Changes occur to the mandible with dental loss and senescence. However, the influence that these changes have on sex and ancestry estimations remains unclear. The purpose of this study was to investigate the influence of dental loss and senescence on changes in mandibular morphology. The outcome has implications for both forensic anthropology and restorative dentistry. The study sample consisted of 717 mandibles consisting of both male and female South Africans of African (SAA) and European ancestry (SAE). To minimise the effects of variation in dentition amongst sex-ancestry groups, the sample included individuals with a spectrum of tooth loss patterns, namely efficient and inefficient occlusions as well as no occlusions. Dentition was considered efficient when the remaining teeth in occlusion were evenly distributed between the sides. Linear measurements as well as geometric morphometric shape analyses were performed. Shape analyses of the complete mandible were performed on models from digitised landmarks by using a MicroScribe G2. Detailed shape analyses of the ramus and chin area as well as measurements of the cortical thickness at specific sites were executed on images generated by cone beam computed tomography (CBCT). A comprehensive assessment of changes in shape, size and cortical thickness of the mandible with age and dental loss were made. Shape and size differences of the mandible were evaluated for discriminant abilities between sex and ancestry groups. Although most dimensions decreased with tooth loss, the greatest impact was noted in the loss of alveolar bone. The mandibular angle increased minimally in size when a few teeth were lost, but recovered to some extent with further tooth loss. The cortical thicknesses at the mental foramen lingually as well as in the midline in females, were relatively spared with tooth loss. Male individuals of SAA were often the most resilient to tooth loss. In general external linear dimensions were maintained with age despite tooth loss. Conversely, measurements of cortical bone thickness decreased slightly, but could have been influenced by dental loss. The shape of the chin and gonial area was more affected by aging in SAE. The sex and ancestry discriminant ability of the linear dimensions when considered collectively approximated 90%, in general improving further when tooth loss was taken into account. All linear measurements were smaller in females and in general tooth loss accentuated sex differences. SAA exhibited greater dimensions, apart from maximum ramus height, bigonial breadth and cortical thickness at the gonion. The mental tubercles were more prominent than the pogonion in SAE (square chin) and vice versa in individuals of SAA (pointed chin). The gonial area in individuals of African ancestry was broad and more convex and the gonial eversion more prominent with a more upright ramus. Discriminant qualities of the gonial shape for sex in individuals of African ancestry reached 90% within dentition groups. Ramus flexure and chin shape were not found to be useful in sex estimation. In conclusion, this research elucidated the effects of tooth loss and senescence on the morphology of the mandible for the forensic anthropological setting. / Thesis (PhD)--University of Pretoria, 2015. / tm2015 / Anatomy / PhD / Unrestricted

Orientador: Jose Ricardo de Albergaria Barbosa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-27T22:57:52Z (GMT). No. of bitstreams: 1 Santos_ZarinaTatiaBarbosaVieirados_M.pdf: 1096819 bytes, checksum: 2006f7be54ec5deb54b18701da9dca26 (MD5) Previous issue date: 2015 / Resumo: Objetivo: Avaliar a resistência mecânica de quatro métodos de fixação interna funcionalmente estável (FIFE) em dois desenhos de osteotomia sagital do ramo mandibular (OSRM), quando submetidos ao carregamento linear. Materiais e Métodos: Dois modelos de osteotomia foram feitos em hemimandíbulas de poliuretano e divididos em dois grupos, ambos com 20 amostras: Grupo I - osteotomia angular e grupo II - osteotomia linear. Depois de um avanço de 5 mm do segmento distal, os segmentos ósseos foram fixados com diferentes sistemas de placa/parafuso de 2,0 mm, estabelecendo os sub-grupos: (A), uma placa reta convencional de 4 furos, (B), uma placa reta convencional de 4 furos associado a um parafuso bicortical, (C), uma placa reta com travamento de 4 furos, (D), uma placa reta com travamento de 4 furos associado a um