Adult Mandibles Research Articles

A review of New Zealand Eomysticetidae (Mammalia, Cetacea) and implications for the evolution of baleen whales: new specimens, functional anatomy, and phylogeny

ABSTRACT Eomysticetidae are a clade of early diverging functionally toothless, longirostrine and likely baleen-bearing stem mysticete whales. Eomysticetid fossils are rare but known worldwide from Oligocene strata. The richest assemblage of eomysticetids has been uncovered in New Zealand from the Kokoamu Greensand and Otekaike Limestone (North Otago and South Canterbury regions, South Island). This includes some of the largest known eomysticetids, Tokarahia kauaeroa and Tokarahia lophocephalus, some older and more archaic forms such as Matapanui waihao, the fragmentary Tohoraata raekohao and Tohoraata waitakiensis, and the well-known Waharoa ruwhenua represented by several well-preserved skulls and mandibles of adults and juveniles. Studies of these New Zealand fossils strongly indicates monophyly of Eomysticetidae and suggest possible skim feeding behaviour, possession of non-functional teeth and baleen, extreme rostral lengthening during growth and peramorphic evolution, rostral kinesis, use of Zealandia as a calving ground, and probable extinction at or near the Oligo-Miocene boundary.

Diagnosis of split fractures of the mandible in adults.

Mandibular split fractures, in which the fracture occurs exclusively in the posterior wall, are uncommon. This study aimed to enhance clinicians' understanding of mandibular split fractures and offer insights for future research. This study included six patients who visited our hospital between January 2020 and June 2023 and were diagnosed with mandibular split fractures. We retrospectively collected data from patients' medical records on their age, sex, symptoms, mechanism, impact site, associated injuries, and treatment method, as well as the location, pattern, and number of fractures observed on computed tomography (CT) and panoramic images. The frequency of split fractures among all mandibular fractures was calculated. The six patients included three men (50%) and three women (50%), ranging in age from 20 to 71 years (mean age, 49.8 years). The split fractures were located in the symphysis in one patient (16.7%), symphysis to parasymphysis in two patients (33.3%), parasymphysis in one patient (16.7%), and parasymphysis to the body in two patients (33.3%). Four patients (66.7%) had condylar head fractures, while two patients (33.3%) had single split fractures. The mechanism of trauma was a slip-down incident in four cases (66.7%), while two cases (33.3%) were caused by motorcycle traffic accidents. Four patients (67%) underwent intermaxillary fixation, while two patients (33%) improved with conservative treatment. Split fractures were diagnosed in all six patients on CT, whereas the fracture line was not clearly visible on panoramic images. Mandibular split fractures accounted for 5.6% of all mandibular fractures. This study provides insights into the clinical characteristics of rare mandibular split fractures and the diagnostic imaging findings. Furthermore, CT scans and three-dimensional image synthesis-instead of panoramic images-may be essential for accurately diagnosing mandibular fractures, including mandibular split fractures, in the future.

Relationship Between Functional Movements of the Mandible and Core Stability in Young Healthy Adults

Background. Temporomandibular joints (TMJs) have a common neuromuscular connection with neck and scapula, so dysfunction of one or both joints can lead to changes in the spine posture and vice versa. Due to the compensatory mechanism, occurring following TMJ functional disorders, the balance between facial and neck muscle activity is disrupted. A change in any biomechanical unit inevitably results in a change of the posture control system, but there is a lack of research evaluating the relationship between functional movements of the TMJ and trunk stability.
 The aim. To determine the relationship between core stability and functional movements of the mandible.
 Methods. The study included 20 participants aged between 20 and 40 years. Participants were tested individually. Tests and measurements selected for the study: trunk stability assessment by functional Dynamic Neuromuscular Stabilization (DNS) tests; assessment of static trunk muscle endurance by McGill endurance tests; assessment of TMJ range of motion using a ruler.
 Results. Participants performed best on the DNS Supine test with legs raised up, and performed worst on the squat, bear position tests and trunk extension static endurance test. 90% of the participants had impaired range of motion of mandible protrusion, 60% had mandibular depression limitations. The static endurance of trunk flexion was 136.85±96.97 s, extension – 141.45±94.52 s, left side– 98.00±76.08 s, right side– 99.95±96, 99 s.
 Conclusion. There are strong, moderate and weak linear inverse functional relationships between trunk stability and TMJ mobility. The weaker the core stability, the more restricted the mobility of the mandible.
 Keywords: temporomandibular joint, TMJ dysfunction, dynamic neuromuscular stabilization, core stability.

