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Sample records for irradiated mandibular autografts

  1. ACL reconstruction with BPTB autograft and irradiated fresh frozen allograft

    Institute of Scientific and Technical Information of China (English)

    Kang SUN; Shao-qi TIAN; Ji-hua ZHANG; Chang-suo XIA; Cai-long ZHANG; Teng-bo YU

    2009-01-01

    Objective: To analyze the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with irradiated bone-patellar tendon-bone (BPTB) allograft compared with non-irradiated allograft and autograft. Methods: All BPTB allografts were obtained from a single tissue bank and the irradiated allografts were sterilized with 2.5 mrad of irradiation prior to distribution. A total of 68 patients undergoing arthroscopic ACL reconstruction were prospectively randomized consecutively into one of the two groups (autograft and irradiated allograft groups). The same surgical technique was used in all operations done by the same senior surgeon. Before surgery and at the average of 31 months of follow-up (ranging from 24 to 47 months), patients were evaluated by the same observer according to objective and subjective clinical evaluations. Results: Of these patients, 65 (autograft 33, irradiated allograft 32) were available for full evaluation. When the irradiated allograft group was compared to the autografi group at the 31-month follow-up by the Lachman test, the anterior drawer test (ADT), the pivot shift test, and KT-2000 arthrometer test, statistically significant differences were found. Most importantly, 87.8% of patients in the autograft group and just only 31.3% in the irradiated allograft group had a side-to-side difference of less than 3 mm according to KT-2000. The failure rate of the ACL reconstruction with irradiated allograft (34.4%) was higher than that with autograft (6.1%). The anterior and rotational stabilities decreased significantly in the irradiated allograft group. According to the overall International Knee Docu-mentation Committee (IKDC), functional and subjective evaluations, and activity level testing, no statistically significant dif-ferences were found between the two groups. Besides, patients in the irradiated allograft group had a shorter operation time and a longer duration of postoperative fever. When the patients had a fever

  2. Anterior cruciate ligament reconstruction with BPTB autograft, irradiated versus non-irradiated allograft: a prospective randomized clinical study.

    Science.gov (United States)

    Sun, Kang; Tian, Shaoqi; Zhang, Jihua; Xia, Changsuo; Zhang, Cailong; Yu, Tengbo

    2009-05-01

    The effect of using gamma irradiation to sterilize bone-patellar tendon-bone (BPTB) allograft on the clinical outcomes of anterior cruciate ligament (ACL) reconstruction with irradiated allograft remains controversial. Our study was aimed to analyze the clinical outcomes of arthroscopic ACL reconstruction with irradiated BPTB allograft compared with non-irradiated allograft and autograft. All BPTB allografts were obtained from a single tissue bank and the irradiated allografts were sterilized with 2.5 Mrad of irradiation prior to distribution. A total of 102 patients undergoing arthroscopic ACL reconstruction were prospectively randomized consecutively into three groups. The same surgical technique was used in all operations done by the same senior surgeon. Before surgery and at the average of 31 months follow-up (range 24-47 months) patients were evaluated by the same observer according to objective and subjective clinical evaluations. Of these patients, 99 (autograft 33, non-irradiated allograft 34, irradiated allograft 32) were available for full evaluation. When compared the irradiated allograft group to non-irradiated allograft group or autograft group at 31 months follow-up by the Lachman test, ADT, pivot shift test and KT-2000 arthrometer testing, statistically significant differences were found. Most importantly, 87.8% of patients in the Auto group, 85.3% in the Non-Ir-Auto group and just only 31.3% in the Ir-Allo group had a side-to-side difference of less than 3 mm according to KT-2000. The failure rate of the ACL reconstruction with irradiated allograft (34.4%) was higher than that with autograft (6.1%) and non-irradiated allograft (8.8%). The anterior and rotational stability decreased significantly in the irradiated allograft group. According to the overall IKDC, functional, subjective evaluations and activity level testing, no statistically significant differences were found between the three groups. However, there was a trend that the functional and

  3. Outcomes of stage IIB osteosarcoma treated by limb salvage surgery using extracorporeally irradiated (ECI autograft

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    Achmad F. Kamal

    2011-05-01

    Full Text Available Background: Extracorporeally irradiated (ECI technique is an alternative of limb salvage procedure in treating osteosarcoma regarding limitation of endoprosthesis and allograft. This study evaluated the outcomes of limb salvage surgery using extracorporeally irradiated (ECI autograft and its correlation with patient’s characteristics.Methods: Retrospective cohort design was performed to study 20 patients with stage IIB osteosarcoma treated by ECI autograft from 1995 to 2008. Survival, local recurrence, metastases, complications, union time and functional score based on Musculoskeletal Tumor Society scoring system-(MSTS were evaluated. Kaplan-Meier method was used to describe survival, local recurrence free survival, and metastases free survival. The correlation among patient’s characteristics that were age, gender, duration, site of tumor size, type of osteosarcoma, SAP (serum alkaline phosphatase level, type of biopsy, and type of Huvos were analyzed by Log rank test. Chi-square test was used to analyze the correlation between MSTS score and patient’s characteristics, local recurrence, metastases, complications.Results: Five-year survival was 54.97 ± 9.8 %, five-year local recurrence free survival was 66.5 ± 7.6%, and five year metastasis-free survival was 57.13 ± 10.04%. Six patients died, five were due to lung metastases and one due to complication of chemotherapy. Three underwent amputation after local recurrence. Kaplan-Meier curve showed that a good type of Huvos (III, IV always gave better survival, local recurrence free survival, and metastases free survival than poor type of Huvos (I,II. Normal SAP level gave better local recurrence free survival compare to increased level of SAP. Mean of union rate was 8.13 months. MSTS mean score was good (70.63% in patients with no evidence of disease. MSTS score was poor in patients with local recurrence (p = 0.025, metastases (p = 0.01, complications (p = 0.03, and the

  4. Reconstruction of mandibular defects in irradiated patients

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    Klotch, D.W.; Gump, J.; Kuhn, L. (Univ. of South Florida, Tampa (USA))

    1990-10-01

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

  5. A magnetic resonance imaging study on changes in rat mandibular bone marrow and pulp tissue after high-dose irradiation

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    Lee, Wan; Lee, Byung Do [Dept. of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan (Korea, Republic of); Lee, Kang Kyoo [Dept. of Radiation Oncology, School of Medicine, Wonkwang University, Iksan (Korea, Republic of); Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju (Korea, Republic of)

    2014-03-15

    This study was designed to evaluate whether magnetic resonance imaging (MRI) is appropriate for detecting early changes in the mandibular bone marrow and pulp tissue of rats after high-dose irradiation. The right mandibles of Sprague-Dawley rats were irradiated with 10 Gy (Group 1, n=5) and 20 Gy (Group 2, n=5). Five non-irradiated animals were used as controls. The MR images of rat mandibles were obtained before irradiation and once a week until week 4 after irradiation. From the MR images, the signal intensity (SI) of the mandibular bone marrow and pulp tissue of the incisor was interpreted. The MR images were compared with the histopathologic findings. The SI of the mandibular bone marrow had decreased on T2-weighted MR images. There was little difference between Groups 1 and 2. The SI of the irradiated groups appeared to be lower than that of the control group. The histopathologic findings showed that the trabecular bone in the irradiated group had increased. The SI of the irradiated pulp tissue had decreased on T2-weighted MR images. However, the SI of the MR images in Group 2 was high in the atrophic pulp of the incisor apex at week 2 after irradiation. These patterns seen on MRI in rat bone marrow and pulp tissue were consistent with histopathologic findings. They may be useful to assess radiogenic sclerotic changes in rat mandibular bone marrow.

  6. Micro-CT evaluation of the radioprotective effect of resveratrol on the mandibular incisors of irradiated rats

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    Rezende Barbosa, Gabriella Lopes de; Almeida, Solange Maria de, E-mail: gabriellalopes@live.com [Universidade de Campinas (UNICAMP), Piracicaba, SP (Brazil). Escola de Odontologia. Departmento de Diagnostico Oral; Pimenta, Luiz Andre [University of North Carolina at Chapel Hill, School of Dentistry, Department of Dental Ecology, Chapel Hill, NC (United States)

    2016-05-01

    The purpose of this study was to perform a micro computerized tomographic evaluation of the radioprotective effect of resveratrol on the volume of mandibular incisors of irradiated rats. A second aim was to make a quantitative assessment of the effect of x-ray exposure on these dental tissues. Twenty adult male rats were divided into four groups: control, irradiated control, resveratrol, and irradiated resveratrol. The resveratrol groups received 100 mg/kg of resveratrol, whereas the irradiated groups were exposed to 15 Gy of irradiation. The animals were sacrificed 30 days after the irradiation procedure, and their mandibles were removed and scanned in a micro computerized tomography unit. The images were loaded into Mimics software to allow segmentation of the mandibular incisor and assessment of its volume. The results were compared by One-way ANOVA and Tukey's post hoc test, considering a 5% significance level. The irradiated groups showed significantly diminished volumes of the evaluated teeth, as compared with the control group (p < 0.05). The resveratrol group presented higher values than those of the irradiated groups, and volumes similar to those of the control group. High radiation doses significantly affected tooth formation, resulting in alterations in the dental structure, and thus lower volumes. Moreover, resveratrol showed no effective radioprotective impact on dental tissues. Future studies are needed to evaluate different concentrations of this substance, in an endeavor to verify its potential as a radioprotector for these dental tissues. (author)

  7. Micro-CT evaluation of the radioprotective effect of resveratrol on the mandibular incisors of irradiated rats

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    Gabriella Lopes DE REZENDE BARBOSA

    2016-01-01

    Full Text Available Abstract The purpose of this study was to perform a microcomputed tomographic evaluation of the radioprotective effect of resveratrol on the volume of mandibular incisors of irradiated rats. A second aim was to make a quantitative assessment of the effect of x-ray exposure on these dental tissues. Twenty adult male rats were divided into four groups: control, irradiated control, resveratrol, and irradiated resveratrol. The resveratrol groups received 100 mg/kg of resveratrol, whereas the irradiated groups were exposed to 15 Gy of irradiation. The animals were sacrificed 30 days after the irradiation procedure, and their mandibles were removed and scanned in a microcomputed tomography unit. The images were loaded into Mimics software to allow segmentation of the mandibular incisor and assessment of its volume. The results were compared by One-way ANOVA and Tukey’s post hoc test, considering a 5% significance level. The irradiated groups showed significantly diminished volumes of the evaluated teeth, as compared with the control group (p < 0.05. The resveratrol group presented higher values than those of the irradiated groups, and volumes similar to those of the control group. High radiation doses significantly affected tooth formation, resulting in alterations in the dental structure, and thus lower volumes. Moreover, resveratrol showed no effective radioprotective impact on dental tissues. Future studies are needed to evaluate different concentrations of this substance, in an endeavor to verify its potential as a radioprotector for these dental tissues.

  8. Autograft versus allograft in anterior cruciate ligament reconstruction

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    Kan, Shun-Li; Yuan, Zhi-Fang; Ning, Guang-Zhi; Yang, Bo; Li, Hai-Liang; Sun, Jing-Cheng; Feng, Shi-Qing

    2016-01-01

    Abstract Background: Anterior cruciate ligament (ACL) reconstruction is considered as the standard surgical procedure for the treatment of ACL tear. However, there is a crucial controversy in terms of whether to use autograft or allograft in ACL reconstruction. The purpose of this meta-analysis is to compare autograft with allograft for patients undergoing ACL reconstruction. Methods: PubMed, EMBASE, and the Cochrane Library were searched for randomized controlled trials that compared autograft with allograft in ACL reconstruction up to January 31, 2016. The relative risk or mean difference with 95% confidence interval was calculated using either a fixed- or random-effects model. The risk of bias for individual studies according to the Cochrane Handbook. The trial sequential analysis was used to test the robustness of our findings and get more conservative estimates. Results: Thirteen trials were included, involving 1636 participants. The results of this meta-analysis indicated that autograft brought about lower clinical failure, better overall International Knee Documentation Committee (IKDC) level, better pivot-shift test, better Lachman test, greater Tegner score, and better instrumented laxity test (P allograft. Autograft was not statistically different from allograft in Lysholm score, subjective IKDC score, and Daniel 1-leg hop test (P > 0.05). Subgroup analyses demonstrated that autograft was superior to irradiated allograft for patients undergoing ACL reconstruction in clinical failure, Lysholm score, pivot-shift test, Lachman test, Tegner score, instrumented laxity test, and subjective IKDC score (P allograft. Conclusions: Autograft is superior to irradiated allograft for patients undergoing ACL reconstruction concerning knee function and laxity, but there are no significant differences between autograft and nonirradiated allograft. However, our results should be interpreted with caution, because the blinding methods were not well used. PMID

  9. Morphometric Study of the Irradiation Effect on the Cartilage Formation in the Rat Mandibular Condyle

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    Kim, Jeong Hwa; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1999-02-15

    This study was undertaken to quantitatively estimate the degree of the damage and recovery of the irradiated rat condylar cartilage using the Image Analyzer. Experimental animals were 16 male rats of the Sprague-Dawley strain at the age of 20 day irradiated with the dose of 10 Gy in their head and neck region. Four rats were sacrificed at the each of the following time intervals - 1, 4, 7 and 14 days, respectively. The same number of control group animals were sacrificed at the each age of 21, 24, 27 and 34 days, respectively. The specimens were stained with 0.5% toluidine blue and examined with light microscope. The condylar cartilage was divided into 4 zones; fibrous zone, proliferating zone, upper hypertrophic zone, and lower hypertrophic zone. And then, the proliferating zone was subdivided into 2 layers - upper and lower layer, and upper and lower hypertrophic zone were subdivided into three layers, respectively - upper, middle and lower layer. With the aid of Image Analyzer, morphometric analysis was performed. The thickness, the numerical density of cells, the cell area density, the extracellular matrix area density, the mean area of single cell, the mean area of extracellular matrix per single cell were measured and analysed. In the experimental group, the thickness of the fibrous zone was slightly increased and that of the proliferating zone and the upper and the lower hypertrophic zone was markedly decreased. With time, the thickness of the fibrous zone was gradually increased and that of the proliferating zone and the upper and the lower hypertrophic zone was steadily in the decreased state. The numerical density of cells of the proliferating zone was increased on post-irradiated 1 day, but decreased after post-irradiated 4 day, and that of the upper hypertrophic zone was decreased. The numerical density of cells of the lower hypertrophic zone was decreased in the early stage and then was decreased or not significantly different from that of the control

  10. Anterior cruciate ligament reconstruction with bone patellar tendon bone autograft, irradiated versus non-irradiated deep frozen allograft%自体与γ射线照射和非照射异体骨-髌腱-骨重建前十字韧带的比较研究

    Institute of Scientific and Technical Information of China (English)

    孙康; 田少奇; 张积华; 张才龙; 夏长所; 于腾波

    2009-01-01

    Objective Analyze the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with bone patellar tendon bone (B-PT-B) allograft or autograft. Methods A total of 107 patients underwent same arthroscopie ACL reconstruction technique were randomized into three groups (A: autograft 36, B: non-irradiated deep-frozen allograft 36, C: irradiated allograft 35). Before surgery and at follow-up, patients were evaluated by general conditions, pivot shift test, Lachman and Anterior Drawer Test (ADT), KT-2000 arthrometer testing, Daniel one-leg hop test, overall IKDC rating, Lysholm and Tegner activ-ity score. Results A total of 103 patients were available for full evaluation. The mean follow-up time of A, B and C groups were 39.5, 36.3 and 37.6 months respectively. 1) In A group, patellar fracture occurred in 1 patient and anterior knee pain occurred in 2. In B group, 1 patient had late septic infection. Patients in the B and C groups underwent shorter operation time and longer fever time. There was no difference between the three groups in hospital stay time. 2) According to pivot shift test, Lachman test, ADT, and KT-2000 arthrom-eter testing, differences were found between C group to A or B groups, while no statistically significant dif-ferences between A and B groups. The failure rate in C group (36%) was higher than that with A (8%) and B group (9%). According to Daniel one-leg hop test, the overall IKDC, Lysholm and Tegner activity score, no differences were found between the three groups. Conclusion Patients underwent ACL reconstruction with B-PT-B non-irradiated deep-frozen allograft or autograft had similar clinical outcomes. Non-irradiated B-PT-B allograft is a reasonable alternative to autograft. While the anterior and rotational stability decreased signifi-cantly, when irradiated B-PT-B allograft was used.%目的 比较自体与γ射线照射和非照射异体骨-髌腱-骨(bone patellar tendon bone,B-PT-B)重

  11. Increased Risk of Revision after ACL Reconstruction with Soft Tissue Allograft Compared to Autograft

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    Maletis, Gregory; Chen, Jason; Inacio, Maria Carolina Secorun; Love, Rebecca; Funahashi, Tadashi Ted

    2016-01-01

    Objectives: The use of allograft tissue for anterior cruciate ligament reconstruction (ACLR) remains controversial. Numerous meta-analysis and systematic reviews of small clinical studies have not found differences between autograft and allograft outcomes but large registry studies have shown an increased risk of revision with allografts. The purpose of this study was to compare the risk of aseptic revision between bone-patellar tendon-bone (BPTB) autografts, hamstring tendon autografts and soft tissue allografts. Methods: A retrospective cohort study of prospectively collected data was conducted using an US ACLR Registry. A cohort of primary unilateral ACLR cases reconstructed with BPTB autografts, hamstring autografts and soft tissue allografts (from any site) was identified. Aseptic revision was the end point of the study. Type of graft and allograft processing methods (non-processed, 1.8 Mrads irradiation with and without chemical processing, and chemical processing alone (BioCleanse)) were the exposures of interest evaluated. Time from surgery was evaluated as an effect modifier. All analyses were adjusted for age, gender, and race. Kaplan-Meier curves and Cox proportional hazard models were employed. Hazard ratios (HR), 95% confidence intervals (CI) are provided. Results: The cohort had 14015 cases, 8924 (63.7%) were male, 6397 (45.6%) were White, 4557 (32.5%) cases used BPTB autograft, 3751 (26.8%) cases used soft tissue allograft and 5707 (40.7%) cases used hamstring autograft. The median age was 34.6 years-old (IQR 24.1-43.2) for allograft cases and 24.3 years-old (IQR 17.7-33.8) for hamstring autograft cases, and 22.0 years-old (IQR 17.6-30.0) for BPTB autograft cases. Compared to hamstring tendon autografts, an increased risk of revision was found in allografts processed with >1.8Mrads without chemical processing after 2.5 years (HR: 3.88 95%CI 1.48-10.12), and >1.8Mrads with chemical processing after only 1 year (HR: 3.43 95%CI 1.58-7.47) and with Bio

  12. Autograft versus non-irradiated allograft for anterior cruciate ligament reconstruction:a meta-analysis%自体与非放射线处理同种异体肌腱重建前交叉韧带的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    王伊伦; 谢东兴; 李辉; 杨拓; 邓桢翰; 杨烨; 张屹; 丁翔; 雷光华

    2014-01-01

    amount of controversies over whether an autograft or anal ograft should be used for primary anterior cruciate ligament reconstruction. OBJECTIVE:To compare the clinical outcomes of al ograft and autograft in primary anterior cruciate ligament reconstruction. METHODS:Randomized control ed trials concerning autograft versus non-irradiated al ograft for anterior cruciate ligament reconstruction were identified from the PubMed/Medline database conducted up to July 12, 2014. These studies were selected independently by two reviewers according to the inclusion and exclusion criteria. Meta-analysis was performed using Revman5.2 software. RESULTS AND CONCLUSION:A total of 6 randomized control ed trials consisting of 858 cases were included, 441 cases in autograft group and 417 cases in non-irradiated al ograft. The results of the meta-analysis indicate no significant difference between autografts and non-irradiated al ografts in overal IKDC [relative risk (RR)=1.02, 95%confidence interval (CI) (0.99 to 1.06), P=0.21], degree of laxity [mean difference (MD)=-0.13, 95%CI (-0.29 to-0.02), P=0.09], Lachman test [RR=1.04, 95%CI (0.95 to 1.13), P=0.37], pivot shift test [RR=1.00, 95%CI (0.95 to 1.05), P=0.96], one-leg hop test [RR=1.01, 95%CI (0.96 to 1.06), P=0.77], Lysholm score [MD=-0.64, 95%CI (-1.45 to 0.17), P=0.12], Tegner score [MD=0.16, 95%CI (-0.16 to 0.47), P=0.34] and rate of postoperative complications [RR=1.42, 95%CI (0.67 to 3.04), P=0.36]. Therefore, in the meta-analysis, there is no significant difference between autograft and non-irradiated al ograft in clinical outcomes. However due to the limitations of our study, further work is needed to determine this conclusion.

  13. MRI of anterior cruciate ligament autografts

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    Ogi, Shigeyuki; Ariizumi, Mitsuko; Yamagishi, Tsuneo [The Aoyama Tokyo Metropolitan office' s Hospital (Japan); Agata, Toshihiko; Tada, Shinpei; Fukuda, Kunihiko

    2000-09-01

    The purpose of this study was to assess the usefulness of MRI in the evaluation of autografts after anterior cruciate ligament reconstruction. The subjects were 110 patients with anterior cruciate ligament reconstruction using patellar tendon autografts who underwent clinical examination, MRI, and arthroscopy of the knee. T1- and T2-weighted MR images were obtained in sagittal plane. Clinical findings were categorized into three groups: normal, borderline, and abnormal. The MRI appearances of the autografts were categorized into three types: straight continuous band (type I), interrupted band (type II) and generalized increased intensity band (type III). The clinical findings and MRI findings were compared with arthroscopic findings. Ninety-six percent of the type I showed no autograft tear on arthroscopy. In comparison with the clinical findings, MRI was found to be well correlated with arthroscopic findings. In conclusion, if the clinical findings are normal, patients are to be followed-up without MRI and arthroscopy. However, if clinical findings are either borderline or abnormal, MRI should be performed prior to arthroscopy. (author)

  14. A clinical case of single-stage correction of penetration combined orofacial defect with two microsurgical autografts

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    A. D. Kaprin

    2015-01-01

    Full Text Available After surgical treatment for locally advanced oral tumors with resection of soft tissues, mucosal membrane, and facial skeletal structures, there are penetration combined defects, removal of which is a challenge for reconstructive surgeons. Mandibular repair is one of the problems in the correction of combined oral defects. Surgeons use different grafts to remove mandibular defects. One-flap transplantation does not always solve all reconstruction problems and ensure the repair of the mucosal membrane, a soft-tissue component, skin integuments, and facial skeleton.The authors describe a clinical case of successful single-stage correction of penetration combined orofacial defect after resection of the tongue, mouth floor, en bloc resection of the lower jaw and mental soft tissues, bilateral cervical supramyochoroidal lymphadenectomy, stage LCL CM mandibular defect formation after J. Boyd, by using two microsurgical autografts (a peroneal skin-muscle-skin autograft and a radial skin-fascia one in a 39-year-old female patient clinically diagnosed with carcinoma of the left mandibular alveolar ridge mucosa, Stage IVA (T4аN0M0.The Department of Microsurgery, P.A. Herzen Moscow Oncology Research Institute, Ministry of Health of Russia, has gained experience in comprehensively correcting extensive combined maxillofacial defects with two or more grafts in 27 patients who underwent autografting with a total of 73 flaps. The most functionally incapacitating and life-incompatible defect was removed at Stage 1 of reconstructive treatment. Delayed reconstruction was made after a complex of specialized antitumor therapy and assessment of treatment results in the absence of progressive growth. A great problem during multi-stage defect correction is presented by the lack of recipient vessels after cervical lymphadenectomy, the presence of soft tissue scar changes, trismus, temporomandibular joint ankylosis, contractures and displacement of the edges of the

  15. Bernese Periacetabular Osteotomy in a Hip Extra-Articular Resection Followed by Reconstruction Using an Extracorporeal Irradiated Acetabulum Autograft with Megaprosthesis, for Proximal Femur Osteosarcoma in a Pediatric Patient

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    Victor Barro

    2015-01-01

    Full Text Available Osteosarcoma is the most common primary malignant tumour of bone. The oncologic surgery of a proximal femur osteosarcoma affecting the hip joint can be very challenging. We present an 8-year-old boy with a 5-month history of right hip pain. Radiographs and magnetic resonance imaging (MRI showed a lytic lesion of the proximal femur extending 13 cm to the diaphysis. Histological evaluation was consistent with high-grade osteoblastic osteosarcoma. After completing chemotherapy we performed an extra-articular resection of the hip. Reconstruction was accomplished by reimplanting the acetabulum after irradiation and modular proximal femur megaprosthesis. Endoprosthetic reconstruction following proximal femur resection is a good treatment alternative achieving good postoperative function. Extra-articular resection of the hip using a periacetabular osteotomy technique enabled us to achieve wide margins and leave an intact posterior column to optimize acetabular reconstruction stability. Extracorporeal irradiation and reimplantation is a valuable treatment option in a situation such as this where allograft geometric fit is a priority. We conclude that an extra-articular resection of the hip, followed by reconstruction with an extracorporeally irradiated acetabulum and a proximal femur modular megaprosthesis, is a useful combined treatment option for malignant lesions involving the hip joint, especially in paediatric patients.

  16. Bernese Periacetabular Osteotomy in a Hip Extra-Articular Resection Followed by Reconstruction Using an Extracorporeal Irradiated Acetabulum Autograft with Megaprosthesis, for Proximal Femur Osteosarcoma in a Pediatric Patient.

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    Barro, Victor; Velez, Roberto; Pacha, Daniel; Giralt, Jordi; Roca, Isabel; Aguirre, Marius

    2015-01-01

    Osteosarcoma is the most common primary malignant tumour of bone. The oncologic surgery of a proximal femur osteosarcoma affecting the hip joint can be very challenging. We present an 8-year-old boy with a 5-month history of right hip pain. Radiographs and magnetic resonance imaging (MRI) showed a lytic lesion of the proximal femur extending 13 cm to the diaphysis. Histological evaluation was consistent with high-grade osteoblastic osteosarcoma. After completing chemotherapy we performed an extra-articular resection of the hip. Reconstruction was accomplished by reimplanting the acetabulum after irradiation and modular proximal femur megaprosthesis. Endoprosthetic reconstruction following proximal femur resection is a good treatment alternative achieving good postoperative function. Extra-articular resection of the hip using a periacetabular osteotomy technique enabled us to achieve wide margins and leave an intact posterior column to optimize acetabular reconstruction stability. Extracorporeal irradiation and reimplantation is a valuable treatment option in a situation such as this where allograft geometric fit is a priority. We conclude that an extra-articular resection of the hip, followed by reconstruction with an extracorporeally irradiated acetabulum and a proximal femur modular megaprosthesis, is a useful combined treatment option for malignant lesions involving the hip joint, especially in paediatric patients.

  17. Iliotibial band autograft versus bone-patella-tendon-bone autograft, a possible alternative for ACL reconstruction

    DEFF Research Database (Denmark)

    Stensbirk, Frederik; Thorborg, Kristian; Konradsen, Lars;

    2014-01-01

    PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi-ligament......PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi......-ligament reconstruction. The purpose is to assess whether the ITB autograft is a long-term reliable alternative to the bone-patella-tendon-bone (BPTB) autograft, using a prospective randomized controlled trial design. METHODS: From 1995 to 1996, sixty patients scheduled for primary ACL reconstruction were included...... compared to the BPTB graft and is recommended as a reliable alternative autograft for ACL reconstruction. LEVEL OF EVIDENCE: Therapeutic studies, Level I....

  18. Dermatome setting for autografts to cover INTEGRA.

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    Fang, P; Engrav, L H; Gibran, N S; Honari, S; Kiriluk, D B; Cole, J K; Fleckman, Philip; Heimbach, D M; Bauer, G J; Matsumura, H; Warner, P

    2002-01-01

    Using the INTEGRA Dermal Regeneration Template requires the outer silastic layer to be replaced with an autograft. We followed the manufacturer's directions for epidermal autografting and frequently obtained shredded, useless grafts, therefore, it seemed important to determine the proper dermatome setting. We evaluated dermatome settings from 0.002 to 0.012 inches. First, with feeler gauges, we verified the dermatome settings. Second, we harvested skin at various dermatome settings and measured the thickness histologically. We found that 1) the dermatome settings are reasonably accurate; 2) harvesting useful sheets at 0.002 and 0.004 inches is virtually impossible; 3) the variability of histologic graft thickness is enormous; and 4) a dermatome setting of 0.006 inches yields useful grafts. We no longer use the term epidermal autografting but rather ultrathin split-thickness grafting. To harvest these grafts, we now merely set the dermatome to 0.006 inches and make whatever midcourse corrections are necessary to obtain translucent grafts.

  19. Bleb Revision With Temporalis Fascia Autograft.

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    Qu-Knafo, Lise; Le Du, Brivael; Boumendil, Julien; Nordmann, Jean-Philippe

    2017-01-01

    We report the first description of temporalis fascia autograft to repair a late leakage bleb with scleral defect that occurred long time after trabeculectomy with mitomycin C. A 65-year-old woman was referred to our hospital with chronic late bleb leakage on her right eye. She had previously undergone a trabeculectomy with mitomycin C 3 years ago for a pigmentary glaucoma. Bleb leakage occurred 1½ year after the initial surgery. She underwent 2 surgical revisions consisting of a conjunctival advancement then an autologous conjunctival with partial scleral grafts without success. The initial best-corrected visual acuity of the right eye was 20/50 (Snellen scale). Slit-lamp examination revealed an avascular filtering bleb with leakage (massive positive Seidel test) and a scleral defect. The anterior chamber was deep and intraocular pressure (IOP) was 9 mm Hg.Faced with the risk of blebitis, endophthalmitis, and with the failure of the previous surgeries announced earlier, a surgical revision with autologous superficial temporalis fascia graft was decided to repair the leaking bleb. After local anesthesia, a sample of superficial temporalis fascia was harvested. The necrotic avascular conjunctiva around the bleb was dissected to separate and excise it from the sclera. The autologous fascia graft was sutured on the scleral defect with 10-0 nylon. Subsequently healthy conjunctiva was sutured above the graft. No bleb leakage occurred postoperatively, best-corrected visual acuity improved to 20/25, and IOP remained within normal levels 6 months after surgery without IOP-lowering medication. Superficial temporalis fascia autograft seems to be an effective, safe, and easy technique for ophthalmologists. It is a new procedure in the management of late-onset bleb leakage.

  20. Exposed Dental Implant? Local Autograft A Saviour!

    Science.gov (United States)

    Rai, Raj; Punde, Prashant A; Suryavanshi, Harshal; Shree, Swetha

    2015-01-01

    Implant exposure due to faulty placement, posses as the most common reason for implant failure. The implant placed too close to buccal or lingual cortex have lead to such failure on numerous occasions. Also, anatomic variations like the thin buccolingual width of alveolar ridge predispose exposure of the implant. 25-year-old female patient had undergone surgical placement of implants in mandibular anterior region 2 months back in the private dental clinic. The clinician noted Grade I mobility in one of the implants placed. The case was referred to the author. Thin overlying gingiva depicted an entire buccal aspect of the implant, which suggested more than 90 % loss of buccal cortex. According to literature and review of similar case reports, the only way suggested was to surgically remove the implant and wait for 12-24 months for the bone to heal for subsequent placement. Rather than the removal of implants as suggested, the author followed a naval approach of reinforcing buccal cortex using an autogenous cortical block from mandibular symphysis. The reinforcement surgery had certainly saved patients time, money and most importantly limits a crucial period of edentulism, which may be enforced on a patient in case the implant was removed. PMID:26668490

  1. Osteochondral lesion of the tibial plafond treated with a retrograde osteochondral autograft: a report of two cases

    Directory of Open Access Journals (Sweden)

    Kensuke Okamura

    2017-04-01

    Conclusion: Use of the retrograde osteochondral autograft produced satisfactory results including the return to sports. The retrograde osteochondral autograft can be considered recommendable for treating OLTPs.

  2. Early histologic, metabolic, and vascular assessment of anterior cruciate ligament autografts

    Energy Technology Data Exchange (ETDEWEB)

    Kleiner, J.B.; Amiel, D.; Harwood, F.L.; Akeson, W.H.

    1989-01-01

    A rabbit model for anterior cruciate ligament (ACL) reconstruction using autogenous patellar tendon was utilized to study the early events of autograft cellular dynamics. Biochemical, autoradiographic, histological, and vascular injection techniques demonstrated that the native autograft cell population rapidly necroses. This repopulation occurs without a vascular contribution; cells entering the autograft are reliant upon synovial fluid nutrition.

  3. ACL graft failure location differs between allografts and autografts

    Directory of Open Access Journals (Sweden)

    Magnussen Robert A

    2012-06-01

    Full Text Available Abstract Background Between 5 and 20% of patients undergoing ACL reconstruction fail and require revision. Animal studies have demonstrated slower incorporation of allograft tissue, which may affect the mechanism of graft failure. The purpose of this study is to determine the location of traumatic graft failure following ACL reconstruction and investigate differences in failure patterns between autografts and allografts. Methods The medical records of 34 consecutive patients at our center undergoing revision ACL reconstruction following a documented traumatic re-injury were reviewed. Graft utilized in the primary reconstruction, time from initial reconstruction to re-injury, activity at re-injury, time to revision reconstruction, and location of ACL graft tear were recorded. Results Median patient age at primary ACL reconstruction was 18.5 years (range, 13–39 years. The primary reconstructions included 20 autografts (13 hamstrings, 6 patellar tendons, 1 iliotibial band, 12 allografts (5 patellar tendon, 5 tibialis anterior tendons, 2 achilles tendons, and 2 unknown. The median time from primary reconstruction to re-injury was 1.2 years (range, 0.4 – 17.6 years. The median time from re-injury to revision reconstruction was 10.4 weeks (range, 1 to 241 weeks. Failure location could be determined in 30 patients. In the autograft group 14 of 19 grafts failed near their femoral attachment, while in the allograft group 2 of 11 grafts failed near their femoral attachment (p  Conclusions When ACL autografts fail traumatically, they frequently fail near their femoral origin, while allograft reconstructions that fail are more likely to fail in other locations or stretch. Level of evidence Level III - Retrospective cohort study

  4. Frozen Autograft-Prosthesis Composite Reconstruction in Malignant Bone Tumors.

    Science.gov (United States)

    Subhadrabandhu, Saran; Takeuchi, Akihiko; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Miwa, Shinji; Tsuchiya, Hiroyuki

    2015-10-01

    Several methods are available using an endoprosthesis or biological reconstruction for malignant bone tumors. Methods that use allograft-prosthesis composites have shown promising results. In 1999, the authors developed a method of reconstruction that uses a tumor-bearing autograft treated with liquid nitrogen. This technique was modified to produce a pedicle frozen autograft to maintain anatomical continuity on one side. In this study, the results of bone reconstructions using frozen autograft-prosthesis composites were retrospectively evaluated. The demographic data, histological records, surgical procedures, functional scores, and complications of 22 patients who had bone sarcoma or metastasis and at least 2 years of follow-up were reviewed. There were 19 patients with primary bone sarcoma and 3 with bone metastasis. Average age was 36 years (range, 9-73 years), and mean follow-up was 63 months (range, 24-176 months). Reconstructions were performed on 10 proximal femurs, 5 distal femurs, 4 proximal tibias, 1 proximal humerus, 1 proximal radius, and 1 hemipelvis. There were 12 pedicle-freezing and 10 free-freezing procedures. Union rate was 90% (9/10), and average union time was 9.5 months. Average Musculoskeletal Tumor Society score was 89.3%. Complications included 1 fracture, 2 infections, 3 soft tissue recurrences, and 1 posterior interosseous nerve palsy. The authors concluded that the frozen autograft-prosthesis composite demonstrated excellent Musculoskeletal Tumor Society scores, a low complication rate, and a good union rate and was superior when used with the pedicle-freezing technique.

  5. Conjunctival Autograft Alone or Combined With Adjuvant Beta-Radiation? A Randomized Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Arruda Viani, Gustavo, E-mail: gusviani@gmail.com [Department of Radiation Oncology, Marilia Medical School, Marilia, Sao Paulo (Brazil); Carrara Fonseca, Ellen [Department of Radiation Oncology, Marilia Medical School, Marilia, Sao Paulo (Brazil); Department of Ophthalmology, Marilia Medical School, Marilia, Sao Paulo (Brazil); De Fendi, Ligia Issa [Department of Ophthalmology, Marilia Medical School, Marilia, Sao Paulo (Brazil); Melani Rocha, Eduardo [Department of Ophthalmology, School of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto (Brazil)

    2012-03-01

    Purpose: To evaluate the effectiveness and safety of postoperative low single-dose of beta-irradiation ({beta}-RT) in pterygium comparing conjunctival autograft (CAG) surgery with CAG plus adjuvant {beta}-RT in a randomized clinical trial. Methods: This trial was designed as a prospective, randomized, single-center study. Surgery was performed in all cases according to the CAG technique. One hundred and eight pterygia were postoperatively randomized to CAG + {beta}-RT or CAG alone. In the case of {beta}-RT, a (90) Sr eye applicator was used to deliver 10 Gy to the sclera surface at a dose rate of between 200 and 250 cGy/min. After treatment, both an ophthalmologist and a radiation oncologist performed the follow-up examinations. The accumulated data were analyzed using a group sequential test. Results: Between February 2008 and September 2008, 116 eyes with primary pterygium were operated on according to the trial protocol. Adjuvant treatment was performed within 24 h postoperatively. Eight patients were lost to follow-up, resulting in 108 patients who could be analyzed. At a mean follow-up of 18 months (range, 8-33), in the 54 eyes randomized to receive CAG + {beta}-RT, 5 relapses occurred compared with 12 recurrences in the 54 eyes in CAG, for a crude control rate of 90.8 % vs. 78%; p = 0.032, respectively. The treatment complications as hyperemia, total dehiscence of the autograft and dellen were significantly more frequent in the CAG (p < 0.05). The arm of {beta}-RT resulted in better cosmetic results and improves of symptoms than CAG. Conclusions: A low single-dose of {beta}-RT of 10 Gy after CAG surgery was a simple, effective, and safe treatment that reduced the risk of primary pterygium recurrence, improved symptoms after surgery, resulting in a better cosmetic effect than only CAG.

  6. Complications of mandibular fractures.

    Science.gov (United States)

    Zweig, Barry E

    2009-03-01

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

  7. Familial aggregation of mandibular prognathism

    Directory of Open Access Journals (Sweden)

    April Lee

    2015-04-01

    Full Text Available Mandibular prognathism is a hereditary condition where there is an excess growth of the mandible in relation to the maxilla that can be associated with maxillary retrusion, mandibular protrusion, or both. Skeletal mandibular prognathism is most prevalent in Eastern Asian populations. This paper focuses on a Korean family with skeletal mandibular prognathism that was inherited through three generations. Apparently, neither mandible nor maxilla is retruded in the affected individuals, but there is a concave facial profile. The dentition has a class I occlusion with skeletal mandibular prognathism, and the only way to treat this case would be orthognathic surgery with the help of orthodontic appliances.

  8. Arthroscopic Technique for Acetabular Labral Reconstruction Using Iliotibial Band Autograft.

    Science.gov (United States)

    Chahla, Jorge; Soares, Eduardo; Bhatia, Sanjeev; Mitchell, Justin J; Philippon, Marc J

    2016-06-01

    The dynamic function of the acetabular labrum makes it an important structure for both hip stability and motion. Because of this, injuries to the labrum can cause significant dysfunction, leading to altered hip kinematics. Labral repair is the gold standard for symptomatic labral tears to keep as much labral tissue as possible; however, in cases where the labrum has been injured to such a degree that it is either deficient or repair is not possible, arthroscopic labral reconstruction is preferred. This article describes our preferred approach for reconstruction of the acetabular labrum using iliotibial band autograft.

  9. Stem cell autograft and allograft in autoimmune diseases.

    Science.gov (United States)

    De Cata, Angelo; Matarangolo, Angela; Inglese, Michele; Rubino, Rosa; Mazzoccoli, Gianluigi

    2016-02-01

    Autoimmune diseases are characterized by an insufficiency of immune tolerance and, although treated with a number of useful drugs, may need more unconventional therapeutic strategies for their more severe presentations. Among such unconventional therapeutic approaches, stem cell autograft and allograft have been used, with the aim of stimulating disease remission by modifying the pathogenic mechanisms that induce anomalous responses against self-antigens. Autologous transplantation is performed with the purpose of retuning autoimmune cells, whereas allogeneic transplantation is performed with the purpose of replacing anomalous immune effectors and mediators. In this article, we comprehensively review up-to-date information on the autoimmune diseases for which the transplantation of stem cells is indicated.

  10. Outcome of pregnancy in women after pulmonary autograft valve replacement for congenital aortic valve disease

    NARCIS (Netherlands)

    Yap, Sing-Chien; Drenthen, Willem; Pieper, Petronella G.; Moons, Philip; Mulder, Barbara J. M.; Klieverik, Loes M.; Vliegen, Hubert W.; van Dijk, Arie P. J.; Meijboom, Folkert J.; Roos-Hesselink, Jolien W.

    Background and aim of the study: The pulmonary autograft has been recommended as the valve of choice for aortic valve replacement (AVR) in young women contemplating pregnancy. However, current information on maternal and perinatal outcome of pregnancy in women with pulmonary autograft valve

  11. Outcome of pregnancy in women after pulmonary autograft valve replacement for congenital aortic valve disease.

    NARCIS (Netherlands)

    Yap, S.C.; Drenthen, W.; Pieper, P.G.; Moons, P.; Mulder, B.J.M.; Klieverik, L.M.; Vliegen, H.W.; Dijk, A.P.J. van; Meijboom, F.J.; Roos-Hesselink, J.W.

    2007-01-01

    BACKGROUND AND AIM OF THE STUDY: The pulmonary autograft has been recommended as the valve of choice for aortic valve replacement (AVR) in young women contemplating pregnancy. However, current information on maternal and perinatal outcome of pregnancy in women with pulmonary autograft valve

  12. Comparing autograft, allograft, and tricalcium phosphate ceramic in a goat instrumented posterolateral fusion model

    NARCIS (Netherlands)

    Delawi, D.; Kruyt, M.C.; Yuan, H.; Vincken, K.L.; Bruijn, de J.D.; Oner, F.C.; Dhert, W.J.A.

    2013-01-01

    The most common application of bone grafts is spinal fusion surgery, in which the use of iliac crest autograft is the gold standard. Harvesting of autograft, however, requires an extra surgical procedure, which is associated with additional morbidity. Allograft is the well-known alternative, but it

  13. Outcome of pregnancy in women after pulmonary autograft valve replacement for congenital aortic valve disease

    NARCIS (Netherlands)

    Yap, Sing-Chien; Drenthen, Willem; Pieper, Petronella G.; Moons, Philip; Mulder, Barbara J. M.; Klieverik, Loes M.; Vliegen, Hubert W.; van Dijk, Arie P. J.; Meijboom, Folkert J.; Roos-Hesselink, Jolien W.

    2007-01-01

    Background and aim of the study: The pulmonary autograft has been recommended as the valve of choice for aortic valve replacement (AVR) in young women contemplating pregnancy. However, current information on maternal and perinatal outcome of pregnancy in women with pulmonary autograft valve replacem

  14. Outcome of pregnancy in women after pulmonary autograft valve replacement for congenital aortic valve disease.

    NARCIS (Netherlands)

    Yap, S.C.; Drenthen, W.; Pieper, P.G.; Moons, P.; Mulder, B.J.M.; Klieverik, L.M.; Vliegen, H.W.; Dijk, A.P.J. van; Meijboom, F.J.; Roos-Hesselink, J.W.

    2007-01-01

    BACKGROUND AND AIM OF THE STUDY: The pulmonary autograft has been recommended as the valve of choice for aortic valve replacement (AVR) in young women contemplating pregnancy. However, current information on maternal and perinatal outcome of pregnancy in women with pulmonary autograft valve replacem

  15. The Use of Dermal Autograft for Fascial Repair of TRAM Flap Donor Sites

    Directory of Open Access Journals (Sweden)

    Ali Arab Kheradmand

    2010-03-01

    Full Text Available Closure of fascia after transverse rectus abdominis musculocutaneous (TRAM flap has usually been performed with direct closure or synthetic material. The dermal autograft was removed from zone IV of flap was an alternative to reinforce fascial closure. The dermal autograft was used in 34 patients after TRAM harvest for breast, head and neck reconstruction and Prolene mesh was used in 42 other patients for closure of fascial defect. All patients were followed by physical examinations. Average follow-up in the dermal autograft group was 27.3 versus 20.7 months in the second group. In the dermal autograft group, one patient complained of bulging of the anterior abdominal wall; one developed a wound infection. In the second group, one patients experienced true hernia. Dermal autografts are a useful alternative to mesh repair of fascial defects after TRAM flap harvest.

  16. Chronic Achilles tendon rupture reconstructed using hamstring tendon autograft.

    Science.gov (United States)

    Ellison, Philip; Mason, Lyndon William; Molloy, Andrew

    2016-03-01

    Chronic rupture of the Achilles tendon (delayed diagnosis of more than 4 weeks) can result in retraction of the tendon and inadequate healing. Direct repair may not be possible and augmentation methods are challenging when the defect exceeds 5-6 cm, especially if the distal stump is grossly tendinopathic. We describe our method of Achilles tendon reconstruction with ipsilateral semitendinosis autograft and interference screw fixation in a patient with chronic rupture, a 9 cm defect and gross distal tendinopathy. Patient reported outcome measures consistently demonstrated improved health status at 12 months post surgery: MOXFQ-Index 38-25, EQ5D-5L 18-9, EQ VAS 70-90 and VISA-A 1-64. The patient was back to full daily function, could single leg heel raise and was gradually returning to sport. No complications or adverse events were recorded. Reconstruction of chronic tears of the Achilles tendon with large defects and gross tendinopathy using an ipsilateral semitendinosis autograft and interference screw fixation can achieve satisfactory improvements in patient reported outcomes up to 1 year post-surgery. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Anterior Cruciate Ligament Reconstruction Using a Combination of Autograft and Allograft Tendon

    Science.gov (United States)

    Darnley, James E.; Léger-St-Jean, Benjamin; Pedroza, Angela D.; Flanigan, David C.; Kaeding, Christopher C.; Magnussen, Robert A.

    2016-01-01

    Background: Anterior cruciate ligament (ACL) reconstruction with hamstring autografts less than 8.5 mm in diameter is associated with worse patient-reported outcome scores and increased risk of revision surgery compared with reconstructions performed with larger grafts. One proposed solution to small autograft harvest is to create a hybrid graft by augmenting autografts with allograft tissue to increase graft diameter. Purpose: To compare hybrid autograft/allograft ACL reconstruction to autograft ACL reconstruction, specifically analyzing the patient-reported outcome scores and the risk of revision surgery at 2 years postoperative. Study Design: Cohort study; Level of evidence, 3. Methods: From the years 2002 to 2009, a total of 34 patients were identified from a prospectively collected database as having undergone hybrid ACL reconstruction. Twenty-seven of 34 (79.4%) patients had a 2-year follow-up. These 27 patients were matched by age (within 1 year) and sex to 27 patients who underwent hamstring autograft ACL reconstruction during the same period. At the 2-year mark, revision surgery risk and patient-reported outcome scores were compared between the 2 groups. Results: The mean age for the hybrid and matched groups (±SD) was 20.9 ± 7.0 years. Both the hybrid and control groups had 17 males and 10 females. There was no significant difference in preoperative patient-reported outcome scores, meniscus tears, or cartilage lesions between the 2 groups. Graft size was larger in the hybrid group (9.5 ± 0.6 mm) than in the autograft group (8.4 ± 0.9 mm) (P reconstruction compared with 2 (7.4%) of those who underwent autograft reconstruction (P = .26). Conclusion: Patients who undergo ACL reconstruction with hybrid hamstring grafts and hamstring autografts report similar patient-reported outcome scores at 2 years postoperative but may be at increased risk for revision ACL reconstruction. PMID:27517057

  18. The Ross II procedure: pulmonary autograft in the mitral position.

    Science.gov (United States)

    Athanasiou, Thanos; Cherian, Ashok; Ross, Donald

    2004-10-01

    The surgical management of mitral valve disease in women of childbearing age, young patients, and children with congenital mitral valve defects is made difficult by the prospect of lifelong anticoagulation. We suggest the use of a pulmonary autograft in the mitral position (Ross II procedure) as an alternative surgical technique. We present a review of the literature, historical perspectives, indications, selection criteria, and surgical technique for the Ross II procedure. Our literature search identified 14 studies that reported results from the Ross II operation. Performed in 103 patients, the overall in-hospital mortality was 7 (6.7%), with a late mortality of 10 (9%). Although further research is needed, current evidence suggests the Ross II operation is a valuable alternative in low-risk young patients where valve durability and the complication rate from other procedures is unsatisfactory and anticoagulation not ideal.

  19. Can bone scintigraphy predict the final outcome of pasteurized autografts?

    Energy Technology Data Exchange (ETDEWEB)

    Eid, Ahmed Shawky [Ain Shams University, Department of Orthopedic Surgery, Cairo (Egypt); Jeon, Dae-Geun; Cho, Wan Hyeong [Korea Cancer Center Hospital, Department of Orthopedic Surgery, Seoul (Korea)

    2010-10-15

    As pasteurization is becoming more widely used in limb salvage reconstruction, more study is required to understand about host-graft junction healing, graft revascularization and incorporation, and the incidence and type of complications among pasteurized autografts. This was mainly achieved by follow-up radiography. We aimed to clarify whether Tc99m bone scanning can be considered a reliable method in determining these three parameters. Twenty-seven osteosarcoma patients with pasteurized autograft reconstructions were retrospectively reviewed using available scintigraphic and radiographic follow-up every 6 months postoperatively for 36 months. Follow-up of the unhealed cases was continued for the maximum follow-up period available for each case beyond the original study period, ranging from 1 to 15 months. Tc99m uptake was classified as cold, faint, moderate and high uptake. Junction healing was classified as none, partial and complete healing. Seventy percent of junctions united with a mean of 22 months. Ninety to 100% of junctions showed increased uptake (high or moderate) at one time of the study regardless of final outcome. 85% of the pasteurized grafts showed the characteristic ''tramline appearance''. Four grafts (15%) were complicated: pseudoarthrosis and implant failure (1), fractured plate (1), intramedullary nail (IMN) fracture (1), and prosthesis stem loosening in the host bone (1), with underlying unhealed junctions in all cases. Bone scanning can determine the stages of the graft's rim revascularization and incorporation; however, it cannot detect or predict junction healing or occurrence of complications. Supplementary treatment of unhealed junctions showing either decreased junctional uptake or graft quiescence may be warranted. Otherwise, detection of distant metastasis and early local recurrence remains the main application of Tc99m scanning in the management of bone sarcomas. (orig.)

  20. Comparison of Clinical Outcome of Autograft and Allograft Reconstruction for Anterior Cruciate Ligament Tears

    Directory of Open Access Journals (Sweden)

    Yu-Hua Jia

    2015-01-01

    Conclusions: In the repair of ACL tears, allograft reconstruction is as effective as the autograft reconstruction, but the allograft can lead to more tunnel widening evidently in the tibial tunnel, particularly.

  1. Composite mandibular allografts in canines

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To evaluate the feasibility of transplanting composite mandibular allografts to repair large mandibular defects. Methods: Three composite mandibular transplantation models were established. The first model consisted of hemimandible with the attached teeth, muscle and skin, and oral mucosa. The second model was transplanted in the same way with the first one excluding oral mucosa and some teeth, and third one excluding the oral mucosa and all dental crowns. Fourteen transplanting operations were performed in canines. Cyclosporine A and methylprednisone were given for immunosuppression. Results: The composite mandibular organs had an effective and closed return circuit. Transplantation of vascularized allograft of mandibular compound organs was feasible. Two longest time survivors of 67 d and 76 d were in the third model group. Cyclosporine A was successful in suppressing rejection of transplanted composite allograft and prolonging survival time of transplantation models. Conclusions: The composite mandibular allografts were available with large block of living composite tissue,and helpful in restoration of appearance and function for severe mandibular defects.

  2. [Statistical study of mandibular resections].