parafuso bicortical. As amostras, foram então, submetidas ao carregamento linear a uma velocidade de 1 mm/min, até alcançar a carga de pico e falha do sistema. Resultados: Pelo teste de Tukey, o grupo de uma placa convencional associado a um parafuso bicortical mostrou ter uma carga superior a 3 mm de deslocamento (87,42 ± 4,86 N) estatisticamente significativa em comparação com o de uma placa convencional com parafusos monocorticais (p <0,01) e uma placa com travamento com parafusos mocorticais (p <0,01). O grupo de uma placa de travamento associado a um parafuso bicortical mostrou ter uma carga superior a 3 mm de deslocamento (72,47 ± 4,86 N) estatisticamente significativa em comparação com o de uma placa convencional com parafusos monocorticais (p = 0,02) e uma placa com travamento com parafusos mocorticais (p = 0,01). Não houve diferença estatisticamente significativa entre os grupos: uma placa convencional com parafusos monocorticais e uma placa com travamento com parafusos mocorticais (p = 0,65); uma placa convencional associado a um parafuso bicortical e uma placa com travamento associado a parafuso bicortical (p = 0,15). A osteotomia angular apresentou maior resistência mecânica em 3 mm de deslocamento do que a linear. No entanto, o único grupo que apresentou diferença estatisticamente significante foi o grupo A (p = 0,05). Conclusão: não houve diferença entre o sistema de fixação placa/parafuso convencional e com travamento; a adição de um parafuso bicortical na região retromolar promoveu uma melhor estabilização dos sistemas de fixação. A OSRM angular apresentou melhor resistência mecânica / Abstract: Purpose: Evaluate the mechanical resistance of four different osteosynthesis in two different design of sagittal split ramus osteotomy (SSRO) when submitted to vertical forces. Materials and Methods: Two osteotomy models were made on polyurethane hemimandibles. Group I - angled osteotomy and group II - linear osteotomy, both with 20 specimes. After 5-mm advancement of the distal segment, the bone segments were fixed by different osteosynthesis methods using 2.0-mm plate/screw systems, establishing sub-groups: A, one 4-hole conventional straight plate, B, one 4-hole conventional plate and one bicortical screw, C, one 4-hole locking straight plate, D, one 4-hole locking straight plate and 1 bicortical screw. The samples were then subjected to a linear load at a speed of 1 mm/min until reaching peak load and system failure. Results: A Tukey post-hoc test revealed that the group of one conventional plate with bicortical screws showed higher load (87.42 ±4.86 N ) with statistically significantly compared to one conventional plate with monocortical screws (p<0.01 ) and one locking plate with mocortical screws (p<0.01). The group of one locking plate with bicortical screws showed higher load (72.47 ±4.86 N ) with statistically significantly compared to one conventional plate with monocortical screws (p=0.02) and one locking plate with mocortical screws (p=0.01). There was not a statistically significant difference between groups: one conventional plate with monocortical screws and one locking plate with mocortical screws (p=0.65); one conventional plate with bicortical screws and one locking plate with bicortical screws (p=0.15). The osteotomy with angle showed higher mechanical resistance than linear. However, the only group that showed statistically significant differences was the group A (p=0.05). Conclusion: no statistical differences were detected between locking and standard system, the placement of 2.0-mm¿diameter bicortical screws in the retromolar region, promoted a better stabilization of bone segments. The angular SSRO offers the best mechanical resistance / Mestrado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Mestra em Clínica Odontológica

