Panhypopituitarism and bifid uvula / Journal of the ASEAN Federation of Endocrine Societies

@#A 20-year-old male was referred to the Endocrinology Clinic in view of abnormal thyroid function test result and poor development of secondary sexual characteristics. He was born out of non-consanguineous marriage and had a history of breech delivery at term. He had perinatal complications in the form of delayed cry and lower respiratory tract infection. Developmental delay was also present (delayed motor, speech and social milestones). His scholastic performance was below average and he reported being the shortest child in class from kindergarten.

Mutations of PTCH1 gene in two pedigrees with bifid rib-basal cell nevus-jaw cyst syndrome / 浙江大学学报·医学版

Two male patients with bifid rib-basal cell nevus-jaw cyst syndrome (BCNS) were admitted to Department of Stomatology, the First Affiliated Hospital of Bengbu Medical College due to radiological findings of multiple low density shadows in the jaw. Clinical and imaging findings showed thoracic malformation, calcification of the tentorium cerebellum and falx cerebrum as well as widening of the orbital distance. Whole exon high-throughput sequencing was performed in two patients and their family members. The heterozygous mutations of c.C2541C>A(p.Y847X) and c.C1501C>T(p.Q501X) in PTCH1 gene were detected in both patients. Diagnosis of BCNS was confirmed. The heterozygous mutations of PTCH1 gene locus were also found in the mothers of the two probands. Proband 1 showed clinical manifestations of low intelligence, and heterozygous mutations of c.C2141T(p.P714L) and c.G3343A(p.V1115I) were detected in FANCD2 gene. Proband 2 had normal intelligence and no FANCD2 mutation. The fenestration decompression and curettage of jaw cyst were performed in both patients. Regular follow-up showed good bone growth at the original lesion, and no recurrence has been observed so far.

Clinical Efficacy of Bifid Triple Viable Capsules for Chemotherapy-induced Diarrhea: A Meta-analysis / 胃肠病学

Background: Chemotherapy-induced diarrhea (CID) is a major challenge during chemotherapy, which not only affects the quality of life, but also reduces the effectiveness of chemotherapy. Aims: To evaluate the clinical efficacy of Bifid triple viable capsules in the treatment of CID in malignant tumors by using meta - analysis. Methods: Randomized controlled trials (RCTs) on Bifid triple viable capsules for the treatment of CID were retrieved from CNKI, Wanfang, VIP, China Biology Medicine disc, Chinese Clinical Trial Registry, PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrails databases from the date of database establishment to December 2022. According to the inclusion and exclusion criteria, literatures were screened, extracted, and the quality of literature was evaluated. Meta - analysis was performed by using Stata/MP 14.0 software. Results: A total of 10 RCTs including 790 patients were enrolled. Meta - analysis results showed that efficacy of Bifid triple viable capsules in the treatment of CID was significantly increased than that of controls (OR=2.22, 95% CI: 1.69 - 2.92, P<0.000 1), and serum endotoxin, tumor necrosis factor - α, D - lactic acid, diamine oxidase were significantly decreased in Bifid triple viable capsules group than in controls (P<0.05). Conclusions: The addition of Bifid triple viable capsules adjuvant to the original symptomatic treatment of CID can optimize the treatment efficacy.

Imaging study of the mandibular forward canal in adults based on cone beam CT / 口腔疾病防治

Objective @#To explore the imaging characteristics of the mandibular nerve canal in adults to provide a reference for clinical mandibular surgery.@*Methods@# One thousand adult patients in Guiyang Stomatological Hospital from January 2018 to January 2021 were randomly selected. Cone beam CT (CBCT) was used to observe the anterior mandibular canal and other branches, and the incidence of anterior canal in the mandibular ramus area, posterior molar area and molar area and the distance to each point of the mandible were measured.@*Results@#Of the 901 patients (1 802 sides) included in the study, 386 patients (42.84%) found branches of the mandibular canal, and 182 patients (97 males and 85 females) found the Anterograde Canal 20.20% (182/901). In total, 225 mandibles were found to have anterior canals. There were 101 cases of left mandible and 124 cases of right mandible. The forward canal mainly occurred in the molar area, the molar posterior area and the ascending branch area, and the ascending branch area was the best starting point of the forward canal and the molar stopping point (P < 0.05). The average length of the forward canal (L1) was (10.364 ± 3.833) mm, the average height of the forward canal to the main trunk of the mandibular nerve (L2-RRB) was (3.623 ± 2.035) mm, and the average height of the forward canal to the crest of the alveolar ridL3 (l3) was (9.280 ± 3.240) mm.@*Conclusion@#Mandibular nerve canal branches are common, and there were no differences in male, female and lateral distribution. In this study, the incidence of mandibular anterior canal was the highest, and it often occurred in the molar area.

