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1.
Braz. dent. sci ; 25(2): 1-8, 2022. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1367400

ABSTRACT

Objective: The aim of this prospective study, with preliminary results, was to evaluate factors related with root migration after lower third molar coronectomy, especially radiographic bone density. Material and Methods:Twenty-two patients were submitted to 31 lower third molar coronectomies. Clinical and radiographic evaluation of all patients were performed preoperatively and at 7, 90 and 365 days postoperatively. Sociodemographic, clinical and radiographic data were collected. The root migration was analyzed by the distance from the tooth apex to the mandibular canal, and radiographic bone density above the remaining roots was obtained, both using the software Image J©.Results: After 1-year follow-up no patients showed paresthesia, symptoms or required reintervention, however all roots showed migration. The mean root migration was 2.66 mm at 90 days, and 3.37 mm at 365 days (p = 0.0007). The rate of migration was higher at the early postoperative period. The simple linear regression test between root migration and radiographic bone density was not significant (R=-0.173 and p=0.453; R=-0.045 and p=0.902; at 90 days and 365 days, respectively) as well as the analysis between root migration and other clinical and radiographic variables. Conclusion: It was possible to conclude, based on these preliminary results, that all roots showed migration during the follow-up period. The radiographic bone density increases and, consequently, the root migration rate diminishes within time, however none of the evaluated factors showed significant association with root migration. (AU)


Objetivo: O objetivo deste estudo prospectivo, com resultados preliminaraes, foi avaliar os fatores relacionados com a migração das raízes após corocetomia de terceiros molares inferiores, especialmente a densidade óssea radiográfica. Material e Métodos: Vinte e dois pacientes foram submetidos à 31 coronectomias de terceiros molares inferiores. Avaliação clínica e radiográfica de todos os pacientes foi executada no momento pré-operatório e aos 7, 90 e 365 dias pós-operatórios. Dados sociodemográficos, clínicos and radiográficos foram coletados. A migração das raízes foi analisada pela distância do ápice radicular ao canal mandibular, e a densidade óssea radiográfica foi mensurada acima dos remanescentes radiculares, usando o software Image J©.Resultados: Após 1 ano de acompanhamento, nenhum paciente apresentou parestesia, sintomatologia ou necessitou reintervenção, porém todas as raízes migraram. A média da migração radicular foi de 2,66mm aos 90 dias e de 3,37mm aos 365 dias (p=0,0007). A taxa de migração foi maior no pós-operatório inicial. O teste de regressão linear simples entre migração das raízes e densidade óssea radiográfica não foi significante (R=-0,173 e p=0,453; R=-0,045 e p=0,902; aos 90 e 365 dias, respectivamanete), assim como a análise entre migration radicular e outras variáveis clínicas e radiográficas. Conclusão: Foi possível concluir, com base nesses resultados prelimiares, que todas as raízes apresetaram migração durante o período de acomapanhamento. A densidade óssea radiográfica aumentou e, consequentemente, a taxa de migration radicular dimininiui com o tempo, porém nenhum dos fatores avaliados mostrou associação significante com a migração das raízes(AU)


Subject(s)
Humans , Surgery, Oral , Bone Density , Mandibular Nerve , Molar, Third
2.
Rev. CEFAC ; 23(4): e0221, 2021. tab, graf
Article in English | LILACS | ID: biblio-1287878

ABSTRACT

ABSTRACT Purpose: to evaluate the occurrence of loss of sensitivity of the inferior alveolar nerve, and to monitor the remission of this change in patients with mandibular fractures subjected to surgical treatment. Methods: patients with mandibular fractures, surgically treated within one year, were prospectively evaluated. Data regarding etiology, fracture location, type and displacement, and surgical access, were obtained. The tactile and thermal tests were applied at eighteen points in the mental region, within a period of six months. Statistical tests were applied to compare the categories of variables and the period of observation (p ≤ 0.050). Results: during the study, 37 patients were included. There were 24 bilateral and 13 unilateral fractures. Sensory changes occurred in 56.8% of the patients in the preoperative period, in 83.8% of the patients, in the postoperative period, and 35.1% of the patients presented complete remission during the final period of the study. Conclusion: sensory changes occurred in about half of the patients, due to the fracture, increasing greatly in the postoperative period, with complete remission in about one third of the cases. The fracture type, degree of displacement and surgical access type influenced the occurrence of sensory alterations.


Subject(s)
Humans , Adult , Somatosensory Disorders/etiology , Mandibular Fractures/complications , Mandibular Nerve/physiopathology , Remission, Spontaneous , Prospective Studies , Jaw Fractures/surgery
3.
Int. j. morphol ; 38(6): 1657-1661, Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134494

ABSTRACT

SUMMARY: The auriculotemporal nerve (ATN) is an important structure lying within a limited area of an infratemporal region (ITR). The ATN is originated from the posterior branch of the mandibular division of the trigeminal nerve (V3). The ATN conveys somatosensory, secretomotor, and parasympathetic fibres of the V3 and gustatory nerve (CN IX). In literature, the most common pattern of the ATN is composed of 2 roots that encloses the middle meningeal artery (MMA). However, in many studies, it has been reported that there are many variations in ATN pattern formation. To study the variation of ATN pattern formation in Thai cadavers, 73 hemifaces from 39 Thai embalmed cadavers were dissected and the relations of the ATN to the MMA were recorded. This study concluded that there were 4 patterns observed in Thai cadavers. The common pattern is 2 roots (67.1 %), 3 roots (15.1 %), 1 root (9.6 %), and 4 roots (8.2 %). Knowledge of this variation in the ATN may be useful in understanding the symptoms of temporo-orofacial pain, paresthesia of temporomandibular joint (TMJ), possible side effects from the TMJ surgery and the efficiency of auriculotemporal nerve block for regional anesthesia of the temporomandibular joint in Thai people.


