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[Changes in kinetic system of the mastication organ in patients with pterygoid dental losses in the mandible].

100 patients with pterygoid dental losses in the mandible randomly selected from the group of 900 patients have been examined. The material under examination has been divided into two groups (according to Kennedy's classification). I group--the persons with both-sided pterygoid dental losses, II group--the persons with one-sided pterygoid dental losses. Presence both extraoral and intraoral changes of the mastication organ in both groups as well as SSZ dysfunction symptoms has been analysed. The results obtained have proved that pterygoid losses essentially influence the presence of extraoral changes and less so the presence of intraoral changes. The span and type of dental losses have influenced the frequency of the presence of such changes as: cheeks' retraction, intensifying of nasolabial sulci, lowering of vertical dimension of the bottom face segment, attrition of teeth, presence of diastems in the maxilla and mandible, enlargement of the resting mouth silt etc. SSZ dysfunction symptoms have been found in 64% of the persons under examinations; intensification of these symptoms was positively greater in the patients with asymmetric losses, i.e. with one-sided losses. The examinations carried out demonstrate the need of all pterygoid dental losses restoration, particularly one-sided losses in the prophylaxis of mas-dysfunction generation.

DMF Index↗

[Effect of chewing training on the postural position of the mandible].

The aim of this project was to study possible effects of chewing gum training on the postural position of the mandible. The material consisted of 11 male and 14 female dental students which were divided in to an experimental and a control group. The subjects were thoroughly informed about the experiment and participated voluntarily. The participants were in good health had a complete natural dentition and had no complaints of mandibular dysfunction. They started chewing-gum training, one hour daily, for one month. The chewing-gum used for this experiment was the resin obtained of the bark of the mastiche tree grown in the greek island Chios which was selected because of its hardness in chewing. In every registration, free way space was measured 4 times with the phonetic method and the mean value was estimated at 5 different occasions. (15 days before the start of the experiment, the day the experiment started before and after half an hour chewing training, and at the end of the experiment, after one month systematic chewing training, one hour daily, free way space was measured again before and after half an hour chewing training. The results of this clinical experimental work indicate: 1) Systematic chewing training does not have any effect on the mandibular postural position of the mandible. 2) Fatigue of the stomatognathic system musculature, caused by half an hour chewing training, very significantly alters the mandibular postural position as it doubles free way space. A possible clinical use of these findings is that free way space does not correlate with the rate of use of the stomatognathic system.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Arteriovenous malformation of the mandible: report of case.

A case of a potentially lethal arteriovenous malformation of the right side of the mandible has been presented. Procedures that may be helpful in diagnosing the lesion have been discussed, and a protocol for treatment of these lesions in the mandible has been proposed. Research of the cause and management of these lesions is greatly needed.

Adult↗

[Split line patterns in the mandible after transposition of the insertion of the masseter muscle in the adult rabbit].

With the aim of studying in the fibrous structure of the compact bone, as revealed by the split-line technique, unilateral surgical transposition of the masseter muscle from the masseteric fossa to the central area of the mandibular body below the molar teeth was performed in seven adult rabbits. Six months later the animals were killed, their mandibles were removed, cleaned and then decalcified. Split-lines were made on the lateral surface of both the control and the operated side of the mandible. Myotransposition induced alterations in the split-line patterns; they showed to be entangled and disorganized, which mean structural changes in the bone itself.

Animals↗

[The mandible in labio-maxillary clefts].

The writers have studied mandibular anomalies in a series of 20 surgically treated clefts. Anomalies of shape occur in one case out of two and are in the form of a mandible which is too long. Anomalies of position most often show a mandible in front of the maxillary and to the rear in comparison to the base of the skull.

Adolescent↗

Interpositional bone graft augmentation of the atrophic mandible: a preliminary report.

The mandible is sectioned in an oblique direction and an iliac crest graft is placed between the fragments for augmentation of an atrophied mandible. The technique was used in 12 patients; follow-up examinations included serial panoramic radiographs and recording of changes in mandibular height. A 10% to 27% loss of the height gained occurred between three and 12 months postoperatively.

Adult↗

[Anatomic-roentgenologic study of the mandibular canal in atrophic mandible].