    Science.gov (United States)

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

    1994-01-01

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

  3. Autologously generated tissue-engineered bone flaps for reconstruction of large mandibular defects in an ovine model.

    Science.gov (United States)

    Tatara, Alexander M; Kretlow, James D; Spicer, Patrick P; Lu, Steven; Lam, Johnny; Liu, Wei; Cao, Yilin; Liu, Guangpeng; Jackson, John D; Yoo, James J; Atala, Anthony; van den Beucken, Jeroen J J P; Jansen, John A; Kasper, F Kurtis; Ho, Tang; Demian, Nagi; Miller, Michael John; Wong, Mark E; Mikos, Antonios G

    2015-05-01

    The reconstruction of large craniofacial defects remains a significant clinical challenge. The complex geometry of facial bone and the lack of suitable donor tissue often hinders successful repair. One strategy to address both of these difficulties is the development of an in vivo bioreactor, where a tissue flap of suitable geometry can be orthotopically grown within the same patient requiring reconstruction. Our group has previously designed such an approach using tissue chambers filled with morcellized bone autograft as a scaffold to autologously generate tissue with a predefined geometry. However, this approach still required donor tissue for filling the tissue chamber. With the recent advances in biodegradable synthetic bone graft materials, it may be possible to minimize this donor tissue by replacing it with synthetic ceramic particles. In addition, these flaps have not previously been transferred to a mandibular defect. In this study, we demonstrate the feasibility of transferring an autologously generated tissue-engineered vascularized bone flap to a mandibular defect in an ovine model, using either morcellized autograft or synthetic bone graft as scaffold material.

  4. An Isolated Medial Patellofemoral Ligament Reconstruction with Patellar Tendon Autograft

    Directory of Open Access Journals (Sweden)

    Dariusz Witoński

    2013-01-01

    Full Text Available The aim of the study was to evaluate the results of the medial patellofemoral ligament reconstruction with a medial strip of patellar tendon autograft after a minimum 2-year followup. Ten patients (10 knees were operated on by one surgeon, according to the modified technique, described by Camanho, without any bone plug at free graft end. The mean age of the patients was 27.2 years (ranging from 18 to 42 years. The mean follow-up period was 3 years and 7 months. All patients were reviewed prospectively. At the last follow-up visit, all the patients demonstrated a significant improvement in terms of patellofemoral joint stability, all aspects of the KOOS questionnaire, and Kujala et al.’s score (59.7 points preoperatively and 84.4 points at the last followup. No patient revealed recurrent dislocation. The SF-36 score revealed a significant improvement in bodily pain, general health, physical role functioning, social role functioning, and physical functioning domains. The described MPFL reconstruction with the use of the medial 1/3rd of patella tendon is an effective procedure that gives satisfactorily patellofemoral joint functions, improves the quality of life, and provides much pain relief. It is relatively simple, surgically not extensive, and economically cost-effective procedure.

  5. Autograft versus allograft reconstruction of acute tibial plateau fractures: a comparative study of complications and outcome.

    Science.gov (United States)

    Bagherifard, Abolfazl; Ghandhari, Hassan; Jabalameli, Mahmoud; Rahbar, Mohammad; Hadi, Hosseinali; Moayedfar, Mehdi; Sajadi, Mohammadreza Minatour; Karimpour, Alireza

    2017-07-01

    There is no consensus regarding the use of filling agent in the re-elevation of depressed tibial plateau fracture (TPF). Although autograft is considered as the gold standard approach of such reconstructions, its limitation has led to a recent attraction toward allograft substitution. In this study, we compare the complications and outcome of autograft and allograft in TPF reconstruction, in order to address the existing controversy. A total of 81 patients with acute TPF were included in this study. Allograft and autograft were applied in 58 and 23 cases, respectively. The mean age of the patients was 40.26 years, and the mean follow-up period of patients was 19.1 months. Clinical and radiological assessment of the outcome was conducted, employing the modified Rasmussen clinical criteria. A total of three infections were observed in our patients, from which two infections occurred in allograft received patients. Articular surface collapse was seen in two cases, including one allograft and one autograft receiving patient. The mean clinical score was 18.65 and 18.55 in autograft and allograft received patients, respectively (p = 0.09). The mean radiological score was 15.65 and 15.68 in autograft and allograft received patients (p = 0.3). With respect to the comparable complication rate, clinical and radiological outcome of allogenic versus autologous reconstruction of TPF, freeze-dried allograft could be recommended as an appropriate substitute of autograft in this treatment. Nevertheless, the longer follow-up period of the patients could further extend our understanding of the clinical outcome of each component.

  6. FUNCTIONAL OUTCOME OF ARTHROSCOPY ASSISTED ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING BONE PATELLAR TENDON BONE AUTOGRAFT

    Directory of Open Access Journals (Sweden)

    Vinod Kumar

    2015-04-01

    Full Text Available INTRODUCTION: The anterior cruciate ligament (ACL is one of the most frequently injured ligaments in the human body. 1 The Anterior Cruciate ligament (ACL is the primary stabilizer of the knee and prevents the knee against anterior translation. 2 It is also important in counteracting rotational and valgus stress. 1 The middle third of the patellar tendon autograft for ACL reconstruction can be readily procured and firmly fixed. 3 It can tolerate the loads produced by an intensive rehabilitation programme. 3 Fixation of bone plugs using interference screws provides sufficient stability to meet the demand of a vigorous postoperative protocol. 3 It remains the gold standard for ACL reconstruction. 3 This study is to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone patellar tendon bone autograft. METHODS: This study was conducted in Kempegowda Institute of Medical Sciences Hospital from November 2012 to April 2014. During this period 20 cases of adult patients with ACL deficient patients were selected according to the inclusion criteria. Study aims to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone - patellar tendon - bone autograft in terms of range of motion, postoperative knee stability, graft site morbidity and subjective knee functions. RESULTS: Results of our study showed that arthroscopy assisted anterior cruciate ligament reconstruction with bone - patellar tendon - bone autograft could effectively improve knee stability and functions after surgery without any complication. CONCLUSION : Arthroscopy assisted anterior cruciate l igament reconstruction with bone - patellar tendon - bone autograft is an excellent treatment option for anterior cruciate ligament deficient knees. It provides a stable knee and reduces postoperative morbidity and enables early rehabilitation. The functional outcome of arthroscopy assisted anterior

  7. Bone-patellar tendon-bone autograft versus LARS artificial ligament for anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Pan, Xiaoyun; Wen, Hong; Wang, Lide; Ge, Tichi

    2013-10-01

    The optimized graft for use in anterior cruciate ligament (ACL) reconstruction is still in controversy. The bone-patellar tendon-bone (BPTB) autograft has been accepted as the gold standard for ACL reconstruction. However, donor site morbidities cannot be avoided after this treatment. The artificial ligament of ligament advanced reinforcement system (LARS) has been recommended for ACL reconstruction. The purpose of this study is to compare the midterm outcome of ACL reconstruction using BPTB autografts or LARS ligaments. Between July 2004 and March 2006, the ACL reconstruction using BPTB autografts in 30 patients and LARS ligaments in 32 patients was performed. All patients were followed up for at least 4 years and evaluated using the Lysholm knee score, Tegner score, International Knee Documentation Committee (IKDC) score, and KT-1000 arthrometer test. There were no significant differences between the two groups with respect to the data of Lysholm scores, Tegner scores, IKDC scores, and KT-1000 arthrometer test at the latest follow-up. Our study demonstrates that the similarly good clinical results are obtained after ACL reconstruction using BPTB autografts or LARS ligaments at midterm follow-up. In addition to BPTB autografts, the LARS ligament may be a satisfactory treatment option for ACL rupture.

  8. Aggressive juvenile mandibular fibromatosis.

    Science.gov (United States)

    Ivanov, Georgi P; Atanasov, Dimitar T; Anavi, Beniamin L

    2013-01-01

    Aggressive juvenile fibromatosis of the jawbones is a rare tumor presenting as infiltrative mass with unpredictable evolution. We report herein a 17-year-old student with a 6-month history of radiologically proven resorption of a part of the mandible, lingual displacement of tooth 34 and malocclusion. Alveolar ridge resorption and three dark-brown foci in the bone were seen after the tooth was extracted. Histological study showed the tumor tissue to have a bundle-like structure; immunohistochemically it was positive for vimentin, smooth muscle actin, beta-catenin, Ki-67 (5%), and negative for desmin and cytokeratin 34bE12. The golden standard in the diagnostics of desmoid fibromatoses is the nuclear or membrane expression of beta-catenin, which is found in 90% of the cases. Differential diagnosis include mandibular fibroma, well-differentiated fibrosarcoma, fibrosing histiocytoma, and infiltration from adjacent soft-tissue tumor. Aggressive juvenile fibromatosis should be managed by radical excision. Local recurrences are not rare, but metastases do not develop. In rare cases this type of fibromatosis has been known to regress spontaneously. Aggressive fibromatosis is a diagnostic challenge, since it remains in the grey zone between benign and malignant lesions of the oral cavity.

  9. Treatment of mandibular prognathism.

    Science.gov (United States)

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

    2006-10-01

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

  10. Mandibular midline distraction osteogenesis.

    Science.gov (United States)

    Botzenhart, Ute Ulrike; Végh, András; Jianu, Rodica; Gedrange, Tomasz

    2013-12-01

    In orthodontics, bone structure, its density and dimensions play an essential role by explaining limitations in magnitude, size and extent of tooth movement. Severe anterior crowding is one of the most frequently encountered dental malocclusions. Its therapy is mostly limited by lack of basal and alveolar bone and it often involves tooth extractions. Mandibular midline distraction osteogenesis is a method of natural bone generation and also a treatment option to achieve space regaining in a much-reduced lower jaw with distinctive frontal place deficit and severe anterior crowding, without sacrificing permanent teeth. McCarthy and Guerrero were of the first researchers reporting on this method applied on human lower jaws and they increased clinical interest in this approach. Although this method has been clinically used ever since, many questions concerning effects on bone regeneration speed, bone quality, tooth movement into regenerated area, periodontal health and long-time stability of treatment outcomes have not been sufficiently investigated. This overview should present the current clinical and biological state of knowledge about bone gain and tooth movement through regenerate bone. Furthermore it should encourage interest in further research on this topic.

  11. BILATERAL BIFID MANDIBULAR CONDYLE WITH TEMPORO-MANDIBULAR JOINT ANKYLOSIS

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    Amit Nandan

    2014-06-01

    Full Text Available We report a case of 10years old female child who presented with presenting complaints of progressive difficulty in jaw opening. The parents gave history of facial trauma suffered five years back. A radiograph obtained at that time was unremarkable. This time she was advised computed tomography (CT examination of temporo-mandibular joint (TMJ to evaluate the severity and extent of ankylosis. Examination was done on a 64 slice CT scanner (GE with isotropic images and additional volume rendered and multiplanar acquisitions. Findings were suggestive of bilateral mediolateral bifid mandibular condyles with fibrous, partial bony ankylosis. Both mandibular condylar head were enlarged with abnormal contour. Condyles were bifid separated by a distinct groove.

  12. Evaluating mandibular cortical index quantitatively.

    Science.gov (United States)

    Yasar, Fusun; Akgunlu, Faruk

    2008-10-01

    The aim was to assess whether Fractal Dimension and Lacunarity analysis can discriminate patients having different mandibular cortical shape. Panoramic radiographs of 52 patients were evaluated for mandibular cortical index. Weighted Kappa between the observations were varying between 0.718-0.805. These radiographs were scanned and converted to binary images. Fractal Dimension and Lacunarity were calculated from the regions where best represents the cortical morphology. It was found that there were statistically significant difference between the Fractal Dimension and Lacunarity of radiographs which were classified as having Cl 1 and Cl 2 (Fractal Dimension P:0.000; Lacunarity P:0.003); and Cl 1 and Cl 3 cortical morphology (Fractal Dimension P:0.008; Lacunarity P:0.001); but there was no statistically significant difference between Fractal Dimension and Lacunarity of radiographs which were classified as having Cl 2 and Cl 3 cortical morphology (Fractal Dimension P:1.000; Lacunarity P:0.758). FD and L can differentiate Cl 1 mandibular cortical shape from both Cl 2 and Cl 3 mandibular cortical shape but cannot differentiate Cl 2 from Cl 3 mandibular cortical shape on panoramic radiographs.

  13. 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 mandibula

  14. Pain level after ACL reconstruction: A comparative study between free quadriceps tendon and hamstring tendons autografts.

    Science.gov (United States)

    Buescu, Cristian Tudor; Onutu, Adela Hilda; Lucaciu, Dan Osvald; Todor, Adrian

    2017-03-01

    The objective of this study was to compare the pain levels and analgesic consumption after single bundle ACL reconstruction with free quadriceps tendon autograft versus hamstring tendon autograft. A total of 48 patients scheduled for anatomic single-bundle ACL reconstruction were randomized into two groups: the free quadriceps tendon autograft group (24 patients) and the hamstring tendons autograft group (24 patients). A basic multimodal analgesic postoperative program was used for all patients and rescue analgesia was provided with tramadol, at pain scores over 30 on the Visual Analog Scale. The time to the first rescue analgesic, the number of doses of tramadol and pain scores were recorded. The results within the same group were compared with the Wilcoxon signed test. Supplementary analgesic drug administration proved significantly higher in the group of subjects with hamstring grafts, with a median (interquartile range) of 1 (1.3) dose, compared to the group of subjects treated with a quadriceps graft, median = 0.5 (0.1.25) (p = 0.009). A significantly higher number of subjects with a quadriceps graft did not require any supplementary analgesic drug (50%) as compared with subjects with hamstring graft (13%; Z-statistics = 3.01, p = 0.002). The percentage of subjects who required a supplementary analgesic drug was 38% higher in the HT group compared with the FQT group. The use of the free quadriceps tendon autograft for ACL reconstruction leads to less pain and analgesic consumption in the immediate postoperative period compared with the use of hamstrings autograft. Level I Therapeutic study. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

  15. Ankle arthrodesis fusion rates for mesenchymal stem cell bone allograft versus proximal tibia autograft.

    Science.gov (United States)

    Anderson, John J; Boone, Joshua J; Hansen, Myron; Brady, Chad; Gough, Adam; Swayzee, Zflan

    2014-01-01

    Ankle arthrodesis is commonly used in the treatment of ankle arthritis. The present study compared mesenchymal stem cell (MSC) bone allografts and proximal tibia autografts as adjuncts in performing ankle arthrodesis. A total of 109 consecutive ankle fusions performed from 2002 to 2008 were evaluated retrospectively. Of the 109 fusions, 24 were excluded from the present study, leaving 85 patients who had undergone ankle arthrodesis. Of the 85 patients, 41 had received a proximal tibia autograft and 44, an MSC bone allograft. These 2 groups were reviewed and compared retrospectively at least 2 years postoperatively for the overall fusion rate, interval to radiographic fusion, and interval to clinical fusion. A modified and adjusted American College of Foot and Ankle Surgeons ankle scale was used to measure patient satisfaction. The overall fusion rate was 84.1% in the MSC bone allograft group and 95.1% in the proximal tibia autograft group (p = .158). The corresponding mean intervals to radiographic fusion were 13.0 ± 2.5 weeks and 11.3 ± 2.8 weeks (p ≤ .001). The interval to clinical fusion was 13.1 ± 2.1 weeks and 11.0 ± 1.5 weeks (p ≤ .001) in the MSC bone allograft and proximal tibia autograft group, respectively. No statistically significant difference was found in the fusion rates between the MSC bone allograft and proximal tibia autograft groups. Also, no statistically significant difference was found between the preoperative and postoperative scores using a modified and adjusted American College of Foot and Ankle Surgeons ankle scale between the 2 groups (p = .41 and p = .44, respectively). A statistically significant delay to radiographic and clinical fusion was present in the MSC bone allograft group compared with the proximal tibia autograft group; however, no difference was found in patient satisfaction.

  16. Comparison of Clinical Outcome of Autograft and Allograft Reconstruction for Anterior Cruciate Ligament Tears

    Institute of Scientific and Technical Information of China (English)

    Yu-Hua Jia; Peng-Fei Sun

    2015-01-01

    Background: Hamstring (HS) autograft and bone-patellar tendon-bone allograft are the most common choice for reconstruction of anterior cruciate ligament (ACL).There was a little report about the clinical outcome and difference of arthroscopic ACL reconstruction using allograft and autograft.This study aimed to compare the clinical outcome of autograft and allograft reconstruction for ACL tears.Methods: A total of 106 patients who underwent surgery because of ACL tear were included in this study.The patients were randomly divided into two groups, including 53 patients in each group.The patients in group Ⅰ underwent standard ACL reconstruction with HS tendon autografts, while others in group Ⅱ underwent reconstruction with bone-patellar tendon-bone allograft.All the patients were followed up and analyzed;the mean follow-up was 81 months (range: 28-86 months).Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC), Lysholm scores, physical instability tests, and patient satisfaction questionnaires.The complication rates of both groups were compared.Tibial and femoral tunnel widening were assessed using lateral and anteroposterior radiographs.Results: At the end of follow-up, no significant differences were found between the groups in terms of IKDC, Lysholm scores, physical instability tests, patient satisfaction questionnaires, and incidences of arthrofibrosis.Tibial and femoral tunnel widening was less in the HS tendon autografts.This difference was more significant on the tibial side.Conclusions: In the repair of ACL tears, allograft reconstruction is as effective as the autograft reconstruction, but the allograft can lead to more tunnel widening evidently in the tibial tunnel, particularly.

  17. 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.

  18. Overwhelming hypercalcaemia in mandibular ameloblastoma.

    Science.gov (United States)

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

    2014-10-17

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

  19. Mandibular development in Australopithecus robustus.

    Science.gov (United States)

    Cofran, Zachary

    2014-07-01

    Australopithecus robustus has a distinct mandibular anatomy, with a broad and deep corpus and a tall, relatively upright ramus. How this anatomy arose through development is unknown, as gross mandibular size and shape change have not been thoroughly examined quantitatively in this species. Herein, I investigate A. robustus mandibular growth by comparing its ontogenetic series with a sample of recent humans, examining age-related size variation in 28 linear measurements. Resampling is used to compare the amount of proportional size change occurring between tooth eruption stages in the small and fragmentary A. robustus sample, with that of a more complete human skeletal population. Ontogenetic allometry of corpus robusticity is also assessed with least squares regression. Results show that nearly all measurements experience greater average increase in A. robustus than in humans. Most notably, A. robustus corpus breadth undergoes a spurt of growth before eruption of M1 , likely due in part to delayed resorption of the ramus root on the lateral corpus. Between the occlusion of M1 and M2 , nearly all dimensions experience greater proportional size change in A. robustus. Nested resampling analysis affirms that this pattern of growth differences between species is biologically significant, and not a mere byproduct of the fossil sample size. Some species differences are likely a function of postcanine megadontia in A. robustus, although the causes of other differences are less clear. This study demonstrates an important role of the postnatal period for mandibular shape development in this species. © 2014 Wiley Periodicals, Inc.

  20. Hypogastric artery autograft treating hemorrhage with infection of external iliac artery secondary to renal transplantation

    Institute of Scientific and Technical Information of China (English)

    WANG Ze-hou; YI Shan-hong; YAO Zhi-yong; SUN Bin; HONG Quan; ZHANG Zhi-chao

    2008-01-01

    @@ Massive hemorrhage from infected anastomosed site between the graft artery and the external iliac artery is one of the most serious complications of renal transplantation. Clinically, it is a rare but fatal occasion. We reported here one case of hemorrhage with infection in the iliac artery anastomosed site treated successfully with hypogastric artery autograft interposition in March 2003.

  1. Cost-efficacy of cultured epidermal autografts in massive pediatric burns

    NARCIS (Netherlands)

    Barret, JP; Wolf, SE; Desai, MH; Herndon, DN

    Objective To assess the efficacy of cultured epidermal autografts (CEA) for closure of burn wounds in pediatric burn patients with full-thickness burns of more than 90% total body surface area. Summary Background Data Paucity of donor sites in massive burns makes the use of expanded skin of

  2. A radiological evaluation of allografts (ethylene oxide sterilized cadaver bone and autografts in anterior cervical fusion.

    Directory of Open Access Journals (Sweden)

    Parthiban J

    2002-01-01

    Full Text Available Serial roentgenograms of 40 patients who had 70 cervical intervertebral spaces grafted with ethylene oxide sterilized cadaver bone and 28 patients who received 44 iliac crest auto grafts for anterior cervical spine fusion, were studied. The radiological evaluation was made on the basis of settlement of intervertebral spaces, fusion rate, delayed union, non-union, graft collapse and extrusion of the graft. Indigenous methodologies were designed for the assessment of settlement of grafted intervertebral spaces in percentage. Disc space settlement was more common in autografts (93% cases than in allografts (80% cases. The average percentage of settlement of intervertebral disc space (S% was 22 in autografts and 28 in allografts during the first four months. By the end of eight months, allograft disc spaces settle more. No significant difference was noted in fusion rate at the end of one year viz. allografts (90% cases and autografts (93% cases. Autograft and allograft (ethylene oxide sterilized cadaver bone are equally useful in anterior cervical spine fusions.

  3. [Subcutaneous autograft with newly synthesized cartilage using ethisorb polymer in rabbits].

    Science.gov (United States)

    Capitán Guarnizo, A; Viviente Rodríguez, E; Osete Albaladejo, J M; Torregrosa Carrasquer, C; Díaz Manzano, J A; Pérez-Mateos Cachá, J A; Sprekelsen Gassó, C

    2002-11-01

    We perform a subcutaneous autograft, in animals with preserved immunity (24 rabbits), of cartilage taken from the auricle, treated with tissue engineering thecnics and embeded in a reabsorbable polimer (Ethisorb) that acts as base. We observed a good quality cartilage with the expression of collagen type II and without graft rejection phenomenon.

  4. Bone regeneration in mandible defect with autograft bone and cell suspension from bone marrow in rabbits

    Directory of Open Access Journals (Sweden)

    C. Gomes

    2011-08-01

    Full Text Available The objective of this study was to investigate the bone regeneration of a "gold standard" (autograft from iliac crest associated with cellular therapy in rabbits. A bone defect was created with 10x5x5mm in 28 rabbit mandibles. The control group animals (n=14 were repaired with autograft of iliac crest and the experimental group animals (n=14 received iliac crest autograft in association with mononuclear cells from the bone marrow of the femur. Weekly radiographs were taken of the surgery region and histological analyses was performed in seven animals in each group at 15 days and in seven animals of each group at 30 days after the surgery. A gradual increase of bone density was observed and the experimental animals presented the bone bridge in 85.7% (6/7 of the cases, while only 42.8% (3/7 of the animals in the control group presented this structure 28 days after the surgery. The histopathological parameters analyzed did not show any statistical difference between the control and experimental group in 15 and 30 days of analysis. The results suggest that the mononuclear cells from the marrow bone can better support the autograft regeneration in mandible defects in rabbits.

  5. A composite semiresorbable armoured scaffold stabilizes pulmonary autograft after the Ross operation: Mr Ross's dream fulfilled.

    Science.gov (United States)

    Nappi, Francesco; Spadaccio, Cristiano; Fraldi, Massimiliano; Montagnani, Stefania; Fouret, Pierre; Chachques, Juan Carlos; Acar, Christophe

    2016-01-01

    Use of resorbable external reinforcement of the pulmonary autograft during the Ross operation has been suggested, but the differential regional potential for dilation of the aorta, mainly regarding the neo-root and the neo-Valsalva sinuses, represents an unresolved issue. Auxetic materials could be useful in preventing dilation given their favorable mechanical properties. We designed a composite semiresorbable armoured bioprosthesis constituted by polydioxanone and expanded polytetrafluoroethylene and evaluated its effectiveness as a pulmonary autograft reinforcement device in an animal model of the Ross procedure. An experimental model of the Ross procedure was performed in 20 three-month-old growing lambs. The pulmonary autograft was alternatively nonreinforced (control group n = 10) or reinforced with composite bioprosthesis (reinforced group n = 10). Animals were followed up during growth for 6 months by angiography and echocardiography. Specific stainings for extracellular matrix and immunohistochemistry for metalloproteinase-9 were performed. Reference aortic diameter increased from 14 ± 1 mm to 19 ± 2 mm over 6 months of growth. In the control group, pulmonary autograft distension (28 ± 2 mm) was immediately noted, followed by aneurysm development at 6 months (40 ± 2 mm, P < .001 vs reference). In the reinforced group, an initial dilation to 18 ± 1 mm was detected and the final diameter was 27 ± 2 mm (42% increase). Two deaths due to pulmonary autograft rupture occurred in the control group. On histology, the control group showed medial disruption with connective fibrous replacement, whereas in the reinforced group compensatory intimal hyperplasia was present in the absence of intimal tears. The bioprosthesis promoted a positive matrix rearrangement process favoring neoarterialization and elastic remodeling as demonstrated on specific staining for elastin collagen and metalloproteinase-9. The device adapted and functionally compensated for the

  6. Arthroscopy-assisted anterior cruciate ligament reconstruction with patellar tendon or hamstring autografts.

    Science.gov (United States)

    Doral, M N; Leblebicioglu, G; Atay, O A; Baydar, M L; Tetik, O; Atik, S

    2000-01-01

    Isolated ACL reconstructions were performed in 138 patients between 1994 and 1998. Patellar bone-patellar tendon-bone, and hamstring tendon autografts were used in 88 patients, and allografts were used in 50 patients. Eighty-eight knees of 88 patients with autograft reconstructions (17 female, 71 male) were included in this study and evaluation of the patients with allograft reconstruction reported separately. The mean age at the time of the operation was 32 years. All ACL reconstructions were performed arthroscopically. Twenty-seven bone-patellar tendon-bone, and 61 hamstring tendon autografts were used. The mean follow-up was 29 months. In the postoperative course the Lachman test was negative in 62 patients, 1+ in 22 patients, and 2+ in 4 patients. In 17 patients, anterior drawer sign were 1+ in comparison to the contralateral side. Pivot shift test was moderately positive only in 5 cases in the bone-patellar tendon-bone and hamstring tendon autograft groups postoperatively. There were 3 patients with subjective "giving way" symptoms. Second look arthroscopy revealed rupture of the neo-ligament. Arthroscopic washout and debridement were performed, and no revision ligamentoplasties were performed. Two of these patients improved with accelerated proprioceptive physical therapy, and one had to decrease his previous level of activity. There were no cases of arthrofibrosis, infection, or extension lag. Clinical results of patellar bone-tendon-bone and hamstring groups did not show any significant clinical difference. Avoiding the disturbance of the extensor mechanism of the knee is probably the most significant advantage of the hamstring autograft.

  7. Mechanoreceptor Reinnervation of Autografts Versus Allografts After Anterior Cruciate Ligament Reconstruction

    Science.gov (United States)

    Young, Simon W.; Valladares, Roberto D.; Loi, Florence; Dragoo, Jason L.

    2016-01-01

    Background: Loss of proprioceptive function occurs after anterior cruciate ligament (ACL) rupture. Clinical, motor, and proprioceptive function is known to improve after ACL reconstruction but does not return to normal. While histological studies of human ACL allografts have been unable to demonstrate mechanoreceptor reinnervation, animal data suggest that reinnervation may occur when an autograft is used. Purpose: To compare the presence or absence of mechanoreceptors between allograft versus autograft after ACL reconstruction in humans. Study Design: Cohort study; Level of evidence, 3. Methods: Ten patients with previous ACL reconstruction presenting for either revision ACL surgery or knee arthroscopy for other reasons were enrolled in a prospective, comparative study. Five patients had a previous autograft ACL and 5 patients had an allograft. Biopsies, either from intact or ruptured grafts, were taken from identical locations as close to the femoral and tibial insertions as possible. Specimens were stained with hematoxylin-eosin (H-E) and monoclonal antibodies against neurofilament protein (NFP), known to be present in mechanoreceptor tissue. Immunohistochemical examination was carried out, and the number of NFP+ neural tissue analogs was counted and compared with that of native ACL tissue. Results: The mean time between original graft and biopsy was 6.9 years (range, 0.5-15 years). Histological examination showed significantly less NFP+ neural analogs in allograft and autograft patients than control tissue (mean number of NFP+ analogs per high-power field, 0.7 ± 0.9 [allograft] and 0.5 ± 0.8 [autograft] vs 4.7 ± 0.9 [controls]; P proprioceptive deficits seen clinically after ACL reconstruction. PMID:27803939

  8. Synthetic porous ceramic compared with autograft in scoliosis surgery. A prospective, randomized study of 341 patients.

    Science.gov (United States)

    Ransford, A O; Morley, T; Edgar, M A; Webb, P; Passuti, N; Chopin, D; Morin, C; Michel, F; Garin, C; Pries, D

    1998-01-01

    We have evaluated the use of a synthetic porous ceramic (Triosite) as a substitute for bone graft in posterior spinal fusion for idiopathic scoliosis. In a prospective, randomised study 341 patients at five hospitals in the UK and France were randomly allocated either to autograft from the iliac crest or rib segments (171) or to receive Triosite blocks (170). All patients were assessed after operation and at 3, 6, 12 and 18 months. The two groups were similar with regard to all demographic and baseline variables, but the 184 treated in France (54%) had Cotrel-Dubouset instrumentation and the 157 treated in the UK usually had Harrington-Luque implants. In the Triosite group the average Cobb angle of the upper curve was 56 degrees, corrected to 24 degrees (57%). At 18 months, the average was 26 degrees (3% loss). In the autograft group the average preoperative upper curve of 53 degrees was corrected to 21 degrees (60%). At 18 months the mean curve was 25 degrees (8% loss). Pain levels after operation were similar in the two groups, being mild in most cases. In the Triosite group only three patients had problems of wound healing, but in the autograft group, 14 patients had delayed healing, infection or haematoma in the spinal wound. In addition, 15 autograft patients had pain at the donor site at three months. Seven had infections, two had haematoma and four had delayed healing. The haematological and serum biochemistry results showed no abnormal trends and no significant differences between the groups. There were no adverse events related to the graft material and no evidence of allergenicity. Our results suggest that Triosite synthetic porous ceramic is a safe and effective substitute for autograft in these patients. Histological findings on biopsy indicate that Triosite provides a favourable scaffolding for the formation of new bone and is gradually incorporated into the fusion mass.

  9. Evaluation of Autograft Characteristics After Pterygium Excision Surgery: Autologous Blood Coagulum Versus Fibrin Glue.

    Science.gov (United States)

    Mittal, Kanhaiya; Gupta, Shikha; Khokhar, Sudarshan; Vanathi, Murugesan; Sharma, Namrata; Agarwal, Tushar; Vajpayee, Rasik Bihari

    2017-01-01

    To compare graft outcomes following pterygium excision and conjunctival autograft fixation using patient's in situ autologous blood or standard fibrin glue-assisted conjunctival autograft adhesion. Outcomes of 23 consecutive eyes which underwent pterygium excision and conjunctival autograft with autologous in situ blood coagulum (group I) were compared with historical case controls (20 eyes) that had undergone fibrin glue-assisted conjunctival autograft (group II). Primary outcome measure was graft stability. Secondary outcome measure was severity of graft inflammation at day 1, day 7, 3 months, and 6 months. The two groups were similar regarding age, gender, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refractive error, tear function tests, and pterygium size. Mean surgical time was similar for the two groups (14.2±2.74 min, group I; 12.25±1.88 min, group II; P=0.1); with the mean difference in operative time being 1.95 min (95% CI, 0.48-3.42 min). Postoperatively, there was a statistically significant reduction in astigmatism and improvement in UCVA, BCVA, and spherical equivalent in all eyes. No difference was found in mean epithelial defect healing time, UCVA, BCVA, astigmatism, tear film break-up time, and Schirmer I and II at 6 months between the two groups. Initial graft stability was better for group II at 1 month (P=0.001) but was similar for both groups at 6 months. Median score of graft inflammation was significantly more for group II during the first week (P<0.05; Wilcoxon rank-sum test). Autologous blood may be used as an effective alternative with lesser postoperative inflammation in comparison to glue-assisted autograft fixation.

  10. Relevance of anterior mandibular body ostectomy in mandibular prognathism

    Science.gov (United States)

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

    2013-01-01

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

  11. Comparison of Alloderm and mucosal graft in mandibular vestibuloplasty

    Directory of Open Access Journals (Sweden)

    Mahmoodhashemi H.

    2009-12-01

    Full Text Available "nBackground and Aim: The usage of free gingival grafts for vestibuloplasty is a routine procedure. The free gingival procedure requires harvesting the graft from a donor site which increases morbidity and the risk of surgical complications. In addition, adequate amount of donor tissue may not be available. Acceptable results of Alloderm application as a substitute for autogenous soft tissue grafts are: Not exposing the patient to an additional surgery, no donor site morbidity, unlimited availability, decreasing the bleeding during the surgery, decreasing the surgical complications, and better color match. The aim of this study was to evaluate the maintenance of the vestibular depth in vestibuloplasty with mucosal graft and Alloderm."nMaterials and Methods: Both methods of anterior mandibular vestibuloplasty by Clark, utilizing Alloderm and mucosal grafts, were employed in ten clinical cases. During the surgeries, half the prepared recipient sites received Alloderm, while the remaining half received autografts in a randomized fashion. Immediately, 1, 3, and 6 months postoperatively, the variables of graft rejection, depth of vestibule and the degree of relapse were evaluated. SPSS software was used for analysis of the data and the methods used for "statistical tests" were as follows: Friedman Method, Paired sample t-test, Smirnov-kolmogrove Method. (The statistical significance level was established at P-value<0.05."nResults: The mean difference of the relapse measurements in both methods throughout the survey did not have significant predictive value (P>0.05. Similar results were achieved for the mean difference of depth of the vestibule."nConclusion: In patients undergoing Vestibuloplasty, Alloderm could be material of choice to be utilized as autogenic soft tissue grafts in pre-prosthesis procedures.

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

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    Aditi Agrawal

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  14. 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.

  15. Staged excisions of moderate-sized burns compared with total excision with immediate autograft: an evaluation of two strategies

    Science.gov (United States)

    Elmasry, Moustafa; Steinvall, Ingrid; Thorfinn, Johan; Abdelrahman, Islam; Olofsson, Pia; Sjoberg, Folke

    2017-01-01

    Background: Different surgical techniques have evolved since excision and autografting became the treatment of choice for deep burns in the 1970s. The treatment plan at the Burn Center, Linköping University Hospital, Sweden, has shifted from single-stage excision and immediate autografting to staged excisions and temporary cover with xenografts before autografting. The aim of this study was to find out if the change in policy resulted in extended duration of hospital stay/total body surface area burned (LOS/TBSA%). Methods: Retrospective clinical cohort including surgically-managed patients with burns of 15%-60% TBSA% within each treatment group. The first had early full excisions of deep dermal and full thickness burns and immediate autografts (1997-98), excision and immediate autograft group) and the second had staged excisions before final autografts using xenografts for temporary cover (2010-11, staged excision group). Results: The study included 57 patients with deep dermal and full-thickness burns, 28 of whom had excision and immediate autografting, and 29 of whom had staged excisions with xenografting before final autografting. Adjusted (LOS/TBSA%) was close to 1, and did not differ between groups. Mean operating time for the staged excision group was shorter and the excised area/operation was smaller. The total operating time/TBSA% did not differ between groups. Conclusion: Staged excisions with temporary cover did not affect adjusted LOS/TBSA% or total operating time. Staged excisions may be thought to be more expensive because of the cost of covering the wound between stages, but this needs to be further investigated as do the factors that predict long term outcome. PMID:28123862

  16. Combined conjunctival autograft and overlay amniotic membrane transplantation; a novel surgical treatment for pterygium.

    Science.gov (United States)

    Ghanavati, Siamak Zarei; Shousha, Mohamed Abou; Betancurt, Carolina; Perez, Victor L

    2014-01-01

    The authors report the long-term results of combined conjunctival autograft and overlay amniotic membrane transplantation (AMT) for treatment of pterygium as a new surgical technique. Nineteen patients including 12 male and 7 female subjects with pterygium (primary, 14 cases; recurrent, 5 cases) underwent combined conjunctival autograft and overlay AMT and were followed from 10 to 26 months. Mean age was 44.21±12.49 (range, 29.0-73.0) years. In one patient with grade T3 primary pterygium, the lesion recurred (5.2%, recurrence rate). No intra-and postoperative complication developed. This procedure seems a safe and effective surgical technique for pterygium treatment. Protection of the ocular surface during the early postoperative period reduces the friction-induced inflammation and might be helpful to prevent the recurrence.

  17. All-arthroscopic iliotibial band autograft harvesting and labral reconstruction technique.

    Science.gov (United States)

    Deshmane, Prashant P; Kahlenberg, Cynthia A; Patel, Ronak M; Han, Brian; Terry, Michael A

    2013-02-01

    The labrum is essential for stability, movement, and prevention of arthritis in the hip. In cases of labral damage where repair of a labral tear is not possible, reconstruction can be a useful alternative. Several different autografts have been used, including the iliotibial band (ITB), the ligamentum teres capitis, and the gracilis tendon. Authors have reported both open and arthroscopic techniques for reconstruction with good preliminary results. However, an all-arthroscopic labral reconstruction technique including the graft harvest and reconstruction portions of a labral reconstruction procedure using an ITB autograft has not been previously described. We describe a technique for an all-arthroscopic labral reconstruction performed using a novel method for arthroscopic harvest of the ITB. The decreased invasiveness of our described technique for labral reconstruction may potentially minimize scarring, bodily disfigurement, infection, and postoperative pain associated with the graft harvesting incision.

  18. PTERYGIUM EXCISION WITH SUTURELESS GLUELESS CONJUNCTIVAL AUTOGRAFTING: AN EXPERIENCE OF 30 CASES

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    Jawed

    2014-03-01

    Full Text Available BACKGROUND: Sutureless glueless conjunctival autografting in pterygium surgery is gaining popularity due to short surgical time, no recurrence and good cosmetic outcome. AIM: To see the outcome of pterygium excision with sutureless glueless conjunctival autografting. METHODS: 30 cases of uncomplicated pterygia irrespective of eyes, age and sex were examined with slit lamp. All were nasal pterygia & progressive type. Blood sugar and xylocaine test were done. Pterygium mass was excised and autologous conjunctival graft without suture or glue were performed. Grafts were taken from inferotemporal area. Follow up was done on 1stday, 7thday, 45th day and on 6th month. RESULT: All the grafts were intact on each follow up. Graft retraction was present in one case on 7th POD. No recurrence was found till 6th month follow up. CONCLUSION: No glue, no suture conjunctival grafting in pterygium surgery takes short surgical time, easy to perform, excellent cosmetic outcome with no recurrence

  19. Number and Quality of Oocytes Collected from Heterotopic Autografted Mice Ovary after PMSG Induction

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    NURBARIAH

    2011-12-01

    Full Text Available Heterotopic grafting sites can be useful in producing oocytes for in vitro Fertilization, therefore, maximising the oocyte yield from the graft by gonadotrophin stimulation would be advantageous. The aim of this study was to investigate the number and quality of oocytes collected from heterotopic autografted ovary after Pregnant Mare Serum Gonadothropin (PMSG induction. Graft recipients were treated either with or without PMSG stimulation 48 hours prior to graft collection. Ovarian tissue from four weeks old mice (DDY strain were autotransplanted under the kidney capsule of the same ovariectomized mice and the oocytes were collected 21 days after autotransplantation. The results showed that the average number of oocytes collected from autografted ovaries without PMSG induction were 9.0. + 2.8 not significantly different with those received PMSG induction, 10.9 + 5.1. The percentage of matured and fertilized oocytes and the developed embryos from the autografted ovaries without PMSG induction were 52.4, 33.4, and 26.0%, respectively not significantly different with those received PMSG induction, 53.2, 35.1, and 29.9%, respectively. The number of oocytes and the capacity to matured, fertilized and developed were significantly lower (P < 0.05 compared to the superovulated nongrafted (control ovaries. In conclusion, PMSG induction on the graft recipients did not significantly increase oocytes yield from grafted heterotopic ovaries. The number and quality of oocytes produced from the autografted ovaries were lower than the superovulated nongrafted ovaries, but still can be used for in vitro embryo production after sequential in vitro maturation and fertilization.

  20. Pterygium surgery by means of conjunctival autograft: long term follow-up

    Directory of Open Access Journals (Sweden)

    Valentín Huerva

    2012-08-01

    Full Text Available PURPOSE: To demonstrate the long term of follow-up of the recurrence rate after conjunctival autograft for pterygium surgery. METHODS: A total of 112 patients operated for pterygium with conjunctival autografts and with more than one year follow-up were registered. Patients were called for voluntary examinations of their respective ocular surface statuses. Completing the study was only possible in 44 cases. Seven had bilateral pterygium. (N=51 operated pterygium. RESULTS: The mean follow-up time was 49.06 months. In 29.45% of the cases, attachment was performed using non-absorbable sutures (nylon 10/0, while fibrin glue was used in 70.55% of the cases. Six cases of recurrence (11.76% were found. The recurrence rate between primary and recurrent pterygium, and between sutures and fibrin glue proved to be not statistically significant; p>0.05. There were no significant differences between women and men with respect to recurrence. The median of age in the recurrence group was 40 years old, in contrast to 55 in the non-recurrence group; p=0.01517. All of these recurrences were associated with patients of Hispanic origins (from Latin America; p=0.001506. CONCLUSIONS: After a long follow-up period after autograft pterygium surgery, there were no statistically significant differences in recurrence rates for the application of sutures as opposed to fibrin glue; similarly, there were no statistically significant differences between the use of autograft in primary and recurrent pterygium. The greatest risk factors for recurrence were young age and Hispanic ethnicity.

  1. Topical negative pressure improves autograft take by altering nutrient diffusion: A hypothesis

    OpenAIRE

    Wang, Xingang; Zhang, Yuanhai; Han, Chunmao

    2014-01-01

    The one-step surgical procedure for dermal substitutes combined with topical negative pressure (TNP) has proven effective for treating deep skin defects with improved graft take. The primary mechanism by which TNP improves autograft take is unknown. Some studies suggest that TNP promotes the rapid angiogenesis of dermal substitutes, improving graft take. However, at the early stage of one-step transplantation, the vascular system has not formed and imbibition is the main mode of nutrient supp...

  2. Evaluation of sterilization methods following contamination of hamstring autograft during anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Plante, Matthew J; Li, Xinning; Scully, Gail; Brown, Michael A; Busconi, Brian D; DeAngelis, Nicola A

    2013-03-01

    Inadvertent contamination of the hamstring autograft during ACL reconstruction is infrequent, but can result in significant complications. The purpose of this study is to evaluate bacterial contamination of hamstring autografts dropped onto the operating room floor and methods of graft decontamination. Hamstring tendons were harvested from patients. Excess tendon not used in the ACL procedure was divided into 6 segments. Segments were assigned to 6 groups (A through F, N = 30 in each group): group A: uncontaminated graft immediately postharvest (control), group B: graft dropped onto the floor (5 s), group C: graft dropped onto the floor (15 s). grafts in groups D to F were dropped onto floor for 15 s then rinsed with saline (group D), bacitracin solution (group E) or chlorhexidine 4 % solution (group F) for 3 min. All grafts were sent to the microbiology laboratory for anaerobic and aerobic cultures. Cultures were positive in 23 % of graft segments from group A (7/30), 33 % of grafts from group B (10/30), 23 % from group C (7/30), 30 % from group D (9/30) and 3 % from both group E (1/30) and group F (1/30). Sixteen unique organisms were identified, with Staphylococcus aureus as the most common isolate. Grafts rinsed in either bacitracin solution or 4 % chlorhexidine solutions were significantly less likely to be culture positive when compared to control graft segments (p sterilely and washed for at least 3 min. This study also demonstrates no advantage in retrieval time of less than 5 s as compared to 15 s for uncontaminated graft. Hamstring harvest in ACL reconstruction may result in positive cultures, thus routine soaking of the hamstring autograft in either bacitracin or 4 % chlorhexidine solution is recommended. In addition, dropped hamstring autograft can be effectively sterilized with bacitracin or 4 % chlorhexidine solution. II.

  3. Intra-articular osteoid osteoma at the femoral trochlea treated with osteochondral autograft transplantation

    Science.gov (United States)

    Leeman, Joshua J; Motamedi, Daria; Wildman-Tobriner, Ben; O’Donnell, Richard J; Link, Thomas M

    2016-01-01

    We present the case of an intra-articular osteoid osteoma at the femoral trochlea. Intra-articular osteoid osteoma can present a diagnostic challenge both clinically and with imaging because it presents differently from the classic cortical osteoid osteoma. Given the lesion’s proximity to overlying cartilage, the patient underwent resection of the lesion with osteochondral autograft transplantation at the surgical defect. A comprehensive literature review and discussion of intra-articular osteoma will be provided. PMID:27761182

  4. Vascularized peripheral nerve trunk autografted in the spinal cord: a new experimental model in adult rats

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To investigate the effect of vascularized peripheral nerve trunk autografted in spinal cord. Methods: With modern microsurgical technique,vascularized peripheral median and ulnar nerve trunk autografted in the upper thoracic region of the spinal cord were established in 20 female adult rats. The origin and the termination of axons in the graft were studied by retrograde neuronal labeling with horseradish peroxidase (HRP).Cord, nerve grafts and some normal median and ulnar nerves in the right upper limb were removed and sectioned for Bielschowsky's silver stain and haematoxylin and eosin (H&E) stain. Light and electron microscopic examination and electrophysiological examination were applied.Results: The grafts were innervated by many new fibers. Studies with HRP indicated that new axons in graft were originated from intrinsic central nervous system (CNS) neurons with their cell bodies from brain stem to sacral segments of spinal cord. Other axons arose from dorsal root ganglia at the level of graft and at least 19 distal segments to them. Together with electron microscopy, electrophysiological examination, silver and H&E stain, the results demonstrated that vascularized peripheral nerve trunk grafted in spinal cord attracted many neurons to grow into the nerve grafts.Conclusions: The findings implicate that CNS is able to regenerate much better in vascularized nerve autografted in spinal cord.

  5. MRI of anterior cruciate ligament repair with patellar and hamstring tendon autografts

    Energy Technology Data Exchange (ETDEWEB)

    Jansson, K.A.; Karjalainen, P.T. [Dept. of Radiology, Helsinki University Central Hospital (Finland); Harilainen, A.; Sandelin, J.; Tallroth, K. [ORTON Hospital, Helsinki (Finland); Soila, K. [Dept. of Radiology, Mount Sinai Medical Center, Miami Beach, FL (United States); Aronen, H.J. [Dept. of Radiology, Helsinki University Central Hospital (Finland); Dept. of Diagnostic Radiology, Kuopio University Hospital (Finland)

    2001-01-01

    Objective. Several MRI sequences were used to evaluate the 2-year postoperative appearance of asymptomatic knee with a torn anterior cruciate ligament (ACL) reconstructed with bone-patellar tendon-bone (BTB) and semitendinosus and gracilis (STG) tendon autografts.Design and patients. Two groups with successful repair of ACL tear with BTB (n=10) or STG (n=10) autografts were imaged at 1.5 T with sagittal and oblique coronal proton density-, T2-weighted and sagittal STIR sequences and plain and contrast-enhanced oblique coronal T1-weighted sequences. The appearance of the graft and periligamentous tissues was evaluated.Results. In all 20 cases, the ACL graft showed homogeneous, low signal intensity with periligamentous streaks of intermediate signal intensity on T2-weighted images. In 10 cases, localised areas of intermediate signal intensity were seen in the intra-articular segment of the graft on proton density- and T1-weighted images. The graft itself did not show enhancement in either of the two groups, but mild to moderate periligamentous enhancement was detected in 10 cases.Conclusion. The MRI appearance of ACL autograft is variable on proton density- and T1-weighted images. Periligamentous tissue showing contrast enhancement is a typical MRI finding after clinically successful ACL reconstruction. (orig.)

  6. [Biomaterials for bone filling: comparisons between autograft, hydroxyapatite and one highly purified bovine xenograft].

    Science.gov (United States)

    Chappard, D; Zhioua, A; Grizon, F; Basle, M F; Rebel, A

    1993-12-01

    Bone grafts are becoming increasingly common in orthopaedics, neurosurgery and periodontology. Twenty one New Zealand rabbits were used in the present study comparing several materials usable as bone substitutes. A 4.5 mm hole was drilled in the inner femoral condyles. Holes were filled with either an autograft (from the opposite condyle), an hydroxylapatite (Bioapatite), or a highly purified bovine xenograft (T650 Lubboc). Animals were sacrificed at 1, 3 and 6 months post implantation and a quantitative analysis of newly-formed bone volume (BNF/IV) and remaining biomaterials (BMAT/IV) was done. In addition, some holes were left unfilled and served as controls. At 6 months, there was no tendency for spontaneous repair in the control animals. The autografted animals have repaired their trabecular mass and architecture within the first month. Hydroxylapatite appeared unresorbed at six months and only thin and scanty new trabeculae were observed. The xenograft induced woven bone trabeculae formation on the first month. This was associated with resorption of the material by two multinucleated cell populations. At six months, the epiphyseal architecture was restored and the biomaterial has disappeared in most cases. Xenografts appear a promising alternative to autografts and allografts, whose infectious risks and ethical problems should always be borne in mind.

  7. Association between 3-dimensional mandibular morphology and condylar movement in subjects with mandibular asymmetry.

    Science.gov (United States)

    Ikeda, Michiyo; Miyamoto, Jun J; Takada, Jun-Ichi; Moriyama, Keiji

    2017-02-01

    The purpose of this study was to evaluate the hypothesis that 3-dimensional mandibular morphology is correlated with condylar movement in patients with mandibular asymmetry. Subjects were classified into 2 groups (n = 25 each): mandibular asymmetry with a menton deviation greater than 4 mm and no mandibular asymmetry with a menton deviation less than 4 mm. Linear and volumetric measurements of 3-dimensional mandibular morphology were recorded using computed tomography. Mandibular functional movement was recorded by computerized axiography (CADIAX; Gamma Dental, Klosterneuburg, Austria), and condylar path length, sagittal condylar inclination, and transverse condylar inclination on protrusion were measured. We calculated side-to-side asymmetry (shifted side vs nonshifted side) in mandibular morphology and assessed condylar movement by using an asymmetry ratio (nonshifted side/shifted side). Significant differences in mandibular morphology and condylar movement were found between the 2 groups. In the group with menton deviation greater than 4 mm, significant correlations were found between the asymmetry ratio of mandibular morphology and condylar movement: ie, condylar path length and transverse condylar inclination. No significant correlations were found between any of these measurements in the group with menton deviation less than 4 mm. In support of our hypothesis, the results suggested that 3-dimensional mandibular morphologic asymmetry is associated with condylar movement in subjects with mandibular asymmetry. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  8. Influence of mandibular length on mouth opening

    NARCIS (Netherlands)

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

    1999-01-01

    Theoretically, mouth opening not only reflects the mobility of the temporomandibular joints (TMJs) but also the mandibular length. Clinically, the exact relationship between mouth opening, mandibular length, and mobility of TMJs is unclear. To study this relationship 91 healthy subjects, 59 women an

  9. 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...

  10. Giant osteochondroma of the mandibular condyle

    Directory of Open Access Journals (Sweden)

    M R Muthu Sekhar

    2015-01-01

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

  11. Mandibular trauma: a two-centre study

    NARCIS (Netherlands)

    Boffano, P.; Kommers, S.C.; Karagozoglu, K.H.; Gallesio, C.; Forouzanfar, T.

    2015-01-01

    The aims of this study were to assess and compare epidemiological data on mandibular fractures from two European centres and to perform a review of the literature. Between 2001 and 2010, a total of 752 patients with a total of 1167 mandibular fractures were admitted to a hospital in Turin, and 245 p

  12. Late surgical treatment of posttraumatic mandibular deformity

    NARCIS (Netherlands)

    Boffano, P.; Gallesio, C.; Roccia, F.; Forouzanfar, T.

    2013-01-01

    Delays in treatment may complicate the treatment of mandibular trauma, leading to a bone healing in an abnormal position and to a posttraumatic mandibular deformity such as malunion, malocclusion, and asymmetry. All these features may make delayed treatment a challenging issue. Therefore, early redu

  13. Sertraline induced acute mandibular dystonia

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    Dhanya Raveendranathan

    2015-01-01

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

  14. Cerebro-costo-mandibular syndrome

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    Flodmark, P. [Dept. of Diagnostic Radiology, Central Hospital Halmstad (Sweden); Wattsgaard, C. [Dept. of Diagnostic Radiology, Malmoe Univ. Hospital (Sweden)

    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.)