RESUMEN: El nervio auriculotemporal (NAT) es una estructura importante que se encuentra dentro de la región infratemporal (ITR). El NAT se origina en la rama posterior de la división mandibular del nervio trigémino (V3), y transmite fibras somato sensoriales, secreto motoras y parasimpáticas del V3 y del nervio gustativo (CN IX). En la literatura, se reporta que el patrón más común de NAT está compuesto por 2 raíces que contienen la arteria meníngea media (AMM). Sin embargo, en diversos estudios, se ha informado que existen múltiples variaciones en la for- mación de patrones NAT. Con el objetivo de estudiar la variación de la formación del patrón NAT en cadáveres tailandeses, se disecaron 73 estructuras hemi faciales de 39 cadáveres tailandeses y se registraron las relaciones del NAT con el AMM. En conclusión, se observaron 4 patrones en los cadáveres tailandeses. El patrón común de 2 raíces (67,1 %), 3 raíces (15,1 %), 1 raíz (9,6 %) y 4 raíces (8,2 %). El conocimiento de esta variación en el NAT puede ser útil para comprender los síntomas de dolor temporo-orofacial, parestesia de la articulación temporomandibular (ATM), posibles efectos secundarios de la cirugía de ATM y la eficacia del bloqueo del nervio auriculo-temporal para la anestesia regional de la articulación temporomandibular en Tailandeses.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Anatomic Variation , Mandibular Nerve/anatomy & histology , Temporomandibular Joint , Thailand , Cadaver , Meningeal Arteries
4.
Rev. cir. traumatol. buco-maxilo-fac ; 20(3): 6-11, jul.-set. 2020. tab
Article in Spanish | LILACS, BBO | ID: biblio-1253212

ABSTRACT

Objetivo: Determinar a prevalência de parestesia do nervo alveolar inferior em exodontias dos terceiros molares mandibulares realizadas por estudantes de Odontologia. Material e métodos: O presente estudo retrospectivo incluiu os prontuários de 226 pacientes submetidos à exodontia dos terceiros molares mandibulares durante o período de julho de 2015 a agosto de 2017 por estudantes de Odontologia da Liga Acadêmica de Cirurgia da Universidade Federal de Campina Grande, Campus-Patos, Paraíba, Brasil. Resultados: Foram removidos 238 terceiros molares mandibulares de pacientes com faixa etária entre 16 a 42 anos, sendo a maioria dos pacientes do gênero feminino (71,68%). Nove dos pacientes (3,9%) relataram algum grau de comprometimento no território de inervação do nervo alveolar inferior com remissão total do sintoma no período de 3,7 meses. A prevalência da parestesia em relação ao número de terceiros molares inferiores extraídos foi de 1:25. Conclusão: A prevalência de parestesia decorrente da exodontia de terceiros molares mandibulares realizadas por estudantes de Odontologia é de 3,9%... (AU)


Objective: To define the prevalence of inferior alveolar nerve damage in mandibular third molar extractions performed by dentistry students. Materials and methods: The present retrospective study included the medical records of 226 patients submitted to mandibular third molar extraction during the period from July 2015 to August 2017 by students of Dentistry of the Academic League of Surgery of the Federal University of Campina Grande, Campus- Patos, Paraíba, Brazil. Results: 238 mandibular third molars were extracted from patients aged 16 to 42 years, with the majority of patients being females (71.68%). Nine of the patients (3.9%) reported some degree of involvement in the territory of innervation of the inferior alveolar nerve with total suspension of the symptom in the period of 3.7 months. The prevalence of damage in relation to the number of lower third molars extracted was 1:25. Conclusion: The prevalence of damage resulting from mandibular third molar extraction performed by dentistry students is 3.9%... (AU)


Subject(s)
Humans , Male , Female , Paresthesia , Surgery, Oral , Mandibular Nerve , Molar , Molar, Third/surgery , Dentistry
5.
Rev. cir. traumatol. buco-maxilo-fac ; 20(3): 12-19, jul.-set. 2020. graf, tab
Article in Portuguese | LILACS, BBO | ID: biblio-1253220

ABSTRACT

Introdução: A Coronectomia é um tratamento alternativo à remoção total do terceiro molar inferior impactado/incluso, removendo apenas a região coronária do dente, preservando suas raízes. O objetivo desta pesquisa é mensurar o nível de conhecimento e percepção dos Cirurgiões e Residentes Buco-Maxilo-Faciais, em três hospitais da rede pública da cidade do Recife, Pernambuco, sobre a técnica da Coronectomia. Metodologia: A amostra foi composta por 40 profissionais, dentre os quais 50% de todos os entrevistados declararam não realizar a técnica da Coronectomia na remoção de terceiros molares. Foi realizado o Teste Exato de Fisher que não apontou dependência entre as categorias de participante da entrevista quanto ao grau de conhecimento sobre a técnica de Coronectomia. Resultados: Os entrevistados conhecem a técnica de Coronectomia, mas a sua indicação não é frequente e as contraindicações mais citadas foram lesões neoplásicas e terceiros molares com patologia apical. Consideram muito importantes e importantes as vantagens do procedimento em relação à remoção total dos terceiros molares. 70% dos entrevistados veem a necessidade de reintervenção como a maior desvantagem na técnica, porém, estudos dizem que raramente ocorrem erupções dessas raízes. Conclusão: A técnica da Coronectomia é eficaz quando corretamente indicada e realizada, pois, reduz o risco de uma lesão ao nervo alveolar inferior... (AU)


