Mental Nerve Research Articles

Frequency and Pattern of Presentation of Mental Nerve Injury During Para Symphysis Fracture

Aim: The mandibular fracture at the parasymphysis is the most often seen fracture of a facial bone. The occurrence of anaesthesia or paraesthesia in the skin and mucous membrane within the distribution of the mental nerve may be seen due to mental nerve injury resulting from fractures in the Parasymphysis region. This condition has the potential to impact the overall well-being of affected individuals. Objective: To determine the Frequency and pattern of presentation of mental nerve injury during Para symphysis fracture. Method: The present research is an observational and descriptive investigation including a sample of 65 patients diagnosed with parasymphysis fracture. The study was done at the Nishter Institute of Dentistry in Multan, Pakistan, spanning from September 2021 to February 2023.Following the endorsement of the research by the Ethical Review Board of the hospital, patients were recruited using a non-probability sequential sampling method. The researchers used clinical neuro-sensory testing (NST) as a means of evaluating nerve damage and determining the specific kind of neurosensory impairment that occurred subsequent to a para symphysis fracture. A specifically prepared proforma is used as a tool for data collecting. The data underwent statistical analysis, and findings and observations were derived from the analysis. Results: The study assessed the incidence of mental nerve damage in instances with Para symphysis fracture, revealing that 23 cases (35%) exhibited the presence of mental nerve injury, whereas it was missing in 42 cases (65%). The study observed a total of 23 individuals, consisting of 17 males and 6 females, who were diagnosed with mental nerve damage. The most often encountered neurosensory problems experienced by patients after surgery are paraesthesia. Additionally, it has been shown that the leading cause of parasymphysis fracture in both males and females is road traffic accidents (RTA). Conclusions: Road traffic accidents (RTAs) have been identified as a significant factor contributing to parasymphysis fractures. These fractures may result in the development of neurosensory deficits either as a consequence of the initial trauma or as a complication after surgical intervention. It has been seen that such fractures can lead to persistent complications and a decrease in overall quality of life. Additionally, it is essential to conduct additional research studies that cover a longer duration and include a bigger cohort of patients. Keywords: Mandibular fracture, Mental nerve, Paraesthesia, Trauma

Impacted Maxillary Canines - Etiology, Diagnosis, Radiologic and Orthodontic Clinical

Canine maxillary teeth are aesthetically most dominant teeth which can present a smile as either holy or evi. They define the mouth’s corner, are involved in the aesthetic smile, maintain occlusal stability, and design the shape of the dental arch. As the position of the impacted canines is amidst vital anatomical structures like the nasal cavity and sinuses in the maxilla and mental nerve in the mandible, a thorough radiographic evaluation to determine the position of the impacted canines is of utmost importance prior to any treatment planning. By using a radiographic image, a clinician can clearly identify its location. The present paper aimed to determine the prevalence, etiology, and clinical diagnosis of impacted maxillary canines in orthodontic patients. Keywords: Canine impaction, Etiology, Inspection, Palpation, Radiographs, CT, CBCT, Transtomography

Effects of RNA m6A writer METTL3 and hDPSCs on the peripheral nerve regeneration: In vitro and in vivo study

PurposeThis study aimed to investigate whether RNA m6A participated in the differentiation and proliferation of dental pulp stem cells and improved peripheral nerve regeneration using a rat model of crushed mental nerve injury. Materials and methodsThe components of RNA m6A were analyzed through qRT-PCR, while cell proliferation of different groups, including over-expression METTL3 (OE-METTL3) hDPSCs group, knock-down METTL3 (KD-METTL3) hDPSCs group and hDPSCs group in vitro, was clarified by MTT assay. Five groups were designed, namely, Control group, Sham group, hDPSCs group, OE-METTL3 group and KD-METTL3 group. After crushed right mental nerve injury, cells of different groups were transplanted into the lesion area (6 ul in volume). At one, two and three weeks later, histomorphometric analysis and sensory test were conducted in vivo. ResultsqRT-PCR results showed that “METTL3” was participated in the differentiation of dental pulp stem cells. There were differences (P < 0.05) between OE-METTL3 group and control group in MTT results in the third, fourth and sixth days. Moreover, the sensory test revealed significant differences (P < 0.05) in difference score and gap score between OE-METTL3 group and KD-METTL3 group in the first and third weeks. The axon counts and retrograde labeled neurons significantly increased in OE-METTL3 group compared with KD-METTL3 group. ConclusionsThese results demonstrated that RNA m6A participated in the differentiation and proliferation of dental pulp stem cells, and that OE-METTL3 group exhibited the greater ability to improve peripheral nerve regeneration than KD-METTL3 group and hDPSCs group.

