Fibrous Ridge Research Articles

A comparison of rugae pattern in males and females as a samples of Iraqi population

The palatine rugae are irregular fibrous connective tissue ridges located in the anterior third of hard palate that extends bilaterally from the midline behind the incisive papilla. Rugae patterns play a role as positive identification of individuals in suspected cases in forensic dentistry. The aim of the present study is to identify and compare the rugae pattern in a sample of Iraqi population. Materials and method: 120 samples of maxillary casts were selected for 60 males and 60 females their ages ranging between (22-35) years old by using Thomas & Kotze classification for assessment rugae patterns. As a result of this study shows that rugae patterns has a unique individual imprint, differ in the number, symmetry between right and left sides, shape of rugae lines for each person with no significant differences for both sexes. This work conclude that rugae patterns can be used as additional method for identification as a personal print, and considered a characteristic to discriminate between individuals.

Managing Fibrous Maxillary Ridge: A Case Series of Impression Techniques.

Fibrous ridges on the edentulous maxillary arch are commonly found in combination syndrome or due to ill-fitting dentures. Often, these cases are managed conservatively using modified impression techniques to achieve better support and peripheral seal without displacing the movable tissue. Many impression techniques were proposed and justified with their respective ideologies, but some may complicate both the clinical and laboratory procedures. In this report, two simplified techniques are demonstrated to make an impression of the maxillary arch with fibrous ridges. Laboratory steps in custom tray fabrication are also emphasised for a successful and predictable impression.

Impression techniques for management of flabby ridges in complete denture patients: A review of literature

Making of a final impression of flabby tissue with minimal or no displacement of tissue and better stability of the denture. A fibrous or flabby ridge is a mobile or extremely resilient alveolar ridge that becomes displaceable due to fibrous tissue deposition. Inadequate support, stability, and retention of a complete denture are the problems encountered in these patients. This article represents a review of different impression techniques for the management of flabby ridge in complete dentures. These impression techniques helped in recording flabby tissue with minimal displacement and hence enhanced the stability, support, and retention of the denture.

Ultrasound Evaluation of the Peroneal Tendons in an Asymptomatic Elite Military Population: A Prospective Cohort Study.

The purpose of this study was to identify the location of the peroneal tendons in relationship to the fibular groove in an asymptomatic population of elite U.S. Military Service members. The peroneal tendons of 41 active duty U.S. Army Rangers were examined. Subjects were placed in a lateral recumbent position with the ankle in a resting neutral position to visualize the tendon in a retromalleolar short-axis view. Maximum active ankle eversion followed by gravity inversion was facilitated while the ultrasound probe was maintained in its original position. Distance from the fibrous lateral ridge of the retromalleolar groove to the anterior aspect of the peroneal brevis was measured in the short axis in neutral, eversion, and inversion. The mean sagittal distance and standard deviation was 0.48±0.9mm. No subjects demonstrated greater than 1mm difference between positions, and no dislocations were identified. Side-to-side difference and dominant vs nondominant differences were not statistically significant. The study demonstrates that the distance between the peroneal brevis and the lateral fibular ridge is consistent throughout extremes of motion. These results further the understanding of peroneal tendon function under dynamic examination. Our findings also establish side-to-side consistency prompting a bilateral examination to help identify abnormal pathology.

An alternative approach for the mainframe of Flabby Ridge

A fibrous or flabby ridge is a superficial area of mobile soft tissue affecting maxillary or mandibular alveolar ridges. It develops when a hyperplastic tissue replaces the bone, often seen in long-term denture wearers and clearly related to residual alveolar ridge resorption. The prevalence studies have shown that it most commonly affects the upper anterior region in denture wearers and affects edentulous maxilla (24%) and edentulous mandible (5%) when alveolar bone is replaced by hypertrophic soft tissues.1 The displacement of this mobile tissue occurs easily during impression making causing distortion and also during mastication resulting in loss of peripheral seal.2 Although these movable tissues does not provide good retention but should be recorded to ensure good support.3,4 Also, when the new denture is adjusted into the mouth, patient’s complains of pain caused by compression of tissues between the denture and the bone. Therefore, the intaglio surface of the dentures or the surface from where pressure is transmitted should have maximum possible area to reduce pressure on the oral mucosa. During impression making this mobile tissue should be recorded without distortion using special techniques that would provide for adequate retention, stability and support in a complete denture.5 Flabby ridges have also been reported in cases with maxillary complete dentures opposing mandibular natural teeth. In 1972 Kelly described the term “ combination syndrome to the changes in patients wearing maxillary complete dentures opposing mandibular anterior teeth.6 The case presented here describes a special technique for such tissues for successful esthetic, functional and phonetic rehabilitation of an edentulous patient with maxillary anterior flabby tissue since conventional muco-compressive and muco-static impression techniques are not suitable for such cases, as the displaceable soft tissue exhibits ‘recoil’ upon compression.7 Keywords: Flabby tissue, Window techn

