Number Of Foramina Research Articles

Anatomic considerations during placement of mandibular retromolar miniplates for orthodontic anchorage – A study of the characteristics of retromolar fossa

Objectives: The mandibular retromolar area offers a novel site for orthodontic skeletal anchorage. It houses the retromolar foramen (RMF), and surgical interventions in this area can lead to undesirable outcomes. This study aims to assess the characteristics of the RMF and its relation to the occlusal plane (OP) using cone-beam computed tomography (CBCT) data. Material and Methods: This cross-sectional observational in vitro study involved the analysis of CBCT data from 136 samples (68 males and 68 females) within the age range of 18–40 years. The study focused on factors such as the presence or absence of the RMF, whether it was unilateral or bilateral, the number of foramina on each side, and the distance of the RMF from the OP. Data analysis was conducted using the Statistical Package for the Social Sciences software, with P < 0.05 deemed statistically significant at a 95% confidence level. Results: About 39% of the sample showed the presence of RMF. The prevalence of unilateral RMF was higher than that of bilateral RMF. The mean distance of RMF above the OP was 5.99 mm, and that below the OP was 3.82 mm. Conclusion: The high prevalence (39%) of RMF suggests that the retromolar fossa region should be evaluated before the placement of mini-plates. The prevalence of RMF above the OP was significantly higher than that below the OP.

Mastoid Emissary Foramina in Dry Skulls: Its Morphometry, Topography, and Associated Clinical Implications.

Mastoid emissary foramen transmitting mastoid emissary vein connects the posterior auricular vein with the sigmoid sinus. This foramen and so the mastoid emissary vein varies in prevalence, number, size and location, knowledge of which is essential for carrying out uneventful surgeries, especially retrosigmoid, mastoidectomy, and skull base surgeries. There is a paucity of literature on this foramen in the Indian context, so the study was done. The purpose of the study is to elaborate on the prevalence, number, size, and location of mastoid foramen in dry adult skulls. The study was conducted in the Department of Anatomy using 90 dry skulls of unknown age and sex, and prevalence, number, size, and location in these skulls were noted. The mastoid foramen was detected in 27.8% of skulls, with an incidence of 31.1% and 12.2% on right and left sides of skulls, respectively. The number of foramina ranged between 1 and 4. The mean diameter of this foramen was 0.9mm, and the most frequent location was mastoid process. The detailed morphology and morphometry of mastoid foramen are of utmost use to neurosurgeons, ENT surgeons, radiologists, and vascular surgeons as it transmits mastoid emissary vein and meningeal branch of the occipital artery, which may be injured during various surgical procedures involving mastoid region and skull base causing catastrophic hemorrhage. In addition to this, mastoid emissary vein may be the source of thrombus, causing thrombus of sigmoid sinus creating helm of neurological complications.

Morphological study of pulp cavity anatomy of canine teeth in domestic cats using micro-computed tomography.

An understanding of the pulp cavity anatomy of individual teeth is essential for success during endodontic therapy. The objective of this study was to document pulp cavity anatomy and summarize numerical data of maxillary and mandibular canine teeth of domestic cats using micro-computed tomography (micro-CT). Thirty-nine canine teeth from eleven domestic cat cadaveric specimens were extracted and prepared for scanning. Segmentation of the pulp cavity was performed using the Avizo (v2022.2) software package. The morphological features of the pulp cavity including overall shape, configuration, presence of apical deltas and lateral canals was recorded. A quantitative analysis was performed on thirty-one teeth to explore associations between pulp cavity volume and length, apical delta length, maximum apical delta foramina number and cusp-to-tip length using a linear mixed model. Correlation between pertinent continuous variables was assessed using a Pearson's correlation test. Most pulp cavities exhibited varying curvature and ranged from a cylindrical configuration in the coronal third to an ovoid configuration in the middle to apical third. A ribbon-like flattened canal was observed in 6/31 teeth (19%). All canine teeth depicted an apical delta with various configurations except for two teeth that showed a single canal exiting at the apex. In 15/31 teeth (48%), the primary root canal within the apical delta could be clearly identified and in 16/31 (52%) the primary root canal was indiscernible. The results showed that the pulp cavities of maxillary canine teeth were significantly larger and longer and the cusp-to-tip length was longer, when compared to mandibular teeth. The apical delta length was negatively correlated to the volume of the pulp cavity. No specimens depicted lateral canals. This study revealed that the anatomy of the canine tooth pulp cavity in cats can vary considerably and should be a consideration when performing thorough debridement, shaping and obturation of the endodontic system.