Dental Pulp-Derived Mesenchymal Stem Cells Increase Axon Numbers in Mental Nerve Repair.

The mental nerve, the extended part of the inferior alveolar nerve, is often injured during dentoalveolar, orthognathic, or tumor surgery. Numerous therapeutic interventions, including surgery and pharmacotherapy, have been used to enhance the recovery of nerve injuries. Dental pulp stem cells (DPSCs) represent an easily accessible source of adult stem cells that can be isolated from the pulp of extracted teeth. This study evaluated the effect of DPSCs on the regeneration of the mental nerve injury model of rabbits. In this presented study, DPSCs were cultured and cell characterizations were performed by using flow cytometry and immunostainings. Bilateral mental nerve injury models of rabbits were created. In the control group (n = 10), saline was applied, and in the study group (n = 10), 2 × 106 DPSCs were applied to the repaired nerve areas. After 3 weeks, animals were killed and histological examination was obtained by using Masson's trichrome staining. An unpaired Student's t test was used when comparing the groups. Differences were considered to be statistically significant at P values of less than 0.05. The DPSCs demonstrated a homogeneous population of mesenchymal stromal cells which expressed cluster of differentiation CD44, CD73, CD90, and CD105 and lack of CD34, CD45, and HLA-DR. Our finding clearly demonstrated that a lower number of cross-sectioned axons were founded in the control group (60.18 ± 2.52) compared to the study group (72.96 ± 2.43) (p = 0.00). DPSCs promote mental nerve axonal regeneration. These results suggest that DPSCs provide an important accessible source of adult stem cells for mental nerve regeneration.

Morphology and Variant Anatomy of the Mandibular Canal in a Kenyan Population: A Cone-Beam Computed Tomography Study

Study Design Descriptive cross-sectional study. Objective The mandibular canal (MC) exhibits surgically significant anatomical variations in its course and terminal segment among different ethnic groups. The aim of this study was to document a surgically relevant position of the MC, its variants, and related anatomical structures in dentate patients from a select Kenyan population. Methods 351 hemi mandibular cone-beam computed tomography (CBCT) scans from 202 patients were used to evaluate the MC and mental foramen (MF) for normal morphology, anatomical variations, and their linear relationship to various reference points. Results The most frequently encountered course of the MC was the progressive descent type seen in 241 (68.7%) scans. Accessory MC were observed in 15 (4.3%) scans. Accessory MF were observed in 29 (8.3%) scans. The mean diameter of the MC was 3.36 ± .39 mm. The orientation of the MC was more lingual towards the angle of the mandible and more buccal towards the MF. The most frequent position of the main MF in relation to the second premolar was anterior (53.3%). The average distance from the MF to the inferior border of the mandible was 12.17 ± 1.91 mm. The anterior loop of the mental nerve was observed in 18 (5.1%) scans and its mean length was 4.83 ± .89 mm. Conclusions Our study revealed significant variations in the position, size, and course of the MC and MF. This knowledge should assist oral surgeons to avoid inadvertent injury to the inferior alveolar neurovascular bundle in the local population.