Einleitung In deutschen Haushalten zählen Katzen, neben Hunden, zu den häufigsten Haustieren. Die Europäisch Kurzhaar gehört dabei zu den beliebtesten Rassen. Auch bei Katzen als Patienten werden ergänzend zu klassischen Therapiemethoden in der Veterinärmedizin zunehmend komplementäre Verfahren angewendet. Da viele Methoden und Therapien der Komplementären Medizin auf segmentale Zusammenhänge zurückzuführen sind, ist unter anderem die genaue Kenntnis der Hautinnervation von Bedeutung für komplementär arbeitende Veterinäre. Jedoch existieren bisher nur wenige Untersuchungen über die detaillierte Verzweigung der Spinalnerven bei Kleintieren, insbesondere bei Katzen. Ziele der Untersuchungen Das Ziel dieser Dissertation war eine präzise, detaillierte Präparation und Beschreibung des Innervationsmusters der Spinalnerven bei Katzen mit besonderem Augenmerk auf die Rami dorsales mit ihren Hautästen und ihrer kaudalen Verschiebung in der Regio thoracolumbalis. Tiere, Material und Methoden Dafür wurde an 15 Katzen der Rasse Europäisch Kurzhaar eine mesoskopische Präparation durchgeführt. Die Katzen wurden mit 4%-igen Formalin über die A. femoralis in Brust-Bauchlage fixiert und anschließend die Spinalnerven im Bereich des Thorakalnerven (Th) 9 bis zum Lumbalnerven (L) 7 in 4 Schichten präpariert: 1) im Bereich der Nerveneintritte in die Haut (Haut), 2) auf Höhe der Fascia thoracolumbalis (Faszie), 3) auf dem Niveau der langen Rückenmuskulatur (Muskulatur) und 4) im Bereich der Foramina (Forr.) intervertebralia (Forr. intervertebralia). Für jeden einzelnen Ramus dorsalis zwischen Th9 und L7 wurde für jede Katze die symmetrische Verteilung und der Verlauf durch die Ebenen dargestellt. Daraus ergaben sich die Kaudalverschiebungsindizes (KVI) der Rami dorsales für die jeweilige Katze (KVIj) und für jeden einzelnen Ramus dorsalis bei allen Katzen (KVIi). Weiterhin wurde eine paramediane Verschiebung zwischen den Rami dorsales einer Körperseite in einer Ebene und den Ebenen 2 (Faszie) und 3 (Muskulatur) jedes Ramus dorsalis bestimmt. Zur Überprüfung eines linearen Zusammenhangs zwischen der Länge der Lendenwirbelsäule und der KVI der einzelnen Katzen wurden der Korrelationskoeffizient r und das Bestimmtheitsmaß R² ermittelt. Ergebnisse Die Rami dorsales waren fast vollzählig und nahezu symmetrisch bei allen Katzen ausgebildet. Der Seitenvergleich zeigte vor allem Unterschiede für die kaudalen Rami dorsales ab L4. Die Anzahl der Hautnerven lag zwischen 8 und 11 pro Körperseite. Der Ramus dorsalis L6 konnte bei keiner der untersuchten Katzen nachgewiesen werden. Die Durchtrittshöhen der einzelnen Rami dorsales variierten zwischen den Ebenen und in einer Ebene auf einer Körperseite sowie im Seitenvergleich. Der KVIj ergab ein Verhältnis von 3:2:1 von der Haut bis zur Muskulatur für beide Körperseiten. Es zeigte sich, dass auch für die einzelnen Rami dorsales dieses Verhältnis für ihren Verlauf durch die Ebenen zutraf. Bei der morphometrischen Analyse der Korrelation zwischen der Länge der Lendenwirbelsäule und den KVIj ergaben sich für die KVIj-H (links: r = -0,0782, rechts: r = -0,0188) beider Körperseiten und die KVIj-M (r = -0,1134) der rechten Seite ein sehr geringer negativer Zusammenhang. Der KVIj-M (r = 0,0823) der linken Seite sowie die KVIj-F (links: r = 0,4903, rechts: r = 0,3521) beider Körperseiten wiesen eine geringe positive Korrelation auf. Durch die computertomografischen Aufnahmen konnte ein Vergleich zwischen der Längenmessung der LWS am Präparat und den Schnittbildrekonstruktionen am Computer durchgeführt werden. Die Bestimmung der Standardkorrelation (Pearson Korrelation) ergab einen signifikanten Zusammenhang beider Messmethoden (r = 0.875691, p = 8,74 x 10^-5). Schlussfolgerungen In der vorliegenden Arbeit wurden erstmals Spinalnerven mit ihrem individuellen Verlauf und ihrer symmetrischen Verteilung bei der Katze untersucht. Die resultierenden Erkenntnisse etablieren die anatomische Basis für verschiedene therapeutische Verfahren, für die Kenntnisse über den Verlauf der Nerven eine hohe Relevanz besitzen. Die Ergebnisse der vorliegenden Arbeit zeigen eine symmetrische Ausprägung der Rami dorsales Th9 bis L3 für die untersuchten Katzen. Diese regelmäßige Ausprägung der Spinalerven bis L3 unterscheidet sich sichtlich von der des Hundes. Für die ab L3 kaudal folgenden Rami dorsales bestand eine größere interindividuelle Variation und Unregelmäßigkeit. Jedoch wurde eine Korrelation zwischen den KVIj und der Länge der Lendenwirbelsäule nicht bestätigt. Zudem konnte bei keiner Katze ein Ramus dorsalis L6 nachgewiesen werden. Diese Ergebnisse zeigen bereits merkliche Unterschiede zwischen den einzelnen Katzen ab dem Spinalnerven L4 und Katzen zu anderen Tierarten wie dem Hund. Damit wird deutlich, dass eine Übertragbarkeit der Nervenverläufe und Innervationsgebiete zwischen den Tierarten oder von der Katze auf den Menschen aufgrund der speziesspezifischen neuroanatomischen Unterschiede nicht möglich ist und die tierartlichen Besonderheiten berücksichtigt werden sollten.