Introduction: Coronectomy is an alternative treatment to the total removal of the impacted / included lower third molar, removing only the coronary region of the tooth, preserving its roots. The objective of this research is to measure the level of knowledge and perception of Surgeons and Buco-Maxillofacial Residents, in three public hospitals in the city of Recife, Pernambuco, on the technique of Coronectomy. Methodology: The sample consisted of 40 professionals, among whom 50% of all respondents stated that they did not perform the Coronectomy technique in the removal of third molars. Fisher's Exact Test was performed, which did not show any dependence between the interviewee categories regarding the degree of knowledge about the Coronectomy technique. Results: The interviewees are familiar with the Coronectomy technique, but its indication is not frequent and the most frequently mentioned contraindications were neoplastic lesions and third molars with apical pathology. The advantages of the procedure in relation to the total removal of third molars are considered very important and important. 70% of respondents see the need for reintervention as the biggest disadvantage in the technique; however, studies say that eruptions of these roots rarely occur. Conclusion: The Coronectomy technique is effective when correctly indicated and performed, as it reduces the risk of injury to the lower alveolar nerve... (AU)


Subject(s)
Humans , Male , Female , Surgery, Oral , Tooth, Unerupted , Facial Nerve Injuries , Mandibular Nerve , Molar, Third , Molar, Third/surgery
6.
Rev. cir. traumatol. buco-maxilo-fac ; 20(3): 39-43, jul.-set. 2020. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1253321

ABSTRACT

Introdução: A Odontectomia Parcial Intencional ou Coronectomia é uma abordagem cirúrgica que consiste na remoção da porção coronária de molares mandibulares impactados e a manutenção das suas raízes no alvéolo dentário. Esta técnica é indicada quando há íntima relação entre o dente e o canal mandibular e tem por principal objetivo evitar lesões ao nervo alveolar inferior. Relato de Caso: Paciente do sexo masculino, 24 anos, ASA I, compareceu a Clínica Escola de Cirurgia de uma universidade pública para exodontia de terceiro molar inferior impactado (48). Ao exame clínico o dente apresentava-se semi-incluso e ao exame radiográfico (panorâmica e tomografia computadorizada), observou-se íntima relação da raiz do dente com o canal mandibular. Diante disto, foi realizada Odontectomia Parcial Intencional, com o intuito de preservação de feixe vásculo-nervoso adjacente. Paciente evoluiu satisfatoriamente sem sinais de infecção ou alteração sensorial de nervo alveolar inferior. Considerações finais: A Odontectomia Parcial Intencional é uma técnica segura, eficaz e de previsibilidade significativa, sendo uma alternativa que pode ser empregada em exodontias de molares mandibulares inclusos próximos ao canal mandibular, minimizando os riscos de lesões nervosas para os pacientes... (AU)


Introduction: Intentional partial odontectomy or coronectomy is a surgical approach that consists of removing the coronary portion of impacted mandibular molars and maintaining their roots in the dental alveolus. This technique is indicated when there is an intimate relationship between the tooth and the mandibular canal and its main objective is prevent injuries to the lower alveolar nerve. Case Report: Male patient, 24 years old, ASA I, compared the Clinical School of Surgery of a public university for extraction of the impacted lower third molar (48). On clinical or dental examination, we present semi impacted wisdom tooth and on radiographic examination (panoramic + computed tomography), an intimate relationship between the root of the tooth and the mandibular canal was observed. Therefore, intentional partial odontectomy was performed in order to preserve the adjacent vascular-nervous bundle. The patient progressed satisfactorily without signs of infection or sensory alteration of lower alveolar nerve. Final considerations: Intentional partial odontectomy is a safe, effective and predictable technique, being an alternative that can be used in extractions of mandibular molars, including those close to the mandibular canal, minimizing the risk of nerve injuries to patients... (AU)


Subject(s)
Humans , Male , Adult , Surgery, Oral , Tooth, Impacted , Mandibular Nerve , Molar , Molar, Third , Tooth , Tomography, X-Ray Computed , Tooth Socket
7.
Int. j interdiscip. dent. (Print) ; 13(2): 84-87, ago. 2020. tab
Article in Spanish | LILACS | ID: biblio-1134347

ABSTRACT

RESUMEN: Objetivo: analizar y comparar las modalidades actuales de reconstrucción microquirúrgica (autoinjertos, aloinjertos y conductos nerviosos) para lograr recuperación sensitiva funcional (RSF) en reparaciones de nervio alveolar inferior (NAI) y nervio lingual (NL). Materiales y Métodos: se realizó una revisión de la literatura para identificar estudios relacionados con reconstrucciones de NAI y NL. Los estudios incluidos proporcionaron un tamaño de muestra definido, modalidad de reconstrucción microquirúrgica y tasas de RSF. Se realizó un test de proporciones para saber si existían diferencias estadísticamente significativas (P <0,05) entre las modalidades de reconstrucción mencionadas. Resultados: se seleccionaron y analizaron 9 estudios que dieron como resultado una muestra de 130 reconstrucciones de NAI y 102 de NL. Entre las reconstrucciones de NAI, se encontró que los autoinjertos y aloinjertos eran superiores para lograr una RSF sobre los conductos nerviosos (P de 0,033 y 0,0397 respectivamente). Entre las reconstrucciones de NL, no se encontraron diferencias estadísticamente significativas. Y al comparar reconstrucciones mediante autoinjertos con aloinjertos, no hubo diferencias estadísticamente significativas para NAI y NL. Conclusiones: Las reconstrucciones mediante aloinjertos y autoinjertos tiene tasas de RSF equivalentes y mejores que los conductos nerviosos. Además, con el uso de aloinjertos, se evitan comorbilidades asociadas al sitio donante.


