Mandibular Incisive Canal Morphometry: A Cone-Beam Computed Tomography Study in Jordan

SUMMARY: Mandibular incisive canal (MIC) and related mental foramen (MF) and anterior loop (AL) morphometrics are important landmarks in medical and dental clinical applications. The main aim of this retrospective study to determine the morphometry of the mandibular incisive canal (MIC) in a Jordanian population and to propose a new shape-pattern classification of the MIC. In addition, MF and AL morphometrics were determined. Carestream 3D imaging software was used on 100 Cone-Beam Computed Tomography (CBCT) of a Jordanian population to determine the MF, AL and MIC morphometrics. The detection prevalence of the MIC was 96 %. The right and left MIC showed four distinct line patterns, proposed for the first time in this paper. The line-patterns were angular (L-line), straight (I-line), curved (V-line) and wavy (W-line), with a prevalence of 41 %, 19 %, 25.5 %, and 10.5 %, respectively. MF was detected in all mandibles with a round shape in 58 % of the images. The most common horizontal and vertical positions of the MF were H4 and H3 (73.5 %) and V3 and V2 (95 %), respectively. An accessory MF was detected in 14.5 % of the samples and was more prevalent in males and on the right side. AL was detected in 92.5 % of the samples and exhibited a pattern prevalence of 25.5 %, 40 % and 27 % for types I, II and III, respectively. Results revealed that asymmetry and gender differences between right and left MIC, MF, AL and AMF was seen in patient's mandibles. In conclusion, this is the first study to propose and show that Mandibular incisive canal exhibits four potential line patterns (L, I, V and W lines patterns). Gender and ethnic variations of the mandibular canal landmarks morphometrics of both right and left hemi-mandible are important to be acknowledged in learning anatomy and when planning or performing dental and medical procedures.

Las relaciones de la morfometría del canal incisivo mandibular (MCI), del foramen mentoniano (FM) y del asa anterior (AA) son hitos importantes en las aplicaciones clínicas médicas y dentales. El objetivo principal de este estudio retrospectivo fue determinar la morfometría del MCI en una población jordana y proponer una nueva clasificación de patrón de forma del MCI. Además, se determinaron la morfometría de FM y AA. Se utilizó el software de imágenes 3D Carestream en 100 tomografías computarizadas de haz cónico (CBCT) de una población jordana para determinar la morfometría de FM, MCI y AA. La prevalencia de detección de MCI fue del 96 %. El MCI derecho e izquierdo mostraron cuatro patrones de líneas distintas, propuestas por primera vez en este artículo. Los patrones de líneas fueron angulares (línea L), rectos (línea I), curvos (línea V) y ondulados (línea W), con una prevalencia del 41 %, 19 %, 25,5 % y 10,5 % respectivamente. Se detectó el FM en todas las mandíbulas y con forma redonda en el 58 % de las imágenes. Las posiciones horizontal y vertical más comunes del FM fueron H4 y H3 (73,5 %) y V3 y V2 (95 %), respectivamente. Se detectó FM accesorio en el 14,5 % de las muestras y fue más prevalente en el sexo masculino y en el lado derecho. AA se detectó en el 92,5 % de las muestras y exhibió un patrón de prevalencia del 25,5 %, 40 % y 27 % para los tipos I, II y III, respectivamente. Los resultados revelaron asimetría y diferencias en el sexo entre MCI, FM, AA derecha e izquierda en las mandíbulas de los pacientes. En conclusión, este es el primer estudio que propone y muestra que el canal incisivo mandibular exhibe cuatro patrones de líneas potenciales (patrones de líneas L, I, V y W). Es importante reconocer las variaciones étnicas y de sexo de la morfometría de los puntos de referencia del canal mandibular de la hemimandíbula derecha e izquierda al estudiar y aprender anatomía y al planificar o realizar procedimientos médicos y dentales.

Nasopalatine Duct Cyst in a 31 Year-Old Male: Imaging Findings in Computed Tomography / Quiste del Canal Nasopalatino en un Hombre de 31 años: Hallazgos en Imágenes de Tomografía Computarizada

A 31-year-old man is presented and is evaluated by panoramic radiography. As a finding, an extensive lesion with a cystic appearance was detected in the anterior part of the maxilla. Computed tomography shows a lesion corresponding to the characteristics of a cyst. In the histology the combination of two types of epithelium is observed, pseudostratified columnar and stratified squamous, confirming that this was a nasopalatine duct cyst.

Se presenta el caso de un hombre de 31 años, evaluado mediante radiografía panorámica. Como hallazgo se detecta una extensa lesión de aspecto quístico en la parte anterior del maxilar. En la tomografía computada se observa una lesión que corresponde a las carácterísticas de un quiste. La histología muestra una combinación de dos tipos de epitelio, pseudostratificado columnar y estratificado escamoso, confirmando que se trataba de un quiste del canal nasopalatino.

