Ectopic right anterior inferior segmental bile duct and iatrogenic proximal bile duct injury: report of eight patients / 中华肝胆外科杂志

Objective@#To summarize our clinical experience and management of an anomalous proximal bile duct joining the cystic duct in laparoscopic cholecystectomy (LC).@*Methods@#A retrospective study was conducted on 8 patients who had an anomalous right anterior bile duct joining the cystic duct who were treated at the Hunan Provincial People's Hospital from March 2003 to January 2019.@*Results@#All the 8 patients were diagnosed to have gallstones cholecystitis on preoperative CT, MRI and abdominal ultrasound. There were no suggestions of an anomalous bile duct. A total of 6 patients underwent reoperation after LC due to abdominal pain and biliary peritonitis. These 6 patients were treated with drainage and T-tube insertion. In the other 2 patients, the anomalous bile duct opening which joined the cystic duct were detected during LC. There was one patient converted to open laparotomy with preservation of the cystic duct and underwent common bile duct T-tube drainage. The other patients continued with laparoscopic surgery. The cystic duct was partially resected with removal of gallbladder, followed by common bile duct drainage. The average follow-up period was 3.4 years and the results were satisfactory.@*Conclusions@#Biliary duct anomaly is the main cause of iatrogenic proximal bile duct injury during laparoscopic cholecystectomy. It is not uncommon to have the anomaly of insertion of right anterior segmental bile duct to the cystic duct. To avoid iatrogenic biliary tract injury, careful preoperative study of X-ray films, accurate identification of the intraoperative gallbladder triangle anatomical structures. Strict adherence to carry out the three-word procedure of " discrimination, cut, identify" will help to reduce the incidence of biliary tract complications in laparoscopic cholecystectomy.

Morphometric study of the dental roots of permanent lower anterior teeth in Brazilian individuals / Estudio morfométrico de las raíces dentales de los dientes anteriores inferiores permanentes de individuos brasileños

The knowledge of dental morphometry, especially of its radicular portion, is of great importance for certain dental specialties, such as, endodonty. Regarding the permanent lower anterior teeth we know that its morphology and root length, are variable. The aim of this study was to analyze the average length of the dental roots of permanent lower anterior teethin Brazilian individuals. The average root length obtained in this study for the lower central incisors was 13.07 mm; to lower canines the value found was 15.81 mm; the average value for the radicular portion of lower lateral incisors was 13.08 mm. We conclude that the mean value for the length of the radicular portion of permanent lower central incisors is similar to that found for permanent lower lateral incisors, because they have similar anatomical features. Among the lower incisors and lower canines the discrepancy is greater because the lower canines are bulkier. Furthermore, we could conclude that the values obtained in our study may be used as a parameter to characterize the average length of the dental roots of permanent lower anterior teethin Brazilian individuals.

El conocimiento de la morfometría dental, especialmente de su porción radicular, es de gran importancia para determinadas especialidades odontológicas, tales como la endodoncia. En cuanto a los dientes anteriores inferiores permanentes se sabe que su morfología y longitud radicular son variables. El objetivo de este estudio fue analizar el valor promedio de la longitud de las raíces dentales de los dientes anteriores inferiores permanentes de individuos brasileños. El valor promedio de la longitud de la raíz obtenido para el incisivo central inferior fue el 13,07 mm; para el canino inferior el valor promedio encontrado fue el 15,81 mm; el valor promedio para la porción radicular del incisivo lateral inferior fue el 13,08 mm. Se concluye que el valor promedio de la longitud de la porción radicular de los incisivos centrales mandibulares permanentes es similar al valor encontrado para los incisivos laterales mandibulares permanentes, hecho que se debe a las características anatómicas similares existentes entre ellos. Entre los incisivos y caninos mandibulares la discrepancia es mayor porque los caninos mandibulares son más voluminosos. Adicionalmente, concluimos que se puede utilizar los valores promedios obtenidos en este estudio como parámetro para caracterizar la longitud promedio de las raíces dentales de los dientes anteriores mandibulares permanentes de individuos Brasileños.

Peripheral ossifying fibroma in Pregnancy: A multifactorial consequence.

Pregnancy is the most remarkable time in every woman’s life. The upsurge in levels of estrogen and progesterone leads to the plethora of changes in various parts of human body, including the oral cavity. In the oral cavity, changes are commonly seen on the gingiva. These include pyogenic granuloma, peripheral giant cell granuloma and also peripheral ossifying fibroma. Not many cases have been reported in literature of the latter. Peripheral ossifying fibroma can interfere with normal tooth position, may become a plaque retentive factor and can be unaesthetic. The pathogenesis of such lesions still remains an enigma. Many believe that peripheral ossifying fibroma may be a progressive stage of pyogenic granuloma. Here, we present a rare case of a peripheral ossifying fibroma seen in a pregnant female in the lower left front tooth region and have discussed the possible etiopathogenesis of the same.

Gingival recession of lower anterior incisors in orthodontic treatment / 대한치주과학회지

PURPOSE: These case reports show the orthodontic treatment of lower anterior incisors with gingival recession. MATERIALS AND METHODS: Three cases were treated by an orthodontist and a periodontist. Each case had lingually tilted lower anterior incisors, anterior crossbite and skeletal Cl III pattern. RESULTS: A variety of etiological factors were thought to cause gingival recession: aging, oral hygiene, tooth malpositioning, occlusal trauma. CONCLUSION: Due to the interaction among many possible contributing factors, it is difficult to predict whether further gingival recession may occur at a given site. The position and the movement of the lower anterior incisors with gingival recession are important factors in diagnosis and orthodontic treatment planning.