BILATERAL ORTHOKERATINED ODONTOGENIC CYST: A REPORT OF TWO NEW CASES

Orthokeratinized odontogenic cyst (OOC) is an uncommon developmental cyst of the jaws that usually occur singly, as a unilocular radiolucency affecting the posterior mandible of males. Bilateral OCCs are exceedingly rare, with less than 10 cases reported in the literature. Our study presents two new cases of bilateral OOCs. The first patient was an 18-year-old man who presented two bilateral well-circumscribed unilocular radiolucent lesions in the posterior mandible. The second patient was a 29-year-old woman with bilateral well-circumscribed unilocular (left) and multilocular (right) radiolucent lesions, located in the posterior mandible. The unilocular lesions were associated with unerupted lower molars. Microscopically, the cysts were entirely lined by orthokeratinized stratified squamous epithelium, confirming the diagnosis of OOC. Both patients were treated conservatively, and to date, no recurrence was evident. Clinicians should consider OOC during the evaluation of bilateral pericoronal radiolucent lesions in the posterior mandible of young adults. Orthokeratinized odontogenic cyst (OOC) is an uncommon developmental cyst of the jaws that usually occur singly, as a unilocular radiolucency affecting the posterior mandible of males. Bilateral OCCs are exceedingly rare, with less than 10 cases reported in the literature. Our study presents two new cases of bilateral OOCs. The first patient was an 18-year-old man who presented two bilateral well-circumscribed unilocular radiolucent lesions in the posterior mandible. The second patient was a 29-year-old woman with bilateral well-circumscribed unilocular (left) and multilocular (right) radiolucent lesions, located in the posterior mandible. The unilocular lesions were associated with unerupted lower molars. Microscopically, the cysts were entirely lined by orthokeratinized stratified squamous epithelium, confirming the diagnosis of OOC. Both patients were treated conservatively, and to date, no recurrence was evident. Clinicians should consider OOC during the evaluation of bilateral pericoronal radiolucent lesions in the posterior mandible of young adults.

A Two-Year Retr ear Retrospectiv ospective Evaluation of Cone Beam Computed aluation of Cone Beam Computed Tomography Indications in Pediatric, Adolescent and Adult Patients

Objective: The objective was to evaluate cone-beam computed tomography (CBCT) indications and distribution in pediatric, adolescent and adult patients. Methods: A total of 1013 CBCT images were reviewed in detail from the electronic patient database. The patient’s age, gender, CBCT indications and acquisition sites, referral departments, reason for referral, incidental findings in the imaging field and the presence of artifacts in the CBCT images were all recorded. The European DIMITRA project recommendations were used to categorize CBCT indications in the children and the European Guidelines were used for adults. Results: From a total of 1013 images; 5.3% were from children, 9.2% were from adolescents and 85.5% from were adult patients. The most common indication was impacted permanent teeth in children (37%) and adolescents (34%) and impacted 3rd molars (28.7%) and implant dentistry (25.8%) in adults. While the most common regional image was taken from children (37%) and adolescents (43.4%), it was determined that CBCT was taken from the maxilla+mandible (37.7%) in adults. Conclusion: Our results show that while attention was paid to use CBCT in children and adolescents in accordance with clinical guidelines and taking into account radiation protection protocols, it was used in the adult patient group in cases where it is not superior to traditional methods.

Topographic analysis of mandibular ramus zone and anesthetic technique optimizing device

This is a study on the topographic relationship between the final extremity of the lingula of the mandible and the anterior and posterior borders of the ramus of the mandible. This work proposes the creation of a device which directs the positioning of the syringe cartridge + needle assembly, optimizing the execution of the anesthetic technique for blocking the inferior alveolar nerve. Thirty macerated adult mandibles were used, in which two measurements were obtained with the aid of a digital caliper: 1- distance between the anterior border of the mandibular ramus and the final extremity of the lingula; 2- distance between the final extremity of the lingula and the posterior border of the mandibular ramus. Photographs of the mandibles were analyzed on a computer, calculating the angle formed between three points: (1) the anterior border of the mandibular ramus – A point; (2) the anterior point between the inferior premolars of the opposite antimere – P point and (3) the final extremity of the lingula – L point. For the right antimere, 33.33% of the angles found were within the range of 6°-7°, and 23.33% between 9°-10°. As for the left, 30.00% were in the range between 5°-6°, and 23.33% between 7°-8°. It can be concluded that in more than 50% of the analyses, the formed angle varies predominantly between 5° and 10°, therefore, the proposed device will be able to minimize the chances of technical errors and optimize the success for the inferior alveolar nerve block.