  15. Vertebral autograft used as bone transplant for anterior cervical corpectomy: technical note.

    Science.gov (United States)

    Rieger, Andreas; Holz, Carsten; Marx, Thomas; Sanchin, Lhagva; Menzel, Matthias

    2003-02-01

    In this prospective patient study, we used a surgical technique for autograft bone fusion during anterior cervical corpectomy (ACC) in patients experiencing cervical spondylotic myelopathy. We packed the resected bone material of the corpectomy into a titanium mesh cage. To evaluate the efficacy of our autograft technique, we analyzed the results according to neurological outcome, radiological outcome, and complications. Between 1995 and 1998, 27 ACC operations were performed for cervical spondylotic myelopathy caused by multisegmental cervical spondylosis. In all patients, decompression of the cervical canal and/or spinal nerve roots was performed by a median cervical corpectomy by an anterior approach. After the ACC was completed, a titanium mesh cage, which was variable in diameter and length, was filled with morselized and impacted bone material from the cervical corpectomy and was then implanted. An anterior cervical plate was placed in all patients to achieve primary stability of the cervical vertebral column. Age, sex, pre- and postoperative myelopathy, number of decompressed levels, radiological results, and complications were assessed. The severity of myelopathy was graded according to the scoring system of the Japanese Orthopaedic Association. Symptomatic improvement of neurological deficits was achieved in 80% of the patients. The mean preoperative Japanese Orthopaedic Association score improved from 13.1 to 15.2 postoperatively (P vertical movement of 2.25 +/- 0.43 mm of the titanium cage into the adjacent vertebral bodies was observed in 24 patients. In patients with either a lordotic or neutral cervical spinal axis postoperatively, the axis remained unchanged during the entire follow-up period. The results of this study demonstrate that transplantation of autograft bone material harvested during the ACC integrated well in the cage and in the adjacent vertebral bodies. Thus, complications associated with explantation of autograft material from other

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

    Directory of Open Access Journals (Sweden)

    Khalil Mohamed R

    2011-03-01

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

  17. Mandibular reconstruction in adults: a review.

    Science.gov (United States)

    Goh, Bee Tin; Lee, Shermin; Tideman, Henk; Stoelinga, Paul J W

    2008-07-01

    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 mandibular continuity and muscle attachments. There should also be room for implant insertion so as to allow for rehabilitation of occlusion and articulation, whereas the function of the inferior alveolar nerve should be restored to assure adequate sensitivity of the lips. Mandibular reconstruction principles and techniques have evolved dramatically over the years. Refinements in techniques continue to improve patient quality of life. This paper reviews current techniques of mandibular reconstruction in adults and discusses the strengths and weaknesses of each.

  18. Comparison of tendon-bone healing between autografts and allografts after anterior cruciate ligament reconstruction using magnetic resonance imaging.

    Science.gov (United States)

    Ge, Yunshen; Li, Hong; Tao, Hongyue; Hua, Yinghui; Chen, Jiwu; Chen, Shiyi

    2015-04-01

    The purpose of the study is to compare tendon-bone healing between autograft tendons and allograft tendons after anterior cruciate ligament (ACL) reconstruction using 3.0T magnetic resonance imaging. A total of 36 participants (18 with autograft and 18 with allograft reconstruction) underwent MRI scans at least 2 years after the ACL reconstruction operation. Oblique axial images were obtained on three-dimensional dual-echo steady-state images and imported into solid modelling software for three-dimensional model reconstruction of the bone tunnel. The graft signal intensity in the tunnel, tendon-bone interface, tunnel morphology, and tunnel area was analysed using the Siemens software packages to determine the tendon-bone healing between the groups. For the tunnel morphology, both groups exhibited bone tunnel enlargement either at the femoral or tibial tunnel aperture. For the tendon-bone interface, one patient in the autograft group and two patients in the allograft group exhibited a significant fibrous scar tissue bands at the tendon-bone interface. The graft signal/noise quotient values of the allograft group were higher than the autograft group. However, there was no significant difference in the tunnel area between the allograft group and the autograft group. Although the autograft tendons exhibited a better remodelling effect than did the allograft tendons in the bone tunnel, there was no significant difference in the tendon-bone healing between the autograft tendons and the allograft tendons postoperatively. These findings indicate that the biomechanical effect of graft motion may play a significant role in the tunnel aperture. III.

  19. Radiographic study of mandibular asymmetry

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Yeon Hwa; Cho, Bong Hae [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Pusan National University, Pusan (Korea, Republic of)

    1998-02-15

    The purpose of this study was to perform the radiographic measurements and temporomandibular joint evaluation in mandibular asymmetry. For this study, thirty-two patients who have mandibular asymmetry were selected and submentovertex, panoramic and lateral corrected tomographic radiographs were taken. Horizontal and vertical analysis using various landmarks on these radiographs were performed. Also radiographic and clinical evaluation of temporomandibular joint were obtained. The results were as follows: 1. On the submentovertex radiograph, the mean distance of Pogonion to midline was 5.0 {+-} 3.8 mm. 2. The mean distance of Pogonion to Gonion between the deviated and the contra-lateral side (p<0.001). 3. The distance difference of Pogonion to Gonion between the deviated and the contra-lateral side was significantly related to the degree of asymmetry (p<0.001). 4. On panoramic radiograph,the condylar height of the contral-lateral side was significantly longer than the one of the deviated side (p<0.001). 5. On lateral corrected tomogram, bony of temporomandibular joint was observed in 11 condyles of the deviated side and 9 condyles of the contra-lateral side. Erosion and ostephyte were the most common changes in both the deviated and the contra-lateral sides.

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

    Science.gov (United States)

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

    2016-09-01

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

  1. Histological comparison of fate of ligamentous insertion after reconstruction of anterior cruciate ligament:autograft vs allograft

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To analyze the histological results and the biological remodeling of ligamentous insertion after the reconstruction of anterior cruciate ligament ( ACL ) with autograft or allograft tendon.Methods: Extensor digitorum tendon was harvested from hind limb as graft material and transplanted to reconstruct the resected ACL in 12 mongrel dogs. Each free tendon end was secured by holding sutures and then the sutures were tied to the post screw at the femoral and tibial bony tunnel outlet after transplantation respectively.Autograft was randomly performed on one side of knee while allograft on the other side of knee. After transplantation, the histological analysis was undertaken at the 6th, 12th weeks and the 6th month using hematoxylineosin (HE) stain under light microscope.Results: The insertion structure of normal ACL typically consisted of four layers, I. E., dense connective tissue, fibrocartilage, mineralized fibrocartilage and bone.There was a distinct regular tidemark line between fibrocartilage and mineralized fibrocartilage. At the 6th week postoperatively, loose connective tissue presented in the interspace between graft and bony tunnel wall in both autograft and allograft groups. At the 12th week postoperatively, the collagenous fibers between autograft and tunnel wall became well organized and the four layers of insertion with discontinuous tidemark line were demonstrated indistinctly in autograft group but not in allograft group. At the 6th month postoperatively, both of a clear and continuous tidemark line and distinct four layers could be seen in autograft group. In allograft group, only a waved discontinuous tidemark line was shown and either the anatomic morphology or the maturity of insertion was inferior to that of autograft group.Conclusions: At the 6th month postoperatively,although the ligament-cartilage insertion is primarily formed after ACL reconstruction with autograft or allograft tendon, the histological morphology and the

  2. Microskin autografting in the treatment of burns over 70% of total body surface area: 14 years of clinical experience.

    Science.gov (United States)

    Chen, Xu-Lin; Liang, Xun; Sun, Li; Wang, Fei; Liu, Sheng; Wang, Yong-Jie

    2011-09-01

    Despite the fact that early excision and grafting have significantly improved burn outcomes, the management of severely burned patients whose burn size exceeds 70% total body surface area (TBSA) still represents a big challenge for burn surgeons all over the world. During the period of 1997-2010 at our centre, aggressive excision and microskin autografting were performed in 63 severely burned patients. Their burn sizes ranged from 70% to 98% TBSA with a mean of 84.9%. The average full-thickness burn was 66.3% (range, 29-94%). Thirty patients had concomitant inhalation injury. Two to 7 days after burn, these patients underwent aggressive excisions ranging from 25% to 60% TBSA and transplantation of microskin autograft overlaid with allograft. The ratios of donor-site to recipient-site surface area were between 1:6 and 1:18. Signs of epithelialization were shown within 35-55 days. The wound healing rate was 74.9% (176/235), with 51.1% of cases (120/235) healing completely and 23.8% (56/235) improving. Microskin autografting yielded an overall survival rate of 63.5%; only 23 patients died. Our clinical experience in using the microskin autografting for burn coverage suggests that the technique is very effective in covering extensive burns, and that it is particularly useful when graft donor sites are very limited due to its high utilization rate of donor site. The factors affecting the outcome of microskin autografting are discussed herein.

  3. A radiographic study of mandibular canal

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won Chul; Lee, Sang Rae [Dept. of Oral Radiology, Division of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

    1987-11-15

    The author invested the gonial angle, the angle of mandibular and mental canal to the lower border of the mandible, and a relationship of the position of the mandibular canal to the root apex of the posterior teeth and the cortical plate of the lower of the mandible. The materials consisted of 458 pantomograms in male and female aged 11-40 and divided into 5 groups at year intervals and subdivided into 3 groups by gonial angle. The results were as follows: 1. The gonial angle decreased with age, but slight increase occurred over 26-30 years. 2. The average angle of the mandibular canal to the lower border of the mandible was 151.6 degree and did not correlate with age. 3. The average angle of the mental canal to the lower border of the mandible was 36.9 degree and didn't correlate with age. 4. The angles of mandibular and mental canal to the lower border of mandible correlated with gonial angle. 5. The distance from the root apex of the posterior teeth to the upper wall mandibular canal was most short at the region of the distal root of the mandibular second and increased with age at the region of the mandibular second molar. 6. The distance from the lower wall of the mandibular canal to the cortical plate of the lower border of the mandibule was most short at the region of the mesial root of the mandibular first molar and didn't correlate with age.

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

    Science.gov (United States)

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

    2007-10-01

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

  5. Results of Limbal Conjunctival Autograft Transplantation in Primary and Recurrent Pterygium Surgery

    Directory of Open Access Journals (Sweden)

    Raşit Kılıç

    2014-12-01

    Full Text Available Objectives: To evaluate the results of limbal conjunctival autograft transplantation in cases with primary and recurrent pterygium. Materials and Methods: A total of 54 eyes of 49 patients who were operated for pterygium with limbal conjunctival autograft technique between April 2011-July 2013 with at least 6 months of follow-up were retrospectively assessed. All cases were distributed into 3 groups according to the postoperative therapy and the primary/recurrent nature of pterygium: Recurrent pterygium with postoperative topical cyclosporin A+hydroxypropylmethylcellulose treatment were included in group 1, primary pterygium with postoperative topical cyclosporin A+hydroxypropylmethylcellulose were included in group 2, and primary pterygium without either topical cyclosporin A or hydroxypropylmethylcellulose were included in group 3. Results: Eleven eyes of 9 patients were detected for group 1, 11 eyes of 11 patients for group 2, and 32 eyes of 29 patients were detected for group 3. Follow-up period was 17±9.1 months for group 1, 14.4±6.1 months for group 2, 13.2±7 months for group 3, and 14.2±7.3 months for all groups. Totally, two recurrences (3.7% were observed as one case for both group 1 (9.1% and group 3 (3.1% during the follow-up period. The recurrence rate between the three groups was not statistically significantly different (p=0.653. Conclusion: Limbal conjunctival autograft technique is an effective and safe technique in excision of primary and recurrent pterygium. (Turk J Ophthalmol 2014; 44: 449-53

  6. Autografting with CD34+ peripheral blood stem cells: retained engraftment capability and reduced tumour cell content.

    Science.gov (United States)

    Voso, M T; Hohaus, S; Moos, M; Pförsich, M; Cremer, F W; Schlenk, R F; Martin, S; Hegenbart, U; Goldschmidt, H; Haas, R

    1999-02-01

    The efficacy of an immunomagnetic purging method and the Isolex 300 devices were assessed for selecting CD34+ cells from leukapheresis products of 29 patients with non-Hodgkin's lymphoma (NHL), 39 with multiple myeloma and 34 with breast cancer. The mean purity of the CD34+ cell population was 93.6% and the mean recovery was 67.7%. Following enzymatic cleavage by chymopapain the expression of Thy-1 and Leu-8 was significantly reduced without affecting haematological recovery. The population of selected CD34+ cells of 4/8 patients with follicular lymphoma became PCR-negative. A 2.5 log reduction of tumour cells could be achieved in four patients with multiple myeloma as shown by a quantitative PCR assay. There were no tumour cells detectable in any of the 19 CD34+ cell preparations of patients with breast cancer. In 64 patients who received 94 cycles of high-dose therapy, a mean number of 4.7x 10(6) CD34+ cells/kg were autografted. The time needed for platelet reconstitution was different when a comparison was made with 156 patients, who had received unmanipulated leukapheresis products (10 v 12 d, P = 0.006). No significant differences with regard to neutrophil recovery were noted. Five patients had a graft failure. Two of them died (on day 78 and 88 following PBSCT), and three patients were rescued with unmanipulated back-up transplants. In conclusion, the immunomagnetic selection of CD34+ cells provides autografts with reduced tumour cell content and an engraftment ability similar to that of unmanipulated autografts.

  7. Subtalar distraction arthrodesis using fresh-frozen allogeneic femoral head augmented with local autograft.

    Science.gov (United States)

    Chiang, Chao-Ching; Tzeng, Yun-Hsuan; Lin, Chien-Fu Jeff; Huang, Ching-Kuei; Chen, Wei-Ming; Liu, Chien-Lin; Chen, Tain-Hsiung

    2013-04-01

    Tricortical autograft has been commonly used in subtalar distraction arthrodesis (SDA) for severe calcaneal malunion. Structural allograft enriched with orthobiological agents is an alternative. This study was performed to evaluate the results of SDA using fresh-frozen allogeneic femoral head without the addition of orthobiological agents. We retrospectively reviewed 15 consecutive SDA procedures (13 patients) with allogeneic femoral head augmented with local autograft for the treatment of severe calcaneal malunion. Clinical outcome was evaluated with the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, visual analog scale (VAS) pain score, Short Form-12 (SF-12), range of motion (ROM) of the ankle joint, and patient satisfaction rate. Radiographic assessment included the talar declination angle (TDA), calcaneal inclination angle (CIA), lateral talocalcaneal angle (LTCA), heel height, calcaneal length, and union time. At a median follow-up of 36.0 months (range, 24-47 months), all 15 feet (100%) achieved union, at a median of 13.0 weeks (range, 12-18 weeks). The AOFAS score and VAS pain score improved significantly, with a satisfaction rate of 93.3%. The TDA, CIA, LTCA, and heel height improved significantly. The median increase in heel height was 8.6 mm (range, 1.9-20.1 mm). There was a significant reduction in calcaneal length. Complications included 1 varus malalignment, 1 complex regional pain syndrome, 1 hardware irritation, and 1 sural neuralgia. This study found that SDA using fresh-frozen femoral head allograft without an orthobiological agent was cost-effective and may have outcomes comparable to those using autograft or allograft enriched with orthobiological agents.

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

    Directory of Open Access Journals (Sweden)

    Tarek El-Bialy

    2013-01-01

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

  9. Intercalary Reconstruction after Wide Resection of Malignant Bone Tumors of the Lower Extremity Using a Composite Graft with a Devitalized Autograft and a Vascularized Fibula

    Directory of Open Access Journals (Sweden)

    Koichi Ogura

    2015-01-01

    Full Text Available Introduction. Although several intercalary reconstructions after resection of a lower extremity malignant bone tumor are reported, there are no optimal methods which can provide a long-term reconstruction with fewest complications. We present the outcome of reconstruction using a devitalized autograft and a vascularized fibula graft composite. Materials and Methods. We conducted a retrospective review of 11 patients (7 males, 4 females; median age 27 years undergoing reconstruction using a devitalized autograft (pasteurization (n=6, deep freezing (n=5 and a vascularized fibula graft composite for lower extremity malignant bone tumors (femur (n=10, tibia (n=1. Results. The mean period required for callus formation and bone union was 4.4 months and 9.9 months, respectively. Four postoperative complications occurred in 3 patients: 2 infections (1 pasteurized autograft, 1 frozen autograft and 1 fracture and 1 implant failure (both in pasteurized autografts. Graft removal was required in 2 patients with infections. The mean MSTS score was 81% at last follow-up. Conclusions. Although some complications were noted in early cases involving a pasteurized autograft, our novel method involving a combination of a frozen autograft with a vascularized fibula graft and rigid fixation with a locking plate may offer better outcomes than previously reported allografts or devitalized autografts.

  10. A comparative morphological, electrophysiological and functional analysis of axon regeneration through peripheral nerve autografts genetically modified to overexpress BDNF, CNTF, GDNF, NGF, NT3 or VEGF

    NARCIS (Netherlands)

    Hoyng, Stefan A; De Winter, Fred; Gnavi, Sara; de Boer, Ralph; Boon, Lennard I; Korvers, Laura M; Tannemaat, Martijn R; Malessy, Martijn J A; Verhaagen, J.

    2014-01-01

    The clinical outcome of microsurgical repair of an injured peripheral nerve with an autograft is suboptimal. A key question addressed here is: can axon regeneration through an autograft be further improved? In this article the impact of six neurotrophic factors (BDNF, CNTF, GDNF, NGF, NT3 or VEGF) o

  11. Computed Tomographic Evaluation of Mandibular Ameloblastoma

    Directory of Open Access Journals (Sweden)

    N Eswar

    2003-01-01

    Five interesting cases of mandibular ameloblastoma are presented here, each case showing different histological pattern and corresponding computer tomographic appearance. Also an attempt is made to establish CT pattern in these histological varieties of ameloblastoma.

  12. Incidence of Impacted Mandibular Canine and Associated ...

    African Journals Online (AJOL)

    Nigerian Quarterly Journal of Hospital Medicine ... Incidence of Impacted Mandibular Canine and Associated Pathologies in an Orthodontic Patient ... The clinical data and panoramic radiographs were reviewed and observations on the status ...

  13. Predicting pathology in impacted mandibular third molars

    OpenAIRE

    Aveek Mukherji; Mohit Pal Singh; Prashant Nahar; Bhuvaneshwari S Balaji; Hemant Mathur; Saurabh Goel

    2017-01-01

    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: Conse...

  14. 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.

  15. Locating Mandibular Foramen in Children with Mandibular Retrognathism in Mixed Dentition

    Directory of Open Access Journals (Sweden)

    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.

  16. Cytological features of live limbal tissue donor eyes for autograft or allograft limbal stem cell transplantation

    Directory of Open Access Journals (Sweden)

    Jeison de Nadai Barros

    2011-08-01

    Full Text Available PURPOSE: To evaluate by impression cytology (IC the corneal surface of live limbal tissue donor eyes for autograft or allograft limbal stem cell transplantation (LSCT. METHODS: Twenty limbal donors were enrolled (17 for autograft LSCT and 3 for allograft. Impression cytology was performed before transplantation of superior and inferior limbal grafts and after the third postoperative month. RESULTS: Impression cytology analysis showed sheets of corneal epithelial cells and goblet cell absence beyond the edge of the keratectomy sites in all patients, suggesting that conjunctival invasion towards the center did not occur in any eye. Partial conjunctivalization within 2 to 3 clock hours, confirmed by the presence of goblet cells, was limited to the keratectomy site in 10% of the cases. CONCLUSION: A clear central corneal surface was demonstrated in all eyes following surgery leading to the conclusion that limbal donation was a safe procedure in this group of patients. A small percentage of eyes can have donor sites re-epithelized with conjunctival cells at the periphery of the cornea.

  17. Topical negative pressure improves autograft take by altering nutrient diffusion: A hypothesis.

    Science.gov (United States)

    Wang, Xingang; Zhang, Yuanhai; Han, Chunmao

    2014-01-16

    The one-step surgical procedure for dermal substitutes combined with topical negative pressure (TNP) has proven effective for treating deep skin defects with improved graft take. The primary mechanism by which TNP improves autograft take is unknown. Some studies suggest that TNP promotes the rapid angiogenesis of dermal substitutes, improving graft take. However, at the early stage of one-step transplantation, the vascular system has not formed and imbibition is the main mode of nutrient supply. TNP can shorten the diffusion distance from the wound bed to the graft, leading to the timely renewal of the wound exudate via suction, removing any surplus exudate, and reducing tissue edema. In addition, TNP can regulate the local blood flow and inhibit bacterial colonization. Therefore, we hypothesized that TNP establishes a rapid balance between the nutrient supply to the wound bed and nutritional requirement of the graft via these pathways in the relatively closed, moist environment, improving autograft take. However, this balance could be affected by any negative pressure, intermittent or continuous. It is necessary to test this hypothesis in laboratory and clinical studies of the mode of nutrient supply in the imbibition phase and the change in exudate content.

  18. Reconstruction of the medial patellofemoral ligament: Evaluation of the clinical results of autografts versus allografts.

    Science.gov (United States)

    Calvo Rodríguez, R; Figueroa Poblete, D; Anastasiadis Le Roy, Z; Etchegaray Bascur, F; Vaisman Burucker, A; Calvo Mena, R

    2015-01-01

    The purpose of the study was to evaluate the functional results after medial patellofemoral ligament (MPFL) reconstruction in patients using auto- and allograft. A retrospective study was conducted on 28 patients with recurrent patellar dislocation, with 13 patients (13 knees) undergoing MPFL reconstruction with hamstring autograft, and 15 patients (16 knees) with reconstruction surgery with allograft. The total group included 13 males and 15 females, with an age range of 15 to 38 years. The graft-related morbidity was studied and a clinical assessment was performed using the pre- and postoperative Kujala score. Associated complications were reported for each group. All the patients had more than 12 months of follow up. No recurrent dislocations or graft related complications were reported in either group. The post-operative Kujala subjective knee score was 89.2 in the autograft group, and 92.6 in the allograft group (p >.05). One patient in the allograft group received a revision surgery due to poor positioning of anchors. Another patient in the allograft group had non-displaced patella fracture related to the bone tunnels and another patient had flexion deficit and needed mobilization under anesthesia. There were no significant differences between both groups, and the results were comparable. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  19. Limited integrative repair capacity of native cartilage autografts within cartilage defects in a sheep model.

    Science.gov (United States)

    Gelse, Kolja; Riedel, Dominic; Pachowsky, Milena; Hennig, Friedrich F; Trattnig, Siegfried; Welsch, Götz H

    2015-03-01

    The purpose of this study was to investigate integration and cellular outgrowth of native cartilage autografts transplanted into articular cartilage defects. Native cartilage autografts were applied into chondral defects in the femoral condyle of adult sheep. Within the defects, the calcified cartilage layer was either left intact or perforated to induce bone marrow stimulation. Empty defects served as controls. The joints were analyzed after 6 and 26 weeks by macroscopic and histological analysis using the ICRS II Score and Modified O'Driscoll Scores. Non-treated defects did not show any endogenous regenerative response and bone marrow stimulation induced fibrous repair tissue. Transplanted native cartilage grafts only insufficiently integrated with the defect borders. Cell death and loss of proteoglycans were present at the margins of the grafts at 6 weeks, which was only partially restored at 26 weeks. Significant cellular outgrowth from the grafts or defect borders could not be observed. Bonding of the grafts could be improved by additional bone marrow stimulation providing ingrowing cells that formed a fibrous interface predominantly composed of type I collagen. Transplanted native cartilage grafts remain as inert structures within cartilage defects and fail to induce integrative cartilage repair which rather demands additional cells provided by additional bone marrow stimulation. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  20. Mandibulotomy in the irradiated patient

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, J.; Freeman, J.; Birt, D.

    1989-04-01

    Though the mandibular swing, as an approach to certain upper aerodigestive tract malignancies, has been gaining popularity in recent years, there has been little reported as to the feasibility of this procedure in subjects who have received radical preoperative radiotherapy. We have recently reported the results of 23 such patients, and we now present an update. The results presented are of a retrospective analysis of 44 patients, 50% of whom received radical preoperative radiotherapy to fields including the osteotomy site. As in the previous study, there were no statistically significant differences between the complication rates in the irradiated and nonirradiated patient populations. All the patients were orally rehabilitated.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Distraction osteogenesis in the irradiated mandible. A case report

    NARCIS (Netherlands)

    Raghoebar, GM; Jansma, J; Vissink, A; Roodenburg, JLN

    2005-01-01

    Background: Distraction osteogenesis has been suggested as a relatively simple method of mandibular reconstruction following ablative head and neck surgery. Some authors report good results in irradiated patients while other authors report limitations with this group of patients. Patient: In a 72-ye

  3. Distraction osteogenesis in the irradiated mandible. A case report

    NARCIS (Netherlands)

    Raghoebar, GM; Jansma, J; Vissink, A; Roodenburg, JLN

    2005-01-01

    Background: Distraction osteogenesis has been suggested as a relatively simple method of mandibular reconstruction following ablative head and neck surgery. Some authors report good results in irradiated patients while other authors report limitations with this group of patients. Patient: In a 72-ye

  4. Is structural hydroxyapatite tricalcium-phosphate graft or tricortical iliac crest autograft better for calcaneal lengthening osteotomy in childhood?

    DEFF Research Database (Denmark)

    Martinkevich, P; Rahbek, Ole; Stilling, M

    2016-01-01

    AIMS: To compare the structural durability of hydroxyapatite-tricalcium phosphate (HATCP) to autologous iliac crest bone graft in calcaneal lengthening osteotomy (CLO) for pes planovalgus in childhood. PATIENTS AND METHODS: We present the interim results of ten patients (HATCP, n = 6 and autograft...

  5. OP-1 compared with iliac crest autograft in instrumented posterolateral fusion a randomized, multicenter non-inferiority trial

    NARCIS (Netherlands)

    Delawi, Diyar; Jacobs, Wilco; Van Susante, Job L C; Rillardon, Ludovic; Prestamburgo, Domenico; Specchia, Nicola; Gay, Emmanuel; Verschoor, Nico; Garcia-Fernandez, Carlos; Guerado, Enrique; Van Ufford, Henriette Quarles; Kruyt, Moyo C.; Dhert, Wouter J A; Cumhur Oner, F.

    2016-01-01

    Background: Spinal fusion with the use of autograft is a commonly performed procedure. However, harvesting of bone from the iliac crest is associated with complications. Bone morphogenetic proteins (BMPs) are extensively used as alternatives, often without sufficient evidence of safety and efficacy.

  6. OP-1 Compared with Iliac Crest Autograft in Instrumented Posterolateral Fusion : A Randomized, Multicenter Non-Inferiority Trial

    NARCIS (Netherlands)

    Delawi, Diyar; Jacobs, Wilco; van Susante, Job L C; Rillardon, Ludovic; Prestamburgo, Domenico; Specchia, Nicola; Gay, Emmanuel; Verschoor, Nico; Garcia-Fernandez, Carlos; Guerado, Enrique; Quarles van Ufford, Henriette; Kruyt, Moyo C; Dhert, Wouter J A; Oner, F Cumhur

    2016-01-01

    BACKGROUND: Spinal fusion with the use of autograft is a commonly performed procedure. However, harvesting of bone from the iliac crest is associated with complications. Bone morphogenetic proteins (BMPs) are extensively used as alternatives, often without sufficient evidence of safety and efficacy.

  7. Heterografting with nonself rootstocks induces genes involved in stress responses at the graft interface when compared with autografted controls.

    Science.gov (United States)

    Cookson, S J; Clemente Moreno, M J; Hevin, C; Nyamba Mendome, L Z; Delrot, S; Magnin, N; Trossat-Magnin, C; Ollat, N

    2014-06-01

    Although grafting is widely used in the agriculture of fruit-bearing crops, little is known about graft union formation in particular when two different species are grafted together. It is fascinating that two different plant species brought together can develop harmoniously as one organism for many decades. The objective of this study was to determine whether grafting two different grapevine genotypes alters gene expression at the graft interface in comparison to the presumably wound-like gene expression changes induced in autografts. Gene expression at the graft interface was studied 3, 7, 14, and 28 d after grafting in hetero- and autografts of grapevine (Vitis spp.). Genes differentially expressed between the hetero- and autografts during graft union formation were identified. These genes were clustered according to their expression profile over the time course. MapMan and Gene Ontology enrichment analysis revealed the coordinated upregulation of genes from numerous functional categories related to stress responses in the hetero- compared to the autografts. This indicates that heterografting with nonself rootstocks upregulates stress responses at the graft interface, potentially suggesting that the cells of the graft interface can detect the presence of a nonself grafting partner. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology.

  8. Ectopic bone formation in bone marrow stem cell seeded calcium phosphate scaffolds as compared to autograft and (cell seeded allograft

    Directory of Open Access Journals (Sweden)

    J O Eniwumide

    2007-08-01

    Full Text Available Improvements to current therapeutic strategies are needed for the treatment of skeletal defects. Bone tissue engineering offers potential advantages to these strategies. In this study, ectopic bone formation in a range of scaffolds was assessed. Vital autograft and devitalised allograft served as controls and the experimental groups comprised autologous bone marrow derived stem cell seeded allograft, biphasic calcium phosphate (BCP and tricalcium phosphate (TCP, respectively. All implants were implanted in the back muscle of adult Dutch milk goats for 12 weeks. Micro-computed tomography (µCT analysis and histomorphometry was performed to evaluate and quantify ectopic bone formation. In good agreement, both µCT and histomorphometric analysis demonstrated a significant increase in bone formation by cell-seeded calcium phosphate scaffolds as compared to the autograft, allograft and cell-seeded allograft implants. An extensive resorption of the autograft, allograft and cell-seeded allograft implants was observed by histology and confirmed by histomorphometry. Cell-seeded TCP implants also showed distinct signs of degradation with histomorphometry and µCT, while the degradation of the cell-seeded BCP implants was negligible. These results indicate that cell-seeded calcium phosphate scaffolds are superior to autograft, allograft or cell-seeded allograft in terms of bone formation at ectopic implantation sites. In addition, the usefulness of µCT for the efficient and non-destructive analysis of mineralised bone and calcium phosphate scaffold was demonstrated.

  9. Ectopic bone formation in bone marrow stem cell seeded calcium phosphate scaffolds as compared to autograft and (cell seeded) allograft

    NARCIS (Netherlands)

    Eniwumide, J.O.; Yuan, Huipin; Cartmell, S.H.; Meijer, G.J.; de Bruijn, Joost Dick

    2007-01-01

    Improvements to current therapeutic strategies are needed for the treatment of skeletal defects. Bone tissue engineering offers potential advantages to these strategies. In this study, ectopic bone formation in a range of scaffolds was assessed. Vital autograft and devitalised allograft served as

  10. Repair of sheep long bone cortical defects filled with COLLOSS, COLLOSS E, OSSAPLAST, and fresh iliac crest autograft.

    Science.gov (United States)

    Huffer, William E; Benedict, James J; Turner, A S; Briest, Arne; Rettenmaier, Robert; Springer, Marco; Walboomers, X F

    2007-08-01

    COLLOSS and COLLOSS E are osteoinductive bone void fillers consisting of bone collagen and noncollagenous proteins from bovine and equine bone, respectively. The aim of this study was to compare COLLOSS, COLLOSS E, iliac bone autograft, sintered beta tricalcium phosphate (beta-TCP; OSSAPLAST), and COLLOSS E plus OSSAPLAST. Materials were placed for 4, 8, or 24 weeks in 5-mm cortical bone defects in sheep long bones. Histological sections in a plane perpendicular to the long axis of the bone were used to measure the total repair area (original defect plus callus) and the area of bone within the total repair area. The incidence of defect union was also evaluated. At 4 and 8 weeks, defects treated with COLLOSS and COLLOSS E with or without OSSAPLAST had total repair and bone areas equivalent to autograft, and larger than OSSAPLAST-treated defects. At 8 weeks, the incidence of defect union was higher in defects treated with autograft or COLLOSS E plus OSSAPLAST than in untreated defects. At 24 weeks, the incidence of union was 100% in all treatment groups and 0% in untreated defects. The incidence of union was related to the degree of remodeling between 8 and 24 weeks. This was greater in all treated than nontreated defects. In conclusion, COLLOSS and COLLOSS E were equivalent to each other and to autograft, and superior to beta-TCP, in this study model.

  11. Total hip arthroplasty with cementless cups and femoral head autografts for patients with hip dysplasia and osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    吴立东; 金礼斌; 严世贵; 杨泉森; 戴雪松; 王祥华

    2004-01-01

    Objective:To evaluate the outcome of total hip arthroplasty (THA) with cementless cups and femoral head autografts for patients with hip dysplasia and osteoarthritis.Methods: Between 1995 and 2002, we implanted 23cementless cups and femoral head autografts in 20 patients with hip dysplasia and osteoarthritis. In this study, a retrospective study was made on 21 hips in 20 patients (18females and 2 males, aged 50 years on an average) with developmental hip dysplasia treated by THA with acementless cup and femoral head autograft. The acetabular cup was placed at the level of the true acetabuinm and all the patients required autogenous femoral head grafts due to acetabular deficiency. The average rate of the acetabular cup covered by the femoral head autograft was 31%(ranging from 10% to 45%). Eight hips had less than 25%cup coverage and thirteen between 25% and 50%. The average follow-up period was 4.7 years (range, 1-8 years).The replacing outcome was evaluated by modified Harris hip score. Preoperative and follow-up radiographs were made.Results: All the autografts were united to the host bones. No autograft was collapsed or no component from the hip was loosed in all the patients. According to the modified Harris hip score, the average hip score increased from 46 before operation to 89 at the final review. Before operation, the leg-length discrepancy was greater than 2 cm in all the patients except one with bilateral hip dysplasia.After operation, only 2 out of 20 patients had a leg-length discrepancy greater than 1 cm. Three hips showed minor bone resorption in the lateral portion of the graft, which did not support the cup. Three hips developed Grade 1Brooker heterotopic ossification and one developed Grade 2.Conclusions: THA with a cementless cup and a femoral head autograft for patients with osteoarthritis resulted from hip dysplasia can result in favorable outcomes. This method can provide reliable acetabular fixation and restore the acetabular bone stock in

  12. Quantitative computed tomography bone mineral density measurements in irradiated and non-irradiated minipig alveolar bone: an experimental study.

    NARCIS (Netherlands)

    Verdonck, H.W.; Meijer, G.J.; Nieman, F.H.; Stoll, C.; Riediger, D.; Baat, C. de

    2008-01-01

    OBJECTIVE: The objective of this study was to analyse the effect of irradiation on bone mineral density (BMD). MATERIALS AND METHODS: All maxillary and mandibular pre-molars and molars of six minipigs were extracted. After a 3-month healing period, the maxilla and mandibles of three minipigs receive

  13. Mandibular second premolar with four roots

    Directory of Open Access Journals (Sweden)

    Sefika Nur Akyuz

    2012-01-01

    Full Text Available Detection of normal and abnormal variation in tooth anatomy is essential for clinical success. It is generally well known that the mandibular second premolar teeth have a single root and canal. However, the mandibular second premolar teeth have sometimes more than one root and root canal. The endodontic treatment of a mandibular second premolar with four roots which separated at different levels along the middle third of the root is presented in this case report. Preoperative radiographs appeared radiolucency and different root anatomy in the region of the mandibular second premolar. The root canals were prepared using Mtwo rotary system (VDW, Munich, Germany and obturated laterally condensed gutta percha and AH plus (Dentsply De Trey, Konstanz, Germany. After the completion of root canal treatment, the tooth was restored with a posterior composite filling material. On follow-up, the tooth was clinically and radiographically asymptomatic for two years. Clinicians should be aware of the importance of careful clinical and radiographic examination of mandibular premolars during the endodontic treatment. Radiographs exposed at two different horizontal angles and their careful interpretation facilitates the search of additional root canals.

  14. Infused autograft lymphocyte to monocyte ratio predicts survival in classical Hodgkin lymphoma

    Directory of Open Access Journals (Sweden)

    Porrata LF

    2015-02-01

    Full Text Available Luis F Porrata, David J Inwards, Stephen M Ansell, Ivana N Micallef, Patrick B Johnston, William J Hogan, Svetomir N Markovic Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA Abstract: The infused autograft lymphocyte to monocyte ratio (A-LMR as a surrogate marker of host immunity (ie, absolute lymphocyte count and CD14+ HLA-DRlow/neg immunosuppressive monocytes (ie, absolute monocyte count is a prognostic factor for patients with diffuse large B-cell lymphoma after autologous peripheral hematopoietic stem cell transplantation (APHSCT. Thus, we set out to investigate if A-LMR can also affect survival post-APHSCT in classical Hodgkin lymphoma. From 1994 to 2012, 183 patients with classical Hodgkin lymphoma who underwent APHSCT were studied. The patients were randomly divided into a training set (n=122 and a validation set (n=61. The receiver operating characteristic and area under the curve identified an A-LMR ≥1 as the best cut-off value and validated by the k-fold cross-validation in the training set. Multivariate analysis showed A-LMR to be an independent prognostic factor for survival in the training set. Patients with an A-LMR ≥1.0 experienced a superior overall survival (OS versus patients with an A-LMR <1.0 (median OS not reached versus 40.4 months, 5-year OS rates of 86% [95% CI 72–93] versus 43% [95% CI 28–58], P<0.0001, respectively in the training set. In the validation set, an A-LMR ≥1 showed a median OS of not reached versus 41.4 months for an A-LMR ,1, 5-year OS rates of 90% (95% CI 73–97 versus 48% (95% CI 28–68; P<0.0001. A-LMR provides a platform to engineer an autograft versus tumor effect to improve clinical outcomes in patients with classical Hodgkin lymphoma undergoing APHSCT. Keywords: autograft absolute lymphocyte to monocyte count ratio, survival, autologous peripheral hematopoietic stem cell transplantation, classical Hodgkin lymphoma

  15. The evaluation of muscle recovery after anatomical single-bundle ACL reconstruction using a quadriceps autograft.

    Science.gov (United States)

    Iriuchishima, Takanori; Ryu, Keinosuke; Okano, Tatsumasa; Suruga, Makoto; Aizawa, Shin; Fu, Freddie H

    2017-05-01

    The purpose of this study was to reveal the degree of muscle recovery and report the clinical results of anatomical single-bundle ACL reconstruction using a quadriceps autograft. Twenty subjects undergoing anatomical single-bundle ACL reconstruction using a quadriceps autograft were included in this study. A 5-mm-wide, 8-cm-long graft, involving the entire layer of the quadriceps tendon, was harvested without bone block. The average graft diameter was 8.1 ± 1.4 mm. An initial tension of 30 N was applied. The femoral tunnel was created from the far-medial portal. Each femoral and tibial tunnel was created close to the antero-medial bundle insertion site. For the evaluation of muscle recovery (quadriceps and hamstring), a handheld dynamometer was used. The evaluation of muscle recovery was performed pre-operatively, and at 3, 6, 9, and 12 months after surgery. Muscle recovery data were calculated as a percentage of leg strength in the non-operated leg. Anterior tibial translation (ATT), pivot shift test, and IKDC score were evaluated. The average quadriceps strength pre-operatively, and at 3, 6, 9, and 12 months after ACL reconstruction was 90.5 ± 19, 67.8 ± 21.4, 84 ± 17.5, and 85.1 ± 12.6 %, respectively. The average hamstring strength pre-operatively, and at 3, 6, 9, and 12 months after ACL reconstruction was 99.5 ± 13.7, 78.7 ± 11.4, 90.5 ± 19, and 96.7 ± 13.8 %, respectively. ATT pre-operatively and at 12 months after surgery was 5.4 ± 1.3 and 1.0 ± 0.8 mm, respectively. No subjects exhibited positive pivot shift after surgery. Within 6 months following surgery, quadriceps hypotrophy was observed in all subjects. However, the hypotrophy had recovered at 12 months following surgery. No subjects complained of donor site pain after surgery. Anatomical single-bundle ACL reconstruction using a quadriceps autograft resulted in equivalent level of muscle recovery and knee stability when compared with previously reported ACL

  16. Sexual Dimorphism in Human Mandibular Canine Teeth: A Radiomorphometric Study

    Directory of Open Access Journals (Sweden)

    K S Nagesh

    2011-01-01

    Conclusion: The present study establishes a statistically significant sexual dimorphism in mandibular canines- It can be concluded that the standard mandibular canine index is a quick and easy method for sex determination.

  17. [Insertion of autografts after acute damage of the common carotid artery. Experimental microvascular anastomoses after balloon dilatation].

    Science.gov (United States)

    Friedrich, R E; Plambeck, K; Bartel-Friedrich, S; Hellner, D; Schmelzle, R

    1997-02-01

    The objective of our investigation was to study the patency rates of anastomoses in arteries, damaged by a balloon dilatation, in a training model of microvascular surgery. In general anaesthesia, a balloon dilatation was repeated 5 times in 31 left common carotid arteries of female Wistar rats (body weight: 250 to 350 g). A common carotid artery autograft of 4 mm was harvested 1 minute after reflow, turned 180 degrees, and reinserted into the artery. The reflow of the vessels was investigated by micro-Doppler ultrasound equipment. Autografts without balloon dilatation or any other intended damage were performed in further 26 common carotid arteries. In addition, in further 14 common carotid arteries the balloon dilatation was the sole damage. The vessels were harvested and investigated postoperatively after perfusion with 3% glutaraldehyde at 1 day, 7 days, and 1 month. The balloon dilatation in no instance caused an occlusion of the vessel as judged by the micro-Doppler ultrasound. One vessel was found to be occluded after reflow was allowed following insertion of the autograft in the group without balloon dilatation. However, this vessel proved to be patent after explantation (patency rate: 100%). In the group with balloon dilatation preceding the autograft insertion, by micro-Doppler ultrasound, 16 vessels were occluded and 14 were patent. At different times of follow-up, in this group the summarized patency rates were 50%. The patency differences in both groups with autografts proved to be significant, both after micro-Doppler imaging and by histological evaluation (p < 0.001). For clinical use the balloon dilatation is recommended to remove a thrombus or to dilate a spastic vessel segment in anastomized vessels threatening the success of microvascular flaps. In this training model of microvascular surgery we demonstrated the thrombogenic effect of balloon dilatation.

  18. Mandibular Condyle Fractures and Treatment Modalities

    Directory of Open Access Journals (Sweden)

    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

  19. Mandibular Reconstruction, State of the Art

    Directory of Open Access Journals (Sweden)

    Julio ACERO

    2011-08-01

    Full Text Available SUMMARY: Mandibular bone loss can result in severe aesthetic and functional consequences for the patient, posing a challenge to the reconstructive maxillo-facial surgeon. Advent of microvascular surgery revolutionized mandible reconstruction introducing the possibility to transfer vascularized bone and soft tissues with high success rate. Major donor sites are the fibula, iliac crest and scapula. Planning of the reconstruction and advantages and disadvantages of the different reconstructive methods are discussed. The iliac crest provides an excellent bone for mandibular reconstruction but has some limits concerning length and versatility of soft tissues. The fibula permits the repair of large mandibular defects due to its length while the scapular osteocutaneous flap allows for the reconstruction of limited bone defects associated with large soft tissue defects. Nonvascularized reconstructive methods are associated with higher failure rates but can be considered in selected cases.

  20. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 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 facial prosthesis. (a) Identification. A mandibular implant facial prosthesis is a device that...

  1. 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...

  2. Mandibular Second Premolar with Four Canals

    Directory of Open Access Journals (Sweden)

    Javad Ghiasi

    2015-09-01

    Full Text Available A mandibular second premolar with four canals is an interesting example of anatomic variations. This report describes a case of a mandibular second premolar with three roots and four canals (one mesiobuccal, two distobuccal and one lingual. The canals were prepared using K-files and irrigated with NaOCl (5.25% and normal saline as the final irrigant. The canals were filled laterally with gutta percha and AH26 sealer (De Trey, Dentsply, Switzerland. This case shows a rare anatomic configuration and points out the importance of looking for additional canals.

  3. Supplemental mandibular mesiodens: a diagnostic challenge.

    Science.gov (United States)

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

    2013-12-01

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

  4. Pattern of mandibular third molar impaction and its association to caries in mandibular second molar: A clinical variant

    Directory of Open Access Journals (Sweden)

    V K Prajapati

    2017-01-01

    Conclusion: According to this study, pattern of mandibular third molar impaction is in association to caries in mandibular second molar. More future studies are needed. In addition, the results of the present study can be used to screen and inform the patients about the possibility of caries in relation to third molar mandibular impaction.

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

    OpenAIRE

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

    2015-01-01

    Background and Objectives: Sexual dimorphism is one of important tool of forensic science. The objective of this study is to assess the dimorphic status of mesio-distal (MD) and bucco-lingual (BL) diameter of mandibular canine with mandibular first molar among the students of dental college. This study is of definite significance as sex chromosomes and hormonal production influenced tooth morphology. Materials and Methods: The descriptive study adopted the purposive sampling technique, of 50 ...

  6. Oro-mandibular manifestations of primary hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    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.

  7. 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...

  8. 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 o

  9. 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.

  10. Cerebro-costo-mandibular syndrome with consanguinity

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-05-01

    The cerebro-costo-mandibular syndrome is a rare disorder characterized by unique posterior rib defects, 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.

  11. 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

  12. Nerve injury caused by mandibular block analgesia

    DEFF Research Database (Denmark)

    Hillerup, S; Jensen, Rigmor H

    2006-01-01

    : 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...

  13. Kissing mandibular canines: Serendipity at its best

    Directory of Open Access Journals (Sweden)

    Sonali Sharma

    2014-01-01

    Full Text Available Transmigration of teeth is a relatively less well known phenomenon. Its etiology is not so well understood. We present a case of bilateral transmigration of mandibular canines with a type 5 classification pattern (Muparappu in a 21 year old male patient with emphasis on its etiology and complications accompanying its management.

  14. Stabilization of mobile mandibular segments in mandibular reconstruction: use of spanning reconstruction plate.

    Science.gov (United States)

    Yap, Yan Lin; Lim, Jane; Ong, Wei Chen; Yeo, Matthew; Lee, Hanjing; Lim, Thiam Chye

    2012-09-01

    The fibular free flap is the gold standard for mandibular reconstruction. Accurate 3-dimensional contouring and precise alignment of the fibula is critical for reestablishing native occlusion and facial symmetry. Following segmental mandibulectomy, the remaining mandibular fragments become freely mobile. Various stabilization methods including external fixation, intermaxillary fixation, and preplating with reconstruction plate have been used. We describe a modification to the preplating technique. After wide resection of buccal squamous cell carcinoma, our patient had an 11-cm mandibular defect from the angle of the left mandible to the right midparasymphyseal region. A single 2.0-mm Unilock® (Synthes, Singapore) plate was used to span the defect. This was placed on the vestibular aspect of the superior border of the mandibular remnants before resection. Segmental mandibulectomy was then performed with the plate removed. The spanning plate was then reattached to provide rigid fixation. The fibular bone was contoured with a single osteotomy and reattached. The conventional technique involves molding of the plate at the inferior border of the mandible. This is time-consuming and not possible in patients with distorted mandibular contour. It is also difficult to fit the osteotomized fibula to the contoured plate. In comparison, the superiorly positioned spanning plate achieve rigid fixation of the mandible while leaving the defect completely free and unhampered by hardware, allowing space for planning osteotomies and easier fixation of the neomandible. Using this modified technique, we are able to recreate the original mandibular profile with ease.

  15. Predicting pathology in impacted mandibular third molars

    Directory of Open Access Journals (Sweden)

    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.

  16. Autografted vines of cultivar ‘Refošk’ (Vitis vinifera L. reveal symptoms of the rugose wood disease

    Directory of Open Access Journals (Sweden)

    Matjaž HLADNIK

    2015-12-01

    Full Text Available Rugose wood disease complex is one of the most important graft-transmissible grapevine diseases and it is considered to be a viral disease. With the aim to obtain more information about appearance of rugose wood disease observed on cultivar ‘Refošk’, ‘Refošk’ vines from collection vineyard in Komen were used for green grafting on SO4 rootstock and autografts for control were made as well. Rugose wood symptoms were observed on grafts of two ‘Refošk’ biotypes, which confirmed graft transmissibility. Appearance of rugose wood symptoms on autografts excluded the impact of incompatibility in rugose wood disease, but at the same time it could be proposed that stress caused by grafting has an important role.

  17. Incidencia de fracturas mandibulares en Guyana INCIDENCE OF MANDIBULAR FRACTURES IN GUYANA

    Directory of Open Access Journals (Sweden)

    Luis Hernández Pedroso

    2005-04-01

    Full Text Available Se realiza un estudio retrospectivo de la incidencia de las fracturas mandibulares en relación con el total de las fracturas maxilofaciales atendidas en la República de Guyana durante el año 2001 debido a su alta presentación en nuestro quehacer diario, con el objetivo de determinar el comportamiento de estas lesiones y su relación con la edad, sexo, etiología y área mandibular vulnerable. Las variables estudiadas fueron sexo, edad, causa de la fractura y región afectada. Las fracturas mandibulares ocuparon el 56,6 % del total de fracturas maxilofaciales y fue más frecuente en los hombres ( 89,5 %. Los grupos etáreos de mayor incidencia fueron de 25 a 34 y de 35 a 44 años, con el 30,6 %. La causa más común de fracturas mandibulares fue la agresión personal ( 68,6 % y la región anatómica más afectada el ángulo mandibular ( 67,4 %.A retrospective study of the incidence of mandibular fractures in relation to the total of maxillofacial fractures attended in the Republic of Guyana during 2001 was conducted taking into account its high ocurrence in our daily practice in order to determine the behavior of these injuries and its connection with age, sex, etiology and vulnerable mandibular area. The variables studied were sex, age, cause of the fracture and affected region. The mandibular fractures accounted for 56.6 % of the total of maxillofacial fractures and they were more frequent in men (89.5 %. The age groups with the highest incidence were from 25 to 34 and from 35 to 44 years old, accounting for 30.6 %. The most frequent cause of mandibular fracture was personal aggression (68.6 % and the commonest anatomical region was the mandibular angle (67.4 %.

  18. Structural bone allografts with intramedullary vascularized fibular autografts for the treatment of massive bone defects in extremities

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To report the clinical outcome of repairing massive bone defects biologically in limbs by homeochronous using structural bone allografts with intramedullary vascularized fibular auto-grafts. Methods: From January 2001 to December 2005. large bone defects in 19 patients (11 men and 8 women, aged 6 to 35 years) were repaired by structural bone allografts with intramedullary vascularized fibular autografts in the homeochronous period. The range of the length of bone defects was 11 to 25 cm (mean 17. 6 cm), length of vascularized free fibular was 15 to 29 cm (mean 19. 2 cm), length of massive bone allografts was 11 to 24 cm (mean 17. 1 cm). Location of massive bone defects was in humerus(n = 1), in femur(n = 9) and in tibia(n = 9), respectively. Results: After 9 to 69 months (mean 38. 2 months) follow-up, wounds of donor and recipient sites were healed in Ⅰ stage, monitoring-flaps were alive, eject reaction of massive bone allografts were slight, no complications in donor limbs. Fifteen patients had the evidence of radiographic union 3 to 6 months after surgery, 3 cases united 8 months later, and the remained one case of malignant synovioma in distal femur recurred and amputated the leg 2. 5 months, post-operatively. Five patients had been removed internal fixation, complete bone unions were found one year postoperatively. None of massive bone allografts were absorbed or collapsed at last follow-up. Conclusion: The homeochronous usage of structural bone allograft with an intramedullary vascularized fibular au-tograft can biologically obtain a structure with the immediate mechanical strength of the allograft, a potential result of revascularization through the vascularized fibula, and accelerate bone union not only between fibular autograft and the host but also between massive bone allograft and the host.

  19. Dynamic Assessment in Patients Following Bone-Patellar Tendon-Bone Autograft Anterior Cruciate Ligament Reconstruction §

    OpenAIRE

    Lyon, Roger; Liu, Xue-Cheng; Hung, John; Kernozek, Thomas W.

    2011-01-01

    Background: The knee’s passive movement is insufficient to determine function in patients following ACL reconstruction. Hypothesis: We hypothesize that there are kinematic differences in the lower extremities (LE) during stair climbing and ground level walking following ACL surgery between the intact and reconstructed sides. Study Design: This was a retrospective cohort study. Eleven patients with an average age of 15.3 years at the time of their ACL reconstructive surgery (BPTB autograft) pa...

  20. Anterior cruciate ligament reconstruction in a rabbit model using silk-collagen scaffold and comparison with autograft.