Promotion effect of TGF-β-Zfp423-ApoD pathway on lip sensory recovery after nerve sacrifice caused by nerve collateral compensation

Resection of oral and maxillofacial tumors is often accompanied by the inferior alveolar nerve neurectomy, resulting in abnormal sensation in lower lip. It is generally believed that spontaneous sensory recovery in this nerve injury is difficult. However, during our follow-up, patients with inferior alveolar nerve sacrifice showed different degrees of lower lip sensory recovery. In this study, a prospective cohort study was conducted to demonstrate this phenomenon and analyze the factors influencing sensory recovery. A mental nerve transection model of Thy1-YFP mice and tissue clearing technique were used to explore possible mechanisms in this process. Gene silencing and overexpression experiments were then conducted to detect the changes in cell morphology and molecular markers. In our follow-up, 75% of patients with unilateral inferior alveolar nerve neurectomy had complete sensory recovery of the lower lip 12 months postoperatively. Patients with younger age, malignant tumors, and preservation of ipsilateral buccal and lingual nerves had a shorter recovery time. The buccal nerve collateral sprouting compensation was observed in the lower lip tissue of Thy1-YFP mice. ApoD was demonstrated to be involved in axon growth and peripheral nerve sensory recovery in the animal model. TGF-β inhibited the expression of STAT3 and the transcription of ApoD in Schwann cells through Zfp423. Overall, after sacrificing the inferior alveolar nerve, the collateral compensation of the ipsilateral buccal nerve could innervate the sensation. And this process was regulated by TGF-β-Zfp423-ApoD pathway.

Transoral endoscopic thyroidectomy vestibular approach as a novel technique for pediatric populations: Results from a single surgeon.

The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is increasingly being adopted worldwide because of its many advantages. However, there are few reports on the effectiveness and safety of TOETVA in children. In this study, we report the results of the application of TOETVA on 27 pediatric patients in Vietnam. To the best of our knowledge, this is also the largest sample size of the TOETVA technique performed by a single surgeon on pediatric patients worldwide. Patients and methods: From June 2020 to February 2022, we performed TOETVA on 27 pediatric patients (≤ 18 years old). The outcomes of the procedure were retrospectively reviewed. Our study was conducted on 27 pediatric patients, of whom 24 were female (88.9%). The mean age was 16.3 ± 2 (range 10-18). Fifteen patients had benign thyroid nodules with a mean nodule size of 31.6 ± 7.1 (range 20-50mm), and 12 patients had papillary thyroid carcinoma with a mean nodule size of 10.2 ± 5.6 (range 4-19mm). All 27 patients underwent successful TOETVA without any conversion to open surgery. The 15 patients with benign thyroid nodules had lobectomies with a mean operative time of 83.3 ± 10.5 (range 60-105 minutes). Among the 12 patients diagnosed with thyroid cancer, ten had a lobectomy, isthmusectomy, and central neck dissection, with a mean operative time of 89.8 ± 5.7 (range 80-100 minutes). The other two underwent total thyroidectomy with central lymph node dissection with a mean operative time of 132.5 minutes. The mean hospital stay was 4.7 ± 0.9 (range 3-7 days). No patient had permanent complications, such as hypocalcemia, recurrent laryngeal nerve injury, or mental nerve injury. The rates of temporary recurrent laryngeal nerve injury and mental nerve injury were 3.7% and 11.1% respectively. TOETVA may be a feasible and safe surgical method for children with thyroid disease. However, we recommend that only high-volume thyroid surgeons with experience in TOETVA should perform TOETVA on the pediatric population.

