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

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.

scholarly journals Ameloblastic fibro-odontoma associated with paresthesia of the chin and lower lip in a 12-year-old girl

2019 ◽  
Vol 7 ◽  
pp. 2050313X1987064
Author(s):  
Dereen Mohammed Saeed ◽  
Suman Setty ◽  
Michael R Markiewicz ◽  
Robert J Cabay
Keyword(s):  
Panoramic Radiography ◽  
Third Molar ◽  
Mandibular Canal ◽  
Tissue Formation ◽  
Hard Tissue ◽  
Lower Lip ◽  
Odontogenic Epithelium ◽  
Mandibular Third Molar ◽  
Close Proximity ◽  
The Right

Ameloblastic fibro-odontoma is a rare, benign, and slowly growing neoplasm of the jaw composed of proliferating odontogenic epithelium in ectomesenchymal tissue along with dental hard tissue formation. Herein, we describe a case of an ameloblastic fibro-odontoma in 12-year-old female with paresthesia of the chin and lower lip. Panoramic radiography showed a radio-opacity in the right posterior mandible near the mandibular canal and associated with the right mandibular third molar. Histologically, the lesion contained epithelial and mesenchymal odontogenic components in close proximity to odontoma-like elements. Enucleation and curettage of the affected site in the mandible resulted in resolution of the paresthesia postoperatively.

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

2014 ◽  
Vol 18 (3) ◽  
pp. 124-132
Author(s):  
Apostolos N. Eliades ◽  
Kalliopi H. Manta ◽  
Anastasios T. Tsirlis
Keyword(s):  
Case Reports ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Anatomical Variations ◽  
Mandibular Canal ◽  
Terminal Branch ◽  
Anatomical Structures ◽  
Mandibular Foramen ◽  
Anterior Trunk ◽  
Radiological Studies

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

scholarly journals Coronectomy of the wisdom teeth: the dental extraction alternative

2021 ◽  
Vol 3 (59) ◽  
pp. 12-17
Author(s):  
Sergiu Beliniuc ◽  
◽  
Gabriela Motelica ◽  
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Surgical Removal ◽  
Third Molars ◽  
Close Proximity ◽  
Wisdom Teeth ◽  
Low Incidence ◽  
Upper Third ◽  
Surgical Separation

Background. Coronectomy of the wisdom teeth is an alternative surgical procedure to tooth extraction, which aims to preserve the roots of the wisdom teeth in the dental socket after surgical separation of the crown, in order to avoid the injury of the inferior alveolar vascular-nervous bundle. Purpose. Minimizing the damage to the inferior alveolar nerve when extracting lower third molars caused by the intimate relationship between the nerve and the roots of the teeth, by using the technique of coronectomy, or intentional root retention. Material and Methods. Patients who reported to University Dental clinic during the period 2020–2021 for surgical removal of impacted L3M were screened for nerve–root relationship with OPG or CBCT. 15 patients underwent coronectomy as a procedure to remove the crown and upper third of the roots of a lower third molar to reduce the risk of damage to the inferior alveolar nerve. Results. 15 patients were enrolled in this study, with a total of 17 lower third molars. Sixteen sites healed primarily, but in 1 case the sockets on both sides opened and failed to close secondarily. In this case, the root fragments were later removed and found to be mobile. Conclusion. Coronectomies are safer to perform than complete extractions in situations in which the third molar is in close proximity to the mandibular canal. The technique appears to be associated with a low incidence of complications and the removal of remaining roots is required in around 6-7% of cases due to the mesial migration of the fragment and not any symptoms or reinfection.

scholarly journals Occurrence of the Retromolar Foramen in Dry Mandibles of South-Eastern Part of India: A Morphological Study with Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Bhagath Kumar Potu ◽  
Vinod Kumar ◽  
Abdel-Halim Salem ◽  
Marwan Abu-Hijleh
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Molar Tooth ◽  
Review Of The Literature ◽  
South Eastern ◽  
Retromolar Foramen ◽  
Surgical Extraction ◽  
The Right ◽  
First Time

The retromolar foramen (RMF) is a rare anatomical structure situated in the retromolar fossa behind the third molar tooth. When it is present, the foramen is connected with the mandibular canal and is believed to transmit neurovascular structures that provide accessory source to the mandibular molars and the buccal area. Reports from the literature show that the presence of RMF could pose a challenge in complete blockage of the inferior alveolar nerve during mandibular surgeries. We report the incidence of retromolar foramen from ninety-four dry mandibles of south-eastern part of Karnataka State, India. The foramen was observed in 11 mandibles out of 94 included in the study (11.7%). In three mandibles, the foramen was present bilaterally (3.2%) and in three it was on the left side (3.2%) and in five it was on the right side (5.3%). For the first time, we also measured the dimensions of the retromolar area and distance of the foramen from third molar tooth to understand its risks during the surgical extraction of the lower third molar tooth. A thorough review of the literature has also been done to compare the present findings with the studies reported from the various populations.