Should we be concerned about accessory mandibular foramina and canals? A cone-beam computed tomography study

Objective: Analyze the prevalence of mandibular accessory foramina and canals using cone-beam computed tomography (CBCT). Methodology: 136 mandibles divided into 10 predetermined areas were analyzed through CBCT looking for accessory foramina and canals. The Chi-square and Wilcoxon tests were used. Results: We found 1.316 accessory foramina, which 486 were accompanied by canals. 70.3% of accessory foramina were on the internal mandibular surface, most below the mylohyoid line and genial tubercles. The M1 area had the highest number of foramina, especially in the internal surface. The right mandibular side revealed a significantly greater number of foramina when compared to the left side. The mean diameter of accessory foramina analyzed was 0.85mm. Most of the accessory canals were on the internal mandibular surface, with a longer average length when compared to external surface canals. Conclusion: Our study showed that more detailed studies of accessory mandibular foramina and canals should be carried out, since a high prevalence of these structures and they have not named or classified yet. Furthermore, procedures that reach the internal mandibular surface, especially the anterior region, may be more subject to complications, as well as failure of anesthetic blocks on the right side of the mandible.

Morphometric and morphological evaluation of mastoid emissary canal using cone-beam computed tomography.

This study aimed to determine mastoid emissary canal's (MEC) and mastoid foramen (MF) prevalence and morphometric characteristics on cone-beam computed tomography (CBCT) images to underline its clinical significance and discuss its surgical consequences. In the retrospective analysis, two oral and maxillofacial radiologists analyzed the CBCT images of 135 patients (270 sides). The biggest MF and MEC were measured in the images evaluated in MultiPlanar Reconstruction (MPR) views. The MF and MEC mean diameters were calculated. The mastoid foramina number was recorded. The prevalence of MF was studied according to gender and side of the patient. The overall prevalence of MEC and MF was 119 (88.1%). The prevalence of MEC and MF is 55.5% in females and 44.5% in males. MEC and MF were identified as bilateral in 80 patients (67.20%) and unilateral in 39 patients (32.80%). The mean diameter of MF was 2.4 ± 0.9 mm. The mean height of MF was 2.3 ± 0.9. The mean diameter of the MEC was 2.1 ± 0.8, and the mean height of the MEC was 2.1 ± 0.8. There is a statistical difference between the genders (p = 0.043) in foramen diameter. Males had a significantly larger mean diameter of MF in comparison to females. MEC and MF must be evaluated thoroughly if the surgery is contemplated. Radiologists and surgeons should be aware of mastoid emissary canal morphology, variations, clinical relevance, and surgical consequences while operating in the suboccipital and mastoid areas to avoid unexpected and catastrophic complications. CBCT may be a reliable imaging diagnostic technique.

Posição das foraminas linguais na tomografia computadorizada de feixe cônico e suas implicações na escolha das dimensões dos implantes dentários para sínfise mandibular