A relação entre a anatomia mandibular e a ocorrência de fratura indesejada de mandíbula na osteotomia sagital é alvo de estudos. A literatura mostra a existência de diferentes conformações anatômicas da mandíbula, porém não há estudos nessa área direcionados a indivíduos com fissura labiopalatina. Também não há na literatura estudos que mostrem as diferenças morfológicas da mandíbula relacionadas a secção transversal entre primeiro e segundo molar e sua relação com implicações na cirurgia ortognática. O objetivo do presente estudo foi avaliar a morfologia da região entre primeiro e segundo molar inferior e classificar a prevalência dos tipos mandibulares dentro de cada grupo. Foram realizadas análises e medições das reformatações das tomografias da região de molares, bilateralmente, de indivíduos Classe III, com fissura labiopalatina unilateral (Grupo FLP) submetidos à cirurgia ortognática para recuo mandibular no Hospital de Reabilitação de Anomalias Craniofaciais e de indivíduos Classe III, sem fissura (Grupo Controle) do banco de dados do Departamento de Cirurgia e Estomatologia da Faculdade de Odontologia de Bauru. Foram realizadas duas medidas lineares e uma medida angular. As hemimandíbulas foram classificadas segundo a profundidade da fossa mandibular em: Tipo a - 0 e 1mm; Tipo b - 1,1 e 2mm; Tipo c - 2,1 e 3mm; Tipo d - maior que 3,1mm. Foram analisadas 200 hemimandíbulas no Grupo FLP e 100 no Grupo Controle. Os resultados mostraram que não houve diferença entre os grupos quanto a classificação das mandíbulas segunda a profundidade da fossa, sendo o grupo b o mais prevalente, mas houve diferença em relação a angulação e a altura da mandíbula . Também foi notada uma relação entre a altura da mandíbula e a sua angulação em ambos os grupos. Assim, pode ser observada a grande variação morfológica dessa região, tanto para o grupo com fissura labiopalatina, quanto para o grupo controle. / The relationship between a mandibular anatomy and an occurrence of an undesirable jaw fracture in a sagittal osteotomy is the subject of the studies. The literature shows an existence of different anatomical conformations of the mandible, but there are no studies on the area directed to individuals with cleft lip and palate. There are not in the literature, studies that show a prevalence of mandibular types and the relation of these anatomical variations with orthognathic surgery implications. The objective of the present study was evaluate the morphology of the region between the first and second lower molars and analyze the prevalence of mandibular types within each sample group. Analyzes and measurements of the CT scans were performed bilaterally on Class III patients with unilateral cleft lip and palate (CLP Group) submitted to orthognathic surgery for mandibular retreatment at the Hospital for Rehabilitation of Craniofacial Anomalies and Class III individuals, without Fissure (Control Group) of the database of the Department of Stomatology of the Faculty of Dentistry of Bauru. Two linear measurements and one angular measurement were performed. The half of mandibles were classified according to the depth of the mandibular fossa in: Type a - 0 and 1mm; Type b - 1.1 and 2mm; Type c - 2.1 and 3 mm; Type d - greater than 3.1mm. Two hundred half of mandibles were analyzed in the CLP Group and 100 in the Control Group. The results showed that there was no difference between the groups regarding the classification of the mandibles according to the depth of the fossa, being group b the most prevalent, but there was difference in relation to the angulation and the height of the mandible. It was also noted a relationship between the height of the mandible and its angulation in both groups. Thus, the great anatomical variation of this region can be observed, both for the group with fissure and for the group without fissure.