Treatment of bifid ribs by gasless endoscopy using lift device / 中华胸心血管外科杂志

Objective:Gasless laparoscopic surgery using lifting device was first introduced in 1993 mainly for general surgery and gynecology. Here we report its application in bifid rib treatment and explore the feasibility and safety of the surgery.Methods:From July 2008 to December 2019, according to the enrollment criteria, 278 patients of bifid ribs were treated at the Department of Thoracic Surgery, Beijing Children’s Hospital, Capital Medical University, including 183 males and 95 females, the mean age was(5.7±2.5) years old. There were 242 cases of single bifid rib and 36 cases of multiple bifid ribs. The bifid ribs were more common on the right side, as 184 cases had bifid ribs on right side, while only 68 cases on the left side and 26 cases on both sides. Patients’ clinical data were retrospectively summarized and analyzed, including the patients’ gender, age, location and type of bifid rib, perioperative outcome, and follow-up.Results:All the 278 patients successfully completed the operation. The abnormality was most frequently found in the fifth rib(incidence ranking: fifth > fourth > third > sixth). The mean operation time was(64.5±16.1)min, and the mean blood loss was(4.8±2.1)ml. No serious complications occurred during the surgery. Follow-up was done for 7 to 120 months, and no recurrent patients were observed.Conclusion:Gasless endoscopy with lifting device has been used as a safe and effective method to treat bifid ribs in our hospital. This surgery leads to less injury, smaller incision, and no scars on the front chest. Gasless endoscopic surgery with lifting device can be one of the options for correcting bifid ribs.

Popliteal pterygium syndrome: case report from rural India

The popliteal pterygium syndrome is a congenital malformation that includes orofacial, musculoskeletal and genitourinary anomalies. It is also known as faciogenitopopliteal syndrome. It is autosomal dominant disorder. It has highly variable expressivity and incomplete penetrance. The incidence of the popliteal pterygium syndrome is 1/300000, which makes it an extremely rare condition. The most striking characteristic of this syndrome is popliteal pterygium, which consists of a net of connective tissue spreading from the ischial tuberosity to the calcaneus.In this study, authors present the case of a 1 day old male patient with cleft upper lip, cleft palate, bifid scrotum, popliteal pterygium and congenital talipes equinovarus (CTEV).

Duplex kidney anomalies and associated pathology: a single centre retrospective review

Background: Duplex kidneys are common developmental renal anomaly with an incidence of 1% in healthy adult population.Adult individuals may present as non-functional moiety, calculus disease or an incidental finding. Duplex kidney is defined as a renal unit comprised of two pelvicalyceal systems. Based on the degree of fusion, it can present as bifid renal pelvis, partial ureteric duplication (Y-shaped ureter), incomplete ureteric duplication with ureters joining near or in bladder wall (V-shaped ureter) and complete ureteric duplication with separate ureteric orifices. The purpose of this study is to retrospectively review the various duplex kidney anomalies and associated pathology.Methods: This is a retrospective study, performed at Department of Urology, Gauhati Medical College Hospital, a tertiary centre, from September, 2018 to August, 2019. Preoperative imaging, plain intravenous urography or computed tomography intravenous urography was done.Results: 29 patients were diagnosed with variants of duplex kidney anomaly. It includes right side, left side and bilateral anomalies. Among all the patients 4 had incidental findings. 16 patients had associated renal or ureteral calculus. 5 patients had associated ureteropelvic junction obstruction while 1 patient had ureterovesical junction stricture. We found single patient in each group of duplex kidney anomaly associated with non-functional moiety with renal cell carcinoma, ureterocele with urothelial malignancy and horseshoe kidney with ureteropelvic junction obstruction respectively.Conclusions: Duplex kidney anomaly in most individuals is of no clinical significance. High index of suspicion along with good quality imaging can accurately detect specific anomaly and associated condition.

