to alcohol related traffic accidents. Treatment principles of mandibular fractures differ from that of adults due to concerns regarding mandibular growth and development of dentition. A case of a 4.5-year-old boy with fractured body of mandible managed by closed reduction using open occlusal acrylic splint and circum mandibular wiring is presented. This article also provides a review of literature regarding the management of mandibular body fracture in young children.

Management of mandibular body fractures in pediatric patients: A case report with review of literature

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Baby John

2010-01-01

Full Text Available Mandibular fractures are relatively less frequent in children when compared to adults, which may be due to the child′s protected anatomic features and infrequent exposure of children to alcohol related traffic accidents. Treatment principles of mandibular fractures differ from that of adults due to concerns regarding mandibular growth and development of dentition. A case of a 4.5-year-old boy with fractured body of mandible managed by closed reduction using open occlusal acrylic splint and circum mandibular wiring is presented. This article also provides a review of literature regarding the management of mandibular body fracture in young children.

Redução fechada e fixação esquelética externa tipo II para o tratamento de fraturas de tibiotarso em pombos domésticos (Columba livia Closed reduction and type-II external skeletal fixation for treatment of tibiotarsus fractures in domestic pigeons (Columba livia

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Marcelo Meller Alievi

2001-12-01

Full Text Available A redução fechada e o fixador esquelético externo tipo II foram avaliados para o tratamento de fraturas de tibiotarso em pombos domésticos (Columba livia. Foram utilizadas doze aves adultas. Os pombos foram anestesiados com a associação de xilazina e cetamina e, em seguida, foi realizada fratura do tibiotarso direito através de pressão digital sobre a diáfise do membro. Quatro pinos de Kirschner, dois proximais e dois distais ao foco da fratura, foram inseridos através de ambas as corticais ósseas e, após redução fechada da fratura, conectados externamente por duas barras de acrílico autopolimerizável, uma na face lateral e outra na face medial do membro. Em cinco aves, foi observado radiograficamente desvio ósseo angular, porém, a função do membro não foi afetada. O tempo médio e o desvio padrão para a cicatrização óssea foram 24,8 ± 4,89 dias. Os resultados demonstram que a redução fechada e o fixador esquelético externo tipo II são efetivos para o tratamento de fraturas de tibiotarso em pombos domésticos (Columba livia.The aim of this study was to evaluate the use of closed reduction and type-II external skeletal fixation for treatment of tibiotarsus fractures in domestic pigeons (Columba livia. Twelve adult domestic pigeons were used. Anesthesia was induced with xylazine and ketamine hydrochloride; the right tibiotarsus was manually fractured by digital pressure applied at the mid-diaphysis. Four Kirschner wires were placed through both cortices of the bone, two proximal and two distal to the fracture site, and, after closed reduction of the fracture, they were stabilized by two acrilic bars, one in the lateral and another in the medial surface of the tibiotarsus. Abnormalities in bone angulation were observed radiographically in five birds; however, the function of the limb was not noticeably impaired. The mean time ± standard deviation for fracture healing was 24.8 ± 4.89 days. The results of this

Conservative Management of Unilateral Fractures of the Mandibular Rami in Horses.

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Jansson, Nicolai

2016-11-01

To report the outcome of conservative management of unilateral fractures of the mandibular rami in horses. Retrospective case series. 24 client-owned horses with unilateral mandibular fractures METHODS: Medical records (January 2000-January 2014) of horses with unilateral mandibular ramus fractures were retrieved. Only conservatively managed horses with follow-up information were included. Follow-up information on clinical outcome was retrieved from the medical records (n=11) or obtained by telephone interviews with the owners or trainers (n=13). Twenty-three horses (96%) returned to their previous or intended use and had no clinically evident masticatory or fracture healing-related problems at the time of follow-up. The owner of 1 horse (4%) reported it had tooth loosening, feed impaction, and masticatory problems. Conservative management of unilateral fractures of the mandibular rami is a treatment option in horses. © Copyright 2016 by The American College of Veterinary Surgeons.

Efeitos da dieta proteica na cicatrização de fraturas distais de fêmur imobilizadas com pinos intramedulares em cão

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Silveira Iandara Silva

1997-01-01

Full Text Available No presente experimento vinte cães sem raça definida, pesando em média 6kg, com idade variando entre 4 e 12 anos, vindos do Biotério Central da Universidade Federal de Santa Maria (UFSM, foram distribuidos em dois grupos com 10 animais, cada grupo dividido em dois subgrupos com 5 cães, denominados 1A, 1B, 2A e 2B. Os animais do grupo 1 receberam tratamento por 90 dias, e os do grupo 2 por 60 dias após a cirurgia. O subgrupo A correspondem a tratamento com ração crescimento contendo 27% de proteina bruta e o subgrupo B ração manutenção com 21% de proteina bruta. Todos os cães sofreram fratura distal de fêmur, experimental, reduzidas com dois pinos intramedulares, introduzidos através da superfície articular da tróclea. Os cães ficaram confinados em canis individuais até a remoção dos pontos e em canis comuns para no máximo 5 cães até o término do experimento. Foi feita avaliação clínica, radiográfica e histológica da evolução da cicatrização óssea a qual demonstrou que o tratamento com ração com maior teor de proteina proporcionou melhor regeneração e que a técnica de osteossíntese utilizada manteve estabilidade na linha de fratura.

Mandibular Symmetrical Bilateral Canine-Lateral Incisors Transposition: Its Early Diagnosis and Treatment Considerations

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Yehoshua Shapira

2016-01-01

Full Text Available Bilateral mandibular tooth transposition is a relatively rare dental anomaly caused by distal migration of the mandibular lateral incisors and can be detected in the early mixed dentition by radiographic examination. Early diagnosis and interceptive intervention may reduce the risk of possible transposition between the mandibular canine and lateral incisor. This report illustrates the orthodontic management of bilateral mandibular canine-lateral incisor transposition. Correct positioning of the affected teeth was achieved on the left side while teeth on the right side were aligned in their transposed position. It demonstrates the outcome of good alignment of the teeth in the dental arch.

Prolonged vertigo and ataxia after mandibular nerve block for treatment of trigeminal neuralgia

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Arvind Chaturvedi; H H Dash

2011-01-01

Common complications of neurolytic mandibular nerve block are hypoesthesia, dysesthesia, and chemical neuritis. We report a rare complication, prolonged severe vertigo and ataxia, after neurolytic mandibular blockade in a patient suffering from trigeminal neuralgia. Coronoid approach was used for right sided mandibular block. After successful test injection with local anesthetic, absolute alcohol was given for neurolytic block. Immediately after alcohol injection, patient developed nausea and...

Recurrent simple bone cyst of the mandibular condyle: a case report

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Kim, Kyung A; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, and Institute of Oral Bio Science, Chonbuk National University, Jeonju (Korea, Republic of)

2013-03-15

Cysts of the mandibular condyle are rare and can be difficult to diagnose and treat. Clinically, a simple bone cyst is asymptomatic and often discovered incidentally on routine radiographic examination. This report shows an atypical simple bone cyst occurring in the mandibular condyle showing recurrence after surgical curettage. Radiologically, this lesion involving the mandibular condyle should be distinguished from other similar lesions such as a chondriome, a central giant cell granuloma, and an aneurysmal bone cyst. Radiographic assessment was useful for forecasting the prognosis of a simple bone cyst. Possible reasons for the recurrence were discussed radiographically.

Evaluation of mandibular condyles in children with unilateral posterior crossbite

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Edson ILLIPRONTI-FILHO

2015-01-01

Full Text Available The relationship of mandibular condyle dimensions and its association with unilateral posterior crossbite (UPXB has been suggested in the literature. The purpose of this prospective study was to evaluate mandibular condyles on the left and right sides and between crossed and non-crossed sides in the sagittal and coronal planes, using cone-beam computed tomography (CBCT. Twenty CBCT images of 40 temporo mandibular joints (TMJs in individuals in mixed dentition phase, which included 9 males (mean 7.9 years and 11 females (mean 8.2 years, with unilateral posterior crossbite without premature contacts and functional mandibular shifts and with transverse maxillary deficiency. The criteria for sample exclusion included the presence of painful symptoms, facial trauma history, systemic diseases such as juvenile rheumatoid arthritis, mouth opening limitation (< 40 mm, congenital or genetic anomalies, and skeletal asymmetries that may result in TMJ disorders. Dimensional measurements of the condyles between the right and left sides and crossed and non-crossed sides in sagittal and coronal view were made. There was no significant difference between the measurements of the crossed and non-crossed sides in both sagittal and coronal view. These findings suggest that the presence of unilateral posterior crossbite in children with UPXB did not result in changes between the mandibular condyles in the right and left sides or between the crossed and non-crossed sides in the coronal or sagittal plane.

Feasibility of purely endoscopic intramedullary fixation of mandibular condyle fractures.

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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.

Intraoral Approach and Stereolithographic-guided Large Mandibular Reconstruction with Fibula Free Flap

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Artur Diaz-Carandell, MD

2014-08-01

Full Text Available Summary: The reconstruction of mandibular defects has always been of great concern, and it still represents a challenge for head-and-neck reconstructive surgeons. The mandible plays a major role in mastication, articulation, swallowing, respiration, and facial contour. Thus, when undertaking mandibular reconstruction, restoration of both function and cosmetics should be considered as the measure of success. Microsurgical reconstruction is the gold-standard method to repair a segmental mandibular defect. Reconstruction of sizeable defects often needs a large neck incision, leading to unsatisfactory cosmetic outcomes. Virtual surgical planning and stereolithographic modeling are new techniques that offer excellent results and can provide precise data for mandibular reconstruction and improve postoperative outcomes. We present a case of complete intraoral resection and reconstruction of a large ameloblastoma of the mandible.

[Maxillo-facial surgery in skeletal Class II: repercussions on the temporo-mandibular joints].

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Manière-Ezvan, Armelle; Savoldelli, Charles; Busson, Floriant; Oueiss, Arlette; Orthlieb, Jean-Daniel

2016-03-01

These interventions usually aimed at the correction of the skeletal discrepancy by mandibular retrognatism with an advancement of the distal portion of the mandible after mandibular osteotomy. The position of the condyle is determined during the osteosynthesis with miniplates. Condyles are set back in relation with the supine position of the patient and the weakness of his (her) curarized muscle. All studies show that surgery of mandibular advancement causes a lateral, torque and backward movement of the condyles, all harmful to the condyles. Factors that predispose to condylar resorption are "the patient": a woman, young (between 15 and 40), high mandibular angle, with a history of temporo-mandibular disorders and surgical overload applied to the condyles. What are the possible solutions to avoid failures? Patient preparation before surgery and surgery simulation with an articulator, condylar position control during surgery, working with surgeons to achieve a condylar portion stabilization system (with the CAD), quickly set up a mobilization of the mandible by physiotherapy. © EDP Sciences, SFODF, 2016.

Kinematic Modeling of Normal Voluntary Mandibular Opening and Closing Velocity-Initial Study.

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Gawriołek, Krzysztof; Gawriołek, Maria; Komosa, Marek; Piotrowski, Paweł R; Azer, Shereen S

2015-06-01

Determination and quantification of voluntary mandibular velocity movement has not been a thoroughly studied parameter of masticatory movement. This study attempted to objectively define kinematics of mandibular movement based on numerical (digital) analysis of the relations and interactions of velocity diagram records in healthy female individuals. Using a computerized mandibular scanner (K7 Evaluation Software), 72 diagrams of voluntary mandibular velocity movements (36 for opening, 36 for closing) for women with clinically normal motor and functional activities of the masticatory system were recorded. Multiple measurements were analyzed focusing on the curve for maximum velocity records. For each movement, the loop of temporary velocities was determined. The diagram was then entered into AutoCad calculation software where movement analysis was performed. The real maximum velocity values on opening (Vmax ), closing (V0 ), and average velocity values (Vav ) as well as movement accelerations (a) were recorded. Additionally, functional (A1-A2) and geometric (P1-P4) analysis of loop constituent phases were performed, and the relations between the obtained areas were defined. Velocity means and correlation coefficient values for various velocity phases were calculated. The Wilcoxon test produced the following maximum and average velocity results: Vmax = 394 ± 102, Vav = 222 ± 61 for opening, and Vmax = 409 ± 94, Vav = 225 ± 55 mm/s for closing. Both mandibular movement range and velocity change showed significant variability achieving the highest velocity in P2 phase. Voluntary mandibular velocity presents significant variations between healthy individuals. Maximum velocity is obtained when incisal separation is between 12.8 and 13.5 mm. An improved understanding of the patterns of normal mandibular movements may provide an invaluable diagnostic aid to pathological changes within the masticatory system. © 2014 by the American College of Prosthodontists.

Unusal canal configuration in maxillary and mandibular second molars

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Ramachandran Ragunathan

2016-01-01

Full Text Available This clinical article describes three different case reports of maxillary and mandibular second molars with the unusual anatomy of single root with a single canal and their endodontic management. An unusual case of bilateralism is observed in the first two cases in the form of single-rooted second mandibular molars in both the quadrant of the same patient. The presence of maxillary second molar with single root and single canal in the third case is unusual.

Root and Canal Morphology of Mandibular Third Molars in an Iranian Population

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Maryam Kuzekanani

2012-06-01

Full Text Available Background and aims. A through knowledge of the root canal morphology is required for successful endodontic therapy. The aim of this study was to investigate the root and canal morphology of mandibular third molars in Kerman, a province in southeast of Iran. Materials and methods. One-hundred-fifty extracted mandibular third molars were collected randomly from different dental clinics in Kerman. The root canal anatomy and morphology of each tooth was carefully studied using a clearing technique. Root number and morphology, number of canals per root, root canal configuration according to Vertucci classification, and incidence of dilacerated roots and C-shaped canals in mandibular third molars were evaluated under stereomicroscope with ×2 to ×3 magnifications. Results. From the total of 150 mandibular third molars studied, 21% had one root. The majority of teeth (73% had two roots. 5.5% of the teeth had three roots. The incidence of C-shaped canal was 3.5% in this study and 8% of the teeth had at least one dilacerated root. Conclusion. Although root canal anatomy and morphology of mandibular third molars is very variable having two roots seems to be the normal anatomy for these teeth.

Superolateral dislocation of an intact mandibular condyle into the temporal fossa: case report and literature review.

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Sharma, Divashree; Khasgiwala, Ankit; Maheshwari, Bharat; Singh, Charanpreet; Shakya, Neelam

2017-02-01

Temporomandibular joint dislocation refers to the dislodgement of mandibular condyle from the glenoid fossa. Anterior and anteromedial dislocations of the mandibular condyle are frequently reported in the literature, but superolateral dislocation is a rare presentation. This report outlines a case of superolateral dislocation of an intact mandibular condyle that occurred in conjunction with an ipsilateral mandibular parasymphysis fracture. A review of the clinical features of superolateral dislocation of the mandibular condyle and the possible techniques of its reduction ranging from the most conservative means to extensive surgical interventions is presented. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Efectos de los aparatos propulsores mandibulares fijos en la articulación temporomandibular

OpenAIRE

Palomino-Gómez, Sandra Patricia [UNESP; Almeida, Kélei Mathias [UNESP; Melllo, Patricia Bicalho de [UNESP; Restrepo, Manuel [UNESP; Raveli, Dirceu Barnabé [UNESP

2014-01-01

Fixed mandibular propulsion appliances are an alternative for the treatment of Class II malocclusion in individuals with mandibular deficiency. Since they are fixed appliances, said devices keep the mandible in an anterior-forced position during rest and during all mandibular functions. When a propulsive appliance is used, the lower jaw is displaced forward and downward. This movement leads to a new position of the condyle, which can, ultimately affect the normal functioning of the temporoman...

The application of the Risdon approach for mandibular condyle fractures.

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Nam, Seung Min; Lee, Jang Hyun; Kim, Jun Hyuk

2013-07-06

Many novel approaches to mandibular condyle fracture have been reported, but there is a relative lack of reports on the Risdon approach. In this study, the feasibility of the Risdon approach for condylar neck and subcondylar fractures of the mandible is demonstrated. A review of patients with mandibular condylar neck and subcondylar fractures was performed from March 2008 to June 2012. A total of 25 patients, 19 males and 6 females, had 14 condylar neck fractures and 11 subcondylar fractures. All of the cases were reduced using the Risdon approach. For subcondylar fractures, reduction and fixation with plates was done under direct vision. For condylar neck fractures, reduction and fixation was done with the aid of a trochar in adults and a percutaneous threaded Kirschner wire in children. There were no malunions or nonunions revealed in follow-up care. Mild transient neuropraxia of the marginal mandibular nerve was seen in 4 patients, which was resolved within 1-2 months. The Risdon approach is a technique for reducing the condylar neck and subcondylar fractures that is easy to perform and easy to learn. Its value in the reduction of mandibular condyle fractures should be emphasized.

[Longitudinal genetic effects on mandibular position of female twins from six to twelve years old].

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Zhu, Chang-feng; Peng, Jing

2013-06-01

To find the longitudinal genetic effects on mandibular position in mixed dentition. The sample used in this study consisted of lateral cephalograms of eighty-nine pairs of female twins in Beijing. With a mixed longitudinal method, the effective twins were 183 pairs(monozygous 110 pairs and dizygous 73 ones). The genetic and environmental effects on mandibular position were analyzed by statistical methods in female twins from six to twelve years old. Statistical comparisons revealed significant (Pchin is the most subjective to environment change, then the mandibular angle, and the condyle is the least. Using N and S as references, the environmental influence on heights showed different order from the most to least changeable: The mandibular angle, the condyle and the chin. In later stage of our observation, the mandibular morphology and growth type might be family inherited. For environmental influences plays important roles on mandibular position, these findings can be used in orthodontic treatment planning.

The visibility of mandibular canal on orthoradial and oblique CBCT slices at molar implant sites

International Nuclear Information System (INIS)

Alkhader, Mustafa; Jarab, Fadi; Shaweesh, Ashraf; Hudieb, Malik

2016-01-01

The aim of the present study was to compare visibility of the mandibular canal on cone beam computed tomography (CBCT)-based orthoradial and oblique slices at molar implant sites. CBCT images for 132 mandibular molar implant sites were selected for the study. After generating orthoradial and oblique slices, two observers evaluated the visibility of the mandibular canal using three-point scoring scale (1-3, good to excellent). Wilcoxon signed-rank test compared the visibility scores of the two slices. Both orthoradial and oblique slices obtained from CBCT had only very good to excellent mandibular canal visibility scores. At 114 mandibular molar implant sites, the visibility score was equal on both orthoradial and oblique slices. Although the visibility score was higher on orthoradial slices for 12 implant sites, the visibility score was higher for six implant sites on oblique slices and the difference was not significant. Therefore, the visibility of the mandibular canal was excellent and comparable on most of orthoradial and oblique slices obtained from CBCT images

Corrosão de parafusos fixados à madeira tratada com soluções de creosoto vegetal

OpenAIRE

Paes,Juarez Benigno; Benedito Rocha,Vital; Della Lucia,Ricardo Marius; Della Lucia,Terezinha Maria Castro

2002-01-01

O objetivo desta pesquisa foi avaliar a corrosão de parafusos auto-rosqueáveis fixados à madeira tratada com soluções preservativas preparadas com creosoto vegetal, em condições de campo. Obteve-se o creosoto vegetal bruto por meio da destilação à temperatura de 110 - 255masculineC do alcatrão vegetal. Uma fração dos destilados foi lavada com solução a 9% de bicarbonato de sódio, obtendo-se o creosoto vegetal purificado. Ambas as frações foram enriquecidas com 3% de naftenato de cobre; 3% de ...

Meta-analysis of skeletal mandibular changes during Frankel appliance treatment.

Science.gov (United States)

Perillo, Letizia; Cannavale, Rosangela; Ferro, Fabrizia; Franchi, Lorenzo; Masucci, Caterina; Chiodini, Paolo; Baccetti, Tiziano

2011-02-01

The purpose of this study was to perform a meta-analysis of articles to verify the mandibular changes produced by the Fränkel-2 (FR-2) appliance during the treatment of growing patients with Class II malocclusions when compared with untreated growing Class II subjects. The literature published from January 1966 to January 2009 was reviewed with search engines. A quality analysis was performed. The effects on primary end points were calculated with random-effect models. Heterogeneity was assessed using Q statistic and investigated using study-level meta-regression. A total of nine articles were identified. The quality of the studies ranged from low to medium. Meta-analysis showed that the FR-2 was associated with enhancement of mandibular body length [0.4 mm/year 95 per cent confidence interval (CI) 0.182-0.618], total mandibular length (1.069 mm/year, 95 per cent CI 0.683-1.455), and mandibular ramus height (0.654 mm/year, 95 per cent CI 0.244-1.064). A consistent heterogeneity among studies was found for all the considered linear measurements. The FR-2 appliance had a statistically significant effect on mandibular growth. Nevertheless, the heterogeneity of the FR-2 effects, the quality of studies, the differences in age, skeletal age, treatment duration, and the inconsistent initial diagnosis seem to overstate the benefits of the FR-2 appliance. An evidence-based approach to the orthodontic outcomes of FR-2 appliance is needed, by selecting and comparing groups of children with the same cephalometric characteristics with and without treatment.

Changes in the edentulous maxilla in persons wearing implant-retained mandibular overdentures

NARCIS (Netherlands)

Narhi, TO; Geertman, ME; Hevinga, M; Abdo, H; Kalk, W

Statement of problem. It has been suggested that risk for severe resorption in the anterior maxilla is increased in persons wearing mandibular implant-retained overdentures. However, little information is available about the changes in the edentulous maxilla after mandibular implant treatment.

[Orthodontic Management of the Impacted Mandibular Second Molar Tooth].

Science.gov (United States)

Mah, Michael; Takada, Kenji

2016-09-01

When the mandibular permanent second molar becomes impacted, it is identified as a malocclusion that needs treatment as it often leads to unwanted complications such as caries and periodontitis of the adjacent permanent first molar. Other less common complications include root resorption of the adjacent first molar root or continued root development to be in close proximity to the inferior dental alveolar nerve. This paper seeks to differentiate various levels of severity of impaction and review treatment options that are considered clinically available for the proper management of the impacted mandibular permanent second molar. Treatment options that will be discussed in this article include timing of second molar removal for replacement by the third molar, relief of impaction via second premolar removal, surgical repositioning and the combination of third molar removal, surgical exposure and orthodontic uprighting of the impacted tooth. Depending on the severity of the impaction, most impactions can be easily and predictably corrected with nickel titanium archwires or auxillary open coil springs or uprighting springs. Uncommonly, the mandibular permanent second molar can become severely impacted and in close proximity to the inferior dentoalveolar nerve. In these instances, the use of temporary anchorage devices such as microimplants has shown to be successful in uprighting the severely impacted mandibular permanent second molars. © EDP Sciences, SFODF, 2016.

Clinical and orthopantomographic evaluation of mandibular third molar

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F K Saraswati

2010-01-01

Full Text Available Objective: To evaluate sensitivity of orthopentograph (OPG in assessing the number and morphology of roots of the mandibular third molar. Materials and Methods : The study population consisted of 100 ILTMs (impacted lower third molars ranging from 18 to 42 years with equal sex distribution. All the teeth were subsequently extracted , collected and compared with OPG features for position, numb,er, morphology, and relation to mandibular canal. Conclusion: In conclusion, a large sample study is suggested with techniques like Clark′s and right angle technique which determines the three-dimensional orientation of the impacted teeth.

Avaliação epidemiológica e radiológica das fraturas diafisárias do fêmur: estudo de 200 casos Epidemiological and radiological evaluation of femoral shaft fractures: study of 200 cases

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Frederico Barra de Moraes

2009-06-01

Full Text Available OBJETIVO: avaliar as características epidemiológicas e radiológicas dos casos de fratura diafisárias de fêmur, ocorridos de 1990 a 2005, tratados cirurgicamente no Hospital de Acidentados - Clínica Santa Isabel - de Goiânia, Goiás, com o propósito de contribuir para o melhor planejamento de medidas preventivas e terapêuticas a adotar em relação a essas fraturas. MÉTODOS: Foram avaliados retrospectivamente 200 prontuários e radiografias seriadas de pacientes com fraturas diafisárias do fêmur. Não foram incluídos os pacientes com menos de 10 anos de idade, pois o tratamento para esse grupo foi conservador. Foram descartados 25 prontuários por não fornecer todos os dados necessários ao estudo. Os pacientes foram analisados quanto ao sexo, idade, lado da fratura, exposição óssea, mecanismos de trauma, classificação das fraturas, traumas associados, tempo de consolidação e tipos de fixação cirúrgica. A análise estatística foi feita pelos testes do qui-quadrado, exato de Fisher" e t de Student, considerando significância quando p OBJECTIVE: to evaluate epidemiological and radiological characteristics of the femoral shaft fractures, surgically treated from 1990 to 2005 at Hospital de Acidentados - Clínica Santa Isabel - in Goiânia, Goiás, aiming to contribute to better preventive and therapeutic measures planning to adopt on those fractures. METHODS: 200 patients' files and x-rays with femoral shaft fractures have been retrospectively evaluated. Patients below the age of 10 years were not included because the treatment for this group was conservative. 25 files have been discarded for not supplying all the necessary data to the study. The patients were assessed for sex, age, side of the fracture, bone exposure, mechanisms of trauma, classification of the fractures, associated trauma, time for bone healing and types of surgical devices. Statistic analyses were made by chi-squared, Fisher and Student's-t tests

A randomized clinical trial comparing mandibular incisor proclination produced by fixed labial appliances and clear aligners.

Science.gov (United States)

Hennessy, Joe; Garvey, Thérèse; Al-Awadhi, Ebrahim A

2016-09-01

To compare the mandibular incisor proclination produced by fixed labial appliances and third generation clear aligners. Patients underwent a course of orthodontic treatment using either fixed labial appliances or clear aligners (Invisalign). Mandibular incisor proclination was measured by comparing pretreatment and near-end treatment lateral cephalograms. Eligibility criteria included adult patients with mild mandibular incisor crowding (clear aligner group. Baseline characteristics were similar for both groups: Fixed appliance mean crowding was 2.1 ± 1.3 mm vs clear aligner mean crowding, 2.5 ± 1.3 mm; pretreatment mean mandibular incisor inclination for the fixed appliance group was 90.8 ± 5.4° vs 91.6 ± 6.4° for the clear aligner group. Fixed appliances produced 5.3 ± 4.3° of mandibular incisor proclination. Clear aligners proclined the mandibular incisors by 3.4 ± 3.2°. The difference between the two groups was not statistically significant (P > .05). There was no difference in the amount of mandibular incisor proclination produced by clear aligners and fixed labial appliances in mild crowding cases.

Early Experience with Biodegradable Fixation of Pediatric Mandibular Fractures

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Mazeed, Ahmed Salah; Shoeib, Mohammed Abdel-Raheem; Saied, Samia Mohammed Ahmed; Elsherbiny, Ahmed

2014-01-01

This clinical study aims to evaluate the stability and efficiency of biodegradable self-reinforced poly-l/dl-lactide (SR-PLDLA) plates and screws for fixation of pediatric mandibular fractures. The study included 12 patients (3–12 years old) with 14 mandibular fractures. They were treated by open reduction and internal fixation by SR-PLDLA plates and screws. Maxillomandibular fixation was maintained for 1 week postoperatively. Clinical follow-up was performed at 1 week, 6 weeks, 3 months, and...

Mandibular Fracture Patterns at a Medical Center in Central Taiwan: A 3-Year Epidemiological Review.

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Lin, Fu-Yu; Wu, Chao-I; Cheng, Hsu-Tang

2017-12-01

Mandibular fractures constitute a major portion of maxillofacial trauma and may lead to considerable functional and aesthetic sequelae if treatment is inadequate or delayed. An epidemiology study on mandibular fractures may guide the preventive efforts of the Taiwan public health care system. Therefore, a retrospective review was conducted at a medical center in central Taiwan to evaluate the current mandibular fracture epidemiology.The medical records and digitized radiographs of 198 patients who received treatment for mandibular fractures during a 3-year period (from October 2010 to September 2013) at a medical center in central Taiwan were reviewed to obtain demographic and injury data.The average age was 29.4 years (3-82 years). Patients aged 21 to 30 years sustained the most mandibular fractures (62 patients, 31.3%). The overall sex distribution (male to female) ratio was 1.8. Motor-vehicle accidents (MVAs) were the most common mechanism of injury (162 patients, 82%), and scooter and motorcycle riders wearing partial-coverage helmets constituted the majority of patients. A chart review identified 198 patients with 335 mandibular fractures; 113 patients (57.1%) had multiple mandibular fractures. The most common fracture sites were the symphysis and parasymphysis regions (38.9%), followed by the condyle (26.0%), angle (14.3%), body (14.3%), and ramus (6.6%).MVAs are the major cause of mandibular fractures in central Taiwan, and patients aged Taiwan. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Surgical Management of Mandibular Central Incisors with Dumbbell Shaped Periapical Lesion: A Case Report

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Roopadevi Garlapati

2014-01-01

Full Text Available Dental traumatic injuries may affect the teeth and alveolar bone directly or indirectly. Pulpal necrosis and chronic and apical periodontitis with cystic changes are the most common sequelae of the dental traumatic injuries, if the teeth are not treated immediately. This case report focuses on the conventional and surgical management of mandibular central incisors. A twenty-four-year-old male patient presented with pain in the mandibular central incisors. Radiographic examination revealed mandibular central incisors with dumbbell shaped periapical lesion. After root canal treatment, parendodontic surgery was performed for mandibular central incisors. After one-year recall examination, the teeth were asymptomatic and periapical lesion had healed.