Evaluation of the incisive canal using cone beam computed tomography

The incisive canal is innervated by the nasopalatine nerve and irrigated by the anterior branches of the descending palatine vessels, the sphenopalatine and greater palatine artery. Sometimes, the incisor canal interferes with the placement of implants or other surgical procedures, it is necessary to resort to previous treatments in order to have the ideal conditions in the area to be treated and avoid complications. Methods: 100 cone beam computed tomography were studied evaluating the diameter, length and shape of the incisor canal, distance from the lower edge of the incisor canal to the alveolar ridge, length and width of the bone anterior to the incisor canal, and width of the palatal bone. Results and conclusions: The variables that showed a statistically significant difference comparing between male and female patients were vestibulo-palatal and incisor foramen diameter, incisor canal length, distance from the canal to the central incisor, coronal and medial width of the vestibular bone; and the width of the palatal bone at apical and mid-level; being greater in male patients.

Asociación entre la inclinación sagital del incisivo central superior y el ángulo nasolabial en ortodoncia

Objetivo: determinar si existe asociación entre la inclinación del incisivo central superior y el ángulo naso-labial de Legan. Materiales y métodos: se utilizaron las telerradiografías laterales de cráneo de 20 pacientes entre 18 y 39 años, obtenidas al inicio y final de su tratamiento ortodóncico, para un análisis cefalométrico. El total de medidas obtenidas se ordenó en dos tiempos. Tiempo 1 (T1) incluyó la medición del ángulo plano biespinal-eje mayor del incisivo superior (AiT1) y del ángulo naso-labial (AnlT1) en las radiografías tomadas previo al tratamiento y tiempo 2 (T2) incluyó la medición de los mismos ángulos en las radiografías tomadas al finalizar el tratamiento (AiT2 y AnlT2 respectivamente). Los datos obtenidos fueron tabulados y analizados estadísticamente. Resultados: la muestra presentó distribución normal, por lo que se aplicó el test de correlación de Pearson, para determinar si existía asociación entre ambas variables (Ai y Anl) en T1 y T2, obteniendo como resultado un valor de R=0,5. Conclusión: no existe asociación estadística entre la variación en la inclinación del incisivo central superior y el Ángulo naso-labial de Legan.

Aim: to determine if there is an association between the inclination of the upper central incisor and the nasolabial Legan angle. Materials and methods: lateral head radiographs of 20 patients between 18 and 39 years old, obtained at the beginning and end of their orthodontic treatment, were used for a cephalometric analysis. The total of measurements obtained was ordered in two times. Time 1 (T1) included the measurement of the bispinal plane angle-major axis of the upper incisor (AiT1) and the nasolabial angle (AnlT1) in the radiographs taken before treatment and time 2 (T2) included the measurement of the same angles, in the radiographs taken at the end of the treatment (AiT2 and AnlT2 respectively). The data obtained were tabulated and statistically analyzed. Results: the sample presented a normal distribution. So, the Pearson correlation test was applied to determine if there was an association between both variables (Ai and Anl) in T1 and T2, obtaining a value of R=0.5 as a result. Conclusion: there is no statistical association between the variation in the inclination of the upper central incisor and the nasolabial Angle of Legan.

Oclusión basada en evidencia: rompiendo paradigmas / Occlusion based on evidence: breaking paradigms

La odontología basada en evidencias es una metodología que busca que las decisiones clínicas diarias que toman los profesionales en estomatología se encuentren fundamentadas en la evidencia científica, en ella se integran las experiencias clínicas, las necesidades, las preferencias del paciente y la evidencia clínicamente relevante más actual analizada por pares. Estos pilares son parte del proceso en la toma de decisiones para la atención al paciente. La odontología basada en evidencias surge de las exitosas experiencias obtenidas con el desarrollo e implementación de la medicina fundamentada en pruebas, al aplicar el método científico en la evaluación, planificación y toma de decisiones de las prestaciones sanitarias, sobre todo a través de los estudios controlados. En general, toda la práctica odontológica ha tenido grandes avances basados en evidencias, con hechos verídicos comprobados, pero los conceptos fundamentales de oclusión no han tenido una mejora cimentada en el conocimiento científico, prueba de ello es que se siguen ocupando teorías y conceptos de las filosofías de oclusión en la rehabilitación de muchos pacientes, seguimos creyendo en mitos y sofismas que no han podido ser demostrados. En esta revisión, demostramos los grandes avances en los conceptos de oclusión e invitamos a todos los odontólogos a romper los paradigmas de la oclusión antigua sin evidencias científicas y a utilizar las herramientas del método científico en la práctica clínica odontológica (AU)

Evidence-based dentistry is a strategy that seeks to ensure that the daily clinical decisions made by the dental professional are based on scientific evidence. It integrates the clinical experience of the dentist, the needs and preferences of the patient, and the most current relevant clinical evidence. All three are part of the decision-making process for patient care. Evidence-based dentistry arises from the successful experiences obtained with the development and implementation of evidence-based medicine, applying the scientific method in the evaluation, planning and decision-making of health benefits, especially through controlled studies. In general, all dental practice has had great advances based on evidence, with proven true facts, but the fundamental concepts of occlusion have not had an improvement based on scientific knowledge, proof of this is that theories and concepts continue to be used. of the philosophies of occlusion in patient rehabilitation, we follow myths and sophisms that have not been demonstrated, in this review, we demonstrate the great advances in the concepts of occlusion and we know all dentists to break the paradigms of the old occlusion without scientific evidence (AU)