Incidence of bifid uvula and its relationship to submucous cleft palate and a family history of oral cleft in the Brazilian population / Incidence of bifid uvula and its relationship to submucous cleft palate and a family history of oral cleft in the Brazilian population

Abstract Introduction: Bifid uvula is a frequently observed anomaly in the general population and can be regarded as a marker for submucous cleft palate. Objective: In this study aimed to determine the frequency of bifid uvula and submucous cleft palate and their relationship with oral clefts in a Brazilian population. Methods: We conducted a transversal, descriptive and quantitative study of 1206 children between August 2014 and December 2015. A clinical examination of the children was conducted by means of inspection of the oral cavity with the aid of a tongue depressor and directed light. After the clinical examination in children, parents answered a questionnaire with questions about basic demographic information and their family history of oral clefts in their first-degree relatives. After application of the questionnaires, the information collected was archived in a database and analyzed by the statistical program SPSS® version 19.0, by applying Chi-Square tests. Values with p < 0.05 were considered statistically significant. Results: Of the 1206 children included in this study, 608 (50.40%) were female and 598 (49.60%) were male (p = 0.773). The average age of children was 3.75 years (standard deviation ± 3.78 years). Of the 1206 children studied, 6 (0.5%) presented with bifid uvula. Submucosal cleft palate was not found in any child. When the family histories of children were examined for the presence of nonsyndromic cleft lip and/or cleft palate, no first degree relatives presented with the congenital anomaly. Conclusion: This study revealed that the incidence of bifid uvula and submucous cleft palate in this population was quite similar to previously reported incidence rates. Our study suggests an intensification of new reviews, with broader and diverse populations, seeking to associate the occurrence of bifid uvula, submucous cleft palate and oral clefts.

Resumo: Introdução: A úvula bífida é uma anomalia frequentemente observada na população em geral e pode ser considerada como um marcador de fissura palatina submucosa. Objetivo: Determinar a frequência de úvula bífida e fissura palatina submucosa e sua relação com fissura orais em uma população brasileira. Método: Realizamos um estudo transversal, descritivo e quantitativo de 1.206 crianças entre agosto de 2014 e dezembro de 2015. O exame clínico das crianças foi realizado por meio da inspeção da cavidade oral com auxílio de um abaixador de língua e luz direcionada. Após o exame clínico nas crianças, os pais responderam a um questionário com perguntas sobre informações demográficas básicas e antecedentes de fendas orais em familiares de primeiro grau. As informações coletadas foram arquivadas em um banco de dados e analisadas pelo programa estatístico SPSS® versão 19.0, aplicando testes de Qui-Quadrado. Os valores com p < 0,05 foram considerados estatisticamente significativos. Resultados: Das 1.206 crianças incluídas neste estudo, 608 (50,40%) eram do gênero feminino e 598 (49,60%) do masculino (p = 0,773). A idade média das crianças foi de 3,75 anos (desvio-padrão ± 3,78 anos). Das 1.206 crianças estudadas, seis (0,5%) apresentavam úvula bífida. A fissura palatina submucosa não foi encontrada em nenhuma criança. Quando as histórias familiares de crianças foram examinadas quanto à presença de fissura de lábio e/ou palato não sindrômica, nenhum parente de primeiro grau apresentava esta anomalia congênita. Conclusão: Este estudo revelou que a incidência de úvula bífida e fissura palatina submucosa nesta população é bastante semelhante às taxas de incidência previamente relatadas. Nosso estudo sugere uma intensificação de novas revisões, com populações mais amplas e diversas, buscando associar a ocorrência de úvula bífida, fissura palatina submucosa e fissura orais.

