An Ancient Science to Improve Today’s Clinical Practice: Oral Surgery Meets Human Anatomy

Human body dissection was a ubiquitous practice in the past, to better understand anatomy and to develop medicine. Today, its role could still be important to answer everyday clinical queries and help surgeons. The example of the possible lack of anesthesia during symphysis surgeries can emphasize the usefulness of dissection. The mandibular symphysis usually receives innervation from inferior alveolar nerve terminations, but, in some rare cases, a particular anastomosis involves the lingual nerve and the nerve to the mylohyoid. The anatomical knowledge resulting from body dissections could help oral surgeons to understand the reason why the patient could feel pain during the surgery, and ensure performance of the right lingual nerve block to obtain complete anesthesia. This clinical situation shows the educational role of an ancient, yet still valid, practice, human dissection, and the importance of anatomical studies to improve surgical skills, to provide better treatment for the patient.

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COURSE OF THE MAXILLARY ARTERY THROUGH THE LOOP OF THE AURICULOTEMPORAL NERVE. Recorrido de la arteria maxilar a través del bucle del nervio aurículotemporal

Revista Argentina de Anatomía Clínica ◽

10.31051/1852.8023.v5.n3.14081 ◽

2016 ◽

Vol 5 (3) ◽

pp. 235-239

Author(s):

Kavya Bhat ◽

Sampath Madhyastha ◽

Balakrishnan R

Keyword(s):

Inferior Alveolar Nerve ◽

Middle Meningeal Artery ◽

Lingual Nerve ◽

Maxillary Artery ◽

Lateral Pterygoid Muscle ◽

Male Cadaver ◽

The Right ◽

Unique Variation ◽

Meningeal Artery ◽

Auriculotemporal Nerve

Las variaciones en el curso de la arteria maxilar se describen a menudo, con sus relaciones con el músculo pterigoideo lateral. En el presente caso informamos una variación exclusiva en el curso de la arteria maxilar que no fue publicada antes. En un cadáver masculino de 75 años arteria maxilar derecho estaba pasando por el bucle del nervio auriculo-temporal. La arteria meníngea media provenía de la arteria maxilar con un bucle del nervio auriculo-temporal. La arteria maxilar pasaba profunda con respecto al nervio dentario inferior pero superficial al nervio lingual. El conocimiento de estas variaciones es importante para el cirujano y también serviría para explicar la posible participación de estas variaciones en la etiología del dolor mandibular. Variations in the course of the maxillary artery are often described with its relations to the lateral pterygoid muscle. In the present case we report a unique variation in the course of the maxillary artery which was not reported before. In a 75 years old male cadaver the right maxillary artery passed through the loop of the auriculotemporal nerve. The middle meningeal artery was arising from the maxillary artery within the nerve loop of auriculotemporal nerve. Further the maxillary artery passed deep to the inferior alveolar nerve but superficial to the lingual nerve. The knowledge of these variations is important for surgeons and it would also explain the possible involvement of these variations in etiology of the craniomandibular pain.

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A CBCT Based Three-Dimensional Assessment of Mandibular Posterior Region for Evaluating the Possibility of Bypassing the Inferior Alveolar Nerve While Placing Dental Implants

Diagnostics ◽

10.3390/diagnostics10060406 ◽

2020 ◽

Vol 10 (6) ◽

pp. 406 ◽

Cited By ~ 3

Author(s):

Mohammed G. Sghaireen ◽

Kumar Chandan Srivastava ◽

Deepti Shrivastava ◽

Kiran Kumar Ganji ◽

Santosh R. Patil ◽

...

Keyword(s):

Nerve Injury ◽

Age Groups ◽

Inferior Alveolar Nerve ◽

Three Dimensions ◽

High Rate ◽

Cortical Plate ◽

Computed Tomography Images ◽

Group I ◽

Linear Distance ◽

The Right

A high rate of nerve injury and related consequences are seen during implant placement in the posterior mandibular arch. An approach has been proposed to avoid nerve injury by dodging the inferior alveolar nerve (IAN) while placing an implant. A prospective study with a total of 240 CBCT (cone beam computed tomography) images of patients with three dentate statuses, namely, edentulous (group I), partially edentulous (group II) and dentate (group III) were included in the study. The nerve path tracing was done on CBCT images with On-demand 3D software. The three dimensions, i.e., the linear distance from the outer buccal cortical plate to the inferior alveolar nerve (BCPN), linear distance from the outer lingual cortical plate to the inferior alveolar nerve (LCPN) and linear distance from the midpoint of the alveolar crest to the inferior alveolar nerve (ACN) were assessed. The data were presented and analyzed between variables using one-way ANOVA and independent t-test in SPSS version 21.LCPN of the right 1st premolar region (p < 0.05) was significantly different among the groups with edentulous subjects recorded with the minimum value (6.50 ± 1.20 mm). Females were found to have significantly (p < 0.05) less available bone (6.03 ± 1.46 mm) on the right side of the mandibular jaw compared to males in edentulous group of patients. On comparing age groups for partially edentulous subjects, LCPN of the right 1st premolar region had significantly (p < 0.05) less available bone (6.03 ± 0.38 mm) in subjects with age ≥54 years. The IAN follows a lingual course in the molar region and later flips to the buccal side in the premolar region. The LCPN dimension in the 1st and 2nd premolar region was found to be more than 6 mm irrespective of age, gender and side of the jaw. Thus, it can be considered as a suitable site for placing implants while bypassing the IAN with CBCT assessment remaining as the mainstay in the pre-surgical phase.