Alveolar ridge expansion-assisted orthodontic space closure in the mandibular posterior region.

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Ozer, Mete; Akdeniz, Berat Serdar; Sumer, Mahmut

2013-12-01

Orthodontic closure of old, edentulous spaces in the mandibular posterior region is a major challenge. In this report, we describe a method of orthodontic closure of edentulous spaces in the mandibular posterior region accelerated by piezoelectric decortication and alveolar ridge expansion. Combined piezosurgical and orthodontic treatments were used to close 14- and 15-mm-wide spaces in the mandibular left and right posterior areas, respectively, of a female patient, aged 18 years and 9 months, diagnosed with skeletal Class III malocclusion, hypodontia, and polydiastemas. After the piezoelectric decortication, segmental and full-arch mechanics were applied in the orthodontic phase. Despite some extent of root resorption and anchorage loss, the edentulous spaces were closed, and adequate function and esthetics were regained without further restorative treatment. Alveolar ridge expansion-assisted orthodontic space closure seems to be an effective and relatively less-invasive treatment alternative for edentulous spaces in the mandibular posterior region.

Pharyngeal Airway Space Changes After Condylar Replacement and Mandibular Advancement Surgery.

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Yuen, Holly; Rossouw, P Emile; Wolford, Larry M; Wang, Hongyue

2018-01-03

The aim of this study was to examine the total volume and cross-sectional areas of the pharyngeal airway after bilateral condylar replacement and mandibular advancement surgery. A total of 137 patients (126 women and 11 men) underwent bilateral temporomandibular joint total joint replacement performed by 1 surgeon. A subsample of 30 patients who underwent condylar replacement and only mandibular advancement were evaluated for impact on the airway. Measurements were taken preoperatively, postoperatively, and at a follow-up 1 year after surgery on cone beam computed tomography scans. InVivoDental 3-dimensional imaging (Anatomage, San Jose, CA) was used to measure airway space regarding total volume (in cubic centimeters); minimum cross-sectional area (in square millimeters); minimum cross sections of the first, second, and third cervical vertebrae; and whether the patient had mandibular retrognathia before surgery. A second operator was used to test for interoperator error. Descriptive and bivariate statistics were computed, and the P value was set at .05. There was a significant increase in all measurements at the follow-up visit compared with the preoperative visit. There were no significant differences between groups based on simultaneous Le Fort I surgery, mandibular retrognathia, and gender. However, there were statistically significant differences in cross sections 1 and 2, as well as minimum cross-sectional area, regarding age. Condylar replacement and mandibular advancement have a significant association with an increase in airway space. The intraclass correlation coefficient showed excellent agreement between interoperator measurements. Patients undergoing bilateral temporomandibular joint replacement and mandibular advancement surgery showed an increase in pharyngeal airway space at a 1-year follow-up. In this study, age was significantly associated with the cross-sectional areas of the airway, with older patients having smaller values. Copyright © 2018

Prevalence of three rooted permanent mandibular first molars in Haryana (North Indian population

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Alpa Gupta

2017-01-01

Full Text Available Background: Mandibular first molars typically have two roots but sometimes a supernumerary root presents distolingually called as radix entomolaris (RE. Aim: The present study evaluated the prevalence of permanent mandibular first molars featuring a distolingual root in Haryana (North India. Materials and Methods: Five hundred patients possessing bilateral mandibular first molars were selected for this study. The intraoral periapical radiographs were taken. The radiographs of these patients were evaluated under optimal conditions. A total of 1000 mandibular first molars were screened, and the incidence of three-rooted mandibular first molars, RE and the correlation between left and right side occurrence and between either gender were recorded. Statistical Analysis: The binary logistic regression test and Pearson's Chi-square test were used for statistical analysis. Results: The prevalence of three-rooted permanent mandibular first molars was 13% of the patients examined and 8.3% of the teeth examined. There was no statistically significant difference between gender and side of occurrence (P ≥ 0.05. The bilateral incidence of a symmetric distribution was 27.6 (18/65 among the RE teeth examined. Conclusion: RE is considered as an Asiatic trait. The occurrence of this macrostructure in the Haryana (North India population was found to be 13%. The clinician must thoroughly examine the radiographs before the initiation of endodontic therapy.

Root Canal Configuration of Mandibular First and Second Premolars in an Iranian Population

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Nemat Eskandarzadeh

2007-08-01

Full Text Available

Background and aims. It is critical to have a proper knowledge of the normal anatomy of the pulp and its variations for the success of endodontic treatment. The aim of this study was to determine the canal configuration and the prevalence of C-shaped canals in mandibular first and second premolars in a North-Western Iranian population.

Materials and methods. A total of 163 extracted mandibular first and 103 mandibular second premolars were injected with India ink and demineralized . They were made clear and transparent with methyl salicylate and the anatomy of their canal(s was studied.

Results. The results showed that 98% of mandibular first premolars had one root, 2% had two roots, 70.6% had one canal, 27.8% had two canals, 1.2% had three canals and the prevalence of C-shaped canals was 2.4%. All mandibular second premolars had one root, 80.5% had one canal, 17.5% had two canals and the prevalence of C-shaped canals was 2%.

Conclusion. It is important that clinicians, before treatment of mandibular first and second premolars, pay complete attention to radiographs, have a true concept of the number of root(s and canal(s, and prepare a correct access cavitiy.

[Diagnosis and treatment of temporo-mandibular disorders in orthodontics].

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Bocquet, Emmanuelle; Moreau, Alexis; Danguy, Michel; Danguy, Chantal

2010-03-01

Orthodontists are fully prepared to treat the problems of occlusion that they are called upon to deal with every day. On the other hand temporo-mandibular joint disorders present more obscure difficulties from the point of view of detection and diagnosis as well the management of their treatment. That is why a profound understanding of the anatomical and physiological functioning of the temporo-mandibular joint has become indispensable for today's orthodontists who are now asked to detect and diagnose an assortment of TMJ disturbances whose etiology may vary greatly. By performing a rigorous diagnostic procedure, based on a thorough clinical examination supported by careful axiographic and radiological studies, of temporo-mandibular malfunctioning and its underlying etiological causes, which are primarily dento-alveolar and occlusal in nature, orthodontists will be able to adopt an appropriate therapeutic approach that might be purely orthodontic or multi-disciplinary and carried out with the collaboration of specialists in occlusion, oral surgery, and even osteopathy. EDP Sciences, SFODF, 2010.

Recurrent osteochondroma of the mandibular condyle: A case report

International Nuclear Information System (INIS)

Kwon, Young Eun; Choi, Karp Shik; An, Chang Hyeon; Choi, So Young; An, Seo Young; Lee, Jae Seo

2017-01-01

A 21-year-old woman presented with facial asymmetry. Crepitus and clicking of the temporomandibular joint were noted. The midline deviated 5.5 mm to the left, and secondary malocclusion was observed. Panoramic and cone-beam computed tomographic images showed an irregular and exophytic bony mass on the anteromedial surface of the right mandibular condyle. A 3-phase bone scan revealed increased tracer uptake on the affected side. The lesion was treated with excision and reshaping under the diagnosis of osteochondroma confirmed by a histopathological examination. The lesion recurred after 3 years, and the patient underwent condylectomy. Mandibular condylar osteochondroma is often resected because it causes functional and aesthetic problems, but it rarely recurs. To the best of our knowledge, only 2 cases of recurrent osteochondromas of the mandibular condyle have been reported previously. Surgical treatment of the osteochondroma should be performed considering the possibility of recurrence, and long-term follow-up is recommended

Early Experience with Biodegradable Fixation of Pediatric Mandibular Fractures.

Science.gov (United States)

Mazeed, Ahmed Salah; Shoeib, Mohammed Abdel-Raheem; Saied, Samia Mohammed Ahmed; Elsherbiny, Ahmed

2015-09-01

This clinical study aims to evaluate the stability and efficiency of biodegradable self-reinforced poly-l/dl-lactide (SR-PLDLA) plates and screws for fixation of pediatric mandibular fractures. The study included 12 patients (3-12 years old) with 14 mandibular fractures. They were treated by open reduction and internal fixation by SR-PLDLA plates and screws. Maxillomandibular fixation was maintained for 1 week postoperatively. Clinical follow-up was performed at 1 week, 6 weeks, 3 months, and 12 months postoperatively. Radiographs were done at 1 week, 3 months, and 12 months postoperatively to observe any displacement and fracture healing. All fractures healed both clinically and radiologically. No serious complications were reported in the patients. Normal occlusion was achieved in all cases. Biodegradable osteofixation of mandibular fractures offers a valuable clinical solution for pediatric patients getting the benefit of avoiding secondary surgery to remove plates, decreasing the hospital stay, further painful procedures, and psychological impact.

3-D diagnosis-assisted management of anomalous mandibular molar

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Neelam Mittal

2012-01-01

Full Text Available This case report describes the successful non-surgical endodontic management of carious exposed three-rooted mandibular molar with four root canals detected on the pre-operative radiograph taken with 20 degrees mesial angulation and confirmed with a 64-slice helical computed tomography scan-assisted 3-D-reconstructed images. Access cavity shape was modified to locate the extra canal with respect to the distolingual root in the left mandibular first molar. Copious irrigation was accomplished with 5.25% sodium hypochlorite and 17% EDTA. Biomechanical preparation was done using protapers. Calcium hydroxide dressing was done for 1 week. The tooth was obturated using gutta percha and AH 26 root canal sealer, and it was permanently restored with composite. Clinical examination on follow-up visits revealed no sensitivity to percussion and palpation in the left mandibular first molar. Thorough knowledge of root canal variations and use of advanced diagnostic modalities lead to successful non-surgical management of the complex cases.

Recurrent osteochondroma of the mandibular condyle: A case report

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Kwon, Young Eun; Choi, Karp Shik; An, Chang Hyeon; Choi, So Young; An, Seo Young [School of Dentistry, Kyungpook National University, Daegu (Korea, Republic of); Lee, Jae Seo [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Chonnam National University, Gwangju (Korea, Republic of)

2017-03-15

A 21-year-old woman presented with facial asymmetry. Crepitus and clicking of the temporomandibular joint were noted. The midline deviated 5.5 mm to the left, and secondary malocclusion was observed. Panoramic and cone-beam computed tomographic images showed an irregular and exophytic bony mass on the anteromedial surface of the right mandibular condyle. A 3-phase bone scan revealed increased tracer uptake on the affected side. The lesion was treated with excision and reshaping under the diagnosis of osteochondroma confirmed by a histopathological examination. The lesion recurred after 3 years, and the patient underwent condylectomy. Mandibular condylar osteochondroma is often resected because it causes functional and aesthetic problems, but it rarely recurs. To the best of our knowledge, only 2 cases of recurrent osteochondromas of the mandibular condyle have been reported previously. Surgical treatment of the osteochondroma should be performed considering the possibility of recurrence, and long-term follow-up is recommended.

Comparison of different radiographic methods for the detection of the mandibular canal

International Nuclear Information System (INIS)

Kim, Eun Kyung

2003-01-01

To compare the visibility of the mandibular canal at the different radiographic methods such as conventional panoramic radiographs, Vimplant multiplanar reformatting (MPR)-CT panoramic images, Vimplant MPR-CT paraxial images and film-based DentaScan MPR-CT images. Data of 11 mandibular dental implant patients, who had been planned treatment utilizing both panoramic and MPR-CT examination with DentaScan software (GE Medical systems, Milwaukee, USA), were used in this study. The archived axial CT data stored on CD-R discs were transferred to a personal computer with 17' LCD monitor. Paraxial and panoramic images were reconstructed using Vimplant software (CyberMed Inc., Seoul, Korea). Conventional panoramic radiographs, monitor-based Vimplant MPR-CT panoramic images, monitor-based Vimplant MPR-CT paraxial images, and film-based DentaScan MPR-CT images were evaluated for visibility of the mandibular canal at the mental foramen, 1 cm, 2 cm, and 3 cm posterior to mental foramen using the 4-point grading score. Vimplant MPR-CT panoramic, paraxial, and DentaScan MPR-CT images revealed significantly clearer images than conventional panoramic radiographs. Particularly at the region 1 cm posterior to mental foramen, conventional panoramic radiographs showed a markedly lower percentage of 'excellent' mandibular canal images than images produced by other modalities. Vimplant MPR-CT and DentaScan MPR-CT images did not show significant difference in visibility of the mandibular canal. The study results shoe that Vimplant and DentaScan MPR-CT imaging systems offer significantly better images of the mandibular canal than conventional panoramic radiograph.

Endodontic therapy for a fused mandibular molar.

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Rotstein, I; Moshonov, J; Cohenca, N

1997-06-01

Variations in tooth morphology present a clinical challenge when endodontic treatment is required. A case of conservative endodontic therapy for a fused mandibular second and third molar is presented.

Neurovascular Content of the Mandibular Canal and Its Clinical Relevance: A Literature Review of the Related Anatomical and Radiological Studies

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Eliades Apostolos N.

2014-11-01

Full Text Available In literature, anatomical variations of the inferior alveolar nerve branches (infratemporal, extraosseous and intraosseous are reported and their importance in clinical practice is discussed too. The spatial vessels’ position in relationship with the nerve in the mandibular canal was explored, which is of clinical significance in impacted third molar and implant surgery. It is believed that the neurovascular content of the main mandibular canal follows any variations of the mandibular canal i.e. bifid mandibular, retromolar and accessory mental canals. Retrospective studies and case reports reported the presence of multiple foramina on the medial surface of the ramus, near the main mandibular foramen. In some cases, one supplementary mandibular foramen was found to be connected with the lower third molar, which is called “temporal crest canal”. Others found an accessory mandibular foramen that led into a second mandibular canal which joined the main mandibular canal (double anteriorly. The bony canals contained a terminal branch of the anterior trunk of the mandibular nerve or a branch of inferior alveolar nerve before it entered the mandibular foramen.

Use of monocortical miniplates for the intraoral treatment of mandibular fractures.

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Chiodo, Thomas A; Milles, Maano

2009-03-01

Fixation of mandibular fractures using rigid hardware has gained wide acceptance over the past 3 decades. The goal of rigid internal fixation is to allow for fracture healing with limited, or no, time in maxillo-mandibular fixation. There has been significant evolution in plate and screw materials and design over the past 30 years. The term miniplate is used to describe a fracture plate with a screw diameter of 2.0 mm or less. With correct diagnosis and understanding of the forces affecting mandible fractures, miniplates can be applied transorally in various situations, allowing for less invasive treatment with open reduction of mandible fractures. This article describes the use of monocortical miniplates for the intraoral treatment of mandibular fractures.

Relationship of maxillary 3-dimensional posterior occlusal plane to mandibular spatial position and morphology.

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Coro, Jorge C; Velasquez, Roberto L; Coro, Ivette M; Wheeler, Timothy T; McGorray, Susan P; Sato, Sadao

2016-07-01

The purpose of this study was to examine the relationship of the 3-dimensional (3D) posterior occlusal plane (POP) and the mandibular 3D spatial position. The relationship of the POP to mandibular morphology was also investigated. Retrospective data from a convenience sample of pretreatment diagnostic cone-beam computed tomography scans were rendered using InVivo software (Anatomage, San Jose, Calif). The sample consisted of 111 subjects (51 male, 60 female) and included growing and nongrowing subjects of different races and ethnicities. The 3D maxillary POP was defined by selecting the cusp tips of the second premolars and the second molars on the rendered images of the subjects. The angles made by this plane, in reference to the Frankfort horizontal plane, were measured against variables that described the mandibular position in the coronal, sagittal, and axial views. The POP was also compared with bilateral variables that described mandibular morphology. There were significant differences of the POP among the different skeletal malocclusions (P <0.0001). The POP showed significant correlations with mandibular position in the sagittal (P <0.0001), coronal (P <0.05), and axial (P <0.05) planes. The POP also showed a significant correlation with mandibular morphology (P <0.0001). These findings suggest that there is a distinct and significant relationship between the 3D POP and the mandibular spatial position and its morphology. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Análise biomecânica comparativa entre os sistemas plate-nail e plate-rod em fraturas induzidas em fêmures de caninos: estudo ex-vivo

OpenAIRE

Mesquita, Luciane dos Reis

2013-01-01

O objetivo deste estudo foi comparar as propriedades mecânicas da associação da haste intramedular bloqueada e placa óssea (plate-nail) e da associação do pino intramedular e placa óssea (plate-rod), utilizadas em fraturas experimentalmente induzidas em fêmures de caninos. Vinte pares de fêmures de cães foram selecionados para receber os sistemas plate-nail e plate-rod. Em cada fêmur, uma ostectomia no terço médio da diáfise foi realizada e inserido o sistema selecionado. As construções foram...

Application of the Mandible Injury Severity Score to Pediatric Mandibular Fractures.

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Swanson, Edward W; Susarla, Srinivas M; Ghasemzadeh, Ali; Mundinger, Gerhard S; Redett, Richard J; Tufaro, Anthony P; Manson, Paul N; Dorafshar, Amir H

2015-07-01

The Mandible Injury Severity Score (MISS) has been used to evaluate adult mandibular fractures. The purpose of this study was to evaluate the MISS in a cohort of pediatric patients. This was a retrospective study of pediatric patients treated for mandibular fractures over a 20-year period. Patients were included if they had computed tomographic imaging available for review and had at least 1 post-treatment visit. The primary predictor variable was the MISS. Secondary predictors were demographic and injury-associated factors. The outcome was treatment-associated complications. Descriptive, bivariate, and multiple logistic regression statistics were computed. One hundred sixteen patients with mandibular fractures were identified; 73 (62.9%) met the inclusion criteria. The sample's mean age was 8.5 ± 4.1 years; 44% were girls. Motor vehicle collisions (60%) and falls (15.1%) were the most common mechanisms. More than 50% of patients had an extra-mandibular injury. The mean MISS was 13.5 ± 7.8. Forty-five percent of the sample underwent open reduction and internal fixation. Complications were noted in 20.5% of patients, of which malocclusion was the most common (8.2%). Increasing MISS was associated with complications (P pediatric patients with mandibular fractures, increased severity of injury is associated with complications, even after controlling for the effects of multiple confounders, including open treatment. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

TMJ response to mandibular advancement surgery: an overview of risk factors

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VALLADARES-NETO, José; CEVIDANES, Lucia Helena; ROCHA, Wesley Cabral; ALMEIDA, Guilherme de Araújo; de PAIVA, João Batista; RINO-NETO, José

2014-01-01

Objective In order to understand the conflicting information on temporomandibular joint (TMJ) pathophysiologic responses after mandibular advancement surgery, an overview of the literature was proposed with a focus on certain risk factors. Methods A literature search was carried out in the Cochrane, PubMed, Scopus and Web of Science databases in the period from January 1980 through March 2013. Various combinations of keywords related to TMJ changes [disc displacement, arthralgia, condylar resorption (CR)] and aspects of surgical intervention (fixation technique, amount of advancement) were used. A hand search of these papers was also carried out to identify additional articles. Results A total of 148 articles were considered for this overview and, although methodological troubles were common, this review identified relevant findings which the practitioner can take into consideration during treatment planning: 1- Surgery was unable to influence TMJ with preexisting displaced disc and crepitus; 2- Clicking and arthralgia were not predictable after surgery, although there was greater likelihood of improvement rather than deterioration; 3- The amount of mandibular advancement and counterclockwise rotation, and the rigidity of the fixation technique seemed to influence TMJ position and health; 4- The risk of CR increased, especially in identified high-risk cases. Conclusions Young adult females with mandibular retrognathism and increased mandibular plane angle are susceptible to painful TMJ, and are subject to less improvement after surgery and prone to CR. Furthermore, thorough evidenced-based studies are required to understand the response of the TMJ after mandibular advancement surgery. PMID:24626243

Fixação esquelética externa em fratura tarsometatársica de seriema (Cariama cristata: relato de caso External skeletal fixation in tarsumetatarsus fracture of red-legged seriema (Cariama cristata: a case report

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B.B.J. Torres

2007-02-01

Full Text Available Uma seriema (Cariama cristata adulta foi atendida com histórico de traumatismo por tentativa de captura. A ave apresentava dificuldade de apoio do membro pélvico direito, dor à manipulação e fratura exposta do osso tarsometatarso. Optou-se pelo tratamento cirúrgico com redução fechada, utilizando-se fixador esquelético externo tipo II, com barra de conexão acrílica. A técnica cirúrgica utilizada foi satisfatória para o tratamento da fratura, possibilitando reparação óssea e retorno funcional do membro 60 dias após a cirurgia.An adult red-legged seriema (Cariama cristata was referred for examination with history of trauma by capture. The physical examination revealed lameness in the right pelvic limb, sensibility to touch and open fracture of tarsumetatarsus. The treatment was done with surgical closed reduction using a external skeletal fixator type II with acrylic connecting bar. The surgical technique applied was satisfactory for the treatment of the fracture of tarsumetatarsus, since there was bone healing and functional return of the limb at 60 days after surgery.

Osteossíntese com parafuso intramedular nas fraturas proximais do quinto metatarsiano do atleta Intramedullary screw fixation of proximal fifth metatarsal fractures in athletes

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Marta Maria Teixeira de Oliveira Massada

2012-01-01

Full Text Available OBJETIVO: Avaliar os resultados clínicos e radiológicos da osteossíntese com parafuso de compressão intramedular nas fraturas proximais do quinto metatarsiano no atleta. MÉTODOS: Foram incluídos no estudo 11 homens e seis mulheres com diagnóstico de fratura das zonas II e III do quinto metatarsiano. Quinze dos pacientes praticavam esporte a nível profissional ou de alto rendimento (futebol: n=11; basquetebol: n=1; atletismo: n=3 e dois praticavam atividade esportiva regular a nível recreacional. Foram submetidos a fixação cirúrgica com parafuso canulado de compressão (4.5mm de diâmetro. Todos os pacientes foram avaliados clinicamente e através da revisão do processo clínico e dos estudos imagiológicos. O tempo médio de seguimento após a cirurgia foi 54 meses (38-70. RESULTADOS: O tempo médio de consolidação (como demonstrado pelo estudo radiológico e de retorno à atividade esportiva foi 7.3 e 7.5 semanas, respectivamente. Todos os atletas retornaram aos níveis de atividade prévios. Não verificamos atrasos de consolidação, não-união ou refraturas à data do estudo. CONCLUSÃO: A osteossíntese com parafuso de compressão intramedular nas fraturas proximais do quinto metatarsiano demonstrou, nos nossos pacientes, ser um procedimento eficaz com taxas de morbilidade muito reduzidas e que permite ao atleta um retorno precoce à atividade esportiva. Nível de evidência I, Série de Casos.OBJECTIVE: The purpose of this study was to review the short- and long-term clinical and radiological results of intramedullary compression screw fixation of proximal fifth metatarsal fractures in athletes. METHODS: Eleven male and six female active patients with fifth metatarsal zone II and zone III fractures fixed with a 4.5-mm cannulated compression screw were evaluated by chart review, review of radiographs, and clinical evaluation. Fifteen of the patients were high-level athletes (soccer: n=11; basketball: n=1; track and field: n

Two independent anion transport systems in rabbit mandibular salivary glands

DEFF Research Database (Denmark)

Novak, I; Young, J A

1986-01-01

Cholinergically stimulated Cl and HCO3 transport in perfused rabbit mandibular glands has been studied with extracellular anion substitution and administration of transport inhibitors. In glands perfused with HCO3-free solutions, replacement of Cl with other anions supported secretion in the foll......Cholinergically stimulated Cl and HCO3 transport in perfused rabbit mandibular glands has been studied with extracellular anion substitution and administration of transport inhibitors. In glands perfused with HCO3-free solutions, replacement of Cl with other anions supported secretion...... stimulated secretion by about 30%, but when infused in addition to furosemide (0.1 mmol/l), it inhibited by about 20%. Amiloride (1.0 mmol/l) caused no inhibition. The results suggest that there are at least three distinct carriers in the rabbit mandibular gland. One is a furosemide-sensitive Na-coupled Cl...

A Simplified Way for the Stabilization of Pediatric Mandibular Fracture With an Occlusal Splint.

Science.gov (United States)

Demirkol, Mehmet; Demirkol, Nermin; Abdo, Omar Hasan; Aras, Mutan Hamdi

2016-06-01

The management of pediatric mandibular fractures is challenging for maxillofacial surgeons due to ongoing mandibular growth involving tooth buds. The treatment of such fractures has been a topic of much research. Generally accepted methods for the treatment of mandibular parasymphyseal or symphyseal fractures in children are conservative approaches involving the use of acrylic splints, lateral compression with an open-cap splint stabilized by circummandibular wiring, and maxillomandibular fixation with an arch bar and eyelet wiring. The aim of this technical note was to describe a straightforward approach to the treatment of pediatric mandibular fractures, in which an occlusal splint is secured to prevent trauma to the soft tissue, without the need for general anesthesia.

Active Shape Analysis of Mandibular Growth

DEFF Research Database (Denmark)

Hilger, Klaus Baggesen; Larsen, Rasmus; Kreiborg, Sven

2003-01-01

This work contains a clinical validation using biological landmarks of a Geometry Constrained Diffusion registration of mandibular surfaces. Canonical Correlations Analysis is extended to analyse 3D landmarks and the correlations are used as similarity measures for landmark clustering. A novel Ac...

Caracterização por FT-IR da superfície de borracha EPDM tratada via plasma por micro-ondas

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Renata P. dos Santos

2012-01-01

Full Text Available A superfície de uma borracha de etileno-propileno-dieno (EPDM vulcanizada foi modificada via plasma por microondas, com gases Ar, Ar/O2, N2/O2 e N2/H2, tendo como objetivo melhorar as propriedades adesivas da superfície. A técnica FT-IR/UATR foi escolhida para caracterizar as superfícies após tratamento, pois apresentou menor interferência dos ingredientes da formulação da EPDM, dentre as técnicas analisadas (ATR/KRS-5 e Ge. Grupos oxigenados foram inseridos na superfície da amostra tratada, mesmo quando não foi utilizado o oxigênio, pois estes grupos foram formados quando a superfície ativada foi exposta à atmosfera. Já em tratamentos contendo N2, grupos oxigenados e possíveis grupos nitrogenados foram identificados por FT-IR. Redução nos valores do ângulo de contato, aumento no trabalho de adesão e aumento no ensaio de resistência ao descascamento (EPDM × Poliuretano foram observados após tratamento com Ar e N2/H2, resultando em melhora nas propriedades adesivas da superfície tratada.

Aesthethic and masticatory rehabilitation on post mandibular resection with combination of hollow obturator and hybrid prosthesis

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Arif Rachman

2009-06-01

Full Text Available Background: Replacing tooth lost caused by caries, periodontal disease, trauma and neoplasm including ameloblastoma which requires mandibular resection is important. Purpose: The aim of the study to rehabilitation of post mandibular resection with combination of hollow obturator and hybrid prosthesis. Case: A patient 25 years old, male, for having prosthesis to cover defect due to post right mandibular resection. Case Management: In this presented case, mandibular plate was applied due to spreading defect with losing almost a half body of mandible (class II modification 2 according to cantor and curtis classification. The design of therapy was mandibular obturator using hybrid prosthesis (removable partial denture metal frame and fixed splint crown with precision attachment with hollow obturator. The application was based on several advantages: good aesthetic performance, retention, stability, lighter weight and equal share of vertical load for teeth on non surgical site. The result of control I, II, III, showed that aesthetic performance, masticatory function, speech and swallowing were in good condition. Conclusion: The design of mandibular obturator using hybrid denture with hollow obturator could rehabilitate aesthetic performance, masticatory function, speech and swallowing for patient with post mandibular resection.

Efecto inmunomodulador de la solución CM-95 tratada magnéticamente en ratones Balb/c inoculados con 5-fluorouracilo

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Clara Martínez

2011-04-01

Full Text Available El 5-fluorouracilo es un antineoplásico usado en la terapia del cáncer y posee acción inmunosupresora al inhibir la proliferación de células del tejido hematopoyético. En este trabajo se evaluó el efecto inmunomodulador de la solución CM-95 tratada magnéticamente en ratones Balb/c inoculados con 5-fluorouracilo a través de su acción protectora rehabilitadora sobre parámetros celulares y tisulares del tejido hematopoyético. A los ratones, entre 20-22 g de peso y 6 semanas de nacidos, se les administró esta solución CM-95 tratada magnéticamente por vía intraperitoneal en un esquema de dos inoculaciones; luego se administró por la misma vía el 5_fluorouracilo a una dosis de 150 mg/m2 de superficie corporal de cada ratón. Se evaluó el conteo total y diferencial de leucocitos antes de inocular el 5-fluorouracilo, y a los tres y siete días de aplicado este. La celularidad de médula ósea y bazo y la observación microscópica del corte histológico de hígado y bazo por la técnica de inclusión en parafina y tinción con eosina hematoxilina al 10% se evaluaron a los siete días de haber aplicado el 5- fluorouracilo. La solución CM-95, tratada magnéticamente, logró modular los efectos del 5-fluorouracilo con una actividad protectora rehabiltadora, para los parámetros evaluados en médula ósea, sangre periférica, bazo e hígado. Estos resultados abren nuevas perspectivas para la aplicación del sistema acuoso tratado magnéticamente como inmunomodulador.

[The temporo-mandibular articulation].

Science.gov (United States)

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.