Computed tomography for the assessment of the potential risk following implant placement in fresh extraction sites in the posterior mandible

2020 ◽  
Author(s):  
Bahaa Haj Yahya ◽  
Gavriel Chaushu ◽  
Yafit Hamzani
Keyword(s):  
Computed Tomography ◽  
High Risk ◽  
Survival Rates ◽  
Inferior Alveolar Nerve ◽  
Primary Stability ◽  
Mandibular Canal ◽  
Anatomical Structures ◽  
Background Factors ◽  
Second Molar ◽  
Immediate Implants

Background and purpose: Immediate implants placement (IIP) are considered a reliable procedure, with survival rates of 94.9% to 98.4%. Nevertheless, in the posterior mandible it poses high risk of damage to anatomical structures. The aim of this study was to determine the risk of anatomical structures injury associated with IIP in the posterior mandible based on apical primary stability, respecting a safe distance from inferior alveolar nerve (IAN) and lingual plate. Moreover, to evaluate the influence of different factors on those risks. Materials and methods: Pre-extraction cone beam computed tomography (CBCT) scans of 100 patients were retrospectively analyzed. Measurements were taken from tooth apices to lingual plate and to mandibular canal. Values of <4mm of the former and <6mm of the later categorized as considerable risk. Values of <2mm at both measurements considered as high risk. Two-sided p values <0.05 were considered statistically significant.  Results: Mean root-to-alveolar canal (RAC) distance was 7.6±2.7mm in the first molar, 6.5±3mm in second premolar and 5.4±3 mm in the second molar ( p <0.005). Mean distance to the outer lingual cortex (DLC) was 3.9±2.1mm in the first molar and 3.2±0.1mm in the second molar. Thus, second molars were at the higher risk of inferior alveolar nerve injury and lingual plate perforation during IIP. Background factors associated with higher IIP risk were female sex and age <40 years. Conclusions: In the mandible, the anatomic risk posed by IIP is greatest for second molars and lowest for first molars. Several background factors affect the distances between root apices and the mandibular canal.

scholarly journals A Remarkable Rare Case of Fractured Endodontic Instrument in Periradicular Region Compressing Inferior Alveolar Nerve

2018 ◽  
Vol 2 (1) ◽  
pp. 76
Author(s):  
Zainab Chaudhry ◽  
Rakesh Sharma ◽  
Ambica Khetarpal ◽  
Sarika Chaudhary ◽  
Sangeeta Talwar
Keyword(s):  
Rare Case ◽  
Inferior Alveolar Nerve ◽  
Mandibular Canal ◽  
Neurological Symptoms ◽  
Endodontic Treatment ◽  
Surgical Removal ◽  
Second Molar ◽  
Iatrogenic Injuries ◽  
Mandibular Second Molar

This study aims to present the management of a rare case of a separated endodontic instrument in the periradicular area. The broken instrument had penetrated within and along the mandibular canal from the periapical zone of mandibular second molar after endodontic treatment, leading to acute neurological symptoms. These subsided completely following surgical removal of the separated instrument. Because of the close anatomic relation between the second molars and the inferior alveolar nerve, careful clinical and radiographic examinations should always be performed before endodontic treatment of these teeth, so as to prevent iatrogenic injuries of the type described here. Dentists should also be aware of the anatomic characteristics of the mandibular canal (i.e., cribriform rather than solid), as well as the consequences of overinstrumentation.

Right Ventricle Mass Removal from Tricuspid Valve Apparatus: An Unusual Thromboembolic Complication of Severe Ketoacidosis

2016 ◽  
Vol 19 (2) ◽  
pp. 077
Author(s):  
Ireneusz Haponiuk ◽  
Maciej Chojnicki ◽  
Konrad Paczkowski ◽  
Wojciech Kosiak ◽  
Radosław Jaworski ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Tricuspid Valve ◽  
Mild Hypothermia ◽  
Heart Function ◽  
Thromboembolic Complication ◽  
Surgical Removal ◽  
Unusual Complication ◽  
Type I ◽  
Definitive Therapy ◽  
The Right

