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At least 127 records · Page 7Linked to original sources
PubMed1997

Patients' perception of sensory disturbances of the mental nerve before and after implant surgery: a prospective study of 110 patients.

In a randomized controlled clinical trial 110 edentulous patients with severe mandibular bone loss have been treated with ITI-dental implants using three different treatment strategies: (1) a mandibular overdenture supported by two implants with ball attachments, (2) two implants with an interconnecting bar or (3) by four interconnected implants. As implant surgery involves elevation of the mucoperiosteum, bone remodelling at the implant site and insertion of implants close to the mental foramen, altered sensations of the mental nerve caused by the surgery are to be expected. An altered sensation of the lower lip can also be caused by pressure of an ill-fitting lower denture on the mental foramen, or in the case of severe bone loss of the alveolar ridge, on the alveolar nerve itself. This article presents the results of the patients' perception of the sensation of their lower lip before, 10 days after and 16 months after implant surgery in the mandible. It shows that 25% of the patients describe a sensory disturbance before treatment. This 25% also showed high scores on the Hopkins Symptoms Check List indicating a tendency to somatize complaints. Eleven percent of the patients report a sensory disturbance in the lower lip 10 days after surgery. Ten percent report a sensory disturbance 16 months after surgery of which one third also reported a disturbance before the treatment. This implies the risk of a sensory disturbance of the lower lip to be a possible complication after implant surgery. Therefore patients must be informed about this phenomenon before treatment.

Adult↗
PubMed1997

Morphological variability of the human inferior alveolar nerve.

The aims of this study were: to compare the radiographic appearance of the neurovascular bundle and its surrounding bone with the actual situation revealed on dissection; to reveal the morphology of the neurovascular bundle in dentate and edentulous subjects; and to note any changes occurring following the removal of the teeth and the consequent resorption of alveolar bone. Twenty-nine human mandibles were examined; 20 were dry skeletal specimens that were examined radiographically and the remaining nine were radiographed then dissected after decalcification and the branches of the inferior alveolar nerve were identified, sketched, and photographed. Different patterns of identifying characteristics of the mandibular canal were noted on the radiographs, ranging from alternating bands of radiopacity and radiolucency to continuous radiopaque lines. Dissections indicated that the radiographic appearance related to the number, distribution, and pattern of trabeculae around the canal. The dissections revealed that in all cases, the main nerve divided into its incisive and mental branches in the molar area well before reaching the mental foramen. A branch to the molar teeth, and in two instances to the second premolar as well, was given off from the main trunk before it divided into incisive and mental branches. In the dentate specimens, the neurovascular bundle formed two distinct curvatures, one between the mandibular and mental foraminae and the other between the mental foramen and the incisor teeth apices. In the edentulous specimens, the neurovascular bundle was reduced in size and although some small nerve branches, notably to the molar areas, were distinguishable, the blood vessels seemed to have atrophied beyond macroscopic identification. This project confirmed the inaccuracy of descriptions repeated in many anatomical textbooks suggesting that the inferior alveolar branch of the trigeminal nerve divides at the mental foramen into its incisive and mental branches and that during their path through the body of the mandible they give off fibers to the individual teeth. It further confirmed that the neurovascular bundle reduces in size quite markedly after removal of teeth and that the vascular component cannot be clearly identified.

Aged↗
PubMed1992

Selective excitation of parasympathetic nerve fibers to elicit the vasodilatation in cat lip.

Electrical stimulation of the tongue and the proximal cut end of the lingual nerve caused a blood flow to increase in a stimulus-intensity dependent manner in the ipsilateral lower lip of the cats. Pretreatment with hexamethonium (an autonomic ganglionic blocker, 1.0 mg/kg) abolished the vasodilator response, while atropine, phentolamine, propranolol and tripelennamine had no effect on these vasoresponses. Ipsilateral sections of either the glossopharyngeal nerve root, inferior alveolar nerve or mental nerve at the main mental foramen, but not at the posterior mental foramen, abolished the vasodilator response caused by electrical stimulation of the tongue and the lingual nerve. Electrical stimulation of the distal cut ends of the glossopharyngeal nerve root and inferior alveolar nerve caused the vasodilator and vasoconstrictor responses, whereas stimulation of the tongue and the proximal cut ends of the lingual nerve did not elicit the vasoconstrictor response. These results suggest that reflex vasodilatation in the cat mandibular division is exclusively mediated via activation of the parasympathetic nerve fibers, and that selective excitation of the parasympathetic nerve fibers in the oral area is possible.