Clinical and imaging analysis of 22 cases of supernumerary teeth in the mandibular region

PurposeThis study aimed to describe clinical and imaging analysis of supernumerary teeth in the mandibular region of 22 cases. Study designRetrospective study. MethodsThis study enrolled patients diagnosed with supernumerary teeth who underwent cone beam computed tomography (CBCT) at Stomatology Hospital of Xi'an Jiaotong University from August 2016 to September 2022. Participants included individuals aged 7-29 years of both genders. The following variables were examined: number of supernumerary teeth, location, shape, direction, length, relationship with adjacent teeth and surrounding anatomical structures, and secondary effects. ResultsOut of 236 subjects, 22 (6.02%) were found to have supernumerary teeth in the mandibular region, with a total of 62 teeth identified. The male-to-female ratio was 5:6. Most supernumerary teeth were located in the lingual side of the mandibular region, particularly in the 34-35 tooth area (21.66%), followed by the 44-45 tooth region. The vast majority of supernumerary teeth (96.77%) were impacted, and more than half (51.67%) were located near the mental nerve canal. The average length of the supernumerary teeth was 10.5 mm. While no primary complications were observed, some secondary symptoms were noted, such as the ectopic eruption of adjacent teeth and crowding of permanent teeth. ConclusionThe supernumerary teeth in the mandibular area have regional characteristics, which can provide for clinical diagnosis and treatment. CBCT can accurately analyze the location of supernumerary teeth and their secondary effects, and provides the treatment plan on that basis.

Gasless submental-transoral combined approach endoscopic thyroidectomy: a new surgical technique.

The development of transoral endoscopic vestibular approach thyroidectomy (TOETVA) has been limited by inherent defects, such as mental nerve injury and carbon dioxide (CO2)-related complications. Herein, we proposed a new technique without CO2 called gasless submental-transoral combined approach endoscopic thyroidectomy (STET) to solve the problems in TOETVA. We reviewed 75 patients who successfully underwent gasless STET using novel instruments at our institution from November 2020 to November 2021. A main incision of approximately 2 cm was made in the natural submental crease line and then combined with two vestibule incisions to complete the procedure. Demographic data, surgical technique and perioperative outcomes were retrospectively recorded. Thirteen male and sixty-two female patients with a mean age of 34.0 ± 8.1 years were enrolled in this study. Sixty-eight patients had papillary thyroid carcinomas and seven had benign nodules. We successfully performed all gasless STET without conversion to open surgery. The average postoperative hospital stay was 4.2 ± 1.8 days. One transient recurrent laryngeal nerve injury and two transient hypoparathyroidisms were observed. Three patients complained of slight lower lip numbness on the first postoperative day. One case of lymphatic fistula, subcutaneous effusion, and incision swelling occurred each, all of which were conservatively cured. One patient developed a recurrence six months after surgery. Gasless STET using our own designed suspension system is technically safe and feasible with reasonable operative and oncologic results.

A Comparison of Clinical Outcomes of Single Versus Two Miniplate Fixation of Parasymphysis Fracture

Background: Many methods have been discovered to treat the fracture of parasymphysis region of mandible i.e., using miniplates. However not many studies have been done to prove the good clinical outcomes of one miniplate versus two miniplates. Aim: The purpose of the study is to compare the clinical results of one miniplate vs two miniplate for the parasymphysis of mandible. Material and Methods: 20 patients were treated with single miniplate and 20 for 2 miniplates. Many outcomes variable after surgery such as post-surgical scar, mental nerve paresthesia, need for plate removal and interincisal opening were calculated and interpreted using chi square test. Results: All outcome variables such as post-surgical scar, mental nerve paresthesia, need for plate removal and interincisal opening did not show any statistically significant relation with both groups(P value &gt;0.05). Conclusion: Both types of miniplate ensure osseous healing but depending upon the individual factors such as mandible height and bio mechanics pattern should be considered before deciding scheme of treatment for an individual. Keywords: miniplate fixation, parasymphysis mandible, osteosynthesis.

