Magister Chirurgiae Dentium (MChD) / Even though the mandibular nerve is of great importance to the dentist, very little research on the course of the nerve and the relationship of the mandibular canal to the adjacent anatomical structures has been carried out. From the. literature, it appears that the lateral ramus prominence (L.R.P.),or antilingula, is found to be present in from 50% to 100% of cases and is situated anterior and superior to the mandibular foramen. Most authors are in agreement on the situation of the mandibular foramen. Only one mandibular foramen is described in each ramus. The mandibular canal is described as lying inferior to the teeth. There is no agreement on the possibility of the existence of a second mandibular canal per hemimandible. Concerning the mental foramen, it is accepted that one is found on each side, but a second foramen,as well as accessory foramina, namely, the major and the minor variety, are described. In the horizontal plane, the mental foramen is found at the apex of the second premolar tooth or between the premolar teeth. In the vertical plane, the mental foramen is situated from inferior to the apex of the premolar teeth to halfway between the apex and the crown of the premolar teeth. The mylohyoid groove is converted into a canal in 16% of cases but never commences from within the mandibular canal, according to available literature.

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Indiana University-Purdue University Indianapolis (IUPUI) / Bisphosphonates, drugs which inhibit bone resorption and remodeling, are currently prescribed for the treatment of osteoporosis. Previous research suggests that decreased bone turnover may lead to accumulation of microdamage, possibly increasing the risk for fracture in some sites. The effects of bisphosphonate therapy on the mandibular condyle have not been quantitatively studied. The purpose of the proposed study was to histomorphometrically quantify the effects of etidronate (a bisphosphonate) on trabecular bone sites of the dog mandibular condyle and to compare this to another trabecular bone site (vertebrae) to determine whether the two sites were affected differently. Eleven mature female dogs were treated with high- (5 mg/kg/d) and low- (0.5 mg/kg/d) dose etidronate therapy for seven months. Fluorochrome labels were used to mark sites of bone mineralization for the calculation of static and dynamic histomorphometric parameters. High-dose therapy resulted in a complete inhibition of remodeling, as shown by the reduction of mineral apposition rate (MAR), bone formation rate (BFR), and mineralizing surface (MS/BS) to zero. Low-dose therapy also decreased BFR and MS/BS. Osteoid accumulation was only significant in the high-dose therapy group, but there was no evidence of osteomalacia (osteoid volume < 5%). Etidronate treatment had no significant effect on bone volume, trabecular number, trabecular thickness, or trabecular separation. Vertebral trabeculae ranged from 5.5 to 9.5 times greater in number than mandibular trabeculae, but were 45 to 60 percent thinner and closer together. The interaction between dosage and site was insignificant for all parameters studied. Further investigation is needed to determine whether these effects will prove to be harmful to the mandibular condyle, especially over a long period of time.

Purpose The purpose of the present study was to assess the clinical outcomes of mandibular overdentures supported by dental implants (ISMO - implant-supported mandibular overdenture) based on a systematic review of the literature.   Materials and methods An electronic search, limited to studies published between 2018-2021, was performed in three databases, supplemented by hand searching of selected journals. Eligibility criteria included clinical human studies, either randomized or not, reporting case series of patients rehabilitated with ISMO. Interval survival rate (ISR) and cumulative survival rate (CSR) of implants and prosthesis were calculated in life-table survival analyses.   Results Sixty studies were included in the review, which reported 2261 ISMOs, supported by 4495 implants. A total of 111 implants and 191 ISMOs failed. The correlation between the survival rate of implants and the number of implants was very weak. Patients with less implants presented higher prosthesis failure rates than patients with more implants per prosthesis. There was no influence of the attachment system on the implant failure rates. The estimated CSR for the implants and the prostheses were 92.2% and 75.6%, respectively (23-year period). Replacement of attachment components was very often needed, as well as relining of the ISMO base. Complete transverse fracture of the ISMO was the most common technical complication.   