Terminal branching pattern of facial nerve seen in adult cadavers: an anatomical study

Introduction: There are twelve cranial nerves and seventh one is the Facial cranial nerve, which supplies the muscles of facial expression. It gives of five terminal branches, which form a plexus with in the parotid gland. These branches exhibit variations in their branching pattern. Detection of the main trunk of facial nerve and its branches is important in all surgeries of this area, to avoid any injury that may lead to the loss of function of this nerve. This study has elaborated the branching and communications among the terminal branches of facial nerve in parotid gland

Objectives: To study the anatomical variations in the terminal branching and communicating pattern of the seventh cranial nerve and to observe the division pattern of the facial nerve trunk in parotid area

Study Design: It was carried out at Department of Forensics and Department of Anatomy in King Edward Medical University Lahore

Period: The study commenced in March 2014 after approval of the synopsis by the Advance Studies and Research Board of KEMU and was successfully completed in December 2015

Methodology: Dissection of one hundred hemi-faces in the Departments of Forensic and Anatomy at King Edward Medical University Lahore. Adult cadavers of both sexes were included and with mutilated face were excluded. A Descriptive Cross-sectional type of study. Collected data was analyzed in SPSS 13. Simple frequency/percentages tables and charts were used to presents the outputs. Chi-Square, Student t-test and ANOVA were used

Results: Branching and Communicating Pattern according to occurrence were: Type I, 9%, Type II, 39%, Type III, 20%, Type IV, 25%, Type V, 6%, Type VI, 1%. 95% cases showed bifurcation

Conclusion: Most common branching pattern was Type II [39%], and least common was Type VI [1%]. Surgery of Zygomatic region must be done carefully due to complexity of branching in this area

study of demineralized and remineralized enamel and hydroxyapatite using nuclear magnetic resonance (nmr)

The study was conducted to observe if there is any difference in the chemical structure of demineralized and remineralized enamel and hydroxyapatite using solid state 3IP MAS NMR techniques. Chemical structure and composition of enamel and hydroxy apatite powder were analyzed using different acids i.e. hydrochloric acid, citric acid and acetic acid, of different molarities, followed by treatment in remineralizing solution for a time period of 1, 3, 6 and in some cases 7 days, using NMR. We expected to change current concepts of remineralizing and demineralizing processes of enamel and hydroxy apatite

Synthetic hydroxy apatite provided by Plasma Biotal was used for the experiments, while extracted teeth provided by tissue culture labs were used for the enamel. The enamel crowns were converted into powder using Gyro Mill. All the measurements for NMR were done in Bruker NMR spectrometer which had a magnetic field strength of 600MHz or 14.1 Tesla. The nucleus used for the experiments was Phosphorous-31. Changes were observed in the peak positions of HAP as well as enamel powder samples. Remineralized samples [both enamel and HAP] also showed increase in mass which may be due to precipitation of hydroxy apatite on consuming the ions, used from the remineralizing solution

This study provides a better insight into the remineralization and demineralization of enamel and HAP and the changes that take place in the chemical structure after and during the processes. The work also demonstrates that NMR is a very powerful and modern technique which can be used to detect structural changes in different complicated materials

Zinc and flouride containing bioactive glasses in dentistry

The bioactive glasses have been used in the medical field due to their wide spread benefits as implant coatings, bone substitutes and for treatment of dentine sensitivity. The purpose of this study was to incorporate zinc and fluoride in the bioactive glass for potential use in dentifrices as antibacterial and anticaries agents. A series of glass compositions based on SiO2, CaO, CaF2, MgO, and ZnO were prepared with varied amounts of ZnO content ranging from 0% to 15%. Glass synthesis was done by using melt-quench route and fine powder having particle size <38 micro m was obtained by grinding and sieving. Particle size analysis and Differential scanning calorimetry were performed on powder samples. The dissolution study was done in Tris buffer and Acetic acid. Zinc in bioactive glass caused a decrease in glass transition and crystallization temperature. The behavior of zinc free glass was entirely different from zinc containing glass in both Tris and acetic acid. There was rapid release of high concentrations of zinc along with other ions in acetic acid whereas relatively small amount was released in Tris. The fluoride release was slow and small concentrations were recorded in Tris while in acetic acid there was relatively high concentration of fluoride as compared to Tris. The release of calcium and magnesium has been affected in the presence of zinc in Tris and acetic acid. Zinc and fluoride containing bioglasses which are degradable in acetic acid were formulated. But the stability of glass in normal physiological condition has to be further improved with future research work