An Anatomical Study of Dry Mandibles to Determine the Important Surgical Reference Points in Ramus Osteotomy - An Evaluative Study.

The variable relation and clinical significance of mandibular foramen (MF) and Lingula with inferior alveolar neurovascular bundle (IANB) is important for dental surgeons. Knowing the landmarks on the ramus of the mandible is of paramount importance to perform the surgery without causing damage to the neurovascular bundle. This study was conducted on 85 dry adult mandibles of unknown sex and age. The distances were measured from the anatomical reference points (anti-Lingula, Lingula and MF) using digital callipers. The distance from the anti-Lingula to the anterior border of the ramus (A) was significantly longer on the right side (14.91 mm) than on the left side (14.5 mm). There was a significant difference in mean distances between the anti-Lingula and MF of both the sides (P ≤ 0.005). No significant difference was noted in the distances between the Lingula and the Anti-Lingula, observed for the posterior (B, P = 0.75) and the inferior margin of the mandible (D, P = 0.54). However we found correlation of vertical distances of anti-Lingula with Lingula and MF exhibited moderate positive correlation. The IANB is prone to damage during mandibular surgery. Using anti-Lingula alone as a reference point is not guaranteed, but it is still an important anatomical landmark for the surgeon to operate.

Gender-based Morphometric Analysis of Mandibular Foramen in Dry Adult Human Mandibles in the Tertiary Care Centre, Dehradun: A Cross-sectional Cadaveric Study

Introduction: The knowledge of the location of the Mandibular Foramen (MF) is important for effective local anaesthesia in dental surgeries and mandibular implants. The location of the foramen can vary in different populations, but very few studies have explored the differences between males and females. Aim: To estimate the morphometric parameters of the MF in male and female dry adult mandibles. Materials and Methods: A cross-sectional cadaveric study was conducted in the Department of Anatomy at Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun (Uttarakhand) India, from October 2019 to December 2022. The location of MF in 75 dry adult male mandibles and 50 dry adult female mandibles was measured. All the anatomical parameters (MF to Anterior Border of mandibular ramus (MF-AB), MF to Posterior Border of mandibular ramus (MF-PB), MF to Mandibular Notch (MF-MN), MF to Angle of Mandible (MF-AG), MF to Inferior Border of mandibular ramus (MF-IB), MF to Mandibular Condyle (MF-MC), MF to apex of Retromolar Trigone (MF-RT), and AB of mandibular ramus to PB of mandibular ramus (AB-PB)) were measured using a sliding digital vernier caliper in both genders, based on the right and left mandibular foramina from different bony landmarks. Continuous data obtained was expressed as mean±Standard Deviation (SD). Analysis was done by applying an independent t-test via Statistical Package for Social Sciences (SPSS) version 23.0. Results: MF-IB was 26.09 mm±3.52 mm (RT) and 25.31 mm±3.24 mm (LT) in males, while it was 24.29 mm±3.27 mm (RT) and 24.12 mm±3.21 mm (LT) in females. The difference was found to be statistically significant (p<0.05), implying that the distance is larger in males as compared to females. MF-MC was 35.59 mm±4.44 mm (RT) and 34.89 mm±4.91 mm (LT) in males and 32.39 mm±4.11 mm (RT) and 32.52 mm±4 mm (LT) in females. The difference between the two was found to be statistically significant (p<0.05). MF-RT in males was 11.41 mm±2.19 mm (RT) and 11.87 mm±2.57 mm (LT), while in females, it was 11.40 mm±2.05 mm (RT) and 11.30 mm±2.09 mm (LT). The difference between these two was statistically significant (p<0.001) on the left-side. AB-PB was longer on the right-side in males (32.31 mm±3.05 mm) than in females (21.66 mm±3.0 mm), and the difference was statistically significant (p<0.001). Therefore, the results imply that the MF is located lower and slightly more anteriorly in males as compared to females. Conclusion: The results indicate significant differences in the location of the male and female MF. The present study provides useful information for successful inferior alveolar nerve blocks during dental surgeries and maxillofacial surgeries.