    Directory of Open Access Journals (Sweden)

    Fanggang Bi

    Full Text Available The objective of the present study was to perform an in vivo assessment of a novel silk-collagen scaffold for anterior cruciate ligament (ACL reconstruction. First, a silk-collagen scaffold was fabricated by combining sericin-extracted knitted silk fibroin mesh and type I collagen to mimic the components of the ligament. Scaffolds were electron-beam sterilized and rolled up to replace the ACL in 20 rabbits in the scaffold group, and autologous semitendinosus tendons were used to reconstruct the ACL in the autograft control group. At 4 and 16 weeks after surgery, grafts were retrieved and analyzed for neoligament regeneration and tendon-bone healing. To evaluate neoligament regeneration, H&E and immunohistochemical staining was performed, and to assess tendon-bone healing, micro-CT, biomechanical test, H&E and Russell-Movat pentachrome staining were performed. Cell infiltration increased over time in the scaffold group, and abundant fibroblast-like cells were found in the core of the scaffold graft at 16 weeks postoperatively. Tenascin-C was strongly positive in newly regenerated tissue at 4 and 16 weeks postoperatively in the scaffold group, similar to observations in the autograft group. Compared with the autograft group, tendon-bone healing was better in the scaffold group with trabecular bone growth into the scaffold. The results indicate that the silk-collagen scaffold has considerable potential for clinical application.

  1. Effect of pulmonary autograft transplantation in the surgical treatment of aortic valve disease

    Institute of Scientific and Technical Information of China (English)

    LI Wen-bin; LIU Hai-yan; ZHOU Qi-wen; XU Xiu-fang; ZHANG Jian-qun; SONG Shi-qiu; PENG Jin-feng; WANG Sheng-xun; LIU Wei; ZHOU Hai-po; WANG Zhu-heng

    2008-01-01

    Background Aortic root replacement with pulmonary autograft (Ross procedure) has the advantages of good haemodynamics and growth potential without the need for anticoagulation.In this study,we reviewed our expedence of the Ross procedure for patients with aortic valve disease.Methods From October 1994 to January 2005,42 Ross procedures were performed in our centre.There were 30 males and 12 females.The mean age was 28+15 years (range,5-56 years).Congenital heart disease (CHD) with aortic valve stenosis (AS) and/or aortic valve insufficiency (A1) in 40 cases including one associated with ventdcular septal defect (VSD),degenerated aortic valve disease with AS in 1 and subacutive bacterial endocarditis (SBE) with A1 in 1 were studied.The diagnosis was made by ultracardiography (UCG) in all patients.The mean aortic valve annulus diameter (AVD) was (2.45±0.31) cm and pulmonary valve annulus diameter (MPVD) was (2.34±0.21) cm.All patients had normal pulmonary valves.The New York Heart Association (NYHA) function class was Ⅱ in 36 cases and Ⅲ in 6 cases.The operation was performed under moderate hypothermic cardiopulmonary bypass (CPB) with aortic root replacement using pulmonary autograft and pulmonary valve replacement with a homograft.Results There was no early hospital mortality.Postoperative UCG showed normal aortic valve function in all our patients.The mean gradient across the aortic valve was (6.11±0.12) mmHg.The left ventricular diastole diameter (LVDD)decreased significantly from (62±5) mm to (56±3) mm (P<0.001).The mean postoperative left ventricular ejective fraction (LVEF) was 0.49±0.23.All patients were in NYHA class Ⅰ-Ⅱ.Follow-up was completed in 38 cases for a mean period of 3.2 years (range 1-10 years).All survivors were in NYHA class Ⅰ with normal neo-aortic and pulmonary valve function.One patient died after secondary operation due to homograft fungal endocarditis 1 year after the Ross procedure.The cause of death was uncontrolled

  2. Three-dimensional remodelling to determine best fit for hemihamate autograft arthroplasty.

    Science.gov (United States)

    Shih, Jessica; Podolsky, Dale; Binhammer, Paul

    2014-01-01

    To determine the best fit of a hamate osteochondral graft to reconstruct a palmar defect of a middle phalanx articular fracture using three-dimensional remodelling. The proximal middle phalanx and distal hamate articular surfaces of 10 cadaveric right hands were scanned using a three-dimensional laser scanner. A defect was marked on the middle phalanx digital image to simulate a 50% palmar lip fracture. A hemihamate autograft surgical procedure was simulated by aligning the middle phalanx and hamate digital articular surfaces. In addition to the second digit measurements, the midpoint distances of the central ridge of proximal articular surface of the middle phalanx digital image for digits 3, 4 and 5 were recorded for reference value, as well as the offset distances for the long and small finger. The mean midpoint distance for the index finger was 2.96 mm (95% CI 2.71 mm to 3.21 mm). The mean angle of offset was 20.09° (95% CI 15.54° to 24.64°). The mean graft offset distance was prominent by 1.23 mm (95% CI 0.57 mm to 1.89 mm). The reference values for the third, fourth and fifth middle phalange midpoint distances were 3.26 mm (95% CI 3.09 mm to 3.43 mm), 3.13 mm (95% CI 2.93 mm to 3.33 mm) and 2.48 mm (95% CI 2.33 mm to 2.63 mm), respectively. The offset distances for digits 3 and 5 were 1.24 mm (95% CI 0.48 mm to 2.00 mm) and 1.08 mm (95% CI 0.48 mm to 1.68 mm), respectively. The present study provides information about best fit for placing a hamate autograft for the hemihamate arthroplasty procedure. In this model, the hamate graft must be offset to recreate the curvature of the middle phalanx.

  3. Muscle activity during mandibular movements in normal and mandibular retrognathic subjects.

    Science.gov (United States)

    Harper, R P; de Bruin, H; Burcea, I

    1997-03-01

    The masticatory muscles function as a unit during precise mandibular positioning movements that occur during such activities as speech, singing, or playing musical instruments. This investigation was designed to assess jaw muscle recruitment patterns during controlled mandibular movement in normal subjects and in patients with mandibular retrognathism. A computer-integrated electromyography (EMG) and movement monitoring (Selspot) system was used to collect data over 7 seconds of a sagittal border movement (Posselt envelope) of the mandible and 4 seconds each of rest position, light tooth contact, and maximum clench. Fine wire bipolar electrodes were placed into the inferior belly of the lateral pterygoid muscles bilaterally and surface electrodes were placed bilaterally over the anterior belly of the temporalis muscles and the masseter muscles. Ten subjects with Class I occlusion, normal cephalometric values, and an absence of temporomandibular joint (TMJ) dysfunction were compared with 12 patients with mandibular retrognathism, Class II malocclusion, and an absence of clinical signs of TMJ internal derangement before and after a bilateral sagittal split and advancement of the mandible. There was a wide variation in standard deviations of EMG activity for the lateral pterygoid muscles in the retrognathic patients compared with normal controls before surgery (P EMG activity levels during the forward movement phase of the envelope, before surgery compared with controls (P < .001). After surgery, the lateral pterygoid muscle showed early recruitment in the forward movement similar to control levels. The masticatory muscles function as a unit during mandibular positioning movements. Patients with mandibular retrognathism have different muscle recruitment patterns from those of normal subjects with the mandible at rest and during mandibular movement. After orthognathic surgery, adaptation occurs in the phasic timing of jaw muscle activity.

  4. A polycaprolactone-tricalcium phosphate composite scaffold as an autograft-free spinal fusion cage in a sheep model.

    Science.gov (United States)

    Li, Yi; Wu, Zhi-gang; Li, Xiao-kang; Guo, Zheng; Wu, Su-hua; Zhang, Yong-quan; Shi, Lei; Teoh, Swee-hin; Liu, Yu-chun; Zhang, Zhi-yong

    2014-07-01

    Titanium (Ti) based spinal fusion cages are frequently used in the clinics for the treatment of spinal degeneration and related diseases, however, their further clinical application is generally harassed by several drawbacks such as stress shielding, non-biodegradability and additional bone grafting procedure. Our earlier work has demonstrated the efficacy of a biodegradable macro-porous polycaprolactone-tricalcium phosphate (PCL-TCP) composite scaffold in promoting bony tissue ingrowth as well as its ability to sustain mechanical loads upon implantation into an orthotopic defect site. In this study, we investigated the use of PCL-TCP scaffold as an autograft-free spinal fusion cage in a preclinical sheep model over 12 months, and compared the fusion efficacy against Ti cages incorporated with autografts. Results showed that despite PCL-TCP scaffold as an autograft-free cage attaining a slower fusion rate at early stage (6 month), it achieved similar degree of spinal fusion efficacy as Ti cages aided with autograft at 12 month post-operation as evidenced by the radiographic and histological evaluation. PCL-TCP cages alone demonstrated better bone ingrowth with 2.6 fold higher bone/interspace ratio (B/I) and more homogeneous bone tissue distribution compared with that of the Ti cages (88.10  ±  3.63% vs. 33.74  ±  2.78%, p CT analysis. Moreover, besides the bone tissue ingrowth, a quantitative approach was illustrated to accurately evaluate the osteointegration of fusion cage with surrounding bone tissue, and showed a 1.36 fold higher degree of osteointegration occurred in PCL-TCP cage group than Ti cage group (CS/PC: 79.31  ±  3.15% vs 58.44  ±  2.43%, p  0.05). The degradation profile of the PCL-TCP cages was noted to increase in tandem with new bone ingrowth into the pores, while maintaining good structural integrity necessary for supporting the spinal interbody segments. Therefore, with the better osteointegration, more bone tissue

  5. Histologic evaluation of the efficacy of rhBMP-2 compared with autograft bone in sheep spinal anterior interbody fusion.

    Science.gov (United States)

    Sandhu, Harvinder S; Toth, Jeffrey M; Diwan, Ashish D; Seim, H B; Kanim, Linda E A; Kabo, J Michael; Turner, A Simon

    2002-03-15

    The sheep anterior lumbar spinal fusion model was used to study the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2)-collagen composite in comparison with autograft to enhance spinal interbody fusion. Comparisons were drawn from temporal radiographic and end-point biomechanical and histologic data. To analyze histologically the ability of rhBMP-2 to achieve complete arthrodesis between vertebral bodies. Studies using rhBMP for enhancement of anterior interbody fusion have used numerous endpoints. However, systematic histologic evaluation of the fusion has not been conducted. Twelve sheep underwent single-level anterior lumbar interbody fusion performed with a cylindrical fenestrated titanium interbody fusion device (INTER FIX, Medtronic Sofamor Danek, Inc., Memphis, TN). The device was filled either with rhBMP-2-collagen (n = 6) or autogenous iliac crest bone graft (n = 6). Radiologic evaluation was carried out at 2-month intervals, and all sheep were killed 6 months after surgery. Nondestructive biomechanical testing for stiffness to flexion, extension, and lateral bending moments, un-decalcified histology, and qualitative and quantitative histologic evaluation were performed. Radiographs revealed a bony bridge anterior to the cage in five of six rhBMP-2-treated animals, whereas it was present only in one of five in the autogenous bone graft group. Segments treated with rhBMP-2 were 20% stiffer in flexion than autograft-treated segments at 6 months. Six of six in the rhBMP-2 group and two of six in the autograft group showed complete fusion. There was a significantly higher rate of bony continuity observed at the fenestrations of the rhBMP-2 group. Three times more number of cage fenestrations in the rhBMP-2 group demonstrated "all-bone" when compared with the autograft group (P fusion and a more consistent increased stiffness of the segments when compared with autograft in sheep anterior lumbar interbody fusion. Furthermore, a three times

  6. Microskin autograft with pigskin xenograft overlay: a preliminary report of studies on patients.

    Science.gov (United States)

    Lin, S D; Lai, C S; Chou, C K; Tsai, C W; Wu, K F; Chang, C W

    1992-08-01

    Split-thickness pigskin graft (STPSG) was used to replace allograft skin for microskin grafting in 16 patients, nine of whom were burn patients, five suffered from traumatic defects and two from diabetic ulcers. The expansion ratios used in these patients ranged from 8:1 to 12:1. The STPSG preparation described was found to be safe for clinical application. The autogenous donor skin was excised from the inguinal area, and the donor site was primarily closed. There were no instances of donor site morbidity. The majority of the STPSG overlays adhered to the wound firmly. Histological examination showed that the microskin grafts proliferated actively immediately beneath the STPSG overlay. The time for the wound to be fully resurfaced varied from 13 to 21 days depending on the expansion ratio employed. There were only two episodes of pseudomonas infection and no further grafting was required in any of the patients. In this study the pigskin xenograft was found to provide a suitable environment for the epithelialization of microskin autografts. When allograft is not available, this is an alternative way of ensuring successful microskin grafting.

  7. FIRST USE OF STEREOLOGY TO QUANTIFY THE SURVIVAL OF FAT AUTOGRAFTS

    Directory of Open Access Journals (Sweden)

    Eduardo Serna Cuéllar

    2011-05-01

    Full Text Available It is not usual to perform quantitative analyses on surgical materials. Rather, they are evaluated clinically, through qualitative methods, and if quantitation is done, it is on a 2-dimensional basis. In this study, the long-term survival of fat autografts (FAG in 40 subjects with facial soft tissue defects is quantified. An adipose tissue preparation from the abdomen obtained through liposuction and centrifugation is injected subcutaneously. Approximately 14 months later, the treated area is biopsied. Extensive computer-based histological analyses were performed using the stereological method in order to directly obtain three parameters: volume fraction of adipocytes in the fat tissue (VV, density (number per volume of adipocytes in the fat tissue (NV, and the mean cell volume of adipocytes (VA in each tissue sample. A set of equations based on these three quantitative parameters is produced for evaluation of the volumetric survival fraction (VSF of FAG. The presented data evidenced a 66% survival fraction at the 14-month follow-up. In routine practice, it would be sufficient to perform this volumetric analysis on the injected and biopsied fat samples to know what fraction of the FAG has survived. This is an objective method for quantifying FAG survival and will allow a standardized comparison between different research series and authors.

  8. Dynamic assessment in patients following bone-patellar tendon-bone autograft anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Lyon, Roger; Liu, Xue-Cheng; Hung, John; Kernozek, Thomas W

    2011-04-28

    The knee's passive movement is insufficient to determine function in patients following ACL reconstruction. We hypothesize that there are kinematic differences in the lower extremities (LE) during stair climbing and ground level walking following ACL surgery between the intact and reconstructed sides. This was a retrospective cohort study. Eleven patients with an average age of 15.3 years at the time of their ACL reconstructive surgery (BPTB autograft) participated in the study. Patients were followed for at least 2 years post surgery. The subjects underwent a non-weight bearing ability test to reproduce predetermined knee joint positions. Their LE's velocity and joint kinematics were then measured during level ground walking and on a set of custom designed stairs as they ascended and descended. During level ground walking the maximum internal rotation at the ankle during the swing phase on the reconstructed side increased significantly from 2.3º to 19.9 º compared to the unreconstructed limb (P=0.04). The leading reconstructed knee during stair ascent exhibited less knee flexion as compared to the unreconstructed knee for each step (1(st) step: 74.2º vs 81.5º; 2(nd) step:93.6º vs 97.6º; 3(rd) step: 48º vs 53.5º; 4(th) step: 72.5º vs 78.1º; pstairs.

  9. Effect of platelet-rich plasma on reconstruction with nerve autografts

    Directory of Open Access Journals (Sweden)

    Hakan Teymur

    2017-02-01

    Full Text Available Despite advances in understanding of peripheral nerve injuries and regeneration and advances in surgical techniques, successful outcomes cannot be guaranteed after reconstructive surgery. Platelet-rich plasma (PRP has been reported to have positive effects on nerve regeneration, as well as on tissue healing. The present study was designed to evaluate the effect of PRP on nerve-grafted defects. Sprague–Dawley rats were divided into four surgery groups (n=7 in each. A 1-cm long nerve defect was created in the upper thigh and then reconstructed using a nerve autograft in all groups. The wet muscle weights, electromyographic findings, and histomorphologic changes were evaluated 10 weeks later. As shown by both the electromyographic (p<0.001 and histomorphologic findings (p<0.001, PRP had more positive effects on nerve gap reconstruction in Group 3 then Group 4 as compared to the control groups. The present study is novel in that it evaluated the regeneration effect of PRP on a large nerve defect reconstructed with a nerve graft rather than primary repair. The results are encouraging for further experimental studies on the role of PRP in nerve healing.

  10. Clinical observation on fibrin glue technique in pterygium surgery performed with limbal autograft transplantation

    Directory of Open Access Journals (Sweden)

    Hui Liu

    2013-07-01

    Full Text Available AIM: To compare the efficiency and safety of fibrin glue to suture technique in pterygium surgery performed with limbal autograft.METHODS: A prospective randomized clinical trial was carried out in 60 eyes of 48 patients operated for primary nasal pterygium. Autologous limbal graft taken from the superotemporal limbus was used to cover the sclera after pterygium excision under local anesthesia with 2% lidocaine. In 22 cases(30 eyes, the transplant was attached to the sclera with a fibrin tissue adhesive(group 1and in 26 cases(30 eyeswith 10-0 Virgin silk sutures(group 2. Patients were followed up at least for 3 months. Time of operation, matching degree of graft and visual analogue scale(VASscore were mainly observed and recorded. RESULTS: Patient symptoms were significantly less and biomicroscopic findings were better in group 1. Pterygium recurrence was seen in 1 case of group 1, and 1 case of group 2. Average surgery time was shorter(PCONCLUSION: Using fibrin glue for graft fixation in pterygium surgery causes significantly less postoperative pain and shortens surgery time significantly.

  11. Treatment of chronic patellar ligament lesion with autograft and v-y quadricepsplasty

    Directory of Open Access Journals (Sweden)

    Marco Túlio Lopes Caldas

    2013-06-01

    Full Text Available OBJECTIVE: Review of the literature concerning the subject and to compare the results of the technique we have been using with the ones reported on the literature. METHODS: This is a retrospective, cross-sectional and observational study. We evaluated the records of patients treated surgically at the Hospital from Hospital Maria Amelia Lins January 1997 to January 2011.The following variables were considered: age, gender, side, degree of injury, mechanism of trauma, associated injuries, time elapsed between injury and surgical procedure, complications, range of motion and muscle strength. RESULTS: Five patients underwent surgical treatment with the use of autograft semitendinosus and gracilis tendons and V-Y quadricepsplasty. Regarding gender, there was a male predominance (80%. The average age was 35.2 years old. The right side was the most affected (60%. The predominant mechanism of injury was motorcycle accident (80%. All patients had a complete tendon lesion. Time between injury and surgery averaged 10.4 months. Four patients (80% had had associated injuries. In all patients muscle strength was satisfactory (M4/M5. Wound dehiscence was observed in 01 patient. Average postoperative range of motion was 110°. CONCLUSIONS: These are rare lesions. Stretching the quadriceps is essential to decrease the tension to the reconstructed patellar ligament and patellofemoral joint. Use of a quadriceps transtendon tunnel is an option to prevent fractures. Hypotrophy of the quadriceps is inevitable, however, the resulting force is sufficient for daily living activities.

  12. Relationship between mandibular angle fracture and state of eruption of mandibular third molar: A digital radiographic study

    Directory of Open Access Journals (Sweden)

    Mahesh Kumar Talkad Subbaiah

    2015-01-01

    Full Text Available Objectives: The purpose of this study was to assess the relationship between mandibular angle fracture and the status of eruption of the mandibular third molars. Materials and Methods: The sample consisted of 50 mandibular angle fracture cases with or without the presence of mandibular third molars, inclusive of both genders in the age group 18 years and above. The mandibular angle fractures were assessed by taking an orthopantomograph for each case following strict radiation protection protocol after an informed consent was obtained. The captured image was assessed and traced for the presence of mandibular angle fracture, angulation, and status of mandibular third molar by using Windows Trophy DICOM and Master View 3.0 software. Pell and Gregory′s and Winter′s classifications were followed. Results: We observed the following: Increased incidence of angle fractures in the presence of mandibular third molar, male predominance, the mean average age being 29 years, and the most common cause of angle fractures was road traffic accident; the fractures were observed more on the left side. In the total sample, mandibular third molar was present in 90% of the cases with angle fracture; of this, 73% of the teeth were impacted. Increased incidence of mandibular angle fracture was observed in position A, class II, and mesioangular impaction of third molar, which were statistically significant. Conclusion: The presence of mandibular third molar was in strong association with mandibular angle fracture and there was an increased incidence of position A, class II, and mesioangular impaction, when compared with other positions. This study concludes that there is a direct relationship between the presence and status of impacted third molars with increased risk of mandibular angle fracture.

  13. In vivo bioreactors for mandibular reconstruction.

    Science.gov (United States)

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

    2014-12-01

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

  14. Primate experiments on mandibular growth direction.

    Science.gov (United States)

    Tomer, B S; Harvold, E P

    1982-08-01

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

  15. Transpositional flap technique for mandibular vestibuloplasty.

    Science.gov (United States)

    Wessberg, G A; Hill, S C; Epker, B N

    1979-06-01

    Various surgical techniques for a mandibular vestibuloplasty have been advocated. A transpositional labial flap technique used by us for 23 patients since May 1976, and based on a procedure described by Edlan, has been presented with results of nine-month follow-up examinations of six patients. Clinical, radiographic, and histological evaluations completed at three-month intervals showed that this transpositional vestibuloplasty compared favorably with other similar techniques in postoperative time of healing, condition of attached mucosa, stability of increased vestibular depth, and amount of resorption of labial bone. Advantages of this procedure over other mandibular vestibuloplasty techniques are its simplicity, low morbidity, decreased operating time, feasibility of use of local anesthesia and conscious sedation on an outpatient basis, and elimination of the need for a graft. The disadvantage of the procedure is that it requires healthy preexisting vestibular mucosa for optimal results.

  16. Clinical management of the mandibular molars.

    Science.gov (United States)

    Canut, J A

    1975-09-01

    The complex variety of clinical problems posed by the lower molars requires maximum care in diagnosis and in treatment planning. In this article several therapeutic solutions to these problems are presented. The need to treat positional anomalies of the second molars and to control their drifting in cases of bracing and mandibular insertion, may be an effective auxillary means of treatment of those malocclusions in which lengthening of the dental bracing zones is indicated.

  17. Mandibular metastasis of cholangiocarcinoma: A case report

    Energy Technology Data Exchange (ETDEWEB)

    You, Tae Min [Dept. of Advanced General Dentistry, Dankook University, Cheonan (Korea, Republic of); Kim, Kee Dong; Jeong, Ho Gui; Park, Won Se [Advanced General Dentistry, Dankook University, Cheonan (Korea, Republic of)

    2015-12-15

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

  18. Cortical potentials associated with voluntary mandibular movements.

    Science.gov (United States)

    Yoshida, K; Kaji, R; Hamano, T; Kohara, N; Kimura, J; Shibasaki, H; Iizuka, T

    2000-07-01

    Movement-related cortical potentials (MRCPs) are negative potentials over the scalp, which gradually increase prior to voluntary movements, and might be applied to elucidate the cortical efferent function of the mandibular movements. We compared the MRCPs accompanying various mandibular movements to study the motor control mechanism underlying these movements. Electroencephalograms (EEGs) were recorded from 11 electrodes placed over the scalp (F3, Fz, F4, T3, C3, Cz, C4, T4, P3, Pz, and P4), according to the International 10-20 System, and electromyograms (EMGs) were obtained from surface electrodes over the masseter muscle and the anterior belly of the digastric muscle. Ten healthy subjects were requested to make brisk and self-paced mandibular movements in 4 different directions (mouth-opening and -closing, and left and right lateral movements). We obtained MRCPs by averaging the EEG, using the visually determined EMG onset as a trigger signal. In all the movements, a slowly increasing, bilaterally widespread negativity starting 1.5 to 2.0 sec before the EMG onset (Bereitschaftspotential, or BP proper) was observed, with the maximum over the vertex region. The negative slope (NS') occurred about 300 to 700 msec before the EMG onset. The cortical maps of BP/NS' (BP and NS' combined), immediately prior to the mouth-opening and closing, showed a symmetrical distribution, whereas that for the lateral movements showed a tendency of predominance over the hemisphere ipsilateral to the direction of the movement. BP/NS' amplitudes at the onset of movement differed significantly or tended to do so between open, close, and lateral movements, suggesting that MRCP recordings may thus provide a means to explore the role of the cerebral cortex in the control of mandibular movements.

  19. Single-rooted primary first mandibular molar

    OpenAIRE

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

    2014-01-01

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

  20. Supernumerary maxillary and Mandibular Fourth Molars.

    Science.gov (United States)

    1981-09-23

    in earlier primates then in man. Hyperdontia has occasionally been associated with clefts of the lip and palate , I0 cleldocranial dysostosis, 2...year-old black male was seen In the clinic for treatment of pain which was originating from a deep carious lesion in the mandibular left second molar...incompletely formed impacted left fourth molar and right bicuspid were also noted. Case III. A 24-year-old male was seen in the clinic for treatment of

  1. Tratamento cirúrgico de ameloblastoma mandibular

    OpenAIRE

    Jardim, Ellen Cristina Gaetti [UNESP; Faverani, Leonardo Peres [UNESP; Melo, Rosana Leite de; Miyahara, Glauco Issamu [UNESP; Soubhia, Ana Maria Pires; Mendonça, José Carlos Garcia de; Shinohara, Elio Hitoshi [UNESP

    2013-01-01

    Ameloblastomas are benign, invasive locally and highly recurrent. It is an odontogenic tumor, characterized by the proliferation of epithelial ameloblastic in a fibrous stroma. This paper reports a case of mandibular ameloblastoma, in patients 27 years of age without pain with developments around 4 years, with about 20 mm at its greatest extent, sessile base and surface coatings full. The treatment of choice was the surgical conservative Ameloblastomas son benignos, localmente invasivo y a...

  2. Multiple myeloma presenting as mandibular pain

    LENUS (Irish Health Repository)

    Crowley, Miriam

    2016-10-01

    Introduction: Multiple myeloma (MM) is a systemic malignancy of plasma cells defined by monoclonal production of circulating immunoglobulins. Bone pain is a presenting feature in the majority of cases. Treatment may involve intravenous use of bisphosphonates, chemotherapy or haematopoietic stem cell transplantation. Here, we illustrate a first presentation of MM in a patient with mandibular pain and discuss radiographic, diagnostic and treatment challenges of orofacial issues in patients with MM.\\r\

  3. Irradiation damage

    Energy Technology Data Exchange (ETDEWEB)

    Howe, L.M

    2000-07-01

    There is considerable interest in irradiation effects in intermetallic compounds from both the applied and fundamental aspects. Initially, this interest was associated mainly with nuclear reactor programs but it now extends to the fields of ion-beam modification of metals, behaviour of amorphous materials, ion-beam processing of electronic materials, and ion-beam simulations of various kinds. The field of irradiation damage in intermetallic compounds is rapidly expanding, and no attempt will be made in this chapter to cover all of the various aspects. Instead, attention will be focused on some specific areas and, hopefully, through these, some insight will be given into the physical processes involved, the present state of our knowledge, and the challenge of obtaining more comprehensive understanding in the future. The specific areas that will be covered are: point defects in intermetallic compounds; irradiation-enhanced ordering and irradiation-induced disordering of ordered alloys; irradiation-induced amorphization.

  4. Mandibular nerve entrapment in the infratemporal fossa.

    Science.gov (United States)

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

    2011-05-01

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

  5. Pyogenic Granuloma with Severe Mandibular Bone Destruction

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Jeong Won; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul; Park, Tae Won [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2000-06-15

    Pyogenic granuloma is a overzealous proliferation of a vascular type connective tissue as a result of some minor trauma and is a well circumscribed elevated, pedunculated or sessile benign inflammatory lesion of skin and mucous membrane. The clinical features of pyogenic granuloma are indicative but not specific and nearly all cases of pyogenic granulomas are superficial in nature, and there is little if any mention in the literature of these lesions producing alveolar bone even jaw bone loss. This case is somewhat unique in that the lesion was an obvious histologic pyogenic granuloma; however, it appeared to invade the mandibular bone which resulted in the loss of the adjacent teeth. A 12-year-old boy came to Seoul National University Dental Hospital with chief complaints of left facial swelling. The features obtained were as follows ; Plain radiograms showed a large well-circumscribed radiolucent lesion on left mandibular ramus area, which made severe expansion of lingual cortex and displacement of lower left 3rd molar tooth germ. Computed tomograms showed large soft tissue mass involving left masticator space with destruction of left mandibular ramus. Histologically, sections revealed loose edematous stroma with intense infiltration of inflammatory cells and proliferation of vascular channels. Also, there were focal areas of extensive capillary proliferation, bone destruction and peripheral new bone formation.

  6. Hyperplastic conditions of the mandibular condyles

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Soo [Pusan National University College of Medicine, Busan (Korea, Republic of)

    2003-12-15

    To evaluate the clinical and radiographic features of unilateral hyperplastic mandibular condyles for some useful preliminary diagnostic recommendations. Clinical records, radiographs and histologic diagnoses of 35 cases with asymmetric mandibular condyles due to apparent unilateral condylar hyperplasia were evaluated retrospectively. Among 35 cases, 28 were true hyperplastic conditions of condyles whereas the remaining 7 were unilateral internal derangement occurring on the short side. 17 of the 28 hyperplastic condyles showed a mass or irregular radiographic shadow with histologic diagnosis including osteochondroma and osteoma. Only 5 of these cases showed facial asymmetry. 2 out of ths 17 cases showed hyperplastic round shaped irregular condyles consistent with ankylosis and their histologic diagnoses were osteochondromas. 11 of the 28 cases showed smooth enlargement of condylar head with elongation of the neck causing facial asymmetry, but histologic diagnoses were not available because the surgical operation conserved the condyles. The hyperplastic conditions of the mandibular condyles include not only true hyperplasia, osteochondroma, osteoma, and ankylosis, but also unilateral internal derangement occurring on the short side.

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

    Science.gov (United States)

    Samant, Asha; DeSciscio, Peter

    2014-01-01

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

  8. Bifid mandibular canal: a rare or underestimated entity?

    Directory of Open Access Journals (Sweden)

    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.

  9. Some morphological features related to mandibular third molar impaction

    OpenAIRE

    Kaya, Göksel Şimşek; ASLAN, MUZAFFER; Omezli, M. Melih; DAYI, Ertunç

    2010-01-01

    Objective: The aim of this study was to evaluate the effect of some morphological features of the mandible and mandibular permanent molars on impaction of mandibular third molars with panoramic measurements in a Turkish patient group. Study design: Standardized panoramic radiography variables compiled from 140 patients retrospectively were eva- luated. Predictive variables included mesio-distal crown width and inclination of the mandibular molars, vertical and horizo...

  10. Transparotid approach for mandibular condylar neck and subcondylar fractures

    OpenAIRE

    Croce, A; Moretti, A.; Vitullo, F.; CASTRIOTTA, A.; M. Rosa; Citraro, L

    2010-01-01

    SUMMARY Mandibular condylar neck fractures and subcondylar fractures represent, respectively, 19-29% and 62-70% of all mandibular fractures; treatment involves some problems, common to both, concerning the choice of an adequate approach. Herewith, personal experience is reported related to the surgical treatment of some cases of mandibular condylar neck and subcondylar fractures by transparotid approaches with partial parotidectomy, removing the salivary tissue overlying the condylar neck and...

  11. Effect of irradiation on the dental pulp tissues in streptozotocin-induced diabetic rats

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ho Duk; Hwang, Eui Hwan; Lee, Sang Rae [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    2005-03-15

    To observe the histological changes in the pulp tissues of mandibular molars in streptozotocin-induced diabetic rats after irradiation. The male Sprague-Dawley rats weighing approximately 250 gm were divided into four groups : control, diabetes, irradiation, and diabetes-irradiation groups. Diabetes mellitus was induced in the rats by injecting streptozotocin. Rats in control and irradiation groups were injected with citrate buffer only. After 5 days, the head and neck region of the rats in irradiation and diabetes-irradiation groups were irradiated with a single absorbed dose of 10 Gy. All the rats were sacrificed at 3, 7, 14, 21, and 28 days after irradiation. The specimen including the mandibular molars were sectioned and observed using a histopathological method. In the diabetes group, capillary dilatation was observed. However, there was no obvious morphologic alteration of the odontoblasts. In the irradiation group, generalized necrosis of the dental pulp tissues was observed. Vacuolation of the odontoblasts and dilatation of the capillaries were noted in the early experimental phases. In the diabetes-irradiation group, generalized degeneration of the dental pulp tissues was observed. Vacuolation of the dental pulp cells and the odontoblasts was noted in the late experimental phases. This experiment suggest that dilatation of the capillaries in the dental pulp tissue is induced by diabetic state, and generalized degeneration of the dental pulp tissues is induced by irradiation of the diabetic group.

  12. The smallest detectable difference of mandibular function impairment in patients with a painfully restricted temporomandibular joint

    NARCIS (Netherlands)

    Kropmans, T.J.B.; Dijkstra, P.U.; van Veen, A.; Stegenga, B; de Bont, Lambertus

    Mandibular functions such as speech, laughing, yawning, mastication, and taking a large bite may be impaired if temporomandibular disorders exist. The Mandibular Function Impairment Questionnaire is a validated instrument that scores perceived difficulty of representative mandibular functions in

  13. Reconstruction of beagle hemi-mandibular defects with allogenic mandibular scaffolds and autologous mesenchymal stem cells.

    Directory of Open Access Journals (Sweden)

    ChangKui Liu

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

  14. The first cervical vertebra as an indicator of mandibular growth.

    Science.gov (United States)

    Huggare, J

    1989-02-01

    The association between the morphology of the first cervical vertebra, the atlas, and the direction of mandibular growth is studied by analysing two sets of lateral roentgenocephalograms--one comprising 18 non-treated children and another comprising 18 orthodontically treated subjects divided into three groups with regard to mandibular growth rotation. Among the non-treated cases there was a significant correlation between horizontal growth of the mandible during a two-year period and the initial height of the atlas dorsal arch. The treated subjects with forward mandibular rotation during treatment, demonstrated a significantly higher pretreatment dorsal arch than the subjects with either no rotation or a backward mandibular rotation.

  15. Bilateral bifid mandibular canal: Report of two cases

    Directory of Open Access Journals (Sweden)

    Karamifar Kasra

    2009-01-01

    Full Text Available Bifid mandibular canal is a rare anatomical variation that can be of considerable interest to a dentist. This condition can lead to complications when performing mandibular anesthesia or during surgery of the lower third molar, orthognatic or reconstructive mandibular surgery, or placement of dental implants and prosthesis; bleeding and traumatic neuroma are possible complications. Therefore, awareness of this condition is important. We report two cases of bilateral bifid mandibular canal: one in a 22-year-old male and the other in a 24-year-old female.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2013-07-01

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

  18. Morphology of the mandibular canal and the angulation between the mandibular and mental canals in dry skulls

    DEFF Research Database (Denmark)

    Pálsson, S R; Kjaer, I

    2008-01-01

    to be wide, while a wide mental angle was interrelated with a narrow mandibular angle. External morphology: a statistically significant correlation was found between the mandibular and gonial angles (correlation coefficient: 0.57, P=0.0009). A weaker correlation was also found between the mandibular and beta......The aim of this study was to analyse the correlation between external and internal mandibular morphology in adult or adolescent normal anthropological mandibles. Lateral radiographs of 31 symmetrical mandibles were analysed. The external morphology was defined by the gonial and beta...... correlation analysis was used to investigate the relationships between the angles. Internal morphology: a statistically significant correlation was found between the mental and mandibular angles (correlation coefficient: -0.60, P=0.0004). When the mental angle was narrow, the mandibular angle tended...

  19. Cone beam computed tomography findings of ectopic mandibular third molar in the mandibular condyle: report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Soo [School of Dentistry, Chosun University, Gwangju (Korea, Republic of)

    2011-09-15

    Impaction of third molar is a common developmental abnormality. However, ectopic impaction of the mandibular third molar in condylar region is an extremely rare condition. This report describes a case of impacted tooth in the mandibular condyle without any associated pathologic condition. Also, this report presents the spatial relationship of the impacted mandibular third molar to the surrounding anatomic structures using cone beam computed tomography.

  20. Food irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Webb, T.

    1986-01-01

    The proposed use of gamma radiation from cobalt 60 and cesium 137 for food irradiation in the United Kingdom is discussed, with particular reference to the possible dangers and disadvantages to the safety and wholesomeness of the food.

  1. Histological and biochemical characteristics of the rabbit anterior cruciate ligament in comparison to potential autografts.

    Science.gov (United States)

    Hoyer, Mariann; Meier, Carola; Kohl, Benjamin; Lohan, Anke; Kokozidou, Maria; Schulze-Tanzil, Gundula

    2016-08-01

    Tissue engineering of an anterior cruciate ligament (ACL) implant with ACL cells requires detailed analysis of the tissue characteristics that should be mimicked. Therefore, we studied the histological and biochemical properties of rabbit derived ACLs in comparison to other knee-associated tendons that are used as autografts in men. Rabbit derived ACLs and Musculus (M.) semimembranosus, M. semitendinosus tendons and patellar ligaments were explanted from adult New Zealand white rabbits and analyzed histologically for tissue organization (e.g. cellularity, nuclear shapes, elastic fibers), total collagen and sulfated glycosaminoglycan (sGAG) contents. Gene expression analysis was performed for the main extracellular matrix (ECM) components type I collagen, decorin and the glycoprotein tenomodulin. The ACLs had a dimension of 1.39x0.39x0.1 cm in situ. They were characterized by high sGAG content in comparison to the other tendons/ligaments, whereas the total collagen content did not differ. ACLs possessed higher cellularity and lower feret diameter of the cell nuclei compared with the investigated rabbit-derived tendons. In ACLs long elastic fibers were observed. Concerning the gene expression level, lower transcription of tenomodulin was detected in the ACL compared with the other tendons, without significant difference in the decorin gene expression. The M. semitendinosus tendon had a significantly higher type I collagen expression than the ACL and the other investigated tendons. This phenotypical characterization of the lapine ACL presented in this study provides some key standards to evaluate tissue engineered ACL constructs to be tested in the rabbit model.

  2. [Food irradiation].

    Science.gov (United States)

    Migdał, W

    1995-01-01

    A worldwide standard on food irradiation was adopted in 1983 by Codex Alimentarius Commission of the Joint Food Standard Programme of the Food and Agriculture Organization (FAO) of the United Nations and the World Health Organization (WHO). As a result, 41 countries have approved the use of irradiation for treating one or more food items and the number is increasing. Generally, irradiation is used to: food loses, food spoilage, disinfestation, safety and hygiene. The number of countries which use irradiation for processing food for commercial purposes has been increasing steadily from 19 in 1987 to 33 today. In the frames of the national programme on the application of irradiation for food preservation and hygienization an experimental plant for electron beam processing has been established in Institute of Nuclear Chemistry and Technology. The plant is equipped with a small research accelerator Pilot (19MeV, 1 kW) and an industrial unit Elektronika (10MeV, 10 kW). On the basis of the research there were performed at different scientific institutions in Poland, health authorities have issued permission for irradiation for: spices, garlic, onions, mushrooms, potatoes, dry mushrooms and vegetables.

  3. Medial hamstring muscle activation patterns are affected 1-6 years after ACL reconstruction using hamstring autograft.

    Science.gov (United States)

    Arnason, Stefán Magni; Birnir, Bjartmar; Guðmundsson, Tómas Emil; Guðnason, Garðar; Briem, Kristín

    2014-05-01

    Although changes in hamstring muscle morphology after anterior cruciate ligament reconstruction (ACLR) using a semitendinosus autograft hamstrings-gracilis (HG) of the ipsilateral limb are recognized, alterations in muscle activation patterns have not been extensively studied. The purpose of this controlled laboratory trial was therefore to monitor muscle activation levels of the medial (MH) and lateral (LH) hamstring muscles in athletes who had undergone ACLR using a HG autograft and to contrast these to activation levels demonstrated by healthy controls. Surface electromyography (EMG) was sampled from bilateral hamstring muscles of 18 athletes 1-6 years after ACLR and 18 matched controls (CTRL) during the performance of two dissimilar exercises, both involving eccentric knee flexor activity. Peak normalized muscle activation levels were identified for MH and LH of both limbs during the performance of the Nordic Hamstring (NH) exercise and TRX) hamstring curl (TRX) exercise. A statistically significant limb by exercise interaction was found for peak activation levels of LH, due to significant interlimb differences in activation during the performance of the TRX exercise compared to more symmetrical activation during the NH (p exercise type (p = 0.025). Whereas CTRL group participants consistently favoured one limb over the other during the performance of both exercises, ACLR participants demonstrated dissimilar peak MH activation patterns between limbs during the performance of the NH exercise compared to the TRX. In light of these results and considering the surgical procedure, patients who undergo ACLR using a HG autograft from the ipsilateral limb may benefit from post-operative rehabilitation that involves muscle activation and strengthening specifically targeting the MH component.

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

    Directory of Open Access Journals (Sweden)

    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

  5. Predictors of treatment preference for mandibular fracture.

    Science.gov (United States)

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

    2010-01-01

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

  6. Cephalometric evaluation of surgical mandibular advancement

    Directory of Open Access Journals (Sweden)

    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.

  7. Effect of topical autologous platelet-rich fibrin versus no intervention on epithelialization of donor sites and meshed split-thickness skin autografts: a randomized clinical trial

    DEFF Research Database (Denmark)

    Danielsen, P.; Jorgensen, B.; Jorgensen, L.N.;

    2008-01-01

    BACKGROUND: Autologous platelet-rich fibrin contains multiple growth factors. The aim of this randomized clinical trial was to study the effect of topical platelet-rich fibrin on epithelialization of donor sites and meshed split-thickness skin autografts. METHODS: Twenty consecutive leg ulcer...... surgically revised leg ulcer were randomized by concealed allocation to platelet-rich fibrin, and the other donor wound and autografted half were not (control). Biopsy specimens (4 mm) from donor wounds were evaluated for percentage neoepidermal coverage in tissue sections immunostained for keratin on days 5...... and 8. Epithelial barrier function, macroscopic healing, microbiology, and pain at dressing removal were assessed. Epithelialization of meshed autografts was assessed macroscopically. RESULTS: Epithelial coverage of donor wounds did not differ significantly between platelet-rich fibrin and control...

  8. Mandibular Fractures at Veer Chandra Singh Garhwali Government ...

    African Journals Online (AJOL)

    Mandibular fractures constitute a substantial proportion of cases of maxillofacial ... facial injury that the average practicing dental surgeon may expect to encounter. .... anterior, left and right lateral oblique, panoramic and computed tomography. Simple ... Table 4 shows the relation of fracture site to cause of the mandibular ...

  9. Morbidity of mandibular bone harvesting : A comparative study

    NARCIS (Netherlands)

    Raghoebar, Gerry M.; Meijndert, Leo; Kalk, Wouter W. I.; Vissink, Arjan

    2007-01-01

    Purpose: To assess the objective and subjective morbidity of mandibular bone harvesting. Materials and Methods: Forty-five patients who had been subjected to mandibular bone harvesting from the chin region (group 1, n = 15), the retromolar region (group 2, n = 15), or the retromolar region after rem

  10. Radiographic features of mandibular trabecular bone structure in hypodontia

    NARCIS (Netherlands)

    Créton, M.; Geraets, W.; Verhoeven, J.W.; van der Stelt, P.F.; Verhey, H.; Cune, M.

    2012-01-01

    Purpose: Radiographic parameters of mandibular trabecular bone structure between 67 subjects having hypodontia and those without were studied on digital panoramic radiographs. Materials and Methods: Three regions of interest (ROI) were defined: the ascending ramus, apical of the mandibular molar and

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

    Science.gov (United States)

    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.

  12. 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

  13. Radiographic features of mandibular trabecular bone structure in hypodontia

    NARCIS (Netherlands)

    M. Créton; W. Geraets; J.W. Verhoeven; P.F. van der Stelt; H. Verhey; M. Cune

    2012-01-01

    Purpose: Radiographic parameters of mandibular trabecular bone structure between 67 subjects having hypodontia and those without were studied on digital panoramic radiographs. Materials and Methods: Three regions of interest (ROI) were defined: the ascending ramus, apical of the mandibular molar and

  14. Radiographic Features of Mandibular Trabecular Bone Structure in Hypodontia

    NARCIS (Netherlands)

    Creton, Marijn; Geraets, Wil; Verhoeven, Jan Willem; van der Stelt, Paul F.; Verhey, Hans; Cune, Marco

    2012-01-01

    Purpose: Radiographic parameters of mandibular trabecular bone structure between 67 subjects having hypodontia and those without were studied on digital panoramic radiographs. Materials and Methods: Three regions of interest (ROI) were defined: the ascending ramus, apical of the mandibular molar and

  15. [Temporo-mandibular joints and orthognathic surgery].

    Science.gov (United States)

    Bouletreau, P

    2016-09-01

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

  16. 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

  17. Mandibular condyle position in cone beam computed tomography

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    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.

  18. [Mandibular tumours: epidemology, diagnostic and therapeutic aspects concerning 91 cases].

    Science.gov (United States)

    Kpemissi, E; Amana, B; Tchandana, K

    2009-01-01

    Oro-facial tumours are frequent and raise post-operational functional and aesthetic problems. What might be the situation of the mandibular tumours at CHU Tokoin-Lome (University Hospital Centre of Lome-Tokion). The aim of this study was to determined epidemiological, diagnostic and therapeutic aspects concerning the mandibular tumours. This retrospective study concerning 91 colligated files from January 1988 to December 2006 at the Oto-rhino-laryngologic and Cervico-Maxillo-Facial Surgery Service of the University Hospital Centre ( CHU) of Lome-Tokoin. The main inclusion criteria was the anatomopathological examination of the tumour. The mandibular tumours represented 19.95% of the Oto-rhino-laryngological and Cervico-Maxillo-Facial tumours. They were diagnosed with annual average of 5 cases. The most affected age bracket was one going from 10 to 39 years , or the equivalent of 68.13% of the patients. The spreading of these tumours in both sexes was equal. 80.21% of patients were examined after a development period going from 0 to 4 years. The major circumstances of findings were the mandibular tumefaction (98.9%) dental or mandibular pains (48.35%). The favourite seat of these mandibular tumours was the hemi mandible (48.35%). The odontologic tumours were the predominant histological types or the equivalent of 64.84% of the mandibular tumours. The benign forms were the most frequent (72.88%), the ameloblastoma in particular. The treatment was a surgical one. The partial resection of the mandibular bone was the surgical technique that was the most used (67.03%). The short-term development was preferred (69%). The long-term follow-up was difficult. The mandibular tumours were relatively frequent and predominated by the ameloblastoma. The findings circumstances were predominated by the mandibular tumefaction. The treatment was the preservative surgery as advocated by the majority of authors.

  19. Maxillary anterior and mandibular posterior residual ridge resorption in patients wearing a mandibular implant-retained overdenture

    NARCIS (Netherlands)

    Tymstra, N.; Raghoebar, G. M.; Vissink, A.; Meijer, H. J. A.

    P>The mandibular implant-retained overdenture could improve masticatory function compared to the conventional complete denture. However, increased forces exerted by the overdenture could increase residual ridge resorption of the maxillary anterior and mandibular posterior areas. The aim of this

  20. Maxillary anterior and mandibular posterior residual ridge resorption in patients wearing a mandibular implant-retained overdenture

    NARCIS (Netherlands)

    Tymstra, N.; Raghoebar, G. M.; Vissink, A.; Meijer, H. J. A.

    2011-01-01

    P>The mandibular implant-retained overdenture could improve masticatory function compared to the conventional complete denture. However, increased forces exerted by the overdenture could increase residual ridge resorption of the maxillary anterior and mandibular posterior areas. The aim of this stud

  1. Canine Trichomonas tenax mandibular gland infestation.

    Science.gov (United States)

    Szczepaniak, Klaudiusz; Łojszczyk-Szczepaniak, Anna; Tomczuk, Krzysztof; Skrzypek, Tomasz; Lisiak, Barbara; Abd-Al-Hammza Abbass, Zahrai

    2016-02-18

    Several species of trichomonads are intestinal or urogenital parasites of humans and animals, with only a few species typically being located in the oral cavity. The prevalence of oral trichomoniasis in dogs is approximately 15-25 %, although the prevalence varies among different populations and depends on age, sex and the health of the oral cavity. A case of mandibular gland infestation by trichomonads in a 13-year-old female Dachshund with advanced periodontal disease and oral trichomoniasis is reported. The dog was referred due to a history of a painless swelling over the left submandibular region that increased in size over time. Based on physical and ultrasound examinations, a final diagnosis of mandibular gland cyst was established and transcutaneous needle aspiration was carried out. Numerous mobile trophozoites of trichomonads were found by microscopy and culturing for trichomonas was performed. The species was finally characterized as Trichomonas tenax by polymerase chain reaction and sequencing. Studies have shown that T. tenax can be found in humans in atypical locations such as the salivary glands and upper and lower respiratory tracts. According to our knowledge this is the first report of T. tenax being present in the salivary glands of a dog. Because of the relatively high prevalence of trichomoniasis in dogs with periodontal diseases, these parasites should be considered together with bacterial and viral agents in salivary gland infections, especially in individuals with compromised oral health.

  2. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  4. Persistent bone marrow edema after osteochondral autograft transplantation in the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Nemec, Stefan Franz [MR Centre of Excellence, Department of Radiology, Medical University Vienna, Lazarettgasse 14, 1090 Vienna (Austria)], E-mail: stefan.nemec@meduniwien.ac.at; Marlovits, Stefan [Department of Traumatology, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Trattnig, Siegfried [MR Centre of Excellence, Department of Radiology, Medical University Vienna, Lazarettgasse 14, 1090 Vienna (Austria)

    2009-07-15

    Background and objective: The assessment of bone marrow edema-like signal intensity in magnetic resonance imaging (MRI) in patients after osteochondral autograft transplantation (OCT) in the knee joint is a parameter of yet indefinite value. This study determines the prevalence of persistent edema-like signal intensity in OCT patients and evaluates the correlation between edema and morphological imaging findings of the graft and clinical pain symptoms. Materials and methods: In this longitudinal observational study, 10 patients after OCT were followed by MRI prospectively 1 month, 3 months, 6 months, 12 months, and 24 months post-operatively. All MR examinations were performed on a 1.0 T MR unit with the same protocol using a modified scoring system (magnetic resonance observation of cartilage repair tissue-MOCART) for evaluation. Edema-like signal intensity in and beneath the osteochondral graft was assessed in its prevalence and graded using a coronal short tau inversion recovery fast spin echo (STIR-FSE) sequence: grade 1, normal; grade 2, moderate (diameter <2 cm); grade 3, severe (diameter >2 cm). The finding of edema-like signal intensity was correlated with graded parameters describing the morphology of the repair tissue assessed in a sagittal dual FSE sequence including: (a) surface of repair tissue: grade 1, intact; grade 2, damaged. (b) Cartilage interface: grade 1, complete; grade 2, incomplete. (c) Bone interface: grade 1, complete; grade 2, delamination. The finding of edema-like signal intensity was also correlated with the KOOS pain score assessing knee pain after 12 months. Results: Initially, after 1 month the prevalence of edema-like signal intensity was 70% (7/10 patients) and finally after 24 months 60% (6/10 patients). We found no significant relationship between the prevalence and degree of edema-like signal intensity and parameters describing the morphology of the repair tissue. Also the clinical pain score did not show significant

  5. Twelve-Year Outcomes of Pterygium Excision with Conjunctival Autograft versus Intraoperative Mitomycin C in Double-Head Pterygium Surgery

    Directory of Open Access Journals (Sweden)

    Tommy C. Y. Chan

    2015-01-01

    Full Text Available Purpose. The study aims to compare the long-term outcome of conjunctival autograft (CAU and mitomycin C (MMC in double-head pterygium surgery. Methods. This is a follow-up study of a comparative interventional trial. Thirty-nine eyes of the 36 patients with double-head pterygium excision in the original study 12 years ago were recruited for clinical assessment. Seven out of the 36 patients were lost. In the original study, each eye with double-head pterygium was randomized to have pterygium excision with CAU on one “head” (temporal or nasal and MMC on the other “head.” All patients were invited for clinical assessment for conjunctival bed status and the presence of pterygium recurrence in the current study. Results. There was no significant difference between the size, morphology, and type of pterygium among the two treatment groups. The recurrence rate of CAU group and MMC group 12 years after excision was 6.3% and 28.1%, respectively (P=0.020. Among eyes without recurrence, the conjunctival bed was graded higher in the MMC group than the CAU group (P=0.024. Conclusion. The use of conjunctival autograft has a significantly lower long-term recurrence rate than mitomycin C in double-head pterygium surgery.

  6. Prognostic factors affecting long-term outcome after stem cell transplantation in Hodgkin's lymphoma autografted after a first relapse.