ABSTRACT Objective: To identify the lingual foramina in a Brazilian population of 210 individuals through Cone-Beam Computed Tomography images, in order to guide the installation of dental implants in the region of the mental symphysis. Methods: After identifying the lingual foramina on a parasagittal section, four measurements were taken: distance to the alveolar ridge, distance to the mandibular lower border, distance to the limit of the vestibular cortical, and alveolar ridge inclination angle. The measurements were compared in relation to gender by the Mann-Whitney test. The association between gender and the number of foramina was done by the chi-square test. Pearson’s correlation analyzed the linear relationship between age and number of foramina. Results: Lingual foramina are present in 99.6% of the research participants. In the upper-inferior direction, a mean distance to the alveolar ridge of 21.4 mm was noted, while the mean distance to the lower mandibular border was 13.1 mm. In the bucco-lingual direction, a mean distance from the lingual foramina to the vestibular cortical of 15.2 mm is noted. The inclination angle of the alveolar ridge had a mean of 25.4º. Regarding gender, the test was not significant only for the distance to the vestibular cortical. Conclusion: The lingual foramina had a descending way in 100% of cases, being positioned mainly in the middle thirds (66.5%) and lower thirds (32.7%) of the mandibular ridge height. The use of dental implants up to 13 mm in length and up to 4 mm in diameter in the region of the symphysis mentualis is recommended.

Accessory infraorbital foramen location using cone-beam computed tomography.

Accessory infraorbital foramen (AIOF) can change the normal course of emerging branches of the infraorbital nerve and blood vessels exiting the infraorbital foramen (IOF). This study aimed to examine the AIOF, number of foramina, and their position in relation to IOF using cone-beam computed tomography (CBCT). We performed a retrospective CBCT assessment of hospital records between January 2018 and August 2022. The CBCT of 507 patients were examined to extract information on the prevalence, number, position, linear distance from the IOF, and diameter of AIOF in relation to demographic factors. Descriptive statistics were used to evaluate the prevalence of AIOF. Mean and standard deviation were used to calculate the linear distance and diameter of the AIOF, respectively. The AIOFs, its distribution, and number were compared between sexes and sides using the chi-square test. The independent t-test and Mann-Mann-Whitney test were used to compare the mean difference between the sexes and sides. Statistical significance was set at P < 0.05. In this current study, the prevalence of AIOF was 7.1% (36 of the 507 patients). Additionally, the current study examined the number of foramina using a single foramen on each side and double foramina located bilaterally at a distance from the AIOF to the IOF. The mean AIOF diameter was also studied, and the AIOF position with respect to the IOF on CBCT was superomedial or inferomedial. There were no statistically significant associations between any of the parameters assessed in this study when comparing sex and sides. A greater number of patients with AIOF presented with a single foramen and unilateral occurrence, without a statistically significant difference. The AIOF was most commonly located superomedial to the IOF.

Prevalence of retromolar foramen in nineteenth century Spanish population.

Among the non-metrical variants of the mandible that have been proven to be a key issue for dental practitioners, the retromolar foramen constitutes one of the most controversial details regarding its prevalence and associated variables. Thus, this study evaluated the prevalence of the retromolar foramen and the variables associated with its presence in a large Spanish collection of human dry mandibles from the nineteenth century. Six hundred Spanish human dry mandibles (1200 sides) belonging to an osteology collection were examined. The presence of teeth, the presence or absence of retromolar foramen, as well as its side, diameter, number, and location were evaluated. Descriptive analysis and analysis of the associations between the variables were performed. The retromolar foramen was observed in 184 mandibles (31%) and was predominantly present unilaterally (60.8%). Most mandibles (54.9%) had a single foramen. The most common location was the retromolar trigone region (84%). On analysis of the association of variables, it was observed a strong association (p < 0.001) between the presence or absence of the foramen and the presence of teeth. Moreover, a significant association was also found between sex vs. presence of teeth (p = 0.033), sex vs. presentation side of the foramen (p = 0.028), sex vs. number of foramina found (p = 0.004), and diameter vs. number of foramina found (p < 0.001). This study reveals that the retromolar foramen showed a high prevalence of 31% in nineteenth century Spaniards and was located primarily in the retromolar trigone, suggesting that dentists should be aware of and consider the relevant findings of this study.