AMELOBLASTIC FIBROSARCOMA OF THE MANDIBLE: REPORT OF TWO NEW CASES

The aim of the present study is to report the clinicopathologic features of 2 new cases of ameloblastic fibrosarcoma (AFS). Case 1 was a 9-year-old boy presenting with a painful ulcerated swelling in the posterior mandible causing facial asymmetry. Case 2 presented as an asymptomatic swelling in the anterior mandible of a 14-year-old female patient. Imaging exams revealed destructive multilocular radiolucencies with irregular margins, associated with impacted teeth, causing exuberant cortical expansion and tooth displacement. Microscopically, both cases showed mesenchymal cells with marked hypercellularity and nuclear pleomorphism containing small islands of odontogenic epithelium with peripheral palisading. Both patients were treated by surgical excision; case 1 showed recurrence after 2 years of follow-up. AFS usually affects the posterior mandible of young adults with previous history of ameloblastic fibroma; nevertheless, clinicians should also consider this rare odontogenic sarcoma when evaluating aggressive ill-defined radiolucent lesions in the mandible of pediatric patients.

Study of mental foramen in dry human mandibles of adult and its significance

Mandible also known as the largest and inferior, primary facial bone of the face giving a curved shape to it. It changes its shape and gives variations to the bony structure of the face from birth till older age. Mental foramen is known as the vintage of the mandible and is an important mark of the face for carrying out many diagnostics and surgical processes along with aesthetic procedures of the face. Thus, the present study is designed with an aim to get insight knowledge of position and shape of mental foramen in dry adult human mandible. The present study was designed as a comparative and descriptive study conducted in the Department of Anatomy at Tertiary Care Teaching Hospital. Total 70 bones were included in the study for consideration. Unknown mandibles with intact alveolar sockets removed from cadavers and unknown mandibles from storage room of dry adult mandibles were obtained in 2 years. The position of mental foramen was studied using an instrument known as digital Vernier Calliper (in mm) while shape was analysed visually. Position of mental foramen was calculated using Statistical package for social sciences (SPSS) software.

Transverse Analysis of Maxilla and Mandible in Adults with Normal Occlusion: A Cone Beam Computed Tomography Study.

Objectives: To study the transverse widths of maxilla and mandible and their relationship with the inclination of first molars. Materials and Methods: Fifty-six untreated adults (12 males, 44 females) with normal occlusion were included. On each Cone Beam Computed Tomography (CBCT) image of the subject, inter-buccal and inter-lingual bone widths were measured at the levels of hard palate, alveolar crest and furcation of the first molars, and maxillomandibular width differentials were calculated. In addition, the buccolingual inclination of each first molar was measured and its correlation with the maxillomandibular width differential was tested. Results: At the furcation level of the first molar, the maxillary inter-buccal bone width was more than the mandibular inter-buccal bone width by 1.1 ± 4.5 mm for males and 1.6 ± 2.9 mm for females; the mandibular inter-lingual bone width was more than the maxillary inter-lingual bone width by 1.3 ± 3.6 mm for males and 0.3 ± 3.2 mm for females. For females, there was a negative correlation between the maxillomandibular inter-lingual bone differential and maxillary first molar buccal inclination (p < 0.05), and a positive correlation between the maxillomandibular inter-lingual bone differential and mandibular first molar lingual inclination (p < 0.05). Conclusions: This is a randomized clinical study on transverse analysis of maxilla and mandible in adults with normal occlusion using CBCTs. On average: (1) At the furcation level of the first molars, the maxillary inter-buccal bone width was slightly wider than mandibular inter-buccal bone width; whereas the mandibular inter-lingual bone width was slightly wider than maxillary inter-lingual bone width; (2) A statistically significant correlation existed between the maxillomandibular transverse skeletal differentials and molar inclinations.