ABSTRACT: Objective: to analyze and compare the current modalities of microsurgical reconstruction (autografts, allografts, and nerve ducts) to achieve functional sensory recovery (RSF) in repairs of the inferior alveolar nerve (NAI) and lingual nerve (NL). Materials and Methods: a literature review was performed to identify studies related to NAI and NL reconstructions. The studies included provided a defined sample size, microsurgical reconstruction modality, and RSF rates. A test of proportions was performed to find out if there were statistically significant differences (P <0.05) between the mentioned reconstruction modalities. Results: 9 studies were selected and analyzed that resulted in a sample of 130 reconstructions of NAI and 102 of NL. Among the NAI reconstructions, autografts and allografts were found to be better in achieving an RSF than the nerve ducts (P of 0.033 and 0.0397 respectively). Among the NL reconstructions, no statistically significant differences were found. And when comparing reconstructions using autografts with allografts, there were no statistically significant differences for NAI and NL. Conclusions: Reconstructions using allografts and autografts have equivalent and better RSF rates than nerve conduits. Furthermore, with the use of allografts, comorbidities associated with the donor site are avoided.


Subject(s)
Humans , Surgery, Oral , Autografts , Lingual Nerve , Mandibular Nerve
8.
Article in English | WPRIM | ID: wpr-811270

ABSTRACT

OBJECTIVES: One of the most common complications of bilateral sagittal split ramus osteotomy (BSSRO) is neurosensory impairment of the inferior alveolar nerve (IAN). Accurate preoperative determination of the position of the IAN canal within the mandible using cone-beam computed tomography (CBCT) is recommended to prevent IAN dysfunction during BSSRO and facilitate neurosensory improvement after BSSRO.MATERIALS AND METHODS: This randomized clinical trial consisted of 86 surgical sites in 43 patients (30 females and 13 males), including 21 cases (42 sides) and 22 controls (44 sides). Panoramic and lateral cephalographs were obtained from all patients. In the experimental group, CBCT was also performed from both sides of the ramus and mandibular body. Neurosensory function of the IAN was subjectively assessed using a 5-point scale preoperatively and 7 days, 1 month, 3 months, 6 months, and 12 months post-surgery. Data were analyzed using Fisher's test, Spearman's test, t-test, linear mixed-model regression, and repeated-measures ANCOVA (α=0.05, 0.01).RESULTS: Mean sensory scores in the control group were 1.57, 2.61, 3.34, 3.73, and 4.20 over one year and were 1.69, 3.00, 3.60, 4.19, and 4.48 in the CBCT group. Significant effects were detected for CBCT intervention (P=0.002) and jaw side (P=0.003) but not for age (P=0.617) or displacement extent (P=0.122).CONCLUSION: Preoperative use of CBCT may help surgeons to practice more conservative surgery. Neurosensory deficits might heal faster on the right side.


Subject(s)
Cone-Beam Computed Tomography , Female , Humans , Jaw , Mandible , Mandibular Nerve , Osteotomy, Sagittal Split Ramus , Surgeons
9.
Article in English | WPRIM | ID: wpr-811260

ABSTRACT

PURPOSE: The aim of our study was to determine the prevalence and degree of lingual concavities in the first molar region of the mandible to reduce the risk of perforating the lingual cortical bone during dental implant insertion.METHODS: A total of 163 suitable cross-sectional cone-beam computed tomography images of edentulous mandibular first molar regions were evaluated. The mandibular morphology was classified as a U-configuration (undercut), a P-configuration (parallel), or a C-configuration (convex), depending on the shape of the alveolar ridge. The characteristics of lingual concavities, including their depth, angle, vertical location, and additional parameters, were measured.RESULTS: Lingual undercuts had a prevalence of 32.5% in the first molar region. The mean concavity angle was 63.34°±8.26°, and the mean linear concavity depth (LCD) was 3.03±0.99 mm. The mean vertical distances of point P from the alveolar crest (Vc) and from the inferior mandibular border were 9.39±3.39 and 16.25±2.44, respectively. Men displayed a larger vertical height from the alveolar crest to 2 mm coronal to the inferior alveolar nerve (Vcb) and a wider LCD than women (P<0.05). Negative correlations were found between age and buccolingual width at 2 mm apical to the alveolar crest, between age and Vcb, between age and Vc, and between age and LCD (P<0.05).CONCLUSION: The prevalence of lingual concavities was 32.5% in this study. Age and gender had statistically significant effects on the lingual morphology. The risk of lingual perforation was higher in young men than in the other groups analyzed.