The observation of bifid mandibular canals using cone beam computed tomography / 口腔疾病防治

Objective@#To investigate the prevalence of bifid mandibular canals (BMC), and to measure their diameter and angle. @*Methods @#CBCT images of 500 patients were used for this study. The incidence and types of bifid mandibular canals were recorded according to a modified classification of Naitoh: Ⅰ, retromolar canal; Ⅱ, dental canal; Ⅲ, forward canal; Ⅳ buccolingual canal. The diameter and angle between the accessory canal and the main mandibular canal were recorded.@*Results@#Bifid mandibular canals were found in 32.2% of the 1 000 hemi- mandibles, with the incidence rate of 52.17%, 36.02%, 6.21%, 5.59% in TypeⅠ, Ⅱ, Ⅲ, Ⅳ respectively. There are 90 cases of the mandibular branch with a diameter greater than or equal to the backbone 1/2, and 100 cases that are less than 1/2 of the backbone. The angle between the mandibular branch and the trunk Ⅰ, Ⅱ and Ⅲ were 50.21° ± 22.25°、28.81° ± 11.5° and 13.50° ± 2.39° respectively. @*Conclusion @#Bifid mandibular canals were observed at a relatively high incidence using CBCT, and the most common type was the retromolar canal. It is suggested CBCT should be taken before mandibular surgery to give an accurate evaluation of bifid mandibular canals.

The observation of bifid mandibular canals using cone beam computed tomography / 口腔疾病防治

Objective@# To investigate the prevalence of bifid mandibular canals (BMC), and to measure their diameter and angle.@*Methods @# CBCT images of 500 patients were used for this study. The incidence and types of bifid mandibular canals were recorded according to a modified classification of Naitoh: Ⅰ, retromolar canal; Ⅱ, dental canal; Ⅲ, forward canal; Ⅳ buccolingual canal. The diameter and angle between the accessory canal and the main mandibular canal were recorded. @*Results @#Bifid mandibular canals were found in 32.2% of the 1 000 hemi- mandibles, with the incidence rate of 52.17%, 36.02%, 6.21%, 5.59% in TypeⅠ, Ⅱ, Ⅲ, Ⅳ respectively. There are 90 cases of the mandibular branch with a diameter greater than or equal to the backbone 1/2, and 100 cases that are less than 1/2 of the backbone. The angle between the mandibular branch and the trunk Ⅰ, Ⅱ and Ⅲ were 50.21° ± 22.25°、28.81° ± 11.5° and 13.50° ± 2.39° respectively. @*Conclusion@#Bifid mandibular canals were observed at a relatively high incidence using CBCT, and the most common type was the retromolar canal. It is suggested CBCT should be taken before mandibular surgery to give an accurate evaluation of bifid mandibular canals.

Are you prepared for pancreas bifidum? A case report

Pancreas divisum—failure of fusion of the dorsal and ventral pancreatic ducts—is relatively well known as the most common congenital anomaly of the pancreatic duct, of with an incidence approximately 10% of all embryos. And there is a rare anomaly similar to pancreas divisum in which doubled ducts are formed. This condition is a rare developmental anomaly called pancreas bifidum or bifid pancreas or fish tail pancreas. This report describes a patient with pancreas bifidum who had 2 separated ducts within the pancreas from tail to neck but did not have a separated parenchyma. We hope that this report helps pancreatic surgeons to have knowledge of pancreas bifidum and helps them to be prepared for this anatomical variant.

Sonographic Findings of the Bifid Median Nerve and Persistent Median Artery in Carpal Tunnel: A Preliminary Study in Chinese Individuals