Submitted by FUED SAMIR SALMEN null (drfued@icloud.com) on 2017-02-21T18:50:10Z No. of bitstreams: 1 Tese Fued Final.pdf: 11040704 bytes, checksum: beabe0fff11bde78e21ae9af617233af (MD5) / Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2017-02-24T18:54:46Z (GMT) No. of bitstreams: 1 salmen_fs_dr_arafo.pdf: 11040704 bytes, checksum: beabe0fff11bde78e21ae9af617233af (MD5) / Made available in DSpace on 2017-02-24T18:54:46Z (GMT). No. of bitstreams: 1 salmen_fs_dr_arafo.pdf: 11040704 bytes, checksum: beabe0fff11bde78e21ae9af617233af (MD5) Previous issue date: 2017-02-02 / O objetivo deste estudo retrospectivo foi avaliar a precisão de procedimentos bimaxilares realizados para correção de excesso maxilar vertical, quando a cirurgia é iniciada pelo reposicionamento mandibular ou pelo reposicionamento maxilar. Foram incluídos no estudo 32 prontuários de pacientes, divididos em dois grupos de dezesseis. O primeiro grupo (Grupo 1) de pacientes foi submetido a cirurgia bimaxilar com a sequência clássica do procedimento, no qual a maxila foi reposicionada primeiro que a mandíbula. O segundo grupo (Grupo 2) de pacientes sofreu alteração desta sequência, na qual a mandíbula foi reposicionada primeiro que a maxila. A mensuração para determinar a precisão do reposicionamento dos maxilares foi realizada por sobreposição, pela base do crânio, os traçados obtidos de uma telerradiografia lateral realizada com, no máximo, 30 dias de pós-operatório e os traçados de planejamento. A análise estatística foi realizada utilizando o teste t pareado para verificar a diferença entre os valores previstos e os obtidos em cada grupo. O teste t de Student para amostras independentes foi utilizado para comparar o erro de previsão entre os dois grupos. Na amostra estudada, ambas as sequências operatórias permitiram precisão satisfatória. O erro de previsão para as variáveis incisal do incisivo superior (IIS), Ponto A e cúspide mesiovestibular do molar inferior (6i Oclusal), no sentido vertical, foi maior para o Grupo 2, quando comparado ao Grupo 1. O erro de previsão no sentido vertical para o Pogônio (P) foi menor quando a cirurgia foi iniciada pela mandíbula. Em conclusão, embora ambas as sequências cirúrgicas possam ser utilizadas, iniciar a cirurgia pela mandíbula provocou maior imprecisão em relação ao traçado preditivo do que iniciar a cirurgia pela maxila. A sequência clássica, reposicionando a maxila primeiro, resultou em maior precisão no reposicionamento vertical do ponto A, bem como da incisal do incisivo superior e, portanto, da maxila, do ponto de vista estético. Iniciar a cirurgia pela mandíbula permitiu maior precisão na posição vertical do pogônio. / This study aims to evaluate the precision of bimaxillary surgery performed to correct vertical maxillary excess, when the procedure is sequenced by mandibular surgery first or maxillary surgery first. Thirty-two patients were included in this retrospective study, divided into two groups. The first group was composed by patients who received bimaxillary surgery following the classic sequence of repositioning the maxilla first. In the second group patients received bimaxillary surgery by operating the mandible first. The data were tabulated and statistically analyzed. Precision of the maxillo-mandibular repositioning was measured by superimposing, through the cranial base, digital postoperative tracings taken at a maximum of 30 days after surgery to the prediction tracings. The paired t test was used to determine the difference between predicted and obtained values for each group. The Student’s t test for independent samples was applied to compare the prediction error between groups. In this sample, both surgical sequences provided adequate clinical accuracy. The classical sequence, repositioning the maxilla first, resulted in greater accuracy of A point, lower first molar and incisor edge vertical position. Repositioning the mandible first allowed greater precision in the vertical position of pogonion. In conclusion, although both surgical sequences may be used, repositioning the mandible first will result in greater imprecision in relation to the predictive tracing, than repositioning the maxilla first. The classical sequence resulted in greater accuracy in the vertical position of the maxilla, which is key for esthetics. Repositioning the mandible first allowed greater accuracy for the vertical position of pogonion.