Animals↗
PubMed2005

The evaluation of vertical heights of maxillary and mandibular bones and the location of anatomic landmarks in panoramic radiographs of edentulous patients for implant dentistry.

The purpose of this study was to determine variations in the vertical height measurements in the edentulous maxilla and mandible, and to assess positions of the maxillary sinus, mandibular foramen, and the mandibular canal, which are important for implant length selection and planning using panoramic radiographs. The study sample included 346 edentulous alveolar ridges of 90 men and 83 women. Sixty-three dentate patients' panoramic radiographs were used for location of the first premolar and molar area. Panoramic radiographs were made with a Siemens Orthophos panoramic machine which had been standardized previously. All radiographs were made using a standardized manner by the same technician. Fourteen sites were measured on every panoramic radiograph whenever possible, eight sites in the maxilla and six sites in the mandible. Correlation analyses were performed between age groups and all measurements to determine if age is significant as a covariate. In order to examine the effect of gender the statistical analysis of differences between men and women was performed with Student t-test. The 5% significance level was used for statistical significancy. The height of the maxilla and the mandible in the anterior, first premolar, and first molar regions were significantly greater in men than in women. A majority of the most inferior border of the maxillary sinuses was located anterior to the first molar area (premolar regions) both in men (48.9%) and women (55.4%). Although, there was no statistically significant difference between edentulous men and women for the vertical distances from the mental foramen to the alveolar crest, and horizontal distances from mental foramen to midline, there were statistically significant differences between edentulous men and edentulous women for the vertical distances from the upper border of the mandibular canal to the alveolar crest in the first molar area. Mental foramens were located at the crest of the ridge in 7.2% of the edentulous women, and 6.7% of the edentulous men. The results of this study may guide clinicians to make primer decision of implant insertion area for implant supported prosthesis in edentulous patients.

Adult↗
PubMed1997

Morphology of the mandibular cortex on panoramic radiographs as an indicator of bone quality.

OBJECTIVES: To determine whether the bone mineral density (BMD) of the mandibular cortex is correlated with an ordinal classification of the morphology of the inferior cortex on panoramic radiographs. METHODS: The cortical BMD of the mandible was measured by single-energy quantitative computed tomography at two sites: (1) buccally and distally from the mental foramen, (2) lingually and distally from the mental foramen. The morphology of the mandibular cortex was assessed on panoramic radiographs, and classified into three groups. RESULTS: The severity of the changes in the mandibular cortex was significantly related to the BMD of the buccal cortex (ANOVA: p = 0.002). CONCLUSIONS: The use of an ordinal classification of the mandibular cortex on panoramic radiographs may be helpful for general dental practitioners in the assessment of the local quality of the cortical bone.

Alveolar Bone Loss↗
PubMed1992

Treatment of mandibular fractures with or without intermaxillary fixation--a comparative study.

The aim of the present study was to evaluate titanium miniplates for treatment of mandibular fractures compared to routine treatment of the department (control). The study included 74 dentate patients with fractures within the tooth bearing regions of the mandible. Two groups of patients were studied:(A), 42 patients with unilateral fractures of the angle or anterior to the mental foramen and (B), 32 patients with bilateral fractures of the mandible. Patients with unilateral fractures were randomized for the control group (n = 20) or the experimental group (n = 22). Group B included two groups of patients, a control group of 16 consecutive patients previously treated, and an experimental group of 16 consecutive prospectively studied patients. All patients in the control groups received open reduction and IMF for 5 weeks. Fractures of the angle were stabilized with an 0.4 stainless-steel wire superior border osteosynthesis, whereas fractures anterior to the mental foramen were treated with a stainless steel plate osteosynthesis. Patients in the experimental groups were treated with IMF only during surgery, thereafter the IMF was released. In fractures of the angle, one titanium mini-plate was used, whereas two were employed in fractures anterior to the mental foramen. The results were comparable in both groups with respect to occlusion and complications. We conclude that the titanium mini-plates offer sufficient stabilization of mandibular fractures to allow treatment without post-reduction IMF. This technique is associated with a low complication rate and reduced morbidity as compared to conventional treatment.

Adolescent↗
PubMedDate not supplied

Evaluation of the mandible as an alternative autogenous bone source for oral and maxillofacial reconstruction.