Morphological Variations of Mandibular Lingula in Dried Adult Nigerian Bones

The lingula of the mandible (also known as Spix spine) is a finger like bony projection or ridge on the medial surface of the ramus of the mandible, immediately superior to the mandibular foramen. This study aims to determine the morphology and precise location of mandibular lingula in dry adult mandibles. A total number of 42 dry adult mandible gotten from the Department of Anatomy University of Port-Harcourt were used for this study. The four various shapes of lingula were bilaterally determined, classified, measured with Vernier calipers and statistically analyzed. The most predominate found was truncated shape (41.6%), followed by triangular shape (39.27%), while the nodular and assimilated were less prevalent having (9.52%) respectively. Bilateralism were observed in the various shapes but more evident in the truncated and triangular shape. There was no statistically significant difference in the mean right and left values. The right and left mean lingula height were 7.00±1.03 and 7.14±1.11 respectively. The right and left mean lingula distance from anterior were 17.13±3.27 and 17.26±3.44 while the right and left lingula distance from the posterior ramus of the mandible were 17.46± 3.12 and 17.58± 3.03. The right and left mandibular ratio were 0.30±0.25 and 0.52±0.04 respectively. The study has provided a useful data which may give clue of the relevant anatomical structures to dental surgeons during surgical procedures. However, establishment morphological variations of mandibular lingula is very necessary in every population considering it clinical significance in oral and maxillofacial surgical procedures.

Morphological and Morphometric Evaluation of Mandibular Coronoid Process, Condylar Process and Mandibular Ramus in Jharkhand and Bihar Population

Background: Coronoid process of mandible gives attachment to temporalis and masseter muscles. The shape and size of coronoid process varies widely due to influence of many factors. Its shape has been described as triangular, hook shaped and rounded in various studies. Mandibular Condyle, is the part of the mandible that articulates with the temporal bones articular fossa and its appearance is influenced by various factors. The superior border of the mandible's ramus is formed by the mandibular notch and its contour is influenced by shape of the Coronoid process and the Mandibular condyle. Knowledge of these morphological variations is of great help to anthropologists, maxillofacial surgeons and forensic experts. Aim: Aim of present study is the morphological differences in Coronoid process, Condylar process, and Mandibular Notch in adult dry human mandibles in Jharkhand and Bihar. Material and method: 100 dry adult Mandible of known sex from the Department of Anatomy, Phulo-Jhano Medical College Dumka, Jharkhand and other medical colleges of Jharkhand and Bihar were studied. Shape of the coronoid process was visually assessed. Length of the coronoid process and mandibular process were measured by employing standardized method, using digital Vernier calliper. Results: The triangular (120) shape of the coronoid process was the most common among the 200 sides, with 72 (60%) on the right side and 48 (40%) on the left. The second was beak-shaped (68), with 36 (52.9 percent) on the right side and 32 (47 percent) on the left side, followed by the round shape (12), of which 7 (58.4%) were on the right side and 5 (41.6%) on the left side. Mean length of right and left side of coronoid process among male was 17.79 ±0.88 mm and 17.51±0.83mm respectively, while in females these measurements were 16.59±0.97mm and 16.33±0.68 mm respectively. Mean length of right and left side of mandibular condyle among male was 12.9 ± 2.13mm and 10.88±2.01mm respectively, while in females this value was 11.8± 1.67mm and 11.21± 1.75mm respectively. Average distance from the head of the mandible to the base of the mandible on right and left sides were64.22±5.77 mm and 64.05 ± 5.92 mm respectively. Similarly values for distance from the base of the mandible to mandibular notch were 46.32±7.21mm and46.24±8.49mm respectively and values for distance from the anterior border to the posterior border of the ramus of mandible were 30.48 ± 2.36mmand 30.31±2.32mm on right and left side respectively. Conclusion: Triangular shape of coronoid process was most common type seen in Jharkhand and Bihar population. This finding is similar to many other such studies. There was statistically significant difference between length of coronoid process and mandibular condyle of male and female. All these findings are of immense importance to anthropologists, maxillofacial reconstructive surgeons and forensic experts. Keywords: Morphology, Morphometry, Coronoid, Condyloid, sigmoid notch, Mandible.