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Marginal and internal fit and intaglio surface trueness of interim crowns fabricated from tooth preparation of four finish line locations

Scientific Reports ◽

10.1038/s41598-021-93455-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Keunbada Son ◽

Young-Tak Son ◽

Ji-Min Lee ◽

Kyu-Bok Lee

Keyword(s):

Three Dimensional ◽

Clinical Situation ◽

Intraoral Scanner ◽

Replica Technique ◽

Finish Line ◽

Marginal Fit ◽

Tooth Preparation ◽

The Right ◽

Internal Fit ◽

Marginal Region

AbstractThis study evaluated the marginal and internal fit and intaglio surface trueness of interim crowns fabricated from tooth preparation scanned at four finish line locations. The right maxillary first molar tooth preparation model was fabricated using a ceramic material and placed in four finish line locations (supragingival, equigingival, subgingival, and subgingival with a cord). Intraoral scanning was performed. Crowns were designed based on the scanned area. Interim crowns were fabricated using a stereolithography three-dimensional (3D) printer (N = 16 per location). Marginal and internal fit were evaluated with a silicone replica technique. Intaglio surface trueness was evaluated using a 3D inspection software. One-way analysis of variance and Tukey HSD test were performed for comparisons (α = 0.05). The marginal and internal fit showed significant differences according to locations (P < 0.05); the marginal fit showed the best results in the supragingival finish line (P < 0.05). Intaglio surface trueness was significantly different in the marginal region, with the highest value in the subgingival location (P < 0.05). Crowns fabricated on the subgingival finish line caused inaccurate marginal fit due to poor fabrication reproducibility of the marginal region. The use of an intraoral scanner should be decided on the clinical situation and needs.

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Multiple hepatic aneurysms and dry gangrene of fingertips in eosinophilic granulomatosis with polyangiitis: a case report

Allergy Asthma & Clinical Immunology ◽

10.1186/s13223-020-00484-4 ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

Eunsil Koh ◽

Noeul Kang ◽

Jin-Young Lee ◽

Duk-Kyung Kim ◽

Young Soo Do ◽

...

Keyword(s):

Eosinophil Count ◽

Granulomatosis With Polyangiitis ◽

Stable State ◽

Clinical Situation ◽

High Dose ◽

Eosinophilic Granulomatosis With Polyangiitis ◽

Case Presentation ◽

The Right ◽

Small Aneurysms ◽

Eosinophilic Granulomatosis

Abstract Background Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic necrotizing vasculitis mainly affecting small-sized arteries. Involvement of medium-sized vessels is very rare in EGPA. Here we present the case of a patient with EGPA who showed multiple hepatic aneurysms and distal gangrene. Case presentation A known EGPA patient visited to the emergency room (ER) with abrupt squeezing abdominal pain. She had suffered from gangrene in the fingertips of both hands for 1 year because of arterial thrombosis associated with hypereosinophilia. However, her absolute eosinophil count in the ER was 1120 cells/µL. An abdomen-pelvis CT demonstrated subcapsular hematoma in the right hepatic lobe. A celiac angiogram demonstrated multiple sized aneurysms in both hepatic lobes and some aneurysms in S7 and S8 were huge, more than 1 cm in size. The shape of the small aneurysms resembled a string of beads, as in polyarteritis nodosa. Given the clinical situation, emergency embolization was performed. Before this patient visited to the ER, she had been treated with a high dose of systemic corticosteroid, azathioprine, and cyclophosphamide. After addition of mepolizumab, the eosinophil count remained stable state with a near zero percentage of total white blood cell count. Conclusions Aneurysm and gangrene resulting from the involvement of medium-sized vessels can occur in EGPA. Destruction of vessels might occur even if eosinophil count is below 1500 cells/µL. If involvement of medium-sized arteries is suspected, thorough investigation to identify the involved organs and prompt management are needed to prevent fatal complications.