    Science.gov (United States)

    Sureda, A; Constans, M; Iriondo, A; Arranz, R; Caballero, M D; Vidal, M J; Petit, J; López, A; Lahuerta, J J; Carreras, E; García-Conde, J; García-Laraña, J; Cabrera, R; Jarque, I; Carrera, D; García-Ruiz, J C; Pascual, M J; Rifón, J; Moraleda, J M; Pérez-Equiza, K; Albó, C; Díaz-Mediavilla, J; Torres, A; Torres, P; Besalduch, J; Marín, J; Mateos, M V; Fernández-Rañada, J M; Sierra, J; Conde, E

    2005-04-01

    To analyse outcome and prognostic factors for overall survival (OS) and time to treatment failure (TTF) in 357 patients with Hodgkin's lymphoma (HL) undergoing an autologous stem cell transplantation (ASCT) after a first relapse and reported to the The Grupo Espanol de Linfomas/Trasplante Autologo de Medula Osea (GEL/TAMO) Cooperative Group. Two hundred and twenty males and 137 females with a median age of 29 years were autografted in second remission (n=181), first sensitive relapse (n=148) and first resistant relapse (n=28). Five-year actuarial TTF and OS were of 49% +/- 3% and 57% +/- 3%. Advanced stage at diagnosis, complementary radiotherapy before ASCT, a short first complete response (CR) and detectable disease at ASCT adversely influenced TTF. Year of transplant or =1 extranodal areas involved at ASCT were adverse factors for OS. ASCT constitutes a therapeutic option for HL patients after a first relapse. Promising results are observed in patients with low tumour burden at diagnosis, autografted after a long CR and without detectable disease at ASCT. Innovative approaches should be pursued for patients with risk factors at relapse.

  7. 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.

  8. RESEARCH OF BASIFACIAL CONTOURING SCULPTURE BY MANDIBULAR ANGLE OSTECTOMY

    Institute of Scientific and Technical Information of China (English)

    FANG Jian-lin; DAI Chuan-chang; ZHU Guo-xian; ZHANG Ying; JIN Yu-qing; WANG Wei; QI Chuan-liang

    2006-01-01

    Objective Mandibular angle ostectomy is usually applied to the facial contouring sculpture.We evaluated the various techniques in order to enhance the precision and avoid unnecessary damage. Methods Before operation the area and quantity resected bone were designed according to facial measurement, mandible pantomography and orthophoria and lateral localized radiograph of skull. The Incises of mandibular angle ostectomy included intraoral, retroauricular or intraoral associated with retroauricular. Howerer, the sagittal resection of mandible outer table was necessary in all intraoral incise. Results Single mandibular angle ostectomy was not satisfactory for the patients having mandible hypertrophy with over-width basifacial contouring. Mandibular angle ostectomy combined with the sagittal resection of outer table of mandibular angle were required. Good symmetry and ap pearance were gained in 206 cases. One case had facial paralysis. Two patients occured mandibular fracture during the operation. Three cases complicated angled deformity at mandible body. Conclusion Reduction mandibuloplasty should be selected depends on varied types of mandibular angle hypertrophy before operation.

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

    Science.gov (United States)

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

    2013-09-01

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

  10. Radiologic study of mandibular third molar of Korean youths

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Hyung Kyu [Dept. of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1982-11-15

    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%.

  11. Topographical evaluation of the mandibular canal through panoramic radiograph

    Directory of Open Access Journals (Sweden)

    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.

  12. Bone changes after bilateral sagittal split osteotomy for mandibular prognathism

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hyun Jung; Jung, Yun Hoa; Cho, Bong Hae [Pusan National Univ. Collefe of Dentistry, Pusan (Korea, Republic of)

    2006-12-15

    The purpose of this research was to study bone changes after bilateral sagittal split osteotomy through fractal analysis and measurement of mandibular cortical thickness. This study included twenty-two prognathic patients who underwent bilateral sagittal split osteotomy. Panoramic radiographs of these patients were taken immediately before operation and at 1 month, 6 months, and 12 months postoperatively. The fractal dimension was measured by the box-counting method in the region of interest centered on both the basal and interdental bones between the first and second mandibular molars. Measurements of mandibular cortical thickness were taken both in the area between the first and second mandibular molars and at the osteotomy site. Changes of fractal dimension and cortical thickness over four stages were statistically analyzed. The fractal dimension of the mandibular basal bone before surgery and after 1 month, 6 months and 12 months were 1.4099{+-}0.0657, 1.382{+-}0.0595, 1.2995{+-}0.0949, and 1.4166{+-}0.0676. respectively (Repeated-measures ANOVA, P<0.001). However, no statistically significant differences were noted in interdental fractal dimensions among the four stages. Mandibular cortical thickness between the first and second mandibular molars before operation and after 1 month, 6 months and 12 months was 3.74{+-}0.48 mm. 3.63{+-}0.47 mm. 3.41{+-}0.61 mm and 3.55{+-}0.66 mm (P<0.01), respectively. Mandibular cortical thickness at the osteotomy site at each of the four stages was 3.22{+-}0.44 mm, 2.87{+-}0.59 mm, 2.37{+-}0.61 mm and 2.64{+-}0.62 mm, respectively (P<0.001). This study suggests that the mandibular tissue continued decreasing for 6 months postoperatively and then increased over the subsequent 6 months.

  13. Surgical approach to impacted mandibular third molars--operative classification.

    Science.gov (United States)

    Abu-El Naaj, Imad; Braun, Refael; Leiser, Yoav; Peled, Micha

    2010-03-01

    The aim of the present study is to suggest a convenient way to classify the position of the impacted third mandibular molar relative to the mandibular canal and to suggest indications for the use of each surgical approach for mandibular third molar extraction. The presented new typing system, Third Molar Classification (TMC), is a simple and easy-to-apply method for the surgical management of mandibular third molars and can be extended for any ectopic or impacted mandibular tooth. There are 3 major types of third molar positions. The second type is subdivided further into 2 subtypes. In the present study, 9 patients with high-risk mandibular third molars were treated according to the present classification and are presented and discussed. Patients typed as TMC IIb were treated with a sagittal split osteotomy approach and patients typed as TMC III were treated with an extraoral approach. The operative classification was successfully implemented in very rare cases of deeply impacted mandibular third molars. In 3 of 9 cases (33%) minor complications included some degree of hypoesthesia using the extraoral approach; these complications resolved spontaneously without the need for any intervention. The present study describes the use of a new surgical classification system for treatment planning in all types of mandibular third molar extractions. We believe that the present classification could help the oral and maxillofacial surgeon in decision-making and limit the possible risks that are present when attempting to extract impacted mandibular third molars. Copyright (c) 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  14. Influence of third molars in mandibular fractures. Part 2: mandibular condyle-a meta-analysis.

    Science.gov (United States)

    Armond, A C V; Martins, C C; Glória, J C R; Galvão, E L; Dos Santos, C R R; Falci, S G M

    2017-06-01

    The aim of this systematic review was to investigate the influence of the presence and position of mandibular third molars in mandibular condyle fractures. An electronic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and VHL, through January 2016. The eligibility criteria included observational studies. The search strategy resulted in 704 articles. Following the selection process, 13 studies were included in the systematic review and 11 in the meta-analysis. In terms of the risk of bias analysis, six studies presented ≤6 stars in the Newcastle-Ottawa scale assessment. The presence of a mandibular third molar decreased the probability of condylar fracture (cross-sectional and case-control studies: odds ratio (OR) 0.26, 95% confidence interval (CI) 0.17-0.40, I(2)=87.8%; case-control studies: OR 0.30, 95% CI 0.16-0.58, I(2)=91.6%). The third molar positions most favourable to condylar fracture according to the Pell and Gregory classification are class A (OR 1.32, 95% CI 1.09-1.61, I(2)=0%) and class I (OR 1.37, 95% CI 1.05-1.77, I(2)=32.8%). Class B (OR 0.69, 95% CI 0.49-0.97, I(2)=56.0%) and class II (OR 0.71, 95% CI 0.57-0.87, I(2)=0%) act as protective factors for condylar fracture. The results suggest that the presence of a mandibular third molar decreases the chance of condylar fracture and that the positions of the third molar most favourable for condylar fracture are classes A and I, with classes B and II acting as protective factors. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Johnston, C C; Doris, P E

    1980-08-01

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

  16. Bilateral Transverse Mandibular Second Molars: A Case Report

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    James Puryer

    2016-11-01

    Full Text Available Impaction of mandibular second permanent molars is a rare occurrence, with prevalence rates reported to be between 0.65% and 2.0%. In the absence of systemic conditions, impactions are usually unilateral. There appears to be no consensus as to the optimal treatment for impacted mandibular second molars and treatment plans will be based upon the individual case. Treatment may involve orthodontics and/or various surgical techniques, and early diagnosis is important. This paper presents an unusual case of bilateral transverse impaction of both mandibular second and third molars that was diagnosed at 18 years of age. All impacted molars were extracted.

  17. Management of Mandibular Hypoplasia Using Distraction Osteogenesis Technique

    Institute of Scientific and Technical Information of China (English)

    陶学金; 樊敏; 凌翔; 陈卫民

    2004-01-01

    Summary: By using distraction osteogenesis technique, 3 cases of mandibular hypoplasia were treated by home-made and German-made jaw distractors: including one patient suffered from bilateral ankylosis of temporo-mandibular joint and 2 patients from deficiency of mandible. The duration of distraction osteogenesis was one month. The bone distractor was removed 3 months after operation. Satisfactory results were obtained in all 3 cases. Distraction osteogenesis can successfully be used in mandibular functional reconstruction and has much more advantages than traditional technique.

  18. Efficacy of autograft and freeze-dried allograft to enhance fixation of porous coated implants in the presence of interface gaps.

    Science.gov (United States)

    Kienapfel, H; Sumner, D R; Turner, T M; Urban, R M; Galante, J O

    1992-05-01

    Autogenous cancellous bone and freeze-dried allogeneic cancellous bone were tested in a total of 41 adult male mongrel dogs. In each humerus, an implant with a commercially pure titanium fiber metal porous coating was placed in an overreamed cavity so that a uniform 3-mm gap was present between the implant and host cancellous bone. Graft material was placed in the gap of one humerus while the gap of the other humerus was left empty and served as a paired negative control. Histologically, both autograft and allograft appeared to aid repair of the defect, but quantitatively only autograft enhanced new bone formation within the defect. Treatment with autograft significantly increased the amount of bone ingrowth within the implants by nearly three-fold at 4 weeks and eight-fold at 8 weeks. The enhancing effect was recognizable as early as 2 weeks. The strength of fixation was increased by nearly seven-fold at 4 weeks and two-fold at 8 weeks in the autograft group, but this was only statistically significant at 4 weeks. Treatment with allograft did not enhance bone ingrowth at any time period, but had a small positive effect on strength of fixation at 4 weeks.

  19. Flow cytometric detection of growth factor receptors in autografts and analysis of growth factor concentrations in autologous stem cell transplantation: possible significance for platelet recovery

    DEFF Research Database (Denmark)

    Schiødt, I; Jensen, Charlotte Harken; Kjaersgaard, E

    2000-01-01

    In order to improve prediction of hematopoietic recovery, we conducted a pilot study, analyzing the significance of growth factor receptor expression in autografts as well as endogenous growth factor levels in blood before, during and after stem cell transplantation. Three early acting (stem cell...

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

    Directory of Open Access Journals (Sweden)

    Hom-Lay Wang

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

  1. Material Properties of the Mandibular Trabecular Bone

    Science.gov (United States)

    Lakatos, Éva; Magyar, Lóránt; Bojtár, Imre

    2014-01-01

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

  2. Ceramic onlay for endodontically treated mandibular molar

    Directory of Open Access Journals (Sweden)

    Roopadevi Garlapati

    2014-01-01

    Full Text Available Restoration of endodontically treated teeth is important for the success of endodontic treatment. In full coverage restorations, maximum amount of tooth structure is compromised, so as to conserve the amount of tooth structure partial coverage restorations, can be preferred. This case report is on fabrication of a conservative tooth colored restoration for an endodontically treated posterior tooth. A 22-year-old male patient presented with pain in the mandibular left first molar. After endodontic treatment, composite material was used as postendodontic restoration. The tooth was then prepared to receive a ceramic onlay and bonded with self-adhesive universal resin cement. Ceramic onlay restoration was periodically examined up to 2 years.

  3. Mandibular coronoid hyperplasia in pediatric patients.

    Science.gov (United States)

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

    2007-07-01

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

  4. Mandibular brown tumor in renal osteodystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jin Woo; Choi, Bo Ram; Huh, Kyung Hoe; Yi, Won Jin; Choi, Soon Chul [Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul (Korea, Republic of); Gang, In Tae [Department of Oral and Maxillofacial Surgery, Kangnam Sacred Heart Hospital, Hallym Medical Center, Seoul (Korea, Republic of)

    2008-12-15

    Brown tumor is a histologically benign lesion that is a serious complication of renal osteodystrophy because it may result in severe deformity and discomfort. We report a case of brown tumor, which occurred in a 35-year-old woman with chronic renal failure, who had been treated with hemodialysis for 14 years. The lesion was found on the lingual side of the mandible. Standard panoramic radiograph showed generally decreased bone mineral density, loss of lamina dura, and thin cortical plates. Computed tomography (CT) revealed multilocular expansible lesions with heterogeneous attenuation in the anterior mandible, as well as generalized trabecular alteration with homogeneous sclerosis, and thinning or obliteration of cortical plates. Excision of the mandibular lesion and curettage of the affected bone were performed.

  5. Material Properties of the Mandibular Trabecular Bone

    Directory of Open Access Journals (Sweden)

    Éva Lakatos

    2014-01-01

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

  6. Mandibular reconstruction with composite microvascular tissue transfer

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, J.J. III; Wooden, W.A. (Emory Univ. School of Medicine, Atlanta, GA (USA))

    1990-10-01

    Microvascular free tissue transfer has provided a variety of methods of restoring vascularized bone and soft tissue to difficult defects created by tumor resection and trauma. Over 7 years, 26 patients have undergone 28 free flaps for mandibular reconstruction, 15 for primary squamous cell carcinoma of the floor of the mouth or tongue, 7 for recurrent tumor, and 6 for other reasons (lymphangioma (1), infection (1), gunshot wound (1), and osteoradionecrosis (3)). Primary reconstruction was performed in 19 cases and secondary in 9. All repairs were composite flaps including 12 scapula, 5 radial forearm, 3 fibula, 2 serratus, and 6 deep circumflex iliac artery. Mandibular defects included the symphysis alone (7), symphysis and body (5), symphysis-body-ramus condyle (2), body or ramus (13), and bilateral body (1). Fourteen patients had received prior radiotherapy to adjuvant or curative doses. Eight received postoperative radiotherapy. All patients had initially successful vascularized reconstruction by clinical examination (28) and positive radionuclide scan (22 of 22). Bony stability was achieved in 25 of 26 patients and oral continence in 24 of 26. One complete flap loss occurred at 14 days. Complications of some degree developed in 22 patients including partial skin necrosis (3), orocutaneous fistula (3), plate exposure (1), donor site infection (3), fracture of reconstruction (1), and fracture of the radius (1). Microvascular transfer of bone and soft tissue allows a reliable reconstruction--despite previous radiotherapy, infection, foreign body, or surgery--in almost every situation in which mandible and soft tissue are absent. Bony union, a healed wound, and reasonable function and appearance are likely despite early fistula, skin loss, or metal plate or bone exposure.

  7. EXPRESSION OF ACTIVIN DURING THE MANDIBULAR DISTRACTION OSTEOGENESIS IN RABBIT

    Institute of Scientific and Technical Information of China (English)

    李昕; 祁佐良; 王炜; 董佳生; 林晓曦; 戴传昌

    2002-01-01

    Objective To investigate the role of activin on osteogenesis during mandibular distraction.Methods Rabbit mandibular distraction model was used and the new regenerating tissue in the distraction zone were harvested at different time points. lmmunohistochemical technique for activin A was performed in the harvested tissues. Results Positive stain was noted in early phases of distraction. At the end of distraction phase osteoblasts and osteoid in primary mineralization front were strongly stained and osteoblasts and osteocytes in peripheral new bone zone were moderately stained. There were also broad activin A stains in osteoblasts and active osteocytes in early consolidation phase. Conclusion The expression of activin is increased during mandibular distraction. It could play an important role in the process of osteoblastic cells secretion, differentiation to osteocytes and bone formation during mandibular distraction.

  8. Prediction of postoperative pain after mandibular third molar surgery

    DEFF Research Database (Denmark)

    Rudin, Asa; Eriksson, Lars; Liedholm, Rolf;

    2010-01-01

    To evaluate the predictive potential of preoperative psychological and psychophysiological variables in estimating severity of postoperative pain following mandibular third molar surgery (MTMS). Methods: Following ethical committee approval and informed consent, 40 consecutive patients scheduled...

  9. Prediction of postoperative pain after mandibular third molar surgery

    DEFF Research Database (Denmark)

    Rudin, Asa; Eriksson, Lars; Liedholm, Rolf

    2010-01-01

    To evaluate the predictive potential of preoperative psychological and psychophysiological variables in estimating severity of postoperative pain following mandibular third molar surgery (MTMS). Methods: Following ethical committee approval and informed consent, 40 consecutive patients scheduled ...

  10. 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.

  11. Autotransplantation of Mandibular Third Molar: A Case Report

    Directory of Open Access Journals (Sweden)

    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.

  12. Intermaxillary Fixation Screw Morbidity in Treatment of Mandibular Fractures

    DEFF Research Database (Denmark)

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

    2016-01-01

    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......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...

  13. Effect of irradiation on the temporomandibular joint in streptozotocin-induced diabetic rat

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Ki Dong; Hwang, Eui Hwan; Lee, Sang Rae [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    2004-06-15

    To investigate the histopathological changes in the temporomandibular joint in streptozotocin-induced diabetic rat following irradiation. Sprague-Dawley rats weighing about 250 gm were divided into three groups: control, diabetic, and diabetic-irradiated groups. Diabetes mellitus was induced in the rats by injecting streptozotocin. Rats in the control group were injected with citrate buffer only. After 5 days, the head and neck region of the rats in diabetic-irradiated group were irradiated with single absorbed dose of 10 Gy. The rats were killed at 1, 3, 7, 14, 21, and 28 days after irradiation. The specimen including the temporomandibular joint were sectioned and observed using a histopathological method. In the diabetic group, severe bone resorption in the mandibular condyle was observed throughout the period of experiment. Necrosis of bone marrow and trabeculae was observed at 28 days after diabetic state. Atrophy and fibrosis in the retrodiscal tissue was gradually progressed during the time of the experiment. In the diabetic-irradiated group, severe bone resorption in the mandibular condyle was observed during the early experimental phases, but regeneration of bone marrow was initiated at 14 days after diabetic state and irradiation. Also, calcification of abnormal trabeculae was observed at 28 days after diabetic state and irradiation. The retrodiscal tissue was degenerated in the early experimental phases, but it had been gradually regenerated during the experimental time. This experiment suggests that bone resorption and degeneration in the mandibular condyle are caused by the induction of diabetes, and abnormal bone formation is induced after irradiation in diabetic state.

  14. Mandibular metastasis of follicular thyroid carcinoma. Case report.

    Science.gov (United States)

    Ostrosky, Alejandro; Mareso, Eduardo Arístides; Klurfan, Federico Juan; Gonzalez, Maximiliano Jorge

    2003-01-01

    Thyroid carcinoma mandibular metastasis are not very frequent and the cases described in literature are few. Due to its bloodstream dissemination, most of them are a consequence of the follicular variant of thyroid carcinomas. A case is presented and a review of the clinicopathologic characteristics of the lesion is made, so the oral and maxilofacial surgeon can recognize it, make a correct differential diagnosis with other mandibular radioluciencies and in consequence, carry out an adequate treatment.

  15. Unusal canal configuration in maxillary and mandibular second molars

    Directory of Open Access Journals (Sweden)

    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.

  16. The application of the Risdon approach for mandibular condyle fractures

    OpenAIRE

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

    2013-01-01

    Background Many novel approaches to mandibular condyle fracture have been reported, but there is a relative lack of reports on the Risdon approach. In this study, the feasibility of the Risdon approach for condylar neck and subcondylar fractures of the mandible is demonstrated. Methods A review of patients with mandibular condylar neck and subcondylar fractures was performed from March 2008 to June 2012. A total of 25 patients, 19 males and 6 females, had 14 condylar neck fractures and 11 sub...

  17. Correlation of plasma FL expression with bone marrow irradiation dose.

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    Mary Sproull

    Full Text Available PURPOSE: Ablative bone marrow irradiation is an integral part of hematopoietic stem cell transplantation. These treatment regimens are based on classically held models of radiation dose and the bone marrow response. Flt-3 ligand (FL has been suggested as a marker of hematopoiesis and bone marrow status but the kinetics of its response to bone marrow irradiation has yet to be fully characterized. In the current study, we examine plasma FL response to total body and partial body irradiation in mice and its relationship with irradiation dose, time of collection and pattern of bone marrow exposure. MATERIALS/METHODS: C57BL6 mice received a single whole body or partial body irradiation dose of 1-8 Gy. Plasma was collected by mandibular or cardiac puncture at 24, 48 and 72 hr post-irradiation as well as 1-3 weeks post-irradiation. FL levels were determined via ELISA assay and used to generate two models: a linear regression model and a gated values model correlating plasma FL levels with radiation dose. RESULTS: At all doses between 1-8 Gy, plasma FL levels were greater than control and the level of FL increased proportionally to the total body irradiation dose. Differences in FL levels were statistically significant at each dose and at all time points. Partial body irradiation of the trunk areas, encompassing the bulk of the hematopoietically active bone marrow, resulted in significantly increased FL levels over control but irradiation of only the head or extremities did not. FL levels were used to generate a dose prediction model for total body irradiation. In a blinded study, the model differentiated mice into dose received cohorts of 1, 4 or 8 Gy based on plasma FL levels at 24 or 72 hrs post-irradiation. CONCLUSION: Our findings indicate that plasma FL levels might be used as a marker of hematopoietically active bone marrow and radiation exposure in mice.

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

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    Anendd Jadhav

    2015-01-01

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

  19. Evaluation of mandibular anterior alveolus in different skeletal patterns

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    Nga Hoang

    2016-07-01

    Full Text Available Abstract Background The boundaries for orthodontic tooth movement are set by the bony support of the dentition. This study compares the mandibular anterior alveolar housing in individuals with low, average, and high mandibular plane angles before orthodontic treatment and measures alveolar bone loss and root resorption after orthodontic treatment. Methods Pretreatment cone-beam computed tomography (CBCT images of 75 non-growing individuals, 25 in three groups: low-angle (sella-nasion to mandibular plane ≤28°, average-angle (30°–37°, and high-angle (≥39°, were analyzed. Buccolingual bone thickness was measured at the root apex, mid-root, and alveolar crest of the mandibular right central incisor. Pre- and posttreatment CBCT images of 11 low-angle, 20 average-angle, and 27 high-angle patients were compared to determine changes in the alveolus and mandibular incisor root after orthodontic treatment. Results The pretreatment anterior alveolar bone widths were significantly different, wider in low-angle than in average- and high-angle individuals (p value = 0.000. High-angle individuals also had greater posttreatment external root resorption, even though the bony housing changed minimally. Conclusions Negative sequelae of orthodontic treatment are more frequently found in individuals with high mandibular plane angles and could be linked to their thin pre-existing alveolar housing.

  20. 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.

  1. Relationship between neck disability and mandibular range of motion.

    Science.gov (United States)

    Packer, Amanda Carine; Dibai-Filho, Almir Vieira; de Souza Costa, Ana Cláudia; dos Santos Berni, Kelly Cristina; Rodrigues-Bigaton, Delaine

    2014-01-01

    There is a close interaction between the mandibular and cervical systems due to the existing neurological and biomechanical communications. This study aimed to evaluate the relationship between neck disability and mandibular range of motion (ROM). Fifty-two women aged between 18 and 40 years were recruited and allocated to four groups using two outcome measures: the Neck Disability Index (NDI) and the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD): Group I (n=13), healthy volunteers; Group II (n=13), volunteers with TMD and neck disability; Group III (n=13), volunteers with TMD and without neck disability; and Group IV (n=13), volunteers with neck disability and without TMD. Mandibular ROM was evaluated as part of the RDC/TMD clinical examination. Statistical analysis involved one-way ANOVA followed by Tukey's test for comparisons between groups. Spearman's correlation coefficients were calculated to determined correlations among the variables. Significant differences were found in the mandibular ROM of functional opening in the comparisons between Groups I and III (p=0.009) and between Groups III and IV (p=0.024). No significant association was found between mandibular ROM and the NDI score (p > 0.05). Based on the methodology employed, there is no association between mandibular ROM and neck disability in university women. In this sense, clinical interventions focusing on the flexibility of the temporomandibular joint does not have repercussions on the neck disability and vice versa.

  2. Panoramic Image of Mandibular Condyle According to Head Position

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Hwa; Choi, Soon Chul [Dept. of Oral Radiology, College of Dentistry, Seoul National, Seoul (Korea, Republic of)

    1990-08-15

    Panoramic radiography is convenient in clinic and visualizes those areas which other technique do not give. But the technique has limitation of image distortion which results from the relationship of the ramus to the focal trough and from the direction of the central ray. This study is, using 7 dry skulls, to determine the effect of rotation of patient's head on reducing those distortion and determine the magnification ratio of images of mandibular condyle in rotated patient head position. The obtained results were as follows: 1. Generally, in panoramic radiography the anterolateral portion of the mandibular condyle was best to be visualized. 2. There are no significant difference between the image readability of anteromedial portion and that of antercentral portion of the mandibular condyle. 3. Anterolateral portion of the mandibular condyle was better visualized in rotated head position by 20 degree or horizontal condylar inclination than in conventional position or in rotated head position by 10 degree. 4. The magnification ratio of the anteroposterior diameter in the image of mandibular condyle was least in the rotated head position by horizontal inclination of the mandibular condyle and was largest by 20 degree.

  3. Evaluation of mandibular morphology in different facial types

    Directory of Open Access Journals (Sweden)

    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.

  4. Clinical application of cultured epithelial autografts on acellular dermal matrices in the treatment of extended burn injuries.

    Science.gov (United States)

    Fang, Taolin; Lineaweaver, William C; Sailes, Frederick C; Kisner, Carson; Zhang, Feng

    2014-11-01

    Achieving permanent replacement of skin in extensive full-thickness and deep partial-thickness burn injuries and chronic wounds remains one of the fundamental surgical problems. Presently, split-thickness skin grafts are still considered the best material for surgical repair of an excised burn wound. However, in burns that affect greater than 50% of total body surface area, the patient has insufficient areas of unaffected skin from which split-thickness skin grafts can be harvested. The use of cultured epithelial (or epidermal) autografts (CEAs) has achieved satisfactory results. But the take rate of CEAs is poor in full-thickness bed or in chronically infected area. Providing temporary cover with allograft skin, or a more permanent allodermis, may increase clinical take. This review aims to (1) describe the use of CEAs in the regeneration of the epidermis, (2) introduce the application of the acellular dermal matrices (ADMs) in the clinics, and (3) enhance understanding of the CEAs applied with ADM as an appropriate strategy to treat the extended burn injuries. The current evidence regarding the cultured epithelial cell or keratinocyte autograft and dermal grafts applied in the treatment of burn injuries was investigated with an extensive electronic and manual search (MEDLINE and EMBASE). The included literature (N=136 publications) was critically evaluated focusing on the efficacy and safety of this technique in improving the healing of the deep dermal and full-thickness burn injuries. This review concluded that the use of ADM with CEAs is becoming increasingly routine, particularly as a life-saving tool after acute thermal trauma.

  5. Cirugía de torus mandibular

    Directory of Open Access Journals (Sweden)

    Manuel Ramon Osorio Castillo

    2014-06-01

    Full Text Available ResumenLos huesos maxilares no son ajenos a las patologías que se pueden presentar en el sistema esquelético. Algunas de esas condiciones y patologías son singulares por sus características clínicas, su distribución y prevalencia. Los torus palatinos, los torus mandibulares (TM y las exostosis de los maxilares son un claro ejemplo de ellos. Hasta la presente existen ideas especulativas acerca de su etiopatogenia, de los factores asociados, de su incidencia y prevalencia, de su necesidad de tratamiento, lo que puede crear confusión entre los clínicos tanto en diagnóstico como en el manejo.El torus como tumor óseo benigno puede localizarse en el maxilar a nivel del paladar, o en la mandíbula a nivel de las tablas internas; o puede aparecer en cualquier parte del esqueleto. El TM es una exostosis o crecimiento óseo en la superficie lingual de la mandíbula. Este crecimiento ocurre generalmente cerca de la línea milohioidea, opuesto a los premolares, pero se puede extender del canino al primer molar. La mucosa que los recubre tiende a ser fina y no tolera por lo general las fuerzas de las prótesis que se colocan encima de ellos. La incidencia del torus de la mandíbula es baja en el 6% a 12.5% entre caucásicos y en los habitantes de la llanura africana. De manera contraria, algunos autores reportan una prevalencia mucho más elevada en la Costa Atlántica Colombiana.Se presenta el caso de un paciente con torus mandibulares bilaterales, con muchos años de crecimiento, hasta que por situaciones tanto fonéticas como de ulceraciones repetitivas decidió someterse al acto quirúrgico de forma bilateral. Se presentan algunas consideraciones para el manejo de esta. (Duazary 2008; 111-114AbstractThe jawbone is not a strange to the pathologies that can occur in the skeletal system. Some of these terms and conditions are unique for their clinical features, distribution and prevalence. The torus palate, jawbone torus (TM in spanish and

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

    Science.gov (United States)

    Shah, Ankit H; Shah, Darshit H

    2016-01-01

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

  7. Patency of experimental microvascular autografts of the common carotid artery after balloon dilatation in rats: a technical note and preliminary results.

    Science.gov (United States)

    Friedrich, R E

    1998-10-01

    To study the patency rates of anastomoses in damaged common carotid arteries in a training model of microvascular surgery (Wistar rats). Under general anaesthesia with xylazine (Rompun) and ketamine (Ketanest) balloon dilatation was repeated five times in 31 left common carotid arteries of female Wistar rats. One minute after reflow an autograft of 4 mm was harvested, turned 180 degrees, and reinserted into the artery. The flow through the vessels was investigated by micro-Doppler ultrasound (60 s after balloon dilatation and 30 min after insertion of the autograft). Autografts were fashioned in a further 26 common carotid arteries but left undamaged. A further 14 arteries were dilated, but no autografts were inserted. The vessels were harvested after perfusion with 3% glutaraldehyde after one day, seven days, and one month. The specimens were evaluated by light microscopy in longitudinal sections of 1.5 microm slides embedded in Epon. In addition, cross-sections were taken from arteries treated by balloon dilatation. In no instance did dilatation lead to occlusion of the vessel as judged by micro-Doppler ultrasound. In the group with autografts that were not dilated, one vessel was occluded after flow had restarted. However, this vessel proved to be patent after perfusion and examination. In this group, therefore, all arteries were patent after perfusion. In the group in which dilatation preceded the insertion 13 vessels were occluded and 13 were patent on micro-Doppler ultrasound. At different perfusion times, 14 vessels were patent, and 12 vessels were completely thrombosed. The differences in patency in both groups with autografts was significant, both after Doppler imaging and on histological evaluation (P < 0.001). Balloon dilatation is recommended for the removal of a thrombus or to dilate a spastic vessel segment in anastomosed vessels that threaten the success of microvascular flaps. For experimental research, balloon dilatation of the common carotid

  8. [Imaging of oto-mandibular dysplasias].

    Science.gov (United States)

    Montoya, P; Leboucq, N; Bigorre, M

    2001-10-01

    The modern imaging opened a possibility of precise exploration of otomandibular dysplasias. The techniques of browsing by IRM and CT Scan and the software of image processing which is associated with these techniques (three-dimensional, superposition and removing of the anatomical structures) allow to carry out a true anatomical dissection of the whole of these malformative syndromes. The study of the skeletal anomalies gains by specifying the disorders of development of the various mandibular segments: temporomandibular joint, ramus and horizontal branch and also, all cranio-maxillar structures: orbital rim, cranial basis. Study of masticatory muscles shows an important damage correlated with skeletal troubles and performs a grading of morphological and functional gravity. This analytical study emphasizes some malformative axis: malar axis in cases of mandibulofacial dystosis, temporomandibular axis in hemifacial microsomia. Modern imaging can appreciate, by development of three-dimensional cephalometry, growth anomalies and quantification of post therapeutical results. At last usefulness of imaging appears in therapeutic modelisation and in the field of Computer-Aided Planning of surgical techniques of osteotomies and overall maxillaries distractions.

  9. Dimorfismo sexual mandibular en una coleccion formativa

    Directory of Open Access Journals (Sweden)

    Barboza, María Carolina

    2005-01-01

    Full Text Available Muchas piezas óseas permiten la estimación sexual. En la mandíbula es mediante la observación de sectores morfoestructurales (gonion, mentón, rama, etc. La efectividad discriminatoria de esta estructura puede verse incremententada y/o complementada con nuevas propuestas técnico-metodológicas. Una de estas propuestas (Loth y Henneberg 1996, basada en la conformación anatómica de la inflexión del borde posterior de la rama mandibular, ha sido cuestionada en su eficiencia diagnóstica. Puesto que la expresión del dimorfismo sexual puede variar entre poblaciones, es necesario verificar la efectividad del nuevo procedimiento. El objetivo de este trabajo ha sido comprobar la eficiencia diagnóstica de la nueva técnica, utilizando un conjunto de mandíbulas pertenecientes a esqueletos con una fuerte expresión dimórfica del sitio Formativo SJ Til. 20, Tilcara, Jujuy. Se discuten e interpretan las coincidencias e inconsistencias encontradas.

  10. Functional Reconstruction in Mandibular Avulsion Injuries.

    Science.gov (United States)

    Leiser, Yoav; Shilo, Dekel; Wolff, Amir; Rachmiel, Adi

    2016-11-01

    The present report describes the planning and surgery as well as pitfalls and management of a patient with a near total mandibular avulsion injury that was rehabilitated using three-dimensional (3D) laser printing of a titanium lower jaw. Laser-sintering involves zapping layers of powdered metal to recreate a 3D implantable skeletal defect. The process involves using either mirror imaging of the unaffected side or using archival image database of healthy individuals. A 25-year-old man presented with a gunshot injury that left him with a near total avulsed mandible. The patient received state-of-the-art treatment using a laser 3D printed mandible which was connected to the muscles of mastication for functionality. The inner side of the titanium jaw was filled with the patient's comminuted fractured bones in addition to harvested iliac crest bone graft that was covered with the patient's remaining periosteal tissue. The implantation of a near total mandible using 3D laser printing is a fast and predictable process that in selected patients can result in aesthetically as well as functionally excellent results. The authors believe that the future of craniofacial reconstruction will employ these methods for facial bony reconstruction.

  11. Torus palatino, torus mandibular y exostosis maxilares

    Directory of Open Access Journals (Sweden)

    Ivan Alberto Manotas Arevalo

    2013-12-01

    Full Text Available Los huesos maxilares son parte de la estructura esquelética corporal por lo cual no son ajenos a las patologías que se presentan en ella. Algunas guardan semejanza entre sí, otras son muy singulares por sus características patognomónicas, por ejemplo, los torus palatinos, los torus mandibulares y las exostosis de los maxilares. Sin embargo, existen ideas especulativas acerca de su etiopatogenía, de los factores asociados, de su incidencia y prevalencia, de su necesidad de tratamiento, entre otras. El propósito de esta revisión es presentar la información existente sobre estas patologías en textos usados para la formación de profesionales de salud en nuestro medio y en el ámbito universal, y en otras publicaciones que hayan servido de soporte a las ideas concebidas acerca de los torus y las exostosis, haciendo énfasis en los aspectos diagnósticos. Se pretende que esta información sirva de orientación para investigaciones futuras. 

  12. Long term results of mandibular distraction

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    Batra Puneet

    2006-03-01

    Full Text Available Mandibular distraction osteogenesis has become a popular surgical modality due to its many advantages over conventional orthognathic surgical procedures. However, in spite of the technique having been used for over 15 years, no concrete long term results are available regarding the stability of results. We discuss the various studies which have reported either in favour or against the stablility of results after distraction. We report a series of 6 cases (3 unilateral and 3 bilateral distraction where distraction was carried out before puberty and followed them up to seven years after removal of distractors. This case series shows that results achieved by distraction osteogenesis are unstable or best unpredictable with respect to producing a permanent size increase in the mandible. The role of the distraction osteogenesis in overcoming the pterygomassetric sling is questionable. We suggest a multicenter study with adequate patient numbers treated with a similar protocol and documented after growth cessation to have meaningful conclusions on the debate of distraction osteogenesis versus orthognathic surgery.

  13. Distraction osteogenesis in a severe mandibular deficiency

    Directory of Open Access Journals (Sweden)

    Ozyigit Aykut H

    2007-01-01

    Full Text Available Abstract Objective Distraction osteogenesis is an alternative treatment method for the correction of mandibular hypoplasia. In this case report, distraction with a multidirectional extraoral device was performed to gradually lengthen the corpus and ramus of a patient who had a severe hypoplastic mandible. Materials and methods The patient underwent bilateral extraoral ramus and corpus distraction osteogenesis. After seven days of latency period, distraction was performed 0.5 mm twice a day. Subsequent consolidation period was 12 weeks. Results The patient's mandible was elongated successfully. Cephalometric analysis revealed that ANB angle decreased from 13° to 6°, overjet of 15 mm decreased to 4 mm, corpus length increased from 49 mm to 67 mm, and ramus length increased from 41 mm to 43 mm. Posterior airway space (PAS also increased due to advancement of the mandible. In stereolithographic model evaluation it was determined that the distances from condylion to gonion and from gonion to pogonion increased. Conclusion Satisfactory results from both aesthetic and functional standpoints were obtained by distraction osteogenesis of the ramus and corpus.

  14. Diversity Of Mandibular Morphology In Some Carnivorans

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    Rahmat S. J.

    2015-06-01

    Full Text Available Comparison of mandibular morphology of some aquatic (seals, walruses, and sea otters and terrestrial (hyenas and pandas carnivorans demonstrates a rather general pattern correlating size of condyloid angle, size of gape, and diet. Structural differences of carnivoran jaws reveal morphological and ecological adaptations that are directly correlated with availability of prey, diving depth, feeding competition and specialized feeding methods. Specifically, the inclination of the condyloid process relative to the axis of the alveolar row (= condyloid angle can be used to determine dietary preferences, including size of prey. Generally, carnivorans with a large condyloid angle feed on larger prey, while a low condyloid angle suggests feeding on small prey or can be an advantageous feeding mechanism. Mirounga angustirostris (Northern elephant seal displays sex-specific characters in cranial and postcranial elements. Likewise, significant sexually dimorphic differences in the size of condyloid angle imply that deeper-diving male Northern elephant seals have a feeding niche dissimilar to that of females. Morphological assessment of male M. angustirostris suggests they are bottom-feeding seals that utilize a suction-feeding mechanism to capture small prey and crush shells with their teeth, which become weaker as they age.

  15. Evidence of secular trend in mandibular pubertal growth.

    Science.gov (United States)

    Patcas, Raphael; Wiedemeier, Daniel B; Markic, Goran; Beit, Philipp; Keller, Heidi

    2017-04-20

    During puberty, mandibular growth follows a growth curve comparable to somatic growth. This study aimed to review the relationship between mandibular pubertal peak height velocity (PHV) and skeletal age, and to investigate the possibility of a secular trend. Retrospective analysis was performed of two historical craniofacial growth studies (Denver Growth Study; observational time: 1943-1965, and Zurich Growth Study; observational time: 1982-1984) of healthy untreated subjects. Two mandibular growth measures (Articulare-Pogonion [Ar-Pg], Condylion-Pogonion [Co-Pg]) were retrieved from cephalograms (n: 990) and corresponding skeletal age based on hand-wrist radiographs. Mandibular growth velocity was related to skeletal age, PHV was established by use of cubic smoothing splines and variability was calculated by bootstrap resampling for every growth study and gender separately. Sexual dimorphism in mandibular growth was apparent in both cohorts. In subjects of the Denver Growth Study, mandibular PHV occurred at a more advanced skeletal age than in subjects of the Zurich Growth Study. This trend was more pronounced in males, for whom PHV of Co-Pg shifted from 14.4 to 13.8 years and of Ar-Pg from 14.6 to 13.7 years. This tendency was more subtle in females: PHV of Co-Pg shifted from 12.7 to 12.4 years and of Ar-Pg from 12.6 to 11.8 years. Mandibular growth appears to be subject to a secular trend. When related to skeletal age, this secular trend seems to be more accentuated than the established secular trend for somatic pubertal growth.

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  17. Changes in mandibular mobility after different procedures of orthognathic surgery.

    Science.gov (United States)

    Zimmer, B; Schwestka, R; Kubein-Meesenburg, D

    1992-06-01

    A prospective study including 63 adult Class II and Class III patients was carried out in order to examine short- and long-term effects of four different treatment methods on mandibular mobility. The patients were treated either (Group A, control-group) orthodontically alone or (Group B) by a LeFort I-osteotomy, a (Group C) mandibular advancement or (Group D) a two-jaw surgery/mandibular set-back. In the surgery-groups (B, C, and D) maximum opening, protrusion and lateral excursions were measured 2 days pre-operatively (T0), and 3, 8, 14.5, and 25.5 months post-operatively (T1-T4). In the control-group (A) at T0 and T4 was measured, only. Significantly differing effects of the four treatment methods on mandibular mobility were detected. (A) Orthodontic treatment alone, (B) maxillary advancement by LeFort I osteotomy, and (D) two-jaw surgery/mandibular set-back osteotomy did not influence mandibular mobility permanently. Temporary decreases in groups B and D (P less than or equal to 0.05) were observed, however. In contrast, permanent reductions after (C) mandibular advancement took place (P less than or equal to 0.001). Longitudinal survey showed that in all surgery groups recoveries were limited to a short period of 3-14.5 months, depending on the movement. Surprisingly, a closer similarity between the LeFort-I group (B) and the two-jaw surgery group (D), rather than between the sagittal-split groups (C and D), was seen indicating that the problem of reduced mobility after orthognathic surgery can be limited to Class II therapy. It was concluded that in Class III therapy, the application of rigid fixation in combination with a method of maintaining condyle-position, thereby dispensing with maxillomandibular fixation, prevents permanent reductions in mobility and guarantees a rapid recovery to pre-operative mobility levels.

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

    Science.gov (United States)

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

    2007-10-01

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

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

    Science.gov (United States)

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

    2009-04-01

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

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

    Science.gov (United States)

    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.

  1. Bone changes of mandibular condyle using cone beam computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    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.

  2. Sex determination by mandibular ramus: A digital orthopantomographic study

    Directory of Open Access Journals (Sweden)

    K Samatha

    2016-01-01

    Full Text Available Aims and Objectives: (1 To determine the usefulness of mandibular ramus as an aid in sex determination. (2 To evaluate Anteroposterior | superioinferior angle of mandibular condyle. Materials and Methods: A retrospective study was conducted using orthopantomographs of 60 males and 60 females,which were taken using Kodak 8000C Digital Panoramic and Cephalometric System (73 kVp, 12 mA, 13.9 s. The age group ranged between 18 – 45 years. Mandibular ramus measurements were carried out using Master View 3.0 software. The measurements of the mandibular ramus will be subjected to Discriminant function analysis. Results: Maximum ramus breadth, Minimum ramus breadth, Condylar height, Projective height of ramus Coronoid height were calculated for both the sexes differently with the formula & analyzed with Discriminant function analysis using Fischer exact test. The P value was statistically significant with the P value < 0.05 for the following parameters Max. ramus breadth, Condylar height and Projective height of ramus. Conclusion: Mandibular ramus measurements can be a useful tool for gender determination.

  3. Endodontic management of mandibular canine with two canals

    Directory of Open Access Journals (Sweden)

    Nidhi Shrivastava

    2013-01-01

    Full Text Available Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment procedures. Many investigators have reported the anatomical variations associated with mandibular canines. Mandibular canines are recognized as usually having one root and one root canal in most cases. This case report describes a clinical case of mandibular canine with two canals. Human mandibular canines do not present internal anatomy as simple as could be expected; there are such canines with a single root and two canals, two roots or fused roots. The existence of mandibular canines with more than one root canal is a fact that clinicians ought to keep in mind, in order to avoid failure during endodontic treatment. In spite of the low incidence of lower canines with one root and two canals, this possibility cannot be forgotten, inasmuch as the presence of a second canal in these teeth leads to difficulties in endodontic treatment. The precise knowledge of the dental endocanalicular system′s anatomy is essential in the success of the root canal therapy, because the failure to detect the accessories canals and the incomplete radicular obturation leads to the infection of the periapical space, which will ultimately result in the loss of the tooth.

  4. Update on patterns of mandibular fracture in Tasmania, Australia.

    Science.gov (United States)

    Verma, Shreya; Chambers, Ian

    2015-01-01

    Mandibular fractures often present to hospital, so if we understand trends in patterns of fractures and their demographics it may help us to deliver a better service, and prevent these injuries. Here, we compare current data on mandibular fractures in Tasmania with data from 15 years ago, and with current world trends. Patients who presented to the Royal Hobart Hospital with fractured mandibles were audited, and the data analysed and compared with those from a previous study. About 37 fractured mandibles presented to hospital each year. Most patients were men aged 20-30 years old. Ninety-seven of the 159 fractures (61%) were secondary to assault, 27 (17%) were the result of sport, and 24 (15%) followed falls. Road crashes contributed only 5% of mandibular fractures. Sixty-six patients (60%) were intoxicated at the time of injury. The angle of the mandible was the most common site of fracture and open reduction and internal fixation was the treatment of choice. There have been important changes in mandibular fracture patterns in Tasmania in the last 15 years. There was a rise in alcohol-related interpersonal violence, and men were most commonly involved. There was also a decrease in mandibular fractures caused by road crashes, which suggests an improvement in road safety.

  5. 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.

  6. 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.

  7. Unerupted lower third molars and their influence on fractures of the mandibular angle and condyle.

    Science.gov (United States)

    Patil, Pavan M

    2012-07-01

    Our aim was to assess the influence of the presence and state of impaction of mandibular third molars on the incidence of fractures of the mandibular angle and condyle. We designed a retrospective study of patients who presented for the treatment of mandibular fractures from January 2006 to April 2011. The independent variables were the presence and degree of impaction of lower third molars, and the outcome variables were the incidence of fractures of the mandibular angle and condyle. The information was acquired from hospital records and panoramic radiographs. Personal data included age, sex, mechanism of injuries, and number of fractures of the mandibular angle and condyle. We studied 110 fractures of the mandibular condyle and 80 of the angle. The incidence of fractures of the mandibular angle was higher in the group with incompletely erupted third molars (37/80, pthird molar reduces the risk of condylar fractures and increases the risk of fractures of the mandibular angle.

  8. Delayed dental maturity in dentitions with agenesis of mandibular second premolars

    DEFF Research Database (Denmark)

    Daugaard, S; Christensen, I J; Kjaer, I

    2010-01-01

    To evaluate dental maturity in the mandibular canine/premolar and molar innervation fields in children with agenesis of the 2nd mandibular premolar and to associate these findings with normal control material....

  9. Effect of Fatty degeneration of the infraspinatus on the efficacy of arthroscopic patch autograft procedure for large to massive rotator cuff tears.

    Science.gov (United States)

    Mori, Daisuke; Funakoshi, Noboru; Yamashita, Fumiharu; Wakabayashi, Tsuguru

    2015-05-01

    In a 2013 study involving 24 patients whose shoulders had large or massive rotator cuff tears (RCTs) and low-grade fatty degeneration of the infraspinatus (Goutallier stage 1 or 2), we reported significantly improved clinical results after an arthroscopic fascia lata autograft patch procedure, with a 79.2% rate of intact repairs. Based on that study, we began applying the fascia lata autograft patch procedure to shoulders with stage 3 or 4 degeneration of the supraspinatus and stage 3 or 4 degeneration of the infraspinatus. To investigate the effects of the fascia lata autograft patch procedure on massive RCTs in shoulders with high-grade degeneration of the infraspinatus by comparing the clinical outcomes and structural features with those in shoulders with low-grade degeneration of the infraspinatus. Cohort study; Level of evidence, 3. A case series of 45 consecutive patients with large to massive RCTs with high-grade fatty degeneration of the supraspinatus and either low-grade (group L; n=26 [the same patients as in our previous study plus 2 additional patients]) or high-grade (group H; n=19) fatty degeneration of the infraspinatus were treated with the fascia lata autograft patch procedure. Clinical (Constant and American Shoulder and Elbow Surgeons [ASES]) scores, structural outcomes on MRI, and muscle strength were assessed at a minimum 2-year follow-up and compared between the 2 groups. Patients in group L had a higher frequency of intact repairs than did those in group H (73.1% vs 10.6%; Pinfraspinatus as other treatment options that produce similar functional results. © 2015 The Author(s).

  10. Comparison between lamellar keratoplasties produced by conjunctival pedicle and free corneal autografts. Experimental study in the dog (Canis familiaris - LINNAEUS, 1758

    Directory of Open Access Journals (Sweden)

    José Luiz Laus

    1996-03-01

    Full Text Available A comparative study of conjunctival pedicle and corneal autografts, for experimental healing of superficial keratectomies in dogs (Canis familiaris was performed. It was carried out by using 24 animals, and the technical procedures were analysed according to clinical, histologic and scanning electron microscopy parameters, in early and late postoperative periods. The obtained results are believed to represent feasible methods of proteresis, applied to the healing ophthalmic surgery. There were few, irrelevant differences between the two tested techniques.

  11. Combined Reconstruction of the Medial Collateral Ligament and Anterior Cruciate Ligament Using Ipsilateral Quadriceps Tendon-Bone and Bone-Patellar Tendon-Bone Autografts.

    Science.gov (United States)

    Hetsroni, Iftach; Mann, Gideon

    2016-06-01

    The exclusive autograft choice for medial collateral ligament (MCL) reconstruction that has been described until today is the semitendinosus tendon. However, this has some potential disadvantages in a knee with combined MCL-anterior cruciate ligament (ACL) injury, including weakening of the hamstring's anterior restraining action in an already ACL-injured knee and nonanatomic distal MCL graft insertion when leaving the semitendinosus insertion intact at the pes anserinus during reconstruction. Moreover, because some surgeons prefer to use the hamstring for autologous ACL reconstruction, the contralateral uninjured knee hamstring needs to be harvested as a graft source for the MCL reconstruction if autografts and not allografts are the surgeons' preference. We describe a technique for performing combined reconstruction of the MCL and ACL using ipsilateral quadriceps tendon-bone and bone-patellar tendon-bone autografts. This technique of MCL reconstruction spares the hamstring tendons and benefits from the advantage provided by bone-to-bone healing on the femur with distal and proximal MCL tibial fixation that closely reproduces the native MCL tibia insertion.

  12. Comparison of outcomes and safety of using hydroxyapatite granules as a substitute for autograft in cervical cages for anterior cervical discectomy and interbody fusion

    Directory of Open Access Journals (Sweden)

    Hosein Mashhadinezhad

    2014-03-01

    Full Text Available Background:   After cervical discectomy, autogenetic bone is packed into the cage to increase the rate of union between adjacent vertebral bodies, but donor site–related complications can still occur. In this study we evaluate the use   of hydroxyapatite granules as a substitute for autograft for interbody fusion.     Methods:   From November 2008 to November 2011, 236 patients participated in this study. Peek cages were packed with autologous bone grafts taken from the iliac crest in 112 patients and hydroxyapatite (HA granules in 124 patients.   Patients were followed for 12 months. The patients’ neurological signs, results, and complications were fully recorded   throughout the procedure. Radiological imaging was done to assess the fusion rate and settling ratio.     Results:   Formation of bony bridges at the third month was higher in the autograft group versus the granule group. However, there was no difference between both groups at the 12-month follow-up assessment. No difference (     P > 0.05   was found regarding improvement in neurological deficit as well as radicular pain and recovery rate between the two groups. Conclusions:   Interbody fusion cage containing HA granules proved to be an effective treatment for cervical spondylotic radiculopathy and/or myelopathy. Clinical and neurological outcome, radiographic measurement and fusion rate   in cage containing HA are similar and competitive with autograft packed cages.