Subject(s)
Alveolar Process , Cone-Beam Computed Tomography , Dental Implants , Female , Humans , Jaw, Edentulous , Male , Mandible , Mandibular Nerve , Molar , Prevalence
10.
Article in English | WPRIM | ID: wpr-811207

ABSTRACT

BACKGROUND: This study aimed to compare the pain levels during anesthesia and the efficacy of the QuickSleeper intraosseous (IO) injection system and conventional inferior alveolar nerve block (IANB) in impacted mandibular third molar surgery.METHODS: This prospective randomized clinical trial included 30 patients (16 women, 14 men) with bilateral symmetrical impacted mandibular third molars. Thirty subjects randomly received either the IO injection or conventional IANB at two successive appointments. A split-mouth design was used in which each patient underwent treatment of a tooth with one of the techniques and treatment of the homologous contralateral tooth with the other technique. The subjects received 1.8 mL of 2% articaine. Subjects' demographic data, pain levels during anesthesia induction, tooth extractions, and mouth opening on postoperative first, third, and seventh days were recorded. Pain assessment ratings were recorded using the 100-mm visual analog scale. The latency and duration of the anesthetic effect, complications, and operation duration were also analyzed in this study. The duration of anesthetic effect was considered using an electric pulp test and by probing the soft tissue with an explorer.RESULTS: Thirty patients aged between 18 and 47 years (mean age, 25 years) were included in this study. The IO injection was significantly less painful with lesser soft tissue numbness and quicker onset of anesthesia and lingual mucosa anesthesia with single needle penetration than conventional IANB. Moreover, 19 out of 30 patients (63%) preferred transcortical anesthesia. Mouth opening on postoperative first day was significantly better with intraosseous injection than with conventional IANB (P = 0.013).CONCLUSION: The IO anesthetic system is a good alternative to IANB for extraction of the third molar with less pain during anesthesia induction and sufficient depth of anesthesia for the surgical procedure.


Subject(s)
Anesthesia , Anesthetics , Appointments and Schedules , Carticaine , Female , Humans , Hypesthesia , Jupiter , Mandibular Nerve , Molar, Third , Mouth , Mucous Membrane , Needles , Pain Measurement , Prospective Studies , Tooth , Tooth Extraction , Tooth, Impacted , Visual Analog Scale
11.
Braz. J. Vet. Res. Anim. Sci. (Online) ; 57(1): e161658, 2020. ilus, tab
Article in English | LILACS, VETINDEX | ID: biblio-1122156

ABSTRACT

Boars kept on commercial farms use their canine teeth as a mechanism of defense and attack in order to express their natural instincts, which could result in fractures of the teeth and jaws. Thus, utilizing local desensitization of the inferior alveolar nerve is crucial for executing therapeutic procedures in the oral cavities of those animals. Then, the goal is to carry out the morphometry of the mandibular foramen of that species, correlating it with the mandibular structures, while doing so in the safest manner for the animals. For that purpose, six hemimandibles of young-aged Sus scrofa scrofa were used, from which the proposed measurements were taken. On average, the lateral margin of the condylar process stood 142.43 mm away from the root of the lower medial incisive tooth. The longitudinal axis of the body of the mandible measured 22.3 mm at the level of the diastema that exists between the fourth lower premolar tooth and the first lower molar tooth. The mandibular foramen, from the caudal limit of the ventral margin, would be positioned at 26.6 mm from the ventral margin of the angle of the mandible in that level, 34.92 mm away from the medial margin of the condylar process, and 38.63 mm away from the dorsal limit from the caudal margin of the coronoid process. The lack of statistically significant differences, and observing that the osseous accident under scrutiny had been positioned in the ramus of the mandible, indicated that the proposed procedure should be performed from the introduction of the needle in an oblique and rostrodorsal direction for 2.0 cm, and angulated at 60º with the anatomic reference created by the medial demarcation obtained via the support of the thumb on the lateral margin of the ramus of the mandible, ventrally to the zygomatic arch, all while preserving neighboring structures and establishing an unheard-of anesthetic methodology for boars.(AU)


Javalis mantidos em criatórios comerciais utilizam os dentes caninos como mecanismo de defesa e ataque a fim de expressar seus instintos naturais, o que pode resultar em fraturas dentárias e da mandíbula propriamente dita. Desta forma, propiciar a dessensibilização local do nervo alveolar inferior é essencial para a execução de procedimentos terapêuticos na cavidade oral destes animais. Logo, objetivou-se realizar a morfometria do forame mandibular desta espécie a fim de correlacioná-lo com as estruturas mandibulares, inferindo, também, sobre a forma mais segura de realização da referida técnica nos espécimes. Para tanto, foram utilizadas seis hemimandíbulas de Sus scrofa scrofa jovens, a partir das quais foram realizadas as mensurações propostas. Em média, a margem lateral do processo condilar distanciou-se 142,43 mm da raiz do dente incisivo medial inferior; o eixo longitudinal do corpo da mandíbula mediu 22,3 mm ao nível do diastema existente entre o quarto dente pré-molar e o primeiro dente molar inferiores; e o forame mandibular, a partir do extremo caudal de sua margem ventral, posicionou-se a 26,6 mm da margem ventral do ângulo da mandíbula neste nível, 34,92 mm da margem medial do processo condilar, e 38,63 mm do extremo dorsal da margem caudal do processo coronóide. Na falta de diferenças estatisticamente significantes, e observando que o acidente ósseo estudado posicionou-se no ramo da mandíbula, indica que o procedimento proposto deva ser realizado a partir da introdução da agulha em sentido oblíquo rostroventral por 2,0 cm e angulada a 60º com o referencial anatômico criado pela delimitação medial obtida pelo apoio do dedo polegar na margem lateral do ramo da mandíbula, ventralmente ao arco zigomático, preservando as estruturas próximas e definindo-se uma metodologia anestésica inédita para os Javalis.(AU)