Posttraumatic Mandibular Asymmetry Presenting in a Young Adult

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Mahnaz Sheikhi, DDS,MS

2017-03-01

Full Text Available One of the most common sites of injury of the facial skeleton is mandibular condyle. However, it is the least diagnosed site of trauma in the head and neck regions. A trauma to the mandible and specifically condylar zone during childhood, may lead to asymmetry or mandibular bilateral distortion, which is usually manifested in the second decade of life when the etiology is unknown to most people. This report is about an adult male complaining about facial asymmetry with an unknown source. Obvious clicking at the right side and shorter right ramus and condyle's head deviation directed us to a childhood trauma and fracture.

Management of pediatric mandibular fracture: a case series.

Science.gov (United States)

Agarwal, Ravi M; Yeluri, Ramakrishna; Singh, Chanchal; Chaudhry, Kalpna; Munshi, Autar K

2014-09-01

A pediatric mandibular fracture can cause a child severe pain and the parent or caregiver extreme worry. While the pattern of fractures and associated injuries in children is similar to adults, the incidence is low. Due to a number of factors, including the anatomical complexity of the developing mandible in a child, management of such fractures differs from that of adults and can greatly challenge the pediatric dentist. Various treatment modalities of managing mandibular fracture are available, such as closed/open cap splint with circummandibular wiring, arch-bar fixation, and cementation of the cap splint. This article reviews 19 cases in the management of pediatric facial fracture using varied treatment methods.

Mandibular molar crown-topography, a biological predisposing ...

African Journals Online (AJOL)

Mandibular molar crown-topography, a biological predisposing factor to development of caries – a post-mortem analysis of 2500 extracted lower permanent molars at the dental centre, University of Benin teaching hospital.

Coronectomy of the mandibular third molar: Respect for the inferior alveolar nerve

NARCIS (Netherlands)

Kouwenberg, A. J.; Stroy, L. P. P.; Rijt, E. D. Vree-V. D.; Mensink, G.; Gooris, P. J. J.

2016-01-01

The aim of this study was to evaluate the outcomes of coronectomy as an alternative surgical procedure to complete removal of the impacted mandibular third molar in patients with a suspected close relationship between the tooth root(s) and the mandibular canal. A total of 151 patients underwent

Cephalometric evaluation of surgical mandibular advancement

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Eloísa Marcantônio Boeck

2010-06-01

Full Text Available The treatment of Class II adult individuals with mandibular deficiency has been the combination of orthodontic treatment and orthognathic surgery. Therefore, a study was conducted in which cephalometric analysis was used to evaluate the influence of dentoalveolar decompensation in Class II patients submitted to orthodontic and surgical treatment for mandibular advancement, by bilateral osteotomy of the mandibular ramus. A sample of 15 leukoderma adult female patients were selected and three cephalometric radiographs of each patient, taken before the orthodontic treatment, before surgery and after at least 6 months postoperatively, were analyzed in a total of 45 roentgenograms. The tracings were made by the manual method and the points were digitalized using software. The results showed that values of SNB increased from 75.6 to 78.6°. The measures BNP and PGNP were reduced from -12.7 to -7.7 mm and -12.7 to -6.6 mm, respectively. For ANB there was a reduction of 3.23° (from 8.1° to 4.9°. Likewise, the values of AOBO were diminished by 6.3 mm (from 7.6 to 1.3 mm, and in the values of OJ there was a reduction of 5.7 mm (from 9 to 3.3 mm. It was concluded that the pre-surgical orthodontic treatment promoted minimal and variable dental and skeletal changes in the final result. The surgical treatment caused significant skeletal changes, especially in the measurements related to the mandible (SNB, BNP, PGNP and SNPM or indirectly to it (ANB, AOBO and OJ.

Cephalometric evaluation of surgical mandibular advancement.

Science.gov (United States)

Boeck, Eloísa Marcantônio; Kuramae, Mayury; Lunardi, Nádia; Santos-Pinto, Ary dos; Mazzonetto, Renato

2010-01-01

The treatment of Class II adult individuals with mandibular deficiency has been the combination of orthodontic treatment and orthognathic surgery. Therefore, a study was conducted in which cephalometric analysis was used to evaluate the influence of dentoalveolar decompensation in Class II patients submitted to orthodontic and surgical treatment for mandibular advancement, by bilateral osteotomy of the mandibular ramus. A sample of 15 leukoderma adult female patients were selected and three cephalometric radiographs of each patient, taken before the orthodontic treatment, before surgery and after at least 6 months postoperatively, were analyzed in a total of 45 roentgenograms. The tracings were made by the manual method and the points were digitalized using software. The results showed that values of SNB increased from 75.6 to 78.6 degrees. The measures BNP and PGNP were reduced from -12.7 to -7.7 mm and -12.7 to -6.6 mm, respectively. For ANB there was a reduction of 3.23 degrees (from 8.1 degrees to 4.9 degrees). Likewise, the values of AOBO were diminished by 6.3 mm (from 7.6 to 1.3 mm), and in the values of OJ there was a reduction of 5.7 mm (from 9 to 3.3 mm). It was concluded that the pre-surgical orthodontic treatment promoted minimal and variable dental and skeletal changes in the final result. The surgical treatment caused significant skeletal changes, especially in the measurements related to the mandible (SNB, BNP, PGNP and SNPM) or indirectly to it (ANB, AOBO and OJ).

Mandibular Kondil Kırıkları ve Tedavi Yöntemleri

OpenAIRE

Kısa, Halil İbrahim; Tatlı, Ufuk; Kürkcü, Mehmet

2014-01-01

Maxillofacial injuries are most commonly associated with falls, motor and vehicle accidents, sports-related trauma, and interpersonel violence. The complexity of mandibular condyle region and its anatomic proximity to other craniofacial structures complicate diagnosis and treatment. Thus, treatment approaches of mandibular condyle fracture are still controversial. In the literature, different success rates are reported about observation versus treatment, closed reduction versus open reduction...

Computerized tomography of the mandibular joints and masticatory muscles

International Nuclear Information System (INIS)

Huels, A.B.

1981-01-01

A methodology for computerized tomography of the mandibular joints was developed and applied in 80 test persons. Imaging of the mandibular joints is possible with a tomographic technique with 5 mm-overlap, full utilisation of the enlargement capacity of the imaging device, and combined use of transversal and coronary tomography. The method yields full latero-medial, cranio-caudal and anterior-posterior views of the condyle and fossa contours, free of interferences and of distortions caused by the projection. Positional diagnoses are thus possible as well as diagnoses of pathological structural changes. (orig./MG) [de

Use of rectangular grid miniplates for fracture fixation at the mandibular angle.

Science.gov (United States)

Hochuli-Vieira, Eduardo; Ha, Thi Khanh Linh; Pereira-Filho, Valfrido Antonio; Landes, Constantin Alexander

2011-05-01

The aim of this study was to evaluate the clinical outcome of patients with mandibular angle fractures treated by intraoral access and a rectangular grid miniplate with 4 holes and stabilized with monocortical screws. This study included 45 patients with mandibular angle fractures from the Department of Oral and Maxillofacial Surgery São Paulo State University, Araraquara, Brazil, and from the Clinic of Oral and Maxillofacial Surgery at the University of Frankfurt, Germany. The 45 fractures of the mandibular angle were treated with a rectangular grid miniplate of a 2.0-mm system by an intraoral approach with monocortical screws. Clinical evaluations were postoperatively performed at 15 and 30 days and 3 and 6 months, and the complications encountered were recorded and treated. The infection rate was 4.44% (2 patients), and in 1 patient it was necessary to replace hardware. This patient also had a fracture of the left mandibular body; 3 patients (6.66%) had minor occlusal changes that have been resolved with small occlusal adjustments. Before surgery, 15 patients (33.33%) presented with hypoesthesia of the inferior alveolar nerve; 4 (8.88%) had this change until the last clinical control, at 6 months. The rectangular grid miniplate used in this study was stable for the treatment of simple mandibular angle fractures through intraoral access, with low complication rates, easy handling, and easy adjustment, with a low cost. Concomitant mandibular fracture may increase the rate of complications. This plate should be indicated in fractures with sufficient interfragmentary contact. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Surgical treatment of sagittal fracture of mandibular condyle using long-screw osteosynthesis.

Science.gov (United States)

Luo, Shufang; Li, Bo; Long, Xing; Deng, Mohong; Cai, Hengxing; Cheng, Yong

2011-07-01

The retrospective study evaluated long-screw (bicortical screw) osteosynthesis used in the surgical treatment of sagittal fracture of the mandibular condyle and compared it with titanium plates and removal of the condylar fragment. Ninety-five patients with sagittal fracture of the mandibular condyle received open surgical treatment from 1997 to 2008. Among these patients, the condylar fragments were fixed with long screws in 56 cases (group A), were fixed with titanium plates in 12 cases (group B), and were completely removed in 24 cases (group C). Follow-up was carried out clinically and radiologically. The clinical features included limitation of mandibular mobility, occlusion disturbance, lateral deviation on mouth opening, joint pain, clicking, facial asymmetry, and patient's subjective evaluation. The radiologic parameters consisted of degree of bony resorption, bony change, change of osteosynthesis material, and shortening of mandibular ramus height. Anatomic reduction and functional restoration were obtained and no severe complication was detected in group A. However, 3 of 14 patients had severe osteoarthrosis and 2 of 14 patients had ankylosis in group B. In group C 3 of 24 patients had mandibular retrusion, 4 of 24 patients had front teeth open bite, 4 of 24 patients had severe osteoarthrosis, and 1 of 24 patients had ankylosis. The long-screw fixation group had a more favorable prognosis than the titanium plate group and the group in which removal of the condylar fragment was performed. The long-screw fixation technique might be suitable for use in the surgical treatment of sagittal fractures of the mandibular condyle. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Occlusion and Temporomandibular Function among Subjects with Mandibular Distal Extension Removable Partial Dentures.

NARCIS (Netherlands)

Creugers, N.H.J.; Witter, D.J.; Spijker, A. van 't; Gerritsen, A.E.; Kreulen, C.M.

2010-01-01

Objective. To quantify effects on occlusion and temporomandibular function of mandibular distal extension removable partial dentures in shortened dental arches. Methods. Subjects wearing mandibular extension removable partial dentures (n = 25) were compared with subjects with shortened dental arches

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

Science.gov (United States)

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

2016-01-01

This case report presents the camouflage treatment that successfully improved the facial profile of a patient with a skeletal Class III malocclusion using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy. The patient was an 18-year-old woman with chief complaints of crooked teeth and a protruded jaw. Camouflage treatment was chosen because she rejected orthognathic surgery under general anesthesia. A hybrid type of bone-borne rapid maxillary expander with palatal mini-implants was used to correct the transverse discrepancy, and a mandibular anterior subapical osteotomy was conducted to achieve proper overjet with normal incisal inclination and to improve her lip and chin profile. As a result, a Class I occlusion with a favorable inclination of the anterior teeth and a good esthetic profile was achieved with no adverse effects. Therefore, the hybrid type of bone-borne rapid maxillary expander and a mandibular anterior subapical osteotomy can be considered effective camouflage treatment of a skeletal Class III malocclusion, providing improved inclination of the dentition and lip profile. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Cerebro-costo-mandibular syndrome with consanguinity

International Nuclear Information System (INIS)

Clarke, E.A.; Nguyen, V.D.

1985-01-01

The cerebro-costo-mandibular syndrome is a rare disorder characterized by unique posterior rib defectes, micrognathia, and mental deficiency. The mode of transmission is undetermined. This report describes the first case with documented parental consanguinity as well as hitherto undescribed CT and skeletal findings. (orig.)

Oro-mandibular manifestations of primary hyperparathyroidism

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Sachin Rai

2012-01-01

Conclusion : Loss of lamina dura, ground glass appearance, and mandibular cortical width reduction are common findings in primary hyperparathyroidism and these are significantly correlated with elevated parathormone and alkaline phosphatase. However, the presence of brown tumors and oral tori are less commonly encountered features.

Efectos de los aparatos propulsores mandibulares fijos en la articulación temporomandibular

OpenAIRE

Palomino-Gómez, Sandra P; Almeida, Kelei M; de Mello, Patricia B; Restrepo, Manuel; Ravelr, Dirceu B

2014-01-01

Resumen Los aparatos propulsores mandibulares fijos son una alternativa en el tratamiento de la maloclusión Clase II con deficiencia mandibular. La propiedad de ser fijo, condiciona a la mandíbula a una posición anterior forzada en reposo y durante todas las funciones mandibulares. Cuando se utiliza un aparato de propulsión, la mandíbula se desplaza hacia delante y hacia abajo. Este movimiento conduce a una nueva posición al cóndilo, que puede afectar el funcionamiento normal de la articulaci...

Transmigration of Mandibular Canine: Report of Four Cases and Review of Literature

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Gaurav Sharma

2011-01-01

Full Text Available Transmigration of canine is a rare phenomenon. The prevalence of transmigration of mandibular canine has been found to be only 0.14%–0.31%. The treatment of impacted transmigrated canine is very complicated if it is diagnosed at a later stage. We report 4 cases of transmigration of mandibular canine and review the literature regarding the etiology and treatment. Panoramic radiograph should be taken during the mixed dentition period if the mandibular canine has not erupted from more than one year from its normal chronological age of eruption as intraoral periapical radiograph examination will not always detect an impacted or transmigrated canine.

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

International Nuclear Information System (INIS)

Kang, Sang Hoon; Kim, Yeon Ho; Won, Yu Jin; Kim, Moon Key

2016-01-01

To analyze the relative position of the mandibular foramina (MnFs) in patients diagnosed with skeletal class III malocclusion. 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 Mn F. The horizontal and vertical positions were examined by regression analysis. 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. 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

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

Energy Technology Data Exchange (ETDEWEB)

Kang, Sang Hoon; Kim, Yeon Ho; Won, Yu Jin; Kim, Moon Key [Dept. of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, Goyang (Korea, Republic of)

2016-06-15

To analyze the relative position of the mandibular foramina (MnFs) in patients diagnosed with skeletal class III malocclusion. 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 Mn F. The horizontal and vertical positions were examined by regression analysis. 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. 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.

Glenoid fossa position in Class III malocclusion associated with mandibular protrusion.

Science.gov (United States)

Innocenti, Cristina; Giuntini, Veronica; Defraia, Efisio; Baccetti, Tiziano

2009-04-01

Our aim in this study was to investigate the position of the glenoid fossa in subjects with Class III malocclusion associated with mandibular protrusion to better clarify the role of this craniofacial component in Class III skeletal disharmony. A sample of 30 subjects, aged 8 years +/- 6 months, with skeletal and dental Class III malocclusion associated with mandibular protrusion, normal skeletal vertical relationships, and normal mandibular dimensions, was compared with a control group of 33 subjects with skeletal and dental Class I relationships. The comparisons between the Class III group and the control group on the cephalometric measures for the assessment of glenoid fossa position were performed with the Mann-Whitney U test at P <0.05. Subjects with Class III malocclusion had a significantly more mesial position of the glenoid fossa, when compared with the control group as measured with 3 parameters. An anterior position of the glenoid fossa is a possible diagnostic anatomic feature of Class III malocclusion associated with mandibular protrusion. An effective measurement to evaluate glenoid fossa position in craniofacial relationships is the cephalometric distance from the glenoid fossa to the frontomaxillary-nasal suture.

Effects of mandibular protraction appliance associated to fixed appliance in adults

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Bruno D'Aurea Furquim

2013-10-01

Full Text Available OBJECTIVE: This retrospective study aimed to conduct a cephalometric evaluation of the skeletal, dental and soft tissue effects resulting from treatment of adult patients presenting Class II malocclusion, performed with a Mandibular Protraction Appliance (MPA combined with a fixed orthodontic appliance. METHODS: The sample consisted of teleradiographs obtained before and after treatment of 9 adult patients (initial mean age of 22.48 years with bilateral Class II, division 1, malocclusion. Paired t test (p < 0.05 was applied to compare initial and final values. RESULTS: t test revealed an increase in anteroinferior facial height and posterior facial height. The dental changes include: extrusion of upper incisors, buccal inclination, protrusion of lower incisors, mesialization and extrusion of mandibular molars. Regarding the soft tissue component, there was an increase in nasolabial angle in addition to upper lip retrusion. CONCLUSIONS: The effects of treating Class II malocclusion adult patients, by means of using Mandibular Protraction Appliance (MPA combined with a fixed appliance were mostly observed in the mandibular arch, and consisted of buccal inclination, protrusion and intrusion of incisors, and mesialization and extrusion of the molars.

Computer Simulation Surgery for Mandibular Reconstruction Using a Fibular Osteotomy Guide

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Woo Shik Jeong

2014-09-01

Full Text Available In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

Uso de medicamentos como fator de risco para fratura grave decorrente de queda em idosos Medication as a risk factor for falls resulting in severe fractures in the elderly

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Evandro da Silva Freire Coutinho

2002-10-01

Full Text Available Quedas seguidas de fraturas entre idosos constituem um importante problema de saúde pública. Um estudo caso-controle foi conduzido para avaliar o papel do uso de um conjunto de medicamentos, como fator de risco para esses acidentes entre pessoas com 60 anos ou mais, na cidade do Rio de Janeiro, Brasil. Cento e sessenta e nove casos de internação por fratura conseqüente a queda, e 315 controles hospitalares foram pareados por idade, sexo e hospital. Odds ratios (OR, ajustados por fatores potenciais de confusão, foram obtidos utilizando-se regressão logística condicional. Observou-se um aumento no risco desses acidentes para o uso de drogas bloqueadoras dos canais de cálcio (OR = 1,96, 1,16-3,30 e benzodiazepínicos (OR = 2,09, 1,08-4,05, e uma redução para o uso de diuréticos (OR = 0,40, 0,20-0,80. Antiácidos, digitálicos e laxantes mostraram-se associados a uma redução do risco de fraturas por quedas, cuja significância estatística atingiu níveis limítrofes (0,05 Falls leading to fractures among the elderly are a major public problem. A case-control study was conducted on the use of certain drugs as a risk factor for hospitalization due to fractures after falls among individuals aged 60 years or over in the city of Rio de Janeiro, Brazil. One hundred sixty-nine cases and 315 in-patient controls were matched by age, sex, and hospital. Odds ratios (OR adjusted for potential confounders were calculated using conditional logistic regression. Increased risk of such accidents was found for calcium channel antagonists (OR = 1.96, 1.16-3.30 and benzodiazepines (OR = 2.09, 1.08-4.05, and decreased risk was associated with diuretics (OR = 0.40, 0.20-0.80. Antacids, digitalis, and laxatives were associated with reduced risk of fractures after falls that reached borderline statistical significance (0.05 < p < 0.10. The findings highlight the need to weigh risks and benefits of medication in the elderly. It is also important to advise

MANDIBULAR MORPHOMETRY APPLIED TO ANESTHETIC BLOCKAGE IN THE MANED WOLF (CHRYSOCYON BRACHYURUS).

Science.gov (United States)

de Souza Junior, Paulo; de Moraes, Flavio Machado; de Carvalho, Natan da Cruz; Canelo, Evandro Alves; Thiesen, Roberto; Santos, André Luiz Quagliatto

2016-03-01

Chrysocyon brachyurus (maned wolf) is the biggest South American canid and has a high frequency of dental injuries, both in the wild and in captivity. Thus, veterinary procedures are necessary to preserve the feeding capacity of hundreds of captive specimens worldwide. The aim of this study was to investigate the mandibular morphometry of the maned wolf with emphasis on the establishment of anatomic references for anesthetic block of the inferior alveolar and mental nerves. Therefore, 16 measurements in 22 mandibles of C. brachyurus adults were taken. For extraoral block of the inferior alveolar nerve at the level of the mandibular foramen, the needle should be advanced close to the medial face of the mandibular ramus for 11.4 mm perpendicular to the palpable concavity. In another extraoral approach, the needle may be introduced for 30.4 mm from the angular process at a 20-25° angle to the ventral margin. For blocking only the mental nerve, the needle should be inserted for 10 mm from ventral border, close to the labial surface of the mandibular body, at the level of the lower first premolar. The mandibular foramen showed similar position, size, and symmetry in the maned wolf specimens examined. Comparison of the data observed here with those available for other carnivores indicates the need to determine these anatomic references specifically for each species.

Management of Pediatric Mandibular Fracture Using Orthodontic ...

African Journals Online (AJOL)

2017-05-22

May 22, 2017 ... The pediatric patient is a challenge to manage and ... and osteosynthesis of the pediatric fracture with titanium ... impression material and surgical model prepared with ... circum-mandibular wire were removed under local.

Radiography of the mandible prior to endosseous implant treatment. Localization of the mandibular canal and assessment of trabecular bone

Energy Technology Data Exchange (ETDEWEB)

Lindh, C.

1996-03-01

Mandibular autopsy specimens were examined with different radiographic techniques in order to evaluate the visibility of the mandibular canal and the measurement accuracy of distances related to the mandibular canal. Hypocycloidal, spiral and computed tomography (CT) were superior to periapical and panoramic radiography in visualizing the mandibular canal. The tomographic techniques were more accurate when measurements of distances related to the mandibular canal were performed. No difference in measurement accuracy was found between the tomographic techniques. Concerning visibility of the mandibular canal, interobserver agreement was lowest for periapical radiography and highest for CT. Intraobserver agreement was moderate or good for all techniques. A high interobserver variation was found for measurability of distances related to the mandibular canal. The trabecular bone tissue in mandibular autopsy specimens was studied concerning different characteristics. A classification system to be used prior to implant treatment, based on the trabecular pattern in periapical radiographs, was proposed. 74 refs.

Radiography of the mandible prior to endosseous implant treatment. Localization of the mandibular canal and assessment of trabecular bone

International Nuclear Information System (INIS)

Lindh, C.

1996-03-01

Mandibular autopsy specimens were examined with different radiographic techniques in order to evaluate the visibility of the mandibular canal and the measurement accuracy of distances related to the mandibular canal. Hypocycloidal, spiral and computed tomography (CT) were superior to periapical and panoramic radiography in visualizing the mandibular canal. The tomographic techniques were more accurate when measurements of distances related to the mandibular canal were performed. No difference in measurement accuracy was found between the tomographic techniques. Concerning visibility of the mandibular canal, interobserver agreement was lowest for periapical radiography and highest for CT. Intraobserver agreement was moderate or good for all techniques. A high interobserver variation was found for measurability of distances related to the mandibular canal. The trabecular bone tissue in mandibular autopsy specimens was studied concerning different characteristics. A classification system to be used prior to implant treatment, based on the trabecular pattern in periapical radiographs, was proposed. 74 refs

Donor site complications in bone grafting: comparison of iliac crest, calvarial, and mandibular ramus bone.

Science.gov (United States)

Scheerlinck, Laura M E; Muradin, Marvick S M; van der Bilt, Andries; Meijer, Gert J; Koole, Ronald; Van Cann, Ellen M

2013-01-01

To compare the donor site complication rate and length of hospital stay following the harvest of bone from the iliac crest, calvarium, or mandibular ramus. Ninety-nine consecutively treated patients were included in this retrospective observational single-center study. Iliac crest bone was harvested in 55 patients, calvarial bone in 26 patients, and mandibular ramus bone in 18 patients. Harvesting of mandibular ramus bone was associated with the lowest percentages of major complications (5.6%), minor complications (22.2%), and total complications (27.8%). Harvesting of iliac crest bone was related to the highest percentages of minor complications (56.4%) and total complications (63.6%), whereas harvesting of calvarial bone induced the highest percentage of major complications (19.2%). The length of the hospital stay was significantly influenced by the choice of donor site (P = .003) and age (P = .009); young patients with the mandibular ramus as the donor site had the shortest hospital stay. Harvesting of mandibular ramus bone was associated with the lowest percentage of complications and the shortest hospital stay. When the amount of bone to be obtained is deemed sufficient, mandibular ramus bone should be the first choice for the reconstruction of maxillofacial defects.

SYNOVIAL CHONDROMATOSIS OF THE TEMPORO-MANDIBULAR JOINT. A CASE REPORT

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V. MALANCHUK

2015-09-01

Full Text Available The study describes a rare clinical case of synovial chondromatosis of the temporo-mandibular joint, in a 53 year-old patient. In the prehospital stage, the patient was examined by additional diagnostic methods – 3D CT and subsequent computer simulation, in view of subsequent surgery. In January 2015, partial synovektomy of the right temporo-mandibular joint with removal of cartilaginous impurities was performed under general anesthesia. After histopathological confirmation of the clinical diagnosis, the patient was discharged in satisfactory condition, with recommendations for further examination and radiological control. Synovial chondromatosis of the temporo-mandibular joint is a disease characterized by impaired formation of cartilage or of intraarticular, cartilaginous, and relatively rare bone impurities. An important role in the diagnosis of joints’ synovial chondromatosis is played by the instrumental research methods, especially X-ray. Surgical treatment is recommended as a function of the prevalence of lesions.

Prevalence and morphometric analysis of three-rooted mandibular first molars in a Brazilian subpopulation

OpenAIRE

Rodrigues, Clarissa Teles; de Oliveira-Santos, Christiano; Bernardineli, Norberti; Duarte, Marco Antonio Hungaro; Bramante, Clovis Monteiro; Minotti-Bonfante, Paloma Gagliardi; Ordinola-Zapata, Ronald

2016-01-01

ABSTRACT The knowledge of the internal anatomy of three-rooted mandibular molars may help clinicians to diagnose and plan the root canal treatment in order to provide adequate therapy when this variation is present. Objectives: To determine the prevalence of three-rooted mandibular molars in a Brazilian population using cone beam computed tomography (CBCT) and to analyze the anatomy of mandibular first molars with three roots through micro-CT. Material and Methods: CBCT images of 116 patien...

Nerve injury caused by mandibular block analgesia

DEFF Research Database (Denmark)

Hillerup, S; Jensen, Rigmor H

2006-01-01

Fifty-four injection injuries in 52 patients were caused by mandibular block analgesia affecting the lingual nerve (n=42) and/or the inferior alveolar nerve (n=12). All patients were examined with a standardized test of neurosensory functions. The perception of the following stimuli was assessed......: feather light touch, pinprick, sharp/dull discrimination, warm, cold, point location, brush stroke direction, 2-point discrimination and pain perception. Gustation was tested for recognition of sweet, salt, sour and bitter. Mandibular block analgesia causes lingual nerve injury more frequently than...... inferior alveolar nerve injury. All grades of loss of neurosensory and gustatory functions were found, and a range of persisting neurogenic malfunctions was reported. Subjective complaints and neurosensory function tests indicate that lingual nerve lesions are more incapacitating than inferior alveolar...

Mandibular third molar development after mantle radiation in long-term survivors of childhood Hodgkin's disease

International Nuclear Information System (INIS)

McGinnis, J.P. Jr.; Hopkins, K.P.; Thompson, E.I.; Hustu, H.O.

1987-01-01

Sequential panoramic radiographs were assessed for mandibular third molar development in 47 long-term survivors of childhood Hodgkin's disease after treatment with 37 Gy mantle field radiation. To make a comparison, panoramic radiographs of 149 healthy, nonirradiated children were reviewed for the presence of mandibular third molars. In children between the ages of 7 and 12 years, bilateral agenesis of mandibular third molars was more frequent in patients who had been treated with mantle radiation than in nonirradiated patients. Unilateral agenesis, crown hypoplasia, and root growth impairment of mandibular third molars were also found. Similar, apparent, radiation-induced developmental anomalies were noted in maxillary third molars of the irradiated patients

Dynamic MR imaging of mandibular osteoradionecrosis

International Nuclear Information System (INIS)

Store, G.; Smith, H.J.; Larheim, T.A.

2000-01-01

Osteoradionecrotic bone has been characterised as hypovascular and metabolically inactive tissue with impaired perfusion. The present study was conducted to determine if dynamic contrast-enhanced MR imaging could provide additional information about the vascularity of radionecrotic mandibular bone. Dynamic contrast-enhanced MR imaging was performed on 10 patients with mandibular osteoradionecrosis (ORN), and on 6 patients, irradiated for oropharyngeal tumours, without symptoms or signs of ORN. Nine patients in the ORN group received a series of 20 hyperbaric oxygen (HBO) treatments, after which the dynamic MR investigation was repeated. Radiation per se did not lead to increased contrast enhancement, whereas all patients with ORN showed marked contrast enhancement of the osteoradionecrotic bone marrow. After HBO treatment, pathological contrast enhancement of the abnormal bone marrow could still be seen, but the rate of enhancement was less than before in 7 of 9 patients. Two patients had an increase in the enhancement rate. The findings suggest the existence of an increased and patent microvasculature

A study of angle of mandibular canal and mental foramen on the panoramic radiograph

International Nuclear Information System (INIS)

Choi, Hang Moon

2009-01-01

To assessment the angle between mandibular canal and occlusal plane at each posterior tooth region and location of mental foramen on the panoramic radiographs. This study analysed 46 half-mandibles of panoramic radiographs. Inferior border of mandibular canal was traced. Occlusal plane was drawn from lingual cusp tip of the first premolar to distolingual cusp tip of the second molar. Perpendicular line from occlusal plane was drawn at each tooth region and then tangential lines were drawn from the crossing points at canal. The angle between occlusal plane and tangential line was measured. The location of mental foramen was also studied. According to the location of mental foramen, radiographs were divided into M (mesial) group and D (distal) group on the basis of the second premolar. and then inter-group analysis about mandibular canal angle was done. The angles of mandibular canals were -17.7 .deg. C, -9.5 .deg. C, 8.2 .deg. C, 22.3 .deg. C, and 39.2 .deg. C at first premolar, second premolar, first molar, second molar, and third molar, respectively. The commonest position of the mental foramen was distal to the second premolar. Inter-group comparison showed statistically significant difference at the second premolar and the first molar (p<0.001). The acknowledgement of mandibular canal angulation and location of mental foramen can help understanding the course of mandibular canal.