The objective of this study was to quantify the amount of bone graft material present in the different regions of the mandible while avoiding the inferior alveolar neurovascular bundle, mental foramen and tooth injury. The study was carried out on 16 samples of dry, cadaverous skull. The dimensions of the anterior part of ascending ramus, mandibular symphysis and mandibular body in these samples were evaluated. The osteotomy lines in the anterior part of the ascending ramus were made in front of the mandibular canal from the mandibular notch to 3 mm posterior of the root of the third molar. The osteotomy line in the mandibular body was made just medial to the external oblique ridge from the ascending ramus to approximately 3 mm posterior to the mental foramen. Vertical osteotomy lines were then made from the cut ends of the first osteotomy down to the lower border of the mandible. The osteotomy lines in the mandibular symphysis were performed on the mandible with 5-mm safety margins caudal to the expected position of the mandibular dentition, anterior to the position of the mental foramen, and cephalad to the inferior border of the mandible. It was determined that the dimensions of the anterior part of the ascending ramus were 37.60 mm x 33.17 mm x 22.48 mm x 9.15 mm, and the thickest part of the graft material was 12.23 mm. The average horizontal length of the mandibular body bone was 35.10 mm, and the average vertical length was 19.13 mm. The dimensions of the bone graft obtained from the mandibular symphysis were 45.36 mm x 10.31 mm, and the average thickness was 9.63 mm. Based on the results of this study, it is apparent that the different regions of the mandible can reliably be selected as the harvest site in a variety of oral and maxillofacial reconstructive procedures.

Bone Transplantation↗
PubMed2002

3D volume rendering using multislice CT for dental implants.

OBJECTIVES: To determine the precision and accuracy of three-dimensional (3D) volume rendering spiral multislice computed tomography (CT)-based linear measurements of the mental foramen for dental implants, in vitro, and their precision, in vivo. METHODS: Five cadaver heads were imaged by multislice spiral CT (Toshiba Aquilion) with 0.5 mm thick axial slices (0.5 mm/0.5 s of table feed) at 0.5 mm interval reconstructions. The image data sets were transferred to a networked computer workstation. Using computer graphics the data were analysed with a 3D volume rendering technique using Vitrea software. Two oral and maxillofacial radiologists, independently, made electronic linear measurements from the superior border of the mental foramen to the crest of the alveolar process. The soft tissues were removed and physical measurements made using a 3 Space (Polhemus, Colchester, VT, USA) electromagnetic digitizer with a personal computer running Windows 98. The same linear measurements of 15 patients using the same imaging methodology were performed and the precision was analysed. RESULTS: The findings showed no statistically significant inter- or intra-observer differences in vitro and in vivo, or between imaging and physical measurements in vitro (P>0.05). CONCLUSIONS: 3D multislice spiral CT imaging allows highly accurate measurements for dental implant placement in proximity to the mental foramen. Computer graphics software, using volume rendering is suitable for implant planning.

Aged↗
PubMed2004

Implant stability, tissue conditions, and patient self-evaluation after treatment with osseointegrated implants in the posterior mandible.

BACKGROUND: Implant treatment in the posterior mandible is considered challenging because of bone resorption and the presence of the inferior alveolar nerve, which may result in the use of short implants. PURPOSE: To evaluate implant stability, tissue conditions, and patient opinion after treatment with implant-supported bridges in the posterior mandible. MATERIALS AND METHODS: Thirty-four patients treated with implant-supported bridges in the posterior mandible according to a two-stage protocol were clinically and radiographically examined and interviewed after a mean functional time of 3.9 years. One hundred five Brånemark implants (Nobel Biocare AB, Gothenburg, Sweden) were placed in premolar and molar regions to support 40 bridges. Twenty-eight implants were placed anterior to the mental foramen, and 77 implants were placed posterior to the mental foramen. Bridges were supported either by two or by three implants. After 2 to 6 years, the bridges were removed to analyze the resonance frequency of the implants with the use of a special instrument (Osstell instrument, Integration Diagnostics AB, Gothenburg, Sweden), and an implant stability quotient (ISQ) was recorded for each implant. RESULTS: One implant was lost. An ISQ range of 59 to 90 (mean, 70.05) expressed stability of fully integrated implants in the posterior mandible. Significantly higher (p < .024) ISQ values were found in implants in three-implant bridges when compared with implants in two-implant bridges. There were no differences in ISQ values between molars/premolars, implant types, implant widths, implant lengths, anchoring depth, or uni- or bilateral mandibular bridges. Good mucosal health in the periimplant soft tissue and minor bone resorption around the implants were observed. Patients were generally very satisfied with the treatment outcome. CONCLUSIONS: High implant stability can be reached in the posterior mandible. The implants were more stable in three-implant bridges than in two-implant bridges. The patients were highly satisfied with the treatment, and few complications were seen.