Comparación de las características anatómicas del conducto nasopalatino en pacientes dentados y desdentados mediante tomografía computarizada de haz cónico. Lima 2018-2020 / Comparison of the anatomic characteristics of the nasopalatine duct in toothed and edentulous patients by cone beam computed tomography. Lima 2018-2020

Objetivo : Comparar las características anatómicas del CNP en pacientes dentados y desdentados mediante Tomografía Computarizada de Haz Cónico (TCHC) del Servicio de Radiología Bucomaxilofacial realizadas en el Centro Dental Docente de la Universidad Peruana Cayetano Heredia. Material y métodos : Se evaluaron todas las TCHC adquiridas entre los años 2018 y 2020, que cumplan con ciertos criterios; donde se comparó las características anatómicas del CNP. Los datos fueron registrados en una base de datos, luego representados en tablas. Resultados : Se evaluaron 216 volúmenes tomográficos (VT), divididos en dos grupos: dentados y desdentados. La forma cilíndrica y la forma de canal único fueron las más encontradas en ambos grupos. La longitud y la distancia fueron mayores en pacientes dentados, no se encontró asociación con relación al diámetro; la inclinación fue mayor en pacientes desdentados, encontrándose asociación con relación a la inclinación entre los grupos comparados. Conclusiones : Se encontraron múltiples diferencias anatómicas del CNP entre los pacientes dentados y desdentados evaluados con TCHC con relación al sexo y la edad.

Objective : To compare the anatomical characteristics of the NPC in dentate and edentulous patients using Cone Beam Computed Tomography (CBCT) of the Bucomaxillofacial Radiology Service performed at the Centro Dental Docente of the Universidad Peruana Cayetano Heredia. Material and methods : All TCHC acquired between the years 2018 and 2020, which meet certain criteria, were evaluated; where the anatomicals characteristics of the CNP were compared. The data were recorded in a database, then represented in tables. Results : 216 tomographic volumes were evaluated, divided into two groups: dentate and edentulous. The single cylindrical shape and the single channel shape were the most found in both groups. The length and distance were greater in dentate patients, no association was found in relation to the diameter, the inclination was greater in edentulous patients, finding an association in relation to the inclination between the compared groups. Conclusions : Multiple anatomical differences of the CNP were found between the dentate and edentulous patients evaluated with TCHC in relation to sex and age.

Relation entre la pente condylienne anatomique et la pente incisive chez des sujets mélanodermes: apport de l'imagerie numérique / Relationship between anatomical condylar slope and incisal slope in melanoderm subjects: contribution of digital imaging

Introduction. Le frein labial est un repli muqueux tendu entre la lèvre et le procès alvéolaire du maxillaire ou de la mandibule. Il est considéré pathologique lorsque son insertion ou sa taille interfère avec une fonction, une thérapeutique ou a des effets délétères sur les tissus parodontaux environnants. L'objectif de ce travail était de montrer l'intérêt de la frénectomie associée ou non à la greffe épithélioconjonctive dans la prise en charge des freins labiaux pathologiques à travers un rapport de deux cas clinques. Observation clinique et prise en charge. Deux patientes présentant des freins labiaux pathologiques ont été prises en charge dans le service de parodontologie de l'Institut d'Odontologie et de Stomatologie de l'Université Cheikh Anta Diop de Dakar. Des frénectomies ont été réalisées, dont l'une associée à une greffe épithélioconjonctive. La technique de l'incision en V est utilisée pour améliorer l'esthétique et la fonction. En présence de défaut parodontaux associés, la greffe épithélioconjonctive permet à la fois d'éliminer un frein aberrant, d'approfondir le vestibule et de renforcer le parodonte. Conclusion. Une élimination complète du frein et un bon rendu esthétique ont été obtenus par la frénectomie seule. Un approfondissement du vestibule et une augmentation en hauteur et en épaisseur de tissu kératinisé ont été observés grâce à la combinaison frénectomie et greffe épithélioconjonctive.

Introduction. Physiological determination of the condylar slope is difficult and its relationship with the incisal guidance slope has been the subject of several studies in leucodermal people. This study aimed to determine relationships bet ween incisal guidance and anatomical condylar slopes relative to axio-orbital plane in melanoderm population group. Materials and methods. It was a descriptive cross-sectional study. An exhaustive selection was made from teleradiographic files taken with a Carestream Dental CS 9600®. Incisal and anatomical condylar slopes were measured by Carestream's Imaging® software. Statistical analysis was performed using R 4.2.2 software at risk of 5%. Results. The sample consisted of 54 subjects, 53.7% of whom were men. The average of incisal slope was 57.5°±10° and 51.07°±7° for anatomical condylar slope. Mean difference according to gender was non-significant. Relationship between two types of slope revealed a Pearson correlation of 0.5. Linear regression yielded an equation Pi = 23.13+0.66 Pca. Conclusion. The Agreement between incisal slope and anatomical condylar slope could provide a reference for prosthetic rehabilitation. Racial and sexual difference suspected for incisal slope could be confirmed by further work. In this context, digital imaging provides great interest by its accessibility and reliability.