Ranibizumab injection and laser photocoagulation to treat type 1 retinopathy of prematurity after 40\u2009weeks post menstrual age: a retrospective case series study

BackgroundType 1 retinopathy of prematurity (ROP) is occasionally observed in preterm infants after the postmenstrual age (PMA) of 40 weeks; however, evidence-based treatment guidelines are largely lacking. In this study, we report the clinical characteristics of preterm infants with type 1 ROP at PMA of > 40 weeks and compare the treatment outcomes of intravitreal ranibizumab (IVR) and laser therapy.MethodsTwenty-seven eyes of 14 infants, primarily treated for type 1 ROP after 40 weeks PMA by IVR (17 eyes in 9 infants) or by laser photocoagulation (10 eyes in 5 infants) were included in this retrospective analysis. The preoperative fundus characteristics and the structural outcomes and additional treatment after 6 months were analyzed.ResultsOf the 27 eyes, 20 eyes (74%) had zone II stage 3 plus disease (+) ROP and 7 eyes had zone II stage 2 + ROP. Seventeen (63%) eyes showed thick fibrous ridges. After primary treatment at 40–48 weeks PMA, ROP regression was observed in a similar proportion of eyes in the IVR and laser groups (88% vs. 70%; p = 0.326); complete vascularization was observed in 24% eyes in the IVR group. Compared to laser group, a higher proportion of eyes in IVR group received additional treatment (IVR group 76% vs. laser group 30%; p = 0.040), for unresolved peripheral avascularity in 11 eyes and ROP progression with fibrotic contraction in 2 eyes after primary IVR.ConclusionPreterm infants with type 1 ROP at > 40 weeks PMA displayed enhanced fibrotic proliferation. Both primary IVR and laser effectively promote ROP regression. Primary IVR cannot guarantee full retinal vascularization but is associated with a risk of fibrotic contraction.

Prosthodontic approach to manage maxillary flabby ridge and severely resorbed mandibular residual ridge – a case report

Brief Background Fabrication of any dental prosthesis over a compromised residual alveolar ridge is really a challenge for prosthodontists. Fibrous or flabby ridge and highly resorbed residual alveolar ridge are two clinical situations that require special considerations during construction of any prosthesis. Mobile soft tissue and flattened alveolar ridge significantly compromise denture stability and support. There are different treatment modalities to manage these clinical conditions like surgical excision of soft tissue, ridge augmentation, modification in impression technique, etc. Materials and Methods This case report is about an old completely edentulous male patient who reported with a complaint of difficulty in chewing with his present denture. Discussion Prosthodontic management of a patient with compromised residual alveolar ridges needs special consideration . Selection of treatment modality depends on patients general health ,clinical condition of residual alveolar ridges , financial capacity and skill of the clinician A modification from conventional impression procedure was used to record maxillary flabby anterior ridge and neutral zone concept was applied for teeth arrangement to improve denture stability in atrophied lower alveolar ridge. Summary and Conclusions Surgical removal of soft tissue and implant supported prosthesis may not be possible in all situations. In that case a conservative approach using modified impression technique, neutral zone concept provides the basic triad of a successful denture prosthesis that is retention, stability and support. Key Words Flabby tissue, Window technique, Resorbed ridge, Neutral zone.

Biomechanical Strategies Underlying the Robust Body Armour of an Aposematic Weevil.

Robust body armor is one of many anti-predator strategies used among animal taxa. The exoskeleton of insects can serve as the secondary defense mechanism in combination with the primary defense such as warning color. Aposematic Pachyrhynchus weevils advertise their unprofitability and use their robust exoskeleton for effective defense against lizard predators. While the mature weevils survive after the predatory attack, the soft teneral ones can easily be consumed. To reveal how the mature weevils achieve such effective protection, we investigated the ontogenetic changes in the microstructure and material properties of the exoskeleton of the adult weevils. We also tested the functional role of a weevil-specific structure, the fibrous ridge, in the robustness of the elytral cuticle of the mature weevils. The results showed that the mature weevils have thicker, stiffer and more sclerotized cuticle than the teneral ones. The fibrous ridges in the endocuticle considerably increase the overall stiffness of their cuticle. Together these biomechanical strategies enable Pachyrhynchus weevils to achieve robust body armor that efficiently protects them from lizard predation.