  13. Oral and mandibular manifestations in the Ehlers-Danlos syndromes.

    Science.gov (United States)

    Mitakides, John; Tinkle, Brad T

    2017-02-13

    The Ehlers-Danlos syndromes (EDS) are hereditary disorders that affect the connective tissue and collagen structures in the body. Several types of EDS have been identified. Oral and mandibular structures, which include oral soft tissue, dentition, facial and head pain, and the functioning of the temporomandibular joint (TMJ), are variably affected in the various types of EDS. These various manifestations of EDS have been noted for many years, but newer diagnostic techniques and studies are shedding additional light on the challenges faced by EDS patients in the area of oral and mandibular disorders. Further, the impact of temporomandibular disorder (TMD) on musculoskeletal dysfunction and vice versa, make this an important feature to recognize. Oral and mandibular hypermobility of the TMJ with associated consequences of EDS are noted. These features, diagnostic parameters and treatment procedures are presented. © 2017 Wiley Periodicals, Inc.

  14. Surgical-prosthetic treatment of large mandibular cysts

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    1993-10-01

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

  16. Recurrent osteochondroma of the mandibular condyle: A case report

    Science.gov (United States)

    Kwon, Young-Eun; Choi, Karp-Shik; An, Chang-Hyeon; Choi, So-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. PMID:28361031

  17. 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...

  18. Recurrent osteochondroma of the mandibular condyle: A case report

    Energy Technology Data Exchange (ETDEWEB)

    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.

  19. Cementoblastoma Relating to Right Mandibular Second Primary Molar

    Science.gov (United States)

    Manepalli, Swapna; Mohapatra, Abinash

    2016-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  1. The mandibular muscles in contemporary orthodontic practice: a review.

    Science.gov (United States)

    Woods, M G

    2017-03-01

    It is widely accepted that all dentists should have a thorough understanding of the muscles involved in moving or stabilizing the mandible. However, there is still much discussion regarding the influence of the mandibular muscles on normal facial growth and dental development, as well as on orthodontic treatment and post-treatment stability. Potential patients with different underlying vertical muscle patterns will have differences in the expected directions of future mandibular growth, lateral profile shape, facial and arch widths and vertical occlusal relationships. In turn, thorough diagnoses are likely to lead to differences in individual aims and objectives, treatment plans, timing of commencement, mechanical design, lateral profile and smile-aesthetics outcomes, choice of retention and plans for long-term maintenance. The potential influence of the mandibular muscles on normal morphologic variation and the soft tissue implications on contemporary orthodontic treatment and stability will be addressed in this review. © 2017 Australian Dental Association.

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

    Science.gov (United States)

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

    2009-01-01

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

  3. Alveolar rhabdomyosarcoma involving the mandibular ramus and its surrounding tissues

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Suk Ja; Kang, Byung Cheol [Chonnam National University College of Medicine, Gwangju (Korea, Republic of)

    2004-06-15

    Rhabdomyosarcoma, when it occurs in the head and neck, is primarily found in children. Alveolar rhabdomyosarcoma is rarely seen in the oral lesion, comparing to the embryonal and the pleomorphic variants. This is a report of a case of alveolar rhabdomyosarcoma in the mandible in a ten-year old girl who complained of a non-painful swelling on the right cheek. The right lower 1st molar was mobile. Her radiographs revealed an extensive radiolucency with somewhat irregular border on the right mandibular ramus. The right mandibular 1st and 2nd molars lost their lamina dura and were floating. CT images revealed smooth-outlined soft tissue mass occupying the pterygomandibular space, the infratemporal space, and the masseteric muscle with thinning and perforation of the right mandibular angle and ramus. Histopathological and immunohistochemical findings established the final diagnosis of alveolar rhabdomyosarcoma.

  4. Prognosis of teeth involved in the line of mandibular fractures.

    Science.gov (United States)

    Kahnberg, K E; Ridell, A

    1979-06-01

    The management of teeth positioned in the line of mandibular jaw fractures was studied by a follow-up examination of 132 patients with mandibular fractures involving 185 teeth. The observation period varied from 1 to 3 years. The clinical and radiographic findings revealed complete recovery in 59% of the involved teeth. The degree of periodontal and pulpal complications were closely related to the displacement between the fragments and to the type of fracture. Six different fracture types were classified with regard to the extent of involvement of the tooth supporting tissue; 23% of the teeth which initially responded negatively to electric stimulation showed positive sensibility at the time of reexamination. Thus, a long time observation period is advisable with regard to the final outcome of the pulp damage. Conservative treatment of teeth involved in the line of mandibular fractures has a favorable prognosis especially if optimal reduction of the jaw fragments is achieved.

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

    Directory of Open Access Journals (Sweden)

    Khalid H. Zawawi

    2014-01-01

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

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

    Science.gov (United States)

    Zawawi, Khalid H.

    2014-01-01

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

  7. Atypical situations in root canals anatomy of human mandibular premolars

    Directory of Open Access Journals (Sweden)

    Fabrício SCAINI

    2005-05-01

    Full Text Available The knowledge of the teeth internal anatomy that will receive endodontic treatment is very important for the success of the treatment and prognosis of those teeth. In this study, the morphological variations that may occur in relation to the number of root canals present in the premolar mandibular teeth group were discussed, as well as the most efficient methods to diagnose the existence of these variations, in order to have a clearer diagnosis of the number of root canals to be treated.A case of an endodontic treatment of a mandibular premolar with 4 root canals was reported and some cases of endodontic treatment in mandibular premolars with 1, 2 and 3 root canals were shown.

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

    Directory of Open Access Journals (Sweden)

    Proff Peter

    2009-08-01

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

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

    Science.gov (United States)

    Zawawi, Khalid H

    2014-01-01

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

  10. Mandibular dysfunction as a reflection of bulbar involvement in SMA type 2 and 3.

    NARCIS (Netherlands)

    Bruggen, H.W. van; Wadman, R.I.; Bronkhorst, E.M.; Leeuw, M. de; Creugers, N.H.; Kalaykova, S.I.; Pol, W.L. van der; Steenks, M.H.

    2016-01-01

    OBJECTIVE: In a cross-sectional study, we aimed to determine (1) the effect of spinal muscular atrophy (SMA) type 2 and 3 on mandibular function reflected as masticatory performance, mandibular range of motion, and bite force and (2) the predictors of mandibular dysfunction. METHODS: Sixty patients

  11. Segmentation of the mandibular canal in cone-beam CT data

    NARCIS (Netherlands)

    Kroon, Dirk-Jan

    2011-01-01

    Accurate information about the location of the mandibular canal is essential in case of dental implant surgery. The goal of our research is to find an automatic method which can segment the mandibular canal in Cone-beam CT (CBCT). Mandibular canal segmentation methods in literature using a priori

  12. 78 FR 79308 - Dental Devices; Reclassification of Temporary Mandibular Condyle Prosthesis

    Science.gov (United States)

    2013-12-30

    ... Temporary Mandibular Condyle Prosthesis AGENCY: Food and Drug Administration, HHS. ACTION: Final order... mandibular condyle prosthesis, a preamendments class III device, into class II (special controls), and rename... section 513(b) of the FD&C Act with respect to temporary mandibular condyle prosthesis (the 1997...

  13. Ionizing irradiation affects the microtensile resin dentin bond strength under simulated clinical conditions.

    Science.gov (United States)

    Yadav, Suman; Yadav, Harish

    2013-03-01

    This study evaluated the effect of ionizing radiations on resin-dentin interface in terms of marginal adaptation and micro-tensile bond strength under thermocycling and mechanical loading. Forty extracted human mandibular third molars were divided into four groups. GR I: No Irradiation and Class II MO cavities were prepared that were restored with composite restorations; GR II: Teeth were irradiated and restored; GR III: Teeth were restored and irradiated; GR IV: Teeth were restored during irradiation dosage fractions. All samples were thermal and mechanical loaded with 5000 cycles, 5 ± 2-55 ± 2°C, dwell time 30 s and 150,000 cycles at 60N. Resin-dentin slabs were trimmed into dumbbell-shaped slabs and microtensile bond strength was measured. The bond strength data was analyzed by one-way analysis of variance test. Irradiation before tooth preparation deteriorated the microtensile bond strength.

  14. Músculos mandibulares de Puma concolor (Mammalia, Carnivora, Felidae

    Directory of Open Access Journals (Sweden)

    Romina Paola Llanos

    2016-09-01

    Full Text Available En este trabajo se describen los músculos mandibulares del puma (Puma concolor, un mamífero carnívoro de amplia distribución en América. Se disecaron y fotografiaron los músculos izquierdos y derechos de la cabeza de tres individuos, dos machos adultos y una hembra juvenil. Este estudio incrementa nuestro conocimiento de los tejidos blandos mandibulares y por lo tanto, aporta información anatómica valiosa de la escasamente conocida y documentada musculatura de este félido, el más grande de la subfamilia Felinae.

  15. Morphological description of mandibular canal in panoramic radiographs

    OpenAIRE

    Maise Mendonça Amorim

    2006-01-01

    Resumo: O conhecimento da morfologia e topografia do canal mandibular é importante para as intervenções odontológicas realizadas na mandíbula, pois implica na preservação das estruturas nobres que o atravessam. O objetivo deste trabalho foi analisar morfológica e morfometricamente o trajeto e as relações do canal mandibular em indivíduos de ambos os gêneros, pertencentes a duas faixas etárias distintas, ambas na fase adulta. A amostra foi composta por 300 radiografias panorâmicas, divididas e...

  16. Recurrent mandibular ameloblastoma with anterior skull base invasion: Case report.

    Science.gov (United States)

    Santini, L; Varoquaux, A; Giovanni, A; Dessi, P; Michel, J

    2015-01-01

    Recurrent ameloblastoma with skull base invasion is a rare clinical entity with poor prognosis. We report a case of a mandibular ameloblastoma recurrence involving the anterior skull base. The diagnostic and therapeutic processes are presented with emphasis on the radiologic features of ameloblastoma. Another aim of this case report is to underline the importance of close and long-term follow-up after resection. Ameloblastoma recurrences are frequent and mainly occur after incomplete surgical resection. These recurrences may be diagnosed late because of lack of symptoms in the mandibular area.

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

    Science.gov (United States)

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

    2014-05-01

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

  18. THE MANDIBULAR MUSCLES OF Puma concolor (MAMMALIA, CARNIVORA, FELIDAE

    Directory of Open Access Journals (Sweden)

    Romina Paola LLANOS

    2016-01-01

    Full Text Available En este trabajo se describen los músculos mandibulares del puma (Puma concolor, un mamífero carnívoro de amplia distribución en América. Se diseccionaron y fotografiaron los músculos izquierdos y derechos de la cabeza de tres individuos, dos machos adultos y una hembra juvenil. Este estudio incrementa nuestro conocimiento de los tejidos blandos mandibulares y por lo tanto, aporta información anatómica valiosa de la escasamente conocida y documentada musculatura de este félido, el más grande de la subfamilia Felinae.

  19. 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.

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

    Science.gov (United States)

    Miller, S; Kerr, W J

    1992-04-01

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

  1. Mandibular vestibuloplasty and gingival grafts using impacted posts.

    Science.gov (United States)

    Bousquet, P; Montal, S; Gibert, P

    1997-01-01

    In the presence of an atrophic endentulous mandible, the stability of the mandibular denture is related to the quality of the osteomucosal support and the muscles surrounding it. A new procedure for vestibuloplasty is described that combines a periosteal flap and a gingival graft. Titanium impacted posts are used for fixation and the stabilization of the flap and graft. This clinical report presents the results for 12 patients. Clinical appraisal indicates that the technique appears to improve the anteroposterior stability of the mandibular denture, increasing the attached mucosa and offering better long-term results. The management of the gingival and muscular environment can improve the peri-implant area.

  2. Preliminary functional impression for the mandibular complete denture.

    Science.gov (United States)

    Aiche, H

    1989-01-01

    A technique for producing a preliminary impression of a resorbed edentulous mandibular ridge is presented. A 2-mm metal wire is adapted to the curve of the mandibular arch. A high-viscosity impression material is then formed to the wire and placed in the patient's mouth. Speech movements are used to functionally shape the material. Following polymerization, additional material is added to create extensions not captured in the first impression. A final wash using a low-viscosity silicone or polysulfide rubber material completes the impression. The resultant preliminary impression has the advantage of not being distorted by an ill-fitting stock tray or artificially manipulated by the clinician.

  3. Posttraumatic Mandibular Asymmetry Presenting in a Young Adult

    Directory of Open Access Journals (Sweden)

    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.

  4. Occlusion for maxillary dentures opposing osseointegrated mandibular prostheses.

    Science.gov (United States)

    Denissen, H W; Kalk, W; van Waas, M A; van Os, J H

    1993-01-01

    This paper presents a combination of several occlusal concepts designed to contribute to the successful use of maxillary dentures in opposition to osseointegrated mandibular prostheses. To ensure a positive outcome when designing such an occlusion, three factors must be considered: patient satisfaction, maxillary anterior bone preservation, and mandibular arch shortening. It is recommended that for centric occlusion the molars have a lingual contact occlusion, the premolars have a buccal contact occlusion, and the anterior teeth have an open occlusal relationship. For an eccentric occlusion, a balanced articulation is favored instead of mutually protected occlusion.

  5. How will mandibular third molar surgery affect mandibular second molar periodontal parameters?

    Science.gov (United States)

    Tabrizi, Reza; Arabion, Hamidreza; Gholami, Mehdi

    2013-07-01

    Several conflicting findings have been published in the previous literature regarding the effects of impacted third molar surgery on the periodontal parameters of the adjacent second molar; some authors have shown improvement of periodontal health distal to the adjacent second molar, whilst others have demonstrated loss of attachment level (AL) and reduction of alveolar bone height. The purpose of this study was to evaluate the changes in periodontal health parameters distal to the adjacent second molar following extraction of an impacted third molar. Out of 50 patients participated in the study, 42 patients completed the study. The mean age of the sample was 20.9 (range, 18-25) years. All teeth were mesioangular impacted mandibular third molars categorized at C1 class based on the Pell and Gregory classification. All surgeries were performed by one surgeon and the same surgeon recorded the pre-operative and post-operative measurements of probing depth (PD) and AL on the distobuccal aspect of the second molars. Data analysis were carried out with the SPSS software (version 19), using the paired-samples t-test and one sample t-test. Surgical extraction of impacted mandibular third molar resulted in a significant increase of PD on the distobuccal aspect of the second molars, whereas AL was decreased significantly after surgery (P molar after extraction of impacted third molar, our study showed a significant increase in PD at the distal aspect of the second molar. Further follow-up on clinical and radiological parameters are required for more profound understanding of the long-term effects of third molar extraction on the periodontal parameters of the adjacent second molar.

  6. Influence of third molars in mandibular fractures. Part 1: mandibular angle-a meta-analysis.

    Science.gov (United States)

    Armond, A C V; Martins, C C; Glória, J C R; Galvão, E L; Dos Santos, C R R; Falci, S G M

    2017-06-01

    The aim of this systematic review was to investigate the influence of the presence and position of mandibular third molars on angle fractures. An electronic search was conducted in the PubMed, Scopus, Web of Science, Cochrane Library, and VHL databases, through January 2016. The eligibility criteria included observational studies. The search strategy resulted in 704 articles. Following the selection process, 35 studies were included in the systematic review and 28 in the meta-analysis. Twenty studies presented a score of ≤6 stars in the Newcastle-Ottawa scale assessment, indicating a risk of bias in the analysis. The presence of a mandibular third molar increases the chance of an angle fracture (case-control and cross-sectional studies: odds ratio (OR) 3.83, 95% confidence interval (CI) 3.02-4.85, I(2)=83.1%; case-control studies: OR 3.27, 95% CI 2.57-4.16, I(2)=81.3%). The third molar positions most favourable to angle fracture according to the Pell and Gregory classification are class B (OR 1.44, 95% CI 1.06-1.96, I(2)=87.2%) and class II (OR 1.67, 95% CI 1.36-2.04, I(2)=72.4%). Class A (OR 0.60, 95% CI 0.45-0.81, I(2)=87.1%) and class I (OR 0.51, 95% CI 0.37-0.71, I(2)=89.4%) act as protective factors for angle fracture. The results suggest that the presence of the third molar increases the chance of angle fracture by 3.27 times and that the most favourable positions of the third molar for angle fracture are classes B and II, whilst classes A and I act as protective factors. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Biphasic calcium phosphate nano-composite scaffolds reinforced with bioglass provide a synthetic alternative to autografts in a canine tibiofibula defect model

    Institute of Scientific and Technical Information of China (English)

    Tang Dezhi; Xu Guohua; Yang Zhou; Holz Jonathan; Ye Xiaojian; Cai Shu; Yuan Wen

    2014-01-01

    Background Bone grafting is commonly used to repair bone defects.As the porosity of the graft scaffold increases,bone formation increases,but the strength decreases.Early attempts to engineer materials were not able to resolve this problem.In recent years,nanomaterials have demonstrated the unique ability to improve the material strength and toughness while stimulating new bone formation.In our previous studies,we synthesized a nano-scale material by reinforcing a porous β-tricalcium phosphate (β-TCP) ceramic scaffold with Na2O-MgO-P2O5-CaO bioglass (β-TCP/BG).However,the in vivo effects of the β-TCP/BG scaffold on bone repair remain unknown.Methods We investigated the efficacy of β-TCP/BG scaffolds compared to autografts in a canine tibioflbula defect model.The tibioflbula defects were created in the right legs of 12 dogs,which were randomly assigned to either the scaffold group or the autograft group (six dogs per group).Radiographic evaluation was performed at 0,4,8,and 12 weeks post-surgery.The involved tibias were extracted at 12 weeks and were tested to failure via a three-point bending.After the biomechanical analysis,specimens were subsequently processed for scanning electron microscopy analysis and histological evaluations.Results Radiographic evaluation at 12 weeks post-operation revealed many newly formed osseous calluses and bony unions in both groups.Both the maximum force and break force in the scaffold group (n=6) were comparable to those in the autograft group (n=6,P >0.05),suggesting that the tissue-engineered bone repair achieved similar biomechanical properties to autograft bone repair.At 12 weeks post-operation,obvious new bone and blood vessel formations were observed in the artificial bone of the experimental group.Conclusions The results demonstrated that new bone formation and high bone strength were achieved in the β-TCP/ BG scaffold group,and suggested that the β-TCP/BG scaffold could be used as a synthetic alternative to

  8. 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

  9. ASTIGMATIC OUTCOME & POST OPERATIVE RECOVERY IN PAT IENTS UNDERGOING PTERYGIUM EXCISION WITH CONJUNCTIVAL AUTOGRAFTS. COMPARISION BETWEEN SUTURE & AUTOLOGUS BLOOD FIBRIN

    Directory of Open Access Journals (Sweden)

    Smita Dileep

    2013-06-01

    Full Text Available ABSTRACT : AIMS: To review the effect of surgery type on the postop erative recovery & astigmatism in pterygium surgery. SETTINGS AND DESIGN: Randomized comparative clinical trial. MATERIALS AND METHODS: Forty six patients (46 eyes with primary pterygiu m were randomised to undergo pterygium surgery using eithe r autologous fibrin glue (23 eyes or 10-0 nylon sutures (23 eyes to attach the conjunctival autograft. The patients were followed up 1day, 1wk, 2wks & 6 w eeks. Outcome measures were keratometry changes & postope rative recovery.. The preoperative and postoperative keratometric measurements, evaluated using keratometer, were noted. RESULTS: Corneal astigmatism was significantly reduced in th e total group from 2.94(SD- 0.52 diopter to 1.91 (sd 0.57 diopter (p 0.05. The intensity of the postoperative watering, itchin g, were significantly lower in the autologous fibrin glue group than in the suture gro up (p<0.001. Postoperative redness was absent in 47.82% (11cases and mild in 52.18% (13 cases 2 weeks postoperatively in the autologous fibrin group while in sutured group 17.4% (4cases had mild redness and 82.6% (19 cases had moderate redness 2weeks postoperatively.

  10. Nerve autografts and tissue-engineered materials for the repair of peripheral nerve injuries: a 5-year bibliometric analysis

    Directory of Open Access Journals (Sweden)

    Yuan Gao

    2015-01-01

    Full Text Available With advances in biomedical methods, tissue-engineered materials have developed rapidly as an alternative to nerve autografts for the repair of peripheral nerve injuries. However, the materials selected for use in the repair of peripheral nerve injuries, in particular multiple injuries and large-gap defects, must be chosen carefully. Various methods and materials for protecting the healthy tissue and repairing peripheral nerve injuries have been described, and each method or material has advantages and disadvantages. Recently, a large amount of research has been focused on tissue-engineered materials for the repair of peripheral nerve injuries. Using the keywords "pe-ripheral nerve injury", "autotransplant", "nerve graft", and "biomaterial", we retrieved publications using tissue-engineered materials for the repair of peripheral nerve injuries appearing in the Web of Science from 2010 to 2014. The country with the most total publications was the USA. The institutions that were the most productive in this field include Hannover Medical School (Germany, Washington University (USA, and Nantong University (China. The total number of publications using tissue-engineered materials for the repair of peripheral nerve injuries grad-ually increased over time, as did the number of Chinese publications, suggesting that China has made many scientific contributions to this field of research.

  11. [Experience of Mitral Valve Replacement Using a Pulmonary Autograft (Ross II Operation) in an Infant;Report of a Case].

    Science.gov (United States)

    Kawahito, Tomohisa; Egawa, Yoshiyasu; Yoshida, Homare; Shimoe, Yasushi; Onishi, Tatsuya; Miyagi, Yuhichi; Terada, Kazuya; Ohta, Akira

    2015-07-01

    A 24-day-old boy suddenly developed progressive heart failure and was transported to our hospital. Echocardiography showed massive mitral regurgitation due to chordal rupture. Mitral valve repair was performed at 28 days of life, but postoperative valvular function was not satisfactory. A mechanical valve was implanted in the supra-annular position at 37 days of life. Two months after valve replacement, the mechanical valve was suddenly stuck. Emergent redo valve replacement was performed, but the prosthetic valve became stuck again 2 months after the 3rd operation, despite sufficient anti-coagulation therapy. At the 4th operation (6 months after birth), we implanted a pulmonary autograft in the mitral position instead of another mechanical valve in an emergent operation. The right ventricular outflow tract was reconstructed with a valved conduit. A postoperative catheter examination, which was performed 1 year after the Ross II operation, showed mild mitral stenosis with no regurgitation. Previous reports of Ross II operations in infants are rare and long-term results are unknown. However, we advocate that this procedure should be a rescue operation for mitral valve dysfunction in the early period of infants.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. [A study on individual mandibular prostheses according to 3D reconstruction of CT images and CNC simulation method].

    Science.gov (United States)

    Pan, Liu-guo; Sun, Li-qun

    2007-03-01

    The new method of manufacturing individual mandibular prostheses, in combination with CT data and CNC technique, can duplicate bone tissues accurately, and can have the individual mandibular prosthesis made to order, and repair the mandibular defect (especially the lager mandibular segmental defect).

  14. Analysis by computed tomography of bone changes in the mandibular head and mandibular fossa in relation to clinical findings in patients with temporomandibular joint (TMJ) disorders

    Energy Technology Data Exchange (ETDEWEB)

    Hamamoto, Yoshioki; Nakajima, Tamio; Hayashi, Takafumi [Niigata Univ. (Japan). School of Dentistry

    1994-12-01

    Bone changes in the mandibular head and mandibular fossa in 33 patients with temporomandibular joint (TMJ) disorders were studied with axial computed tomography in relation to clinical findings to clarify possible factors leading to bone changes in this phenomenon. Bone changes of the mandibular head were observed in 45 (68%) of the 66 TMJs. The mandibular head was juxtaposed to the mandibular fossa in 13 (29%) of the 45 joints in centric occlusion and in 29 joints (64%) in the anterior position on CT, whereas the mandibular head with no pathological bone change was juxtaposed to the mandibular fossa in none of the 21 joints in centric occlusion and in only 1 joint (5%) in the anterior position. In the two groups of patients with and without juxtaposition of the mandibular head and mandibular fossa with bone changes, the incidence of the initial symptoms such as pain, crepitus, and difficulty in opening the mouth was increased compared with the symptoms at presentation. However, the former group had severer symptoms than the latter group. These findings suggest that bony degeneration of the TMJ is accelerated by juxtaposition of the head and fossa. (author).

  15. Microradiography to evaluate bone growth into a rat mandibular defect

    NARCIS (Netherlands)

    Schortinghuis, J; Ruben, JL; Meijer, HJA; Bronckers, ALJJ; Raghoebar, GM; Stegenga, B; Schortinghuisa, Jurjen; Rubenb, Jan L.; Meijera, Henny J.A.; Bronckersc, Antonius L.J.J.; Raghoebara, Gerry M.

    Microradiography has been evaluated to measure bone heating into a 5.0 mm outer diameter mandibular defect in the rat. This method provides high-resolution radiographs of the defects that can be used for an accurate measurement of bone defect heating. In 12 rats, the defect widths of 42-day-old

  16. Morphometric Analysis of Mandibular Growth in Skeletal Class III Malocclusion

    Directory of Open Access Journals (Sweden)

    Jenny Zwei-Chieng Chang

    2006-01-01

    Conclusion: We conclude that thin-plate spline analysis and the finite element morphometric method are efficient for the localization and quantification of size and shape changes that occur during mandibular growth. Plots of maximum and minimum principal directions can provide useful information about the trends of growth changes.

  17. An Epidemiological Study on Pattern and Incidence of Mandibular Fractures

    Directory of Open Access Journals (Sweden)

    Subodh S. Natu

    2012-01-01

    Full Text Available Mandible is the second most common facial fracture. There has been a significant increase in the number of cases in recent years with the advent of fast moving automobiles. Mandibular fractures constitute a substantial proportion of maxillofacial trauma cases in Lucknow. This study was undertaken to study mandibular fractures clinicoradiologically with an aim to calculate incidence and study pattern and the commonest site of fractures in population in and around Lucknow. Patient presenting with history of trauma at various centers of maxillofacial surgery in and around Lucknow were included in this study. Detailed case history was recorded followed by thorough clinical examination, and radiological interpretation was done for establishing the diagnosis and the data obtained was analyzed statistically. Out of 66 patients with mandibular fractures, highest percentage was found in 21–30 years of age with male predominance. Road traffic accidents were the most common cause of fracture with parasymphysis being commonest site. Commonest combination was parasymphysis with subcondyle. There was no gender bias in etiology with number of fracture sites. The incidence and causes of mandibular fracture reflect trauma patterns within the community and can provide a guide to the design of programs geared toward prevention and treatment.

  18. Bilateral dens invaginatus in the mandibular premolar region

    Directory of Open Access Journals (Sweden)

    Canger Emin

    2009-01-01

    Full Text Available Dens invaginatus (dens in dente, DI is a rare developmental anomaly resulting from invagination of a portion of the crown rare. It is an important dental anomaly due to the possible pulpal involvement. DI can be detected clinically in a tooth presenting unusual crown morphology or having deep foramen coaceum. Also, clinically, non-suspected affected teeth are commonly diagnosed as an incidental radiographic finding. Presence of DI in the mandibular premolar teeth is unusual. Aims is to introduce a case of bilateral occurrence of DI in mandibular first premolar teeth. A 33- year-old man was referred to our clinic with a chief complaint of severe pain in his lower third molar tooth. Radiographic examination revealed bilateral DI (single at the left, double at the right in mandibular first premolar teeth. The teeth were restored with fissure sealant. Although bilateral appearance of DI is a frequent situation, mandibular occurrence is very rare. Our review of the literature reveals just nine cases of DI, and only one of them is in a premolar tooth.

  19. Acetate stimulates secretion in the rabbit mandibular gland

    DEFF Research Database (Denmark)

    Novak, I; Young, J A

    1989-01-01

    In isolated perfused rabbit mandibular glands undergoing stimulation with 0.8 microM acetylcholine, replacement of HCO3- with acetate (25 mM) increased fluid secretion by more than 100%. Other short-chain fatty acids, except for propionate, had a similar effect. We focused our further studies...

  20. Ratio between vertical and horizontal mandibular range of motion

    NARCIS (Netherlands)

    Dijkstra, P.U.; Kropmans, T.J.B.; Stegenga, B; de Bont, L.G.M.

    1998-01-01

    Mandibular range of motion (ROM), vertical and horizontal, is often measured as a part of a diagnostic assessment of temporomandibular joint disorders. Ln the literature, a fixed ratio between the vertical and the horizontal ROM has been suggested, i.e. 4:1. The ratio is frequently used to predict t

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

    Science.gov (United States)

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

    1991-01-01

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

  2. Effects of the masticatory demand on the rat mandibular development

    NARCIS (Netherlands)

    Hichijo, N.; Kawai, N.; Mori, H.; Sano, R.; Ohnuki, Y.; Okumura, S.; Langenbach, G.E.J.; Tanaka, E.

    2014-01-01

    The influence of masticatory loading stimulus on mandibular development is not fully clear. In this paper, experimental alterations in the daily muscle use, caused by a changed diet consistency, were continuously monitored, while adaptations in bone and cartilage were examined. It is hypothesised th

  3. Impacted Mandibular Third Molars: Review of Literature and a ...

    African Journals Online (AJOL)

    races, such as in Nigeria[4] mandibular third molars may erupt as early as 14 years and ... as caries, pericoronitis, cysts, tumors, and also root resorption of the adjacent tooth. Even .... taken into account when deciding in case of removal of an.

  4. Mandibular trauma treatment: a comparison of two protocols

    NARCIS (Netherlands)

    Boffano, P.; Kommers, S.C.; Roccia, F.; Forouzanfar, T.

    2015-01-01

    Objectives:The aim of this study was to evaluate the treatment of mandibular fractures treated in two European centre in 10 years. Study Design: This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures in two c

  5. [Severe complication of a bonded mandibular lingual retainer

    NARCIS (Netherlands)

    Pazera, P.; Fudalej, P.S.; Katsaros, C.

    2014-01-01

    Bonding a flexible spiral wire retainer to the lingual surfaces of all six anterior mandibular teeth is a commonly used type of retention. Complications are rare but can be serious enough to produce biologic damage. This article presents a serious complication of a lingual flexible spiral wire retai

  6. Severe complication of a bonded mandibular lingual retainer.

    NARCIS (Netherlands)

    Pazera, P.; Fudalej, P.S.; Katsaros, C.

    2012-01-01

    Bonding a flexible spiral wire retainer to the lingual surfaces of all 6 anterior mandibular teeth is a commonly used type of retention. Complications are rare but can be serious enough to produce biologic damage. This article presents a serious complication of a lingual flexible spiral wire retaine

  7. The effectiveness of articaine in mandibular facial infiltrations

    Science.gov (United States)

    Flanagan, Dennis F

    2016-01-01

    Four percent articaine local anesthetic has been successfully used to attain local anesthesia for dental procedures. Mandibular block anesthesia may consume longer time to attain and have a higher failure of local anesthesia compared to infiltration. Mandibular facial infiltration has been reported to successfully attain effective local anesthesia for dental procedures. This study involved only several tooth sites and found that 1.8 cc of 4% articaine facial infiltration in the mandible may be effective when the facial mandibular cortex is <2.0–3.0 mm. A waiting time of 5–10 minutes may be required for effective anesthesia. An additional 1.8 cc of dose may be required to attain anesthesia if an initial 1.8 cc of dose fails. The need for additional anesthetic may be predicted by a measurement of the facial cortex using cone beam computerized tomography. A study of mandibular sites is needed to delineate the anatomical dimensions, density of cortical bone, and apical neural location for ensuring successful local anesthetic infiltration. PMID:26730209

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

    Science.gov (United States)

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

    2014-01-01

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

  9. Three-dimensional analysis of mandibular growth and tooth eruption

    DEFF Research Database (Denmark)

    Krarup, S.; Darvann, Tron Andre; Larsen, Per

    2005-01-01

    and the teeth were segmented and iso-surfaces generated. Landmarks were placed on the surface of the mandible, along the mandibular canals, the inner contour of the cortical plate at the lower border of the symphysis menti, and on the teeth. Superimposition of the mandibles in the longitudinal series...

  10. Clinical outcomes of surgical management of anterior bilateral mandibular fractures

    NARCIS (Netherlands)

    Boffano, P.; Gallesio, C.; Roccia, F.; van den Bergh, B.; Forouzanfar, T.

    2013-01-01

    Purpose: The aims of this study were to assess the clinical outcomes of patients with anterior bifocal mandibular fractures and to discuss the management of this peculiar type of trauma. Methods: From the systematic computer-assisted database that has continuously recorded patients hospitalized with

  11. Growth regulation of mandibular condylar cartilage in-vitro.

    NARCIS (Netherlands)

    Copray, Joseph Christofoor Vincentius Maria

    1984-01-01

    The significance of the mandibular condylar cartilage in the development of the orofacial complex, and particulary in the growth of the mandible has led to a considarable number of studies regarding its growth regulation. Especially clinicians concerned with craniofacial growth and development and t

  12. High condylectomy for the treatment of mandibular condylar hyperplasia

    DEFF Research Database (Denmark)

    Ghawsi, Sodaba; Aagaard, Esben; Thygesen, Torben Henrik

    2016-01-01

    Mandibular condylar hyperplasia (MCH) is a rare, idiopathic disorder, which can cause both functional and aesthetic problems. MCH has often been described in the literature, but a comprehensive analysis of the current literature on MCH has not been undertaken. This study presents a systematic rev...

  13. Modular endoprosthesis for mandibular reconstruction: a preliminary animal study.

    NARCIS (Netherlands)

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

    2008-01-01

    The use of a mandibular modular endoprosthesis after segmental resection of part of the body of the mandible was studied. This preliminary study was carried out on four pigs and four monkeys. The devices were made of a titanium alloy and were cemented in the prepared medullary spaces with polymethyl

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

    Science.gov (United States)

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

    2015-01-01

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

  15. The effectiveness of articaine in mandibular facial infiltrations

    Directory of Open Access Journals (Sweden)

    Flanagan DF

    2015-12-01

    Full Text Available Dennis F Flanagan Windham Dental Group, Willimantic, CT, USA Abstract: Four percent articaine local anesthetic has been successfully used to attain local anesthesia for dental procedures. Mandibular block anesthesia may consume longer time to attain and have a higher failure of local anesthesia compared to infiltration. Mandibular facial infiltration has been reported to successfully attain effective local anesthesia for dental procedures. This study involved only several tooth sites and found that 1.8 cc of 4% articaine facial infiltration in the mandible may be effective when the facial mandibular cortex is <2.0–3.0 mm. A waiting time of 5–10 minutes may be required for effective anesthesia. An additional 1.8 cc of dose may be required to attain anesthesia if an initial 1.8 cc of dose fails. The need for additional anesthetic may be predicted by a measurement of the facial cortex using cone beam computerized tomography. A study of mandibular sites is needed to delineate the anatomical dimensions, density of cortical bone, and apical neural location for ensuring successful local anesthetic infiltration. Keywords: articaine, local anesthesia, infiltration, dental implant, dental restoration

  16. Clinical outcomes of surgical management of anterior bilateral mandibular fractures

    NARCIS (Netherlands)

    Boffano, P.; Gallesio, C.; Roccia, F.; van den Bergh, B.; Forouzanfar, T.

    2013-01-01

    Purpose: The aims of this study were to assess the clinical outcomes of patients with anterior bifocal mandibular fractures and to discuss the management of this peculiar type of trauma. Methods: From the systematic computer-assisted database that has continuously recorded patients hospitalized with

  17. Mandibular trauma treatment: a comparison of two protocols

    NARCIS (Netherlands)

    Boffano, P.; Kommers, S.C.; Roccia, F.; Forouzanfar, T.

    2015-01-01

    Objectives:The aim of this study was to evaluate the treatment of mandibular fractures treated in two European centre in 10 years. Study Design: This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures in two c

  18. Severe complication of a bonded mandibular lingual retainer.

    NARCIS (Netherlands)

    Pazera, P.; Fudalej, P.S.; Katsaros, C.

    2012-01-01

    Bonding a flexible spiral wire retainer to the lingual surfaces of all 6 anterior mandibular teeth is a commonly used type of retention. Complications are rare but can be serious enough to produce biologic damage. This article presents a serious complication of a lingual flexible spiral wire

  19. Finite-element analysis of the center of resistance of the mandibular dentition

    Science.gov (United States)

    Jo, A-Ra; Lee, Kee-Joon; Sung, Sang-Jin; Chun, Youn-Sic

    2017-01-01

    Objective The aim of this study was to investigate the three-dimensional (3D) position of the center of resistance of 4 mandibular anterior teeth, 6 mandibular anterior teeth, and the complete mandibular dentition by using 3D finite-element analysis. Methods Finite-element models included the complete mandibular dentition, periodontal ligament, and alveolar bone. The crowns of teeth in each group were fixed with buccal and lingual arch wires and lingual splint wires to minimize individual tooth movement and to evenly disperse the forces onto the teeth. Each group of teeth was subdivided into 0.5-mm intervals horizontally and vertically, and a force of 200 g was applied on each group. The center of resistance was defined as the point where the applied force induced parallel movement. Results The center of resistance of the 4 mandibular anterior teeth group was 13.0 mm apical and 6.0 mm posterior, that of the 6 mandibular anterior teeth group was 13.5 mm apical and 8.5 mm posterior, and that of the complete mandibular dentition group was 13.5 mm apical and 25.0 mm posterior to the incisal edge of the mandibular central incisors. Conclusions Finite-element analysis was useful in determining the 3D position of the center of resistance of the 4 mandibular anterior teeth group, 6 mandibular anterior teeth group, and complete mandibular dentition group. PMID:28127536

  20. Correlation of calcification of permanent mandibular canine, mandibular premolars, and permanent mandibular first and second molars with skeletal maturity in Indian population

    Science.gov (United States)

    Motghare, Pawan C.; Bedia, Aarti S.; Degwekar, Shirish S.; Indurkar, Atul D.; Bedia, Sumit

    2016-01-01

    Context: Morphological variation in children can be understood by the knowledge of growth and development. The state of dental development can be used in forensic odontology to ascertain the age of an unidentified child. Aims: This study aims to investigate the relationship of the stages of calcification of the permanent mandibular canine, mandibular premolars, and permanent mandibular first and second molars with skeletal maturity using panoramic and hand–wrist radiographs. Settings and Design: This descriptive work was designed as a cross-sectional study. Materials and Methods: The study was conducted on 300 healthy subjects (150 males and 150 females) ranging 7–20 years of age. Demirjian's method and Björk, Grave, and Brown's method were used to correlate teeth calcification and skeletal maturity, respectively. Statistical Analysis Used: Descriptive statistics and Spearman's rank correlation coefficient were used. Results: 1. Correlation coefficients between the skeletal maturity stages and the developmental stages of the five teeth ranged 0.461–0.877 for females and 0.480–0.790 for males. 2. The second molar showed the highest and the first molar showed the lowest relationship for female and male subjects in the Indian population. Conclusions: The findings of this study indicate that tooth calcification stages might be clinically used as a maturity indicator of the pubertal growth period. PMID:27555721

  1. Do flexible acrylic resin lingual flanges improve retention of mandibular complete dentures?

    Science.gov (United States)

    Ahmed Elmorsy, Ayman Elmorsy; Ahmed Ibraheem, Eman Mostafa; Ela, Alaa Aboul; Fahmy, Ahmed; Nassani, Mohammad Zakaria

    2015-01-01

    The aim of this study was to compare the retention of conventional mandibular complete dentures with that of mandibular complete dentures having lingual flanges constructed with flexible acrylic resin "Versacryl." The study sample comprised 10 completely edentulous patients. Each patient received one maxillary complete denture and two mandibular complete dentures. One mandibular denture was made of conventional heat-cured acrylic resin and the other had its lingual flanges made of flexible acrylic resin Versacryl. Digital force-meter was used to measure retention of mandibular dentures at delivery and at 2 weeks and 45 days following denture insertion. The statistical analysis showed that at baseline and follow-up appointments, retention of mandibular complete dentures with flexible lingual flanges was significantly greater than retention of conventional mandibular dentures (P dentures, retention of dentures increased significantly over the follow-up period (P complete dentures improved denture retention.

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

    Science.gov (United States)

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

    2013-01-01

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

  3. Mandibular two-implant telescopic overdentures.

    Science.gov (United States)

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

    2004-10-01

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

  4. Management of exposure of three-dimensional mandibular reconstructive plates in mandibular reconstruction:Report of 2 cases

    Institute of Scientific and Technical Information of China (English)

    XU Li-qun1; WU Andri; ZHANG Chen-ping; ZHENG Jia-wei

    2004-01-01

    Exposure of three-dimensional mandibular reconstructive plate was a main complication in its clinical application, which includes intraoral exposure and extraoral exposure. This paper reported two typical cases with plate exposure and reviewed the literatures in analysis of the causes of plate exposure and its preventive measures.

  5. Biomechanical Evaluation of a Mandibular Spanning Plate Technique Compared to Standard Plating Techniques to Treat Mandibular Symphyseal Fractures

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    Matthew Richardson

    2015-01-01

    Full Text Available Purpose. The purpose of this study is to compare the biomechanical behavior of the spanning reconstruction plate compared to standard plating techniques for mandibular symphyseal fractures. Materials and Methods. Twenty-five human mandible replicas were used. Five unaltered synthetic mandibles were used as controls. Four experimental groups of different reconstruction techniques with five in each group were tested. Each synthetic mandible was subjected to a splaying force applied to the mandibular angle by a mechanical testing unit until the construct failed. Peak load and stiffness were recorded. The peak load and stiffness were analyzed using ANOVA and the Tukey test at a confidence level of 95% (P<0.05. Results. The two parallel plates’ group showed statistically significant lower values for peak load and stiffness compared to all other groups. No statistically significant difference was found for peak load and stiffness between the control (C group, lag screw (LS group, and the spanning plate (SP1 group. Conclusions. The spanning reconstruction plate technique for fixation of mandibular symphyseal fractures showed similar mechanical behavior to the lag screw technique when subjected to splaying forces between the mandibular gonial angles and may be considered as an alternative technique when increased reconstructive strength is needed.

  6. Pattern of mandibular third molar impaction and its association to caries in mandibular second molar: A clinical variant.

    Science.gov (United States)

    Prajapati, V K; Mitra, Ruchi; Vinayak, K M

    2017-01-01

    Caries in second molar is common and prophylactic removal of the impacted teeth may be considered appropriate. Caries detection and restoration can be difficult and a restored second molar can undergo recurrent caries if the third molar is not removed prophylactically. In this study, the clinical findings related to impaction and its association with angular position and depth of impacted third molar were evaluated. A retrospective descriptive study was carried out among the patients visiting the outpatient, department of Dentistry, RIMS, Ranchi. The clinical examination, periapical radiographs and Pre-op OPG were taken. Teeth positions were analyzed by Pell and Gregory and Winter classification. The angulation and depth of mandibular third molar impaction and caries in the second molar with the eruption status of the mandibular third molar was determined. A total of 200 patients were included in the study between age group 17-45 years. Majority of the Patients reported to the hospital with complaints of decayed tooth (66%) and pain (59%). The most common third molar impaction was mesioangular followed by distoangular. A statistically highly significant difference (P = 0.001) was obtained with the presence of caries in second molar adjacent to mesioangular third molar in class I and level B. According to this study, pattern of mandibular third molar impaction is in association to caries in mandibular second molar. More future studies are needed. In addition, the results of the present study can be used to screen and inform the patients about the possibility of caries in relation to third molar mandibular impaction.

  7. Reconstruction of the limbal vasculature after limbal-conjunctival autograft transplantation in pterygium surgery: an angiography study.

    Science.gov (United States)

    Kim, Yong Joon; Yoo, Seung Hoon; Chung, Jin Kwon

    2014-11-18

    We evaluated the angiographic features of the affected limbus in patients with pterygia and assessed limbal reconstruction outcomes after limbal-conjunctival autograft (LCA) transplantation in terms of vascular remodeling. We studied prospectively 31 eyes of 31 patients who underwent pterygium excision and LCA transplantation; 28 eyes of 28 normal participants served as controls. Anterior segment indocyanine green angiography (ICGA) was performed for each participant preoperatively and at 1 week, and 1 and 3 months postoperatively. The perioperative angiographic features of the pterygium were compared to those in normal eyes. The structural changes of the marginal corneal vascular arcades (MCAs) and LCA were quantitatively assessed postoperatively in terms of vascular density and lacunarity. Deteriorated MCAs that extended beyond the pterygium head were observed in the pterygium group. The pterygium had a dual blood supply from the conjunctival and episcleral circulations. In terms of limbal reconstruction, the engorged reperfusion vessels arose from the adjacent episcleral vessels along the limbus at 1 week postoperatively. The reconstructed MCAs had begun to appear at 1 month postoperatively and became apparent 3 months postoperatively in 26 (83.9%) of 31 eyes of the pterygium group, resulting in a successful clinical outcome. Higher vascular density and lower lacunarity were measured in the limbus and the graft at 3 months than at 1 month (P < 0.001 for all), which indicated fine reorganization of the reconstructed vessels. The pterygium had a dual blood supply, and the remodeling of the affected limbus and LCA continued up to 3 months postoperatively. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  8. Indirect MR-arthrography in osteochondral autograft and crushed bone graft with a collagen membrane-Correlation with histology

    Energy Technology Data Exchange (ETDEWEB)

    Streitparth, F. [Klinik fuer Strahlenheilkunde, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany)], E-mail: florian.streitparth@charite.de; Schoettle, P.; Schell, H. [Center for Musculoskeletal Surgery, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany); Lehmkuhl, L.; Madej, T.; Wieners, G. [Klinik fuer Strahlenheilkunde, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany); Duda, G.N. [Center for Musculoskeletal Surgery, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany); Schroeder, R.J. [Klinik fuer Strahlenheilkunde, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany)

    2009-04-15

    Objective: To analyze the spectrum of findings in indirect MR-arthrography following osteochondral autograft transfer system (OATS) and crushed bone graft using a magnetic resonance imaging (MRI) scoring and grading system in relation to histology as the standard of reference. Materials and methods: Iatrogenic lesions were set at ovine condylar facets (n = 6/group), treated with OATS or crushed bone graft. 1.5 T MRI was performed 6 months after surgery using PD-weighted (w fat saturated (fs) fast spin echo (FSE), T1-w 2D, and 3D fs gradient echo (GE) sequences 30 min. after i.v. Gd-DTPA administration and passive joint exercise. The repair tissue was evaluated by two independent radiologists. The MR findings were compared to histology. Results: In all cases, MRI and histologic grading correlated well and showed significant superior repair in OATS at 6 months (p < 0.05), reproducing the original articular contour and a good subchondral restoration. FsT1-w3DGE proved most appropriate identifying characteristic post-operative findings: the OATS group demonstrated bone marrow edema at the donor site and the graft/host interface showed significant enhancement in indirect MR-arthrography, indicating fibrocartilage. After crushed bone graft, we found an irregular structure and significant contrast uptake, consistent with remnants of bone grafts surrounded by inflammatory tissue. Conclusion: Indirect MR-arthrography is an accurate, non-invasive monitoring tool following OATS and crushed bone graft as the MRI scoring and grading system allows a reliable evaluation of normal and pathological osteochondral repair with a high histologic correlation.

  9. Quantitative analysis of the patella following the harvest of a quadriceps tendon autograft with a bone block.

    Science.gov (United States)

    Ferrer, Gerald A; Miller, R Matthew; Murawski, Christopher D; Tashman, Scott; Irrgang, James J; Musahl, Volker; Fu, Freddie H; Debski, Richard E

    2016-09-01

    The objective of this study was to determine parameters associated with patellar fracture after quadriceps tendon autograft harvest. Thirteen non-fractured and five fractured patella surface models were created based on patient data obtained from a prospective randomized clinical trial in order to assess geometric parameters and bending stress. Measurements that describe the bone block harvest site geometry were used to calculate three normalized parameters. The relative depth parameter describes the thickness of the bone block harvest site with respect to the thickness of the patella at the harvest site. The asymmetry parameter defines the medial-lateral location of the bone bock harvest site. The normalized bending stress parameter assesses the bending stress experienced by the remaining bone beneath the bone block harvest site. The relative depth of the bone block harvest site in the non-fractured patellae was 27 ± 12 % and for the fractured patellae was 42 ± 14 % (p patellae was (1.8 × 10(-3) ± 1.3 × 10(-3)) mm(-3) × M and for the fractured patellae was over three times greater (6.3 × 10(-3) ± 3.7 × 10(-3)) mm(-3) × M (p patella, an emphasis should be made on harvesting a standard percentage of patella thickness rather than a fixed depth. In order to minimize the incidence of a patellar fracture, bone blocks should not be taken laterally and should not exceed 30 % of the total patella thickness at the harvest site.

  10. Clinical outcome of en-block resection and reconstruction with nonvascularized fibular autograft for the treatment of giant cell tumor of distal radius

    Directory of Open Access Journals (Sweden)

    Mohammad H Taraz-Jamshidi

    2014-01-01

    Full Text Available Background: Although giant cell tumor (GCT is considered to be a primary benign bone tumor, its aggressive behavior makes its diagnosis and treatment, difficult and challenging. This is especially true in distal radius where GCT appears to be more aggressive and difficult to control locally. We report our clinical outcome of en-block resection and reconstruction with non-vascularized fibular autograft in 15 patients with distal radius GCT. Materials and Methods: We retrospectively reviewed 15 patients with GCT (Grade 2 and 3 of distal radius who were treated with en-block resection and non-vascularized fibular autograft. Five of 15 were recurrent GCT treated initially with extended curettage; local adjuvant therapy and filling the cavity with cement or bone graft. We followed the patients for mean 7.2 years post operation (range: 4-11 years. Patients were evaluated post operation with clinical examination, plain radiography of distal radius and chest X-ray and/or computed tomography scan. Furthermore pain, function, range of motion and grip strength of the affected limb were evaluated and mMayo wrist score was assessed. Results: A total of 11 patients were women and 4 were men. Mean age of patients was 29 years (range: 19-48. We had no lung metastasis and bony recurrence occurred in one patient (6.6%. Nearly 53.3% of patients had excellent or good functional wrist score, 80% of the patients were free of pain or had only occasional pain and 80% of patients returned to work. Mean range of motion of the wrist was 77° of flexion-extension and mean grip strength was 70% of the normal hand. Conclusion: En-block resection of distal radius GCT and reconstruction with non-vascularized fibular autograft is an effective technique for treatment in local control of the tumor and preserving function of the limb.

  11. Endoscopic-assisted achilles tendon reconstruction with free hamstring tendon autograft for chronic rupture of achilles tendon: clinical and isokinetic evaluation.

    Science.gov (United States)

    El Shazly, Ossama; Abou El Soud, Maged M; El Mikkawy, Dalia M E; El Ganzoury, Ibrahim; Ibrahim, Ayman Mohamed

    2014-05-01

    To evaluate the clinical and functional outcome of endoscopic-assisted reconstruction of chronic ruptures of the Achilles tendon using free hamstring tendon autograft. We present a case series of 15 patients who had chronic ruptures of the Achilles tendon (>6 weeks earlier) and underwent endoscopic-assisted reconstruction with a free hamstring autograft. The graft loop was passed through and fixed to the proximal stump of the tendon. The graft was then passed through suture to the distal stump and finally inserted into a tunnel in the anterior calcaneus to the Achilles tendon insertion and fixed with an bioabsorbable interference screw. The mean follow-up period was 27 months (SD, 3 months; range, 24 to 33 months). All patients underwent magnetic resonance imaging preoperatively, immediately postoperatively, and at follow-up 2 years postoperatively. All patients were functionally evaluated with the American Orthopaedic Foot & Ankle Society (AOFAS) score for the hindfoot preoperatively and postoperatively. Calf muscle power was evaluated by isokinetic strength testing at 2 years' follow-up. The mean size of the gap on preoperative magnetic resonance imaging was 49 mm (SD, 9 mm). The mean preoperative AOFAS score was 32.6 (SD, 7.5). There was a statistically significant improvement in the postoperative AOFAS score after 2 years to 90.8 (SD, 3.54) (P Achilles tendon reconstruction with free hamstring tendon autograft for chronic ruptures of the Achilles tendon showed good to excellent results in all patients. Isokinetic testing showed a nonsignificant deficit between the involved and uninvolved sides at 2 years' follow-up. Level IV, therapeutic cases series. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  12. Transparotid approach for mandibular condylar neck and subcondylar fractures.