OBJECTIVE: The aim of this study was to investigate the prevalence of anatomic variations of the bifid median nerve, persistent median artery and persistent median vein in Chinese individuals and their relationship with carpal tunnel syndrome. METHODS: One hundred and sixty median nerves were examined using ultrasonography and colour Doppler ultrasonography. The location, shape, and size of the bifid median nerve, persistent median artery and persistent median vein were recorded. The cross-sectional area of the bifid median nerve (two trunks) was measured at the level of the pisiform. RESULTS: Among the 160 wrists examined, a bifid median nerve was observed in 15 (9.4%) wrists, and a persistent median artery was observed in 12 (7.5%) wrists. These two variations either coexisted or were observed independently, and the probability of coexistence (6.3%) was higher than the probability of existing independently (bifid median nerve only 3.1%, persistent median artery only 1.3%). The cross-sectional area of the radial trunk was greater than (13 in 15, 86.7%) the cross-sectional area of the ulnaris trunk. Persistent median vein was observed in 9 wrists (5.6%). CONCLUSIONS: The persistent median artery and bifid median nerve tend to coexist, and the persistent median vein sometimes runs parallel to the persistent median artery. Their positional relationship in carpal tunnel is uncertain, and thus, preoperative ultrasound is necessary. These three variations do not present any additional risk for the development of carpal tunnel syndrome.

Effect of Bifid Triple Viable Capsules Adjuvant Tharapy and Influence on Inflammation Cytokine in Type 2 Diabetes Mellitus / 中国药师

Objective:To investigate the clinical effect of probiotics adjuvant therapy and influence on inflammation in the patients with type 2 diabetes mellitus (T2DM). Methods:Totally 102 patients with T2DM were divided into probiotics group (n=53) and the control group (n=49)according to the odd-even admission number. The control group received metformin tablets of 0. 5g,po,tid,pro-bioties group received bifid triple viable capsules of 0. 42g,po,tid additionally, and the treatment course was 8 weeks. Before and after the treatment, the levels of fructosamine(FMN), fasting bloodglucose(FBG),HbA1c,and the serum levels of TNF-αand adiponectin were determined, and the adverse reactions were recorded. Results:After the treatment, the levels of FMN, FBG, HbA1c and TNF-αof the two groups were significantly decreased than before, and adiponectin was significantly increased than before (P<0. 05); com-pared with those of the control group, the indicators mentioned above were improved more greatly in probiotic group (P<0. 05). There were no obvious adverse reactions appeared in both groups. Conclusion:Probiotics is beneficial to glycemic control, and the mecha-nism is related to reducing inflammation.

Effect of bifid triple viable tablets combined with montmorillonite powder in the prognosis of children with diarrhea / 中国生化药物杂志

Objective To study the effect of Bifid Triple Viable tablets combined with montmorillonite powder in the prognosis of children with diarrhea.Methods100 cases of diarrhea patients from October 2015 to December 2016 were selected.The patients were divided into control group and observation group.The control group was treated with Bifid Triple Viable tablets.The observation group was treated with Bifid Triple Viable tablets combined with montmorillonite powder treatment, compared the two groups of patients with the indicators and treatment.ResultsThe indexes of the observation group were better than the control group, the difference between the groups were statistically significant (P<0.05).The total effective rate (98.00%) in the observation group, which was significantly higher than that in the control group (78.00%), the difference between the groups were statistically significant(P<0.05).ConclusionThe combination of Bifid Triple Viable tablets combined with montmorillonite powder in the treatment of diarrhea patients can effectively improve the prognosis of patients and accelerate the remission time of patients, which is worth applying.

Bifid Cardiac Apex in an Old Woman

No abstract available.

Effect of Bifid Triple Viable Capsules Adjuvant Tharapy and Influence on Inflammation Cytokine in Type 2 Diabetes Mellitus / 中国药师

Objective:To investigate the clinical effect of probiotics adjuvant therapy and influence on inflammation in the patients with type 2 diabetes mellitus (T2DM). Methods:Totally 102 patients with T2DM were divided into probiotics group (n=53) and the control group (n=49)according to the odd-even admission number. The control group received metformin tablets of 0. 5g,po,tid,pro-bioties group received bifid triple viable capsules of 0. 42g,po,tid additionally, and the treatment course was 8 weeks. Before and after the treatment, the levels of fructosamine(FMN), fasting bloodglucose(FBG),HbA1c,and the serum levels of TNF-αand adiponectin were determined, and the adverse reactions were recorded. Results:After the treatment, the levels of FMN, FBG, HbA1c and TNF-αof the two groups were significantly decreased than before, and adiponectin was significantly increased than before (P<0. 05); com-pared with those of the control group, the indicators mentioned above were improved more greatly in probiotic group (P<0. 05). There were no obvious adverse reactions appeared in both groups. Conclusion:Probiotics is beneficial to glycemic control, and the mecha-nism is related to reducing inflammation.