El canal incisivo: ¿maxilar o mandibular? Revisión narrativa / The incisive canal: a maxillary or mandibular structure? Narrative review

El canal incisivo es una estructura anatómica ósea que, según la terminología anatómica actual, se encuentra ubicada exclusivamente en la premaxila. Sin embargo, a continuación de los canales mandibulares, se desprenden hacia lateral los canales mentonianos (que contiene el paquete vasculonervioso del mismo nombre) y hacia anterior continua un paquete vasculonervioso, también denominado incisivo que inerva e irriga a dichos dientes mandibulares. Con el fin de aclarar lo previamente mencionado y distinguir ambas estructuras incisivas, se pretende agregar un sufijo (maxilar o mandibular) rectificando los nombres de dichos canales. Para lo anterior, se realizó una revisión de la bibliografía disponible en PubMed y Google Académico, con las palabras clave "CANAL INCISIVO" e "INCISIVE CANAL", utilizando como operador booleano la palabra OR. Los criterios de inclusión de los estudios fueron: 1) que se refieran a algún canal incisivo (ya sea maxilar o mandibular) 2) que estén disponibles para ser leídos a texto completo y 3) que su idioma sea inglés o español. De la totalidad de los artículos analizados, un 52 % hablaba exclusivamente del canal incisivo maxilar, un 43 % solo del canal incisivo mandibular y un 5 % sobre ambos. Concluyendo, podemos colegir que es de suma importancia que se regularice la nomenclatura de dichas estructuras anatómicas, debido a que, el hecho de reconocerla como tal permite garantizar su estudio y aporte desde toda la comunidad científica, sin importar la procedencia ni el idioma. Además, el canal incisivo mandibular está bien documentado, por lo que, al no ser reconocido en la terminología anatómica, se pierde la principal misión de la asociación internacional de asociaciones de anatomía (IFAA), la cual es unificar y organizar los nombres de las estructuras anatómicas existentes.

SUMMARY: The incisive canal is an anatomical bone structure that, according to current anatomical terminology, is located exclusively in the premaxilla. However, following the mandibular canals, the mental canals (containing the neurovascular bundle of the same name) branch off laterally and a neurovascular bundle continues anteriorly, also called the incisor, which innervates and irrigates said mandibular teeth. In order to clarify what was previously mentioned and to distinguish both incisive structures, it is intended to add a suffix (maxillary or mandibular) correcting the names of said canals. For the above, a review of the literature available in PubMed and Google Scholar was carried out, with the keywords "INCISIVE CANAL" and "INCISIVE CANAL", using the word OR as a boolean operator. The inclusion criteria of the studies were: 1) that they refer to an incisive canal (whether maxillary or mandibular) 2) that they be available to be read in full text and 3) that their language be English or Spanish. Of all the articles analyzed, 52% spoke exclusively about the maxillary incisive canal, 43% only about the mandibular incisive canal, and 5% about both. In conclusion, we can infer that it is of the utmost importance that the nomenclature of these anatomical structures be regularized, because the fact of recognizing it as such allows guaranteeing its study and contribution from the entire scientific community, regardless of origin or language. In addition, the mandibular incisive canal is well documented, therefore, by not being recognized in anatomical terminology, the main mission of the international association of anatomy associations (IFAA) is lost, which is to unify and organize the names of the anatomy. existing anatomical structures.

Determinación de la morfología del canal incisivo mandibular mediante tomografía computarizada de haz cónico (CBCT) en población de Valdivia, Chile / Determination of mandibular incisor canal morphology by cone beam computed tomography (CBCT) in a population of Valdivia, Chile

RESUMEN: El canal incisivo mandibular (MIC) es un canal neural que contiene una de las ramas inferiores del nervio alveolar inferior, llamado nervio incisivo mandibular, que puede resultar dañado durante intervenciones quirúrgicas y causar complicaciones postoperatorias. Estudio descriptivo de corte transversal. Se identificó el MIC en la imagen transversal del canino en 83 hemiarcadas. Se registró edad, sexo, hemiarcada, longitudes desde reborde alveolar vestibular de canino a MIC, cortical lingual y vestibular de canino a MIC, base mandibular de canino a MIC y ubicación del MIC (tercio lingual, medio, vestibular). Medidas se registraron en milímetros. Se aplicó test T-student para muestras independientes para variables de longitud y Chi-cuadrado para ubicación espacial del MIC, en relación con grupo etario y sexo. Se evaluó el MIC en todas las muestras (100 %). El MIC fue encontrado mayormente en el tercio medio mandibular (p <0,05). La media desde el MIC a la cortical lingual es de 5,25 mm ? 1,42 mm (derecho) y 5,24 mm ? 1,18 mm (izquierdo). La media desde el MIC a la cortical vestibular fue de 4,42 mm ? 1,29 mm (derecho) y 4,53 mm ? 1,24mm (izquierdo). La media entre centro del canal y reborde alveolar vestibular fue 18,89 mm ? 2,68mm (derecho) y 18,20 mm ? 3,06 mm (izquierdo), media desde centro del MIC al margen basal fue de 9,77 mm ? 1,93 (derecho) y 10,12 mm ? 1,92 mm (izquierdo). Se encontró mayor distribución del MIC en el tercio medio mandibular. Se identificó el MIC en el 100 % de las muestras a través de CBCT por lo que su uso como examen complementario debe ser considerado al planificar cirugías en el sector anterior mandibular.