Aged↗
PubMed2001

The mandibular canal of the edentulous jaw.

The morphology of the mandibular canal after loss of teeth has received little detailed attention. Improved documentation of this topic would allow better interpretation of dental radiographs and would enable those engaged in tooth implantation to better understand the nature of the tissue into which the prostheses are placed. In this study on mandibles from seven dissecting room cadavers panoramic radiographs usually showed the mandibular canal clearly, an incisive canal less so. The wall of the mandibular canal was similar in dentate and edentulous mandibles, and was highly perforated, as suggested by Cryer (Anderson et al., 1991). In edentulous specimens, it was composed mainly of cancellous bone with only occasional single osteons. The inferior alveolar nerve near the mandibular foramen was a large trunk, consisting of three to four nerve bundles with connective tissue sheaths. It became more loosely arranged toward the mental foramen. Medial to the mental foramen, the nerves were frequently in the form of small bundles in the marrow. Any incisive canal was ill-defined and neurovascular bundles, when present, ran through a labyrinth of intertrabecular spaces.

Aged↗
PubMed2004

Perioperative neurosensory changes associated with treatment of mandibular fractures.

PURPOSE: The purpose of this study was to document perioperative neurosensory changes in the inferior alveolar nerve (IAN) after mandibular fracture treatment and to identify risk factors associated with these changes. MATERIALS AND METHODS: This was a prospective cohort study composed of patients treated for mandibular fractures. The primary study variable was the change between the postinjury/pretreatment IAN neurosensory examination score and the score after fracture reduction. Risk factors were categorized as demographic, anatomic, and treatment. Appropriate descriptive, bivariate, and multivariate statistics were computed. RESULTS: The cohort was composed of 61 patients with 97 fractured sides. Forty-seven fractures (49%) were located between the lingula and mental foramen, and 50 fractures (51%) were located distal to the mental foramen. Thirty-nine fractures (41%) were displaced by 5 mm or more. Abnormal preoperative IAN neurosensory examinations were documented in 81% of the fractured sides. Fifty-three fractures (54%) were treated by closed reduction and 44 (46%) by open reduction and internal fixation. In 82 fractures (85%), the IAN neurosensory score was unchanged or improved after treatment. In a multivariate model, preoperative neurosensory score, displacement, and treatment were associated with a statistically significant risk (P < or =.05) for postoperative deterioration of IAN sensation. CONCLUSION: Open reduction and internal fixation, fracture displacement of 5 mm or more, and a normal preoperative IAN neurosensory examination were associated with an increased risk for deterioration of the IAN neurosensory score after treatment of mandibular fractures. Additional studies are indicated to determine long-term IAN neurosensory function after mandibular fracture treatment and the factors that affect prognosis.

Adult↗
PubMed1998

Trigeminal neuropathy: improved imaging with a dental computed tomography software program.

PURPOSE: This study evaluated the use of images obtained by a dental computed tomography (CT) software program in the diagnosis and treatment of trigeminal neuropathy associated with jaw abnormality. PATIENTS AND METHODS: Twelve patients with jaw abnormality associated with trigeminal neuropathy as the presenting symptom were studied by plain film radiography (PFR) and by a dental CT software program (DS) that displays multiple panoramic and cross-sectional views of the mandible and maxilla. The two modalities were compared for delineation of the integrity of mandibular foramen, mandibular canal, mental foramen, incisive foramen, and incisive canal. Also, displacement of the neurovascular bundle was evaluated and scored. RESULTS: The DS was superior to PFR in showing the bony integrity of the foramina and canals in the jaws, as well as the degree of displacement of the neurovascular bundle. CONCLUSION: DS should be the study of choice for evaluating trigeminal neuropathy associated with abnormalities of the jaws.

Adult↗
PubMed1978

Intraosseous neurofibroma of the jaws.