    Science.gov (United States)

    Croce, A; Moretti, A; Vitullo, F; Castriotta, A; Rosa, De M; Citraro, L

    2010-12-01

    Mandibular condylar neck fractures and subcondylar fractures represent, respectively, 19-29% and 62-70% of all mandibular fractures; treatment involves some problems, common to both, concerning the choice of an adequate approach. Herewith, personal experience is reported related to the surgical treatment of some cases of mandibular condylar neck and subcondylar fractures by transparotid approaches with partial parotidectomy, removing the salivary tissue overlying the condylar neck and/or the subcondylar region. Over the last 5 years, we observed 22 fractures of the condylar neck and 10 fractures of the subcondylar region. In 13 patients (11 male, 2 female, age range 10-68 years, mean 33 years), 10 of whom had other mandibular and/or other maxillo-facial and skeleton fractures - 50% of these with dislocated condylar heads - and the other 3 for their free choice, regarding the different treatments, 18 transparotid approaches with partial parotidectomy (bilateral in 5 cases), were performed reducing and fixing 12 condylar neck fractures and 5 subcondylar region fractures with appropriate plates (2.0 mm) and screws. After surgery, no intermaxillary fixation was performed. Complications included 4 salivary fistulae (bilateral in 1 patient), which closed spontaneously after 4 or 5 weeks with a dressing, 1 case of Frey's syndrome, which healed after 2 treatments with botulin and 6 cases of transient facial palsy lasting 4-8 weeks (1 case bilateral) affecting zygomatic, buccal and marginal mandibular nerves. During follow-up, functional parameters considered were: restoration of original pre-injury occlusion; vertical, lateral and protrusion mandibular movements. All patients re-acquired the original pre-injury occlusion; the maximal post-operative intrinsical distance was at least 40 mm after a variable period of rehabilitation and lateral and protrusion movements also led to satisfactory final results. All patients were free of pain and had no deflection or clicking upon

  13. A COMPARATIVE STUDY BETWEEN SURGICAL OUTCOME OF PATIENT’S OWN BLOOD VS. 10-0 NYLON FOR CONJUNCTIVAL AUTOGRAFTING IN PTERYGIUM EXCISION

    Directory of Open Access Journals (Sweden)

    Ayush Mahendra

    2016-04-01

    Full Text Available CONTEXT (BACKGROUND Pterygium is a frequently occurring progressive ocular surface disorder which is a fleshy triangular wing shaped growth, encroaching from conjunctiva on cornea. Pterygium is frequent in hot, dry, dusty environment and prevalence is 0.3% to 29%. Surgical removal is main treatment for pterygium. The recurrence rate after pterygium surgery varies according to type of surgery. Various surgical modalities tried like simple excision, bare sclera technique, amniotic membrane transplantation and conjunctival autografting. AIM To compare surgical outcome of patient’s own blood Vs 10-0 Nylon for conjunctival autografting in pterygium excision. SETTINGS AND DESIGN It is a prospective randomised interventional control trial, with a sample size of minimum 30 patients in each group studied in a tertiary care hospital from Oct. 2013 to Dec. 2015. METHODS AND MATERIAL Out of 63 patients who underwent pterygium excision, patient’s own blood was used in 32 patients (Group A and 10-0 Nylon suture was used in 31 patients (Group B for conjunctival autografting. All patients were followed up regularly on postoperative day 1, 8, 30, 90 and 180. Variables for postoperative assessment were pain, watering, irritation, redness, graft displacement, graft loss and recurrence. STATISTICAL ANALYSIS Statistical analysis was performed using SPSS 13.0 (SPSS, Chicago. Outcome variables between the two groups were compared using the non-parametric Mann–Whitney U Test. RESULTS The mean surgical time of group B (31.48±6.15 min is significantly high as compared to group A (19.71±5.13 min with p<0.001. The regression analysis revealed that except surgery type, no other variable had significant impact on the duration of surgery. Postoperative symptoms are less in group A as compared to group B. Group B showed two recurrences whereas no recurrence was seen in group A. CONCLUSIONS Conjunctival autografting by patient’s own blood is better than 10-0 Nylon

  14. A NEW METHOD OF SINGLE-STAGE ISLAND PLASTY BY TWO BONE AUTOGRAFTS WITH BLOOD SUPPLY IN PATIENTS WITH PSEUDOARTHROSIS OF BOTH FOREARM BONES

    Directory of Open Access Journals (Sweden)

    R. M. Tikhilov

    2010-01-01

    Full Text Available The applied topographic-anatomic studies prepared in 14 fixed and 16 unfixed preparations of upper extremity allowed to precise the details of radius blood supply with reference to possibilities of formation of bone autografts with blood supply. Due to this fact the novel method of single-stage bone plasty for pseudoarthrosis of both forearm bones was developed and successfully approved in clinic. This method proposes the formation of two periosteal-cortical grafts with blood supply and small muscle cuff in distal and middle one-thirds of radius simultaneously.

  15. Sterilization with electron beam irradiation influences the biomechanical properties and the early remodeling of tendon allografts for reconstruction of the anterior cruciate ligament (ACL).

    Science.gov (United States)

    Schmidt, Tanja; Hoburg, Arnd; Broziat, Christine; Smith, Mark D; Gohs, Uwe; Pruss, Axel; Scheffler, Sven

    2012-08-01

    Although allografts for anterior cruciate ligament (ACL) replacement have shown advantages compared to autografts, their use is limited due to the risk of disease transmission and the limitations of available sterilization methods. Gamma sterilization has shown detrimental effects on graft properties at the high doses required for sufficient pathogen inactivation. In our previous in vitro study on human patellar tendon allografts, Electron beam (Ebeam) irradiation showed less detrimental effects compared to gamma sterilization (Hoburg et al. in Am J Sports Med 38(6):1134-1140, 2010). To investigate the biological healing and restoration of the mechanical properties of a 34 kGy Ebeam treated tendon allograft twenty-four sheep underwent ACL replacement with either a 34 kGy Ebeam treated allograft or a non-sterilized fresh frozen allograft. Biomechanical testing of stiffness, ultimate failure load and AP-laxity as well as histological analysis to investigate cell, vessel and myofibroblast-density were performed after 6 and 12 weeks. Native sheep ACL and hamstring tendons (HAT, each n = 9) served as controls. The results of a previous study analyzing the remodeling of fresh frozen allografts (n = 12) and autografts (Auto, n = 18) with the same study design were also included in the analysis. Statistics were performed using Mann-Whitney U test followed by Bonferroni-Holm correction. Results showed significantly decreased biomechanical properties during the early remodeling period in Ebeam treated grafts and this was accompanied with an increased remodeling activity. There was no recovery of biomechanical function from 6 to 12 weeks in this group in contrast to the results observed in fresh frozen allografts and autografts. Therefore, high dose Ebeam irradiation investigated in this paper cannot be recommended for soft tissue allograft sterilization.

  16. Food irradiation makes progress

    Energy Technology Data Exchange (ETDEWEB)

    Kooij, J. van (Joint FAO/IAEA Div. of Isotope and Radiation Applications of Atomic Energy for Food and Agricultural Development, Vienna (Austria))

    1984-06-01

    In the past fifteen years, food irradiation processing policies and programmes have been developed both by a number of individual countries, and through projects supported by FAO, IAEA and WHO. These aim at achieving general acceptance and practical implementation of food irradiation through rigorous investigations of its wholesomeness, technological and economic feasibility, and efforts to achieve the unimpeded movement of irradiated foods in international trade. Food irradiation processing has many uses.

  17. Food irradiation in China

    Energy Technology Data Exchange (ETDEWEB)

    Wedekind, L.

    1986-08-01

    The paper concerns food irradiation in The People's Republic of China. Its use is envisaged to prolong storage times and to improve the quality of specific foodstuffs. Commercialisation in China, demonstration plants, seasonal shortages and losses, Shanghai irradiation centre, health and safety approval, prospects for wider applications and worldwide use of food irradiation, are all discussed.

  18. Surgical orthodontic correction of acromegaly with mandibular prognathism.

    Science.gov (United States)

    Yagi, Takakaza; Kawakami, Masayoshi; Takada, Kenji

    2004-02-01

    A male (30 years five months) who complained of mandibular prominence and masticatory dysfunction was diagnosed as a mandibular prognathic with acromegaly after cephalometric and endocrine examinations. The level of growth hormone (GH) subsequent to a transsphenoidal hypophysectomy had been controlled by medicines for about five years. Surgical orthodontic correction improved his occlusion and profile, but magnetic resonance imaging detected a recurrent adenoma in the cranial base during the retention period. The recurrence resulted in slight prognathic changes of the patient with a high level of GH. This is a case report of the treatment of an acromegalic patient discussing growth considerations that could influence the orthodontic treatment plan and long-term stability.

  19. Three-dimensional analysis of mandibular growth and tooth eruption

    DEFF Research Database (Denmark)

    Krarup, S.; Darvann, Tron Andre; Larsen, Per

    2005-01-01

    , relocated laterally during growth. Furthermore, the position of tooth buds remained relatively stable inside the jaw until root formation started. Eruption paths of canines and premolars were vertical, whereas molars erupted in a lingual direction. The 3D method would seem to offer new insight into jaw......Normal and abnormal jaw growth and tooth eruption are topics of great importance for several dental and medical disciplines. Thus far, clinical studies on these topics have used two-dimensional (2D) radiographic techniques. The purpose of the present study was to analyse normal mandibular growth...... and tooth eruption in three dimensions based on computer tomography (CT) scans, extending the principles of mandibular growth analysis proposed by Bjork in 1969 from two to three dimensions. As longitudinal CT data from normal children are not available (for ethical reasons), CT data from children...

  20. Simultaneous Glossectomy with Orthognathic Surgery for Mandibular Prognathism.

    Science.gov (United States)

    Jung, Young-Wook; On, Sung-Woon; Chung, Kyu-Rhim; Song, Seung-Il

    2014-09-01

    Macroglossia can create dental and skeletal instability after orthodontic treatment or orthognathic surgery for mandibular prognathism. In relevant literature, partial glossectomy is suggested for a good post-treatment prognosis. Most of the published partial glossectomy cases are two-staged surgery, because of concern about postoperative airway obstruction. As orthognathic surgical techniques and fixation method develop, however, concerns about postoperative airway obstruction have lessened. In this case, mandibular setback surgery and partial glossectomy were performed simultaneously, leading to stable recovery without any postoperative respiratory problems. After surgical technique to preserve the tongue tip, we achieved good outcomes without postoperative side effects of lingual hypoesthesia, pronunciation disorder and dyskinesia. We report this case with a literature review.

  1. Assessment of a method for the prediction of mandibular rotation.

    Science.gov (United States)

    Lee, R S; Daniel, F J; Swartz, M; Baumrind, S; Korn, E L

    1987-05-01

    A new method to predict mandibular rotation developed by Skieller and co-workers on a sample of 21 implant subjects with extreme growth patterns has been tested against an alternative sample of 25 implant patients with generally similar mean values, but with less extreme facial patterns. The method, which had been highly successful in retrospectively predicting changes in the sample of extreme subjects, was much less successful in predicting individual patterns of mandibular rotation in the new, less extreme sample. The observation of a large difference in the strength of the predictions for these two samples, even though their mean values were quite similar, should serve to increase our awareness of the complexity of the problem of predicting growth patterns in individual cases.

  2. Maintenance of condylar position in a patient with mandibular deficiency

    Directory of Open Access Journals (Sweden)

    Nicolaos TOPOUZELIS, Maria LAZARIDOU, Nicolaos LAZARIDIS, Christos ILIOPOULOS

    2011-12-01

    Full Text Available Maintaining the preoperative position of condyles within the temporal fossa is necessary in any orthognathic surgery, in order to ensure a stable postoperative result and the normal functioning of the temporomandibular joints. A variety of condylar positioning devices have been described to help preserve the preoperative position of condyles within the temporal fossa and prevent temporomandibular joint disorders or relapses.Case report: A 18-year-old female patient presented with a severe class II maxillofacial deformity, which was treated with sagittal split mandibular osteotomy and simultaneous genioplasty with the use of a polytetrafluoroethylene allograft. A condylar positioning device was used to maintain the preoperative position of the condyles. The patient did not develop any temporomandibular joint symptoms postoperatively, and the final skeletal result remained stable despite the considerable anterior displacement of the peripheral mandibular segment.

  3. MANDIBULAR INCISOR EXTRACTION: A 5-YEAR FOLLOW-UP

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    Kadir BEYCAN

    2016-10-01

    Full Text Available This case report presents the mandibular incisor extraction treatment of a patient with dental Class I malocclusion and lower crowding, in whom one mandibular incisor extraction was selected as the treatment of choice to improve the dental occlusion. A 19-year-old male patient’s chief complaint was the crowding of lower incisors. He had a straight profile with normal upper and lower lip projection. Upper and lower dental midlines were coincident with the facial midline. The patient had Class I molar and canine relationships on both sides. He had Class I skeletal relationship, low angle vertical pattern, and proclined upper and lower incisors. The treatment plan included the extraction of lower right central incisor to resolve the crowding. At the end of 16-month active fixed treatment, lower dental crowding was resolved. At the 5-year follow-up, the patient had a stable occlusion, with the results of the orthodontic treatment maintained.

  4. Bilateral elongated mandibular coronoid process in an Anatolian skull

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Erol Cansiz

    2016-01-01

    Full Text Available Mandibular third molars are the most common impacted teeth. Mandibular first and second molars do not share the same frequency of occurrence. In rare cases the occlusal surfaces of impacted molars are united by the same follicular space and the roots pointing in opposite direction; these are called kissing molars. In some cases, a supernumerary fourth molar can be seen as unerupted and, in this case, such a supernumerary, deeply impacted fourth molar is seen neighboring kissing molars. The extraction of deeply impacted wisdom molars from the mandible may necessitate excessive bone removal and it causes complications such as damage to the inferior alveolar nerve and iatrogenic fractures of the mandible. This case report describes the use of the sagittal split osteotomy technique to avoid extensive bone removal and protect the inferior alveolar nerve during surgical extruction of multiple impacted teeth.

  6. Alveolar ridge changes in patients congenitally missing mandibular second premolars.

    Science.gov (United States)

    Ostler, M S; Kokich, V G

    1994-02-01

    This study investigated changes in ridge width over time in patients who were congenitally missing mandibular second premolars. Data were obtained from stone casts and radiographs of 35 edentulous sites on 22 patients representing three time periods: (1) before extraction of the primary mandibular second molar, (2) completion of orthodontic treatment, and (3) long-term evaluation. The findings indicate that ridge width decreases 25% within 3 years after primary molar extraction. The rate of decrease diminishes to 4% over the next 3 years. The change in ridge width had a weak association with the age of the patient at the time of the extraction but a small predictive value. No correlation was found between changes in ridge width and height and the time since the extraction or the age of the patient at the time of extraction.

  7. Inferior alveolar nerve injuries associated with mandibular fractures.

    Science.gov (United States)

    Bede, Salwan Yousif Hanna; Ismael, Waleed Khaleel; Al-Assaf, Dhuha A; Omer, Saad Salem

    2012-11-01

    The study evaluates the incidence of inferior alveolar nerve injuries in mandibular fractures, the duration of their recovery, and the factors associated with them. Fifty-two patients with mandibular fractures involving the ramus, angle, and body regions were included in this study; the inferior alveolar nerve was examined for neurological deficit posttraumatically using sharp/blunt differentiation method, and during the follow-up period the progression of neural recovery was assessed. The incidence of neural injury of the inferior alveolar nerve was 42.3%, comminuted and displaced linear fractures were associated with higher incidence of inferior alveolar nerve injury and prolonged recovery time, and recovery of inferior alveolar nerve function occurred in 91%.Fractures of the mandible involving the ramus, angle, and body regions, and comminuted and displaced linear fractures are factors that increase the incidence of inferior alveolar nerve injuries. Missile injuries can be considered as another risk factor.

  8. Treatment of displaced mandibular condylar fracture with botulinum toxin A.

    Science.gov (United States)

    Akbay, Ercan; Cevik, Cengiz; Damlar, Ibrahim; Altan, Ahmet

    2014-04-01

    The aim of this case report is to discuss the effect on condylar reduction of botulinum toxin A treatment used in a child with displaced fracture at condylar neck of mandible. A 3-years old boy was admitted to our clinic for incomplete fracture of mandibular symphysis and displaced condylar fracture at the left side. An asymmetrical occlusal splint with intermaxillary fixation was used instead of open reduction and internal fixation because of incomplete fracture of symphysis and possible complications of condyle surgery. However, it was observed that condylar angulation persisted despite this procedure. Thus, botulinum toxin A was administered to masseter, temporalis and pterygoideus medialis muscles. At the end of first month, it was seen that mandibular condyle was almost completely recovered and that fusion was achieved. In conclusion, Botulinum A toxin injection aiming the suppression of masticatory muscle strength facilitates the reduction in the conservative management of displaced condyle in pediatric patients.

  9. The Osteochondroma of the Mandibular Condyle: report of a case

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Wook Jin; Hwang, Eui Hwan; Lee, Sang Rae [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Kyunghee University, Seoul (Korea, Republic of)

    2000-06-15

    The osteochondroma, also known as osteocartilagenous exostosis, is one of the most common benign tumors of the axial skeleton, but is rarely found in the facial bones. When present, the tumor is most often reported to affect the mandibular coronoid process. Osteochondroma of the mandibular condyle is extremely rare and may cause signs and symptoms like those seen in patients with temporomandibular joint dysfunction. Sometimes, differentiation between osteochondroma and condylar hyperplasia is not possible on histologic grounds alone, but the radiographic and intraoperative findings together are usually sufficient to establish a definite diagnosis. This report reviews the literature concerning osteochondroma, especially of the maxillofacial region, and describes a case of osteochondroma of the condyle.

  10. 关节镜下自体、异体骨-髌腱-骨与半腱肌腱3种重建后交叉韧带方法的比较%A comparative study on arthroscopic posterior cruciate ligament reconstruction using bone-patellar tendon-bone allograft, bone-patellar tendon-bone autograft and semitendinosus tendon autograft

    Institute of Scientific and Technical Information of China (English)

    郑小飞; 黄华扬; 张余; 李凭跃; 尹庆水

    2009-01-01

    现为胫骨隧道外口持续果酱样液体流出,经换药、激素或消炎痛治疗后痊愈.结论:关节镜下自体、异体骨-髌腱-骨与半腱肌腱移植重建后交叉韧带均取得满意的结果,并且疗效相似.%BACKGROUND: There are many methods for posterior cruciate ligament (PCL) reconstruction, which is involved in many graft materials, but few studies aim to compare the differences in outcomes of different grafts for PCL reconstruction. OBJECTIVE: To compare the clinical results of arthroscopic PLC reconstruction with bone-patellar tendon-bone (B-PT-B) autograft, B-TP-B allograft and semitendinosus tendon autograft. DESIGN, TIME AND SETTING: A retrospective case analysis was completed in the Department of Orthopedics, Guangzhou General Hospital of Guangzhou Area Military Command of Chinese PLA from January 2000 to September 2005. MATERIALS: Totally 76 patients underwent arthroscopic PLC reconstruction from January 2000 to September 2005, with the use of B-TP-B autograft in 21 patients, B-TP-B allograft in 27 patients, semitendinosus tendon autograft in 28 patients. METHODS: A retrospective analysis was performed in 76 patients underwent arthroscopic PCL reconstruction, with the use of B-TP-B autograft in 21 patients, B-TP-B allograft in 27 patients, semitendinosus tendon autograft in 28 patients. Postoperative body temperature was examined duration hospitalization. The follow-up parameters included International Knee Documentation Committee (IKDC) scores, Lysholm knee joint scores, and KT-1000 evaluation.MAIN OUTCOME MEASURES: ①Range of motion. ②joint stability: posterior draw test and KT-1000 test. ③overall function of knee: IKDC scores and Lysholm scores; ④complications and side effect. RESULTS: The time of follow-up visit was 26-79 months. Differences were no statistically significant among the IKDC scores, Lysholm scores, KT-1000 side-side difference, the positive rate of posterior draw test in three groups of patients with PCL

  11. Diagnosis of the Aesthetic Components of the Mandibular Anterior Prosthesis.

    Science.gov (United States)

    1981-08-14

    instructions for the dental laboratory technicians regarding occlusion, shade and pontic morphology, the seven factors listed above should be addressed...WVAD-AL03 381 ARMY INST OF DENTAL RESEARCH WASHINGTON DC F/B 6/12 DIAGNOSIS OF THE AESTHETIC COMPONENTS OF THE MANDIBULAR ANTERIO-ETC(LU AUG al L...PeterIWhitbeck- J. ERFZORMING ORGANIZATON NAME AND ADDREST I A0 F’* .MS -UEMENT FUR2FL. TASK US Army Institute of Dental Research ~ Walter Reed Army

  12. Epidemiological analysis of mandibular fractures treated in Sao Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Kelly Marinho

    2015-10-01

    Conclusion: The treatment of mandibular fractures should be aimed at restoring the occlusion and mastication function, with surgery being the most indicated treatment, using reduction and internal fixation with the use of a plates and screws system based on the experience of the authors. Knowledge of surgical techniques and methods of reduction and fixation of fractures, and periodic monitoring allow these patients to receive the appropriate treatment.

  13. Factors contributing to the surgical retreatment of mandibular fractures

    Directory of Open Access Journals (Sweden)

    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.

  14. Early diagnostic evaluation of mandibular symmetry using orthopantomogram

    Directory of Open Access Journals (Sweden)

    Francesca Silvestrini-Biavati

    2014-01-01

    Full Text Available Aims: The aim of this research was to complete Habets′s method on orthopantomogram, in order to measure mandibular symmetry horizontally and diagonally in mixed dentition as the first diagnostic evaluation. Settings and Design: Mixed dentition subjects were consecutively selected according to skeletal maturity. Materials and Methods: Inclusion criteria were: Mixed dentition, cervical vertebral stages 1-2, Class II or Class III malocclusions, with or without unilateral posterior cross-bite. Fourteen subjects with cross-bite (mean age 8 y, 9 m cross group (CG and 14 subjects with normal transverse occlusion (mean age 8y, 6m non-cross group (NCG were selected. Nine measurements were determined. An asymmetry index was performed for all linear variables. Statistical Analysis Used: NCG patients′ data were compared with CG data using parametric t-tests. Probabilities of <0.05 were accepted as significant. Results: In CG, comparing right and left side, single values showed no significant differences up to 6% (twice if compared to the 3% threshold value. T-tests showed statistically significant differences between the groups for ramus + condyle height (index 2.5% vs 4.5%, P = 0.04, condylar height (index 3.7% vs 6.6%, P = 0.02 and mandibular length (index 1.4% vs 2.3%, P = 0.04. Overall CG group was more asymmetrical than NCG. Conclusions: In mixed dentition (CS1-2, a first appraisal of mandibular symmetry may be performed on orthopantomogram utilizing this modified Habets′s method. This tracing method provides an early evaluation about mandibular symmetry and is able to show slight asymmetries in mixed dentition thereby reducing the number of cone beam computed tomograms performed.

  15. Mandibular fracture with a mouth formed mouthguard in kickboxing.

    Science.gov (United States)

    Shimoyama, Tetsuo; Masuda, Issei; Numa, Takehiro; Horie, Norio

    2009-04-01

    Reports of injuries caused by kickboxing, one of the contact sports that potentially causes a large number of injuries, are relatively rare. Wearing a mouthguard is obligatory in kickboxing, but the association between maxillofacial injuries and the quality of mouthguards has not been described thus far. In this article, we present a case of mandibular fracture in a 25-year-old male, who was injured during kickboxing despite wearing a mouth formed mouthguard.

  16. Iatrogenic Mandibular Fracture Associated with Third Molar Removal

    Directory of Open Access Journals (Sweden)

    Abdulkadir Burak Cankaya, Mehmet Ali Erdem, Sirmahan Cakarer, Muhsin Cifter, Cuneyt Korhan Oral

    2011-01-01

    Full Text Available Third molar extraction is one of the most common procedures performed in oral and maxillofacial surgery units. It is sometimes accompanied by complications such as alveolar osteitis, secondary infection, hemorrhage, dysesthesia and, most severely, iatrogenic fracture. This article describes two mandibular angle fractures that occurred in two patients during the surgical extraction of one erupted and one unerupted third molar, including a brief review of the literature.

  17. Iatrogenic Mandibular Fracture Associated with Third Molar Removal

    OpenAIRE

    Abdulkadir Burak Cankaya, Mehmet Ali Erdem, Sabri Cemil Isler, Sabit Demircan, Merva Soluk, Cetin Kasapoglu, Cuneyt Korhan Oral

    2011-01-01

    Third molar extraction is one of the most common procedures performed in oral and maxillofacial surgery units. It is sometimes accompanied by complications such as alveolar osteitis, secondary infection, hemorrhage, dysesthesia and, most severely, iatrogenic fracture. This article describes two mandibular angle fractures that occurred in two patients during the surgical extraction of one erupted and one unerupted third molar, including a brief review of the literature.

  18. Canino mandibular con dos raíces

    Directory of Open Access Journals (Sweden)

    Laura Ricardina Ramírez-Sotelo

    Full Text Available El canino inferior es un diente con raíz larga y ancha que le permite una adecuada implantación en el arco dentario. Es considerado un pilar valioso en muchos tratamientos rehabilitadores. Con la finalidad de mantener este elemento dentario es necesario realizar un correcto diagnóstico, para lo que se tendrá en cuenta el conocimiento de las variaciones anatómicas. El objetivo del artículo es presentar un caso de canino mandibular con dos raíces con sus respectivos canales radiculares .Paciente femenina de 21 años, que acudió a la Clínica de Radiología de la Facultad de Odontología de Piracicaba con indicación de una radiografía panorámica para valorar cirugía de terceros molares. Llamó la atención una configuración inusual de las raíces de los caninos mandibulares. En el examen de tomografía computarizada de haz cónico se observó que el canino mandibular del lado derecho presentaba dos raíces separadas, cada una con sus respectivos canales radiculares. Se concluyó que a pesar de la baja prevalencia de las variaciones anatómicas, estas pueden ocurrir en el número de raíces y canales de los caninos mandibulares, tal como se presenta en este reporte de caso.

  19. Estudio anatómico del tercer molar mandibular incluido

    OpenAIRE

    Larrazabal Morón, Carolina

    2015-01-01

    Los terceros molares son los últimos dientes en erupcionar, debido a ello no encuentran suficiente espacio para establecerse en el arco dentario, por lo que fácilmente pueden quedar retenidos. El diagnóstico inadecuado del tercer molar inferior incluido puede ser causa de numerosas complicaciones como infecciones odontogénicas, tumores benignos, malignos, caries dental entre otros. Por ello el objetivo de este estudio es conocer el desarrollo del tercer molar mandibular, analizar los c...

  20. A rare presentation of lipoma on mandibular mucogingival junction

    Science.gov (United States)

    Sharma, Gaurav; Jain, Kanu; Nagpal, Archna; Baiju, Chandrababu Sudha

    2016-01-01

    Lipoma is the most common tumor of mesenchymal tissues of body, but its occurrence in oral cavity is infrequent. Buccal mucosa is the most common intraoral site of lipoma followed by tongue, floor of the mouth, and buccal vestibule. The involvement of mucogingival junction is rare. We present a unique case report of oral lipoma occurring on mandibular mucogingival junction with review of literature which has emphasis on differential diagnosis. PMID:27143835

  1. Mandibular osteomas in sporadic colorectal carcinoma. A genetic marker

    DEFF Research Database (Denmark)

    Søndergaard, J O; Rasmussen, M S; Videbaek, H;

    1993-01-01

    Pantomography of the mandible was performed in 98 patients with sporadic colorectal adenocarcinoma. Twenty-eight patients (29%) had osteomas versus 5% in a control group (P osteomas are found in most patients with the premalignant dominant syndrome familial adenomatous...... polyposis. Sporadic colorectal cancer examinations of married couples have shown that diet has only a moderate influence on the development of colorectal cancer, whereas pedigree studies indicate a genetic component. On this basis we conclude that mandibular osteomas are probably genetic markers...

  2. EVALUATION OF MANDIBULAR HARD AND SOFT TISSUES IN CLEFT PATIENTS*

    Directory of Open Access Journals (Sweden)

    Işıl ARAS

    2017-04-01

    Full Text Available Purpose: The aim of this study was to compare the mandibular hard and soft tissue measurements of unilateral and bilateral cleft lip and palate patients with non-cleft individuals. Materials and Methods: The study sample comprised of lateral cephalograms of 45 subjects. Sample included 15 non-cleft (NC, 15 unilateral cleft lip and palate (UCLP and 15 bilateral cleft lip and palate (BCLP cases whose age were between 15 to 17. 1 angular 13 linear measurements were carried out using Arnett and Gunson soft tissue cephalometric analysis and 4 angular measurements were calculated with Steiner Analysis. Results: Mandibular incisor inclinations relative to the occlusal plane (Md1-Md OP were significantly greater and mandibular incisor projections (Md1-TVL were significantly retrusive in cleft subjects (p<0.05. Projection values pertaining to lower lip anterior (LLA-TVL, soft tissue B point (B’-TVL, and soft tissue pogonion (Pog’-TVL were significantly deficient as well in cleft patients (p<0.05. Sagittal position of the maxilla (SNA (p<0.001 and intermaxillary relation of the jaws (ANB were significantly deficient in UCLP subjects (p<0.05 and BCLP individuals (p<0.01. LLA-TVL and B’-TVL correlated with SNB in cleft patients (p<0.05. Conclusion: Decreased lower lip and chin projection values suggest that mandibular region of cleft patients should be taken into account in forming the treatment plan to improve the esthetic outcome of orthodontic and plastic surgery interventions.

  3. Fusion or gemination? An unusual mandibular second molar

    Directory of Open Access Journals (Sweden)

    Angela Jordão Camargo

    2016-01-01

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

  4. [Osteomuscular serrato-costal free flap: application to mandibular reconstruction].

    Science.gov (United States)

    Breton, P; Henry, J F; Crezoit, E; Souchere, B; Freidel, M

    1992-06-01

    The serrato-costal free flap provides a large costal flap vascularized by a digitation of the serratus anterior muscle supplied by the dorsal thoracic artery. The flap is easy and rapid to raise with low morbidity. The repair obtained is functionally very satisfactory, but does not allow insertion of an implant. Six cases are reported. The indications of this technique of mandibular reconstruction are discussed.

  5. Retrospective Study of Root Canal Configurations of Mandibular Third Molars Using CBCT- Part-II.

    Science.gov (United States)

    Somasundaram, Pavithra; Rawtiya, Manjusha; Wadhwani, Shefali; Uthappa, Roshan; Shivagange, Vinay; Khan, Sheeba

    2017-06-01

    Abnormal root canal morphologies of third molars can be diagnostically and technically challenging during root canal treatment. The aim of this retrospective study was to investigate the root and canal morphology of mandibular third molars in Central India population by using Cone Beam Computed Tomography (CBCT) analysis. CBCT images of 171 mandibular third molars were observed and data regarding number of roots, number of canals, Vertucci's classification in each root, prevalence of C shaped canal, gender and topographical relation of morphology in mandibular third molar was statistically evaluated. Majority of mandibular third molars had two roots (84.2%) and three canals (64.3%). Most mesial root had Vertucci Type II (55.6%) and Vertucci Type IV (22.2%), distal root had Type I canals (87.5%). Over all prevalence of C shaped canals in mandibular third molars was 9.4%. There was a high prevalence of two rooted mandibular third molars with three canals.

  6. Is the mandibular nerve block passé?

    Science.gov (United States)

    Malamed, Stanley F

    2011-09-01

    Providing effective pain control is a critical part of dental treatment, yet achieving consistently reliable anesthesia in the mandible has proved elusive. The traditional inferior alveolar nerve block (IANB) has a high failure rate; for example, the failure rate in lateral incisors is 81 percent. As a consequence, new approaches and techniques have been developed. The purpose of this supplement to The Journal of the American Dental Association is to determine whether the mandibular nerve block has become passé. The high failure rate of the IANB can be frustrating for dentists and lead to discomfort for the patient during treatment. The reasons for this high failure rate include thickness of the cortical plate of bone in adults, thickness of the soft tissue at the injection site leading to increased needle deflection, the difficulty of locating the inferior alveolar nerve and the possibility of accessory innervation. Although the IANB can be unreliable, it is used commonly to provide mandibular anesthesia. Pain control is an essential part of dental treatment. Alternative injection techniques and devices that can help increase the success rate of mandibular anesthesia are available.

  7. Predicting Agenesis of the Mandibular Second Premolar from Adjacent Teeth.

    Directory of Open Access Journals (Sweden)

    Geetanjali Sharma

    Full Text Available Early diagnosis of agenesis of the mandibular second premolar (P2 enhances management of the dental arch in the growing child. The aim of this study was to explore the relationship in the development of the mandibular first molar (M1 and first premolar (P1 at early stages of P2 (second premolar. Specifically, we ask if the likelihood of P2 agenesis can be predicted from adjacent developing teeth. We selected archived dental panoramic radiographs with P2 at crown formation stages (N = 212 and calculated the likelihood of P2 at initial mineralisation stage 'Ci' given the tooth stage of adjacent teeth. Our results show that the probability of observing mandibular P2 at initial mineralisation stage 'Ci' decreased as both the adjacent P1 and M1 matured. The modal stage at P2 'Ci' was P1 'Coc' (cusp outline complete and M1 'Crc' (crown complete. Initial mineralisation of P2 was observed up to P1 'Crc' and M1 stage 'R½' (root half. The chance of observing P2 at least 'Coc' (coalescence of cusps was considerably greater prior to these threshold stages compared to later stages of P1 and M1. These findings suggest that P2 is highly unlikely to develop if P1 is beyond 'Crc' and M1 is beyond 'R½'.

  8. 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.

  9. Head posture and cervicovertebral anatomy as mandibular growth predictors.

    Science.gov (United States)

    Huggare, J A; Cooke, M S

    1994-06-01

    In this study, the separate and the combined influence of head posture and cervicovertebral anatomy on mandibular growth direction was analysed. The subjects, 20 boys and 16 girls, were a subsample of 12-year-old Chinese children in Hong Kong, all with initial and 2-5-year follow-up lateral cephalometric radiographs recorded in natural head position (NHP). Postural variables were measured in terms of craniovertical, craniocervical, and cervicohorizontal angulations. Morphological variables of the craniocervical junction region were measured in terms of intervertebral space and atlantoaxial dimensions. Mandibular growth was estimated as the direction of displacement of prognathion in relation to the sella nasion line when superimposing on stable cranial base structures. The data were analysed with a multiple regression model, separately for boys and girls. In both sexes the height of the atlas dorsal arch showed a statistically significant correlation (P atlas dorsal arch height (DORS C1) combined with cervicohorizontal angulation (OPT/HOR) in girls and with craniovertical angulation (NSL/VER; C1/VER) in boys, displayed a significantly (P atlas morphology and head posture predicts mandibular growth direction better than either variable alone.

  10. Mandibular reconstruction using stereolithographic 3-dimensional printing modeling technology.

    Science.gov (United States)

    Cohen, Adir; Laviv, Amir; Berman, Phillip; Nashef, Rizan; Abu-Tair, Jawad

    2009-11-01

    Mandibular reconstruction can be challenging for the surgeon wishing to restore its unique geometry. Reconstruction can be achieved with titanium bone plates followed by autogenous bone grafting. Incorporation of the bone graft into the mandible provides continuity and strength required for proper esthetics and function and permitting dental implant rehabilitation at a later stage. Precious time in the operating room is invested in plate contouring to reconstruct the mandible. Rapid prototyping technologies can construct physical models from computer-aided design via 3-dimensional (3D) printers. A prefabricated 3D model is achieved, which assists in accurate contouring of plates and/or planning of bone graft harvest geometry before surgery. The 2 most commonly used rapid prototyping technologies are stereolithography and 3D printing (3DP). Three-dimensional printing is advantageous to stereolithography for better accuracy, quicker printing time, and lower cost. We present 3 clinical cases based on 3DP modeling technology. Models were fabricated before the resection of mandibular ameloblastoma and were used to prepare bridging plates before the first stage of reconstruction. In 1 case, another model was fabricated and used as a template for iliac crest bone graft in the second stage of reconstruction. The 3DP technology provided a precise, fast, and cheap mandibular reconstruction, which aids in shortened operation time (and therefore decreased exposure time to general anesthesia, decreased blood loss, and shorter wound exposure time) and easier surgical procedure.

  11. [Mandibular distraction osteogenesis in patients with craniofacial malformation].

    Science.gov (United States)

    Marañés Gálvez, C; Martínez Plaza, A; Fernández Valadés, R; Liceras Liceras, E; Martín Cano, F; Cortés Sánchez, R; Martínez Tellería, A; Cabello, A; García Medina, B

    2011-04-01

    Craniofacial malformations (Pierre-Robin sequence, Treacher-Collins syndrome, Nager syndrome, etc.) are frequently associated to severe mandibular hypoplasia, which can cause upper airway obstruction by retroposition of the base of the tongue in the posterior pharyngeal space. Most of the patients respond to postural treatment. In prone decubitus position, it may be necessary to monitor oxygen saturation, insert a nasopharyngeal tube and even an endotracheal one. In more severe cases with prolonged and frequent pauses of apnea, tracheostomy may be necessary, but it is associated with high morbidity and sometimes mortality. In the last two years, in the Multidisciplinary Cleft Lip and Palate Unit of the Hospital Virgen de las Nieves, 4 children with severe obstructive apnea secondary to severe mandibular hypoplasia have been treated with mandibular distraction osteogenesis, this procedure being effective in the resolution of the condition. It has avoided tracheostomy, it has lengthened the jaw in a period of 2-3 weeks. During this time, the obstructive respiratory problems and also swallowing problems have disappeared. The esthetic results were excellent and the complications, for the moment, minimum.

  12. Classification of bifid mandibular canals using cone beam computed tomography

    Directory of Open Access Journals (Sweden)

    Gisele Maria Correr

    2013-12-01

    Full Text Available The objective of this study was to classify the morphology of bifid mandibular canals and to evaluate their relationship with the roots of third molars, using cone beam computed tomography (CBCT scans. The CBCT scans of 75 patients were analyzed and the bifurcations were classified according to Langlais et al. (1985. The relationship of bifurcation and third molars was established according to the following classification: class A - uninvolved, class B - close relationship, class C - intimate relationship and class D - absence of third molars. Data were submitted to descriptive statistics, and the results indicated that the patients' mean age was 48.2 (± 13.2 years. Unilateral bifurcation (Type 1 was the most frequent type (72.6%, followed by unilateral Type 2 (19.3%. Class D was the most frequent (57.33%, followed by class C (21.33%, class B (13.33% and class A (8%. It could be concluded that most cases presented unilateral bifid mandibular canals extending to the third molar or adjacent regions, and when present, the roots seemed to be a continuation of the bifid mandibular canal

  13. An isogenic model of murine mandibular distraction osteogenesis.

    Science.gov (United States)

    Deshpande, Sagar S; Weiss, Daniela M; Donneys, Alexis; Gallagher, Katherine K; Tchanque-Fossuo, Catherine N; Sarhaddi, Deniz; Buchman, Steven R

    2013-03-01

    The advent of stem cell-based therapies makes current models of mandibular distraction osteogenesis unwieldy. We thereby designed an isogenic model of distraction osteogenesis whose purpose was to allow for the free transfer of cells and components between rats. As immune response plays a significant role in healing and prevention of infection, an immune-competent mode is desirable rather than an athymic rat/xenograft model. The purposes of this study were as follows: (1) to replicate established models of distraction osteogenesis in a rodent model using an isogenic rat strain, and (2) to characterize the differences between inbred, isogenic rats and outbred rats in mandibular distraction osteogenesis via radiomorphometry and biomechanical response analysis. We demonstrated successful distraction osteogenesis to 5.1 mm in all Lewis (isogenic) rat mandibles as well as all Sprague-Dawley (outbred) rat mandibles, with no significant difference in volume-normalized radiomorphometrics, trending difference in non-volume-normalized radiomorphometrics and significant differences in biomechanical response parameters. We attribute the differences demonstrated to the decreased size of the Lewis rat mandible in comparison to Sprague-Dawley mandibles. We also provide information with caring with the additional needs of the Lewis rat. Given these differences, we find that Lewis rats function as an excellent model for isogenic mandibular distraction osteogenesis, but data procured may not be comparable between isogenic and nonisogenic models.

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

    Science.gov (United States)

    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.

  15. Fractures of the mandibular coronoid process: a two centres study.

    Science.gov (United States)

    Boffano, Paolo; Kommers, Sofie C; Roccia, Fabio; Gallesio, Cesare; Forouzanfar, Tymour

    2014-10-01

    The aim of this study was to assess the characteristics of patients with coronoid fractures treated in two European centres over 10 years and to briefly review the literature. This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures and surgically treated in two European centres between 2001 and 2010. During the 10 years, 1818 patients and 523 patients with maxillofacial fractures were admitted to the two centres respectively: 21 patients (16 males, 5 females) were admitted with 21 coronoid fractures and 28 associated maxillofacial fractures. A mean age of 42.1 years was observed. The fractures were mainly the result of motor vehicle accidents, followed by assaults and falls. The most frequently observed associated maxillofacial fracture was a zygomatic fracture (13 fractures). In both centres, mandibular coronoid fractures are treated unless a severe dislocation of the fractured coronoid is observed or a functional mandibular impairment is encountered. Conservative treatment can be used, together with the open reduction and internal fixation of associated fractures. The crucial point is to prevent ankylosis, which may be prevented by correct and early postoperative physiotherapy and mandibular function.

  16. 3-D diagnosis-assisted management of anomalous mandibular molar

    Directory of Open Access Journals (Sweden)

    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.

  17. Independent and Confluent Middle Mesial Root Canals in Mandibular First Molars: A Report of Four Cases

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Zhou, Shuncheng; Yan, Juanjuan; Da, Hu; Yang, Yang; Wang, Na; Wang, Wenyong; Ding, Yin; Sun, Shiyao

    2013-01-01

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

  19. Distracción mandibular y articulación temporomandibular Mandibular distraction and the temporomandibular joint

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. [The relation of pericoronitis to the position of the mandibular third molar].

    Science.gov (United States)

    Lee, D K; Kim, B J

    1989-02-01

    Pericoronitis is the most commonly encountered pathologic condition involving the mandibular third molar. Because of the dangers associated with mandibular third molar pericoronitis, prophylactic extraction of third molar at high risk has been recommended. We studied 411 patients with mandibular third molar pericoronitis by clinical symptoms and radiographic measurement of mandibular third molar height, wideth and angulation. The results were as follows: 1. Mandibular third molar pericoronitis is frequently seen in third decade and there are no sexual difference significantely. 2. In inflammatory type of mandibular third molar pericoronitis, chronic pericoronitis occured more frequently than acute type. 3. In relation to angulation and height, mandibular third molar most likely to be afflicted with pericoronitis is vertical eruption at occlusal plane of the second molar. 4. In relation to angulation and width, it appears that the position of the mandibular third molar most likely to be afflicted with pericoronitis is in a vertically erupted tooth of which the space between the ramus and the distal side of the second molar is less than the mesiodistal diameter of crown. (Class II). 5. In relation to height and width, it appears that the position of the mandibular third molar most likely to be afflicted with pericoronitis is class II width (described above)at occlusal plane of the second molar.

  2. Treatment of a Class I malocclusion with a carious mandibular incisor and no Bolton discrepancy.

    Science.gov (United States)

    Kokich, V O

    2000-07-01

    Occasionally orthodontists must plan treatment for a patient with extensive caries or a traumatic injury to one mandibular incisor. If the patient has a Bolton discrepancy, one treatment option could involve extraction of the affected mandibular incisor. However, if the patient does not have a Bolton discrepancy and a mandibular incisor is extracted, the treatment becomes more complicated. This case report will present and discuss the ramifications of extracting one mandibular incisor in a patient without an anterior tooth-size discrepancy. The CDABO Student Case Selection Committee chose this case for publication.

  3. Mandibular midline supernumerary tooth associated with agenesis of permanent central incisors: a diagnostic conundrum.

    Science.gov (United States)

    Marya, Charu Mohan; Sharma, Gaurav; Parashar, Vijay P; Dahiya, Vandana; Gupta, Anil

    2012-01-01

    Concomitant hypo-hyperdontia is a rare mixed numeric anomalous condition. The presence of this condition in the same area of dental arch and specifically in the mandibular anterior region is reported very infrequently. This case report presents a case of 20 years old male with congenitally missing permanent mandibular central incisors in conjunction with a mandibular midline supernumerary tooth. Only 3 cases have been documented in English literature till date. The article focuses on the review of mandibular mesiodens and the clarity regarding the usage of the terminology "mesiodens".

  4. Mandibular Angle Fractures: Comparison of One Miniplate vs. Two Miniplates

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    Saeed Hajmohammadi

    2013-01-01

    Full Text Available Background: Monocortical miniplate fixation is an accepted and reliable method for internal fixation of mandibular angle fractures. Although placement of a second miniplate may theoretically provide more stability; however, the clinical importance of this issue remains controversial.Objectives: The present study assessed the postoperative complications and outcomes associated with the fixation of mandibular angle fractures using 1 and 2 miniplates in patients with favorable mandibular angle fractures.Patients and Methods: A prospective study of 87 patients (73 males, 14 females with favorable mandibular angle fractures was done. In the first group, a 4-hole miniplate was placed at the superior border through an intraoral approach. In group 2, patients were treated with 2 miniplates, one placed at the superior border (similar to group 1 and the other on the lateral aspect of the angle at the inferior border through an intraoral and transcutaneous approach using a trocar. Postoperative complications including malocclusion, malunion and sensory disturbances associated with surgery, additional maxillomandibular fixation (MMF by means of an arch bar and wires for a longer period (for delayed union and infection were assessed in patients of both groups up to 12 months postoperatively. The data were analyzed using the chi-square test.Results: In the single miniplate group, 25 patients showed lip numbness associated with surgery (55.6%, 22 patients required additional use of MMF (48.9% and 3 patients developed infections (6.7%. In the double miniplate group 20 patients showed lip numbness associated with surgery (47.6%, 18 patients required additional use of MMF (42.9% and 1 patient developed infection (2.4%. None of the patients in either group showed malocclusion or malunion. No significant difference was observed between the groups regarding overall complication rate.Conclusions: In this study, use of one miniplate or two miniplates for treatment of

  5. Cytomegalovirus induces abnormal chondrogenesis and osteogenesis during embryonic mandibular development

    Directory of Open Access Journals (Sweden)

    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

  6. 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

    Directory of Open Access Journals (Sweden)

    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.

  7. Canal mandibular bífido: Presentación de una serie de casos Bifid mandibular canal: Case series report

    OpenAIRE

    C.L. Guzmán Zuluaga; I.C. Guzmán Zuluaga; C.M. Ardila Medina

    2012-01-01

    La ubicación y configuración de las variaciones del canal mandibular son relevantes en diferentes procedimientos clínicos de la mandíbula. En esta serie de casos un radiólogo evaluó el recorrido del canal mandibular identificando la presencia y tipos de canales bífidos. Se observaron cuatro pacientes con canal mandibular bífido tipo retromolar y tres sujetos con canal bífido tipo anterior sin convergencia. En otro paciente se encontraron forámenes dentarios bífidos bilaterales. La Tomografía ...

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Autograft-prosthesis composite for aggressive giant cell tumor of bone around knee%自体骨复合旋转铰链膝关节治疗骨巨细胞瘤

    Institute of Scientific and Technical Information of China (English)

    Xiuchun Yu; Ming Xu; Zhihou Fu; Songfeng Xu

    2009-01-01

    Objective: The aim of the research was to study the clinical feasibility of autograft-prosthesis composite for aggressive giant cell tumor of bone around knee. Methods: Seven patients (5 males and 2 females, the mean age of 30.5 years old) with giant cell tumor of bone around knee underwent tumor resection and reconstructed with autograft-prosthesis composites since January 2006. Five lesions located at the distal femur and 2 at the proximal tibia. There were 3 patients with primary tumor and 4 with recurrent. Three patients with pathological fracture and all patients were of Campanacci Ⅲ. Results:All patients were done follow-up from 12 to 36 months. No recurrence, metastasis, and prosthesis loosening were found. The mean healing time between autograft and host bone was 5 months. The mean motion range of affected knee were 90° (70°-110°). Conclusion: Our data documented the clinical feasibility of autograft-prosthesis composite for giant cell tumor of bone around knee which should be performed tumor resection and reconstructed with prosthesis. The long-term outcomes remain to be further proven.

  11. [Intraoral paratrichosis after autograft].

    Science.gov (United States)

    Segura-Sampedro, Juan José; Sampedro-Abascal, Consuelo; Parra-López, Loreto; Muñoz-Rodríguez, Juan Carlos

    2015-01-01

    Radial graft is one of the optimal treatments for reconstruction after tongue cancer, but it is not free of side effects. Hypertrichosis over the graft, causing an intraoral paratrichosis, might downgrade the quality of life and even require further interventions. The case is presented of a 58 year-old man, who developed hypertrichosis after surgery for tongue carcinoma. The therapeutic options, from choosing a graft from less hairy areas to laser depilation or de-epithelisation of the graft are discussed. Intraoral paratrichosis is a serious complication that can produce dysphagia, nauseas, and vomiting, and can evolve into mal nutrition and produce an important decrease in life quality of our patients. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  12. 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.

  13. Development of the first permanent mandibular molar in young children with unilateral complete cleft lip and palate (UCCLP)

    DEFF Research Database (Denmark)

    Hermann, Nuno Vibe; Darvann, Tron A; Kreiborg, Sven

    Development of the first permanent mandibular molar in young children with unilateral complete cleft lip and palate (UCCLP)......Development of the first permanent mandibular molar in young children with unilateral complete cleft lip and palate (UCCLP)...

  14. Morphometric analysis of mandibular growth in skeletal Class III malocclusion.

    Science.gov (United States)

    Chang, Jenny Zwei-Chieng; Chen, Yi-Jane; Chang, Frank Hsin-Fu; Yao, Jane Chung-Chen; Liu, Pao-Hsin; Chang, Chih-Han; Lan, Wan-Hong

    2006-04-01

    The craniofacial growth patterns of untreated individuals with skeletal Class III malocclusion have rarely been systemically investigated. This study used morphometric techniques to investigate the growth characteristics of the mandible in individuals with skeletal Class III malocclusion. Lateral cephalometric head films of 294 individuals with untreated skeletal Class III malocclusion (134 males, 160 females) were selected and divided into five triennial age groups (T1-T5) and by gender to identify the morphologic characteristics and sexual dimorphism in changes of mandibular growth. Procrustes, thin-plate spline, and finite element analyses were performed for localization of differences in shape and size changes. Maximum and minimum principal axes were drawn to express the directions of shape changes. From T1 (age 6-8 years) to T4 (age 15-17 years), the distribution of localized size and shape changes of the mandible was very similar between the two genders. From T1 to T2 (age 9-11 years), significant lengthening of the condylar region was noted (23.4-39.7%). From T2 to T3 (age 12-14 years), the greatest size and shape change occurred at the condylar head (27.4-34.9%). From T3 to T4, the greatest size and shape changes occurred in the symphyseal region (23.6-42.1%). From T4 to T5 (age>or=18 years), significant sexual dimorphism was found in the distribution and amount of localized size and shape changes. Females displayed little growth increments during T4. Despite differences in the remodeling process, the whole mandibular configurations of both genders exhibited similarly significant upward and forward deformation from T4 to T5. We conclude that thin-plate spline analysis and the finite element morphometric method are efficient for the localization and quantification of size and shape changes that occur during mandibular growth. Plots of maximum and minimum principal directions can provide useful information about the trends of growth changes.

  15. Internal fixation of mandibular angle fractures: a meta-analysis.

    Science.gov (United States)

    Regev, Eran; Shiff, Jacob S; Kiss, Alex; Fialkov, Jeffrey A

    2010-06-01

    The degree of rigidity of internal fixation required for the treatment of mandibular angle fractures has long been at the center of debate in the literature. A statistical comparison between rigid fixation and monocortical fixation has been difficult because of multiple terms, definitions, and technical variations. The purpose of this study was to use the meta-analysis tool to combine information from multiple studies and to compare complication rates for different fixation methods. An English language literature search was conducted for articles on mandibular angle fractures. Information was collected on four variables of interest: compression/noncompression technique, monocortical/bicortical screws, number of plates, and location of plates. Five outcome rates were analyzed: infection, reoperation, hardware removal, malunion, and nonunion. Meta-analyses were run using Comprehensive Meta Analysis, version 2.2.03. Twenty-four studies with relevant data on the variables and outcomes of interest met the inclusion criteria. Significantly higher rates of infection, reoperation, and hardware removal were found for compression compared with noncompression, two plates compared with one plate, and for plates located on both the inferior and superior borders as compared with superior or inferior only. There were also significantly higher infection rates for bicortical screws compared with monocortical screws and higher malunion rates for compression compared with noncompression plating techniques. The results of this meta-analysis found lower complication rates with the use of noncompression, monocortical, and single-plate fixation, supporting the trend toward a single, superiorly placed, monocortical miniplate for fixation of mandibular angle fractures.