SUMMARY: The objective of the study was to determine the morphology of the mandibular incisive canal (MIC) and its location using cone beam computed tomography (CBCT) in the population of Valdivia, Chile. Descriptive cross-sectional study. MIC was identified in the canine cross image in 83 quadrants. Age, gender, quadrants, length from buccal alveolar ridge of canine to MIC, lingual and buccal cortical of canine to MIC, mandibular base of canine to MIC, and location of MIC (lingual, middle and buccal third) were recorded. Measurements were recorded in millimeters. Independent sample Student-T test was performed to determine length variables and Chi-square test was performed to determine spatial location of MIC, in relation to age group and gender. MIC was evaluated in all samples (100 %). MIC was found mainly in the mandibular third quadrant (p < 0.05). The mean from the MIC to the lingual cortex is 5.25 mm ? 1.42 mm (right) and 5.24 mm ? 1.18 mm (left). The mean from the MIC to the buccal cortex was 4.42 ? 1.29 mm (right) and 4.53 mm ? 1.24 mm (left). The mean between the center of the canal and the buccal alveolar ridge was 18.89 mm ? 2.68mm (right) and 18.20 mm ? 3.06 mm (left), the mean from the center of the MIC to the basal edge was 9.77 mm ? 1.93 (right) and 10.12 mm ? 1.92 mm (left). A greater distribution of MIC was found in the mandibular third quadrant. MIC was identified in 100 % of the samples through CBCT, therefore, its use as a complementary examination should be considered when planning surgeries in the anterior mandibular area.

Morphometric study of incisive, greater and lesser palatine foramina: a novel point of maxillary nerve block in a Thai population / Estudio morfométrico del foramen palatino incisivo, mayor y menor: un punto novedoso de bloqueo del nervio maxilar en una población tailandesa

SUMMARY: To study the morphometric location of the incisive, greater, and lesser palatine foramina for maxillary nerve block. Two hundred Thai dry skulls were randomly organized from the Forensic Osteology Research Center. The distances of the parameters were measured via Vernier caliper.: Thedistances from the incisive foramen to the incisive margin of the premaxilla were 10.93?2.42 mm in males and 10.98?2.06 mm in females. From the left side, the incisive foramen to the greater palatine foramen (GPF) was39.07?2.23mm in males and 38.57?2.41 mm in females, and from the right side were 39.81?2.37 mm in males and 38.62?2.53mm in females. From the left side, the incisive foramen to the lesser palatine foramen (LPF) was 43.16?2.23 mm in males and 41.84?2.42mm in females and from the right side were 42.93?2.14 mm in males and 41.76?2.61 mm in females. The GPF found at medial to the maxillary third molar were 94-95 % in males and 84 % in females. These findings suggest that the medial position to the third molar teeth be used as a landmark for a palatine nerve block in Thais. These findings will help dentists to perform local anesthetic procedures, especially the nasopalatine and greater palatine nerve blocks, more effectively.

RESUMEN: El objetivo de este trabajo fue estudiar la localización morfométrica de los forámenes palatinos incisivos, mayores y menores para el bloqueo del nervio maxilar. Se organizaron al azar doscientos cráneos secos tailandeses del Centro de Investigación de Osteología Forense. Las distancias de los parámetros se midieron mediante un calibre Vernier. Las distancias desde el foramen incisivo hasta el margen incisivo de la premaxila fueron 10,93 ? 2,42 mm en hombres y 10,98 ? 2,06 mm en mujeres. Desde el lado izquierdo, el foramen incisivo al foramen palatino mayor (FPM) fue de 39,07 ? 2,23 mm en los hombres y 38,57 ? 2,41 mm en las mujeres, y del lado derecho fue de 39,81 ? 2,37 mm en los hombres y 38,62 ? 2,53 mm en las mujeres. Del lado izquierdo, el foramen incisivo al foramen palatino menor (LPF) fue de 43,16 ? 2,23 mm en hombres y 41,84 ? 2,42 mm en mujeres y del lado derecho 42,93 ? 2,14 mm en hombres y 41,76 ? 2,61 mm en mujeres. El FPM encontrado medial al tercer molar maxilar fue 94-95 % en hombres y 84 % en mujeres. Estos hallazgos sugieren que la posición medial de los terceros molares se utilice como punto de referencia para un bloqueo del nervio palatino en individuos tailandeses. Estos hallazgos ayudarán, de manera más eficaz, a los dentistas a realizar procedimientos anestésicos locales, especialmente los bloqueos nasopalatinos y del nervio palatino mayor.