Mental Foramen - A Morphological Evaluation of Dry Adult Human Mandible in Indian Population

Background: Mental foramen is an important anatomical and surgical landmark. Mental nerve and vessels emerge from it. Knowledge of variations in morphology of mental foramen in various populations is important, as it is a common site for regional anaesthesia in various dental and maxillofacial surgical procedures. Aim: Aim of present study is to look into the morphological differences in mental foramen of dry adult mandibles in Indian. Material and Method: Forty-one (41) dry adult human mandible of known sex obtained from the Department of Anatomy, Phulo-Jhano Medical College Dumka, Jharkhand and students of this institution were studied. Shape, direction and position of mental foramen were visually assessed. Distance from mental foramen to symphysis menti and distance from alveolar crest to mental foramen was measured. Results: Oval shape was the most common type. Position below second premolar tooth was most common. Direction of opening of MF was postero-superior in 88.6% and in the rest, it was antero-superior. Conclusion: This study reaffirms that morphological variations of mental foramen do exist between different populations and knowledge of these variations is important for various anaesthetic and surgical procedures. Keywords: Morphology, Morphometry, Mental Foramina, Mandible, Mental Nerve.

A Rationale for the Activity of Bone Target Therapy and Tyrosine Kinase Inhibitor Combination in Giant Cell Tumor of Bone and Desmoplastic Fibroma: Translational Evidences

Giant cell tumor of bone (GCTB) and desmoplastic fibroma (DF) are bone sarcomas with intermediate malignant behavior and unpredictable prognosis. These locally aggressive neoplasms exhibit a predilection for the long bone or mandible of young adults, causing a severe bone resorption. In particular, the tumor stromal cells of these lesions are responsible for the recruiting of multinucleated giant cells which ultimately lead to bone disruption. In this regard, the underlying pathological mechanism of osteoclastogenesis processes in GCTB and DF is still poorly understood. Although current therapeutic strategy involves surgery, radiotherapy and chemotherapy, the benefit of the latter is still debated. Thus, in order to shed light on these poorly investigated diseases, we focused on the molecular biology of GCTB and DF. The expression of bone-vicious-cycle- and neoangiogenesis-related genes was investigated. Moreover, combining patient-derived primary cultures with 2D and 3D culture platforms, we investigated the role of denosumab and levantinib in these diseases. The results showed the upregulation of RANK-L, RANK, OPN, CXCR4, RUNX2 and FLT1 and the downregulation of OPG and CXCL12 genes, underlining their involvement and promising role in these neoplasms. Furthermore, in vitro analyses provided evidence for suggesting the combination of denosumab and lenvatinib as a promising therapeutic strategy in GCTB and DF compared to monoregimen chemotherapy. Furthermore, in vivo zebrafish analyses corroborated the obtained data. Finally, the clinical observation of retrospectively enrolled patients confirmed the usefulness of the reported results. In conclusion, here we report for the first time a molecular and pharmacological investigation of GCTB and DF combining the use of translational and clinical data. Taken together, these results represent a starting point for further analyses aimed at improving GCTB and DF management.

Multi-headed (bifid and trifid) mandibular condyles in archaeological contexts: Two posttraumatic cases

ObjectiveBifid and trifid mandibular condyles are infrequent morphological alterations of the mandibular condyle. With the aim of better identifying its possible causing factors in the past and provide clues on the potential types and severities of joint dysfunction that may occur if clinical intervention is not undertaken, two archaeological cases of multi-headed mandibular condyles are presented, and their possible aetiology and pathogenesis are discussed. DesignIn this study, 143 adult mandibles recovered in the northwest of Spain were examined: 91 exhumed from San Juan Bautista church (Guardo, Palencia; 16th-19th centuries), and 52 from San Salvador de Palat de Rey church (León, 13th-19th centuries). All mandibles were observed macroscopically for the presence of any morphological and/or pathological alterations. When justified, the mandibles were also scrutinized through computed tomography. ResultsTwo isolated mandibles (n = 1, Palencia; n = 1, León) with multi-headed mandibular condyles (bifid and trifid) were identified. The computed tomography scan of the affected mandibles revealed alterations compatible with traumatic events, namely line fractures and deformations at the angle of the mandible. ConclusionsBoth the bifid and trifid mandibular condyles here described probably result from traumatic events during childhood leading to a posttraumatic deformation. Although no severe impairment of mandibular use was identified, some asymmetries probably resulted in some sort of malfunction, with TMJ-OA and gonial angle eversion as supporting evidence. Nevertheless, the degree of bone remodelling observed indicates that both individuals lived long after the traumatic occurrence.