Subject(s)
Animals , Sus scrofa/anatomy & histology , Fractures, Bone/veterinary , Anesthesia, Dental/veterinary , Mandible/anatomy & histology , Mandibular Nerve/anatomy & histology
12.
Int. j. odontostomatol. (Print) ; 14(3): 400-406, 2020. graf
Article in Spanish | LILACS | ID: biblio-1114914

ABSTRACT

La reconstrucción de nervios periféricos con aloinjertos nerviosos acelulares humanos en neurocirugía ha sido bastante estudiada estableciendo su predictibilidad y éxito en intervenciones principalmente en los nervios digitales de las manos. En cirugía maxilofacial existe una creciente investigación para poder restaurar el nervio alveolar inferior en cirugías de resección mandibular en donde la extirpación de esta estructura nerviosa es inevitable. El objetivo de esta publicación es mostrar un reporte de un caso en donde se realizó la reconstrucción del nervio alveolar inferior con aloinjerto de nervio acelular humano (Avance® Nerve Graft, Axogen) con microcirugía para poder proveer de sensibilidad a la región de la cara afectada en un paciente reconstruido con un injerto de fíbula microvascularizada posterior a una hemimandibulectomía por ameloblastoma plexiforme.


The reconstruction of peripheral nerves with allografts of human acellular nerves in neurosurgery is well studied, establishing its predictability and success in interventions mainly in the digital nerves of the hands. In maxillofacial surgery there is a growing investigation to be able to restore the inferior alveolar nerve in mandibular resection surgeries where the removal of this nervous structure is inevitable. The objective of this publication is to show a case report in which the reconstruction of the inferior alveolar nerve was performed with human acellular nerve allograft (Avance® Nerve Graft, Axogen) with microsurgery in order to provide sensitivity to the region of the affected face in a reconstructed patient with a microvascularized bone fibula graft after hemimandibulectomy due to plexiform ameloblastoma.


Subject(s)
Humans , Male , Adolescent , Peripheral Nerves/transplantation , Neurosurgical Procedures/methods , Mandibular Nerve/surgery , Allografts
13.
Rev. ADM ; 76(5): 272-277, sept.-oct. 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1053115

ABSTRACT

Introducción: El nervio dentario inferior es una estructura anatómica de la mandíbula, la cual presenta variaciones como el asa mandibular, ambas estructuras están relacionadas con iatrogenias con tratamientos como cirugías orales, regeneraciones óseas e implantes. El objetivo del presente estudio es evaluar las características del asa mandibular y el agujero mentoniano utilizando tomografía axial computarizada de haz cónico (CBCT) en pacientes del Postgrado de Periodoncia de la Universidad Autónoma de Nuevo León. Material y métodos: Se analizaron un total de 110 CBCT, de los cuales 61 entraron al estudio cumpliendo con los criterios de inclusión, se realizaron cortes transversales utilizando el software On Demand® para identifi car y medir el asa mandibular y localizar la posición del agujero mentoniano de ambos lados separando los grupos por género. Resultados: La prevalencia del asa mandibular fue de 32.8% de 61 CBCT que se analizaron, se observó más comúnmente en hombres y de manera bilateral, y cuando fue unilateral sólo se encontró en el lado derecho, la longitud promedio fue de 6 ± 1 mm. El agujero mentoniano se detectó en mayor porcentaje apical al segundo premolar inferior con un diámetro promedio de 3.5 ± 0.5 mm, alejándose de la raíz del diente adyacente en un promedio de 6 ± 1 mm y del borde de la mandíbula 12.5 mm ± 0.5 mm. Conclusión: Es de suma importancia identifi car las características anatómicas del asa mandibular y localizar la posición del agujero mentoniano durante la planifi cación del tratamiento para evitar complicaciones durante y después del acto quirúrgico (AU)


Introduction: The inferior dental nerve is an anatomical structure of the mandible which presents variations such as the anterior loop, both structures are related to iatrogenies with treatments such as oral surgeries, bone regenerations and implants. The aim of the present study is to evaluate the characteristics of the anterior loop and the mental foramen using cone beam computed tomography (CBCT) in patients of the Graduate Periodontics Program, School of Dentistry, Universidad Autónoma de Nuevo León. Material and methods: 110 CBCT were analyzed of which 61 entered the study fulfi lling the inclusion criteria, cross sections were made using the On Demand® software to identify and measure the anterior loop and locate the position of the mental foramen both sides separating our groups by gender. Results: The prevalence of the anterior loop was 32.8% of 61 CBCT that were analyzed, it was found more commonly in men and bilaterally, and when it was unilateral only found on the right side, the average length was 6 ± 1 mm. The mental hole was found in greater percentage apical to the second lower premolar with an average diameter of 3.5 ± 0.5 mm, moving away from the root of the adjacent tooth by an average of 6 ± 1 mm and from the edge of the mandible 12.5 ± 0.5 mm. Conclusion: It is very important to locate these anatomical structures during treatment planning and avoid complications during and after the surgical act (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Cone-Beam Computed Tomography , Mandible/anatomy & histology , Mandible/diagnostic imaging , Sex Factors , Epidemiology, Descriptive , Statistical Analysis , Retrospective Studies , Mandibular Nerve/anatomy & histology , Mexico
14.
J. oral res. (Impresa) ; 8(1): 82-90, feb. 28, 2019. ilus
Article in English | LILACS | ID: biblio-1145295