Prevalence and features of distolingual roots in mandibular molars analyzed by cone-beam computed tomography

International Nuclear Information System (INIS)

Choi, Mi Ree; Moon, Young Mi; Seo, Min Seock

2015-01-01

This study evaluated the prevalence of distolingual roots in mandibular molars among Koreans, the root canal system associated with distolingual roots, and the concurrent appearance of a distolingual root in the mandibular first molar and a C-shaped canal in the mandibular second molar. Cone-beam computed tomographic images of 264 patients were screened and examined. Axial sections of 1056 mandibular molars were evaluated to determine the number of roots. The interorifice distances from the distolingual canal to the distobuccal canal were also estimated. Using an image analysis program, the root canal curvature was calculated. Pearson's chi-square test, the paired t-test, one-way analysis of variance, and post-hoc analysis were performed. Distolingual roots were observed in 26.1% of the subjects. In cases where a distolingual root was observed in the mandibular molar, a significant difference was observed in the root canal curvature between the buccolingual and mesiodistal orientations. The maximum root canal curvature was most commonly observed in the mesiodistal orientation in the coronal portion, but in the apical portion, maximum root canal curvature was most often observed in the buccolingual orientation. The canal curvature of distolingual roots was found to be very complex, with a different direction in each portion. No correlation was found between the presence of a distolingual root in the mandibular first molar and the presence of a C-shaped canal in the mandibular second molar

Epidemiology of Surgically Managed Mandibular Condylar Fractures at a Tertiary Referral Hospital in Urban Southwest China.

Science.gov (United States)

Thapa, Swosti; Wang, Jun; Hu, Hong-Tao; Zhang, Fu-Gui; Ji, Ping

2017-01-01

Mandibular condylar fracture is one of the commonest maxillofacial fractures treated by maxillofacial surgeons. Demography of the patients, causation, and characteristics of the fracture depends on various socio-economic factors. Hence, maxillofacial surgeons should be familiar with epidemiology of mandibular condylar fracture. This study retrospectively describes the demography, etiology, fracture characteristics, and hospital utilization of surgically treated mandibular condylar fractures in a tertiary referral hospital in urban China in past five years. Data of all patients who underwent surgical management between 2011 and 2015 were collected. This included aetiology, characteristics of fracture, time, age, sex, associated injuries, and hospital utilization of 166 patients with 208 mandibular condylar fractures. These patients had undergone open reduction and internal fixation with either miniplates or lag screws. Among the fracture of head of mandibular condyle, 21.28% of the patients had the fracture segments removed. These data were statistically analyzed to describe the epidemiology of mandibular condylar fracture. Most of the patients had unilateral mandibular condylar fractures (74.7%). Male patients (76.51%) outnumbered female patients (23.49%) in this cohort. The average age of the patients was 37 years. The fractures were mostly caused by fall from height (60.84%) and were located at the condylar neck (53.61%). Most of the patients had other associated maxillofacial injuries (71.08%) which were mostly located at symphysis and parasymphysis (44.59%). It took 12.58 +/- 0.35 days of hospitalization for the treatment. Fall from height was the most prevalent cause of mandibular condylar injury in mountainous urban China. The people at highest risk were middle-aged men. Mandibular condylar fracture was mostly located at the condylar neck and was usually associated with fracture at the symphysis and parasymphysis.

Patient satisfaction and dissatisfaction with mandibular two-implant overdentures using different attachment systems: 5-year outcomes.

Science.gov (United States)

Al-Zubeidi, Mohammed I; Alsabeeha, Nabeel H M; Thomson, W Murray; Payne, Alan G T

2012-10-01

Different attachment systems for mandibular two-implant overdentures could influence levels of patient satisfaction. Positive consensus of the majority of patients being satisfied does not preclude the possibility of dissatisfaction for some. To evaluate patient satisfaction and dissatisfaction before and after 5 years of wearing mandibular two implant overdentures using different attachment systems ; to determine the prognostic relevance of pretreatment complete denture complaints to treatment outcomes. A total of 106 edentulous participants enrolled in a clinical trial completed a preliminary self-report inventory of their original complete denture complaints.New complete maxillary dentures and mandibular two-implant overdentures were provided to each participant using one of six different attachment systems. Patient satisfaction was determined at pretreatment; at baseline with mandibular two-implant overdenture insertion; and then annually for 5 years, using visual analogue and Likert-type scales. Patient satisfaction with mandibular two-implant overdentures showed significant changes pre- to posttreatment(baseline) in all domains, but these were significant immediately and maintained without further significance for 5 years, other than pain with the overdenture. After 5 years, no significant differences were observed with all the attachment systems. Highly significant differences were found with some social and psychological aspects by the fifth year compared to baseline. Diagnostic and prognostic indicators from a pretreatment inventory identified 12 participants (13.5%) who were dissatisfied. These indicators revealed a maladaptive predisposition to mandibular two-implant overdentures. The provision of mandibular two-implant overdentures will, in the majority of patients, significantly enhance levels of patient satisfaction for 5 years, as compared to complete mandibular dentures, regardless of the attachment system. Careful evaluation of pretreatment

Fixation of zygomatic and mandibular fractures with biodegradable plates.

Science.gov (United States)

Degala, Saikrishna; Shetty, Sujeeth; Ramya, S

2013-01-01

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. To assess the fixation of zygomatic-complex and mandibular fractures with biodegradable copolymer osteosynthesis system. 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. Descriptives, Frequencies, and Chi-square test were used. 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. 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.

Maxillary complete denture outcome with two-implant supported mandibular overdentures. A systematic review.

Science.gov (United States)

Rutkunas, Vygandas; Mizutani, Hiroshi; Peciuliene, Vytaute; Bendinskaite, Ruta; Linkevicius, Tomas

2008-01-01

Research data regarding maxillary complete denture outcome with two-implant supported mandibular overdentures are not consistent. Considering multiple publications on implant supported mandibular overdentures, it was decided to summarize currently present evidence on the maxillary complete dentures opposed by implant-supported mandibular overdentures, and analyze factors that could potentially influence the outcomes. The articles from 1985 to 2007 related to the topic were identified in the online MEDLINE/Pubmed and other databases and manually. Primary articles were scanned, and irrelevant studies were excluded from the further review process. Potentially relevant titles and abstracts were provisionally included for consideration on the basis of full text articles. Full text articles were obtained from on-line and printed sources. The data from the studies were extracted and reviewed. The study has failed to identify any prospective satisfying inclusion/exclusion criteria RCT reporting on maxillary bone resorption. The number of maxillary complete denture relining incidences per patient was constantly increasing during the 10-year period. Maxillary complete denture remake incidences comprised 16-33 % of the number of patients followed during the 10-year period. Comparing patient satisfaction with upper dentures at the baseline and after two years, no decrease in satisfaction was noticed. There is no evidence that maxillary ridge resorption is accelerated with certain types of two-implant supported mandibular overdenture attachments. Most common complication for the maxilla - prosthetic maintenance. There is a risk of decreased patient satisfaction with bar-supported mandibular overdenture. Further studies are needed to provide evidence for the maxillary complete denture outcome with two-implant supported mandibular overdentures.

Visibility of the mandibular canal and the mental foramen in panoramic radiography

International Nuclear Information System (INIS)

Jeong, Seon Jin; Choi, Eui Hwan; Kim, Jae Duk

2001-01-01

To determine the head position that the superior border of the mandibular canal as well as mental foramen can be more clearly visualized in panoramic radiography. Ten dry mandibles were radiography bilaterally using PM 2002 CC panoramic machine. A 20 mm thick aluminium filter was added to the slit collimator to obtain radiographs with acceptable density. The specimens were tilted by 2, 4, 6, 8 and 10 degrees downward with and without radiopaque markers. Radiopaque markers were inserted into the mandibular canals and the mental canals of each side of the specimens to serve as reference image when assessing the radiographs. The obtained results were analyzed statistically. Mandibular canals were significantly more clearly visible in the radiographs with 4 and 6 degree downward position on both sides (P<0.05). Mental foramen were significantly more clearly visible in the was not significant difference between right and left sides. Panoramic radiographs with 4 to 6 degree downward tilting could be valuable in locating the mandibular canal as well as the mental foramen

The correlationship between mandibular radiomorphometric indices in panorama and bone mineral density in Cu-equivalent image of intraoral film

International Nuclear Information System (INIS)

Kim, Jae Duk

2003-01-01

To determine whether the mandibular radiomorphometric indices in panoramic radiography are correlated with the bone mineral density of Cu-equivalent images in intraoral film. The bone mineral density (BMD) of the mandibular premolar area was measured in the Cu-equivalent image of intraoral film. The Panoramic Mandibular Index (PMI) and Mandibular Cortical Width (MCW) were measured in panoramic radiographs of six dry mandibles, and the Pearson correlation between PMI, MCW, and BMD were tested. There were no significant correlations between PMI and BMD (r=0.280), nor between MCW and BMD (r=0.237). The results show that PMI and MCW were poor diagnostic indicators of mandibular BMD in the six dry mandibles used in this study. The correlationship between the mandibular radiomorphometric indices (PMI and MCW) and mandibular BMD needs to be researched further using large in vivo patient samples.

Function impairment and pain after closed treatment of fractures of the mandibular condyle

NARCIS (Netherlands)

Dijkstra, P.U.; Stegenga, B.; de Bont, L.G.; Bos, R.R.

Background: To determine the prognosis of fractures of the mandibular condyle after closed treatment. Methods: Patients (n = 144) with a fracture of the mandibular condyle, all treated closed, were included in the study. Fracture types and position of the fracture parts were determined on

Treating dental crowding with mandibular incisor extraction in an Angle Class I patient

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Gislana Braga Machado

2015-06-01

Full Text Available Mandibular dental crowding often encourages patients to seek orthodontic treatment. The orthodontist should decide between protrusion of incisors or decrease in dental volume so as to achieve proper alignment and leveling. The present study reports the treatment of an Angle Class I malocclusion adolescent female brachyfacial patient with severe mandibular dental crowding, increased curve of Spee and deep overbite. The patient was treated with extraction of a mandibular incisor. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO as a requirement for the title of certified by the BBO.

Evaluation of aural manifestations in temporo-mandibular joint dysfunction.

Science.gov (United States)

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.

[Combined orthodontic-orthoganthic surgery to treat asymmetric mandibular excess malocclusions].

Science.gov (United States)

Li, Xiao-Bing; Chen, Song; Chen, Yang-Xi; Li, Jun

2005-06-01

To discuss the skeletal and dentoalveolar characteristics of asymmetric mandibular excess malocclusions and to discuss the procedures of combined orthodontic-orthonganthic surgery treatments of asymmetric mandibular excess malocclusions. 25 cases treated by combined orthodontic-orthognathic surgery treatments were reviewed to find out the specialties of this kind of therapy. The asymmetric of mandible presents anterior and posterior teeth tipped both sagitally and horizontally, as well as upper and lower jaws incompatibility. The pre-surgical orthodontic treatments included decomposition of anterior and posterior teeth, leveling and aligning the teeth etc. The post-surgical orthodontic treatments were to detail the occlusions. The patients all got functional and aesthetic good results after the combined orthodontic-orthognathic surgery treatments. The asymmetric mandibular excess affects the harmony of the face badly, and the correction of it must be carried out by the combined orthodontic-orthognathic surgery treatments. The pre- and post-surgical orthodontic treatments are the key stages to make the skeletal corrections stable.

Rotational movements of mandibular two-implant overdentures.

Science.gov (United States)

Kimoto, Suguru; Pan, Shaoxia; Drolet, Nicolas; Feine, Jocelyne S

2009-08-01

Clinicians have reported that their patients complain that their mandibular two-implant overdentures (IOD) rotate. Therefore, we studied the frequency and severity of rotation of IODs with two-ball attachments, how rotation may influence perceived satisfaction ratings of chewing ability, and the factors that are involved in the rotation of IODs. Seventy-nine participants were recruited and asked to rate their general satisfaction of their IODs, as well as their ability to chew foods, the existence of any mandibular denture rotation, and to what degree denture rotation bothered them. Data on participant sociodemographic, anatomical, and prosthesis characteristics were also collected. Student's t-test and logistic regression analyses were performed to analyze the differences between participants who did (R group) and did not report (NR group) denture rotation. Thirty-seven of 79 participants were aware of rotational movement in their IODs. These patients were significantly less satisfied with their chewing ability than those who felt no rotation (69.1 mm R group vs. 82.9 mm), and discomfort caused by the rotation bothered them moderately (39/100 mm). The multivariate logistic regression analysis revealed that the arrangement of the anterior teeth and the length of the denture are significantly associated with awareness of denture rotation. Thirty-eight percent in the R group and 31% in the NR group had non-scheduled visits. Rotational movement with a mandibular two-IOD has a negative effect on perceived chewing ability and is associated with anterior tooth arrangement and denture length.

Endodontic management of mandibular second premolar with three roots and three root canals: A case report

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Nidhi Shrivastava

2014-01-01

Full Text Available High level of success in endodontic treatment requires an understanding of root canal anatomy and morphology. The clinician must be prepared to identify those teeth that tend to vary generally from norm. Thorough debridement and obturation of such teeth can be challenging and failing to do so can lead to treatment failure. Mandibular premolars have earned the reputation for having aberrant anatomy. However, the occurrence of three separate canals with three separate foramina in mandibular premolars is very rare. The incidence of three canals is as high as 23% in mandibular first premolars, whereas in second premolars incidence is as low as 0.4%. Three rooted mandibular second premolar is reported to be 0.2%. This case report describes endodontic management of one such tooth with unusual morphological variations in canal anatomy of mandibular second premolar.

Neurovascular structures of the mandibular angle and condyle: a comprehensive anatomical review.

Science.gov (United States)

Yang, Hun-Mu; Won, Sung-Yoon; Kim, Hee-Jin; Hu, Kyung-Seok

2015-11-01

Various surgical interventions including esthetic surgery, salivary gland excision, and open reduction of fracture have been performed in the area around the mandibular angle and condyle. This study aimed to comprehensively review the anatomy of the neurovascular structures on the angle and condyle with recent anatomic and clinical research. We provide detailed information about the branching and distributing patterns of the neurovascular structures at the mandibular angle and condyle, with reported data of measurements and proportions from previous anatomical and clinical research. Our report should serve to help practitioners gain a better understanding of the area in order or reduce potential complications during local procedures. Reckless manipulation during mandibular angle reduction could mutilate arterial branches, not only from the facial artery, but also from the external carotid artery. The transverse facial artery and superficial temporal artery could be damaged during approach and incision in the condylar area. The marginal mandibular branch of the facial nerve can be easily damaged during submandibular gland excision or facial rejuvenation treatment. The main trunk of the facial nerve and its upper and lower distinct divisions have been damaged during parotidectomy, rhytidectomy, and open reductions of condylar fractures. By revisiting the information in the present study, surgeons will be able to more accurately prevent procedure-related complications, such as iatrogenic vascular accidents on the mandibular angle and condyle, complete and partial facial palsy, gustatory sweating (Frey syndrome), and traumatic neuroma after parotidectomy.

Demência como fator de risco para fraturas graves em idosos Dementia as risk factor for severe bone fractures among the elderly

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Aline de Mesquita Carvalho

2002-08-01

Full Text Available INTRODUÇÃO: As quedas entre pessoas idosas constituem importante problema de saúde pública devido à sua alta incidência, às complicações para a saúde e aos altos custos assistenciais. O estudo realizado visa a estimar a associação entre demência e ocorrência de quedas e fraturas entre idosos. MÉTODOS: Foi conduzido estudo caso-controle de 404 indivíduos com 60 ou mais anos de idade, da cidade do Rio de Janeiro, Brasil. Casos e controles foram pareados por idade, sexo e hospital. Os dados foram coletados por meio de entrevista estruturada com os idosos. Foram considerados portadores de quadro demencial idosos cuja pontuação no questionário BOAS fosse superior a dois. Foram obtidos odds ratios (OR ajustados por fatores potenciais de confusão, utilizando-se regressão logística condicional. RESULTADOS: As quedas distribuíram-se igualmente entre os períodos da manhã, tarde e noite, havendo uma redução em sua freqüência durante a madrugada. Acidentaram-se dentro de casa 78% dos idosos com demência, contra 55% daqueles sem essa doença. O OR não-ajustado para a associação entre demência e fratura grave foi de 2,0 (IC95%, 1,23-3,25. Após o ajuste por fatores de confusão, houve uma pequena redução dessa associação (OR=1,82, 1,03-3,23. CONCLUSÃO: Idosos com quadro demencial apresentam maior risco de caírem e ser hospitalizados por fratura do que idosos sem demência. Tal fato implica a necessidade de cuidados especiais com esses indivíduos, visando a minimizar o risco desses acidentes.INTRODUCTION: Falls among elderly represent an important public health concern due to its high incidence, health implications, and medical care costs. The study aims to assess the association between dementia and bone fracture risk after falls among the elderly. METHODS: A case-control of 404 subjects aged 60 years old or more living in Rio de Janeiro, Brazil, was carried out. Cases and controls were matched by age, sex, and

Evaluation of Satisfaction Level in Patients With Mandibular Implant Supported Overdentures

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Masoumeh khoshhal

2016-01-01

Full Text Available Background Implant-supported overdentures could have many benefits for patients, especially in the lower jaws. As a matter of fact, the most common reason for prescribing mandibular overdenture is dissatisfaction of patients with mandibular dentures usually because of a lack of retention, stability and function and speech difficulties. On the other hand, patients' expectations of overdenture treatments are their main disadvantage. Objectives The aim of this study was to evaluate the satisfaction of patients who had received mandibular implant supported overdenture treatment with different number of implants. Patients and Methods This study was a descriptive cross-sectional study. Twenty-five patients with a mean age of 62.7 years who had received mandibular implant supported overdenture treatment at the dental school of Hamadan University of Medical Sciences were enrolled. Among these patients, six had overdentures supported by one implant, nine had overdentures supported by two implants, two had overdentures supported by three implants, five had overdentures supported by four implants and three had overdentures supported by five implants. The visual analogue scale (VAS questionnaire was used to evaluate the general satisfaction, comfort, esthetic, fitness, satisfaction of chewing and social communication, and the data was analyzed by the analysis of variance (ANOVA test. Results All patients in all five groups were satisfied with their overdentures; however there was no significant relationship between the number of implants and fitness (P = 0.446, esthetic (P = 0.843, comfort (P = 0.805, satisfaction of chewing (P = 0.133, social communication (P = 0.322 and general satisfaction (P = 0.493. Conclusions There was no difference in satisfaction level of patients who had received mandibular overdentures with different number of implants.

Dislocation of a mandibular condyle in the middle cranial fossa, diagnosed 54 years after trauma

OpenAIRE

De Mol, Antoni; Nicolielo, Laura; Ghekiere, Olivier; Jacobs, Reinhilde; Politis, Constantinus

2017-01-01

Abstract Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of mandibular trauma. We report the remarkable case of a 63-year-old patient in whom trauma 54 years prior to consultation resulted in intrusion of the right mandibular condyle into the middle cranial fossa. The diagnosis was missed because of insufficient data provided by conventional radiographies. Failure of timely diagnosis and lack of appropriate treatment resulted in temporomandibular joi...

Comparative study of single and multislice computed tomography for assessment of the mandibular canal

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Adriana da Silva Ferreira Paes

2007-06-01

Full Text Available OBJECTIVE: The purpose of this study was to evaluate the accuracy of relative measurements from the roof of the mandibular canal to the alveolar crest in multislice (multidetector computed tomography (MDCT and single-slice computed tomography (SSCT. MATERIAL AND METHODS: The sample consisted of 26 printed CT films (7 SSCT and 19 MDCT from the files of the LABI-3D (3D Imaging Laboratory of the School of Dentistry of the University of São Paulo (FOUSP, which had been acquired using different protocols. Two observers analyzed in a randomized and independent order a series of 22 oblique CT reconstructions of each patient. Each observer analyzed the CT scans twice. The length of the mandibular canal and the distance between the mandibular canal roof and the crest of the alveolar ridge were obtained. Dahlberg test was used for statistical analysis. RESULTS: The mean error found for the mandibular canal length measurements obtained from SSCT was 0.53 mm in the interobserver analysis, and 0.38 mm for both observers. On MDCT images, the mean error was 0.0 mm in the interobserver analysis, and 0.0 and 0.23 mm in the intraobserver analysis. Regarding the distance between the mandibular canal roof and the alveolar bone crest, the SSCT images showed a mean error of 1.16 mm in the interobserver analysis and 0.66 and 0.59 mm in the intraobserver analysis. In the MDCT images, the mean error was 0.72 mm in the interobserver analysis and 0.50 and 0.54 mm in the intraobserver analysis. CONCLUSION: Multislice CT was demonstrated a more accurate method and demonstrated high reproducibility in the analysis of important anatomical landmarks for planning of mandibular dental implants, namely the mandibular canal pathway and alveolar crest height.

A mandibular third molar with three mesial roots: a case report.

Science.gov (United States)

Plotino, Gianluca

2008-02-01

Although its most common configuration is 2 roots and 3 root canals, mandibular molars might have many different combinations. A case of unusual root canal morphology is presented to demonstrate anatomic variations in mandibular molars. Endodontic therapy was performed in a mandibular third molar with 3 separate mesial roots. The appearance of the pulp chamber floor revealed 4 separate canal orifices. Radiographically the 4 root canals ended in their own distinct foramen. Many reports deal with 3 orifices or 3 independent canals in the mesial root, but none described 3 mesial canals in 3 separate mesial roots, indicating a rare anatomic configuration. This report points out the importance of looking for additional canals and unusual canal morphology, because knowledge of their existence might occasionally enable clinicians to treat a case successfully that otherwise might have ended in failure.

Orthodontic treatment for a mandibular prognathic girl of short stature under growth hormone therapy

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Chin-Yun Pan

2013-12-01

Full Text Available This report presents a case of a 12-year-old girl with maxillary deficiency, mandibular prognathism, and facial asymmetry, undergoing growth hormone (GH therapy due to idiopathic short stature. Children of short stature with or without GH deficiency have a deviating craniofacial morphology with overall smaller dimensions; facial retrognathism, especially mandibular retrognathism; and increased facial convexity. However, a complete opposite craniofacial pattern was presented in our case of a skeletal Class III girl with idiopathic short stature. The orthodontic treatment goal was to inhibit or change the direction of mandibular growth and stimulate the maxillary growth of the girl during a course of GH therapy. Maxillary protraction and mandibular retraction were achieved using occipitomental anchorage (OMA orthopedic appliance in the first stage of treatment. In the second stage, the patient was treated with a fixed orthodontic appliance using a modified multiple-loop edgewise archwire technique of asymmetric mechanics and an active retainer of vertical chin-cup. The treatment led to an acceptable facial profile and obvious facial asymmetry improvement. Class I dental occlusion and coincident dental midline were also achieved. A 3½-year follow-up of the girl at age 18 showed a stable result of the orthodontic and dentofacial orthopedic treatment. Our case shows that the OMA orthopedic appliance of maxillary protraction combined with mandibular retraction is effective for correcting skeletal Class III malocclusion with midface deficiency and mandibular prognathism in growing children with idiopathic short stature undergoing GH therapy.

Impact of mandibular conventional denture and overdenture on quality of life and masticatory efficiency

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Rachel Gomes CARDOSO

Full Text Available Abstract The aim of this non-randomized controlled clinical trial was to evaluate the oral health-related quality of life and masticatory efficiency of patients rehabilitated with mandibular two-implant overdentures with immediate loading or conventional dentures. Fifty completely edentulous patients wearing bimaxillary conventional dentures, for at least one year, were recruited. The patients were then assigned to either two treatment groups: mandibular overdentures supported by two implants with bar-clip system and a maxillary conventional denture (n = 25, and new maxillary and mandibular conventional complete dentures (n = 25. Masticatory efficiency and oral health-related quality of life were assessed before and 3 months after denture insertion. The Brazilian version of OHIP-Edent questionnaire was used to assess the oral health-related quality of life. Masticatory efficiency was evaluated with chewing capsules through a colorimetric method. The results revealed fewer oral health–related quality of life problems in patients wearing mandibular two-implant overdentures compared to the conventional dentures group. In addition, the implant overdenture group presented statistically significant improvement in masticatory efficiency (p = 0.001. There was no correlation between masticatory efficiency and OHIP in the implant group (p > 0.05, however a correlation was found in the conventional denture group (p < 0.05. Therefore, these short-term results suggest that mandibular overdenture retained by 2 implants with immediate loading combined with maxillary conventional dentures provide better masticatory efficiency and oral health–related quality of life than mandibular conventional dentures.

Endodontic treatment of an unusual connation of permanent mandibular molars: a case report.

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Liu, Shengbo; Fan, Bing; Peng, Bin; Fan, Mingwen; Bian, Zhuan

2006-10-01

A 27-year-old patient with an anomalous mandibular molar was referred for endodontic therapy. Clinical and radiographic examination revealed the connation of a second mandibular molar with a third molar. Challenging endodontic therapy was performed in the unusual connated molars. A 2-year recall showed good treatment result.

Dislocation of the mandibular condyle into the middle cranial fossa causing an epidural haematoma.

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Struewer, Johannes; Kiriazidis, Ilias; Figiel, Jens; Dukatz, Thomas; Frangen, Thomas; Ziring, Ewgeni

2012-07-01

Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of mandibular trauma due to anatomical and biomechanical factors. Owing to the proximity of the temporal glenoid fossa to the middle meningeal artery, there is the risk of serious sequelae in case of trauma. The authors report the case of a 36-year-old male patient, who was beaten up in a family dispute and presented with complex mandibular and maxillofacial fractures, including mandibular condyle intrusion into the middle cranial fossa causing extensive meningeal bleeding. The patient underwent immediate surgery, with evacuation of the epidural haematoma via a temporal approach. In addition open reduction and reconstruction of the temporal glenoid fossa via anatomic reduction of the fragments was performed. A functional occlusion was re-established via miniplate reconstruction of the complex mandibular body and ramus fractures. Prompt diagnosis and a multidisciplinary approach are essential to minimize the complications. Advanced imaging modalities of computed tomography are indicated. Treatment options should be individualized in particular in case of suspected neurological injury. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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

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Mah, Deuk-Hyun; Kim, Su-Gwan; Moon, Seong-Yong; Oh, Ji-Su; You, Jae-Seek

2015-02-01

We retrospectively evaluated the impact of mandibular third molars on the occurrence of angle and condyle fractures. 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. 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; Pcondyle 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; Pfractures 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.

Mandibular Angle Fractures: A Clinical and Biomechanical Comparison-the Works of Ellis and Haug.

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Haug, Richard H; Serafin, Bethany L

2008-11-01

In a series of articles spanning 8 years, Ed Ellis reviewed the clinical results of the treatment of 478 mandibular angle fractures managed by eight different techniques. During a series of benchtop investigations employing polyurethane synthetic mandible replicas, Rich Haug investigated the biomechanical behavior of approximately 15 different techniques designed to reconstruct mandibular angle fractures. This article reviews these two series of investigations in an attempt to gain insight into the biomechanical and biological factors that affect the successful reconstruction of mandibular angle fractures. It appears that the current techniques used to reconstruct mandibular angle fractures are sound from the standpoint of biomechanics within a range of forces encountered during clinical function. It also appears that an unsuccessful reconstruction is based on a biological result of a behavioral issue such as noncompliance, substance abuse, and/or nutritional or immune compromise.

An indigenous method for closed reduction of pediatric mandibular parasymphysis fracture

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

2015-01-01

Mandibular fractures in children are very rare as compared to adults due to protected anatomic features of child and less exposure to road traffic accidents. Management becomes complicated due to inherent dynamic nature, instability of mixed dentition and fear of surgery. Conservative management can be done with the help of acrylic cap splints along with circum-mandibular wiring, intermaxillary fixation with eyelet wires, arch wires or open reduction and internal fixation with bio-resorbable ...

Management of Unilaterally Impacted Permanent Mandibular First, Second and Third Molars

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Rohit Mehrotra

2014-01-01

Full Text Available This case report describes the treatment of a teenage patient with simultaneous impaction of all three right mandibular permanent molars. The impacted first and second mandibular molars were surgically exposed and orthodontically erupted into good alignment and occlusion while the impacted third molar in the same quadrant was extracted. The unique clinical presentation, various treatment alternatives, the decision making process in finalizing the treatment plan and its clinical implementation are discussed.

Canal configuration of mandibular first premolars in an Egyptian population

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Hatem A. Alhadainy

2013-03-01

Full Text Available The purpose of this study was to investigate canal configuration of mandibular first premolars in an Egyptian population. Two hundred fifty human extracted mandibular first premolars were collected from Egyptian patients and a small hole in the center of the occlusal surface of each tooth was made perforating the roof of the pulp chamber. Teeth were decalcified by immersing in nitric acid and dehydrated in ascending concentrations of ethyl alcohol. A waterproof black ink was passively injected from the occlusal hole into pulp system and stained teeth were immersed in methyl salicylate solution for clearing. Standardized pictures of the cleared teeth were obtained and anatomical features of the root canal were observed. The average length of the mandibular first premolar teeth was 22.48 ± 1.74 mm, one-rooted teeth were 96.8% and the two-rooted were 3.2%. Vertucci Type I canal configuration represented the highest percentage (61.2% followed by Type V (16.4%, Type IV (13.2%, Type II (5.6% and Type III (2.8%. Vertucci Type VI canal configuration represented the lowest percentage (0.4% and a complex configuration was found in one tooth. Accessory canals were detected in 22.8% and inter-canal connections were observed in 24.8% while 54% showed apical delta. Such knowledge is clinically useful for localization and negotiation of canals of mandibular first premolar, as well as their subsequent management in Egyptian population.