  16. Root canal morphology of South asian Indian mandibular premolar teeth.

    Science.gov (United States)

    Singh, Shishir; Pawar, Mansing

    2014-09-01

    The purpose of this study was to study the root canal morphology of South Asian Indian mandibular premolars using a tooth clearing technique. Two hundred mandibular premolar teeth were collected from different dental schools and clinics in India. After pulp tissue removal and root canal staining with Indian ink, the specimens were decalcified with 5% nitric acid, dehydrated in ethyl alcohol, and subsequently cleared in methyl salicylate. Of the 200 mandibular premolars, 100 were first premolars and 100 were second premolars. Of the first premolars, 94% had a single root, whereas 6% were 2 rooted. Seventy-six percent had a single canal, 22% had 2 canals, and 2% had 3 canals. Eighty-two percent had a single apical foramen, 16% had 2 foramens, and 2% teeth had 3 apical foramens. Eighty percent of teeth had type I, 6% had type II, 10% had type IV, 2% had type V, and 2% teeth had type IX root canal anatomy. Of the 100 second premolars, 92% had a single root, whereas 8% teeth were 2 rooted and fused. Fifty-eight percent of teeth had a single canal, and 42% had two canals. Eighty-eight percent had a single apical foramen, and 12% had 2 foramens. Sixty-six percent had type I, 30% had type II, and 4% had type V root canal anatomy. A high prevalence of 2 canals was noted in the first and second premolars. Also, 20% of first premolars and 34% of second premolars had a root canal anatomy other than type I. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  17. Asymmetric muscle function in patients with developmental mandibular asymmetry.

    Science.gov (United States)

    Dong, Y; Wang, X M; Wang, M Q; Widmalm, S E

    2008-01-01

    The aim was to test the hypothesis that developmental mandibular asymmetry is associated with increased asymmetry in muscle activity. Patients with mandibular condylar and/or ramus hyperplasia having unilateral cross-bite were compared with healthy subjects with normal occlusion. Muscle activity was recorded with surface electrodes in the masseter, suprahyoid, sternocleidomastoid muscle (SCM) and upper trapezius areas during jaw opening-closing-clenching, head-neck flexion-extension, and elevation-lowering of shoulders. Root mean square (RMS) and mean power frequency (MPF) values were calculated and analysed using anova and t-tests with P masseter muscles showed co-activation during jaw and head movements, significantly more asymmetric in the patients than in the healthy subjects. The RMS and MPF values were higher in the patients than in the controls in the SCM and suprahyoid areas on both sides during jaw opening-closing movement. The results indicate that the ability to perform symmetric jaw and neck muscle activities is disturbed in patients with developmental mandibular asymmetry. This is of clinical interest because asymmetric activity may be an etiologic factor in temporomandibular joint and cervical pain. The results support that co-activation occurs between jaw and neck muscles during voluntary jaw opening and indicate that postural antigravity reflex activity occurs in the masseter area during head extension. Further studies, where EMG recordings are made from the DMA patients at early stages are motivated to verify activity sources and test if the asymmetric activity is associated with muscle and joint pain in the jaw and cervical areas.

  18. Pamidronate Affects the Mandibular Cortex of Children with Osteogenesis Imperfecta

    Science.gov (United States)

    Apolinário, A.C.; Figueiredo, P.T.; Guimarães, A.T.; Acevedo, A.C.; Castro, L.C.; Paula, A.P.; Paula, L.M.; Melo, N.S.; Leite, A.F.

    2015-01-01

    We hypothesized that mandibular cortical width (MCW) is smaller in children with osteogenesis imperfecta (OI) than in healthy children and that pamidronate can improve the cortical mandibular thickness. The aim of this study was to assess changes in the MCW on dental panoramic radiographs (DPRs) of children with normal bone mineral density (BMD) and with OI. We also compared the MCW of children with different types of OI regarding the number of pamidronate cycles and age at the beginning of treatment. MCW measurements were retrospectively obtained from 197 DPRs of 66 children with OI types I, III, and IV who were in treatment with a comparable dosage of cyclical intravenous pamidronate between 2007 and 2013. The control group had 92 DPRs from normal BMD children. Factorial analysis of variance was used to compare MCW measurements among different age groups and between sexes and also to compare MCW measurements of children with different types of OI among different pamidronate cycles and age at the beginning of treatment. No significant differences in results were found between male and female subjects in both OI and healthy children, so they were evaluated altogether (P > 0.05). There was an increase of MCW values related to aging in all normal BMD and OI children but on a smaller scale in children with OI types I and III. Children with OI presented lower mean MCW values than did children with normal BMD at the beginning of treatment (P < 0.05). A linear model estimated the number of pamidronate cycles necessary to achieve mean MCW values equivalent to those of healthy children. The thinning of the mandibular cortex depended on the number of pamidronate cycles, the type of OI, and the age at the beginning of treatment. DPRs could thus provide a way to identify cyclic pamidronate treatment outcomes in patients with OI. PMID:25608973

  19. The quality of root fillings remaining in mandibular incisors after root-end cavity preparation

    NARCIS (Netherlands)

    Wu, MK; de Schwartz, FBC; van der Sluis, LWM; Wesselink, PR

    2001-01-01

    Aim The aim of this study was to determine the quality of root fillings remaining in mandibular incisors after root-end resection and root-end cavity preparation. Methodology Roots of 40 mandibular incisors. 12 mm in length. were divided into two groups and instrumented using a balanced force techni

  20. Mandibular dysfunction as a reflection of bulbar involvement in SMA type 2 and 3.

    Science.gov (United States)

    van Bruggen, H Willemijn; Wadman, Renske I; Bronkhorst, Ewald M; Leeuw, Maureen; Creugers, Nico; Kalaykova, Stanimira I; van der Pol, W Ludo; Steenks, Michel H

    2016-02-09

    In a cross-sectional study, we aimed to determine (1) the effect of spinal muscular atrophy (SMA) type 2 and 3 on mandibular function reflected as masticatory performance, mandibular range of motion, and bite force and (2) the predictors of mandibular dysfunction. Sixty patients with SMA type 2 and 3 (mean age 32.3 years, SD 17.4 years) and 60 age-matched controls filled out questionnaires about impairments of mandibular function. All participants underwent detailed clinical examination to document the mandibular range of motion including maximal mouth opening, bite force, and masticatory function. All mandibular movements, including mouth opening, lateral range of motion, and protrusion of the mandible, were reduced in patients with SMA type 2 and 3 compared to healthy controls (p SMA type 2 than type 3. The strongest predictive factor was SMA type for impairment of mandibular range of motion (R(2) = 0.82) and weakness of neck muscles for bite force (R(2) = 0.47). Reduced mandibular mobility and bite force are common complications in SMA. SMA type and neck muscle strength are important correlates of these complications. We provide further evidence for clinically relevant bulbar involvement in patients with SMA. © 2016 American Academy of Neurology.

  1. Coherence Filtering to Enhance the Mandibular Canal in Cone-Beam CT data

    NARCIS (Netherlands)

    Kroon, Dirk-Jan; Slump, Cornelis H.

    2009-01-01

    Segmenting the mandibular canal from cone beam CT data, is difficult due to low edge contrast and high image noise. We introduce 3D coherence filtering as a method to close the interrupted edges and denoise the structure of the mandibular canal. Coherence Filtering is an anisotropic non-linear

  2. An unusual presentation of all the mandibular anterior teeth with two root canals - A case report

    Directory of Open Access Journals (Sweden)

    Tiku A

    2005-01-01

    Full Text Available A rare case of two root canals in all mandibular anterior teeth is presented. The patient initially reported for the treatment of mandibular right central and lateral incisors. However, radiographic evaluation revealed variant root canal and apical foramen patterns.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Endodontic management of three-canalled mandibular lateral incisor using dental operating microscope.

    Science.gov (United States)

    Ashwinkumar, Vijayakumar; Nandini, Suresh; Velmurugan, Natanasabapathy

    2014-07-01

    This case report presents endodontic management of a mandibular lateral incisor with three canals using surgical dental operating microscope. This study describes the root canal variation of mandibular lateral incisor and highlights the importance of surgical operating microscope in detecting an unusual canal morphology.

  5. The quality of root fillings remaining in mandibular incisors after root-end cavity preparation

    NARCIS (Netherlands)

    Wu, MK; de Schwartz, FBC; van der Sluis, LWM; Wesselink, PR

    2001-01-01

    Aim The aim of this study was to determine the quality of root fillings remaining in mandibular incisors after root-end resection and root-end cavity preparation. Methodology Roots of 40 mandibular incisors. 12 mm in length. were divided into two groups and instrumented using a balanced force techni

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

    NARCIS (Netherlands)

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

    2000-01-01

    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. Purpo

  7. Predictive factors for premature loss of Martin 2.7 mandibular reconstruction plates

    NARCIS (Netherlands)

    van der Rijt, E. E. M.; Noorlag, R.; Koole, R.; Abbink, J. H.; Rosenberg, A. J. W. P.

    Mandibular reconstruction with a plate, with or without a vascularised free (bone) flap, is commonly used to treat patients with a segmental mandibular defect. Common complications are loosening of the osteosynthesis screws, malposition, intraoral or extraoral exposure, or infection. To define

  8. A rare report of mandibular facial talon cusp and its management

    Directory of Open Access Journals (Sweden)

    Sivakumar Nuvvula

    2014-01-01

    Full Text Available Talon cusp is an uncommon dental anomaly showing morphologically well delineated, accessory cusp-like structure projecting from cingulum to the incisal edge of anterior teeth. This anomaly is rare in the mandibular dentition and rarer on the facial aspect. A case of this infrequent entity of mandibular facial talon cusp and its management is reported here.

  9. 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.

    2005-01-01

    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 radiograph

  10. 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

  11. Etiology and management of mandibular fractures associated with endosteal implants in the atrophic mandible

    NARCIS (Netherlands)

    Raghoebar, GM; Stellingsma, K; Batenburg, RHK; Vissink, A

    2000-01-01

    Mandibular fractures can occur with the insertion of endosseous implants. Four patients whose mandibles were fractured with the removal or insertion of mandibular endosseous implants are described. Three of the patients required an autogenous bone graft to repair the fracture, and 1 patient was mana

  12. Tissue-engineered mandibular bone reconstruction for continuity defects: a systematic approach to the literature

    NARCIS (Netherlands)

    Chanchareonsook, N.; Junker, R.; Jongpaiboonkit, L.; Jansen, J.A.

    2014-01-01

    Background: Despite significant surgical advances over the last decades, segmental mandibular bone repair remains a challenge. In light of this, tissue engineering might offer a next step in the evolution of mandibular reconstruction. Purpose: The purpose of the present report was to (1) systematica

  13. Combined maxillary and mandibular midline and mandibular ramus distraction osteogenesis for treatment of a Class II patient with implants as orthodontic anchorage.

    Science.gov (United States)

    Takahashi, Ichiro; Kawamura, Hiroshi; Takano-Yamamoto, Teruko

    2010-03-01

    This case report describes the treatment of a woman with severe mandibular retrusion and maxillomandibular transverse deficiency. Her malocclusion was characterized by a large overjet, a deep overbite, and a V-shaped dental arch, and she had a skeletal Class II profile. Treatement included combined maxillary and mandibular midline expansion, maxillary downward repositioning, and mandibular ramus lengthening with distraction osteogenesis with implants as orthodontic anchorage. During the postdistraction orthodontic treatment period, some skeletal relapse occurred. Implants provided absolute orthodontic anchorage to overcome the unexpected skeletal changes. Combined orthodontic treatment with implants for anchorage and distraction osteogenesis successfully expanded the maxilla and the mandible and corrected the mandibular deficiency. Two-year follow-up records show a morphologically and functionally stable result.

  14. Irregular Periapical Radiopacity in Mandibular Premolars and Molars

    Directory of Open Access Journals (Sweden)

    S. Aravind Warrier

    2014-01-01

    Full Text Available Increased deposition of cementum is observed in a wide number of both benign and malignant conditions. Many cases are often diagnosed during routine examination as an incidental finding. Diagnosing correctly without confusing it with other similarly appearing lesions, thus avoiding subjecting the patient to unnecessary investigations and stress, is of prime importance. We report one such case, where the patient presented with the routine complaint of a painful tooth, during the investigation of which he was also diagnosed with hypercementosis affecting the mandibular second premolars and molars bilaterally. The literature review reveals that not many cases of hypercementosis are frequently reported.

  15. Recurrent unicystic ameloblastoma in mandibular anterior teeth area

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Do; Lee, Wan; Kim, Jin Hoa; Choi, Dong Hoon; Paeng, Jun Young; Kim, Eun Cheol [Department of Oral and Maxillofacial Radiology, School of Dentistry, Wonkwang University, Wonkwang Dental Research Institute, Iksan (Korea, Republic of)

    2008-06-15

    The unicystic ameloblastoma (UA) is a variant of the solid or multicystic ameloblastoma, a less encountered variant of the ameloblastoma. It appears more frequently in the second or third decade with no sexual or racial predilection. It is almost exclusively encountered asymptomatically in the posterior mandible. We report a case of a 43-year old patient with UA, who had previously undergone a surgical treatment on the same site about 1 year ago, this lesion recurred and presented as an exophytic gingival lesion in the anterior mandibular region.

  16. Vascularized mandibular anterior ameloblastoma - an entity still unresolved.

    Science.gov (United States)

    Maheshwari, P; Chandrashekhar, C; Radhakrishnan, R

    2013-05-01

    Vascularized ameloblastoma is a bewildering entity whose existence is questionable from its origin to nosology and its very characterization as a distinct variant of ameloblastoma. This uncertainty is largely because of a fewer number of documented cases and loss of long-term follow-up. The current paper describes two cases of ameloblastoma in the mandibular anterior region, which had features of so-called "hemangiomatous ameloblastoma" as it was originally described. Understanding its pathophysiology based on various views and clinical implications in terms of its biologic behavior are brought to light in this paper.

  17. Management of fractures of the mandibular body and symphysis.

    Science.gov (United States)

    Goodday, Reginald H B

    2013-11-01

    Mandibular fracture, specifically in the symphysis and body regions combined, is the most common facial fracture requiring hospitalization in North America. The primary treatment objective is to restore form and function by achieving anatomic reduction and placing fixation that eliminates mobility of the bone fragments. Several treatment options and surgical techniques are available for performing closed or open reduction. Special considerations are necessary when treating pediatric patients and fractures of the edentulous mandible. Complications relating to the tooth and denture-bearing regions of the mandible include infection, nonunion, and neurosensory changes.

  18. Surto de abscesso mandibular por Pseudomonas aeruginosa em ovinos

    Directory of Open Access Journals (Sweden)

    Rogério Martins Amorim

    2011-09-01

    Full Text Available Descreve-se um surto de abscesso mandibular em ovelhas da raça Bergamácia no município de Botucatu, estado de São Paulo. Do rebanho de 120 animais, 35 apresentaram aumento de volume mandibular com a presença de nódulos únicos, de consistência pétrea, de diferentes tamanhos, fistulados ou não e sem indicativos de inflamação dos tecidos moles adjacentes. Os animais eram criados em pasto de Panicum maximum cv. Tanzânia com água e sal mineral ad libitum e everminados, via oral, com pistolas dosificadoras. O material para diagnóstico microbiológico e antibiograma foi coletado de cinco animais acometidos, por punção e aspiração dos nódulos. Dos 35 animais acometidos, 19 foram submetidos ao exame radiográfico, um ao exame tomográfico e outro à biópsia óssea da região submandibular. O único ovino que morreu, encontrava-se em estado de caquexia provavelmente devido à localização do aumento de volume que afetou a implantação dos dentes molares daquela região impedindo a apreensão e mastigação adequadas levando a perda da condição corporal e morte. Ao exame necroscópico, observaram-se áreas de necrose caseosa na mandíbula direita de onde isolou-se Pseudomonas aeruginosa. O tratamento utilizado foi baseado na aplicação de iodeto de sódio a 10% por via intramuscular e antibioticoterapia segundo antibiograma com enrofloxacina por via intramuscular, porém com pouca eficácia. Diante do quadro clínico, dos dados de anamnese, da localização das lesões no tecido ósseo mandibular, do resultado do cultivo microbiológico, das alterações radiográficas e tomográficas foi feito o diagnóstico de abscesso mandibular causado por Pseudomonas aeruginosa.

  19. Projection angles of mandibular condyles in panoramic and transcranial radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Soo [Pusan National Univ. College of Dentistry, Pusan (Korea, Republic of)

    2006-09-15

    To evaluate the true projection angles of film-side mandibular condyles in panoramic and transcranial radiographs. 52 panoramic and transcranial radiographs of 4 condyles from two human dry mandibles with gradual horizontal and vertical angle changes were taken. The results were compared with the standard panoramic and transcranial radiographs and the identical pairs were selected. Panoramic radiography projected 10 degree to the film-sided condyles both horizontally and vertically. Transcranial radiography projected 15 degree to the film-sided condyles vertically. The medical and lateral poles were not forming the outline of condylar images in both projections when the horizontal angles of condyles were not sufficiently big enough.

  20. Treatment of Ectopic Mandibular Second Permanent Molar with Elastic Separators

    Directory of Open Access Journals (Sweden)

    R. Rajesh

    2014-01-01

    Full Text Available Ectopic eruption is a developmental disturbance in which the tooth fails to follow its normal eruption pathway. Ectopic eruption of the second molar is relatively rare. This paper presents the case of thirteen-year-old male with an ectopic mandibular second permanent molar. The condition was corrected with surgical exposure and placement of elastic separators. This case report lays emphasis on the practice of basic methods to obtain acceptable results rather than extensive surgical or orthodontic corrections. It is advised that ectopic teeth should not be neglected especially when it concerns developing caries and malocclusion.

  1. Canine transmigration accompanying mandibular retrognathism secondary to osteitis

    Directory of Open Access Journals (Sweden)

    Koszowski Rafał

    2015-12-01

    Full Text Available Transmigration is a tooth pathology in which the migrating tooth bud passes the median plane. Methods: This study is a presentation of the diagnostic and therapeutic outcomes in the cases of 4 stomach teeth transmigrations diagnosed in 3 patients with mandibular retrognathia which was a complication after osteitis in the postnatal period and infancy. Results: Extending imaging diagnostics to include CT, most preferably CBCT, makes it possible to precisely evaluate a transmigrated canine’s position and to plan a course of treatment. Conclusions: Planning of the treatment of teeth in transmigration in patients with temporomandibular ankylosis should be done by a team consisting of an orthodontist and a surgeon.

  2. Mandibular Ameloblastoma in an Elderly Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Kokoro Nagata

    2013-01-01

    Full Text Available Ameloblastomas frequently occur in relatively young people, but are rarely seen in people aged 80 years or older. We report a case of mandibular ameloblastoma in an elderly patient with a review of the literature. The patient was a 82-year-old man who noticed swelling of the gingiva approximately 2 weeks prior to his initial visit. Computed tomography showed a radiolucent area with little radiopacity. Internal uniformity was observed at the site, with thinning of cortical bone which lacked continuity in some areas. The excision and curettage were performed under general anaesthesia. No recurrence has been observed 14 months after surgery.

  3. Mandibular Ameloblastoma in an Elderly Patient: A Case Report

    Science.gov (United States)

    Nagata, Kokoro; Shimizu, Kasumi; Sato, Chu; Morita, Hiroshi; Watanabe, Yoshihiro; Tagawa, Toshiro

    2013-01-01

    Ameloblastomas frequently occur in relatively young people, but are rarely seen in people aged 80 years or older. We report a case of mandibular ameloblastoma in an elderly patient with a review of the literature. The patient was a 82-year-old man who noticed swelling of the gingiva approximately 2 weeks prior to his initial visit. Computed tomography showed a radiolucent area with little radiopacity. Internal uniformity was observed at the site, with thinning of cortical bone which lacked continuity in some areas. The excision and curettage were performed under general anaesthesia. No recurrence has been observed 14 months after surgery. PMID:23533821

  4. Atypical situations in root canals anatomy of human mandibular premolars

    OpenAIRE

    Fabrício SCAINI; Fabio Leal BRAGA; Irdival Cristino FIGUEIREDO JÚNIOR; Rafael Brandão FERREIRA; Baratto Filho,Flares; de SOUSA NETO, Manoel Damião

    2005-01-01

    The knowledge of the teeth internal anatomy that will receive endodontic treatment is very important for the success of the treatment and prognosis of those teeth. In this study, the morphological variations that may occur in relation to the number of root canals present in the premolar mandibular teeth group were discussed, as well as the most efficient methods to diagnose the existence of these variations, in order to have a clearer diagnosis of the number of root canals to be treated.A cas...

  5. Mandibular bone necrosis after use of paraformaldehyde-containing paste

    Science.gov (United States)

    Lee, Chi-hwan; Choi, Yoorina

    2016-01-01

    Paraformaldehyde has been used in the past as a pulpotomy agent. However, it has a severe cytotoxic effect and may cause alveolar bone necrosis. Depulpin, a devitalizing agent containing 49% paraformaldehyde, is no longer used frequently due to its severe side effects. In the two cases described in the present study, Depulpin was used as a devitalizing agent during root canal treatment. It caused a gradual loss of sensibility in adjacent teeth, gingival necrosis, and osteomyelitis. This case report demonstrates the serious side effects of using a paraformaldehyde-containing paste as a devitalizing agent for pulp, particularly mandibular bone necrosis. PMID:27847756

  6. Modelling property changes in graphite irradiated at changing irradiation temperature

    CSIR Research Space (South Africa)

    Kok, S

    2011-01-01

    Full Text Available A new method is proposed to predict the irradiation induced property changes in nuclear; graphite, including the effect of a change in irradiation temperature. The currently used method; to account for changes in irradiation temperature, the scaled...

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Bilateral Intraosseous Migration of Mandibular Second Premolars in a Patient with Nine Missing Teeth

    Directory of Open Access Journals (Sweden)

    H. Shahoon

    2010-03-01

    Full Text Available Intraosseous migration is an unusual developmental dental anomaly, which demonstrates horizontal movement of unerupted teeth only affecting the permanent dentition of the lower jaw. Mandibular second premolar is the most common impacted tooth after the thirdmolars and maxillary canines. Distal migration of the second premolar is rare and early loss of the permanent first molar is one of the most important predisposing factors of intrabony migration of this tooth. Bilateral migration of the mandibular premolars is veryrare compared to unilateral migration. Hereby, we present an 18-year-old man with bilateral intrabony migration of the mandibular second premolars to the mandibular angle (at the inferior and buccal side of the mandibular canal in the presence of first molars. Thepatient also had nine congenitally missing teeth without any systemic complication or abnormality in the skeleton. The teeth were surgically extracted. The clinical and diagnostic features and treatment of this case are discussed.

  9. A correlational study of serum alkaline phosphatase level and developmental mandibular laterognathism.

    Science.gov (United States)

    Dai, Jiewen; Li, Hongliang; Yu, Hongbo; Si, Jiawen; Fang, Bing; Shen, Steve Guofang

    2015-03-01

    The abnormal cartilage/bone metabolism in unilateral condyle may be a direct factor that contributes to developmental mandibular laterognathism. However, although many molecules have been demonstrated to play crucial roles in the development of temporomandibular joints, the exact molecular mechanisms that lead to the disrupted condylar cartilage/bone development were greatly unknown. In this retrospective study, our findings revealed that serum alkaline phosphatase (ALP) level in adult patients with developmental mandibular laterognathism was lower than that in control subjects, and the serum ALP levels continue to reduce in adult patients (>20 years old). Although the exact relationship between the lower serum ALP level and developmental mandibular laterognathism is unclear, the findings further support the opinion that the condylar growth may sustain for a long time in the affected condyle in patients with developmental mandibular laterognathism and offer an alternative choice to use total serum ALP activity as a possible biomarker to assess condylar growth activity in patients with developmental mandibular laterognathism.

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

    Science.gov (United States)

    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.

  11. Analysis of dimensions of sella turcica in patients with mandibular prognathism

    Directory of Open Access Journals (Sweden)

    Čutović Tatjana

    2008-01-01

    Full Text Available Introduction/Aim. Patients with mandibular prognathism as dominant symptom have disordered sagittal interjaw relations that make prominent appearance to this dental craniofacial anomaly beside hyperplastic mandibles and inverted front teeth overlap. The aim of this study was to examine the differences in dimensions of sella turcica in patients with mandibular prognathism and in eugnathic. Methods. On profile teleradiographs of 30 eugnathic control and 30 patients with mandibular prognathism, three parameters, which represent dimensions of sella turcica, were measured (surface, width and depth. Results. Statistically significant difference in values between the groups was found. All the three measured parameters were significantly higher in the patients with mandibular prognathism (p < 0.01. Conclusion. In the patients with mandibular prognathism all the measured dimensions of sella turcica were bigger, and so was sella turcica, but that enlargement was not in correlation with the degree of anomaly itself.

  12. 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.

  13. Mandibular repositioning modulates IGFBP-3, -4, -5 and -6 expression in the mandibular condylar cartilage of young rats.

    Science.gov (United States)

    Hajjar, Denise; Santos, Marinilce F; Kimura, Edna Teruko

    2006-01-01

    Functional orthopedic appliances correct dental malocclusion partially by exerting indirect mechanical stimulus on the condylar cartilage, modulating growth and the adaptation of orofacial structures. However, the exact nature of the biological responses to this therapy is not well understood. Insulin-like growth factors I and II (IGF-I and II) are important local factors during growth and differentiation in the condylar cartilage [D. Hajjar, M.F. Santos and E.T. Kimura, Propulsive appliance stimulates the synthesis of insulin-like growth factors I and II in the mandibular condylar cartilage of young rats, Arch. Oral Biol. 48 (2003), 635-642]. The bioefficacy of IGFs at the cellular level is modulated by IGF binding proteins (IGFBP). The aim of this study was to verify the mRNA and protein expression of IGFBP-3, IGFBP-4, IGFBP-5 and IGFBP-6 in the condylar cartilage of young male Wistar rats that used a mandibular propulsive appliance for 3, 9, 15, 20, 30 or 35 days. For this purpose, sagittal sections of decalcified and paraffin-embedded condyles were submitted to immunohistochemistry and the condylar cartilage to RT-PCR. The control group showed a gradual increase in the protein expression of all IGFBPs, except IGFBP-4. Following use of the appliance, IGFBP-3 and IGFBP-6 expression decreased in the early stage of the treatment. At 20 days of treatment there was a decline in the IGFs and IGFBP-3, IGFBP-4 and IGFBP-5 expression and at 30 days there was a peak in the IGFs and all IGFBPs expression except for IGFBP-3 where the peak was observed in the control animals. The expression patterns of all IGFBPs in the condylar cartilage were similar. The modulation of IGFBP-3, -4, -5 and -6 expression in the condylar cartilage in response to the propulsive appliance suggests that those peptides are involved in the mandibular adaptation during this therapy.

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

    Science.gov (United States)

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

    2016-01-01

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

  15. Ipsilateral vascularised ulnar transposition autograft for limb-sparing surgery of the distal radius in 2 dogs with osteosarcoma : clinical communication

    Directory of Open Access Journals (Sweden)

    G.S. Irvine-Smith

    2006-06-01

    Full Text Available Canine osteosarcoma is the most commonly diagnosed primary bone tumour in the dog, affecting mainly large and giant breed dogs with the predilection site being the metaphysis of long bones, specifically the distal radius, proximal humerus, distal femur and proximal tibia and fibula. Treatment options are either palliative or curative intent therapy, the latter limb amputation or limb-sparing surgery together with chemotherapy. This article describes the use of an ipsilateral vascularised ulnar transposition autograft as well as chemotherapy in 2 dogs with osteosarcoma of the distal radius. Both dogs showed minimal complications with the technique and both survived over 381 days following the surgery. Complications seen were loosening of the screws and osteomyelitis. The procedure was well tolerated with excellent limb use. This technique is indicated for use in cases with small tumour size that have not broken through the bone cortex.

  16. The Importance of Immediate Bone Block Autograft to Successfully Restore the Function and Aesthetic of the Anterior Alveolar Process and Teeth.

    Science.gov (United States)

    Singer, Lawrence David

    2015-12-01

    Maxillofacial traumatic injuries can damage the jaw, teeth, and soft tissues of the head and neck region. When these injuries occur, best practice is to reconstruct as comprehensively as is clinically prudent at time of injury. Smart and efficient procedures during the initial surgery can minimize subsequent reconstructive procedures in scope and number, minimize expense, and result in a better final aesthetic and functional outcome. Restoration of anterior alveolar jaw fractures with comminuted or avulsed segments becomes a complex prospect when left untreated after initial trauma or injury and can result in alveolar ridge defects that are difficult, costly, and cumbersome to repair. This case report details one 19-year-old woman who had a traumatic injury in these areas and has a best result outcome because of immediate reconstruction efforts involving a bone block autograft to preserve alveolar process anatomy.

  17. Cicatrización periodontal del segundo molar mandibular tras la exodoncia del tercer molar mandibular incluido

    OpenAIRE

    Inocêncio Teixeira de Faria, Ana Cristina

    2015-01-01

    La extracción quirúrgica del tercer molar (M3) puede provocar complicaciones periodontales en la cara distal del segundo molar (M2) adyacente. Se realizó un estudio clínico prospectivo a 12 meses en 25 pacientes jóvenes sanos (edad media 21 años) sometidos a 40 extracciones quirúrgicas de M3 mandibulares incluidos con elevado riesgo periodontal, con objeto de estudiar la cicatrización periodontal espontánea en la cara distal del M2. Prequirúrgicamente y a 3, 6 y 12 meses tras l...

  18. Cicatrización periodontal del segundo molar mandibular tras la exodoncia del tercer molar mandibular incluido

    OpenAIRE

    Inocêncio Teixeira de Faria, Ana Cristina

    2015-01-01

    La extracción quirúrgica del tercer molar (M3) puede provocar complicaciones periodontales en la cara distal del segundo molar (M2) adyacente. Se realizó un estudio clínico prospectivo a 12 meses en 25 pacientes jóvenes sanos (edad media 21 años) sometidos a 40 extracciones quirúrgicas de M3 mandibulares incluidos con elevado riesgo periodontal, con objeto de estudiar la cicatrización periodontal espontánea en la cara distal del M2. Prequirúrgicamente y a 3, 6 y 12 meses tras l...

  19. A comparative study on arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone between allograft and autograft%自体和异体骨-髌腱骨移植物重建膝前十字韧带的比较研究

    Institute of Scientific and Technical Information of China (English)

    江东; 王永健; 程序; 余家阔; 敖英芳; 于长隆; 王健全; 崔国庆; 胡跃林; 田得祥; 龚熹

    2008-01-01

    Objective To compare clinical results of arthroscopic anterior cruciate ligament(ACL) reconstruction with bone-patellar tendon-bone(B-PT-B) between allograft and autograft.Methods Twentyseven patients underwent ACL reconstruction using irradiated deep-frozen B-PT-B allograft,including 18 males and 9 females,with an average age of 25.5 years(range,16-49 years).Twenty-five patients underwent the same operation but using autograft B-PT-B,including 19 males and 6 females,with an average age of 26.7 years (range,18-43 years).The same arthroscopie technique was used to perform the reconstruction.Postoperative temperature,erythrocyte sedimentation rate,C reactive protein examined.During follow-up,parameters included International Knee Documentation Committee (IKDC) scores,Tegner scores,Lysholm scores,anterior knee pain and KT-2000 side-to-side difference.Muscle strength were measured by the Biodex dynamometer.Results The average follow-up was 37.1 (range,30-48) months in the allograft group and 36.3 (range,30-54) months in the autograft group.No significant difference was found for IKDC scores (89.5/86.5),Lysholm scores (93.0/94.6),Tegner scores (8.0/7.7),anterior knee pain (44.4%/72.0%)and side-to-side difference[30°: (1.72±1.73) mm vs (1.16±1.32) mm; 90°:(1.37±1.90) nun vs (-0.08±1.62)mm].Quadriceps muscle strength recovered to 82.7%/82.8% (60°/s and 120°/s) and 86.6%/85.3% (60°/sand 120°/s) for the allograft and autograft group with no significant difference.Conclusion There was no significant difference with stability and muscle strength recovery between B-PT-B aUograft and autograft.%目的 比较异体和自体骨-髌腱-骨(B-Pt-B)移植物重建膝关节前十字韧带(ACL)的临床效果.方法 27例ACL断裂患者接受关节镜下异体B-PT-B重建ACL手术,男18例,女9例;年龄16~49岁,平均25.5岁.同期25例ACL断裂患者接受关节镜下自体B-PT-B重建ACL手术,男19例,女6例;18~43岁,平均26.7岁.两组患者均采用相同的

  20. Irradiation Creep in Graphite

    Energy Technology Data Exchange (ETDEWEB)

    Ubic, Rick; Butt, Darryl; Windes, William

    2014-03-13

    An understanding of the underlying mechanisms of irradiation creep in graphite material is required to correctly interpret experimental data, explain micromechanical modeling results, and predict whole-core behavior. This project will focus on experimental microscopic data to demonstrate the mechanism of irradiation creep. High-resolution transmission electron microscopy should be able to image both the dislocations in graphite and the irradiation-induced interstitial clusters that pin those dislocations. The team will first prepare and characterize nanoscale samples of virgin nuclear graphite in a transmission electron microscope. Additional samples will be irradiated to varying degrees at the Advanced Test Reactor (ATR) facility and similarly characterized. Researchers will record microstructures and crystal defects and suggest a mechanism for irradiation creep based on the results. In addition, the purchase of a tensile holder for a transmission electron microscope will allow, for the first time, in situ observation of creep behavior on the microstructure and crystallographic defects.

  1. Dolor mandibular de origen cardíaco

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    MR Sáez Yuguero

    2003-10-01

    Full Text Available En las complejas estructuras anatómicas orofaciales, asientan muchos procesos dolorosos. Las algias orofaciales más comunes tienen su origen a nivel dental, periodontal o en estructuras musculoesqueleticas. Sin embargo, el paciente puede manifestar dolor en esta región, bien en dientes o estructuras musculoesqueleticas, y la fuente originaria localizarse a distancia. A este tipo de dolor se le llama dolor heterotópico. Una posible fuente de dolor heterotópico es el dolor de origen cardíaco. Este articulo presenta un caso clínico en el que el dolor mandibular bilateral fue el síntoma inicial de una cardiopatía isquémica que fue erróneamente etiquetada de artrosis de la articulación temporomandibular.In the complex orofacial anatomic structures, many painful processes are felt. The most common orofacial pains have their origin at dental or periodontal level, or in muscle -skeletical structures. However, the patient can have pain in this area- either in teeth or muscle-eskeletical structures- and the originating source can be located at a distance. This type of pain is called heterotopic pain. A possible source of heterotopic pain is the pain of cardiac origin. This paper presents a clinical case in which the bilateral mandibular pain is the initial symptom of an ischemic cardiopathy that was erroneously labeled as temporomandibular arthrosis.

  2. Digital image processing of mandibular trabeculae on radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Ogino, Toshi

    1987-06-01

    The present study was aimed to reveal the texture patterns of the radiographs of the mandibular trabeculae by digital image processing. The 32 cases of normal subjects and the 13 cases of patients with mandibular diseases of ameloblastoma, primordial cysts, squamous cell carcinoma and odontoma were analyzed by their intra-oral radiographs in the right premolar regions. The radiograms were digitized by the use of a drum scanner densitometry method. The input radiographic images were processed by a histogram equalization method. The result are as follows : First, the histogram equalization method enhances the image contrast of the textures. Second, the output images of the textures for normal mandible-trabeculae radiograms are of network pattern in nature. Third, the output images for the patients are characterized by the non-network pattern and replaced by the patterns of the fabric texture, intertwined plants (karakusa-pattern), scattered small masses and amorphous texture. Thus, these results indicates that the present digital image system is expected to be useful for revealing the texture patterns of the radiographs and in the future for the texture analysis of the clinical radiographs to obtain quantitative diagnostic findings.

  3. Radiographic Study of Bony Changes of the Mandibular Condyle

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-03-15

    The purpose of this study is to compare radiographic techniques for the diagnostic accuracy in the detection of osteophytes of the mandibular condyle. A series of bone chips were placed at four locations on the condylar head of a dried human skull. Eight radiographic techniques such as panoramic, transcranial, infracranial, transorbital, reverse-Towne's, submentovertex, multidirectional tomographic and computed tomographic techniques were compared. Three oral radiologists were asked to rate the lesions by four stage score. The statistical analysis was performed by ANOVA test. For the detection of lateral osteophyte, transcranial, infracranial, transorbital and reverse-Towne's views showed superiority. Also, transcranial and infracranial views showed superiority for medial osteophyte. While for the detection of superior and anterior osteophyte, panoramic, transcranial, infracranial, transorbital views showed superiority. Lateral tomograph showed superiority for the detection of superior and anterior osteophyte, but it showed inferiority for lateral and medial osteophte. And antero-posterior tomograph showed superiority for the detection of all osteophytes. Axial computed tomograph showed superiority for the detection of all osteophytes, and coronal computed tomograph showed superiority for lateral, medial and superior osteophytes. While reconstructed sagittal computed tomograph showed relatively superiority for the detection of anterior and superior osteophytes. The conventional radiographs can be used for the detection of bony changes of the mandibular condyle, and tomograph or computed tomograph can be used additionally when it is difficult to detect bony changes on conventional radiographs.

  4. Mandibular condylar hyperplasia: clinical, histopathological, and treatment considerations.

    Science.gov (United States)

    Angiero, Francesca; Farronato, Giampietro; Benedicenti, Stefano; Vinci, Raffaele; Farronato, Davide; Magistro, Sarah; Stefani, Michele

    2009-01-01

    Condylar hyperplasia is a rare disorder characterized by an increased volume of the condyle, ramus, and mandibular body leading to facial asymmetry. We present three cases of condylar hyperplasia: two women and one man, age range 27 to 34. Clinically, all three patients showed a deviation of the mandible to the opposite side and a protruded position of the chin, hypertrophy of the lower border of the mandible, combined with an elongation of the mandibular ramus, open-bite on the deformed side, and cross-bite on the opposite side. In all three cases, scintigraphy showed an increased uptake. Radiography and CT scanning confirmed the clinical diagnosis and patients were subjected to surgery, comprising high condylectomy on the affected side with access in the pre-tragus area. The surgical piece sent to the Institute of Pathological Anatomy for histological examination revealed a nonuniform picture, in terms of both the depth of cartilage islands and the thickness of the fibrous layer covering the joint surface. Common to all three cases, however, was the apparent evolution of fibrous tissue to cartilage, and of this to compact bone tissue. At two-four years, all cases have maintained a good occlusal response. The asymmetric deformity of the mandible resulting from the rare condition of hemimandibular hyperplasia is presented and the clinical, histopathological and therapeutic aspects discussed.

  5. Incidence of mandibular fractures in Eastern part of Libya.

    Science.gov (United States)

    Elgehani, Rafa-Abdelsalam; Orafi, Maraai-Idris

    2009-10-01

    The objective of this retrospective study is to evaluate the incidence of mandibular fractures in the eastern part of Libya and to present our experience in treating this type of facial fracture. We analyzed factors such as the incidence of age, sex, time distribution, cause and site of the fracture and the associated injuries in 493 patients presenting a total of 666 mandibular fractures. These patients were treated at Al-Jala Trauma Hospital, Benghazi-Libya between 2000 and 2006. The results were obtained from 432 males and 61 females, for which the ages ranged from 8 months to 72 years. The maximum number of the patients was recorded in 2004, and the busiest month was May. The most common cause of fracture was road traffic accidents and the most common site was the parasymphysis. Among those treated with closed reduction were 241 patients, whereas 201 patients were treated with open reduction. In conclusion, we found that the results were similar to most studies from developing countries and were in contrast to other studies. This may be due factors such as geography, socioeconomic trends, religion, road traffic legislation and seasons, which differ from one country to another. The period during which there was an embargo in Libya also appears to have affected the results.

  6. Augmented mandibular bone structurally adapts to functional loading.

    Science.gov (United States)

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

    2013-12-01

    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 analysis program. Parameters studied were trabecular area and perimeter and marrow cavity area and perimeter. After skeletonisation of the trabecular network, the number of end points and branching points, skeleton length, and branch angle were determined. The observed structural changes agree with the development of a more complex and more delicate or fine osseous structure. The bone shows more trabecular branching. All changes are most pronounced in the graft spongiosa, but are also found in the graft cortex and in the original mandible. The mean trabecular branch angle becomes more horizontal. The applied technique can be used to analyse long-term changes in the architecture of bone grafts. Changes found in the graft architecture correspond to changes expected after functional adaptation to loading. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Implant-supported Mandibular Overdentures in Very Old Adults

    Science.gov (United States)

    Müller, F.; Duvernay, E.; Loup, A.; Vazquez, L.; Herrmann, F.R.; Schimmel, M.

    2013-01-01

    The purpose of this study was (1) to investigate denture satisfaction following the conversion of existing mandibular complete dentures to implant overdentures (IOD) in very old edentulous patients who depend on help for activities of daily living and (2) to evaluate secondary end points, such as functional, structural, nutritional, and patient-centered aspects. For this randomized clinical trial, 2 interforaminal short implants were placed in the intervention group (n = 16, 85.0 ± 6.19 yrs) to retain mandibular IODs; the control group (n = 18, 84.1 ± 5.55 yrs) received conventional relines. During the first year, no implant was lost; however, 2 patients died. IODs proved more stable, and participants in the intervention group demonstrated significantly higher denture satisfaction as well as an increased oral health–related quality of life compared to the control group. Maximum voluntary bite force improved significantly with IODs, yet the chewing efficiency was not different between groups. Masseter muscle thickness increased with IODs, mainly on the preferred chewing side. Body mass index decreased in both groups, but the decline tended to be smaller in the intervention group; blood markers and the Mini Nutritional Assessment did not confirm this tendency. These results indicate that edentulous patients who depend on help for activities of daily living may benefit from IODs even late in life (ClinicalTrial.gov NCT01928004). PMID:24158342

  8. Chondrosarcoma of the Mandibular Condyle: A Case Report

    Directory of Open Access Journals (Sweden)

    Keshani F.

    2012-12-01

    Full Text Available Chondrosarcomas are slow-growing, malignant mesenchymal neoplasms characterized by formation of cartilage by the tumoral cells. They display a wide range of morphological features from a well-differentiated growing mass resembling a benign cartilage tumour to a high-grade malignancy with aggressive local invasion. Only 5% to 10% of this neoplasm is confined to the head and neck region. Chondrosarcomas of the mandibular condyle may manifest the typical symptoms of the temporomandibular joint dysfunction syndrome. Tumours of the condyle can reach a large size without producing clinically obvious swellings. A rare case of chondrosarcoma of the mandibular condyle in a 34-years old woman is presented in this report. Patient’s chief complaint was pain in the right temporomandibular joint when her mouth was in a maximum opening position. Mild malocclusion, figured as an occlusal discrepancy, was also detected. Radiographs illustrated erosion in the head of condyle. After condylectomy, the excised mass was histologically diagnosed as a grade II chondrosarcoma.

  9. Location of the mandibular branch of the facial nerve according to the neck position.

    Science.gov (United States)

    Hwang, Kun; Huan, Fan; Ki, Sae Hwi; Nam, Yong Seok; Han, Seung Ho

    2012-09-01

    The aim of this study was to elucidate the exact location of the mandibular branch of the facial nerve according to different neck positions. Twenty-two hemifaces of 11 fresh human cadavers were used (age range, 53-89 y; mean age, 72.3 ± 10.5 y; 8 men and 3 women). Working through skin windows, the distance from the mandibular border to the mandibular branch of the facial nerve (border-nerve distance or BND) was measured at 3 points: (1) the mandible angle (gonion or Go point), (2) the point where the mandibular branch of the facial nerve crosses the facial artery (FA point), and (3) the one-fourth point from the gonion to the menton (1/4 point). Threads were hung on the skin windows along the mandibular border. With the neck in the neutral position and then full flexion (15 degrees), extension (15 degrees), and left and right rotations (30 degrees), the distance of the mandibular branch from the thread of the mandibular border was measured using calipers. In the neutral position, the mandibular branch was 3.50 ± 2.82 mm above the mandibular border at the Go point, 5.34 ± 2.98 mm above the mandibular border at the FA point, and 5.28 ± 1.86 mm above the mandibular border at the 1/4 point. At all 3 points, flexion or extension of the neck did not significantly move the mandibular branch. At the Go point and FA point, there was no significant difference between the ipsilateral rotation position and the contralateral rotation. Yet at the 1/4 point, the BND decreased (4.32 ± 2.60 mm) with the neck in ipsilateral rotation and the BND increased (5.97 ± 2.62 mm) with the neck in contralateral rotation. There was a significant difference between the ipsilateral rotation position and the contralateral rotation position (P = 0.020, t-test). Surgeons should keep in mind that at the 1/4 point, the mandibular branch of the facial nerve moves downward 1.10 ± 1.42 mm with the neck in ipsilateral rotation and moves upward 0.49 ± 1.84 mm with the neck in contralateral

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

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Mi Ree; Moon, Young Mi; Seo, Min Seock [Dept. of Conservative Dentistry, Wonkang University Daejeon Dental Hospital, Daejeon (Korea, Republic of)

    2015-12-15

    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.

  11. Mandibular Third Molar Impaction: Review of Literature and a Proposal of a Classification

    Directory of Open Access Journals (Sweden)

    Gintaras Juodzbalys

    2013-06-01

    Full Text Available Objectives: The purpose of present article was to review impacted mandibular third molar aetiology, clinical anatomy, radiologic examination, surgical treatment and possible complications, as well as to create new mandibular third molar impaction and extraction difficulty degree classification based on anatomical and radiologic findings and literature review results.Material and Methods: Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandibular third molar, impacted mandibular third molar, inferior alveolar nerve injury third molar, lingual nerve injury third molar. The search was restricted to English language articles, published from 1976 to April 2013. Additionally, a manual search in the major anatomy and oral surgery journals and books was performed. The publications there selected by including clinical and human anatomy studies.Results: In total 73 literature sources were obtained and reviewed. Impacted mandibular third molar aetiology, clinical anatomy, radiographic examination, surgical extraction of and possible complications, classifications and risk factors were discussed. New mandibular third molar impaction and extraction difficulty degree classification based on anatomical and radiologic findings and literature review results was proposed. Conclusions: The classification proposed here based on anatomical and radiological impacted mandibular third molar features is promising to be a helpful tool for impacted tooth assessment as well as for planning for surgical operation. Further clinical studies should be conducted for new classification validation and reliability evaluation.

  12. Mandibular third molar impaction: review of literature and a proposal of a classification.

    Science.gov (United States)

    Juodzbalys, Gintaras; Daugela, Povilas

    2013-07-01

    The purpose of present article was to review impacted mandibular third molar aetiology, clinical anatomy, radiologic examination, surgical treatment and possible complications, as well as to create new mandibular third molar impaction and extraction difficulty degree classification based on anatomical and radiologic findings and literature review results. Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandibular third molar, impacted mandibular third molar, inferior alveolar nerve injury third molar, lingual nerve injury third molar. The search was restricted to English language articles, published from 1976 to April 2013. Additionally, a manual search in the major anatomy and oral surgery journals and books was performed. The publications there selected by including clinical and human anatomy studies. In total 75 literature sources were obtained and reviewed. Impacted mandibular third molar aetiology, clinical anatomy, radiographic examination, surgical extraction of and possible complications, classifications and risk factors were discussed. New mandibular third molar impaction and extraction difficulty degree classification based on anatomical and radiologic findings and literature review results was proposed. The classification proposed here based on anatomical and radiological impacted mandibular third molar features is promising to be a helpful tool for impacted tooth assessment as well as for planning for surgical operation. Further clinical studies should be conducted for new classification validation and reliability evaluation.

  13. Pattern of mandibular third molar impaction: A cross-sectional study in northeast of Iran.

    Science.gov (United States)

    Eshghpour, M; Nezadi, A; Moradi, A; Shamsabadi, R Mahvelati; Rezaei, N M; Nejat, A

    2014-01-01

    Impacted teeth, if left untreated, have a potential to induce various complications. The aim of the current study was to determine the prevalence and pattern of impacted mandibular third molar in the Iranian population. This cross-sectional study was performed in patients who were referred to the Department of Oral Radiology between July 2009 and October 2010 to obtain an orthopantomogram (OPG). Data were collected regarding age and gender, prevalence of impacted mandibular third molars, angulation of impacted teeth (Winter's classification), level of impaction (Pell and Gregory classification), and relationship of the mandibular third molar with the ramus (Pell and Gregory classification). The collected data were analyzed using SPSS software version 11.0 with a confidence interval of 95%. Among the 1433 patients included in the study, 489 (34.12%) patients were male and 944 (65.88%) were female. Of the total OPGs performed, 871 (60.78%) OPGs demonstrated at least one impacted mandibular third molar. In addition, of the 2866 mandibular third molars investigated, 1397 (48.74%) were found to be impacted. A significant association was observed between gender and the number of impacted teeth or the presence of impaction of any mandibular tooth (or teeth) (P third molar (P > 0.05). The pattern of mandibular third molars in the Northeast region of Iran revealed a high prevalence of impaction, which was mostly mesioangular, level B, and Class II with a gender predilection for females.

  14. The relationship between unilateral mandibular angle fracture and temporomandibular joint function.

    Science.gov (United States)

    Baltrusaityte, Ausra; Surna, Algimantas; Pileicikiene, Gaivile; Kubilius, Ricardas; Gleiznys, Alvydas; Zilinskas, Juozas

    2014-01-01

    PURPOSE. Aim of this study was to analyze relation of occlusal correction and alterations of temporomandibular joint function during treatment of unilateral mandibular fractures. MATERIALS AND METHODS. We compared 49 patients treated for unilateral mandibular fracture without occlusal correction with 21 patient treated for unilateral mandibular fracture along with early and consequent occlusal analysis and correction and with 49 control subjects. Patients' complaints, mandibular movements and occlusal parameters were evaluated during the period of healing. ZEBRIS ultrasound system (Jaw Motion Analyzer, Zebris Medical GmbH, Isny, Germany) was used for analysis of mandibular movements and T-Scan analyzer (Tekscan, Inc., Boston, MA, USA) was used for occlusal analysis. RESULTS. Findings of our study showed statistically significant (p<0.05) diminution of patients complaints, mandibular movement alterations and occlusal disturbances in patients who received occlusal correction during MF treatment if compared to patients treated without occlusal correction, except noises from the joint in the injured side and mandibular lateral track to the injured side in the final stage of investigation. Despite applied treatment recovery of the TMJ function was not complete and the investigated parameters remained worse if compared to the control group. CONCLUSIONS. Results of this study confirmed positive influence of early and subsequent occlusal analysis and correction during stages of MF treatment on diminution of functional alterations of the temporomandibular joint function. Timely occlusal correction improves and hastens process of rehabilitation therefore it is indispensable part of MF treatment.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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.

  17. 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.

  18. Treatment effects of mandibular total arch distalization using a ramal plate

    Science.gov (United States)

    Yu, Jonghan; Park, Jae Hyun; Bayome, Mohamed; Kim, Sungkon; Kook, Yoon-Ah; Kim, Yoonji

    2016-01-01

    Objective The purpose of this study was to evaluate treatment effects after distalization of the mandibular dentition using ramal plates through lateral cephalograms. Methods Pre- and post-treatment lateral cephalograms and dental casts of 22 adult patients (11 males and 11 females; mean age, 23.9 ± 5.52 years) who received ramal plates for mandibular molar distalization were analyzed. The treatment effects and amount of distalization of the mandibular molars were calculated and tested for statistical significance. The significance level was set at p orthognathic surgery. PMID:27478798

  19. 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.

  20. Double Mandibular Foramina and Canal: Report of a Case with Interactive CT-Based Planning Softwar

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    S. Nikzad

    2008-06-01

    Full Text Available The identification of the mandibular canal and its anatomic variations is of great importance in many branches of dentistry, especially in implant dentistry and prior to endosteal implant insertion. This knowledge is even more demanding when the mandible has been compromised by different degrees of atrophy and bone resorption. In this study we describe a rare case of double mandibular canal identified by three-dimensional imaging techniques during the process of diagnosis. It is concluded that mandibular canals may often be undetected during the diagnosing phase of implant treatment, and tomographic imaging is the only way to identify some of these distinctive features.