Evaluation of Position and Symmetry of Mental Foramen on Digital Panoramic Radiographs: A Retrospective Study

Background: The mental foramen is an important anatomical landmark located on the anterolateral surface of the mandible, and it transfers the mental nerve and vessels. Knowledge of the position of the mental foramen is important both when administering regional anaesthesia and performing periapical surgery in the mental region of the mandible. Aim: The aim of this study was to determine the position and symmetry of the mental foramen on a digital orthopantomogram (OPG) among the Nalgonda population. Materials and Methods: A total of 400 digital OPGs taken by the Rotograph evo OPG machine of both genders were analysed retrospectively. The position of the mental foramen was recorded according to criteria given by Wei Cheong Ngeow and Yosuf Yuzawati. The symmetrical or asymmetrical position of the mental foramen was also recorded. Results: The most common position in the current study for the right side was position 4 (n = 202; 50.5%) followed by position 3 (n = 102; 25.5%), position 5 (n = 82; 20.5%), position 2 (n = 8; 2%), position 1 (n = 4; 1%) and the least common was position 6 (n = 2; 0.5%) and the most common position of mental foramen for left side was position 4 (200;50%) followed by position 3 (n = 132; 33%) , position 5 (n = 60; 15%), position 1 and 2 (n = 4; 1%) and the least common was position 6 (n = 0; 0%). The mental foramen was symmetrical in 250 patients (62.5%) and asymmetrical in 150 patients (37.5%). For the symmetrically placed mental foramina, the most common location was position 4 (n = 126; 50.4%) followed by position 3 (n = 76; 30.4%), position 5 (n = 42; 16.8), position 6 (n = 4; 1.6%), position 2 (n = 2; 0.8%), position 1 (n = 0; 0%). Conclusion: In the present study, it was found that the most common position of the mental foramen in the given population in both males and females was below the second premolar, followed by between two premolars. It was symmetrical in 62.5% of OPG’s. The current study was limited to evaluating the position and symmetry of the mental foramen relative to mandibular teeth in a small sample of the Nalgonda population in Telangana state using digital panoramic radiographs. In further studies, utilizing a larger sample size for evaluation of the mental foramen using advanced imaging modalities would be required for a more precise identification of the mental foramen.

Resolution of Apical Periodontitis-induced Mental Nerve Paresthesia Through Nonsurgical Endodontic Retreatment: A Case Report

Paresthesia is a potential consequence of unsuccessful root canal treatment. Persistent infection resulting in apical periodontitis may enlarge sufficiently to involve the mental neurovascular bundle. The case presented in this report was referred for endodontic evaluation with a chief complaint of discomfort on mastication and persistent numbness of the lower left lip. Clinical and radiographic evaluation revealed incomplete primary endodontic treatment of the left mandibular second premolar with complex internal anatomy. The untreated root canal system resulted in the progression of apical periodontitis involving the left mental neurovascular bundle as confirmed by cone-beam computed tomography imaging. Nonsurgical root canal retreatment was performed over 2 visits. At the 3-year follow-up visit, the paresthesia had resolved with return of normal sensation. Nonsurgical endodontic retreatment may be sufficient to allow healing of large periapical lesions and resolve complications including paresthesia without the need for surgical intervention.

Lower Lip Reconstruction Using a Sensory Anterolateral Thigh Flap as the First Choice

Summary: Local flaps from the upper lip and cheeks have been the first choice for two-thirds to total resection of the lower lip. However, these local flap techniques involve many clinical problems, including small a mouth, drooling, scarring, and hypesthesia. The improvement of free anterolateral thigh (ALT) flap transfer can solve these problems with expansion of the application of free flaps for lower lip reconstruction. The patient in this case was a 56-year-old man with squamous cell carcinoma of the lower lip (cT3N1M0). Subtotal lower lip resection preserving both corners of the mouth with bilateral neck dissection was performed. Simultaneously, a sensory ALT flap was elevated with an 8 × 6 cm skin island and a lateral femoral cutaneous nerve. The lateral and medial sides of the fascia lata were processed into 1-cm-wide strings, which were tunneled through the orbicularis oris muscle of the upper lip and sutured to the orbicularis oris muscle at the mucosal side of the philtrum. The lateral femoral cutaneous nerve and right mental nerve were sutured. At 3 months, a second surgery was performed to replace the ALT flap on the white labial side with a clavicle full-thickness skin graft. This surgery achieved four important factors: opening and closing of the mouth, sensory function of the lower lip, cosmetic appearance, and minimization of donor-site damage. We believe the worldwide improvement of microsurgery techniques enables lower lip reconstruction using the sensory ALT flap to be selected as the first choice for two-thirds to total lower lip defects.