Age and sex estimation using fractal analysis in Brazilian adults: a discriminant analysis

This study assessed the accuracy of fractal analysis (FA) to estimate chronological age and sex in Brazilian adults for forensic investigations. The gender-balanced sample comprised lateral cephalometric radiographs of 120 individuals, stratified according to age (20-29, 30-39, 40-49, 50-59 years) and sex (female and male). A trained calibrated examiner measured the fractal dimension (FD) of the mandibular ramus and mandibular angle. Linear regression and multiple logistic discriminant analysis were carried out to explore the accuracy of FA. For all analyses, p-values &lt; .05 indicated statistical significance. Overall, mean FD values were 1.49±0.10 for the mandibular ramus and 1.48±0.09 for mandibular angle. Results were more accurate in males than females for discriminating age and sex. The multiple discriminant analysis indicated that FA distinguished sex in 61.7% males and 58.3% females. In addition, the mean difference between actual and predicted value was 9.5 years and 10.1 years for men and women, respectively. Fractal analysis accurately identified sex- and age-related differences in the trabecular pattern of the mandible of Brazilian adults, confirming its utility for forensic investigations. Further studies investigating other populations are needed to assess the accuracy of FA for Forensic Dentistry.

Dental status and prosthetic treatment needs among adult refugees in Germany.

Due to the current global situation of refugees, Europe has experienced increased migration from African, Middle Eastern, and Eastern European countries. The objective of this study was to explore oral health, especially prosthetic status and treatment needs, in adult refugees, and to compare these findings with German cohorts. This representative, multicenter, cross-sectional survey on oral health and treatment needs among refugees was carried out in 10 registration centers for asylum seekers aged 18 to 75 years across Germany in 2016 to 2017. The clinical examination included past caries experience (DMFT) and both existing and necessary prosthetic measures. These measures were registered according to the National German Health Survey 2016 and compared to the German resident population. A high untreated caries experience (DT 3.9 ± 4.6) was found among refugees (n = 288, age 37 ± 12), in addition to the expected increase of caries experience with getting older (DMFT 7.4 ± 5.7 to 14.9 ± 7.7). In contrast to the German resident population, extractions were the preferred past caries treatment, resulting in a considerable number of missing teeth (MT 7.6 ± 7.3, FT 3.6 ± 4.3, 45- to 64-year-olds). Existing prosthetic treatments such as partial and full removable dental prostheses were very rare among refugees (2% to 4%). Fixed dental prostheses were mostly required in the mandible of young adults (25%, 18- to 44-year-olds), while elderly refugees required more often removable dental prostheses (45 to 64 years, 39.7% maxilla, 38.4% mandible). Newly arrived refugees in Germany exhibit higher dental treatment needs in general and prosthetic treatment needs in particular due to former extractions, which were performed as a main caries treatment.

Examination of presence and location of the accessory mental foramen, and its implications on the mental nerve block

Objectives: It is clinically essential to know the location of accessory mental foramen in the mental nerve anesthesia. The aim of this study was to determine the frequency of accessory mental foramen and examining its morphometric properties. Methods: A total of 35 adult mandibles of unknown age, gender, and ethnicity were examined. The presence of accessory mental foramen of the mandible was investigated bilaterally. In cases with the accessory mental foramen, its localization, number, and distance relative to the mental foramen were evaluated. Results: Eleven (15.71%) accessory mental foramens were detected in the 35 mandibles (70 sides) examined. Six (54.55%) of the accessory mental foramens were on the left side, and 5 (45.45%) were on the right side. Conclusion: Knowing the frequency and localization of the accessory mental foramen will make the mental nerve block more effective and facilitate surgical procedures. It should be kept in mind that the presence of accessory mental foramen should be considered in cases where mental nerve block applications are insufficient.

Anatomical Peculiarities Of Mandibular Foramen

A craniometric study of the mandibular foramen was conducted on 178 mandibles of adults. According to the results of all measurements, the transverse size of mandibular foramen on the right side ranges from 1.5 to 5.5 mm and averages 3.36 mm, and on the left side, it varies from 1.00 to 5.00 mm, with an average value of 1.87±0.34 mm. The smallest distance from the center of the mandibular foramen to the anterior edge of the ascending branch of the mandible is from 13.00 to 23.5 mm on the right side, and from 13.50 to 22.50 mm on the left side. The average values of this parameter for the right side are 17.118±2.39 mm, and for the left, respectively, 17.31±2.50 mm, as confirmed by computed tomography data According to craniometric measurements, the mandibular foramen most often has an oval or round shape. Respectively the inferior alveolar neurovascular bundle forming in the region of the mandibular foramen has an oval or rounded shape.