Bilateral triad of persistent median artery, a bifid median nerve and high origin of its palmar cutaneous branch: a case report and clinical implications / Tríada bilateral correspondiente a arteria mediana persistente, nervio mediano bífido y origen alto de la rama cutánea palmar: reporte de caso e implicancias clínicas

We report the association of a persistent median artery, a bifid median nerve with a rare very high origin palmar cutaneous branch, presenting bilaterally in the upper limb of a 75-year-old female cadaver. The persistent median nerve with a bifid median nerve has been reported in patients presenting with carpal tunnel syndrome. Reports of this neurovascular anomaly occurring in association with a high origin palmar cutaneous branch however, are few. This subset of patients is at risk of inadvertent nerve transection during forearm and wrist surgery. Pre-operative magnetic resonance imaging (MRI) and high resolution sonography (HRS) can be used to screen this triad. MRI can reveal if the patient's disability is associated with a persistent median nerve, a bifid median nerve. HRS can help identify a palmar cutaneous branch of the median nerve that arises in an unexpected high forearm location. Such knowledge will help surgeons in selecting the most appropriate surgical procedure, and help avoid inadvertent injury to cutaneous nerves arising in unexpected locations. In patients presenting with a bilateral carpal tunnel syndrome, hand surgeons should consider very high on the list of differential diagnosis a persistent median artery with a concomitant bifid median nerve, with a high suspicion of a possible bilateral occurrence of a bilaterally high arising palmar cutaneous branch of the median nerve.

En este estudio se presenta la disposición bilateral de una arteria mediana persistente, un nervio mediano bífido con ramo cutáneo palmar de origen alto, en los miembros superiores de un cadáver de sexo femenino de 75 años de edad. Clínicamente se asocia la presencia del nervio mediano bífido en pacientes con síndrome de túnel carpiano. Sin embargo, son escasos los informes de esta anomalía neurovascular en asociación con un ramo cutáneo palmar del nervio mediano de origen alto. Este subconjunto de pacientes podría sufrir de transección del nervio durante la cirugía de antebrazo y de la muñeca. Se recomienda utilizar la imagen preoperatoria de resonancia magnética (RM) y sonografía de alta resolución (SAR) para detectar esta tríada. La RM puede revelar si la discapacidad del paciente se asocia con un nervio mediano persistente, un nervio mediano bífido. SAR puede ayudar a identificar un ramo cutáneo palmar del nervio mediano que surge en una situación alta del antebrazo en forma inesperada. Tal conocimiento ayudará a los cirujanos en la selección del procedimiento quirúrgico más apropiado, y a evitar una lesión inadvertida de nervios cutáneos que surgen en lugares inesperados. En los pacientes que presentan un síndrome del túnel carpiano bilateral, los cirujanos de mano deben considerar como prioridad en la lista de diagnóstico diferencial una arteria mediana persistente con un nervio mediano bífido concomitante, con una alta sospecha de una posible aparición bilateral de un ramo cutáneo palmar bilateral alto que surja del nervio mediano.

Classificação e prevalência das alterações do canal mandibular através de exames de tomografia computadorizada de feixe cônico / Classification and prevalence of changes mandibular canal through examination of cone beam computed tomography

As cirurgias odontológicas que envolvem estruturas adjacentes ao canal mandibular requerem exato conhecimento do curso intraósseo dessa estrutura anatômica e suas variações, reduzindo os riscos de injúrias a esse local. Esta pesquisa teve como objetivo verificar a prevalência e classificação das alterações do canal mandibular por meio da análise de imagens de TCFC. A amostra foi composta por 300 tomografias obtidas no banco de dados da Faculdade São Leopoldo Mandic, Campinas-SP. Dos 300 pacientes pesquisados, 90 apresentaram alterações no canal mandibular, ou seja, nos 39 do gênero masculino e nas 51 do gênero feminino, estes somaram 129 condutos acessórios. Em (66,7%), o direcionamento era para mesial ou anterior (classe B), enquanto em (19,4%), a trajetória era no sentido retromolar (classe D). Por outro lado, as classificações E (sentido lingual) e F (sentido para inferior ou base da mandíbula) foram observadas, respectivamente, em (4,6%) e (9,3%) dos casos. Em nenhum caso, foi notada a presença de canais bífidos classificados como classe A (sentido vestibular) ou C (sentido alveolar ou superior). De acordo com os resultados obtidos nesse estudo, encontrou-se uma prevalência de 30% de canais mandibulares bífidos; o tipo de canal bífido mais prevalente foi classe B para mesial ou anterior, e a maior ocorrência dos canais mandibulares bífidos foi bilateral.