Morphological Analysis of Length and Shape Nasopalatine Canal onHuman Dry Skulls

Background:To assess length and shape of nasopalatine canal on human dry skulls. Subjects and Methods:Fifty- four dry human skulls of either gender was recruited for the study. The length of the nasopalatine canal was measured from the definite point (interproximal region) of the central incisors to the distal end of the incisive foramen. Incisive foramen diameter was calculated in the sagittal plane by measuring the anteroposterior distance of the oral entrance of the NPC. Shape was categorized into 4 types, Cylindrical, funnel, hourglass and spindle shape.Results:The mean length of nasopalatine canal was 16.2 mm in males and 13.4 mm in females. A significant difference was observed (P< 0.05). A non- significant difference in male (5.3 mm) and females (4.9 mm) incisive foramen diameter was observed. The most common shape of nasopalatine canal was cylindrical in 23, funnel in 7, hourglass in 21 and spindle shape in 3 skulls. A significant difference was observed (P< 0.05).Conclusion: Nasopalatine canal morphology assessment is essential to prevent iatrogenic injury to the anatomical structures. Mostcommon shape found to be hour glass and cylindrical

Evaluation of Anatomical Characteristics of Mandibular Incisive Canal in a Turkish Subpopulation Using Cone Beam Computed Tomography

ABSTRACT Objective: To assess the anatomical characteristics of mandibular incisive canal and to describe the occurrence of anatomical variations according to side, age and gender using cone beam computed tomography (CBCT). Methods: A retrospective study using CBCT images was performed to evaluate mandibular incisive canal in mandible of 100 patients. Both right and left sides were studied (n = 200). Axial, sagittal, cross-sectional and panoramic images were evaluated, and three dimensional images were also reconstructed and evaluated, as necessary. The morphology, course and length of mandibular incisive canals and the inner and outer diameters of the canals were measured. Results: The incisive canal was found in 87% of the scans. The mean endpoint was approximately 10.98 and 10.26 mm anterior to the mental foramen for left and right side, respectively, without a significant difference (p > 0.05). The mean distance from the lower border of the mandible was 10.7 mm and its course was closer to the buccal border at the starting point while it deviates lingually through the anterior of the mandible. Significant difference was found between gender, side and age groups (p < 0.05). Conclusion: Awareness of these anatomical variations is important to avoid neurovascular damage during surgical intervention and anaesthetic applications. Cone beam computed tomography is an effective imaging modality in the detection of lingual foramina and canals. Further studies with larger data samples are necessary in comparison and estimation of anatomical results.

Caracterización anatómica del conducto nasopalatino mediante tomografía computarizada de haz cónico en una población peruana / Anatomic characterization of the nasopalatine canal through cone beam computed tomography in a Peruvian population

RESUMEN El Conducto Nasopalatino (CNP) es una estructura importante que puede ser susceptible de daño durante procedimientos quirúrgicos en el maxilar superior anterior; por lo tanto examinar meticulosamente la anatomía y variantes del CNP se hace imperativo para un buen diagnóstico y un apropiado plan de tratamiento. Objetivo: Realizar una caracterización anatómica del CNP utilizando Tomografía Computarizada de Haz Cónico (TCHC). Material y métodos: Se evaluaron 154 imágenes de TCHC, en las que se analizó CNP en cuanto a su longitud, forma, e inclinación con respecto al paladar duro y el diámetro anteroposterior del foramen incisivo (FI) en hombres y mujeres de 18 años de edad en adelante. Resultados: A la evaluación del CNP en cortes sagitales de TCHC presentó diferentes formas; se encontró que la forma más común fue la cilíndrica en 89 pacientes (58%), seguida de la forma de embudo en 38 (25%), y las menos frecuentes fueron la forma a de reloj de arena en 20 (13%) y de huso en 7 (5%). La longitud promedio del CNP fue de 10,83 mm (± 2,13), el promedio del diámetro anteroposterior del FI fue de 3,44 mm (± 0,80) y la angulación promedio en relación al paladar duro fue de 16,44° (± 7,32). Conclusiones: El estudio mostró la variabilidad del CNP en la población peruana, tanto en la forma, longitud e inclinación, así como también en el diámetro del FI.

SUMMARY Nasopalatine Canal (NPC) is an important structure that may be susceptible to damage during surgical procedures in the anterior maxilla, therefore a thorough examination of the anatomy and variants of the NPC is imperative for a good diagnosis and an appropriate treatment plan. Objective: To perform an anatomic characterization of NPC using Computed Beam Computed Tomography (CBCT). Material and methods: 154 images of CBCT were evaluated, in which the NPC was analyzed in terms of length, shape, and inclination with respect to the hard palate and the maximum anteroposterior of the incisive foramen (IF) in men and women of 18 years of age and onwards. Results: to the evaluation of the NCP in sagittal slices of CBCT, it presented different forms, it was found to the cylindrical shape as the most common in 89 patients (58%), followed by the funnel shape in 38 (25%), and the less frequent were the shape of hourglass in 20 (13%) and spindle (5%). The average length of the NCP was 10.83 mm (± 2.13), the average of the anteroposterior diameter of the FI was 3.44 mm (± 0.80) and the average angulation of the CNP in relation to the hard palate was 16.44 ° (± 7.32). Conclusions: The study showed the variability of NCP in the Peruvian population, like in shape, length and inclination, as well as the diameter of the FI.