TOPOGRAPHY OF NUTRIENT FORAMINA OF ADULT DRY RADII IN SOUTH INDIAN POPULATION WITH A NOTE ON ITS SURGICAL RELEVANCE

Objective: The objective of this study was to study the average length of adult dry radii in south Indian population, distribution of nutrient foramina, and foraminal index. Methods: This study was conducted using 200 dry, adult radii, obtained from the department of Anatomy at our institute. Fully formed radii of both sides and genders were included in the study. Length of each bone, distribution, and direction of nutrient foramina on diaphysis were studied with the help of a Vernier caliper. Later, foramen index was estimated for all bones using Hughes formula. The data were tabulated and analyzed statistically. Results: Average length of radii in the study was 23.37±1.65 cm. All radii had their nutrient foramina, directed proximally. About 2% of the study sample had double nutrient foramina. Increased number of foramina had no effect on length of bone. As many as, 57.5% of radii had nutrient foramen on the anterior surface of shaft. Mean foramen index was 34.24±4.75. Conclusion: This study provides population-specific data regarding length of adult radii and topography of nutrient foramina of adult radii. An attempt was made to acknowledge its relevance while harvesting a vascular graft.

Internal morphology of distal roots of mandibular first molars revealed by computed microtomography.

To evaluate the internal morphology of 100 distal roots of mandibular first molars using micro-CT. Teeth were scanned to characterise: Vertucci type, root length, canal shape, presence and location of accessory canals, and the number of foramina at 4 mm from the apex, presence of root isthmus and the length from the primary canal to the apical foramen. Vertucci type I was found in 57% of cases, followed by V (27%). The most common cross-section 1 mm from the apex was oval (49%) and circular (38%). The average root length was 16.06 mm (16.61-19.02 mm). The mean foramen size was 0.32 and 0.53 mm for the minor and major diameters, respectively. The volume, surface area and SMI were 7.84 mm3 , 68.87 mm2 and 1.52 mm, respectively. Root isthmi were found in 47% of the samples, and the length mean from the primary canal to the apical foramen was 2,03 mm. The internal morphology of the distal roots of mandibular first molars may be complex and shows variations.

Lingual foramina of the anterior mandible in edentulous patients: CBCT analysis and surgical risk assessment

ObjectiveThe mandible has various unnamed accessory foramina, and surgery is often performed in the symphyseal area. The aim of this study was to analyze the anatomical characteristics of mandibular lingual foramina with the objective of preventing clinical complications during implant surgery on an edentulous mandible. Study designA total of 100 cone beam computed tomography scans of completely edentulous patients were included in this study. For each canal, nine measurements were recorded in millimeters: seven length or height measurements and two diameter measurements. The placement of a standard implant was simulated and whether the implant passed through the canal was noted. The results were analyzed by t-test and chi-squared at a significance level of 0.05. Pearson correlation analysis was used to assess the relationship between variables. ResultsWe identified 309 foramina: 236 medial lingual foramina and 73 lateral lingual foramina. We found no significant relationship between the number of foramina and the age of the individuals, or between diameter and the age or gender of the individuals. The mandibular canal was injured in 32.7 % of implant placement simulations. ConclusionThe risk of injury to neurovascular bundles is increased in edentulous patients due to vertical bone resorption.

Morphological study on distribution of nutrient foramina in femoral neck in relation to retinacula of weitbrecht with its surgical implications

BackgroundNow a day's many surgeries are done around the head and neck of femur like femoral head resurfacing arthroplasty for managing advanced hip-joint degeneration. Thus, it is vital for an orthopaedic surgeon to exactly understand the vascular supply of the neck of femur. The knowledge of distribution of foramina and their relation to the retinacula of Weitbrecht will help orthopaedic surgeons to choose their management technique for various injuries. So, this study was undertaken to study the number, size and distribution of nutrient foramina in all the surfaces of neck of femur and their relations to the retinacula of Weitbrecht. Materials and methodStudy was conducted on 200 adult dry femora. The retinacula of Weitbrecht are first defined later the subcapital, transcervical and basicervical regions of the femoral neck are marked. The number of foramina, size and their distribution in relations to the retinacula of Weitbrecht were observed. Later the results were analyzed statistically. Results40.01% of foramina were observed in the subcapital region, 31.74% in basicervical and 28.24% were noted in transcervical region. The nutrient foraminal density was significantly higher in the upper retinacula (57.03%), followed by anterior retinacula (27.3%) and least in the region of inferior retinacula (15.66%). It was observed that most foramina were less than 1 mm diameter followed by 1–2 mm diameter foramina. ConclusionThis knowledge of foraminal distribution in femoral neck will be helpful in surgeries involving the hip joint and femoral head & neck fractures.