Orientador: Mario Francisco Real [UNESP] Gabrielli / Resumo: O objetivo deste estudo retrospectivo foi avaliar a precisão de procedimentos bimaxilares realizados para correção de excesso maxilar vertical, quando a cirurgia é iniciada pelo reposicionamento mandibular ou pelo reposicionamento maxilar. Foram incluídos no estudo 32 prontuários de pacientes, divididos em dois grupos de dezesseis. O primeiro grupo (Grupo 1) de pacientes foi submetido a cirurgia bimaxilar com a sequência clássica do procedimento, no qual a maxila foi reposicionada primeiro que a mandíbula. O segundo grupo (Grupo 2) de pacientes sofreu alteração desta sequência, na qual a mandíbula foi reposicionada primeiro que a maxila. A mensuração para determinar a precisão do reposicionamento dos maxilares foi realizada por sobreposição, pela base do crânio, os traçados obtidos de uma telerradiografia lateral realizada com, no máximo, 30 dias de pós-operatório e os traçados de planejamento. A análise estatística foi realizada utilizando o teste t pareado para verificar a diferença entre os valores previstos e os obtidos em cada grupo. O teste t de Student para amostras independentes foi utilizado para comparar o erro de previsão entre os dois grupos. Na amostra estudada, ambas as sequências operatórias permitiram precisão satisfatória. O erro de previsão para as variáveis incisal do incisivo superior (IIS), Ponto A e cúspide mesiovestibular do molar inferior (6i Oclusal), no sentido vertical, foi maior para o Grupo 2, quando comparado ao Grupo 1. O erro de previsão no sen... (Resumo completo, clicar acesso eletrônico abaixo) / This study aims to evaluate the precision of bimaxillary surgery performed to correct vertical maxillary excess, when the procedure is sequenced by mandibular surgery first or maxillary surgery first. Thirty-two patients were included in this retrospective study, divided into two groups. The first group was composed by patients who received bimaxillary surgery following the classic sequence of repositioning the maxilla first. In the second group patients received bimaxillary surgery by operating the mandible first. The data were tabulated and statistically analyzed. Precision of the maxillo-mandibular repositioning was measured by superimposing, through the cranial base, digital postoperative tracings taken at a maximum of 30 days after surgery to the prediction tracings. The paired t test was used to determine the difference between predicted and obtained values for each group. The Student's t test for independent samples was applied to compare the prediction error between groups. In this sample, both surgical sequences provided adequate clinical accuracy. The classical sequence, repositioning the maxilla first, resulted in greater accuracy of A point, lower first molar and incisor edge vertical position. Repositioning the mandible first allowed greater precision in the vertical position of pogonion. In conclusion, although both surgical sequences may be used, repositioning the mandible first will result in greater imprecision in relation to the predictive tracing, than repositioning the maxilla first. The classical sequence resulted in greater accuracy in the vertical position of the maxilla, which is key for esthetics. Repositioning the mandible first allowed...(Complete abstract electronic access below) / Doutor

A relação entre a anatomia mandibular e a ocorrência de fratura indesejada de mandíbula na osteotomia sagital é alvo de estudos. A literatura mostra a existência de diferentes conformações anatômicas da mandíbula, porém não há estudos nessa área direcionados a indivíduos com fissura labiopalatina. Também não há na literatura estudos que mostrem as diferenças morfológicas da mandíbula relacionadas a secção transversal entre primeiro e segundo molar e sua relação com implicações na cirurgia ortognática. O objetivo do presente estudo foi avaliar a morfologia da região entre primeiro e segundo molar inferior e classificar a prevalência dos tipos mandibulares dentro de cada grupo. Foram realizadas análises e medições das reformatações das tomografias da região de molares, bilateralmente, de indivíduos Classe III, com fissura labiopalatina unilateral (Grupo FLP) submetidos à cirurgia ortognática para recuo mandibular no Hospital de Reabilitação de Anomalias Craniofaciais e de indivíduos Classe III, sem fissura (Grupo Controle) do banco de dados do Departamento de Cirurgia e Estomatologia da Faculdade de Odontologia de Bauru. Foram realizadas duas medidas lineares e uma medida angular. As hemimandíbulas foram classificadas segundo a profundidade da fossa mandibular em: Tipo a - 0 e 1mm; Tipo b - 1,1 e 2mm; Tipo c - 2,1 e 3mm; Tipo d - maior que 3,1mm. Foram analisadas 200 hemimandíbulas no Grupo FLP e 100 no Grupo Controle. Os resultados mostraram que não houve diferença entre os grupos quanto a classificação das mandíbulas segunda a profundidade da fossa, sendo o grupo b o mais prevalente, mas houve diferença em relação a angulação e a altura da mandíbula . Também foi notada uma relação entre a altura da mandíbula e a sua angulação em ambos os grupos. Assim, pode ser observada a grande variação morfológica dessa região, tanto para o grupo com fissura labiopalatina, quanto para o grupo controle. / The relationship between a mandibular anatomy and an occurrence of an undesirable jaw fracture in a sagittal osteotomy is the subject of the studies. The literature shows an existence of different anatomical conformations of the mandible, but there are no studies on the area directed to individuals with cleft lip and palate. There are not in the literature, studies that show a prevalence of mandibular types and the relation of these anatomical variations with orthognathic surgery implications. The objective of the present study was evaluate the morphology of the region between the first and second lower molars and analyze the prevalence of mandibular types within each sample group. Analyzes and measurements of the CT scans were performed bilaterally on Class III patients with unilateral cleft lip and palate (CLP Group) submitted to orthognathic surgery for mandibular retreatment at the Hospital for Rehabilitation of Craniofacial Anomalies and Class III individuals, without Fissure (Control Group) of the database of the Department of Stomatology of the Faculty of Dentistry of Bauru. Two linear measurements and one angular measurement were performed. The half of mandibles were classified according to the depth of the mandibular fossa in: Type a - 0 and 1mm; Type b - 1.1 and 2mm; Type c - 2.1 and 3 mm; Type d - greater than 3.1mm. Two hundred half of mandibles were analyzed in the CLP Group and 100 in the Control Group. The results showed that there was no difference between the groups regarding the classification of the mandibles according to the depth of the fossa, being group b the most prevalent, but there was difference in relation to the angulation and the height of the mandible. It was also noted a relationship between the height of the mandible and its angulation in both groups. Thus, the great anatomical variation of this region can be observed, both for the group with fissure and for the group without fissure.