Complete dentures: an update on clinical assessment and management: part 1.

The ability to provide high-quality complete dentures has been a key skill for general dental practitioners throughout the history of dental care. The prevalence of edentulism is becoming increasingly concentrated in an older patient cohort and general dental practitioners may more commonly face challenges associated with providing care for these patients. This two-part series explores various aspects of complete denture provision and is designed to act as a refresher on core aspects of managing these patients, while also covering common challenges associated with anatomical or patient factors. This first part will explore changes in the provision and teaching of complete denture care in the UK and will describe important aspects of patient examination. It will discuss the management of unstable lower dentures and fibrous replacement ridges. Part two will cover management of the gag reflex, tori, microstomia and copy dentures.

Ultrasound Evaluation of Peroneal Tendon Location Within the Fibular Groove

Category: Sports Introduction/Purpose: The use of MRI in diagnosing peroneal tendon dysfunction can be difficult due to the anatomic orientation of the tendons and their relationship to the posterior fibula. MRI is also limited in its roll in diagnosing dislocation or intrasubstance subluxation due to the static nature of the examination. Due to these limitations Ultrasound has become increasingly more common. The purpose of this study was to identify the location of the peroneal tendons in relationship to the fibular groove during a dynamic examination in an asymptomatic population of elite United States Military Service members. Methods: We conducted a prospective cohort study composed of 41 active duty United States Army Rangers. Each subject was examined bilaterally. Subjects were placed in a lateral recombinant position and the ankle placed in a resting neutral position to visualize the tendon in a retromalleolar short-axis view. Next, maximum active ankle eversion followed by gravity inversion while the ultrasound probe was maintained in its original position. The distance from the fibrous lateral ridge of the retromalleolar groove to the anterior aspect of the peroneal brevis was measured in the short-axis in all three positions (Neutral, Eversion and Inversion). Results: The mean sagittal distance was 0.48 mm. No subjects demonstrated greater than 1 mm difference between the three positions, no dislocations were identified. The side to side difference and dominant vs non-dominant differences were not statically significant. Conclusion: The current study demonstrates the distance between the peroneal brevis and the lateral fibular ridge is consistent throughout extremes of motion in an asymptomatic population. These results help further the understanding of the peroneal tendons while performing a dynamic exam. Our findings also establish side-to-side consistency prompting a bilateral examination to help identify abnormal pathology. The current study also offers clinicians another means of evaluating reported peroneal tendon subluxation prior to MRI or further subspecialty consultation.

Mishmash Impression Technique for Managing Maxillary Anterior Fibrous Ridge

Introduction: Flabby or fibrous ridge is one of the consequences of long term wearing of complete dentures. It can develop where hyperplasic soft tissue replaces the alveolar bone and is a common finding, particularly in the upper anterior region of long term denture wearers. Forces exerted during impression making can result in distortion of the mobile tissue unless managed appropriately; such flabby ridges adversely affect support, retention and stability of complete dentures. Many impression techniques have been developed to help overcome this problem. While these vary in the method applied, they are similar in their complexity, are often quite time-consuming to perform and rely on materials not commonly used in contemporary general dental practice. The purpose of this article is to describe an impression technique for flabby ridges usingrubber base impression materials, routinely available in general dental practice.

Repair for Congenital Mitral Valve Stenosis.

We report the techniques and long-term outcome of mitral valve (MV) repair to correct congenital mitral stenosis in children. Between 1986 and 2014, 137 children (mean age 4.1 ± 5.0, range 1 month-16.8 years) underwent repair of congenital mitral stenosis (CMS). In 48 patients, CMS is involved in Shone's anomaly. The typical congenital MS (type I) was seen in 56 patients. Hypoplastic MV (type II, n = 15) was associated with severe left ventricular outflow tract abnormalities and hypoplastic left ventricular cavity and muscle mass. Supravalvar ring (type III, n = 48) ranged from a thin membrane to a thick discrete fibrous ridge. Parachute MV (type IV, n = 10) have 2 leaflets and barely distinguishable commissures, but all chordae merged either into 1 major papillary muscle or asymmetric papillary muscles-1 dominant and the other minuscule. Hammock valve (type IV, n = 8) appeared dysplastic with shortened chordae directly inserted into the posterior left ventricular muscle mass. MV repair was performed using commissurotomy, chordal division, papillary muscle splitting and fenestration, and mitral ring resection, each applied according to the presenting morphology. During the 28-year follow-up period, 23 patients underwent repeat MV repair and 3 underwent MV replacement after failed attempts at repeat repair. At 1 and 15 years postoperatively, freedom from reoperation was 89.3 ± 5.1% and 52.8 ± 11.8%, and cumulative survival rates were 92.3 ± 4.3% and 70.3 ± 8.9, respectively. Mortality unrelated to repair accounted for 9 (20%) deaths. Long-term functional outcome of MV repair in children with CMS is satisfactory. Repeat repair or replacement may be deemed necessary during the course of follow-up.