Variations in nutrient foramen in the long bones of lower limb

Morphology and morphometry of nutrient foramen of bones vary from country to country and from place to place. Objective was to study the number, position, location, directions, distance of nutrient foramen from the proximal end of femur, tibia and fibula in eastern Indian region. In a descriptive study, 393 bilateral lower limb long bones (138 femur, 132 tibia &amp; 123 fibulae) were studied. Total nutrient foramen calculated; 178 in femur, 137 in tibia, 121 in fibula. Most had single foramen; femur (66%), tibia (96%) and fibula (94%). Number of foramina ranged from 0-3 in femur, 1-2 in tibia and 0-2 in fibula. Foramina were present mainly on the posterior surface of the bones [linea aspera in femur (96), below soleal line and lateral to the vertical line in tibia (90) and peroneal crest in fibula (74)]. The mean length, mean distance of nutrient foramen from the proximal end of the bones measured. Most foramina found on the middle third, with foraminal index ranging from 33% to 66%; though on tibia it’s not a common finding. The 't' test value of foraminal index was significant for tibia. Mean foraminal index was measured for femur 42.28%, tibia 35.91%, fibula 41.54%. The knowledge of anatomical variations of nutrient foramen is very important as preservation of vascularization of long bones is essential in fracture repair, tumor resection, bone grafting.

Morphometry and Morphology of Vascular Foramen on the Trochlear Groove of the Distal Femur and Its Implications.

Background and objectiveNutrient foramina in supracondylar, medial condyle, lateral condyle, and intercondylar fossa have been described in the literature. The author of the present study observed a vascular foramen on the trochlear groove, which has not been previously reported in the literature. The aim of the study was to elaborate on the morphology, morphometry, and associated clinical implications of this foramen.Materials and methodsForty-five unpaired femora of unknown sex available in the Department of Anatomy at the Uttar Pradesh University of Medical Science (UPUMS), Saifai, India were observed to examine the incidence, shape, size, and location of the foramen on the trochlear groove of the distal femur. The incidence and shape were observed and its location in relation to the upper and lower articulating margin of the patella was recorded using a divider and scale.ResultsThe trochlear foramen was observed in 25 femora, accounting for 55.6% of the total. The average diameter of the foramen was 4 mm. The average distance of the foramen from the upper patellar articulating surface was 2.4 cm and its distance from the lower margin was 0.7 cm. All the foramina were round in shape. The largest number of foramina were located in the midline, and seven foramina were located to the left of the midline of the trochlear groove.ConclusionsThe incidence of the trochlear foramen was 55.6%, meaning that more than half of the population possess this foramen on the trochlear groove. The maximum number of these foramen, amounting to 64%, were found in the midline of the trochlear groove. The morphologic and topographic knowledge of the trochlear foramen is essential for orthopedic surgeons during operative procedures in the region of the distal femur.

Tumours involving the neural foramina in children: beyond neuroblastoma

To characterise tumours that involve the neural foramina in children, including prevalence, demographics, and imaging features. This retrospective single-centre study comprised 36 boys and 34 girls who presented with spinal or paraspinal lesions involving the neural foramina. Two certified radiologists reviewed the imaging features, including the level of spinal involvement, the number of involved foramina, foraminal widening, tumour epicentre, and cord compression. Medical charts were reviewed for patients' demographics and tumour pathology. Tumours were classified as benign or malignant, and neuroblastomas were further classified as low or intermediate risk versus high risk. Thirty-three (47%) of the patients had neuroblastic tumours. Fourteen (20%) of the patients had sarcomas (mainly Ewing sarcoma). Other less common aetiologies included neurofibromas, germ cell tumours, Langerhans cell histiocytosis and haemangiomas. Neuroblastic tumours were particularly common in the thoraco-lumbar region, and considerably less prevalent in the sacral and cervical regions. Additional features, such as foraminal widening, the number of foramina involved, and cord compression, did not help discriminate between neuroblastic and non-neuroblastic tumours. Most tumours (80%) were malignant. Most benign tumours (>50%) were associated with a genetic predisposition syndrome. In evaluating neoplasms that involve the neural foramina in children, neuroblastic tumours are most common. Nevertheless, other aetiologies should be considered, mainly sarcomas. Most lesions in children are malignant. When encountering a benign mass, genetic counselling should be considered.