A reexamination of John Donne's Holy Sonnet “Batter my heart,” especially one looking at the sonnet's relationship to Early Modern rhetoric, is long overdue. In this paper, I hope to show that a focus on Donne's relationship to Early Modern rhetoric yields several useful new insights. I argue specifically that Donne was probably exposed to Non-Ramist rhetorical methods and theory at many points in his education, from his childhood to his college years to his years at the Inns of Court. Furthermore, Non-Ramist rhetoric has moral implications, suggesting that aspects of an author's feelings, character, and desires can be analyzed by looking at the writer's rhetorical choices in relation to a specific audience in a specific situation. After discussing Donne's rhetorical education, I will look at how the rhetorical decisions of the poetic speaker in Donne's “Batter my heart” reveal his opinions of God and develop his attitudes toward God over the course of the poem. Indeed, the poetic speaker uses rhetoric that exerts power back on him, causing him to change: whereas at the beginning of the poem the poetic speaker thinks he controls his relationship with God, at the end he sees himself as God's humble subject. Ultimately, the poetic speaker's feelings of utter separation from God at the end of the poem actually yield a sense that he has found God and has gained a sense of awe surrounding the Divine.

Knowledge of the course of the pudendal nerve (PN) is important when performing perineal surgery. Distances between landmarks were measured after PN dissections in 71 cadavers and after perineal procedures on 30 cadavers. Separate inferior rectal nerve (IRN) entry and medial position of the PN/IRN with shortened sacrospinous ligaments were often seen in black individuals. A PN block should therefore be placed more proximally and medially. The Richter’s stitch should be placed further from the ischial spine. During ischioanal procedures the IRN is at risk in white females, as it was more superficial. The dorsal nerve of the clitoris/penis (DNC/DNP) is in danger during the outside-in procedures in white or obese individuals, as it was closer to the inferior pubic ramus. The dorsal penile nerve block should be administered deeper in white and obese individuals, as the DNP was deeper. The above-mentioned findings should be verified in a clinical setting. / Dissertation (MSc)--University of Pretoria, 2013. / gm2014 / Anatomy / Unrestricted

Introduction: Cardiovascular surgery is a relatively young but progressively evolving field in medicine. More specifically, in the past decades, cardiac surgery achieved significant advances in understanding the causes, progression and treatments of ischemic heart disease (IHD). The IHD is the most common coronary disease, and it ranks first in morbidity and mortality in the developed world. It justifies the need for significant fundamental research as well as its study in clinical practice. It now includes specialized cardiovascular centres with the complex specialized treatments. A group of interventional cardiologists capable of performing routine examinations of the coronary veins using selective angiography has been established. They can eventually also perform percutaneous coronary interventions with direct stent implants. Thus the advances have been made in comprehensive indication of the patients towards their optimal treatments under the regime of a cardio-team. Such team comprises of a cardio-surgeon, interventional cardiologist, echocardiography specialist and the attending physician who is usually the cardiologist. The IHD treatments involve preventive cardiology with the regime measures and checks, pharmacotherapy, interventional cardiology and cardiac surgery to spa treatment and...