The dental surgery involving structures adjacent to the mandibular canal, require accurate knowledge of intraosseous course of this anatomical structure and its variations, reducing the risk of injuries to this site. This research aimed to determine the prevalence of mandibular bifidus channels through analysis (CBCT). The sample comprised 300 CT scans obtained in the database of Radiology and Imaging Department of the Faculty São LeopoldoMandic, Campinas- SP. Was drawn a cutting plane accompanying the bone edge of each patient to obtain the cross section. Of the 300 patients surveyed, 188 (62.7%) were female and 112 gender (37.3%) were male. The age range of patients was comprised of 13 to 87 years of age Changes in the mandibular canal were observed in 90 patients representing (30.0%) of the sample, this total met 51 women (56.7%) and 39 men (43.3%). Regarding side affected by the change, it was found the following percentages right sides 32.2%, left 24.5% and bilateral occurrence were found in 43.3% of cases. According to the results obtained in this study, we found a prevalence of 30% of bifid mandibular canals, bifid canal type most prevalent was class B mesial or earlier and the higher incidence of mandibular bifidus canals was bilateral.

Características tomográficas de la bifurcación del conducto dentario inferior

Objetivos: Evaluar las características tomográficas de la bifurcación del conducto dentario inferior (BCDI) mediante tomografía computarizada de haz cónico (TCHC). Material y Métodos: Se revisaron 1497 TCHC (527 hombres y 970 mujeres) del servicio de Radiología Oral y Maxilofacial de la Facultad de Estomatología de la Universidad Peruana Cayetano Heredia, periodo 2011 - 2014. El análisis de imágenes se realizó utilizando el software Galileos 1.7.2. El rango etario estuvo comprendido entre 10 a 89 años, con una media de 44.8 ± 14 años. Asimismo se utilizó la clasificación de Naitoh, Hiraiwa, Aimiya y Ariji. El análisis estadístico se realizó mediante el uso de la prueba chi-cuadrado. Resultados: La frecuencia de la BCDI fue del 10.75% (161 casos). Se encontró mayor frecuencia en la quinta década de vida para ambos sexos, no hubo diferencia estadísticamente significativa entre el sexo femenino y masculino (p=0.49). La distribución de la BCDI evidenció que el tipo Canal retromolar representó el 64% (103 casos), seguido del tipo Canal sin confluencia anterior con 21.1% (34 casos) y minoritariamente el Canal dental y Canal con confluencia anterior con un 9.9% (16 casos) y 5% (8 casos) respectivamente. Conclusiones: La BCDI tiene una prevalencia del 10.75% y la TCHC permite identificar oportunamente esta variante anatómica

Objectives: To evaluate the tomographic characteristics of the bifurcation of the mandibular canal (BCDI) using cone beam computed tomography (CBCT). Material and Methods: 1497 CBCT were reviewed (from 527 men and 970 women), of the Department of Oral and Maxillofacial Radiology, from Universidad Peruana Cayetano Heredia, period 2011 - 2014. Image analysis were made using the software 1.7.2 Galilee. Patients age was between 10 to 89 years old, averaging 44.8 ± 14 years. Naitoh classification, Hiraiwa, Aimiya and Ariji was also used. Statistical analysis was made by using the chi-square test. Results: The frequency of BCDI was 10.75% (161 cases). The highest frequency was found in the fifth decade of life for both sexes, there wasn't statistically significant difference between female and male sex (p=0.49). The distribution of the BCDI showed that the kind Canal retromolar represents 64% (103 cases), followed by the type Canal without previous confluence with 21.1% (34 cases) and minority was found the dental Canal and Canal above confluence with 9.9% (16 cases) and 5% (8 cases) respectively. Conclusions: The bifurcation of mandibular canal has a prevalence of 10.75% and CBCT allows timely identification of this anatomical variant.