The Number and Determinants of Nutrient foramina among dry human femur bones from the East African population: A Cross-section study

Background: Nutrient foramina form important landmarks on the femur and other bones as the portal of entry for nutrient arteries. Nutrient arteries are important sources of blood supply for growing bones; and their variations may be due to congenital or acquired causes. These variations are important in anatomical comparisons, orthopaedic surgical practice and forensic medicine. Aims: This study aimed at establishing the number and determinants of the nutrient foramina among dry human femur bones from the East African population. Materials and methods: This was a cross-section study of 333 dry femur bones from the East African population, at the Galloway osteological collection of Makerere University college of health sciences. The number of nutrient foramina on the shaft of each femur, the corresponding demographic, clinical and morphometric characteristics were documented. Data were entered in an Excel sheet and exported to STATA 14 for analysis. Univariate, bivariate and multivariable analyses were performed to obtain the summary statistics and the measures of association. At all levels of analysis, a p-value of less than 0.05 was considered statistically significant. Results: Of the 333 femurs, 291 (87.4%) were from males; and 137(50.15%) were right femurs. The age ranged from 20 to 75 years with a mean age of 35 (SD± 12) years. Nutrient foramina ranged from one to four; mean of 1.4 (SD±0.5) and median of 1 (IQR: 1 to 2). Of the 333 femurs, 199 (59.8%) had one foramen, 129 (38.7%) had two foramina, four femurs had three foramina and one femur had four foramina. There was a statistically significant association between the number of nutrient foramina and the femur’s: mid-shaft circumference (p=0.014; 95%CI: 0.003 to 0.028), nationality (p=0.016; 95%CI: -0.284 to -0.030) and sex (p=0.012; 96%CI: -0.405 to -0.050). Conclusion: Nutrient foramina among femurs from the East African population range from one to four per femur, with predominantly one foramen. The key determinants of the number of foramina are: mean mid-shaft circumference, nationality and sex. These findings are significant in anatomical comparisons; forensic and orthopaedic practices. KEY WORDS: Nutrient foramina, dry human femur, East African population, morphometric characteristics.

Rostral neurovasculature indicates sensory trade-offs in Mesozoic pelagic crocodylomorphs.

Metriorhynchoid thalattosuchians were a marine clade of Mesozoic crocodylomorphs that evolved from semi-aquatic, "gharial"-like species into the obligately pelagic subclade Metriorhynchidae. To explore whether the sensory and physiological demands of underwater life necessitates a shift in rostral anatomy, both in neurology and vasculature, we investigate the trigeminal innervation and potential somatosensory abilities of metriorhynchoids by digitally segmenting the rostral neurovascular canals in CT scans of 10 extant and extinct crocodyliforms. The dataset includes the terrestrial, basal crocodyliform Protosuchus haughtoni, two semi-aquatic basal metriorhynchoids, four pelagic metriorhynchids and three extant, semi-aquatic crocodylians. In the crocodylian and basal metriorhynchoid taxa, we find three main neurovascular channels running parallel to one another posteroanteriorly down the length of the snout, whereas in metriorhynchids there are two, and in P. haughtoni only one. Crocodylians appear to be unique in their extensive trigeminal innervation, which is used to supply the integumentary sensory organs (ISOs) involved with their facial somatosensory abilities. Crocodylians have a far higher number of foramina on the maxillary bones than either metriorhynchoids or P. haughtoni, suggesting that the fossil taxa lacked the somatosensory abilities seen in extant species. We posit that the lack of ISO osteological correlates in metriorhynchoids is due to their basal position in Crocodyliformes, rather than a pelagic adaptation. This is reinforced by the hypothesis that extant crocodyliforms, and possibly some neosuchian clades, underwent a long "nocturnal bottleneck"-hinting that their complex network of ISOs evolved in Neosuchia, as a sensory trade-off to compensate for poorer eyesight.