Detection of Vital Anatomical Landmarks in Lower Posterior Premolars and First Molar Area (BuccallyPositioned)During Different Surgical Intervention Using Cone Beam Ct Scan

Background: The mental foramen (MF) is a very important structure; to avoid any trauma to mental nerve may be occur and in order to avoid that, its position, variation in anatomy and shapes should be clearly determined before any surgical procedure.&#x0D; Objective: To detect the exact position of MF and thickness of cortical plates in lower premolars and first molars among the Iraqi resident.&#x0D; Patients and Methods: For this prospective study, a total of 92 Iraqi adults patients (51 females, 41 males; age range 18-69 years). From October 2020 to February 2021, patients aged range from 25 to 65 years old.Five types of classification we used:&#x0D; Type 1, MF under the root of the lower first premolar.&#x0D; Type 2, MF between the root of mandibular first &amp; second premolar.&#x0D; Type 3, MF below the root of the mandibular second premolar.&#x0D; Type 4, MF between the root of lower second premolar &amp; first molar.&#x0D; Type 5, MF below the root of the lower first molar.&#x0D; Bone thickness is measured in the horizontal direction on the both side lingually and buccally.&#x0D; Results: The most common situation of the MF was below the root of lower second premolar.&#x0D; Conclusion: Significant difference can be noted in the mean of the distance between MF and root apex in both gender, also significant difference in mean of bone thickness noted between both genders on both sides.

Detection of Vital Anatomical Landmarks in Lower Posterior Premolars and First Molar Area (BuccallyPositioned)During Different Surgical Intervention Using Cone Beam Ct Scan

Background: The mental foramen (MF) is a very important structure; to avoid any trauma to mental nerve may be occur and in order to avoid that, its position, variation in anatomy and shapes should be clearly determined before any surgical procedure. Objective: To detect the exact position of MF and thickness of cortical plates in lower premolars and first molars among the Iraqi resident. Patients and Methods: For this prospective study, a total of 92 Iraqi adults patients (51 females, 41 males; age range 18-69 years). From October 2020 to February 2021, patients aged range from 25 to 65 years old.Five types of classification we used: Type 1, MF under the root of the lower first premolar. Type 2, MF between the root of mandibular first &amp; second premolar. Type 3, MF below the root of the mandibular second premolar. Type 4, MF between the root of lower second premolar &amp; first molar. Type 5, MF below the root of the lower first molar. Bone thickness is measured in the horizontal direction on the both side lingually and buccally. Results: The most common situation of the MF was below the root of lower second premolar. Conclusion: Significant difference can be noted in the mean of the distance between MF and root apex in both gender, also significant difference in mean of bone thickness noted between both genders on both sides.

A radiographic analysis of the location of the mental foramen

BackgroundAccurate knowledge and identification of anatomical landmarks on radiographic imaging are essential when preparing for any invasive procedure. The mental foramen has been the subject of many publications because of its significance as the origin point of the mental nerve and its proximity to the lower premolar area. The aim of this study was to assess the horizontal location of the mental foramen (MF) in the samples collected from the Faculty of Dental Medicine at Umm Al-Qura University, Mecca, Saudi Arabia. This included comparing genders, ages, and bilateral symmetry. In addition, the study aimed to assess inter-rater reliability in locating the mental foramen on a digital panoramic radiograph (OPG). MethodsA total of 334 digital panoramic radiographs were chosen for retrospective analysis from a total of 2,199 images taken from the Umm Al-Qura University, Faculty of Dental Medicine, teaching hospital database. The locations were scored independently by four examiners. The area was divided into six zones, determined by drawing straight lines along the long axis of the premolars and contact areas. A scoring index of 1–6 was utilized to describe the location in relation to the premolars. Analysis was carried out using chi-square and descriptive statistics. The inter-rater reliability was calculated using Fleiss’ Kappa to determine observer agreement. ResultsThe ages of the patients ranged from 13 to 76 years, with a mean of 29.66. There was no significant difference related to gender, but there was a significant difference related to age. The most frequent location was zone 4, 47.6% on the left side and 51.5% on the right, followed by zone 5, 18.6% on the left side and 16.2% on the right, and zone 3, 15.3% on both the right and the left side. The location was symmetrical in 64.7% of the cases and asymmetrical in 35.3%. The inter-rater reliability among the examiners was fair. ConclusionsThe findings of this study indicate that the MF’s location was more closely related to the mandibular second premolar than the first premolar. Furthermore, bilateral symmetry was found in 65% of the sample. There was no statistical significance observed in differences between the genders. Both newly graduated and experienced dentists could identify the location of the MF from the radiograph using the MF’s location in relation to the six zones.