Employment of the adhesive buthyl-2-cyanoacrylate in the fixation of bone fragments in femural fractures in dogs. Radiologic study; Emprego de adesivo butil-2-cianoacrilato na fixaçäo de esquírolas em fraturas de fêmur de cäes. Aspectos radiológicos

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Borges, A. P.B.; Rezende, C. M.F.; Sampaio, R.; Oliveira, H. P.; Ponpermayer, L. G.

1992-02-15

The butyl-2-cyanoacrylate adhesive was utilized in the fixation of bone fragments in femoral fractures in 30 clinically healthy dogs of both sexes. All animals were anesthetized with sodium pentobarbital and the left femur exposed and fractured at the middle third of the bone. A triangular bone fragment, approximately of 2.0 cm in length was taken off from the proximal fragment of the femur. The fracture was immediately reduced and immobilized using an intramedular Steinman pin. The bone fragment was then reintroduced in the same position and glued on with the adhesive butyl-2-cyanoacrylate, applied in droplets at a distance of 8 mm approximately. Healing was assessed through radiographs at 10 day intervals, when it was observed, in all animals, the bone fragment in place right after the surgical procedure. At the end of the experiment 6.67% of animals showed the bone fragment shifted from the focus of fracture. In 30% of the animals the fracture did not consolidate [Portuguese] O adesivo butil-2-cianoacrilato foi empregado na fixaçäo de esquírolas, em fraturas de fêmur de 30 cäes clinicamente sadios, de ambos os sexos. Os animais foram anestesiados com pentobarbital sódico e tiveram o fêmur esquerdo exposto e fraturado no seu terço médio. Uma esquírola, de aproximadamente 20 mm e de forma triangular, foi retirada do fragmento proximal do fêmur. A fratura foi imediatamente reduzida e imobilizada, utilizando-se pino intramedular de Steinmann. A esquírola foi recolocada em oposiçäo e fixada pelo adesivo butil-2-cianoacrilato, aplicado em gotículas, espaçadas cerca de 8 mm. A consolidaçäo foi avaliada através de radiografias (crânio-caudal e médio-lateral) a intervalos de 10 dias, onde observou-se, em todos os animais, a esquírola em oposiçäo logo após o ato cirúrgico. No final do experimento observou-se, em 6,6//dos casos, a esquírola afastada do foco da fratura. Em 30//dos animais näo houve consolidaçäo da fratura.

Prolonged vertigo and ataxia after mandibular nerve block for treatment of trigeminal neuralgia.

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Chaturvedi, Arvind; Dash, Hh

2011-07-01

Common complications of neurolytic mandibular nerve block are hypoesthesia, dysesthesia, and chemical neuritis. We report a rare complication, prolonged severe vertigo and ataxia, after neurolytic mandibular blockade in a patient suffering from trigeminal neuralgia. Coronoid approach was used for right sided mandibular block. After successful test injection with local anesthetic, absolute alcohol was given for neurolytic block. Immediately after alcohol injection, patient developed nausea and vomiting along with severe vertigo, ataxia and hypertension. Neurological evaluation was normal except for the presence of vertigo and ataxia. Computerised tomography scan brain was also normal. Patient was admitted for observation and symptomatic treatment was given. Vertigo and ataxia gradually improved over 24 hours.

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

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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.

Factors contributing to the surgical retreatment of mandibular fractures

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João Gualberto de Cerqueira Luz

2013-06-01

Full Text Available The purpose of this retrospective study was to evaluate contributing factors in patients requiring surgical retreatment of mandibular fractures. Of all the patients with mandibular fractures who were treated using internal fixation at a trauma hospital over a seven-year period, 20 patients (4.7% required a second surgery and thus composed the “reoperated” group. The control group comprised 42 consecutive patients with mandibular fractures who were treated at the same clinic and who healed without complications. Medical charts were reviewed for gender, age, substance abuse history, dental condition, etiology, location of fracture, degree of fragmentation, fracture exposure, teeth in the fracture line, associated facial fractures, polytrauma, time elapsed between trauma and initial treatment, surgical approach and fixation system. Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS version 20.0; descriptive statistics and the chi-squared test were used to determine differences between groups. Significant differences in substance abuse (p = 0.006, dental condition (p < 0.001, location of fracture (p = 0.010, degree of fragmentation (p = 0.003 and fracture exposure (p < 0.001 were found. With regard to age and time elapsed between trauma and initial treatment, older patients (31.4 years, SD = 11.1 and a delay in fracture repair (19.1 days, SD = 18.7 were more likely to be associated with reoperation. It was concluded that substance abuse, age, dental condition, location of fracture, degree of fragmentation, fracture exposure and the time between trauma and initial treatment should be considered contributing factors to the occurrence of complications that require surgical retreatment of mandibular fractures.

Management of mandibular body fractures in pediatric patients: A case report with review of literature

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Baby John; Reena R John; A Stalin; Indumathi Elango

2010-01-01

Mandibular fractures are relatively less frequent in children when compared to adults, which may be due to the child's protected anatomic features and infrequent exposure of children to alcohol related traffic accidents. Treatment principles of mandibular fractures differ from that of adults due to concerns regarding mandibular growth and development of dentition. A case of a 4.5-year-old boy with fractured body of mandible managed by closed reduction using open occlusal acrylic splint and ci...

Cephalometric analysis of the middle part of the face in patients with mandibular prognathism.

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Cutović Tatjana; Jović, Nebojsa; Kozomara, Ruzica; Radojicić, Julija; Janosević, Mirjana; Mladenović, Irena; Matijević, Stevo

2014-11-01

The middle part of the face, that is the maxilla, has always been mentioned as a possible etiologic factor of skeletal Class III. However, the importance of the relationship of maxillary retroposition towards the cranial base is still unclear, although it has been examined many times. The aim of this study was to conduct cephalometric analysis of the morphology of maxilla, including the whole middle part of the face in patients with divergent and convergent facial types of mandibular prognathism, as well as to determine differences betweeen them. Lateral cephalometric teleradiograph images of 90 patients were analyzed at the Dental Clinic of the Military Medical Academy, Belgrade, Serbia. All the patients were male, aged 18-35 years, not previously treated orthodontically. On the basis of dentalskeletal relations of jaws and teeth, the patients were divided into three groups: the group P1 (patients with divergent facial type of mandibular prognathism), P2 (patients with convergent facial type of mandibular pragmathism) and the group E (control group or eugnathic patients). A total of 9 cephalometric parameters related to the middle face were measured and analyzed: the length of the hard palate--SnaSnp, the length of the maxillary corpus--AptmPP, the length of the soft palate, the angle between the hard and soft palate--SnaSnpUt, the angle of inclination of the maxillary alveolar process, the angle of inclination of the upper front teeth, the effective maxillary length--CoA, the posterior maxillary alveolar hyperplasia--U6PP and the angle of maxillary prognathism. The obtained results showed that the CoA, AptmPP and SnaSnp were significally shorter in patients with divergent facial type of mandibular prognathism compared to patients with convergent facial type of the mandibular prognathism and also in both experimental groups of patients compared to the control group. SnaSnp was significantly shorter in patients with divergent facial type of mandibular prognathism

Reabilitação das fraturas do rádio distal Rehabilitation of distal radius fractures

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Patrícia Silva Hampe Barbosa

2009-01-01

Full Text Available O objetivo deste estudo foi avaliar a evidência do efeito e eleição da conduta terapêutica nas fraturas do rádio distal. A revisão sistemática utilizou as bases de dados PubMed, Lilacs, Pedro, Cochrane, Scielo, OTseeker, sem restrições de período de publicação, com as seguintes palavras chaves: fraturas do rádio, reabilitação, terapia ocupacional, fisioterapia, incluindo línguas inglesa, espanhola, francesa e portuguesa. Os estudos encontrados foram avaliados independentemente pelos dois autores utilizando critérios da escala PEDro. Estudos não experimentais foram incluídos em busca de esclarecimentos sobre a reabilitação. Foram encontrados 22 estudos, sendo 14 ensaios clínicos controlados randomizados (ECRs. Dentre eles, quatro compararam mobilização precoce com tratamento convencional apresentando evidência moderada a favor da primeira; sete confrontaram tratamento baseado em exercícios domiciliares com tratamento em consultório apontando evidência conflitiva (um deles também comprovou eficácia de mobilização acessória passiva; e três analisaram eficácia de procedimentos terapêuticos: campo eletromagnético pulsado, drenagem linfática, ultra-som, indicando evidências limitadas. Os nove estudos não experimentais encontrados não apresentaram informações suficientes sobre os questionamentos desta pesquisa. Observou-se uma tendência dos autores em utilizar os princípios gerais da reabilitação ao elaborar condutas terapêuticas, mas os procedimentos utilizados não estão bem atestados pela literatura.The aim of this study was to assess the evidence regarding the adoption and effectiveness of therapeutic procedures employed for rehabilitation of distal radius fractures. This systematic review used the following databases: PubMed, Lilacs, PEDro, Cochrane, Scielo and OTseeker, without time restrictions. The following keywords were searched for: distal radius fracture, rehabilitation, occupational therapy

Influence of soft tissues on mandibular gray scale levels Influência dos tecidos moles sobre os níveis de cinza mandibulares

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Paulo Henrique Couto Souza

2004-03-01

Full Text Available The purpose of this study was to analyze the gray levels, expressed in pixels, of the mandibular retromolar region, with regard to the influence of muscular and fat soft tissues near this region. Fifteen dry mandibles were X-rayed with the presence of soft tissue simulators. The radiographs were digitized and evaluated by Digora® software. A one cm thick layer of wax was used as a simulator of the muscular soft tissue. Animal fat samples of different thicknesses - 0.5, 1.0, 1.5 and 2.0 cm - were used as a simulator of the fat soft tissue. Results showed that the fat soft tissue simulator influenced the gray level values in pixels of the mandibular retromolar region when analyzed in different thicknesses using the Digora® digitized image software.O presente trabalho foi desenvolvido com o objetivo de analisar os níveis de cinza, expressos em "pixels", da região retromolar mandibular, considerando a influência dos tecidos moles muscular e, principalmente, adiposo adjacentes a essa região. Para o estudo, 15 mandíbulas secas foram tecnicamente radiografadas, sendo que as radiografias obtidas foram escaneadas e avaliadas pelo programa de imagens digitalizadas Digora®. Como simuladores dos tecidos muscular e adiposo, foram utilizadas cera utilidade na espessura de 1,0 cm e amostras de gordura animal em espessuras diferentes de 0,5; 1,0; 1,5 e 2,0 cm. Os resultados mostraram que o tecido adiposo foi capaz de influenciar a análise dos valores de níveis de cinza em "pixels" da região retromolar mandibular quando estudado em espessuras diferentes pelo programa de imagens digitalizadas Digora®.

Mandibular distraction in neonates: indications, technique, results

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Sesenna Enrico

2012-02-01

Full Text Available Abstract Background The Pierre Robin Sequence features were first described by Robin in 1923 and include micrognathia, glossoptosis and respiratory distress with an incidence estimated as 1:8,500 to 1:20,000 newborns. Upper airway obstruction and feeding difficulties are the main concerns related to the pathology. Mandibular distraction should be considered a treatment option (when other treatments result inadequate. Patiants and methods Ten patients between the ages of 1 month and 2 years with severe micrognathia and airway obstruction were treated with Mandibular Distraction Osteogenesis (MDO. All patients underwent fibroscopic examination of the upper airway and a radiographic imaging and/or computed tomography scans to detect malformations and to confirm that the obstruction was caused by posterior tongue displacement. All patients were evaluated by a multidisciplinary team. Indications for surgery included frequent apneic episodes with severe desaturation (70%. Gavage therapy was employed in all patients since oral feeding was not possible. The two tracheotomy patients were 5 months and 2 years old respectively, and the distraction procedure was performed to remove the tracheotomy tube. All patients were treated with bilateral mandibular distraction: two cases with an external multivector distraction device, six cases with an internal non-resorbable device and two cases with an internal resorbable device. In one case, the patient with Goldenhar's Syndrome, the procedure was repeated. Results The resolution of symptoms was obtained in all patients, and, when present, tracheotomy was removed without complications. Of the two patients with pre-existing tracheotomies, in the younger patient (5 months old the tracheotomy was removed 7 days postoperatively. In the Goldenhar's syndrome case (2 years old a Montgomery device was necessary for 6 months due to the presence of tracheotomy-inducted tracheomalacia. Patients were discharged when the

Digital design of scaffold for mandibular defect repair based on tissue engineering.

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Liu, Yun-feng; Zhu, Fu-dong; Dong, Xing-tao; Peng, Wei

2011-09-01

Mandibular defect occurs more frequently in recent years, and clinical repair operations via bone transplantation are difficult to be further improved due to some intrinsic flaws. Tissue engineering, which is a hot research field of biomedical engineering, provides a new direction for mandibular defect repair. As the basis and key part of tissue engineering, scaffolds have been widely and deeply studied in regards to the basic theory, as well as the principle of biomaterial, structure, design, and fabrication method. However, little research is targeted at tissue regeneration for clinic repair operations. Since mandibular bone has a special structure, rather than uniform and regular structure in existing studies, a methodology based on tissue engineering is proposed for mandibular defect repair in this paper. Key steps regarding scaffold digital design, such as external shape design and internal microstructure design directly based on triangular meshes are discussed in detail. By analyzing the theoretical model and the measured data from the test parts fabricated by rapid prototyping, the feasibility and effectiveness of the proposed methodology are properly verified. More works about mechanical and biological improvements need to be done to promote its clinical application in future.

Digital design of scaffold for mandibular defect repair based on tissue engineering

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Yun-feng LIU; Fu-dong ZHU; Xing-tao DONG; Wei PENG

2011-01-01

Mandibular defect occurs more frequently in recent years,and clinical repair operations via bone transplantation are difficult to be further improved due to some intrinsic flaws.Tissue engineering,which is a hot research field of biomedical engineering,provides a new direction for mandibular defect repair.As the basis and key part of tissue engineering,scaffolds have been widely and deeply studied in regards to the basic theory,as well as the principle of biomaterial,structure,design,and fabrication method.However,little research is targeted at tissue regeneration for clinic repair operations.Since mandibular bone has a special structure,rather than uniform and regular structure in existing studies,a methodology based on tissue engineering is proposed for mandibular defect repair in this paper.Key steps regarding scaffold digital design,such as external shape design and internal microstructure design directly based on triangular meshes are discussed in detail.By analyzing the theoretical model and the measured data from the test parts fabricated by rapid prototyping,the feasibility and effectiveness of the proposed methodology are properly verified.More works about mechanical and biological improvements need to be done to promote its clinical application in future.

Evaluation of Pound concept in determination of mediolateral mandibular posterior teeth position

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Majid Naser Khaki

2017-03-01

Full Text Available Background: The ideal teeth arrangement is an important step for success in complete denture fabrication. There are different methods for determining the posterior denture teeth location. The purpose of this study was the comparison of posterior mandibular teeth location in the study group with Pound or Misch theory. Material and methods: An alginate mandibular impression of 80 dentate patients was taken and poured with dental stone. Retromolar pad area, mesial of canine and the lingual cusps of each posterior tooth marked on the cast and then transferred to the graded paper. Distance of each lingual cusp from the internal line of Pound triangle was measured. Data were analyzed with SPSS version 16.0. Result: In the study group, the average distance of lingual mandibular cusp from the internal line of Pound triangle was 1.69 mm in first premolars, 0.94 mm in second premolars, 0.7 mm in first molars and 0.75 mm in second molars. Conclusion: In most cases, distance of lingual mandibular cusps was within 1 mm of Pound triangle. Results were more similar to the Pound rather than the Misch theory.

Using the T-scan III system to analyze occlusal function in mandibular reconstruction patients: A pilot study

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Chao-Wei Liu

2015-02-01

Full Text Available Background: This study was designed to analyze the post-rehabilitation occlusal function of subjects treated with complex mandibular resection and subsequently rehabilitated with fibula osteoseptocutaneous flaps, dental implants, and fixed prostheses utilizing the T-scan system. Methods: Ten mandibular complex resection cases that adopted fibula osteoseptocutaneous flaps, dental implants, and fixed prostheses to reconstruct occlusal function were analyzed. The mandibular reconstructions were divided into three groups based on size: full mandibular reconstructions, mandibular reconstructions larger than half of the arch, and mandibular reconstructions smaller than half of the arch. The T-scan III system was used to measure maximum occlusal force, occlusal time, anterior-posterior as well as left-right occlusal force asymmetries, and anterior-posterior as well as left-right asymmetrical locations of occlusal centers. Results: Subjects with larger mandibular reconstructions and dental implants with fixed partial dentures demonstrated decreased average occlusal force; however, the difference did not reach the statistically significant level (p > 0.05. The most significant asymmetry of occlusal center location occurred among subjects with mandibular reconstructed areas larger than half of the mandibular arch. Conclusions: Comparison of the parameters of T-scan system used to analyze the occlusal function showed that the occlusal force was not an objective reference. Measurements of the location of the occlusal center appeared more repeatable, and were less affected by additional factors. The research results of this study showed that the size of a reconstruction did not affect the occlusal force after reconstruction and larger reconstructed areas did not decrease the average occlusal force. The most significant parameter was left and right asymmetry of the occlusion center (LROC and was measured in subjects with reconstruction areas larger than half

Posterior Mandibular Ridge Resorption Associated with Different Retentive Systems for Overdentures: A 7-Year Retrospective Preliminary Study.

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Elsyad, Moustafa Abdou; Mohamed, Shahinaz Sayed; Shawky, Ahmad Fathalla

This retrospective study compared posterior mandibular residual ridge resorption with two different retentive mechanisms for overdentures after 7 years. A convenience sample of 18 edentulous men was assigned to one of two equal groups. Two implants were placed in the mandibular canine areas for each patient using the conventional two-stage surgical protocol, and the implants were splinted with a round bar 3 months later. New mandibular overdentures were then connected to the bars with clips (clip-retained overdentures, CR group) or resilient liners (resilient liner-retained overdentures, RR group). Posterior mandibular ridge resorption (PMRR) was recorded using proportional measurements and posterior area index (PAI) on panoramic radiographs taken immediately after overdenture insertion (T 0 ) and 7 years later (T 7 ). A linear regression model was used to verify the relationship between PAI and the following considerations: attachment type, age, initial mandibular ridge height, period of mandibular edentulism, number of previously worn dentures, and relining events. After 7 years, the RR group demonstrated a significantly (P = .014) higher change in PAI (0.11 ± 0.02) than the CR group (0.06 ± 0.04). The average PMRR for each mm of posterior mandibular ridge was 0.79 mm (0.11 mm/year) in the CR group and 1.4 mm (0.2 mm/year) in the RR group. Attachment type, initial mandibular ridge height, and relining times were significantly correlated with change in the PAI (P = .004, P = .035, and P = .045, respectively). Within the limitations of this preliminary study's design, it was observed that following a 7-year period of use, resilient liner attachments for bar/implant-retained overdentures appear to be associated with greater posterior mandibular ridge resorption when compared to clip attachments.

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

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Nayak, Reshma; Nayak, Us Krishna; Hegde, Gautam

2010-01-01

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. 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. 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. 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.

Cytomegalovirus induces abnormal chondrogenesis and osteogenesis during embryonic mandibular development

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Bringas Pablo

2008-03-01

Full Text Available Abstract Background Human clinical studies and mouse models clearly demonstrate that cytomegalovirus (CMV disrupts normal organ and tissue development. Although CMV is one of the most common causes of major birth defects in humans, little is presently known about the mechanism(s underlying CMV-induced congenital malformations. Our prior studies have demonstrated that CMV infection of first branchial arch derivatives (salivary glands and teeth induced severely abnormal phenotypes and that CMV has a particular tropism for neural crest-derived mesenchyme (NCM. Since early embryos are barely susceptible to CMV infection, and the extant evidence suggests that the differentiation program needs to be well underway for embryonic tissues to be susceptible to viral infection and viral-induced pathology, the aim of this study was to determine if first branchial arch NCM cells are susceptible to mCMV infection prior to differentiation of NCM derivatives. Results E11 mouse mandibular processes (MANs were infected with mouse CMV (mCMV for up to 16 days in vitro. mCMV infection of undifferentiated embryonic mouse MANs induced micrognathia consequent to decreased Meckel's cartilage chondrogenesis and mandibular osteogenesis. Specifically, mCMV infection resulted in aberrant stromal cellularity, a smaller, misshapen Meckel's cartilage, and mandibular bone and condylar dysmorphogenesis. Analysis of viral distribution indicates that mCMV primarily infects NCM cells and derivatives. Initial localization studies indicate that mCMV infection changed the cell-specific expression of FN, NF-κB2, RelA, RelB, and Shh and Smad7 proteins. Conclusion Our results indicate that mCMV dysregulation of key signaling pathways in primarily NCM cells and their derivatives severely disrupts mandibular morphogenesis and skeletogenesis. The pathogenesis appears to be centered around the canonical and noncanonical NF-κB pathways, and there is unusual juxtaposition of abnormal stromal

Cone-beam computed tomography study of root and canal morphology of mandibular premolars in a western Chinese population

International Nuclear Information System (INIS)

Yu, Xuan; Guo, Bin; Li, Ke-Zeng; Zhang, Ru; Tian, Yuan-Yuan; Wang, Hu; DDS, Tao Hu

2012-01-01

Traditional radiography is limited in its ability to give reliable information on the number and morphology of root canals. The application of cone-beam computed tomography (CBCT) provides a non-invasive three-dimensional confirmatory diagnosis as a complement to conventional radiography. The aim of this study was to evaluate the root and canal morphology of mandibular premolars in a western Chinese population using CBCT scanning. The sample included 149 CBCT images comprising 178 mandibular first premolars and 178 second premolars. The tooth position, number of roots and canals, and canal configuration according to Vertucci’s classification were recorded. The results showed that 98% of mandibular first premolars had one root and 2% had two roots; 87.1% had one canal, 11.2% had two canals and 0.6% had three canals. The prevalence of C-shaped canals was 1.1%. All mandibular second premolars had one root; 97.2% had one canal and 2.2% had two canals. The prevalence of C-shaped canals was 0.6%. The prevalence of multiple canals in mandibular first premolars was mainly of Type V, and mandibular second premolars had a low rate of canal variation in this western Chinese population. Root canal bifurcation occurred at the middle or apical third in most bicanal mandibular premolars. CBCT scanning can be used in the management of mandibular premolars with complex canal morphology

Endodontic Treatment of a Mandibular Second Premolar with Three Roots and Three Canals

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Bonny Paul

2014-01-01

Full Text Available Complex root canal system with atypical variations is a common finding among mandibular premolars. Endodontic treatment in these teeth may not be successful due to the failure to recognise and treat multiple canals. This paper presents endodontic treatment of a mandibular second premolar with three roots and three canals.

Pearls of Mandibular Trauma Management

OpenAIRE

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

2010-01-01

Mandibular trauma is a common problem seen by plastic surgeons. When fractures occur, they have the ability to affect the patient's occlusion significantly, cause infection, and lead to considerable pain. Interventions to prevent these sequelae require either closed or open forms of reduction and fixation. Physicians determining how to manage these injuries should take into consideration the nature of the injury, background information regarding the patient's health, and the patient's comorbi...

An endodontic management of mandibular third molar with five root canals

OpenAIRE

Dakshita Joy Sinha; Ashish Amit Sinha

2014-01-01

The existence of several anatomical variations in the root canal system may contribute to failure of the root canal therapy. The planning and performing of endodontic therapy requires knowledge of the internal dental morphology. This paper reports the case of a left mandibular third molar that presented with five root canals; a case of unusual root canal morphology so as to demonstrate the anatomic variations in mandibular third molars. Root canal therapy and case management are described. Th...

A study of the eruption of the mandibular first permanent molar

OpenAIRE

河野, 美砂子; Kohno, Misako

1995-01-01

The object of this study was to know what positional changes of the mandibular first permanent molars occur just before their gingival emergence. The eruptive process of the mandibular first molars was investigated during the period from alveolareruption to preoraleruption. The subjects were 14 patients whose second primary molars were prematurely lost in one side and remained on the other side. Longitudinal oblique cephalograms were used to estimate the eruptive process of the first molars o...

Lesão oculta da articulação manúbrio-esternal associada à fratura da coluna torácica Occult manubriosternal joint injury associated with fracture of the thoracic spine

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Carlos Fernando Pereira da Silva Herrero

2011-04-01

Full Text Available Os autores relatam a ocorrência de lesão oculta da articulação manúbrio-esternal na avaliação inicial de um paciente com fratura da coluna torácica (T9. Foi diagnosticada fratura de T9 no paciente do sexo masculino de 37 anos de idade associada a déficit neurológico parcial. No atendimento inicial, as radiografias realizadas não demonstraram a lesão da articulação manúbrioesternal. Durante a reabilitação, após a estabilização cirúrgica da fratura da coluna torácica, subitamente o paciente sentiu dor intensa, acompanhada de deformidade ao nível do esterno, tendo sido diagnosticada luxação manúbrio-esternal nos exames de imagem. Devido à recidiva da luxação e de dor incapacitante, foi necessária a realização da redução aberta e fixação da articulação manúbrio-esternal. Na avaliação após 12 meses, o paciente apresentou recuperação completa da lesão neurológica, consolidação da artrodese do segmento vertebral T7-T11, e manutenção da redução da articulação manúbrio-esternal, que era assintomática durante a realização das atividades cotidianas.The authors report the occurrence of an occult manubriosternal joint injury in the initial evaluation on a patient with a thoracic spine fracture (T9. This T9 fracture was diagnosed in a 37-year-old man and was associated with a partial neurological deficit. At the initial evaluation, the radiographs produced did not show the manubriosternal joint injury. During rehabilitation, after surgical stabilization of the thoracic spine fracture, the patient suddenly felt an intense pain accompanied by deformation at the sternal level. From imaging examinations, manubriosternal dislocation was diagnosed. Because of recurrence of the dislocation and the incapacitating pain, open reduction and fixation of the manubriosternal joint had to be performed. At the 12-month follow-up, the patient presented complete recovery of the neurological lesion, consolidation of the

Assessment of simulated mandibular condyle bone lesions by cone beam computed tomography

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Marques, Alexandre Perez; Perrella, Andreia; Arita, Emiko Saito; Pereira, Marlene Fenyo Soeiro de Matos; Cavalcanti, Marcelo de Gusmao Paraiso, E-mail: alexperez34@gmail.co [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Odontologia. Dept. de Estomatologia

2010-10-15

There are many limitations to image acquisition, using conventional radiography, of the temporomandibular joint (TMJ) region. The Computed Tomography (CT) scan is a better option, due to its higher accuracy, for purposes of diagnosis, surgical planning and treatment of bone injuries. The aim of the present study was to analyze two protocols of cone beam computed tomography for the evaluation of simulated mandibular condyle bone lesions. Spherical lesions were simulated in 30 dry mandibular condyles, using dentist drills and drill bits sizes 1, 3 and 6. Each of the mandibular condyles was submitted to cone beam computed tomography (CBCT) using two protocols: axial, coronal and sagittal multiplanar reconstruction (MPR); and sagittal plus coronal slices throughout the longitudinal axis of the mandibular condyles. For these protocols, 2 observers analyzed the CBCT images independently, regarding the presence or not of injuries. Only one of the observers, however, performed on 2 different occasions. The results were compared to the gold standard, evaluating the percentage of agreement, degree of accuracy of CBCT protocols and observers' examination. The z test was used for the statistical analysis. The results showed there were no statistically significant differences between the 2 protocols. There was greater difficulty in the assessment of small-size simulated lesions (drill no.1). From the results of this study, it can be concluded that CBCT is an accurate tool for analyzing mandibular condyle bone lesions, with the MPR protocol showing slightly better results than the sagittal plus coronal slices throughout the longitudinal axis. (author)

Pyogenic granuloma associated with mandibular odontoma.

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Karla Ocampo

2014-08-01

Full Text Available Background: pyogenic granuloma is a kind of inflammatory hyperplasia of multifactorial origin, which is usually related to trauma or constant irritation, drug use, hormonal factors, among others. Meanwhile the odontoma is a benign tumor odontogenic composed of epithelial and mesenchymal cells, their development is usually associated with trauma, infections, inherited disorders or hyperactivity odontoblast. Objectives: The objective is to present the clinical case of a patient that presented a case of pyogenic granuloma related to the presence of a mandibular odontoma, and therapeutic management and postoperative results. Case report: The case shows a female patient of 32 years old with a history of multinodular goiter and hypothyroidism, developing a mandibular odontoma of the left side associated with pyogenic granuloma in the same area, which was treated with surgical excision and reconstructed affected tissues with lyophilized bone and collagen membrane. Favorable outcome after surgery without evidence of recurrence, with proper osseointegration of alloplastic materials and soft tissues. Conclusions: The irritant effect of the presence of a tumor (odontoma in developing confirmed pyogenic granuloma.