ABSTRACT

The Pterygospinous Ligament (PSL) extends from the Pterygospinous process of the lateral Pterygoid plate to the spine of the sphenoid bone. Sometimes, it may be ossified forming a bar of bone bounding the pterygospinous foramen to which mandibular nerve and its branches are variably related. Mandibular and chorda tympani nerves may get compressed depicting various clinical symptoms, which in turn depend upon dimensions of the foramen and grades of compression. Therefore, knowledge of the position and extent of ossification of PSL and its relation to the important structures in the deep infratemporal fossa is important for radiologists, neurologists, maxillofacial surgeons, dental surgeons and anesthesiologists during various anesthetic and surgical procedures.


El ligamento Pterigoespinoso (LP) se extiende desde el proceso Pterigoespinoso de la placa Pterigoideo lateral a la espina etmoidal del hueso esfenoides. A veces, se puede osificar formando un puente de hueso que une el foramen espinoso con el cual el nervio mandibular y sus ramas están relacionados de manera variable. Los nervios mandibulares y el cordón timpánico se pueden comprimir resultando en diversos síntomas clínicos, que a su vez dependen de las dimensiones del foramen y los grados de compresión. Por lo tanto, el conocimiento de la posición y el grado de osificación del ligamento pterigoespinoso y su relación con las estructuras importantes en la fosa infratemporal profunda es importante para radiólogos, neurólogos, cirujanos maxilofaciales, cirujanos dentales y anestesistas durante diversos procedimientos anestésicos y quirúrgicos.


Subject(s)
Humans , Sphenoid Bone , Ligaments/anatomy & histology , Mandibular Nerve , Bridges , Foramen Ovale , Infratemporal Fossa
15.
Article in French | AIM, AIM | ID: biblio-1264228

ABSTRACT

Le schwannome malin est une tumeur des gaines nerveuses développée aux dépens des cellules de Schwann. Il est extrêmement rare dans la région cervico-faciale, et surtout à la mandibule. L'intérêt de cette présentation est qu'elle a permis de mettre en évidence les difficultés de prise en charge de cette tumeur. Nous rapportons le cas d'une patiente de 60 ans qui avait subi en avril 2018 à la clinique mutualiste de Cotonou une résection interruptrice de l'hémimandibule droite pour un schwannome malin du nerf dentaire inférieur droit. Il y a eu récidive 4 mois après la résection. La revue de littérature faite à l'occasion de la présentation de ce cas avait mis en exergue les réelles difficultés diagnostiques et thérapeutiques de cette tumeur. C'est une tumeur agressive avec un taux élevé de métastases et de récidives locales. Le schwannome malin du nerf dentaire inférieur est de pronostic sombre car, en dépit de la résection chirurgicale, seule option thérapeutique dans notre contexte, il y a eu récidive au bout de 4 mois


Subject(s)
Benin , Disease Management , Mandibular Nerve , Neurilemmoma
16.
Article in English | WPRIM | ID: wpr-740004

ABSTRACT

BACKGROUND: The purpose of this study was to compare the pain perception and anesthetic efficacy of 2% lignocaine with 1:200,000 epinephrine, buffered lignocaine, and 4% articaine with 1:200,000 epinephrine for the inferior alveolar nerve block. METHODS: This was a double-blind crossover study involving 48 children aged 5–10 years, who received three inferior alveolar nerve block injections in three appointments scheduled one week apart from the next. Pain on injection was assessed using the Wong-Baker Faces pain scale and the sound eye motor scale (SEM). Efficacy of anesthesia was assessed by subjective (tingling or numbness of the lip, tongue, and corner of mouth) and objective signs (pain on probing). RESULTS: Pain perception on injection assessed with Wong-Baker scale was significantly different between buffered lignocaine and lignocaine (P < 0.001) and between buffered lignocaine and articaine (P = 0.041). The onset of anesthesia was lowest for buffered lignocaine, with a statistically significant difference between buffered lignocaine and lignocaine (P < 0.001). Moreover, the efficacy of local analgesia assessed using objective signs was significantly different between buffered lignocaine and lignocaine (P < 0.001) and between lignocaine and articaine. CONCLUSION: Buffered lignocaine was the least painful and the most efficacious anesthetic agent during the inferior alveolar nerve block injection in 5–10-year-old patients.


Subject(s)
Analgesia , Anesthesia , Appointments and Schedules , Buffers , Carticaine , Child , Cross-Over Studies , Epinephrine , Humans , Hypesthesia , Lidocaine , Lip , Mandibular Nerve , Pain Perception , Tongue
17.
Article in English | WPRIM | ID: wpr-785942