Analysis of the Mental Foramen and Inferior Alveolar Canal pattern based on CBCT data

The mental foramen is located in a position where certain dental procedures may cause inadvertent damage to the mental nerve and lead to disorders of sensory functions such as altered sensa¬tion, complete numbness, and neuropathic pain, which are uncommon but severe treatment complications with significant medico-legal implications. Hence thorough knowledge of its anatomical relation to its surrounding structures is critical while undertaking dental procedures. To investigate the size, shape, and position of the mental foramen (MF), its distance from adjacent teeth and mandibular borders, and the pattern of the inferior alveolar canal using CBCT in the Indian subpopulation. This was a retrospective, cross-sectional study The study evaluated 310 CBCT scans (179 males, 131 females) in axial, sagittal, and coronal planes. CBCT scans were evaluated, mapped and measured for all the parameters listed above based on age and sex. Data were analyzed using ANOVA, independent‘t-test, and chi-square test. The size of MF is independent of age and sex; the most frequent shape of MF was Type III (round); location was below the apex of the second premolar (p&gt;0.05). The distance of MF from the nearest root apex decreased with an increase in age and more in females than males (p&gt;0.05). Inferior Alveolar Nerve Canal (IAC) pattern was perpendicular, and linear patterns of exit at MF were more common than anterior loops in all age groups.

Clinical and Antinociceptive Effects of Distal Inferior Alveolar Nerve Block in Ponies With Tramadol 5% or Lidocaine 2.

This study aimed to compare the antinociceptive effects of tramadol 5% and lidocaine 2% on mental nerve block in horses of the Brazilian Pony breed. Eight adult non-pregnant mares were used in this study. The ponies were tranquilized with acepromazine (5 µg kg-1, IV), and the infiltration of the mental foramen was performed in Treatment 1- tramadol 5% (T, 150 mg) or Treatment 2- lidocaine 2% (L, 60 mg), both at a total dose of 3 ml in each foramen. Heart rate (HR), respiratory rate (RR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), rectal temperature (RT), and formation of skin lesions (SL) were evaluated. Evaluation of nociception of the outer lip (OL), inner lip (IL), and gingiva (GG) were performed using an electronic von Frey device with the evaluation of the ponies' reactions to each stimulus. From these reactions, we determined latency time (LT) and duration of antinociception (DAN). Analysis of variance with 16 observations was performed for HR, RR, SAP, DAP, MAP, LT and DAN. Data were expressed as mean ± standard deviation and the means were compared by the SNK and Student's t-test (P< 0.05). Changes in HR, RR, SAP, DAP, and MAP between evaluation times were associated with the effects of acepromazine (P>0.05). No formation of skin lesions was observed. Latency time did not differ between treatments (P>0.05). Both lidocaine 2% and tramadol 5% produced an antinociceptive effect. We conclude that the duration of the antinociceptive effect of tramadol 5% is longer than that of lidocaine 2%.

Scarless Neck Feminization by Transoral Endoscopic Vestibular Approach Chondrolaryngoplasty: A Prospective Cohort.