Tratamiento ortodóncico en paciente adulta con Periodontitis crónica controlada / Orthodontic treatment in an adult patient with controlled chronic periodontitis

RESUMEN Introducción: En pacientes adultos con periodontitis el tratamiento de Ortodoncia constituye un reto, por las condiciones biomecánicas que impone la edad, y el estado de afectación del periodonto; principal responsable de los movimientos ortodóncicos. Objetivo: Describir el tratamiento ortodóncico realizado en paciente adulta con periodontitis crónica controlada y los resultados conseguidos. Presentación del caso: Paciente femenina de 41 años, con periodontitis crónica tratada. Diastemas y extrusión en incisivos, pérdida de la inserción periodontal y exposición del cemento radicular. Apiñamiento incisivo inferior, con extrusión e incremento de la curva de Spee. Trauma oclusal interincisivo. El plan de tratamiento incluyó control de la periodontitis, la extracción de un incisivo inferior y la intrusión dentaria incisiva bimaxilar. El tratamiento duró año y medio. Los resultados fueron excelentes. Se devolvió la función perdida; se consiguió incrementar la inserción periodontal, con la consiguiente disminución de la movilidad dentaria. Se corrigió la estética afectada y se obtuvo la satisfacción de la paciente. Conclusiones: A partir de la aplicación del tratamiento de Ortodoncia se consiguió corregir las anomalías de posición dentarias y de la oclusión, devolver a la paciente adulta portadora de periodontitis crónica la estética perdida y una oclusión funcional. Las decisiones terapéuticas consideraron el estado del periodonto, el control de la enfermedad y la edad de la paciente. Las fuerzas aplicadas fueron extremadamente controladas y el tiempo de tratamiento el menor posible. La motivación y el cuidado de la higiene bucal contribuyeron a los resultados alcanzados.

ABSTRACT Introduction: The orthodontic treatment is a challenge in adult patients with periodontitis because of the biomechanical conditions imposed by age and the state of involvement of the periodontium, which is the main responsible for orthodontic movements. Objective: To describe the orthodontic treatment performed in an adult patient with controlled chronic periodontitis and to show the results obtained. Case Presentation: Forty-one years old female patient with chronic periodontitis. She presented diastemas and incisors extrusion, loss of periodontal insertion and exposure of the root cement, lower incisor crowding with extrusion and increase of the curve of Spee. She also had interincisive occlusal trauma. The treatment plan included the control of periodontitis, the removal of a lower incisor and the intrusion of bimaxillary incisor. The treatment lasted a year and a half. The results were excellent. The lost function was restored and periodontal insertion was increased with the consequent decrease in tooth mobility. The affected aesthetics was corrected obtaining patient satisfaction. Conclusions: From the application of the orthodontic treatment, it was possible to correct the dental position and occlusion anomalies and give the patient back the lost esthetics and a functional occlusion. Therapeutic decisions considered the state of the periodontium, the control of the disease and the age of the patient. The applied forces were extremely controlled and the treatment time was as short as possible. The motivation and care of oral hygiene contributed to the results achieved.

Morphological features of the incisive canal in patients of the first adult age

The incisive canal and its contents are often subject to intervention in maxillofacial surgery, otorhinolaryngology, and various areas of dentistry. The purpose of this paper is to study the variability of the dimensional and topographic characteristics of the incisive and nasal foramina of the incisive canal depending on the gender, shape, and parameters of the craniofacial complex in the first adult age. The authors have studied the parameters of the craniofacial complex, such as the morphological facial height, the upper morphological facial height, and the morphological facial breadth. They also have determined the Garson facial index and the upper face index. Cone-beam computerized tomography has been used in order to determine the number of foramina of Stensen and incisive foramina, their mesiodistal and vestibulo-lingual diameters, the shape of the incisive foramen; the distance from the incisive foramen to the labial inferior and palatal inferior points of the alveolar process; the distance from the incisive foramen to the central incisors, lateral incisors, canines of the maxilla; the bone density around the incisive canal; the length, shape, and type of incisive canal. Quantitative data were processed by variational statistical methods using the Statistica software package for Windows v 10.0. The significance of differences between groups was assessed using the Kolmogorov- Smirnov criterion at a significance level of p<0.05. It has been discovered that the incisive canal, the nasal and incisive foramina had a pronounced individual variability in size, shape, and topography depending on the gender, shape, the Garson facial index and upper face index, as well as the presence of correlations between the diameters and the number of nasal and incisive foramina. The authors have determined the values of bone tissue density in the area of the nasal and incisive foramina.

Anatomical Study On Location Of Greater Palatine Foramen In Dried Adult Human Skull: Key To Successful Maxillary Nerve Block