Reconstruction of mandibular defects using nonvascularized autogenous bone graft in Nigerians

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Kizito Chioma Ndukwe

2014-01-01

Full Text Available Objectives: The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile-Ife, Nigeria. Patients and Methods: A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife constituted the study sample. Relevant information was retrieved from the patients′ records. This information include patients′ demographics (age and sex as well as the type of mandibular defect, cause of the defect, type of mandibular resection done, source of the bone graft used, and the method of graft immobilization. Morbidity associated with the graft procedures were assessed by retrieving information on graft failures, length of hospital stay following surgery, rehabilitation device used and associated graft donor and recipient site complications. Result: There were 12 males and 13 females with a male:female ratio was 1:1.1. The age of the patients ranged from 13 to 73 years with a mean age for males 32.7 ± standard deviation (SD 12.9 and for females 35.0 ± SD 17.1. Jaw defect was caused by resection for tumours and other jaw pathologies in 92% of cases. Complete symphyseal involvement defect was the most common defect recorded 11 (44%. Reconstruction with nonvascularized rib graft accounted for 68% of cases while iliac crest graft was used in 32% of the patients. Successful take of the grafts was recorded in 22 patients while three cases failed. Wound dehiscence (two patients and postoperative wound infection (eight patients were the most common complications recorded. Conclusion: The use of nonvascularized graft is still relevant in the reconstruction of large mandibular defects caused by surgical ablation of benign conditions in Nigerians. Precise surgical planning and execution, extended antibiotic therapy, and meticulous postoperative care

Accuracy of perioperative mandibular positions in orthognathic surgery.

Science.gov (United States)

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. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Deformidade angular do rádio e da ulna tratada pela distração osteogênica percutânea dinâmica - Relato de caso

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Rezende C.M.F.

2000-01-01

Full Text Available O exame de um cão de quatro meses de idade, macho, sem raça definida, com peso de 5,7kg mostrou que ele se apoiava com os cotovelos e apresentava desvio acentuado bilateral do rádio e da ulna. Ao exame radiográfico, observou-se fratura proximal bilateral do rádio. Após avaliações clínica e radiológica foi indicada a osteotomia corretiva e distração osteogênica do membro anterior esquerdo. O procedimento cirúrgico constou de osteotomia na diáfise proximal do rádio e ulna e emprego de fixadores externos compostos por quatro pinos de Kirschner e duas barras metálicas rosqueadas, configurando um fixador tipo II, bilateral uniplanar dinâmico. Antes da fixação dos pinos com acrílico, os fragmentos ósseos fraturados foram separados em aproximadamente 0,5cm. Após 10 dias, iniciou-se a distração de 1,0mm/dia durante 30 dias. A consolidação da fratura foi observada radiograficamente aos 67 dias após a intervenção, quando o aparelho foi removido. Procedimento semelhante foi realizado no membro anterior direito, quando o animal se encontrava com 16 meses de idade. Foi necessária a retirada de uma cunha óssea de aproximadamente 1,0cm para a correção angular. Atualmente, o cão mostra apoio normal do membro anterior esquerdo e discreto desvio valgus do direito devido à quebra do implante.

Mandibular transformations in prepubertal patients following treatment for craniofacial microsomia: thin-plate spline analysis.

Science.gov (United States)

Hay, A D; Singh, G D

2000-01-01

To analyze correction of mandibular deformity using an inverted L osteotomy and autogenous bone graft in patients exhibiting unilateral craniofacial microsomia (CFM), thin-plate spline analysis was undertaken. Preoperative, early postoperative, and approximately 3.5-year postoperative posteroanterior cephalographs of 15 children (age 10+/-3 years) with CFM were scanned, and eight homologous mandibular landmarks digitized. Average mandibular geometries, scaled to an equivalent size, were generated using Procrustes superimposition. Results indicated that the mean pre- and postoperative mandibular configurations differed statistically (PThin-plate spline analysis indicated that the total spline (Cartesian transformation grid) of the pre- to early postoperative configuration showed mandibular body elongation on the treated side and inferior symphyseal displacement. The affine component of the total spline revealed a clockwise rotation of the preoperative configuration, whereas the nonaffine component was responsible for ramus, body, and symphyseal displacements. The transformation grid for the early and late postoperative comparison showed bilateral ramus elongation. A superior symphyseal displacement contrasted with its earlier inferior displacement, the affine component had translocated the symphyseal landmarks towards the midline. The nonaffine component demonstrated bilateral ramus lengthening, and partial warps suggested that these elongations were slightly greater on the nontreated side. The affine component of the pre- and late postoperative comparison also demonstrated a clockwise rotation. The nonaffine component produced the bilateral ramus elongations-the nontreated side ramus lengthening slightly more than the treated side. It is concluded that an inverted L osteotomy improves mandibular morphology significantly in CFM patients and permits continued bilateral ramus growth. Copyright 2000 Wiley-Liss, Inc.

The relationship between the changes in three-dimensional facial morphology and mandibular movement after orthognathic surgery.

Science.gov (United States)

Kim, Dae-Seung; Huh, Kyung-Hoe; Lee, Sam-Sun; Heo, Min-Suk; Choi, Soon-Chul; Hwang, Soon-Jung; Yi, Won-Jin

2013-10-01

The purpose of this study was to investigate the relationship between changes in three-dimensional (3D) facial morphology and mandibular movement after orthognathic surgery. We hypothesized that facial morphology changes after orthognathic surgery exert effects on 3D mandibular movement. We conducted a prospective follow-up study of patients who had undergone orthognathic surgical procedures. Three-dimensional facial morphological values were measured from facial CT images before and three months after orthognathic surgery. Three-dimensional maximum mandibular opening (MMO) values of four points (bilateral condylions, infradentale, and pogonion) were also measured using a mandibular movement tracking and simulation system. The predictor variables were changes in morphological parameters divided into two groups (deviated side (DS) or contralateral side (CS) groups), and the outcome variables were changes in the MMO at four points. We evaluated 21 subjects who had undergone orthognathic surgical procedures. Alterations in the TFH (total facial height), LFH (lower facial height), CS MBL (mandibular body length), and DS RL (ramus length) were negatively correlated with changes in bilateral condylar movement. The UFH, DS MBL and CS ML (mandibular length) showed correlations with infradentale movement. The CS ML, DS ML, MBL, UFH, and SNB were correlated with pogonion movement. The height of the face is most likely to affect post-operative mandibular movement, and is negatively correlated with movement changes in the condyles, infradentale and pogonion. The changes in CS morphological parameters are more correlated with mandibular movement changes than the DS. The changes in CS MBL and bilateral RL were negatively correlated with condylar movement changes, while the bilateral MBL and CS ML were positively correlated with changes in infradentale and pogonion. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights

A novel computer algorithm for modeling and treating mandibular fractures: A pilot study.

Science.gov (United States)

Rizzi, Christopher J; Ortlip, Timothy; Greywoode, Jewel D; Vakharia, Kavita T; Vakharia, Kalpesh T

2017-02-01

To describe a novel computer algorithm that can model mandibular fracture repair. To evaluate the algorithm as a tool to model mandibular fracture reduction and hardware selection. Retrospective pilot study combined with cross-sectional survey. A computer algorithm utilizing Aquarius Net (TeraRecon, Inc, Foster City, CA) and Adobe Photoshop CS6 (Adobe Systems, Inc, San Jose, CA) was developed to model mandibular fracture repair. Ten different fracture patterns were selected from nine patients who had already undergone mandibular fracture repair. The preoperative computed tomography (CT) images were processed with the computer algorithm to create virtual images that matched the actual postoperative three-dimensional CT images. A survey comparing the true postoperative image with the virtual postoperative images was created and administered to otolaryngology resident and attending physicians. They were asked to rate on a scale from 0 to 10 (0 = completely different; 10 = identical) the similarity between the two images in terms of the fracture reduction and fixation hardware. Ten mandible fracture cases were analyzed and processed. There were 15 survey respondents. The mean score for overall similarity between the images was 8.41 ± 0.91; the mean score for similarity of fracture reduction was 8.61 ± 0.98; and the mean score for hardware appearance was 8.27 ± 0.97. There were no significant differences between attending and resident responses. There were no significant differences based on fracture location. This computer algorithm can accurately model mandibular fracture repair. Images created by the algorithm are highly similar to true postoperative images. The algorithm can potentially assist a surgeon planning mandibular fracture repair. 4. Laryngoscope, 2016 127:331-336, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Prefabricated fibula free flap with dental implants for mandibular reconstruction.

Science.gov (United States)

Pauchet, D; Pigot, J-L; Chabolle, F; Bach, C-A

2018-03-02

Free fibula transplant is routinely used for mandibular reconstruction in head and neck cancer. Dental rehabilitation, the objective of mandibular reconstruction, requires the use of dental implants as supports for fixed or removable dentures. Positioning of fibular bone grafts and implants determines implant osseointegration and the possibilities of dental rehabilitation. Prefabrication of a fibula free flap with dental implants prior to harvesting as a free flap can promote implant osseointegration. The position of the implants must then be precisely planned. Virtual surgery and computer-assisted design and prefabrication techniques are used to plan the reconstruction and then reproduce this planning by means of tailored fibula and mandible cutting guides, thereby ensuring correct positioning of fibular bone fragments and implants. The prefabricated fibula free flap technique requires two surgical procedures (prefabrication and flap transfer) and precise preoperative planning. Prefabricated fibula free flap with dental implants, by improving the quality of osseointegration of the implants before flap transfer, extends the possibilities of prosthetic rehabilitation in complex secondary mandibular reconstructions. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Endodontic management of a mandibular second molar with radix entomolaris: a case report

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Rosaline Hannah

2014-05-01

Full Text Available The presence of radix entomolaris (RE in a mandibular first molar is a common occurrence in certain ethnic groups, but the presence of RE in a mandibular second molar is a rare occurrence. In the present case, RE was identified from preoperative radiographs and confirmed using cone-beam computed tomography (CBCT. The access cavity was modified to locate the RE. Cleaning and shaping were performed with nickel-titanium rotary instruments. Obturation was completed with gutta-percha cones using AH Plus (Dentsply Detrey GmbH as sealer. From the CBCT axial images, the RE was determined to have a Type III curvature by the De Moor classification, Type B separate RE by the Carlsen and Alexandersen classification, and radiographically, a Type i image by the Wang classification. The presence of RE in the mandibular second molar makes it essential to anticipate and treat the distolingual root canal. This case report highlights the usefulness of CBCT for assessing RE in the mandibular second molar, which can help the clinician in making a confirmatory diagnosis and assessing the morphology of the root canal.

Interpretation of mandibular condyle fractures using 2D- and 3D-computed tomography

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Costa e Silva Adriana Paula de Andrade da

2003-01-01

Full Text Available Computed tomography (CT has been increasingly used in the examination of patients with craniofacial trauma. This technique is useful in the examination of the temporomandibular joint and allows the diagnosis of fractures of the mandibular condyle. Aiming to verify whether the three-dimensional reconstructed images from CT (3D-CT produce more effective visual information than the two-dimensional (2D-CT ones, we evaluated 2D-CT and 3D-CT examinations of 18 patients with mandibular condyle fractures. We observed that 2D-CT and 3D-CT reconstructed images produced similar information for the diagnosis of fractures of the mandibular condyle, although the 3D-CT allowed a better visualization of the position and displacement of bone fragments, as well as the comminution of fractures. These results, together with the possibility of refining and manipulating perspectives in 3D images, reinforce the importance of its use in the surgical planning and evaluation of treatment. We concluded that 3D-CT presented supplementary information for a more effective diagnosis of mandibular condyle fractures.

Correlation between mandibular gland secretion and cuticular hydrocarbons in the stingless bee Melipona quadrifasciata.

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Cruz-Landim, C; Ferreira-Caliman, M J; Gracioli-Vitti, L F; Zucchi, R

2012-04-19

We investigated whether Melipona quadrifasciata worker mandibular gland secretions contribute directly to their cuticular hydrocarbon profile. The mandibular gland secretion composition and cuticular surface compounds of newly emerged worker bees, nurse bees, and foragers were determined by gas chromatography and mass spectrometry and compared. Both the mandibular gland secretions and the cuticular surface compounds of all worker stages were found to be composed almost exclusively of hydrocarbons. Although the relative proportion of hydrocarbons from the cuticular surface and gland secretion was statistically different, there was a high similarity in the qualitative composition between these structures in all groups of bees.

Intraoperative Hemorrhage and Postoperative Sequelae after Intraoral Vertical Ramus Osteotomy to Treat Mandibular Prognathism

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Chen, Chun-Ming; Lai, Steven; Chen, Ker-Kong; Lee, Huey-Er

2015-01-01

Objective. To investigate the factors affecting intraoperative hemorrhage and postoperative sequelae after orthognathic surgery. Materials and Methods. Eighty patients with mandibular prognathism underwent surgical mandibular setback with intraoral vertical ramus osteotomy (IVRO). The correlation between the blood loss volume and postoperative VAS with the gender, age, and operating time was assessed using the t-test and Spearman rank correlation coefficient. The correlation between the magnitude of mandibular setback with the presence of TMJ clicking symptoms and lip sensation was also assessed. Results. The mean operating time and blood loss volume for men and women were 249.52 min and 229.39 min, and 104.03 mL and 86.12 mL, respectively. The mean VAS in men and women was 3.21 and 2.93, and 1.79 and 1.32 on the first and second postoperative days. There is no gender difference in the operating time, blood loss, VAS, TMJ symptoms, and lip numbness. The magnitude of mandibular setback was not correlated with immediate and long-term postoperative lip numbness. Conclusion. There are no gender differences in the intraoperative hemorrhage and postoperative sequelae (pain, lip numbness, and TMJ symptoms). In addition, neither symptom was significantly correlated with the amount of mandibular setback. PMID:26543855

Root Anatomy and Root Canal Configuration of Human Permanent Mandibular Premolars: A Systematic Review

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Jojo Kottoor

2013-01-01

Full Text Available Introduction. Mandibular premolars have been reported with complex anatomical aberrations, making them one of the most difficult teeth to manage endodontically. Methodology. An exhaustive search was undertaken to identify associated anatomic studies of mandibular premolars through MEDLINE/PubMed database using keywords, and a systematic review of the relevant articles was performed. Chi-square test with Yates correction was performed to assess the statistical significance of any anatomic variations between ethnicities and within populations of the same ethnicity. Documented case reports of variations in mandibular premolar anatomy were also identified and reviewed. Results. Thirty-six anatomic studies were analyzed which included 12,752 first premolars and nineteen studies assessing 6646 second premolars. A significant variation in the number of roots, root canals, and apical foramen was observed between Caucasian, Indian, Mongoloid, and Middle Eastern ethnicities.The most common anatomic variation was C-shaped canals in mandibular first premolars with highest incidence in Mongoloid populations (upto 24% while dens invaginatus was the most common developmental anomaly. Conclusions. A systematic review of mandibular premolars based on ethnicity and geographic clusters offered enhanced analysis of the prevalence of number of roots and canals, their canal configuration, and other related anatomy.

Intraoperative Hemorrhage and Postoperative Sequelae after Intraoral Vertical Ramus Osteotomy to Treat Mandibular Prognathism

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Chun-Ming Chen

2015-01-01

Full Text Available Objective. To investigate the factors affecting intraoperative hemorrhage and postoperative sequelae after orthognathic surgery. Materials and Methods. Eighty patients with mandibular prognathism underwent surgical mandibular setback with intraoral vertical ramus osteotomy (IVRO. The correlation between the blood loss volume and postoperative VAS with the gender, age, and operating time was assessed using the t-test and Spearman rank correlation coefficient. The correlation between the magnitude of mandibular setback with the presence of TMJ clicking symptoms and lip sensation was also assessed. Results. The mean operating time and blood loss volume for men and women were 249.52 min and 229.39 min, and 104.03 mL and 86.12 mL, respectively. The mean VAS in men and women was 3.21 and 2.93, and 1.79 and 1.32 on the first and second postoperative days. There is no gender difference in the operating time, blood loss, VAS, TMJ symptoms, and lip numbness. The magnitude of mandibular setback was not correlated with immediate and long-term postoperative lip numbness. Conclusion. There are no gender differences in the intraoperative hemorrhage and postoperative sequelae (pain, lip numbness, and TMJ symptoms. In addition, neither symptom was significantly correlated with the amount of mandibular setback.

Prolonged vertigo and ataxia after mandibular nerve block for treatment of trigeminal neuralgia

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Arvind Chaturvedi

2011-01-01

Full Text Available Common complications of neurolytic mandibular nerve block are hypoesthesia, dysesthesia, and chemical neuritis. We report a rare complication, prolonged severe vertigo and ataxia, after neurolytic mandibular blockade in a patient suffering from trigeminal neuralgia. Coronoid approach was used for right sided mandibular block. After successful test injection with local anesthetic, absolute alcohol was given for neurolytic block. Immediately after alcohol injection, patient developed nausea and vomiting along with severe vertigo, ataxia and hypertension. Neurological evaluation was normal except for the presence of vertigo and ataxia. Computerised tomography scan brain was also normal. Patient was admitted for observation and symptomatic treatment was given. Vertigo and ataxia gradually improved over 24 hours.

Prevalence of radix entomolaris in mandibular permanent first molars: a study in a South Indian population.

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Chandra, Saurabh S; Chandra, Supriya; Shankar, Padmanabhan; Indira, Rajamani

2011-09-01

Anatomical racial variations are an acknowledged characteristic in permanent molars. Generally, mandibular first molars have 2 roots; however, the presence of a third root, radix entomolaris (RE), is a major anatomic variant among many population groups. This study evaluated the prevalence of permanent mandibular first molars featuring a distolingual root in a South Indian population. Five hundred patients of South Indian origin possessing bilateral mandibular first molars were selected. The radiographs of these patients were evaluated under optimal conditions. A total of 1000 mandibular first molars were screened and the incidence of 3-rooted mandibular first molars and the correlation between left and right side occurrence and between either gender was recorded. The prevalence of 3-rooted mandibular first molars was 18.6% of the patients examined and 13.3% of the teeth examined. There was no statistically significant difference between genders or side of occurrence (P > .05). The bilateral incidence of a symmetric distribution was 43.01%. RE is considered an Asiatic trait. The occurrence of this macrostructure in the South Indian population was 13.3%, which was lower than that of other patients of Mongoloid origin. The clinician must thoroughly examine the radiograph before initiation of endodontic therapy. Copyright © 2011 Mosby, Inc. All rights reserved.

Associação entre a morfologia de trincas de pisos cerâmicos e seu comportamento mecânico em fratura

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E. S. Fonseca

2015-09-01

Full Text Available ResumoEste trabalho analisou os dados obtidos a partir de ensaios a flexão em um lote de 40 corpos de provas de placas cerâmicos, preparados da mesma forma de acordo com a norma brasileira de ensaios NBR 13818:1997. Os dados de resistência à flexão obtidos nos testes, na forma de curvas tensão versus flexão, foram avaliados estatisticamente. Análises estatísticas detalhadas mostraram dois subgrupos diferentes de comportamento mecânico apresentado pelos corpos de prova cerâmicos testados. A análise fractográfica de amostras representativas destes dois grupos indicaram diferenças morfológicas relevantes nas fraturas obtidas destas amostras durante o ensaio. Essas diferenças puderam ser associadas com o comportamento mecânico apresentados pelas amostras analisadas.

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

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Lin, Han; Zhu, Ping; Lin, Qiuping; Huang, Xiaoqiong; Xu, Yue; Yang, Xiaoping

2016-01-01

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. 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. 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 2.2 mm (before virtual surgery). The

Cerebro-costo-mandibular syndrome

International Nuclear Information System (INIS)

Flodmark, P.; Wattsgaard, C.

2001-01-01

Cerebro-costo-mandibular syndrome is a rare disorder characterized by rib malformations, various degrees of cerebral maldevelopment, mental deficiency, palatal defects, and micrognatia. This syndrome was first described in 1966. The majority of cases are sporadic, but a few instances of familial occurrence have been reported, some with an autosomal recessive pattern of inheritance. Mortality in early age has been high, probably mostly due to respiratory insufficiency secondary to rib abnormalities and flail chest. We report a mother and son with this disorder, suggesting autosomal dominant transmission. (orig.)

Middle mesial canals in mandibular molars: incidence and related factors.

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Nosrat, Ali; Deschenes, Raney J; Tordik, Patricia A; Hicks, M Lamar; Fouad, Ashraf F

2015-01-01

Although the internal anatomy of mandibular molars has been extensively studied, information about middle mesial (MM) canals is limited. The primary aim of this retrospective study was to evaluate the incidence of MM canals in mandibular first and second molars. The secondary aim was to correlate the incidence of MM canals with variables of molar type, sex, age, ethnicity, and presence of a second distal canal. All mature permanent first and second mandibular molars treated from August 2012 to May 2014 were included in the analysis. After completion of root canal instrumentation in all main canals, the clinician inspected the isthmus area of the mesial root using the dental operating microscope. If there was a catch point in this area with a file or explorer, the operator spent more time attempting to negotiate an MM canal. Seventy-five mandibular first and second molars were treated during the specified period. Fifteen (20%) teeth had negotiable MM canals. The incidence of MM canals was 32.1% in patients ≤ 20 years old, 23.8% in patients 21-40 years old, and 3.8% in patients > 40 years. Analysis of data revealed a significant difference in the distribution of MM canals among different age groups (P molar type, and presence of a second distal canal were not significant. The incidence of negotiable MM canals overall and their frequency of identification in younger patients were higher than in previous reports. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Application of biodegradable plates for treating pediatric mandibular fractures.

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An, Jingang; Jia, Pengcheng; Zhang, Yi; Gong, Xi; Han, Xiaodong; He, Yang

2015-05-01

We assessed the clinical results of a biodegradable plate system for the internal fixation of mandibular fractures in children, and observed the imaging features of fracture healing and bone changes around the biodegradable plates and screws during follow-up. We enrolled 39 patients (22 male, 17 female, average age 4 years 10 months) with different mandibular fractures. We used 2.0-mm resorbable plates to repair the fractures. Postoperative follow-up ranged from 6 months to 5 years; average follow-up was 1 year 2 months. The outcome measures identified and assessed included facial symmetry, mouth opening, occlusal relationship, infection, nonunion, malunion, and plate dehiscence. We fixed 42 fractures with 43 resorbable plates; the fracture site of one patient (aged 11 years 3 months) was fixed with two plates. Two patients developed small fistulas at the intraoral incision 2 months after surgery; the fistulas healed after 1 month without special treatment. In the other patients, the incision healed well, there was facial symmetry, mouth opening was >35 mm, and occlusion was good. Follow-up computed tomography examination data were available for 20 cases, and revealed different degrees of radiolucency indicating that osteolysis had occurred. Radiolucency was observed around the resorbable plates 1 month after the surgery. The extent and depth of the radiolucent region were obvious within 1 year of surgery. In the second year, there were obvious repairs, with the bony defect areas becoming shallower. After 2 years, the bony defect areas had almost disappeared. Biodegradable fixation devices are safe and efficient for treating pediatric mandibular fractures. Osteolysis commonly follows biodegradable fixation of pediatric mandibular fractures, and has no adverse effect on fracture healing. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

The relationship between age and the mandibular cortical bone thickness by using panoramic radiograph

International Nuclear Information System (INIS)

Kim, Yun Suk; Kim, Kyoung A; Koh, Kwang Joon

2010-01-01

This study was to determine the relationship between age and the mandibular cortical bone thickness on panoramic radiograph. Panoramic radiographs of 360 patients (180 men and 180 women) over 20 years old, who visited the Chonbuk National University Hospital from January to December in 2007, were assessed. The subjects were divided into 5 age groups. Five indices such as cortical bone thickness at the gonion (GI), antegonion (AI), and below the mental foramen (MI), the panoramic mandibular index (PMI), the mandibular cortical index (MCI) were measured on panoramic radiographs. All five indices including GI, AI, MI, PMI, and MCI showed significant differences between third decade and over 8 decade groups (p,0.05). PMI, MI and GI showed significant differences with gender statistically (p<0.05). The mandibular cortical bone thickness showed negative correlation with age, and the value of the thickness (PMI, MI, and GI) was greater in men than in women.

Cephalometric analysis of the middle part of the face in patients with mandibular prognathism

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Čutović Tatjana

2014-01-01

Full Text Available Background/Aim. The middle part of the face, that is the maxilla, has always been mentioned as a possible etiologic factor of skeletal Class III. However, the importance of the relationship of maxillary retroposition towards the cranial base is still unclear, although it has been examined many times. The aim of this study was to conduct cephalometric analysis of the morphology of maxilla, including the whole middle part of the face in patients with divergent and convergent facial types of mandibular prognathism, as well as to determine differences betweeen them. Methods. Lateral cephalometric teleradiograph images of 90 patients were analyzed at the Dental Clinic of the Military Medical Academy, Belgrade, Serbia. All the patients were male, aged 18-35 years, not previously treated orthodontically. On the basis of dentalskeletal relations of jaws and teeth, the patients were divided into three groups: the group P1 (patients with divergent facial type of mandibular prognathism, P2 (patients with convergent facial type of mandibular pragmathism and the group E (control group or eugnathic patients. A total of 9 cephalometric parameters related to the middle face were measured and analyzed: the length of the hard palate - SnaSnp, the length of the maxillary corpus - AptmPP, the length of the soft palate, the angle between the hard and soft palate - SnaSnpUt, the angle of inclination of the maxillary alveolar process, the angle of inclination of the upper front teeth, the effective maxillary length - CoA, the posterior maxillary alveolar hyperplasia - U6PP and the angle of maxillary prognathism. Results. The obtained results showed that the CoA, AptmPP and SnaSnp were significally shorter in patients with divergent facial type of mandibular prognathism compared to patients with convergent facial type of the mandibular prognathism and also in both experimental groups of patients compared to the control group. SnaSnp was significantly shorter in

Treatment of mandibular symphyseal fracture combined with dislocated intracapsular condylar fractures.

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Xu, Xiaofeng; Shi, Jun; Xu, Bing; Dai, Jiewen; Zhang, Shilei

2015-03-01

To evaluate the treatment methods of mandibular symphyseal fracture combined with dislocated intracapsular condylar fractures (MSF&DICF) and to compare the effect of different treatment methods of condylar fractures. Twenty-eight patients with MSF&DICF were included in this study. Twenty-two sites were treated by open reduction, and all the medial condylar fragments were fixed with titanium screws; whereas the other 22 sites underwent close treatment. The surgical effect between these 2 groups was compared based on clinical examination and radiographic examination results. Seventeen of 22 condyle fractures were repositioned in the surgery group, whereas 4 of 22 condyle fractures were repositioned in the close treatment group. Statistical difference was observed between these 2 groups (P condyle fractures should be treated by surgical reduction with the maintenance of the attachment of lateral pterygoid muscle, which is beneficial to repositioning the dislocated condyle to its original physiological position, to closure of the mandibular lingual gap, to restore the mandibular width.

Unexpected complications of bonded mandibular lingual retainers.

NARCIS (Netherlands)

Katsaros, C.; Livas, C.; Renkema, A.M.

2007-01-01

INTRODUCTION: The flexible spiral wire (FSW) retainer is the most frequently used type of fixed retainer bonded on all 6 anterior teeth. Our aim in this article was to demonstrate unexpected posttreatment changes in the labiolingual position of the mandibular anterior teeth associated with the use

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

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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.

Transmigration of mandibular second premolar in a patient with cleft lip and palate--case report.

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Alves, Daniel Berretta Moreira; Pedrosa, Esio Fortaleza Nascimento Chaves; Andreo, Jesus Carlos; de Carvalho, Izabel Maria Marchi; Rodrigues, Antonio de Castro

2008-01-01

Disturbances involving abnormalities in tooth eruption are named ectopia. Transmigration is the name assigned to ectopia in the presence of teeth in areas distant from the alveolar process. Initial angulation of the tooth bud of the second premolar and premature loss of permanent mandibular 1st molars can influence the distal migration of the second premolar. Some studies have observed that ectopic teeth can be found in a variety of places around the oral cavity and also in other areas of the human body. There are records of teeth in the maxillary sinus, mandibular condyle, coronoid process, mandibular angle, orbit, palate, mentum and also the skin. The prevalence of tooth abnormalities is higher in children with cleft lip and palate compared to children without clefts. This paper presents a case report of migration of the mandibular left second premolar in a patient attending the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo (HRAC/USP), Brazil. Migration of the mandibular left 2nd premolar was confirmed by 8 panoramic and 1 periapical radiographs obtained during patient's treatment between 1978 and 2002, which were available in the files of the Department of Dental Radiology of HRAC/USP. It can be assumed that distal migration of the mandibular left 2nd premolar is not associated with presence of cleft lip and palate; observation of these two events in a same patient is rare, since no similar reported cases were found in the literature.

Eruption age of permanent mandibular first molars and central incisors in the south Indian population

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Gupta Rakhi

2007-01-01

Full Text Available Objective: The existing eruption schedules for permanent and deciduous dentition are based on studies in the Western population. Since Indians differ from Westerners racially, genetically, and environmentally, these studies fail to provide relevant guidance on the eruption schedule in the Indian population. This study aims at determining the eruption pattern of permanent mandibular molars and central incisors in the south Indian population. Materials and Methods: 10,156 apparently healthy Indian children in the age-group of 6-9 years were examined with mouth mirror and probe under adequate illumination for the status of the eruption of the permanent mandibular first molar and permanent mandibular central incisor. Pearson′s Chi-square test with Yates′ continuity correction was used to calculate the P -value for comparison of proportion between girls and boys. The values obtained in our study were compared with the standard values. The Z-test with continuity correction was used to calculate the P -value. Results: As per our study, the permanent mandibular first molars and central incisors erupted one to two years later compared to the values reported in Westerners. The earlier eruption of the permanent mandibular first molars compared to the permanent mandibular central incisors, as well as the earlier eruption of both the teeth in girls compared to boys, were in accordance with the existing literature. Conclusion: The eruption age reported by us may form a standard reference for eruption age in Indians.