Management of flabby ridge case: An arduous task in undergraduate practice

A fibrous or flabby ridge is a superficial area of mobile soft tissue affecting the maxillary or mandibular alveolar ridges. It can develop when hyperplastic soft tissue replaces the alveolar bone and is a common finding particularly in the upper anterior region of long-term denture wearers. Masticatory forces can displace this mobile denture-bearing tissue, leading to altered denture positioning and loss of peripheral seal. Unless managed appropriately, such “flabby ridges” adversely affect the support, retention, and stability of complete dentures. Many impression techniques have been proposed to help overcome this difficulty. This paper presents case report for prosthodontic rehabilitation of a patient with flabby ridge with McCord and Ahmad impression technique.

Modified peroneal retinaculm repair with fibrous ridge preservation for peroneal tendon dislocation

Modified peroneal retinaculm repair with fibrous ridge preservation for peroneal tendon dislocation

Characterization of two new superorders Nautilosiphonata and Calciosiphonata and a new order Cyrtocerinida of the subclass Nautiloidea; siphuncular structure in the Ordovician nautiloid Bathmoceras (Cephalopoda)

Based on differences in the siphuncular structures, the subclass Nautiloidea is divided into two new superorders: Nautilosiphonata and Calciosiphonata. The first superorder is characterized by the nautilus-type of connecting rings, and the second superorder by calcified-perforate type of the connecting rings. A new order Cyrtocerinida is erected for the families Bathmoceratidae, Cyrtocerinidae and Eothinoceratidae, previously included in the order Ellesmeroceratida. The siphuncular structure in the Ordovician nautiloid Bathmocerasholmi n. sp. is described. It is characterized by (1) connecting rings that are composed of an outer, calcareous, spherulitic–prismatic layer and an inner, fibrous, chitinous layer, and (2) prominent siphuncular ridges that originate from the inner surfaces of the connecting rings. The structure of the siphuncular ridges in Bathmoceras is compared with that of the actinosiphonate lamellae in the Silurian oncocerid nautiloid Octamerella.

Application of Multiple Novel Imaging Modalities for Guidance and Treatment of the Patient with Subaortic Stenosis

Discrete Subvalvar Aortic Stenosis (DSS) is an uncommon acquired cause of left ventricular outflow tract obstruction (LVOT) and often found during Transthoracic Echocardiography (TTE). The membranes are located adjacent to the Aortic Valve (AV) or extended to the anterior leaflet of the mitral valve. The high-velocity systolic jet collides and damages the AV leaflets making the valve more likely to fail and more susceptible to clot and vegetation formation. There is an increased risk of moderate to severe Aortic Insufficiency (AI) when the peak LVOT gradient reaches >50mmHg. The clinical course of subvalvar aortic stenosis is generally progressive with increasing obstruction and progression of AI. Surgical resection of the fibrous ridge with myomectomy is the treatment of choice. The DSS was discovered unexpectedly in this 42 year-old white male with a past medical history of ascending aortic aneurysm, diabetes, hypertension and hyperlipidemia. He was admitted with chest pain, shortness of breath and syncope. TTE showed normal left ventricle with calcified and thickened AV. Peak LVOT gradient was 48mmHg. Due to poor acoustic window, Transesophageal Echocardiogram (TEE) with real time 3-dimensional imaging (RT3D-TEE) was performed. TEE revealed a membranous structure located in the LVOT below a severely calcified AV. Doppler study revealed peak LVOT gradient of 57mmHg with a mean gradient of 38mmHg. Severe AI was also noted. Patient received a #25mm porcine valve with resection of the subaortic membrane and septal myomectomy. Pathology report revealed rubbery, fibromembranous tissue, consistent with DSS. Patient did well after surgery and was discharged home in 4 days. Application of multiple novel imaging modalities, such as TEE and RT-3D-TEE allowed us to better characterize the structure of the DSS and provide guidance for better surgical outcome.