Conclusion Using only one implant to support a mandibular overdenture is risky and should be avoided. In addition, metal reinforcement of the prosthesis base is recommended to minimize or prevent ISMO fractures, a common technical complication. / Syfte Syftet med denna studie var att undersöka de kliniska effekterna av implantatretinerade täckproteser i underkäken genom en systematisk översikt av befintlig litteratur. Material och metod En elektronisk sökning av studier publicerade mellan år 2018–2021, utfördes på tre olika databaser och kompletterades med en manuell sökning i utvalda tidskrifter. Studier som inkluderades var humana kliniska fall-kontrollstudier på patienter som behandlades med täckprotes. Både randomiserade och icke-randomiserade studier inkluderades. Intervall avöver överlevnadsfrekvensen och den kumulativ överlevnadsfrekvensen för implantat och täckproteser beräknades med hjälp av överlevnadsanalyser. Resultat I denna studie inkluderades 60 kliniska studier med totalt 2261 täckproteser som stöddes av 4495 implantat. Totalt misslyckades det 111 implantat och 191 täckproteser. Korrelationen mellan antal implantat som installerades och deras överlevnadsgrad var inte tydlig, däremot så uppvisade patienter med färre implantat mer omfattande problem med deras täckproteser jämfört med de proteser som stöddes av fler implantat. Val av retentionselement hade ingen påverkan på misslyckade frekvensen av implantaten. Den uppskattade kumulativa överlevnadsfrekvensen för implantaten och proteserna var 92,2 % respektive 75,6 % över en uppföljning på 23 år. Byte av retentionselement var vanligt förekommande och behövde utföras ofta, likaså relining av täckproteserna. Den vanligast förekommande tekniska komplikationen av täckproteser var en komplett tvärgående fraktur. Slutsats Att endast använda ett implantat för att stödja en täckprotes i mandibeln är riskabelt och bör undvikas. Metallförstärkning av protesbasen rekommenderas för att minska eller förhindra frakturer av täckprotesen, vilket var den vanligaste tekniska komplikationen som påträffades.

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Sabe-se que para determinados procedimentos cirúrgicos em Odontologia, como a exodontia, a cirurgia ortognática, cirurgia ortopédica, cirurgia de neoplasias e a colocação de implantes dentários, é importante conhecer a localização exata do trajeto do canal mandibular (CM) que contém o feixe vasculonervoso. O objetivo desta pesquisa foi determinar por meio da tomografia computadorizada (TC) o trajeto do canal mandibular através da mandíbula com relação as suas faces (vestibular, lingual e ventral), a crista alveolar e as raízes dentárias em duas classes de crânios de cães. Assim, foram avaliados 10 crânios de cadáveres de cães mesaticefálicos e 10 crânios de cadáveres de cães braquicefálicos no Serviço de Diagnóstico por Imagem do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo. Os tomogramas foram realizados no plano transversal tomando como referência para cada corte as raízes dentárias. No tomógrafo foram mensuradas as distâncias do canal mandibular até as faces vestibular, lingual, ventral e crista alveolar da mandíbula. As medidas coletadas foram submetidas à análise estatística que indicou que o trajeto do canal mandibular foi similar nos dois tipos de crânios. Observou-se que o canal mandibular desce suavemente desde o forame mandibular acompanhando o formato da mandíbula em direção à região dos dentes molares, onde alcança a sua máxima profundidade junto ao 1o molar e 4o pré-molar, continua rostralmente aumentando ligeiramente a distância com relação a borda ventral da mandíbula justo antes de terminar no forame mentoniano. O canal mandibular localizou-se em contato ou muito próximo da cortical lingual da mandíbula desde o forame mandibular até a região dos dentes molares, assim, continuou rostralmente ocupando a região ventral do corpo da mandíbula mantendo-se eqüidistante entre a superfície vestibular e lingual. Já na região do dente 3o pré-molar o canal mandibular originou o forame mentoniano caudal na face vestibular da mandíbula antes de incrementar ligeiramente a sua distância em relação a face ventral e lingual da mandíbula, para terminar assim no forame mentoniano médio na face vestibular, ventral à raiz mesial do dente 2o pré-molar. / For some surgical procedures in dentistry, as the exodontia, the orthognathic surgery, orthopedic surgery, oral neoplasm resection, and the dental implants placement, it is important to know the accurate localization of the mandibular canal (MC), which contains the vascular and nerve package. The aim of this research was to determine the course of the mandibular canal through the mandible with relation to the structures that surround it (lingual surface, vestibular surface and ventral surface), alveolar crest and dental roots in two kinds of dog skulls by means of computerized tomography (CT). For that, 10 skulls of mesaticephalic dogs and 10 skulls of brachycephalic dogs were evaluated in the Image Diagnosis Service of the Veterinary Hospital of the Veterinary and Zootechny School of the São Paulo University. In order to determine the localization of the canal passage in the mandible, measures were taken, in relation with: lingual surface, vestibular surface, ventral mandible surface and alveolar crest with CT help. The measurements were submitted to statistical analysis and showed that the mandibular canal course was similar in brachycephalic and mesaticephalic dogs, the measurements indicated that the mandibular canal descends slightly from the mandibular foramen to the molar area, slightly closer to the lingual surface than the vestibular surface until the molar region. The MC continues rostrally occupying the ventral region of the mandible body, reaching its maximum depth in relation with the alveolar crest border at the level of the 1st molar and 4th premolar teeth area. In the 4th and 3rd premolar region the MC maintains a similar distance between the vestibular and lingual border. At the level of the 3rd premolar the MC originates the mental caudal mental foramen before increases the distance in relation with the lingual and ventral border just before its termination at the medial mental foramen on the vestibular surface, ventral to the 2nd premolar roots.