The presence of a pathologic mass in the right ventricle (RV) may lead to hemodynamic consequences and to a life-threatening incident of pulmonary embolism. The diagnosis of an unstable thrombus in the right heart chamber usually necessitates intensive treatment to dissolve or remove the pathology. We present a report of an unusual complication of severe ketoacidosis: thrombus in the right ventricle, removed from the tricuspid valve (TV) apparatus. A four-year-old boy was diagnosed with diabetes mellitus (DM) type I de novo. During hospitalization, a 13.9 × 8.4 mm tumor in the RV was found in a routine cardiac ultrasound. The patient was referred for surgical removal of the floating lesion from the RV. The procedure was performed via midline sternotomy with extracorporeal circulation (ECC) and mild hypothermia. Control echocardiography showed complete tumor excision with normal atrioventricular valves and heart function. Surgical removal of the thrombus from the tricuspid valve apparatus was effective, safe, and a definitive therapy for thromboembolic complication of pediatric severe ketoacidosis.<br /><br />

scholarly journals 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 ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 406 ◽  
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.

scholarly journals Evaluation of Panoramic Radiographs in Relation to the Mandibular Third Molar and to Incidental Findings in an Adult Population

2020 ◽  
Author(s):  
Josefine Cederhag ◽  
Nina Lundegren ◽  
Per Alstergren ◽  
Xie-Qi Shi ◽  
Kristina Hellén-Halme
Keyword(s):  
Incidental Findings ◽  
Adult Population ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Patient Positioning ◽  
Vertical Position ◽  
Surgical Removal ◽  
Third Molars ◽  
Panoramic Radiographs ◽  
The Third

Abstract Objectives The aim was to evaluate the characteristics of the mandibular third molars, especially in relation to the inferior alveolar nerve. Further aims were to investigate incidental findings in panoramic radiographs in an adult population, and to investigate image quality related to patient positioning. Materials and Methods From a previous study with 451 randomly selected adult participants who lived in Sweden, 442 panoramic radiographs from four dental public health clinics were used. The third molars’ characteristics and relation to inferior alveolar nerve were evaluated. Incidental findings and patient positioning were recorded. Statistical Analysis Frequency analysis was used to investigate the occurrence of all findings and their possible interconnections. Whether the patients’ age or gender had an impact or not was also analyzed. Results The third molars were erupted in vertical position among 73% regardless of age. When retained or semi-retained, they were most commonly in mesioangular positions. The inferior alveolar nerve was located inferior to the roots in 52%, whereas an overlapped position was most common if the third molar was retained (90%), semi-retained (83%) or the age was less than 30 years (66%). Common incidental findings were apical radiolucencies, idiopathic osteosclerosis, and tooth fragments. Suboptimal patient positioning was found in one-third of the radiographs. Conclusions Panoramic radiography is a useful method to evaluate third molar prior to surgical removal and may be the only image required. Most incidental findings on panoramic radiographs does not seem to require any further odontological management.

scholarly journals Development of Stage 4 Macular Hole after Spontaneous Closure in a Patient with Stage 2 Macular Hole and a Lamellar Macular Hole-Associated Epiretinal Proliferation

2021 ◽  
pp. 481-484
Author(s):  
Masahisa Watanabe ◽  
Harumasa Yokota ◽  
Hiroshi Aso ◽  
Hirotsugu Hanazaki ◽  
Junya Hanaguri ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Hole ◽  
Spontaneous Closure ◽  
Surgical Removal ◽  
Lamellar Macular Hole ◽  
Full Thickness ◽  
Stage 4 ◽  
Full Thickness Macular Hole ◽  
The Right ◽  
Hole Closure

Herein, we report the longitudinal observation of a case with reopening of the macular hole associated with a lamellar macular hole-associated epiretinal proliferation (LHEP) followed by spontaneous closure in patients with stage 2 idiopathic macular hole. A 64-year-old woman was referred for the decreased visual acuity (VA) and acute anorthopia in the right eye. Funduscopy and optical coherence tomography (OCT) showed stage 2 full-thickness macular hole without posterior vitreous detachment (PVD) and operculum formation. Her best-corrected visual acuity (BCVA) was 20/32. One month later, the diameter of the macular hole was getting small and VA improved. Six months later, the macular hole was treated spontaneously with the attached hyaloid membrane to the macula by OCT and the BCVA improved to 20/20. Fourteen months after the first visit, the BCVA decreased to 20/50 and the patient was diagnosed with stage 4 macular hole with complete PVD. OCT showed full-thickness macular hole with a LHEP in the right eye. After 25G-gauge vitrectomy with the peeling of internal limiting membrane (ILM) and LHEP, the macular hole was closed and BCVA finally improved to 20/25. Spontaneous macular hole closure without PVD may rarely occur in patients with LHEP. The surgical removal of ILM and LHEP may contribute to the successful macular hole closure after vitrectomy.

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