This study analyses the changes observed with atrophy of the mandibular foramen and mental foramen, as well as the mandibular canal. All 43 left halves of the examined mandibles were systematized according to the classification of the reduction of residual ridges by Atwood. This classification allows a precise description of the rate of atrophy. An evaluation of the results of computed tomography and X-ray, as well as measurements of the mandibles showed a number of significant atrophic changes. With extreme reduction of residual ridges the mental canal is significantly shortened. Increasing atrophic change causes the mental foramen to approach both the alveolar ridge and the basic tangent line. The distance of the mandibular canal to the lingual and buccal surface remains constant, whereas the distance to the cranial and caudal surface is markedly reduced according to the degree of atrophy. The mass of compact and spongy bone tissue is reduced to a level of 50% or less of the original volume. In general, the cortical lamina around the mandibular canal is more often found on the caudal side than on the cranial side. At extreme rates of reduction of residual ridges the mandibular canal is enclosed by compact bone tissue. The visibility of the mandibular canal and the mental foramen on X-ray is significantly reduced by extreme rates of resorption.

Aged↗

[Salivary imprints on the mandible. The sign of lordosis of the ramus (author's transl)].

All of the principal salivary glands are in contact with the membranous mandible, in the form of contiguous relationships which develop and disappear respectively at the time of phylogenesis and ontogenesis of the first branchial arch. A contrast must also be drawn concerning the static relations between the submaxillary and sublingual glands and the inner aspect of the horizontal branch and the dynamic relations between the posterior edge of the ramus and the parotid gland ensured by the inter-mandibulo-parotid sliding space. In this perspective, the physiological slope of the posterior border of the ramus is certainly of parotid origin. This slope may be exaggerated in the presence of a parotid tumour, forming the indirect radiological sign of sagittal lordosis of the ramus, sometimes associated with a certain degree of frontal scoliosis in the case of a tumour with pharyngeal prolongation. Once again in this perspective, the inter-mandibulo-parotid sliding space makes for easy separation of the anterior parotid aponeurosis of the mandible and of its muscular sling.

Humans↗

Stability of the mandible after surgical correction of skeletal class III malocclusion in 50 patients.

Fifty cases of skeletal Class III malocclusion were analyzed by the tracings of presurgical and postsurgical cephalograms to evaluate the stability of the mandible a year after surgery. In 33 patients, the curved oblique osteotomy in the ascending ramus was used; the correction was made in the mandibular body for 17 patients by either the rectangular osteotomy or the sliding osteotomy. Minimal relapse was observed in all three procedures, with the least amount occurring after mandibular body ostectomy or osteotomy. The results were considered to be due to careful determination of the correct time for surgery in each patient to avoid skeletal relapse resulting in continued mandibular growth, prompt osseous healing at the surgical sites by providing close and tight bony contact between the segments, elimination of the effect of the major muscles of mastication, minimum alteration in the position of the posterior segment and trimming of the margin of the anterior segment to form a proper gonial angle, and a stable occlusion with maximum intercuspation and an adequate overbite. In addition, preoperative orthodontic treatment and extraoral traction of the mandible by chin cups were considered effective means to stabilize the post-operative occlusion.

Adolescent↗

[Craniofacial growth modified by the blood supply. 7. Dry weight of the skull and growth of the mandible].

The dry weight of the skull and jaw bone increases faster in operated rats than in the controls during the fourth and 12 months, but their rates of growth do not differ in the 8th month. The distances measured on the mandible reveal definite sexual dimorphism in the development of the different lengths and heights, these distance being greater in the male rats. Growth in the length of the processes predominated over the growth of the body of the mandible. Local changes in the bone were observed at the points of origin and attachment of muscles.

Animals↗

[Skull deformities as sequela of unilateral mandibular dysbalance. 4. Secondary changes in the mandible].

Distinct morphological changes were found one year after partial unilateral mandibular resection. The stump left after resection was smaller in all dimensions than the corresponding part of the intact half of the mandible, and the coronoid process inclined further posteriorwards as age increased. The temporomandibular joints were atrophized in all and arthrotically deformed in some cases. The intact halves of the mandibles presented a more or less S-shaped curvature in all cases. No dependence could be found between these changes and post-surgical age.

Animals↗

Augmentation of the edentulous mandible using bone and hydroxyapatite: a comparative study in dogs.

This study compared autogenous bone, freeze-dried homografts, and hydroxyapatite in interpositional grafting of the mandible in beagle dogs. Healing was assessed radiologically and histologically. Results showed that the rate of incorporation of the autografts was greater than that of the homografts, and at both 4 and 12 weeks healing was more advanced. There was also rapid healing around the hydroxyapatite grafts, which became firmly bonded to the surrounding bone. The apatite was not resorbed, and new trabeculae of bone had been deposited onto much of its surface. This investigation confirms that hydroxyapatite is well tolerated and may be a suitable substitute for autogenous bone for augmentation of the atrophic mandible.

Alveolar Ridge Augmentation↗

[Biomorphosis of the mandible].