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Kawasaki disease complicated by cerebral infarction

Cardiology in the Young ◽

10.1017/s1047951103000179 ◽

2003 ◽

Vol 13 (1) ◽

pp. 103-105 ◽

Cited By ~ 14

Author(s):

Kenji Suda ◽

Masahiko Matsumura ◽

Shigeru Ohta

Keyword(s):

Kawasaki Disease ◽

Cerebral Infarction ◽

Clinical Situation ◽

Sudden Onset ◽

X Ray ◽

Coronary Aneurysms ◽

Intracoronary Thrombolysis ◽

Tissue Plasminogen ◽

X Ray Computed ◽

The Right

An 8-month-old boy presented with right hemiplegia of sudden onset after 20 days of Kawasaki disease, which was not initially treated by gamma globulin. Cranial X-ray computed tomography confirmed cerebral infarction as the cause of the right hemiplegia. In subsequent weeks, he developed multiple thromboses in coronary aneurysms. He successfully underwent intracoronary thrombolysis using tissue plasminogen activator without haemorrhagic complications. Cerebral infarction as a complication of Kawasaki disease is rare, and is a difficult clinical situation to manage.

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A STUDY OF THE DIMENSIONS OF HUMAN ACETABULUM IN THE DRY HIP BONES OF SOUTH KERALA POPULATION

10.36106/ijar/2702747 ◽

2021 ◽

pp. 11-14

Author(s):

Rani Raphael M ◽

Sajey P. S. ◽

Rajad. R ◽

Varghese P. D

Keyword(s):

Indian Population ◽

Hip Prosthesis ◽

Human Anatomy ◽

Morphological Data ◽

Male And Female ◽

Medical College ◽

The Mean ◽

Kerala State ◽

The Right ◽

Anatomical Parameters

Introduction: In human anatomy the acetabulum is a cavity on the lateral aspect of the hip-bone. The purpose of this study is to record the depth and diameter of the acetabulum cavity to accumulate morphological data helpful for anthropologists, Forensic medicine experts and orthopedicians. Materials And Methods: The study was done on 88 adult human hip bones (42 right and 46 left) collected from Department of Anatomy, Govt.T.D Medical College, Alappuzha, Kerala state. The diameters and maximum depth were measured using digital vernier calliper. The measurements were compared with other studies in the world. The mean diam Results: eter of acetabulum was 48.08 ± 3.21mm, 44.16 ± 2.60 mm in male and female respectively. The mean ± S.D value of depth was 29.11± 2.37 and 27.20± 2.01 mm. in male and female respectively. The correlation between depth and diameter was signicant only in the right male hip bones. There is signicant variation in the Conclusion: anatomical parameters of hip bone between different Indian population groups. The data from this study may be used for designing population specic hip prosthesis.

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Prosthodontic Rehabilitation of Patient with Anterior Hyper Function Syndrome

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2017.208 ◽

2017 ◽

Vol 5 (7) ◽

pp. 1000-1004

Author(s):

Vesna Korunoska-Stevkovska ◽

Ljuben Guguvcevski ◽

Zaklina Menceva ◽

Nikola Gigovski ◽

Aneta Nikola Mijoska ◽

...

Keyword(s):

Oral Surgery ◽

Diagnostic Tools ◽

Anterior Teeth ◽

High Incidence ◽

Hyperplastic Tissue ◽

Dental Rehabilitation ◽

Natural Teeth ◽

Papillary Hyperplasia ◽

The Right ◽

Maxillary Region

BACKGROUND: The success of prosthetic rehabilitation in patients with removable dentures depends on the achievement of the aesthetics, phonetics and most of all, proper use in the mastication process. All the patients that receive removable prostheses need a feeding education program. They must cut the food into smaller pieces, extend the length of time necessary for chewing and place the food upon both the right and left sides of the mouth at once. Bilaterally chewing with dentures will contribute to increased efficiency and denture stability during mastication. Using the anterior teeth for biting, as a result of increased pressure on the anterior ridge may lead to the anterior hyperfunction syndrome.CASE REPORT: The patient requested dental rehabilitation in our clinic for prosthetic dentistry two and a half years ago. We examined him and made therapy plan, for complete removable maxillary denture and partial mandibular denture. Besides our instructions for proper use of dentures and necessity for regular controls, his next visit was after two and a half years. He came with enlarged tuberosity and papillary hyperplasia in the pre-maxillary region. After oral surgery treatment (laser removing of hyperplastic tissue) and a healing period of four weeks, we made indirect relining on the upper denture, re-occlusion and re-articulation achieving weak contacts between the lower natural teeth and upper teeth of the complete denture. The patient was advised not to bite food with his anterior teeth, and avoid chewing very hard food which tends to imprint and displace dentures.CONCLUSION: Anterior hyperfunction syndrome with its high incidence is a disease with the need of interdisciplinary therapy approach. Fast diagnosis, thorough clinical examination using all available diagnostic tools, and choosing the right treatment is very challenging.