Objetivo: realizar a caracterização do sistema miofuncional orofacial de indivíduos adultos com fraturas de face, que foram submetidos à procedimentos cirúrgicos distintos para a correção das fraturas (redução aberta e fechada). Métodos: 57 participantes divididos em três grupos: G1- composto por 19 indivíduos submetidos a redução aberta de pelo menos uma das fraturas faciais; G2- composto por 19 indivíduos submetidos a redução fechada da fratura; GC - 19 indivíduos voluntários saudáveis, sem alterações no sistema miofuncional orofacial. Todos os participantes foram submetidos à avaliação que consistiu na aplicação de um protocolo clínico para a avaliação da motricidade orofacial, a amplitude dos movimentos mandibulares e a avaliação da musculatura mastigatória por meio da eletromiografia de superfície (EMGs). Resultados: os resultados indicaram que para avaliação clínica da motricidade orofacial, ambos os grupos com fratura de face se diferenciaram do grupo controle, apresentando prejuízo na mobilidade dos órgãos fonoarticulatórios e nas funções de mastigação e deglutição. Os grupos com fratura de face não se diferenciaram neste item da avaliação. Quanto às medidas de amplitude mandibular, os grupos com fratura de face também se diferenciaram do grupo controle, apresentando maior restrição da mobilidade mandibular. Nesta etapa da avaliação, o grupo submetido à redução fechada da fratura apresentou maior amplitude de movimentos, se comparado ao grupo submetido à redução aberta da mesma, principalmente para a medida de abertura oral máxima. Na avaliação eletromiográfica dos músculos mastigatórios, o grupo submetido à redução aberta da fratura apresentou menor ativação muscular se comparado aos demais grupos. Ambos os grupos com fraturas de face se diferenciaram significantemente do grupo controle quando considerado o índice de assimetria do músculo masseter, apresentando funcionamento muscular mais assimétrico na tarefa de máxima intercuspidação dentária. Conclusão: Os pacientes com trauma de face apresentam alterações significativas em postura, mobilidade, funções orofaciais, amplitude mandibular e na atividade eletromiográfica. O tipo de tratamento médico não influenciou os resultados da funcionalidade muscular no período de até seis meses após a correção da fratura / Purpose: to characterize the oral-motor sytem of adults with facial factures, comparing the performance of individuals submitted to open and closed surgical treatment. Methods: 57 adults divided into three groups: G1 - 19 individuals submitted to open surgery for the correction of at least one of the facial fractures; G2 - 19 individuals submitted to closed surgery for the correction of facial fractures; GC - 19 voluntary healthy individuals, with no alterations of the orofacial myofunctional system. All participants underwent the same assessment: clinical assessment of the orofacial myofunctional system; evaluation of the mandibular range of movements; and surface electromyography (sEMG) of the masticatory muscles. Results: the results indicated that both groups with facial fractures presented significant differences when compared to the control group, in terms of the mobility of the oral-motor organs, mastication and swallowing. However, the groups with facial fractures did not differ in performance. Regarding the measurements obtained for the mandibular movements, both groups with facial fractures presented significant differences when compared to the control group, indicating greater restrictions in mandibular movements. The group submitted to closed surgery presented better range of movements when compared to the group submitted to open surgery, especially when considering the measurement of maximal mandibular opening. When analyzing the results of the sEMG, the group submitted to open surgery presented lower muscle activation when compared to the other two groups. Both groups with facial fractures differed significantly from the control group when considering the index of asymmetry for the masseter muscle, presenting a more asymmetrical muscle function during the task of maximum voluntary teeth clenching. Conclusion: Patients with facial trauma present significant deficits in posture, mobility and function of the oral motor system. The type of medical treatment did not have an influence on the results of muscle function during the first six months after fracture reduction