Two cases of intraosseous neurofibromas of the mandible are presented. Only 25 cases of this tumor have been published previously. Of the present two cases, one was located at the upper border of the mandible, in the left second molar area where the tooth had been extracted 2 years previously. In the second case, the tumor presented itself as a 10 x 2 cm large destruction, mainly following the course of the alveolar nerve from the mandibular foramen to the mental foramen in the right side of the jaw. The mandibular first right molar was missing but the relationship between the extraction of the tooth and the development of the tumor could not be demonstrated. Histologically, the two tumors differed in the way that case 1 showed a conspicuous amount of delicate, wavy fibrils, some of which showed concentric lamellations resembling the pacinian corpuscle but without neurites containing nerve fiber bundles and also demonstrated a slight pleomorphism.

Adult↗
PubMed2000

Enlargement of mandibular canal without hypesthesia caused by extranodal non-Hodgkin's lymphoma: a case report.

A rare condition of enlargement of the mandibular canal caused by an extra-nodal non-Hodgkin's lymphoma in a 59-year-old Japanese woman was reported. The patient had a swelling of the hard palate and protrusion of both ocular bulbs, which had been present for 10 years. A panoramic radiograph revealed that the right mandibular canal was widely enlarged, extending from the mandibular foramen to the mental foramen, without bone destruction. The continuous dilation of the mandibular canal to an approximate 15-mm width was associated with peripheral bony sclerosis. Computed tomography and magnetic resonance imaging showed a soft tissue tumor inside the mandibular canal. The lesion demonstrated expansive growth in the orbits, extending to the skull base through the superior orbital fissures and cavernous sinus. The lymphoma was suspected to have grown so slowly that the adjacent mandibular canal and ocular bulbs enlarged without destroying the normal bone and nervous tissue.

Dilatation, Pathologic↗
PubMedDate not supplied

Mandibular condylectomy in the guinea pig: quantitative triple fluorochrome study.

Different-colored fluorochromes were administered sequentially to guinea pigs and the rate of bone formation measured in their condylectomized control contralateral hemimandibles. The values for labeled bone for condylectomized hemimandibles were lower than for the control contralateral hemimandibles of the same guinea pig. The differences in values of condylectomized and control contralateral sides for DCTC- and total surface area-labeled bone were statistically significant, but were not statistically significant for DCAF- and hematoporphyrin-labeled bone. There was partial regeneration of the condylar process. Although the condylectomized area was nearly normal in shape, its size and proportions were different from those of the contralateral hemimandibles that were not operated on. The greatest differences were noted in the length, height, and the distances measured between the inferior alveolar foramen and the mental foramen and the posterior border of the condyle.

Animals↗
PubMed1989

The appearance of mental foramina on panoramic radiographs. I. Evaluation of patients.

The appearance of the mental foramen on panoramic radiographs can be classified as a continuous, separated, diffuse, or unidentified type. In a sample of 297 patients, the most frequent appearance was separated (43%), followed by diffuse (24%), continuous (21%), and unidentified (12%). There were no significant differences in foramen diameter or relative vertical position within foramen types or developmental stages of the dentition. It is strongly suspected that sometimes the radiographic landmark presumed to be the mental foramen may actually be the reappearance of the mental canal.

Adult↗
PubMed1989

Radiologic examination for location of the mandibular canal: a comparison between panoramic radiography and conventional tomography.

Panoramic radiography was compared with conventional tomography as techniques for visualizing the mandibular canal. Tomography gave a significantly clearer image of the canal at and 1 cm posterior to the mental foramen, while no differences were found between the methods 2 cm posterior to the mental foramen. Thus, tomography could be of great value in locating the mandibular canal before implant surgery in edentulous mandibular posterior segments.

Adult↗
PubMed1994

Radiographic findings in the jaws of clinically edentulous old people living at home in Helsinki, Finland.

In the present survey the radiographic findings in the jaws of 124 clinically edentulous old people living at home in Helsinki, Finland, were studied, using panoramic radiography supplemented by intraoral radiographs. Only 9% of the subjects had root remains. Impacted teeth were found in 4%, radiolucent lesions in 3%, and radiopaque findings in 13%. Deviations from normal condylar structure were found in 17% and mucosal thickenings in the maxillary sinuses in 7%. The mental foramen was situated at the top of the residual ridge in 42% of the subjects. Topically situated mental foramen and condylar changes were commoner in women. The radiographic oral health status of the population studied was good.

Aged↗