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Giant Lipoma Presents from the Buccal Vestibule

Case Reports in Dentistry ◽

10.1155/2020/8824548 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Yuki Sakamoto ◽

Gohei Oyama

Keyword(s):

Benign Tumor ◽

Oral Surgery ◽

Detailed Examination ◽

Benign Tumors ◽

Neoplastic Lesion ◽

Facial Swelling ◽

Giant Lipoma ◽

Pedunculated Tumor ◽

The Right

A lipoma is a benign tumor, where the parenchyma is composed of adipose tissue. Lipomas comprise 0.1%–5% of all benign tumors in the oral cavity. A 43-year-old man, with a known masticatory disorder, visited the Department of Oral Surgery at our hospital because of a facial swelling. The swelling, which had worsened over 15 years, was not painful, but the patient had discomfort while eating and talking. A detailed examination revealed a smooth, elastic, soft, circular, and yellowish pink pedunculated tumor-like lesion, with a diameter of approximately 40 mm, on the right buccal mucosa. An oval-shaped neoplastic lesion with a well-defined border of 40 mm × 20 mm was noted on MRI. Based on these results, the lesion was characterized as being a benign lipoma. The tumor was resected under local anesthesia. The pedunculated tumor was excised with an electric knife, and the wound was sutured. No trismus or paresthesia was noted on the postoperative follow-up.

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Discovery of anatomic variant of saphenous nerve from human cadaver dissection

Journal of Morphological Sciences ◽

10.4322/jms.081514 ◽

2016 ◽

Vol 33 (01) ◽

pp. 005-007

Author(s):

U. Ahmad ◽

A. San ◽

C. See ◽

C. Taib ◽

M. Moklas ◽

...

Keyword(s):

Sensory Nerve ◽

Saphenous Nerve ◽

Human Anatomy ◽

Sartorius Muscle ◽

Anatomical Variant ◽

Motor Branch ◽

Adductor Canal ◽

Medial Side ◽

Male Cadaver ◽

The Right

Abstract Introduction: Saphenous nerve is the longest and largest pure sensory nerve, supplying the medial side of the thigh, leg and foot. Materials and Methods: In the present case study, during routine cadaveric dissection of the antero-medial part of the thigh, an interesting anomalous pattern of saphenous nerve was seen in the right lower limb of a 62 years old embalmed male cadaver from the Department of Human Anatomy, Universiti Putra Malaysia (UPM). Results: This saphenous nerve can be recognised as an unusual anatomical variant in which it gives a motor branch to the sartorius muscle during traversing the adductor canal and it was accompanied by blood vessels at the same time. The nerve continues its usual course and pierces the fascia lata, between the tendon of sartorius and gracilis and becomes subcutaneous. Conclusion: Knowledge of the variant anatomy of the saphenous nerve is important to surgeon in avoiding nerve injuries during adductor canal nerve block, nerve entrapment surgery, reconstructive surgery, pain management services and knee surgery successfully.

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Ultrasonic Navigation for the Treatment of Medication-Related Jaw Osteonecrosis Involving the Inferior Alveolar Nerve: A Case Report and Protocol Review

Methods and Protocols ◽

10.3390/mps3040070 ◽

2020 ◽

Vol 3 (4) ◽

pp. 70

Author(s):

Gerardo Pellegrino ◽

Francesca Pavanelli ◽

Agnese Ferri ◽

Giuseppe Lizio ◽

Roberto Parrulli ◽

...

Keyword(s):

Inferior Alveolar Nerve ◽

Mandibular Canal ◽

Surgical Removal ◽

Hard Tissue ◽

Anatomical Structures ◽

Osteonecrosis Of The Jaws ◽

Dynamic Navigation ◽

The Right ◽

Ultrasonic Navigation ◽

Protocol Review

Dynamic navigation (DN) is a computer-guided technique employed in different surgical fields and recently adopted in dental implantology to improve the accuracy of dental implant insertion. Medication-related osteonecrosis of the jaws (MRONJ) often requires the surgical removal of the impaired, hard tissue, trying at the same time to spare the healthy tissue and the noble anatomical structures. A case of extensive bilateral medication-related osteonecrosis, with the symptomatic involvement of the right mandibular canal, was successfully resolved with the use of ultrasonic surgery associated with a dynamic navigation, in order to limit the invasiveness of the surgical approach improving its reliability and accuracy. The usefulness of this technology in the management of MRONJ can be considered in future clinical trials to confirm the advantages and standardize the technique.

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