Described is the postnatal development of the mandible. Estimated are the changes of the basal-angle, gonion -angle, thickness of mandibulae , the postnatal growth of the corpus and ramus mandibulae, the difference of hight between processus coronoideus in equilibrium with caput mandibulae and the width of processus coronoideus and ramus mandibulae. Included are distances of the foramen mentale and the direction of this short canal, the angle of the chin, the linea obliqua , the antilingula and on the medial side of the mandible, the linea mylohyoidea and sulcus mylohyoideus also position and form of foramen mandibulae including the lingula. Measured is the direction of ramus mandibulae, the largest distance between both rami and the distance between the apex of the coronoid process and the outborder of the caput mandibulae. The results are discussed with thoughts of early researchers and some remarks are made to canalis mandibulae.

Adolescent↗

An SEM analysis of the epithelial--mesenchymal interface in the mandible of the embryonic chick.

In this paper the ultrastructural features of the epithelial-mesenchymal interface in mandibular processes of embryonic chicks have been examined using scanning electron microscopy. Mandibular epithelium is required for the mesenchyme to differentiate as osteoblasts and to deposit the membrane bones of the mandible. The surface morphology of the epithelium changes from the lateral to the medial face of the mandible from rounded cells, each with a central cilium to flattened cells with numerous microvilli. Treatment with trypsin and pancreatin was used to digest the basal lamina so as to separate epithelium from mesenchyme. This exposed a thick, fibrillar basement membrane (reticular lamina), which was thicker underlying the caudal epithelium than under the cephalad epithelium. Addition of collagenase to the trypsin/pancreatin solution degraded some of the basement lamella, especially that underlying epithelium on the caudal portion of each mandibular process. Selective degradation of basement lamella is postulated as one means of regulating inductive epithelial-mesenchymal interactions. EDTA was used to isolate basal laminae on mandibular mesenchyme. SEM was used to confirm the integrity of the basal lamina, its structure, and its association with overlying epithelial cells and underlying basement lamella.

Animals↗

[Visor osteotomy of the mandible in edentulous patients].

The use of a sliding osteotomy to reconstruct an incisive block on an edentulous mandible was first described by Frans Harle in 1975. Employed in cases of a flattened widened mandible, when bone material is still present, it supplies an elegant solution to the problem of the anterior stability of inferior total prosthesis. Results of the use of this technique are reported. The problem of the mucoperiosteal cover of the graft after it is slid above the bone base left in place was resolved by performing, with the true osteotomy, a mucous sliding graft completed by a thin skin graft. A slightly different sliding osteotomy is also proposed, in which the mandibular graft is slid in the inverse direction, thus partially correcting the false prognathism of the edentulous patient.

Humans↗

Hyperbaric oxygen therapy with subtotal extirpation surgery in the management of radionecrosis of the mandible.

Radiation-induced obliterative endarteritis causes ischemia and hypoxia in tissue wounds, making them prone to dehiscence, infection and delayed healing. The successful use of hyperbaric oxygen as an adjunct to intensive antibiotic and surgical therapy in the treatment of radionecrosis of the mandible is well established. This report details our experience in four cases of radionecrosis of the mandible of long duration, prior to acceptance of the patients into our hyperbaric oxygen protocol.

Aged↗

Ascending ramus for reconstruction of the mandible.

We have developed a technique for an immediate bone graft utilizing the anterior part of the ascending ramus for repair of bone defects resulting from resection. We applied this operative procedure to a case of an extensive ossifying fibroma of the mandible. As a result, the postoperative x-ray examination showed a well-restored shape of the mandible, and the postoperative function was excellent.

Adult↗

[Absolute strength of the muscles attached to the mandible].

In the course of an anatomical investigation of the muscles, securing movements of the mandible, performed on 10 human corpses, the muscle fibre length, volume and weight of each muscle has been estimated. Owing to the formula suggested by P. F. Leshaft (1880)--q = v/e, the physiological diameter of the muscles has been determined. Since the muscle with the diameter equal to 1 cm2 develops an absolute forse of 10 kg, the absolute muscle force value of the anterior group of muscles has been obtained for the first time (venter anterior musculi digastri--4.8 kg, musculus mylohyoideus--10.7 kg and musculus geniohyoideus--6.3 kg). The data on the absolute force of the posterior group of muscles has been verified (musculus masseter--24.2 kg, musculus temporalis--28 kg, musculus pterygoideus medialis--15.6 kg and musculus pterygoideus lateralis--15.5 kg). Analysing the interaction of forces of the muscles participating in the mandible movements, direction and value of displacements of the mandibular fragments have been explained and confirmed on some clinical examples. The data on the absolute force of the muscles studied can be used for investigating the displacement mechanism of the mandibular fragments after its resection and when its integrity is broken.

Adult↗