ABSTRACT

BACKGROUND: Local anesthetics alone or in combination with adjuncts, such as oral medications, have routinely been used for pain control during endodontic treatment. The best clinical choice amongst the vast numbers of agents and techniques available for pain control for irreversible pulpitis is unclear. This network meta-analysis combined the available evidence on agents and techniques for pulpal anesthesia in the maxilla and mandible, in order to identify the best amongst these approaches statistically, as a basis for future clinical trials.METHODS: Randomized trials in MEDLINE, DARE, and COCHRANE databases were screened based on inclusion criteria and data were extracted. Heterogeneity was assessed and odds ratios were used to estimate effects. Inconsistencies between direct and indirect pooled estimates were evaluated by H-statistics. The Grading of Recommendation, Assessment, Development, and Evaluation working group approach was used to assess evidence quality.RESULTS: Sixty-two studies (nine studies in the maxilla and 53 studies in the mandible) were included in the meta-analysis. Increased mandibular pulpal anesthesia success was observed on premedication with aceclofenac + paracetamol or supplemental 4% articaine buccal infiltration or ibuprofen+paracetamol premedication, all the above mentioned with 2% lignocaine inferior alveolar nerve block (IANB). No significant difference was noted for any of the agents investigated in terms of the success rate of maxillary pulpal anesthesia.CONCLUSION: Direct and indirect comparisons indicated that some combinations of IANB with premedication and/or supplemental infiltration had a greater chance of producing successful mandibular pulpal anesthesia. No ideal technique for maxillary anesthesia emerged. Randomized clinical trials with increased sample size may be needed to provide more conclusive data. Our findings suggest that further high-quality studies are required in order to provide definitive direction to clinicians regarding the best agents and techniques to use for mandibular and maxillary anesthesia for irreversible pulpitis.


Subject(s)
Acetaminophen , Anesthesia , Anesthetics, Local , Carticaine , Lidocaine , Mandible , Mandibular Nerve , Maxilla , Odds Ratio , Population Characteristics , Premedication , Pulpitis , Root Canal Therapy , Sample Size
18.
Article in Korean | WPRIM | ID: wpr-764424

ABSTRACT

In the case of edentulous patients, the total amount of occlusal force is dispersed by the keratinized gingiva during mastication, in result, causing lower masticatory and chewing efficiency. In particular, the mandibular area has more side effects such as pain than the maxilla has. It gets worse when the patient has more absorption of alveolar bone, but the implant treatment is often interrupted due to the existence of the inferior alveolar nerve. In this case, a patient treated with the all-on-4 method by placing the implant in the anterior part of mandible and with the conventional complete denture for the maxilla has maintained without complications and was satisfied with the restoration both functionally and esthetically.


Subject(s)
Absorption , Bite Force , Denture, Complete , Gingiva , Humans , Mandible , Mandibular Nerve , Mastication , Maxilla , Methods
19.
Article in English | WPRIM | ID: wpr-764004

ABSTRACT

PURPOSE: The aim of this study was to evaluate the relationship between the mandibular canal and impacted mandibular third molars using cone-beam computed tomography (CBCT) and to compare the CBCT findings with signs on panoramic radiographs (PRs). MATERIALS AND METHODS: This retrospective study consisted of 200 mandibular third molars from 200 patients who showed a close relationship between the mandibular canal and impacted third molars on PRs and were referred for a CBCT examination of the position of the mandibular canal. The sample consisted of 124 females and 76 males, with ages ranging from 18 to 47 years (mean, 25.75±6.15 years). PRs were evaluated for interruption of the mandibular canal wall, darkening of the roots, diversion of the mandibular canal, and narrowing of the mandibular canal. Correlations between the PR and CBCT findings were statistically analyzed. RESULTS: In total, 146 cases (73%) showed an absence of canal cortication between the mandibular canal and impacted third molar on CBCT images. A statistically significant relationship was found between CBCT and PR findings (P<0.05). The absence of canal cortication on CBCT images was most frequently accompanied by the PR sign of diversion of the mandibular canal (96%) and least frequently by interruption of the mandibular canal wall (65%). CONCLUSION: CBCT examinations are highly recommended when diversion of the mandibular canal is observed on PR images to reduce the risk of mandibular nerve injury, and this sign appears to be more relevant than other PR signs.


Subject(s)
Cone-Beam Computed Tomography , Female , Humans , Male , Mandibular Nerve , Molar, Third , Radiography, Panoramic , Retrospective Studies , Tooth, Impacted
20.
Article in English | WPRIM | ID: wpr-763998

ABSTRACT

PURPOSE: This study reviewed the common conditions associated with displacement of inferior alveolar nerve canal. MATERIALS AND METHODS: General search engines and specialized databases including Google Scholar, Pub Med, Pub Med Central, Science Direct, and Scopus were used to find relevant studies by using keywords such as “mandibular canal”, “alveolar canal”, “inferior alveolar nerve canal”, “inferior dental canal”, “inferior mandibular canal” and “displacement”. RESULTS: About 120 articles were found, of which approximately 70 were broadly relevant to the topic. We ultimately included 37 articles that were closely related to the topic of interest. When the data were compiled, the following 8 lesions were found to have a relationship with displacement of mandibular canal: radicular/residual cysts, dentigerous cyst, odontogenic keratocyst, aneurysmal bone cyst, ameloblastoma, central giant cell granuloma, fibrous dysplasis, and cementossifying fibroma. CONCLUSION: When clinicians encounter a lesion associated with displaced mandibular canal, they should first consider these entities in the differential diagnosis. This review would help dentists make more accurate diagnoses and develop better treatment plans according to patients' radiographs.


Subject(s)
Ameloblastoma , Aneurysm , Bone Cysts , Dentigerous Cyst , Dentists , Diagnosis , Diagnosis, Differential , Fibroma , Granuloma, Giant Cell , Humans , Mandibular Nerve , Odontogenic Cysts , Odontogenic Tumors , Search Engine
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