Avaliação da ocorrência de ramificações dos canais mandibulares em regiões afetadas ou não por inflamação por meio de tomografia computadorizada de feixe cônico / Mandibular canal branching and dental inflammation assessed through cone beam computed tomography

O canal mandibular precisa ser considerado em diversos procedimentos odontológicos, com vistas a evitar injúrias do nervo alveolar inferior. A ocorrência de variações anatômicas do canal mandibular aumenta o risco de lesões neurovasculares. Sensibilidade aumentada e falhas em procedimentos anestésicos em mandíbulas, especialmente em casos com inflamação, também podem estar relacionadas com alterações da inervação local. Este estudo visou avaliar a ocorrência de ramificações dos canais mandibulares em regiões afetadas por inflamação dentária, por meio de tomografia computadorizada de feixe cônico (TCFC), com o intuito de verificar se há algum relacionamento entre ramificações e inflamação. Uma base de dados de 2.484 TCFCs foi revisada para identificar ramificações dos canais mandibulares e inflamação dentária. A amostra final foi pareada para idade e gênero. As ramificações próximas aos dentes posteriores foram consideradas como variável dependente. A ocorrência e localização de inflamação dentária, assim como as medidas dos níveis de cinza nas mesmas regiões, foram consideradas como variáveis independentes. Os testes de Kolmogorov-Smirnov, Qui-quadrado, teste-T e análise por regressão logística foram aplicados para verificar o relacionamento estatístico dos dados (P<0,05). As lesões mais relacionadas às ramificações foram lesões endoperio e lesões apicais. Gênero (P=0,308) e idade (P=0,728) não mostraram associação com a ocorrência de ramificações dos canais mandibulares. A ocorrência de inflamação aumentou o risco para a ocorrência de ramificações dos canais mandibulares próximas aos dentes posteriores. (P<0,001; OR=11,640; IC-95%: 4.327-31.311). As lesões mais frequentemente associadas com as ramificações apresentaram origem endodôntica. Foi verificada associação entre as ramificações dos canais mandibulares e inflamação dentária na região dos dentes posteriores

The mandibular canal must be considered in several dental procedures in order to avoid injuries of the alveolar inferior nerve. The occurrence of anatomical variations of the mandibular canal increases the risk of neurovascular injuries. An increased sensitivity and failed anesthetic procedures in mandibles, especially in cases with inflammation, can be also related with alterations of the local innervation. This study aimed to assess the occurrence of mandibular canal branching (MCB) in alveolar ridges affected by dental inflammation by means of cone beam computed tomography (CBCT), in order to verify if there is some relationship between MCB and dental inflammation. A database of 2,484 CBCTs was reviewed for identifying mandibular canal branching (MCB) and dental inflammation in mandibular alveolar ridges. The final sample was matched by age and gender. MCB nearby the posterior teeth was considered as the dependent variable. Dental inflammation occurrence and location as well as measurements of gray levels at the same region were assessed as independent variables. The Kolmogorov-Smirnov, Chi-square, T-test and multiple logistic regression analysis were applied to verify the statistical relationship of the data (P<0.05). The most frequent inflammatory lesion was apical radiolucency with endodontic origin. The lesions mostly related to MCB were combined endodontic and periodontal lesions and apical lesions. Gender had no influence on mandibular canal branching (P=0.308), not did age (P=0.728). The occurrence of dental inflammation increased the risk for occurrence of the MCB nearby posterior teeth (P<0.001; OR=11.640; CI-95% 4.327-31.311). The gray levels had a minor role on the presence of MCB (P=0.002; OR=1.002; CI95% 1.002-1.003). The lesions most often associated with the branches had endodontic origin. An association between MCB situated around the posterior teeth and dental inflammation was found