The 'anatomically difficult' denture case.

Complete loss of teeth from one or both arches is a disabling condition which is usually managed by a conventional removable denture. Rehabilitation may be poorly tolerated by patients, particularly in the lower jaw, and is more difficult in situations when the anatomy of the denture-bearing area is less favourable. These situations may require specific prosthodontic or surgical techniques, or a combination of both. Prosthodontic solutions involve special impression techniques and the use of soft linings and it is vitally important to manage patient expectations in such cases. This article describes prosthodontic management options for dealing with the fibrous (flabby) anterior ridge and bony exostoses. Although tooth loss in the UK is diminishing, it is nevertheless important that dental practitioners are able to demonstrate good prosthodontic skills for managing an ageing population. Surgical correction of anatomical defects may occasionally be employed.

DISPLACEABLE TISSUE: A CLINICAL CHALLENGE FOR A PROSTHODONTIST

A fibrous or flabby ridge is a superficial area of mobile soft tissue affecting the maxillary or mandi bular alveolar ridges. Restoration of such ridges often requires s pecial consideration in impression making. Masticat ory forces can displace this mobile denture-bearing tissue, leadin g to altered denture positioning and loss of periph eral seal. Forces exerted during the act of impression making can res ult in distortion of the mobile tissue. Unless mana ged appropriately by special impression techniques, suc h ‘flabby ridges’ adversely affect the support, ret ention and stability of complete dentures. This paper describe s a technique especially applicable for mandibular edentulous flabby ridges. The choice of the impression materia l, as well as the design of the impression tray, fo cuses on preventing distortion of the displaceable residual ridges during impression making. The use of this te chnique helps in maintaining the contour and capturing the detail of the tissues, as well as in accurately determini ng the extent of the muccobuccal denture extensions.

Implications of Bicuspid Aortic Valves for Transcatheter Aortic Valve Implantation

Bicuspid aortic valve (BAV) occurs in 0.5% to 2% of the general population, with strong male predilection.1 Valvular complications include aortic stenosis, aortic regurgitation (AR), and infective endocarditis. Vascular complications comprise aortic dilatation, aneurysm formation, and aortic dissection. Coarctation of the aorta and left coronary artery dominance are also associated with BAV.1 BAV consists of 2 cusps, usually of unequal size.2 The larger cusp may contain 1 or 2 raphes—fibrous ridges extending from the malformed commissure to the free edge of the 2 conjoint cusps.2 An anatomic classification distinguishes BAV types principally by the number of raphes (Figure).2 Because a raphe can be missed on echocardiography, Schaefer et al3 proposed 3 types based instead on the pattern of leaflet fusion. Clinical presentation of BAV is variable. Some patients present with severe disease in infancy, whereas others present with asymptomatic disease in old age.1 In a recent series of 642 asymptomatic adults with BAV referred to a tertiary center, 25% had a primary cardiac event at mean follow-up of 9 years.4 Aortic valve or ascending aorta intervention comprised most (22%) events.4 In another series of 212 asymptomatic adults with BAV recruited from the community, primary cardiac outcomes occurred in 42% at 20-year follow-up.5 Overall survival rates were similar to the general population.5 Figure. Anatomic classification of bicuspid aortic valves (BAV) based on a study of 304 surgical specimens.2 Prominent black lines denote the raphe (s). Type 0=no raphe, type 1=1 raphe, and type 2=2 raphes. Each type is subcategorized according to the spatial position of the cusps (type 0) or raphes (types 1 and 2). Percentages represent the approximate prevalence of each BAV type observed in the Sievers study.2 ap indicates anterior-posterior; L, left coronary sinus; lat, lateral; …

Prosthodontic rehabilitation of patient with flabby ridges with different impression techniques – Case reports

A fibrous or flabby ridge is a superficial area of mobile soft tissue affecting the maxillary or mandibular alveolar ridges. It can develop when hyperplastic soft tissue replaces the alveolar bone and is a common finding particularly in the upper anterior region of long term denture wearers. Masticatory forces can displace this mobile denture-bearing tissue, leading to altered denture positioning and loss of peripheral seal. Forces exerted during the act of impression making can result in distortion of the mobile tissue. Unless managed appropriately by special impression techniques, such ‘flabby ridges’ adversely affect the support, retention and stability of complete dentures. This paper presents three case reports for prosthodontic rehabilitation of patient with flabby ridges with three different impression techniques.