A Study on the mandibular setback osteotomy and reduction genioplasty in mandibular prognathism with long anterior facial height / 대한치과교정학회지

The purpose of this study was to evaluate the amount and interrelationship of hard and soft tissue changes after mandibular setback osteotomy and reduction genioplasty in mandibular prognathism with long anterior facial height. The control group (Group A) consisted of 20 patients who had severe horizontal discrepancy. They experienced presurgical orthodontic treatment and orthognathic surgery via mandibular setback. The experimental group (Group B) consisted of 20 patients who had severe horizontal and vertical discrepancy. They experienced presurgical orthodontic treatment and orthognathic surgery via mandibular setback and reduction genioplasty. The presurgical and postsurgical lateral cephalograms were valuated. The computerized statistical analysis was carried on with EXCEL 97 program. The results were as follows : 1. The correlation of hard and soft tissue horizontal changes in lower 2/3 of lower anterior facial height were high for both groups. The correlation coefficients of hard tissue changes and Ls, Stm, Li changes in group B were moderately higher than Group A. 2. The correlation of hard and soft tissue vertical changes in Group B were lower than Group A. (except for pointB-Ils, Me-Me') 3. The ratio for soft tissue to Pog in Group B was lower than Group A. The ratios of hard and soft tissue vertical changes were 32% at Ils, 54% at Pog', and 60% at Me'. 4. The ratio of lower anterior facial height to total anterior facial height was reduced for both group. But ratio of upper 1/3 of lower anterior facial height to total anterior facial height did not changed significantly in Group B. 5. Reduction genioplasty combined with mandibular setback procedure showed no change in upper one third(Sn-Stm) and significant decrease(Stm-Me') in the lower two thirds of the soft-tissue anterior lower facial height.

A study on the relationship of the mandibular symphysis and anterior alveolar and skeletal morphology according to the rotational growth pattern of mandible in skeletal Class III malocclusion / 대한치과교정학회지

The aim of this study was to evaluate the morphology of the mandibular symphysis and anterior alveolar and skeletal d relationship under the influence of the rotational growth pattern of mandible in skeletal Class III malocclusion. A total of 86 untreated adult subjects were divided into two groups-forward rotational growth pattern group, backward rotational growth pattern group-according to the suggestion of Skieller et al. The antero-posterior position, vertical relationship, mandibular symphysis and anterior alveolar and skeletal relationship were assessed on lateral cephalometric radiographs. Mandibular symphysis and anterior alveolar and skeletal relationship in each subject were studied and the following conclusions were drawn: 1. Concerning the antero-posterior position, forward rotational growth pattern group showed significantly larger SNA, SNB. Concerning the vertical relationship, all measurements showed statistically significant differences. 2. Forward rotational growth pattern group showed significantly larger IMPA MnAD, backward rotational growth pattern group showed significantly larger MxABH. 3. There was no statistically significant difference in symphysis ratio to mandibular plane between forward and backward rotational growth pattern group. 4. In the correlative analysis of rotational growth pattern of mandible and mandibular symphysis, anterior alveolar of and skeletal relationship, statistically significant correlations in overbite, IMPA, MnAD, symphysis width were showed.

A study on the skeletal and dentoalveolar dimensions in relation to vertical facial patterns / 대한치과교정학회지

The purpose of this study was to investigate the variations of the skeletal and dentoalveolar dimensions in relation to vertical facial patterns. Lateral cephalogram of 200 cases (100 cases of male and 100 cases of female, average age of which was 23.2 years) were traced and some measurements of skeletal and dentoalveolar dimensions were measured. The ratio of UAFH/LAFH was employed to classify the samples into groups of excess and short lower anterior facial height. And the comparison between two groups were taken statistacally. The following results were obtained. 1. The dentoalveolar height, lower anterior facial height, lower gonial angle, and FMA in the excess-lower-anterior-facial-height group were significantly larger than those in short-lower-anterior-facial-height group. 2. The dentoalveolar height, ramus height, and Jarabak ratio in the male subjects were significantly larger than those in the female subjects. 3. The UAFH/LAFH ratio showed a significant correlation to upper, lower facial height, AUDH, PUDH, ALDH, PLDH, Lower gonial angle, FMA, and Bjok`s Sum.

Clinical experience in the use of stapler anastomosis in anterior resection of rectal carcinoma / 中国普通外科杂志

Objective To evaluate the use of stapling anterior resection for rectal cancer. Methods Data of 1036 patients undergoing anterior resection for rectal cancer during 1983 to 2000 were reviewed retrospectively. Clinical results were compared statistically between patients who received stapling anastomosis (group A, n=652) and those did not (group B, n=384). Results The annual average stapler anterior resection increased from 5 cases per year (during 1983-1987) to 147 cases per year (1998-2000). The 0? Ⅰ? Ⅱ stage patients accounted for 53% in group A, and 62% in group B (P=0.004). There was higher percentage of patients in group A (66%) than in group B (39%) in which the distance from the lower edge of the tumor to anal verge was less than 8 cm (P