Mandibular reconstruction of a post-surgical deformity due to trauma

OpenAIRE

Morales Navarro, Denia; Álvarez Garrido, David; González Vargas, Leticia; Basulto Varela, José Felipe

2016-01-01

La necesidad de una reconstrucción mandibular está dictada por la pérdida de hueso debido, entre otras causas, a trauma. El propósito de este trabajo es caracterizar un caso de reconstrucción mandibular de una deformidad posquirúrgica por trauma. Se trata de un paciente masculino de 34 años que acude a consulta por inconformidad estética y dificultad para masticar. Aproximadamente un año atrás había padecido un trauma facial, por lo cual fue atendido de urgencia e intervenido quirúrgicamente....

Multicentre prospective evaluation of implant-assisted mandibular bilateral distal extension removable partial dentures: patient satisfaction

NARCIS (Netherlands)

Wismeijer, D.; Tawse-Smith, A.; Payne, A.G.T.

2013-01-01

Objective To compare the levels of patient satisfaction with either conventional mandibular bilateral distal extension partial dentures or those assisted by bilateral distal implants. Materials and methods Forty-eight participants who were dissatisfied with their existing conventional mandibular

[Long-term follow-up study of titanium implant impact on pediatric mandibular growth and development].

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Hu, Yun; Li, Wei; Chen, Qi; Song, Fumin; Tang, Wei; Wang, Hang

2015-08-01

To explore the impact of titanium implant on the growth and development of pediatric mandible after suffering from mandibular fracture and undergoing open reduction and internal fixation (ORIF) compared with those that underwent titanium plate removal postoperatively. Fifteen pediatric patients with mandibular fracture who underwent ORIF were included in this study. Eight patients did not undergo titanium implant removal postoperatively, whereas the other seven patients underwent the routine. The postoperative data of the pediatrics were collected for comparative analysis by taking the patients' frontal and lateral photos, recording the inter-incisor distance, and measuring the height of mandibular ramus, length of the mandibular body, and combined length of the mandible in three-dimensional reconstruction image. All patients had acceptable facial contour, mouth opening, and occlusion, without obvious abnormalities. The radiography showed no significant difference between the bilateral mandibular lengths in the two groups of patients (P>0.05). The titanium plants have no significant impact on the growth and development of pediatric mandible postoperatively; hence, the question on whether the titanium plates should be removed or not may be neglected. The removal operation may lead to secondary trauma; thus, performing titanium plate removal routinely is not recommended.

Endoscopically assisted enucleation of a large mandibular periapical cyst.

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Nestal Zibo, Heleia; Miller, Ene

2011-01-01

Enucleation of large cysts in the jaws is an invasive method that might be associated with complications. Marsupialization is a less invasive alternative method but it involves a prolonged and uncomfortable healing period. This study addresses a contemporaneous and less invasive surgical technique for treating larger mandibular cysts. MATERIALS AND METHODS. A 48-year-old woman presented with a large mandibular apical cyst involving the left parasymphysis, body, ramus and condylar neck, with involvement of the alveolar inferior nerve. The cystic lesion was enucleated using a 30° 4.0 mm endoscopic scope and endoscopic instruments through two small accesses: the ostectomy site of previously performed marsupialization and the alveolus of the involved third molar extracted of the time of the enucleation of the cyst. RESULTS. The endoscopic scope provided good visualization of the whole cystic cavity allowing the removal of any residual pathologic tissue and preservation of the integrity of the involved inferior alveolar nerve. The morbidity of the surgical procedure was extremely reduced. At a 6-month follow-up the patient did not present any symptom of inflammation and a panoramic X-ray showed good bone repair and remodelation. CONCLUSIONS. Endoscopically assisted enucleation proved to be effective method of treating a large mandibular cyst, providing total enucleation with a minimal invasive technique.

Dislocation of temporo-mandibular joint - an uncommon circumstance of occurrence: vaginal delivery.

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El Bouazzaoui, Abderrahim; Labib, Smael; Derkaoui, Ali; Adnane Berdai, Mohammed; Bendadi, Azzeddine; Harandou, Mustapha

2010-06-25

Dislocation of temporo-mandibular joint (TMJ) is an infrequent disease but still spectacular. This disease consists of a permanent, to some extent complete disruption of the temporo-mandibular joint. These dislocations often occur in a context of yawning, and less frequently after a burst of laughing or relatively mild facial trauma (slap, punch on the chin). We report a case of TMJ occurring in an uncommon circumstance: vaginal delivery. A woman aged 24-years with no special past medical history; primipara was admitted in the Department of Maternity of the University Hospital Hassan II of Fez for an imminent delivery of a twin pregnancy. Ten minutes after admission, the patient delivered vaginally with episiotomy. She gave birth to twins weighing 2800 g and 2400 g. During labour, and due to efforts of crying, the patient developed a sudden and immediate loss of function of the temporo-mandibular joint, with difficulty of speaking, the mouth permanently opened and with the chin lowered and thrown forward. The examination found an empty glenoid fossa of the temporo-mandibular joint in both sides. The diagnosis of dislocation of the TMJ was established. A CT scan of facial bones was done, objectifying a bilateral dislocation of TMJ. The reduction of this dislocation was performed in the operating room under sedation.

Risk Factors and Surgical Refinements of Postresective Mandibular Reconstruction: A Retrospective Study

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Akiko Sakakibara

2014-01-01

Full Text Available Background. Postresective mandibular reconstruction is common in cases of oral and mandibular tumors. However, complications such as infection, plate exposure, or plate fracture can occur. We identified several significant risk factors of complications after reconstructive surgery and compared the effectiveness of different surgical techniques for reducing the incidence of complications. Methods. This study is a retrospective analysis of 28 oromandibular cancer cases that required reconstructive surgery between January 1999 and December 2011 at Kobe University Graduate School of Medicine in Japan. All cases were classified using Hashikawa’s CAT and Eichner’s classification methods. Then, we determined whether these classifications and different treatment or surgical methods were significantly related to complications. Results. Complications after mandibular reconstruction occurred in 10/28 patients (36%. Specifically, five patients had plate fractures, four had plate exposures, and one had an infection. Radiation therapy and closure without any flaps were significantly related to infection or plate exposure. The wrap-around technique of securing reconstruction plates was used in 14 cases, whereas the run-through technique was used in two cases. Conclusions. The success of mandibular reconstruction depends on both mechanical and biological factors, such as the location of defects, presence of occlusions, and the amount of vascularization of the flap.

Spinal and temporo-mandibular disorders in male workers of the State Police.

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Sancini, Angela; Tomei, Francesco; Tomei, Gianfranco; Caciari, Tiziana; Capozzella, Assunta; Di Famiani, Manuela; Samperi, Ilaria; Scala, Barbara; Fiaschetti, Maria; Cetica, Carlotta; Ciarrocca, Manuela

2013-01-01

The aims of this study are to evaluate the prevalence of disorders of the lumbar region and the temporo-mandibular district co-morbidity in drivers and workers of the State Police employed for different office activities. The study population included 103 drivers as cases and 100 police officers as controls. The study was carried out through questionnaire and clinical evaluation of the spine and temporo-mandibular region. At clinical examination, the drivers were found to have a higher prevalence (p temporo-mandibular joint (TMJ), when compared with the controls. The results also showed a higher prevalence (p < 0.05) of co-morbidity in the two districts among the drivers, when compared with the controls. These results confirm that morbidity related to back and TMJ and increase in co-morbidity between the two districts are higher in professional drivers.

Fratura toracolombar explosão: confiabilidade do método de guerra na análise tomográfica Thoracolumbar burst fracture: reliability of the guerra's method on tomographic analysis

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Osmar Avanzi

2009-01-01

Full Text Available OBJETIVOS: Avaliar as características do fragmento retropulsado nas fraturas explosão da coluna toracolombar, de acordo com dois examinadores independentes no plano sagital da TAC e correlacionar estes achados com a presença de déficit neurológico. MATERIAL E MÉTODOS: Coleta retrospectiva de dados de prontuário e TC em 138 pacientes com fratura toracolombar do tipo explosão internados no nosso serviço entre 1983 e 2004. RESULTADOS: Observamos correlação significante entre dois examinadores independentes (pOBJECTIVES: The objective of the current study was to evaluate the correlation between neurological deficits and the characteristics of retropulsed fragment into the spinal canal in patients with thoracolumbar burst fractures. MATERIAL AND METHODS: From 1983 to 2004, 135 patients with thoracolumbar burst fractures according to Denis' criteria were evaluated at a tertiary teaching institution by two different observers. CT-Scans of the fractured spine were analyzed in order to assess the narrowing of the spinal canal. Neurological deficit was evaluated by using the Franke's classification. RESULTS: A significant correlation was found between two independent observers (P<0.05. The observed characteristics of the retropulsed fragment into the spinal canal were: triangular form, rotation dislocation with average of 20 degrees and cranial dislocation with average of eight millimeters. There was no statistical correlation between neurological deficits and the characteristics of retropulsed fragment of the spinal canal. CONCLUSION: There was no statistical correlation between neurological deficits and the characteristics of retropulsed fragment of the spinal canal.

Simplified Technique for Incorporating a Metal Mesh into Record Bases for Mandibular Implant Overdentures.

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Godoy, Antonio; Siegel, Sharon C

2015-12-01

Mandibular implant-retained overdentures have become the standard of care for patients with mandibular complete edentulism. As part of the treatment, the mandibular implant-retained overdenture may require a metal mesh framework to be incorporated to strengthen the denture and avoid fracture of the prosthesis. Integrating the metal mesh framework as part of the acrylic record base and wax occlusion rim before the jaw relation procedure will avoid the distortion of the record base and will minimize the chances of processing errors. A simplified method to incorporate the mesh into the record base and occlusion rim is presented in this technique article. © 2015 by the American College of Prosthodontists.

Morphologic and Morphometric Analysis of Lingula in Localizing Mandibular Foramen with its Surgical Importance

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Phalguni Srimani

2017-10-01

Full Text Available Introduction: Morphologic and morphometric evaluation of mandible is clinically important. Considering the close relationship of lingula with neurovascular structures entering through mandibular foramen, lingula is often used as an important bony landmark during oral and maxillofacial surgical approach and inferior alveolar nerve block anaesthesia. Inadequate anatomical knowledge may result various intra operative complications like haemorrhge, fractures and nerve injury. Also, structural variations of lingula followed by inaccurate localization of mandibular foramen have been implicated as causative factor for unsuccessful inferior alveolar nerve block anaesthesia. Aim: To determine morphological and morphometric variations related to lingula of mandible in localizing mandibular foramen and to compare the results with similar type of osteological studies performed earlier on different population group. Materials and Methods: The study was performed on 36 adult dry human mandibles on both sides to categorize lingula according to its various shapes and determine the location of lingula based on surrounding mandibular landmarks by using Vernier caliper as 5 distances from tip of lingula as follows: i to anterior border of ramus of mandible; ii to posterior border of ramus of mandible; iii to centre of mandibular notch; iv to the alveolar socket of second molar tooth; and v to the base of mandible. The present study also indicated bilingual distance between tips of lingula of both sides. Data collected were analyzed statistically. Results: The most common shape of lingula was observed as triangular (51.39% followed by truncated (23.61%, then nodular (20.83% and assimilated (4.17% as least prevalent type. The average distances of tip of lingula from anterior and posterior borders of ramus of mandible were 18.21±1.50 mm and 16.33±1.21 mm respectively. On average, the tip of lingula was situated at 18.17±1.51 mm, 33.40±2.11 mm and 32.07±2.68 mm

Repair of Bovine and Equine Mandibular Fractures

OpenAIRE

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.

Ultrasound stimulation of mandibular bone defect healing

NARCIS (Netherlands)

Schortinghuis, Jurjen

2004-01-01

The conclusions of the experimental work presented in this thesis are: 1. Low intensity pulsed ultrasound is not effective in stimulating bone growth into a rat mandibular defect, either with or without the use of osteoconductive membranes. 2. Low intensity pulsed ultrasound does not seem to have an

A Rare Case Report of an Unusual Dislocation of Fractured Mandibular Condyle

OpenAIRE

Mishra, Madan; Singh, Gaurav

2015-01-01

Several cases have been reported regarding superolateral, posterior, or superior dislocation of mandibular condyle. The anteromedial dislocation of fractured condyle is the most common among all. This article reports an unusual and unique case of dislocated fractured mandibular condyle wherein the fractured left condylar head was dislocated to the left anatomic angle of mandible. We have not found a single such case in the world English literature published till date. The presented case falls...

Caracterização de Enterococcus spp. resistentes isolados de águas não tratadas destinadas ao consumo humano

OpenAIRE

Macedo, Ana Sofia

2011-01-01

Trabalho apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas. A água não tratada é constantemente desvalorizada como fonte de resistências a antibióticos em países desenvolvidos. Para averiguar este problema de saúde pública, neste trabalho isolaram-se Enterococcus spp. como bactérias indicadoras de contaminação fecal de poços, fontes e minas que fornecem água a diversas comunidades em Portugal e caracterizou-se o s...

X-cephalometric study of different parts of the upper airway space and changes in hyoid position following mandibular fractures.

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Chen, L-J; Zhao, M-C; Pan, X-F; Wei, Y-Q; Wang, D-Y

2013-09-01

This study analyses the different parts of the upper airway space and the changes in hyoid position. The results provide a clinical reference for developing timely and effective treatment programmes for patients with mandibular fractures caused by maxillofacial trauma. Standard X-cephalometric measurements of the lateral skull of 210 subjects were taken. The subjects were divided into four fracture groups: condylar, mandibular angle, mandibular body, and parasymphyseal. The radiographs of the mandibular fracture groups were compared with the normal occlusion group to analyse the upper airway space and the changes in hyoid position. Different types of fractures have different effects on the upper airway space. Bilateral mandibular body fracture and the parasymphyseal fracture have a significant influence on the lower oropharyngeal and laryngopharyngeal airway spaces, with serious obstructions severely restricting the ventilatory function of patients. Fractures at different parts of the mandibular structure are closely related to the upper airway and hyoid position.

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

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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. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Prevalence of Soft Tissue Calcifications in CBCT Images of Mandibular Region.

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Khojastepour, Leila; Haghnegahdar, Abdolaziz; Sayar, Hamed

2017-06-01

Most of the soft tissue calcifications within the head and neck region might not be accompanied by clinical symptoms but may indicate some pathological conditions. The aim of this research was to determine the prevalence of soft tissue calcifications in cone beam computed tomography (CBCT) images of mandibular region. In this cross sectional study the CBCT images of 602 patients including 294 men and 308 women with mean age 41.38±15.18 years were evaluated regarding the presence, anatomical location; type (single or multiple) and size of soft tissue calcification in mandibular region. All CBCT images were acquired by NewTom VGi scanner. Odds ratio and chi-square tests were used for data analysis and p < 0.05 was considered to be statistically significant. 156 out of 602 patients had at least one soft tissue calcification in their mandibular region (25.9%. of studied population with mean age 51.7±18.03 years). Men showed significantly higher rate of soft tissue calcification than women (30.3% vs. 21.8%). Soft tissue calcification was predominantly seen at posterior region of the mandible (88%) and most of them were single (60.7%). The prevalence of soft tissue calcification increased with age. Most of the detected soft tissue calcifications were smaller than 3mm (90%). Soft tissue calcifications in mandibular area were a relatively common finding especially in posterior region and more likely to happen in men and in older age group.

Detecção de fraturas radiculares em imagens de tomografia computadorizada de feixe cônico utilizando diferentes parâmetros de exposição e materiais intracanais

OpenAIRE

Pinto, Martina Gerlane de Oliveira

2015-01-01

O objetivo deste estudo foi avaliar a detecção de fraturas radiculares (FRs) em imagens de Tomografia Computadorizada de Feixe Cônico (TCFC) utilizando diferentes parâmetros de exposição e analisar a influência da guta- percha, do núcleo metálico fundido e do pino de fibra de vidro no diagnóstico das FRs, assim como a formação de artefatos em TCFC. Cento e sessenta dentes foram selecionados e divididos em quatro grupos de acordo com o material de preenchimento (sem guta-percha, com guta-perch...

A Feedback-Controlled Mandibular Positioner Identifies Individuals With Sleep Apnea Who Will Respond to Oral Appliance Therapy.

Science.gov (United States)

Remmers, John E; Topor, Zbigniew; Grosse, Joshua; Vranjes, Nikola; Mosca, Erin V; Brant, Rollin; Bruehlmann, Sabina; Charkhandeh, Shouresh; Zareian Jahromi, Seyed Abdolali

2017-07-15

Mandibular protruding oral appliances represent a potentially important therapy for obstructive sleep apnea (OSA). However, their clinical utility is limited by a less-than-ideal efficacy rate and uncertainty regarding an efficacious mandibular position, pointing to the need for a tool to assist in delivery of the therapy. The current study assesses the ability to prospectively identify therapeutic responders and determine an efficacious mandibular position. Individuals (n = 202) with OSA participated in a blinded, 2-part investigation. A system for identifying therapeutic responders was developed in part 1 (n = 149); the predictive accuracy of this system was prospectively evaluated on a new population in part 2 (n = 53). Each participant underwent a 2-night, in-home feedback-controlled mandibular positioner (FCMP) test, followed by treatment with a custom oral appliance and an outcome study with the oral appliance in place. A machine learning classification system was trained to predict therapeutic outcome on data obtained from FCMP studies on part 1 participants. The accuracy of this trained system was then evaluated on part 2 participants by examining the agreement between prospectively predicted outcome and observed outcome. A predicted efficacious mandibular position was derived from each FCMP study. Predictive accuracy was as follows: sensitivity 85%; specificity 93%; positive predictive value 97%; and negative predictive value 72%. Of participants correctly predicted to respond to therapy, the predicted mandibular protrusive position proved efficacious in 86% of cases. An unattended, in-home FCMP test prospectively identifies individuals with OSA who will respond to oral appliance therapy and provides an efficacious mandibular position. The trial that this study reports on is registered on www.clinicaltrials.gov, ID NCT03011762, study name: Feasibility and Predictive Accuracy of an In-Home Computer Controlled Mandibular Positioner in Identifying Favourable

Independent and Confluent Middle Mesial Root Canals in Mandibular First Molars: A Report of Four Cases

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Mohanavelu Deepalakshmi

2012-01-01

Full Text Available Mandibular molars demonstrate considerable variations with respect to number of roots and root canals. The possibility of additional root canals should be considered even in teeth with a low frequency of abnormal root canal anatomy. This paper discusses the endodontic management of the rare anatomical complexity middle mesial canals in mandibular first molar and also serves to remind the clinicians that such anatomical variations should be taken into account during the endodontic treatment of the mandibular molars.

Management of pediatric mandibular fracture using orthodontic vacuum-formed thermoplastic splint: A case report and review of literature.

Science.gov (United States)

Sanu, O O; Ayodele, Aos; Akeredolu, M O

2017-05-01

Fractures of the mandible are relatively less frequent in children when compared to adults. The anatomic features of children are protected. Children have a higher adaptation to maxillofacial fractures compared to adults. Treatment principles of mandibular fractures in children differ from that of adults due to concerns regarding mandibular growth and the developing dentition. A case of a 6-year-old boy with fractured mandibular symphysis managed by closed reduction using a vacuum formed thermoplastic splint and circummandibular wiring is presented. This article also provides a review of the literature regarding the management of mandibular fracture in young children.

Occlusion and Temporomandibular Function among Subjects with Mandibular Distal Extension Removable Partial Dentures

Science.gov (United States)

Creugers, N. H. J.; Witter, D. J.; Van 't Spijker, A.; Gerritsen, A. E.; Kreulen, C. M.

2010-01-01

Objective. To quantify effects on occlusion and temporomandibular function of mandibular distal extension removable partial dentures in shortened dental arches. Methods. Subjects wearing mandibular extension removable partial dentures (n = 25) were compared with subjects with shortened dental arches without extension (n = 74) and with subjects who had worn a mandibular extension removable partial denture in the past (n = 19). Subjects with complete dentitions (n = 72) were controls. Data were collected at baseline and at 3-, 6-, and 9-year observations. Results. Occlusal activity in terms of reported awareness of bruxism and occlusal tooth wear of lower anterior teeth did not differ significantly between the groups. In contrast, occlusal tooth wear of premolars in shortened dental arches with or without extension dentures was significantly higher than in the controls. Differences amongst groups with respect to signs and symptoms related to temporomandibular disorders were not found. Occlusal support of the dentures did not influence anterior spatial relationship. Occlusal contacts of the denture teeth decreased from 70% for second premolars via 50% for first molars, to 30% for second molars. Conclusions. Mandibular distal extension removable partial dentures in moderate shortened dental arches had no effects on occlusion and temporomandibular function. PMID:20671961

Retreatment of a mandibular second premolar with two canals in two roots

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Chiara Fossati

2018-06-01

Full Text Available Aim: To present a case of retreatment in mandibular second premolar with two canals in two roots. Summary: Locating, cleaning and shaping the entire root canal system may represent a difficult challenge particularly in mandibular premolars, because of their complex canal systems.For this reason mandibular premolars are often considered the most difficult of all teeth on which to perform successful endodontic treatment. Vertucci stated that the second premolar has one root canal at the apex in 97.5% of the teeth studied and two canals in only 2.5%.1 The following case report describes the diagnosis and retreatment of a second premolar with two canal in two roots.Key learning points: (1 The major cause of failure in root canal therapy is the inability to localize and treat all of the canals of the root canal system. (2 Mandibular premolars have complex canal systems. (3 Mandibular premolars have a high risk of missed anatomy. (4 Preoperative radiograph interpretation is essential to evaluate and detect uncommon anatomies. (5 The operating microscope and CBCT interpretation are fundamental in confirming and preventing mistakes about the configuration of mandibular premolars. Riassunto: Obiettivi: Presentare un caso clinico di ritrattamento canalare di un secondo premolare mandibolare con due canali e due radici. Riassunto: Individuare, sagomare, detergere l’intero sistema radicolare presenta una sfida difficile in ambito endodontico e in particolar modo nei premolari mandibolari per il loro complesso sistema canalare. I premolari mandibolari sono spesso considerati i denti più difficili in cui effettuare una terapia endodontica.Vertucci riscontrò che i secondi premolari mandibolari hanno una radice e un canale nel 97.5% e due canali in solo il 2.5%.1Il case report seguente descrive la diagnosi e il ritrattamento di un secondo premolare con due canali in due radici.Punti chiave di apprendimento: 1. La maggior causa di fallimento endodontico �

Tratamento cirúrgico da fratura instável do anel pélvico em pacientes esqueleticamente imaturos Surgical treatment of unstable pelvic ring fracture in skeletally immature patients

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João Antonio Matheus Guimarães

2010-01-01

Full Text Available OBJETIVO: Apresentar o resultado do tratamento cirúrgico definitivo da fratura instável do anel pélvico na criança submetida a redução e estabilização cirúrgica. MÉTODOS: Avaliamos 10 pacientes com esqueleto imaturo que sofreram fraturas instáveis do anel pélvico tratados cirurgicamente no período entre março de 2004 a janeiro de 2008. O estudo foi retrospectivo, baseado na avaliação clínica e radiográfica. RESULTADOS: A média etária na época do trauma foi de 8,8 anos (dois a 13 anos, sendo sete do sexo feminino e três do sexo masculino. As causas dos traumas foram atropelamento em oito casos, e acidente com motocicleta e queda de altura em um caso cada. Cinco pacientes apresentavam lesões associadas, como fraturas da clavícula, diáfise do fêmur, úmero proximal, ossos da perna, olecrânio e lesão de bexiga. Todos os pacientes avaliados apresentaram excelente evolução clínica. A assimetria pélvica antes do procedimento cirúrgico variava de 0,7 a 2,9cm (média 1,45cm, e caiu para valores entre 0,2 a 0,9cm (média 0,39cm após a redução. Em nenhum dos casos houve alteração da assimetria pélvica medida no pós-operatório imediato e no fim do seguimento. CONCLUSÃO: A fratura do anel pélvico em pacientes esqueleticamente imaturos é rara e a indicação de tratamento cirúrgico não é usual. Diversos autores questionam o tratamento conservador devido às complicações encontradas. A remodelação óssea não parece suficiente para que ocorra uma melhora da assimetria pélvica, fator que justifica a opção pelo tratamento cirúrgico para a redução e correção das deformidades do anel pélvico.OBJECTIVES: To present the outcome of the definitive surgical treatment of unstable fracture of the pelvic ring in children submitted to surgical reduction and stabilization. METHODS: We studied 10 patients with immature skeletons that suffered unstable fractures of the pelvic ring treated during the period between

Post-traumatic changes of the temporo-mandibular joint by bone scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Harris, S.A.; Rood, J.P.; Testa, H.J.

1988-01-01

13 patients who sustained mandibular trauma were investigated with radiographs and scintiscans. The scintiscans showed abnormal uptake of radiopharmaceutical in the temporomandibular joint (TMJ). In patients with a long history of traumatic arthrosis, there was more positive correlation between the scintiscans, and clinical symptoms and histology than between radiographs, and symptoms and histology. In patients with mandibular body fractures and no TMJ symptoms, the scans showed abnormal uptake in the TMJ in 7/8 joints, in the absence of radiographic abnormality. The significance of the abnormal uptake and the value of scintigraphy is discussed.

Post-traumatic changes of the temporo-mandibular joint by bone scintigraphy

International Nuclear Information System (INIS)

Harris, S.A.; Rood, J.P.; Testa, H.J.

1988-01-01

13 patients who sustained mandibular trauma were investigated with radiographs and scintiscans. The scintiscans showed abnormal uptake of radiopharmaceutical in the temporomandibular joint (TMJ). In patients with a long history of traumatic arthrosis, there was more positive correlation between the scintiscans, and clinical symptoms and histology than between radiographs, and symptoms and histology. In patients with mandibular body fractures and no TMJ symptoms, the scans showed abnormal uptake in the TMJ in 7/8 joints, in the absence of radiographic abnormality. The significance of the abnormal uptake and the value of scintigraphy is discussed. (author)

Orthodontic management of a patient with impacted and transposed mandibular canines.

Science.gov (United States)

Almeida, Rhita C; Carvalho, Felipe A R; Almeida, Marco A O; Capelli, Jonas

2009-01-01

This patient report describes the treatment of a 10-year-old female with complete transposition of her impacted mandibular canines and lateral incisors. The patient had a Class I occlusion, and her mandibular lateral incisors were in crossbite with the maxillary central incisors. The treatment objectives were to create space for the impacted canines and align them with the incisors, one of which was extracted. After treatment, the appearance of the patient's teeth was improved, the occlusion was preserved, and overjet and overbite were corrected. © 2009 BY QUINTESSENCE PUBLISHING CO, INC.

Risk Factors and Dose-Effect Relationship for Mandibular Osteoradionecrosis in Oral and Oropharyngeal Cancer Patients

International Nuclear Information System (INIS)

Lee, Ik Jae; Koom, Woong Sub; Lee, Chang Geol; Kim, Yong Bae; Yoo, Sei Whan; Keum, Ki Chang; Kim, Gwi Eon; Choi, Eun Chang; Cha, In Ho

2009-01-01

Purpose: To analyze risk factors and the dose-effect relationship for osteoradionecrosis (ORN) of the mandible after radiotherapy of oral and oropharyngeal cancers. Materials and Methods: One-hundred ninety-eight patients with oral (45%) and oropharyngeal cancer (55%) who had received external radiotherapy between 1990 and 2000 were retrospectively reviewed. All patients had a dental evaluation before radiotherapy. The median radiation dose was 60 Gy (range, 16-75 Gy), and the median biologically effective dose for late effects (BED late ) in bone was 114 Gy 2 (range, 30-167 Gy 2 ). Results: The frequency of ORN was 13 patients (6.6%). Among patients with mandibular surgery, eight had ORN at the surgical site. Among patients without mandibular surgery, five patients had ORN on the molar area of the mandible. The median time to ORN was 22 months (range, 1-69 months). Univariate analysis revealed that mandibular surgery and Co-60 were significant risk factors for ORN (p = 0.01 and 0.04, respectively). In multivariate analysis, mandibular surgery was the most important factor (p = 0.001). High radiation doses over BED 102.6 Gy 2 (conventional dose of 54 Gy at 1.8 Gy/fraction) were also a significant factor for ORN (p = 0.008) and showed a positive dose-effect relationship in logistic regression (p = 0.04) for patients who had undergone mandibular surgery. Conclusions: Mandibular surgery was the most significant risk factor for ORN of mandible in oral and oropharyngeal cancers patients. A BED of 102.6 Gy 2 or higher to the mandible also significantly increases the risk of ORN.

Transmigration of mandibular second premolar in a patient with cleft lip and palate: case report

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Daniel Berretta Moreira Alves

2008-10-01

Full Text Available Disturbances involving abnormalities in tooth eruption are named ectopia. Transmigration is the name assigned to ectopia in the presence of teeth in areas distant from the alveolar process. Initial angulation of the tooth bud of the second premolar and premature loss of permanent mandibular 1st molars can influence the distal migration of the second premolar. Some studies have observed that ectopic teeth can be found in a variety of places around the oral cavity and also in other areas of the human body. There are records of teeth in the maxillary sinus, mandibular condyle, coronoid process, mandibular angle, orbit, palate, mentum and also the skin. The prevalence of tooth abnormalities is higher in children with cleft lip and palate compared to children without clefts. This paper presents a case report of migration of the mandibular left second premolar in a patient attending the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo (HRAC/USP, Brazil. Migration of the mandibular left 2nd premolar was confirmed by 8 panoramic and 1 periapical radiographs obtained during patient's treatment between 1978 and 2002, which were available in the files of the Department of Dental Radiology of HRAC/USP. It can be assumed that distal migration of the mandibular left 2nd premolar is not associated with presence of cleft lip and palate; observation of these two events in a same patient is rare, since no similar reported cases were found in the literature.