Marginal mandibular nerve and its relation with lower border of mandible and facial artery

Marginal mandibular nerve is a motor branch of facial nerve which supplies the muscles of the peri oral region. Surgical and cosmetic procedures might cause injury to this nerve resulting in functional loss and cosmetic imperfection. This study on the anatomical relation of marginal mandibular nerve, with respect to the lower border of mandible and facial artery, will benefit maxillofacial and plastic surgeons in its safe identification, hence preserving the functional integrity of this significant branch of facial nerve. Careful dissection was done on one hundred [100] hemi-faces of adult cadavers in Forensic and Anatomy departments of King Edward Medical University, Lahore from September 2009 to March 2010. Cadavers with scar, disfigurement or putrefaction in face and/or neck region were excluded. In 100 hemi faces, Marginal mandibular nerve present singly above the lower border of mandible was seen in 74% of cases. Marginal mandibular nerve having two rami, both located above the lower border was seen in 14% of cases. Two rami of marginal mandibular nerve, one present above and one below the lower border of mandible was seen in 6% of cases. Three rami of marginal mandibular nerve, two rami above and one below lower border of mandible were present in 6% of cases. In our population marginal mandibular nerve normally exits from anterior border of parotid gland above the lower border of mandible. When two or more rami of nerve are present; chances of lower most rami of nerve coursing below the inferior border of mandible increases. The nerve rami are present superficial to facial artery. It is at risk of iatrogenic injury overlying and anterior to massetter muscle where the nerve lies superficially underneath a thin layer of superficial musculoaponeurotic system

Number of rami of marginal mandibular nerve and its communication with other terminal motor branches of facial nerve in adult unclaimed cadavers - an anatomical study

Marginal mandibular nerve is one of the five terminal motor branches of facial nerve given in the substance of parotid gland. Injury to this nerve during surgical procedures hampers the actions of muscles of the lip and chin causing functional and aesthetic impairment. This study on number of rami and communication of marginal mandibular nerve will benefit maxillofacial, general, cosmetic /plastic surgeons to safely prevent iatrogenic injury to this important branch of facial nerve. Dissection of one hundred [100] hemi-faces of adult unclaimed cadavers of both genders was done [from September 2009 to March 2010] in Forensic and Anatomy departments of King Edward Medical University, Lahore. Cadavers with any scar or mutilated face/ neck were excluded from this study. In 100 hemi faces, number of rami of marginal mandibular nerve varies from 1-3. Single branch is most common [74%] followed by two [20%] and three rami [6%]. In 36% of cases communication was seen with buccal branch, 1% with cervical branch, with both buccal and cervical branches in 1% of cases. No communication with either buccal or cervical branch of facial nerve was seen in 62% of cases. Frequency of communication increases with number of Rami of marginal mandibular nerve. In our population single marginal mandibular nerve is most common [74%] which does not communicate with other branches of facial nerve frequently [74.3%]. Therefore transection of this nerve during surgical procedures can result in permanent paralysis

Bacteremia after orthodontic banding

The placement of orthodontic bands on molar teeth is a routine procedure during orthodontic treatment .There is a possibility that bacteria may enter the blood stream during this process. The objective of this study was to determine the frequency of post procedural bacteremia in patients undergoing orthodontic banding. A Cross sectional survey was carried out at the Department of Orthodontics, de, Montmorency College of Dentistry / Punjab Dental Hospital Lahore during a period of 6 months [1[st] March ,2009 to 31[st] August, 2009] The study included 140 subjects with age range between 8-25 yrs of both sexes. Bands were placed on molar teeth and blood samples were taken before and after placement of bands. Blood cultures were done on the samples to assess the presence of bacteremia. The study revealed that there was no significant bacteremia after orthodontic banding so as to be considered a potential threat for normal patients. It was concluded that the level of bacteremia detected was not significant to be considered hazardous in routine orthodontic treatment. The prescription of antibiotic therapy should be based on the latest guidelines