Background: The greater palatine foramen (GPF) conducts greater palatine nerve, responsible for the innervationof posterior part of the hard palate. Anaesthetic block for greater palatine nerve is highly recommended forsurgical practices involving upper molar, maxillary sinus and nasal region. But the practical problem associatedwith anaesthesia is difficulty in locating the exact position of greater palatine foramen, leading to deliveringinsufficient anaesthetic solution. The greater palatine neurovascular structures enter the oral cavity through thegreater palatine foramen so this foramen should be approached carefully during any surgical procedures toavoid damage to these neurovascular structure.Materials and methods: 126 dried adult skull bones of unknown sex, obtained from the department of anatomy,MVJ Medical College and Research Hospital were used to locate the exact position of greater palatine foramen inrelation to bony landmarks. On both side, the distance of greater palatine foramen from midline maxillarysuture, posterior border of hardpalate, incisive fossa and lesser palatine foramen were measured with digitalvernier caliper. Location of GPF in relation to molar or premolar tooth was also noted. The data obtained wereanalyzed statistically by calculating mean and standard deviation. The percentage was calculated for the locationof GPF in relation to molar or premolar tooth.Result: In the present study of anthropometric analysis of greater palatine foramen of 126 dried skulls, it wasobserved that the most common location of greater palatine foramen was opposite to the third molar tooth. Themean distance between greater palatine foramen to mid maxillary suture was 13.71mm on right side and13.72mm on left side and posterior border of hard palate on right side was 4.62mm and 4.49mm on left side. Themean distance between greater palatine foramen and incisive fossa was 36.73mm and 36.66mm on the right andleft side respectively. The mean distance between greater palatine foramen and lesser palatine foramen was1.47mm on right side and 1.49 mm on left side.Conclusion: Results of present study may contribute greatly to the successful outcome of maxillofacial and oralsurgeries regional anaesthesia.

The incisive papilla as a guide to maxillary anterior teeth position for complete dentures

Context: The incisive papilla as a guide for complete dentures. Aims: To evaluate incisive papilla as a guide to maxillary anterior teeth position for complete dentures. Settings and Design: To measure the linear distances from the incisive papilla to the maxillary central incisors in Odia population and compare it to other ethnic groups. Subjects and Methods: The subjects were selected following inclusion & exclusion criteria. The impressions of maxillary & mandibular arches were taken and poured with die stone to produce the cast. The incisive papilla & incisors were marked on casts with a pencil. The photographs of casts were traced on an acetate tracing paper. The anterior-most points of maxillary incisors, anterior, middle & posterior-most points of incisive papillae were marked on the tracing as A, I1,M, I2 respectively. The A to M and A to I2 distances were measured, analysed and compared with Caucasians, Southern Chinese, and Dravidians. Statistical Analysis: Independent sample “t” test and Analysis of Variance followed by the post-hoc Bonferroni test were used. Results: A sample of 100 subjects in the age group of 20 to 40 years with was selected. The A to M measurements of Odia population differed significantly from Caucasians but were similar to Southern Chinese population. The A to I2 measurements of Odia population differed significantly from Caucasians & Dravidians but were similar to Southern Chinese. Conclusion: The linear measurements from incisive papilla to maxillary incisors of the Odia population are similar to that of Southern Chinese but differ significantly from Caucasians and Dravidians.

Topographical variations of the incisive canal and nasopalatine duct in human fetuses / 대한해부학회지

Morphometric Study Of The Greater Palatine Foramen In The Dried Bones Of Eastern India

Introduction: Greater palatine foramen is a very important landmark for administering anesthesia in maxillofacialand dental surgeries. Getting the anesthesia correct each time is a technical manoeuvre, which require sufficientamount of clinical skill and experience. The anatomical landmark has been described by many authors but asper the data in the eastern Indian population it is sparse. This study aims to define the greater palatine foramenaccording to various landmarks.Materials and Methods: One hundred and three skulls from two medical colleges of eastern India were studiedby the first and second authors separately and consecutively. All the skulls were examined for any broken partsin the hard palate and in the greater palatine foramen region. Only the skulls that were intact in these areas wereconsidered for the study.Result: The mean distance of the greater palatine foramen to the incisive foramen was 35.45mm in the males and34.82mm in the females. The average distance between the greater palatine foramen and the midline maxillarysuture was 13.22mm in the males and 12.98 mm in the females. In 85.92% cases we found the GPF to be oval inshape and it opened in to the oral cavity antero-medially in 58% of the cases. With respect to the molar teeth, in42.71% of the cases the greater palatine foramen was present opposite the anterior ½ of the 3rd molar.

Tratamiento interdisciplinario odontológico en una joven con maloclusiones / Odontological interdisciplinary treatment in a young female patient with malocclusions

Se presenta el caso clínico de una paciente de 23 años de edad, quien acudió al Servicio Estomatológico de su área de salud porque se sentía afectada síquicamente debido a la ausencia de un diente y deseaba recibir un tratamiento que le permitiera lograr un equilibrio estético y funcional. Al efectuar el examen intrabucal se observó una maloclusión en el sector anterosuperior izquierdo, falta de proporcionalidad entre el hueso y el diente, ausencia clínica del incisivo central superior izquierdo (21) y espacios interincisivos. La cooperación cuidadosa y multidisciplinaria de estomatología general integral, ortodoncia y rehabilitación protésica condujo a que la paciente mejorara su apariencia y elevara su autoestima

The case report of a female 23 year-old patient is presented who visited the Estomatological Service of her health area, because she was psychically affected due to the absence of a tooth and she wanted to receive a treatment that allowed her to achieve an aesthetic and functional balance. When making the intraoral examination a malocclusion was observed in the antero-superior left side, lack of proportionality between the bone and tooth, clinical absence of the left central superior incisor (21) and interincisal spaces. The careful and multidisciplinary cooperation of general comprehensive estomatology, orthodontics and prothesis rehabilitation achieved an improvement of her appearance, so that she recovered a higher self-esteem