Proximal mandibular nerve block using electrolocation in 10 dogs undergoing mandibular surgery: a case series report.

OpenAIRE

Ravasio, Giuliano; D'Urso, Elisa Silvia; Macchioni, Chiara; Stefanello, Damiano

2016-01-01

Peripheral nerve block performed using electrical stimulation (i.e. electrolocation) is widely used for perioperative pain management during several surgical procedures in dogs (Campoy 2008), but few data are reported concerning its application to invasive maxillofacial surgery (Carotenuto et al 2011). The aim of this case series report is to evaluate the efficacy of proximal mandibular nerve block (PMNB) in perioperative pain management in dogs undergoing mandibulectomy. Ten dogs of various ...

Determination of mandibular border and functional movement protocols using an electromagnetic articulograph (EMA).

Science.gov (United States)

Fuentes, Ramon; Navarro, Pablo; Curiqueo, Aldo; Ottone, Nicolas E

2015-01-01

The electromagnetic articulograph (EMA) is a device that can collect movement data by positioning sensors at multiple points, measuring displacements of the structure in real time, as well as the acoustics and mechanics of speech using a microphone connected to the measurement system. The aim of this study is to describe protocols for the generation, measurement and visualization of mandibular border and functional movements in the three spatial planes (frontal, sagittal and horizontal) using the EMA. The EMA has transmitter coils that determine magnetic fields to collect information about movements from sensors located on different structures (tongue, palate, mouth, incisors, skin, etc.) and in every direction in an area of 300 mm. After measurement with the EMA, the information is transferred to a computer and read with the Visartico software to visualize the recording of the mandibular movements registered by the EMA. The sensors placed in the space between the three axes XYZ are observed, and then the plots created from the mandibular movements included in the corresponding protocol can be visualized, enabling interpretation of these data. Four protocols for the obtaining of images of the opening and closing mandibular movements were defined and developed, as well as border movements in the frontal, sagittal and horizontal planes, managing to accurately reproduce Posselt's diagram and Gothic arch on the latter two axes. Measurements with the EMA will allow more exact data to be collected in relation to the mandibular clinical physiology and morphology, which will permit more accurate diagnoses and application of more precise and adjusted treatments in the future.

Determination of mandibular border and functional movement protocols using an electromagnetic articulograph (EMA)

Science.gov (United States)

Fuentes, Ramon; Navarro, Pablo; Curiqueo, Aldo; Ottone, Nicolas E

2015-01-01

The electromagnetic articulograph (EMA) is a device that can collect movement data by positioning sensors at multiple points, measuring displacements of the structure in real time, as well as the acoustics and mechanics of speech using a microphone connected to the measurement system. The aim of this study is to describe protocols for the generation, measurement and visualization of mandibular border and functional movements in the three spatial planes (frontal, sagittal and horizontal) using the EMA. The EMA has transmitter coils that determine magnetic fields to collect information about movements from sensors located on different structures (tongue, palate, mouth, incisors, skin, etc.) and in every direction in an area of 300 mm. After measurement with the EMA, the information is transferred to a computer and read with the Visartico software to visualize the recording of the mandibular movements registered by the EMA. The sensors placed in the space between the three axes XYZ are observed, and then the plots created from the mandibular movements included in the corresponding protocol can be visualized, enabling interpretation of these data. Four protocols for the obtaining of images of the opening and closing mandibular movements were defined and developed, as well as border movements in the frontal, sagittal and horizontal planes, managing to accurately reproduce Posselt’s diagram and Gothic arch on the latter two axes. Measurements with the EMA will allow more exact data to be collected in relation to the mandibular clinical physiology and morphology, which will permit more accurate diagnoses and application of more precise and adjusted treatments in the future. PMID:26884903

Treatment of Two Canals in All Mandibular Incisor Teeth in the Same Patient

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Vandana B. Kokane

2014-01-01

Full Text Available The main reason for unfavourable outcome in endodontic treatment of mandibular incisor is the inability to detect the presence of second canal. Pain even after extirpation of complete pulp tissue from root canal of vital teeth is the main indication of hidden canals. The present case report is also on pain because of another neglected canal in all mandibular incisors in the same patient.

Prevalence and morphometric analysis of three-rooted mandibular first molars in a Brazilian subpopulation

Science.gov (United States)

Rodrigues, Clarissa Teles; de Oliveira-Santos, Christiano; Bernardineli, Norberti; Duarte, Marco Antonio Hungaro; Bramante, Clovis Monteiro; Minotti-Bonfante, Paloma Gagliardi; Ordinola-Zapata, Ronald

2016-01-01

ABSTRACT The knowledge of the internal anatomy of three-rooted mandibular molars may help clinicians to diagnose and plan the root canal treatment in order to provide adequate therapy when this variation is present. Objectives: To determine the prevalence of three-rooted mandibular molars in a Brazilian population using cone beam computed tomography (CBCT) and to analyze the anatomy of mandibular first molars with three roots through micro-CT. Material and Methods: CBCT images of 116 patients were reviewed to determine the prevalence of three-rooted first mandibular molars in a Brazilian subpopulation. Furthermore, with the use of micro-CT, 55 extracted three-rooted mandibular first molars were scanned and reconstructed to assess root length, distance between canal orifices, apical diameter, Vertucci's classification, presence of apical delta, number of foramina and furcations, lateral and accessory canals. The distance between the orifice on the pulp chamber floor and the beginning of the curvature and the angle of canal curvature were analyzed in the distolingual root. Data were compared using the Kruskal-Wallis test (α=0.05). Results: The prevalence of three-rooted mandibular first molars was of 2.58%. Mesial roots showed complex distribution of the root canal system in comparison to the distal roots. The median of major diameters of mesiobuccal, mesiolingual and single mesial canals were: 0.34, 0.41 and 0.60 mm, respectively. The higher values of major diameters were found in the distobuccal canals (0.56 mm) and the lower diameters in the distolingual canals (0.29 mm). The lowest orifice distance was found between the mesial canals (MB-ML) and the highest distance between the distal root canals (DB-DL). Almost all distal roots had one root canal and one apical foramen with few accessory canals. Conclusions: Distolingual root generally has short length, severe curvature and a single root canal with low apical diameter. PMID:27812625

Endodontic and periodontal treatments of a geminated mandibular first premolar.

Science.gov (United States)

Aryanpour, S; Bercy, P; Van Nieuwenhuysen, J-P

2002-02-01

To describe a rare case of gemination involving a mandibular first premolar. The complex morphology of geminated teeth renders their endodontic and periodontal management difficult. Root canal and periodontal treatments were performed on a geminated mandibular first premolar with three canals. Clinical examination showed two separated crowns with united roots. Radiographically, two distinct pulp chambers with two joined and a third independent canal were seen. Conventional root canal treatment resulted in complete healing of the apical lesion. However, the occurrence of a vertical fracture led to the extraction of the mesial segment. At the follow-up visit, the distal segment was clinically healthy and continued to satisfy functional demands.

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

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Yeliz Guven

2015-01-01

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

The anatomical relationship between the roots of mandibular second molars and the inferior alveolar nerve.

Science.gov (United States)

Chong, B S; Quinn, A; Pawar, R R; Makdissi, J; Sidhu, S K

2015-06-01

To evaluate the anatomical relationship between the roots of mandibular second molars and the inferior alveolar nerve (IAN) in relation to the risk of potential nerve injury during root canal treatment. Cone-beam computed tomography (CBCT) images from the patient record database at a dental hospital were selected. The anonymized CBCT images were reconstructed and examined in three planes (coronal, axial and sagittal) using 3D viewing software. The relationship between each root apex of mandibular second molars and the IAN was evaluated by measuring the horizontal and vertical distances from coronal CBCT sections, and the actual distance was then calculated mathematically using Pythagoras' theorem. In 55% of the 272 mandibular second molar roots evaluated, from a total of 134 scans, the distance between the anatomical root apex and the IAN was ≤3 mm. In over 50% of the cases evaluated, there was an intimate relationship between the roots of mandibular second molars and the inferior alveolar nerve (IAN). Therefore, root canal treatment of mandibular second molars may pose a more significant potential risk of IAN injury; necessary precautions should be exercised, and the prudent use of CBCT should be considered if an intimate relationship is suspected. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Contemporary Management of Mandibular Fracture Nonunion-A Retrospective Review and Treatment Algorithm.

Science.gov (United States)

Ostrander, Benjamin T; Wang, Howard D; Cusano, Alessandro; Manson, Paul N; Nam, Arthur J; Dorafshar, Amir H

2018-02-06

Nonunion is an uncommon complication after mandibular fractures. The purpose of this investigation was to compare outcomes of patients with mandibular fracture nonunion who were treated with a 1- versus 2-stage approach and propose a pragmatic treatment algorithm for surgical management based on preoperative characteristics. The authors conducted a retrospective study consisting of patients who presented to 2 level 1 trauma centers for the management of mandibular fracture nonunion over a 10-year period. The primary predictor variable was 1- versus 2-stage treatment. Outcomes were examined to propose a treatment algorithm. Eighteen patients were included in the study. The sample's mean age was 44.0 ± 19.3 years and most were men (88.9%). Mandibular angle and body accounted for 77.8% of cases. A single-stage approach was used in 13 patients (72.2%). Bone grafts or vascularized bone flaps were required in 13 patients (72.2%). Patients who required 2-stage treatments had intraoral soft tissue defects. Mean length of follow-up was 13.3 ± 20.4 months. All patients achieved bony union, with complications occurring in 5 patients (27.8%). The authors' 10-year experience was used to formulate a treatment algorithm based on bony defect size and soft tissue status, which can be used to inform optimal surgical management. Nonunion of mandibular fractures is an infrequent and complex condition requiring careful and deliberate surgical management. A single-stage approach is appropriate in most cases and does not negatively affect outcomes. Bony defect size and soft tissue status are essential parameters for determining the approach and timing of reconstruction. Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Avaliação dos resultados da redução aberta e da fixação interna das fraturas graves da extremidade proximal do úmero em idosos

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Alberto Naoki Miyazaki

2014-01-01

Full Text Available Objetivo: avaliar clinica e radiologicamente os resultados obtidos com a redução aberta e a fixação interna das fraturas graves da extremidade proximal do úmero (FGEPU na população com idade igual ou superior a 60 anos. Métodos: entre junho de 1992 e fevereiro de 2011, o Grupo de Ombro e Cotovelo do Departamento de Ortopedia e Traumatologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo tratou, com redução aberta e fixação interna, 21 pacientes com FGEPU e com idade superior a 60 anos. Desses, 18 foram reavaliados. Resultados: dois pacientes evoluíram com resultados excelentes, 12 bons, três regulares e um ruim. Portanto, verificamos que 77,7% evoluíram com bons e excelentes resultados. Todos os pacientes estavam satisfeitos com o tratamento e apenas três não retornaram às atividades prévias. As médias de mobilidade pós-operatória foram de 122° de elevação (90° -150°, 39° de rotação lateral (20 °-60° e T11 de rotação medial (T5 a Glúteo. Conclusão: a redução aberta e a fixação interna das FGEPU podem ser indicadas também para pacientes idosos e obtivemos 77,7% de bons e excelentes resultados. Estatisticamente (p < 0,05, a redução anatômica da fratura mostrou-se importante para a obtenção de bons resultados.

Association between third mandibular molar impaction and degree of root development in adolescents

DEFF Research Database (Denmark)

Lauesen, Søren Rødsgaard; Andreasen, Jens O; Gerds, Thomas Alexander

2013-01-01

of the mandibular third molar region from 132 subjects (71 male and 61 female) from 15 to 20 years of age. Based on the films, 264 lower third molars were classified into an eruption and an impaction group. Root development was recorded according to a quantitative method described by Haavikko (1970......: Delayed mandibular third molar root development is associated with impaction. Radiographs taken at age 15 may predict the risk of impaction and thereby guide decision making for the orthodontist or the oral and maxillofacial surgeon.......Abstract Objective: To compare the root development and the growth rate of the mandibular third molar (M3 inf) in individuals where the M3 inf erupted vs individuals exhibiting M3 inf impaction. Materials and Methods: Serial standardized intraoral radiographs (Eggen technique) were taken annually...

[Exploring a new method for superimposition of pre-treatment and post-treatment mandibular digital dental casts in adults].

Science.gov (United States)

Dai, F F; Liu, Y; Xu, T M; Chen, G

2018-04-18

To explore a cone beam computed tomography (CBCT)-independent method for mandibular digital dental cast superimposition to evaluate three-dimensional (3D) mandibular tooth movement after orthodontic treatment in adults, and to evaluate the accuracy of this method. Fifteen post-extraction orthodontic treatment adults from the Department of Orthodontics, Peking University School and Hospital of Stomatology were included. All the patients had four first premolars extracted, and were treated with straight wire appliance. The pre- and post-treatment plaster dental casts and craniofacial CBCT scans were obtained. The plaster dental casts were transferred to digital dental casts by 3D laser scanning, and lateral cephalograms were created from the craniofacial CBCT scans by orthogonal projection. The lateral cephalogram-based mandibular digital dental cast superimposition was achieved by sequential maxillary dental cast superimposition registered on the palatal stable region, occlusal transfer, and adjustment of mandibular rotation and translation obtained from lateral cephalogram superimposition. The accuracy of the lateral cephalogram-based mandibular digital dental cast superimposition method was evaluated with the CBCT-based mandibular digital dental cast superimposition method as the standard reference. After mandibular digital dental cast superimposition using both methods, 3D coordinate system was established, and 3D displacements of the lower bilateral first molars, canines and central incisors were measured. Differences between the two superimposition methods in tooth displacement measurements were assessed using the paired t-test with the level of statistical significance set at Pdigital dental cast superimposition methods in 3D displacements of the lower first molars, and sagittal and vertical displacements of the canines and central incisors; transverse displacements of the canines and central incisors differed by (0.3±0.5) mm with statistical significance

Tooth axis and skeletal structures in mandibular molar vertical sections in jaw deformity with facial asymmetry using MPR images

International Nuclear Information System (INIS)

Nojima, Kunihiko; Yokose, Taishi; Ishii, Takenobu; Kobayashi, Makoto; Nishii, Yasushi

2007-01-01

The objective of the present study was to investigate frontal morphological asymmetry in the mandibular molar region in terms of tooth axis and skeletal structures using vertical MPR sections in jaw deformity accompanied by facial asymmetry. Subjects consisted of 15 patients with jaw deformity accompanied by facial asymmetry aged 17.4 years to 37.8 years. There were four men and eleven women. Based on X-ray computed tomography (CT) scans, Digital Imaging and Communications in Medicine (DICOM) viewer software was used to prepare multiplanar reconstruction (MPR) sections. The mandible was then positioned on a reference plane based on the menton and left and right gonions, and a vertical MPR section passing through the mesial root of the first mandibular molar was prepared. The following measurements were made on both the shifted and non-shifted sides: maximum buccolingual width of the mandibular body; height of the mandibular body; inclination angle of the mandibular body; degree of buccal protrusion of the mandibular body; and inclination angle of the buccolingual tooth axis of the first molar. Furthermore, degree of median deviation in the menton was measured using frontal cephalograms. Differences in morphological parameters between the shifted and non-shifted sides were assessed. Furthermore, the relationship between median deviation and asymmetry were statistically analyzed. There was no significant asymmetry in the maximum buccolingual width of the mandibular body, the height of the mandibular body or the degree of buccal protrusion of the mandibular body. However, when compared to the shifted side, the inclination angle of the buccolingual tooth axis of the first molar for the non-shifted side was significantly greater. There was a relatively strong correlation between median deviation and inclination angle of the mandibular body. The above findings clarified that, in orthognathic surgery for jaw deformity accompanied by facial asymmetry, actively improving

Use of personal computers for Gothic arch tracing: analysis and evaluation of horizontal mandibular positions with edentulous prosthesis.

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Watanabe, Y

1999-11-01

Determining mandibular position for an edentulous patient raises the question of whether to emphasize centric relation or muscular position. This challenge results from the lack of a convenient procedure for quantifying the horizontal mandibular position, which can be determined by a variety of methods. This study analyzed and evaluated the horizontal mandibular positions produced by different guidance systems. Twenty-six edentulous subjects with no clinical evidence of abnormality of temporomandibular disorder were selected. Horizontal position data for the mandible obtained by gothic arch tracing was loaded into a personal computer by setting the sensor portion of a digitizer into the oral cavity to serve as a miniature lightweight tracing board. By connecting this with a digitizer control circuit set in an extraoral location, each mandibular position was displayed in a distinguishable manner on a computer display in real time, then recorded and analyzed. The gothic arch apex and tapping point varied, depending on body position. In the supine position, the gothic arch apex and the tapping point were close to the mandibular position determined by bilateral manipulation. This system provides effective data concerning mandibular positions for fabrication of dentures.

[3D mandibular distraction planification in a case of severe temporomandibular ankylosis].

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Weber, E; Meyer, C; Ernoult, C; Chatelain, B; Benassarou, M

2015-06-01

When occurring in childhood, temporomandibular ankylosis joint is responsible for complex maxillofacial deformities, including mandibular growth deficiency. We present a case of temporomandibular joint ankylosis associated with severe mandibular asymmetry treated by mandibular bone distraction performed under computer assistance. A 27-year-old patient presented with a severe facial asymmetry consisting in hypoplasia of the left hemi-mandible and maxilla. Mouth opening was non-existent. The CT-scan showed a left temporomandibular ankylosis. A left mandibular distraction was decided. The distraction characteristics (choice and positioning of the distractor, axis and amount of distraction) were determined preoperatively on the 3D CT-scan. The planning has been transferred to a navigation console (Kolibri®, Brainlab®). A combined intraoral and cutaneous was performed. Navigation allowed for an appropriate placement of the osteotomy line and fixation of the distractor. Distraction was started at the 5th postoperative day at the rate of 1mm per day and lasted 25 days without complication. 3D planning allows for better indication setting, better preparation of the procedure, reducing complications and operative time. It may help as an educational tool for young surgeons and for a better understanding from the patient. Navigation is an accurate method for the transfer of the planning in the operation room. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Visibility of the mandibular canal on cross-sectional CBCT images at impacted mandibular third molar sites

International Nuclear Information System (INIS)

Alkhader, Mustafa; Jarab, Fadi

2016-01-01

The aim of the present study was to assess visibility of the mandibular canal (MC) on cross-sectional cone beam CT (CBCT) images at impacted mandibular third molar (IMTM) sites. CBCT images for 150 IMTMs were selected for the study. The type of tooth impaction (horizontal, vertical, mesial and distal) and location of the MC (inferior in contact and superimposed) were evaluated on pseudo panoramic images. Cross-sectional images were generated and two observers evaluated the location of the MC (buccal, lingual, inter-radicular and inferior) and its visibility using 3-point scoring scale: (1-3, good-excellent). Kruskal-Wallis test was used to examine the differences in the visibility of the MC according to its location and the type of tooth impaction. The visibility scores of the MC were good, very good and excellent at 3, 25 and 122 IMTM sites, respectively. There were no statistically significant differences in the visibility scores of the MC according to its location or the type of tooth impaction (P < 0.05). Therefore, despite the different locations of the MC and different types of tooth impaction at IMTM sites, the visibility of the MC was excellent on most of the cross-sectional CBCT images. CBCT is considered a valuable diagnostic tool for achieving these results

Two-Implant-Supported Mandibular Overdentures: Do Clinical Denture Quality and Inter-Implant Distance Affect Patient Satisfaction?

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Alfadda, Sara A; Al Amri, Mohammad D; Al-Ohali, Amal; Al-Hakami, Arwa; Al-Madhi, Noura

To investigate the following three null hypotheses in patients rehabilitated with a mandibular overdenture supported by two unsplinted implants: (1) patient satisfaction is not related to the clinical quality of the dentures; (2) inter-implant distance (IID) has no effect on the clinical quality of the dentures; and (3) IID does not influence patient satisfaction. Forty edentulous patients who were rehabilitated with a two-implant-supported mandibular overdenture participated in the study. Independent investigators evaluated the dentures on the basis of five clinical criteria using the validated Denture Quality Evaluation Form, and the patients completed the validated Denture Satisfaction Scale. Irreversible hydrocolloid impressions of the mandible were made and poured immediately in die stone. The IID was measured by adapting an orthodontic wire to the mandibular alveolar ridge crest, extending from the center of one implant to the center of the other. Spearman correlation analyses were used to identify possible correlations, with a significance level set at P overdenture and of the maxillary conventional complete denture was significantly related to satisfaction (r = 0.389 and r = 0.44, respectively). Significant associations were found between the mandibular stability items and satisfaction with both maxillary and mandibular dentures. The stability of the maxillary denture was significantly associated with patient satisfaction with mandibular denture retention, stability, and comfort. None of the 12 denture satisfaction items were significantly associated with IID. Similarly, IID did not have an effect on the quality of either denture in terms of retention, stability, or occlusion. Denture stability was the feature that had the most influence on patient satisfaction with the mandibular overdenture and with the maxillary conventional denture. IID had no effect on the clinical quality of either denture and did not influence patient satisfaction.

The Influence of a Mandibular Advancement Plate on Polysomnography in Different Grades of Obstructive Sleep Apnea

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Antti Raunio

2015-03-01

Full Text Available Objectives: The purpose of this study was to investigate the effect of a mandibular advancement device on different grades of obstructive sleep apnea using a relatively simple test for the apnea-hypopnea index to determine if a mandibular device will be effective. Material and Methods: A total of 68 patients with obstructive sleep apnea syndrome (OSAS including, 31 with mild, 23 with moderate and 14 with severe OSAS were treated with a mandibular advancement device (MAD and monitored with polysomnography. Results: 25 of the 31 mild, 15 of the 23 moderate and 2 of the 14 severe OSAS patients were cured of their OSAS if a post treatment apnea-hypopnea index of less than 5 is regarded as cured. The odds ratios for success with MAD therapy are 3 for women over men, 14.9 for mild obstructive sleep apnea, 5.42 for moderate obstructive sleep apnea if severe obstructive sleep apnea is assigned an odds ratio of 1. Conclusions: The use of the apnea-hypopnea index alone is useful in mild and moderate disease to predict the effectiveness of mandibular advancement device. Treatment with a mandibular advancement device is very effective in treating mild and moderate obstructive sleep apnea. Conservative treatment with a mandibular advancement device can be successful in less severe grades of sleep apnea and may be an alternative for non-surgical patients with severe obstructive sleep apnea intolerant of Continuous Positive Airway Pressure management.

Patient satisfaction and prosthetic aspects with mini-implants retained mandibular overdentures. A 5-year prospective study.

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Elsyad, Moustafa Abdou

2016-07-01

This study aimed to evaluate patient satisfaction and prosthetic aspects during a 5-year prospective clinical study of mini dental implants (MDIs) retaining mandibular overdentures. This observational prospective clinical study was conducted on a group of completely edentulous patients (n = 28) with retention problems of conventional mandibular dentures. All patients received new maxillary and mandibular conventional dentures. A total of 112 MDIs (four per patient) were inserted using the flapless surgical approach and immediately loaded by the new mandibular dentures (overdentures). Patients indicated satisfaction with their prosthesis using a questionnaire and a visual analogue scale (VAS). Patient satisfaction and prosthetic complications were recorded 6 months (T6 m ), 1 (T1), 3 (T3), and 5 (T5) years after overdenture insertion. The patient satisfaction with eating (hard/soft) food (P teeth (n = 10), overdentures relines (n = 10), detachment of the metal housings (n = 9), and fracture of mandibular overdentures (n = 8). Mucositis, soreness, and decubitis ulcer under overdenture occurred most often at T6 m and decreased significantly with time (P = 0.002, 0.005, and 0.024, respectively). Within the limitations of this clinical study, patient satisfaction with mini-implant retained mandibular overdentures increased significantly with time. However, this treatment required a considerable amount of prosthetic maintenance and repair after 5 years of service. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of root canal morphology of human mandibular incisors in Yazd

Directory of Open Access Journals (Sweden)

Tabrizi-zadeh M. Assistant Professor

2003-06-01

Full Text Available Statement of Problem: The main objective of endodontic therapy is chemomechanical cleansing of entire pulp cavity and its complete obturation with an inert material. During this procedure, the failure of detection and inadequate cleaning of a canal will result in failed endodontic therapy. Therefore, the dentist must have enough knowledge of root canal morphology to treat a tooth successfully."nAim: The aim of this study was to determine the number and type of root canals of mandibular incisor teeth."nMaterials and Methods: In order to do this in-vitro, descriptive study, 68 non-carious mandibular incisor teethj collected from different clinics in Yazd, were immersed in indian ink, decalcified and cleared."nResults: It was found that 55.9% of the teeth had two separate canals that in 5.5% of them, the canals"nmerged before' apical foramen. In 4.4% of these samples, two separate canals existed along the whole"nroot."nConclusion: Considering high percentage of two canals in lower mandibular incisors, during access preparation, more attempts in detection of the second canal, is emphasized.

[Pre- and post-surgical orthodontic treatment of mandibular asymmetry and prognathism].

Science.gov (United States)

Chen, Song; Chen, Yang-xi; Hu, Jing

2005-01-01

The purpose of this study was to analyze the pre- and post surgical orthodontic treatment of mandibular asymmetry and prognathism in our hospital, and to summarize some helpful experiences for future clinical work. The data were derived from 21 adults aged from 19 - 28 years who had severe mandibular asymmetry and prognathism. The ANB angle of all patients is from -3 degrees to -8 degrees. The value of wits of all patients is from -7 mm to -14 mm. The deviation of chin point of all patients is from 3 mm to 7 mm. The duration of pre- and post-surgical orthodontic treatment was 10-20 months (mean 18 months) and 5-10 months (mean 7.5 months), respectively. The keys in pre-surgical orthodontic treatment include (1) three dimensional dental decompensation; (2) arch form and transverse discrepancy correction; (3) model surgery and the splint making. The main objective of post surgical orthodontic treatment is to detail the occlusion. Pre- and post surgical orthodontic treatment is essential for the orthognathic treatment of patients with mandibular asymmetry and prognathism.

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

OpenAIRE

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 ov...

Neuromandibular integration in humans and chimpanzees: Implications for dental and mandibular reduction in Homo.

Science.gov (United States)

Veneziano, Alessio; Meloro, Carlo; Irish, Joel D; Stringer, Chris; Profico, Antonio; De Groote, Isabelle

2018-05-08

Although the evolution of the hominin masticatory apparatus has been linked to diet and food processing, the physical connection between neurocranium and lower jaw suggests a role of encephalization in the trend of dental and mandibular reduction. Here, the hypothesis that tooth size and mandibular robusticity are influenced by morphological changes in the neurocranium was tested. Three-dimensional landmarks, alveolar lengths, and mandibular robusticity data were recorded on a sample of chimpanzee and human skulls. The morphological integration between the neurocranium and the lower jaw was analyzed by means of Singular Warps Analysis. Redundancy Analysis was performed to understand if the pattern of neuromandibular integration affects tooth size and mandibular robusticity. There is significant morphological covariation between neurocranium and lower jaw in both chimpanzees and humans. In humans, changes in the temporal fossa seem to produce alterations of the relative orientation of jaw parts, while the influence of similar neurocranial changes in chimpanzees are more localized. In both species, postcanine alveolar lengths and mandibular robusticity are associated with shape changes of the temporal fossa. The results of this study support the hypothesis that the neurocranium is able to affect the evolution and development of the lower jaw, although most likely through functional integration of mandible, teeth, and muscles within the masticatory apparatus. This study highlights the relative influence of structural constraints and adaptive factors in the evolution of the human skull. © 2018 Wiley Periodicals, Inc.

Cervical vertebral maturation method and mandibular growth peak: a longitudinal study of diagnostic reliability.

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Perinetti, Giuseppe; Primozic, Jasmina; Sharma, Bhavna; Cioffi, Iacopo; Contardo, Luca

2018-03-28

The capability of the cervical vertebral maturation (CVM) method in the identification of the mandibular growth peak on an individual basis remains undetermined. The diagnostic reliability of the six-stage CVM method in the identification of the mandibular growth peak was thus investigated. From the files of the Oregon and Burlington Growth Studies (data obtained between early 1950s and middle 1970s), 50 subjects (26 females, 24 males) with at least seven annual lateral cephalograms taken from 9 to 16 years were identified. Cervical vertebral maturation was assessed according to the CVM code staging system, and mandibular growth was defined as annual increments in Co-Gn distance. A diagnostic reliability analysis was carried out to establish the capability of the circumpubertal CVM stages 2, 3, and 4 in the identification of the imminent mandibular growth peak. Variable durations of each of the CVM stages 2, 3, and 4 were seen. The overall diagnostic accuracy values for the CVM stages 2, 3, and 4 were 0.70, 0.76, and 0.77, respectively. These low values appeared to be due to false positive cases. Secular trends in conjunction with the use of a discrete staging system. In most of the Burlington Growth Study sample, the lateral head film at age 15 was missing. None of the CVM stages 2, 3, and 4 reached a satisfactorily diagnostic reliability in the identification of imminent mandibular growth peak.