Chondrolaryngoplasty (laryngeal-prominence reduction) is a gender affirmation surgery for transgender women, or for cisgender people desiring an esthetic correction. Up until recently, chondrolaryngoplasty required a visible neck scar. The transoral endoscopic vestibular approach (TOEVA) is gaining widespread use as a scarless alternative for thyroid/parathyroid surgeries. This study aims to describe the feasibility, safety, and outcomes of TOEVA-chondrolaryngoplasty, based on the first-ever performed cases. A prospective cohort. An academic referral center. Adult patients interested in chondrolaryngoplasty underwent scarless TOEVA-chondrolaryngoplasty between 2019 and 2022, according to the described protocol. Video stroboscopy was recorded pre-and postoperatively. Surgical data, adverse events, and complications were recorded. Patients' satisfaction was measured using an outcome instrument for esthetic chondrolaryngoplasty. Twelve patients (10 transgender women, a cisgender man, and a woman) were included. The mean age was 26.7 ± 6.5 years, ranging from 19 to 37. The average operative time was 3:01 ± 0:51hours. The thyroid cartilage and laryngeal prominence were easily and safely approached and reduced, with no adverse events or major complications. All patients were discharged on postoperative day 1. A single patient had a temporary mental nerve hypoesthesia that resolved spontaneously. Otherwise, no other complications were encountered. Vocal folds' function remained unchanged in all patients. Patients were very much to completely satisfied with the surgical results as measured by the outcome instrument; median (interquartile range), 25 (21-27.75). In this first reported cohort of scarless TOEVA-chondrolaryngoplasty, this approach was proven to be safe and feasible, with no adverse events or major complications, and with high patient satisfaction.

The ambulatory transoral endoscopic thyroidectomy vestibular approach is safe and economical for patients with thyroid nodules.

Ambulatory thyroid surgery has been increasingly performed in recent years. However, the feasibility of the ambulatory transoral endoscopic thyroidectomy vestibular approach (TOETVA) has not been evaluated. We aimed to evaluate the safety, economy, and mental health outcomes of ambulatory TOETVA. We retrospectively reviewed the data of patients who underwent TOETVA between March 2019 and August 2022. The procedure was performed by a skilled surgical team from the Department of Thyroid Surgery of the affiliated Yantai Yuhuangding Hospital of Qingdao University. Patients were enrolled in the ambulatory (n=166) and conventional (n=290) groups, based on their chosen procedure. We analyzed patients' clinical characteristics, surgical outcomes, Hamilton Anxiety Rating Scale (HAM-A) scores, and hospitalization costs. Of 456 patients, 166 underwent ambulatory TOETVA and 290 underwent conventional TOETVA. No significant differences were found in clinical and surgical characteristics between the groups, including sex (P=0.363), age (P=0.077), body mass index (P=0.351), presence of internal diseases (P=0.613), presence of Hashimoto's thyroiditis (P=0.429), pathology (P=0.362), maximum tumor diameter (P=0.520), scope of surgery (P=0.850), or operative time (P=0.351). There were no significant differences in maximum tumor diameter (P=0.349), extrathyroidal tissue invasion (P=0.516), number of retrieved central lymph nodes (P=0.069), or metastatic central lymph nodes (P=0.897) between the groups. No significant differences were found in complications, including transient hypoparathyroidism (P=0.438), transient vocal cord palsy (P=0.876), transient mental nerve injury (P=0.749), permanent mental nerve injury (P=0.926), and other complications (P=1.000). Ambulatory patients had shorter hospital stays (P<0.001) and reduced hospitalization costs (P<0.001). There was no significant difference in HAM-A scores between the groups (P=0.056). Ambulatory TOETVA is a safe, feasible, and cost-effective procedure for selected patients. This procedure resulted in shorter hospital stays, decreased medical costs, and did not increase patient anxiety. To ensure patient safety, surgical teams must inform patients of the indications, when to seek help, and how to receive the fastest medical attention.