A Study of Diaphyseal Nutrient Artery Foramina of Dry Fibula in Human, done in a Government Medical College of Upper Assam, India

Introduction: The nutrient foramina is the external opening in each bone which has a particular position and number in its diaphysis. A thorough knowledge of the position, number, direction and variation of the nutrient foramina of fibula is very much important, as this is one of the most common bone used in bone grafts, vascularised bone microsurgery and mandibular reconstruction. Aim: To determine the position of nutrient artery foramina in fibula and also their size and direction. Materials and Methods: This was a descriptive cross-sectional study which was conducted in the Department of Anatomy, Assam Medical College, Dibrugarh, Assam, India, from March- June 2021. The study was conducted on 167 numbers of adult human cleaned and dried fibulae. The number, position, size and direction of nutrient foramina were recorded in a pretexted proforma. Foraminal Index (FI) was calculated and the range, mean and standard deviation of FI were determined. Results: In the present study, 167 bones were taken but only 159 showed nutrient foramina. Single dominant foramen was found in 92.5% (147/159) of bones. Secondary foramina were present in 7.5% (12/159) of bones. The FI was calculated. According to FI, maximum number of foramina was present on middle third of fibula (92.56%). In 7.44% of fibula the foramina were located in distal third of the bone. Conclusion: A thorough anatomical knowledge of the nutrient foramen is useful in planning the vascularised fibular graft. Hence the result of this study will provide detail data about the number, position and direction of nutrient artery foramina in fibula for successful outcome of various orthopaedic and plastic reconstructive surgeries.

Volar and Dorsal Blood Supply to the Lunate: A Cadaveric Study.

Although various studies have proposed vascular and mechanical factors, the etiology of Kienböck disease is unknown. Kienböck theorized that lunatomalacia resulted from traumatic disruption of blood supply and bony nutrition to the lunate. Extraosseous supply to the lunate, as far as volar or dorsal vessels are concerned, is still controversial. This study evaluated the extraosseous nutrient foramina from the dorsal and volar aspects of lunate specimens. A total of 913 specimens from the Hamann-Todd Osteological Collection in Cleveland, Ohio, were examined. The nutrient artery foramina on left and right lunate specimens were examined from dorsal and volar aspects. The number of nutrient artery foramen was tabulated. Age, sex, and race data were collected. Specimens were divided into groups according to the number of nutrient artery foramina, and the dorsal and volar foramina were compared. The average number of foramina on the dorsal aspect of the lunate (1.71) was greater than the volar aspect (1.64), except in specimens younger than 35 years. A greater number of specimens had 3 or more foramina on the dorsal side compared with the volar aspect. Based on this study, there was significant contribution of dorsal arterial vessels to the blood supply of lunate specimens older than 35 years, which contrasts with findings in earlier studies. The disruption of dorsal intercarpal and radiocarpal ligaments leading to the disruption of the dorsal arterial arches may contribute to vascular insufficiency of the lunate and should be evaluated further in the etiopathogenesis of Kienböck disease. [Orthopedics. 2021;44(2):e243-e247.].

Root Canal Morphology of 116 Maxillary Second Premolars by Micro–Computed Tomography in a Mixed Swiss-German Population with Systematic Review

IntroductionThe aim of this investigation was to examine the root canal system morphology of maxillary second premolars (Mx2Ps) of a Swiss-German population by means of micro–computed tomography and provide systematic review of the root canal configuration (RCC) literature of Mx2Ps. MethodsThe RCC, main foramina as well as accessory canals and foramina frequency of 116 Mx2Ps, were investigated by means of micro–computed tomography and 3-dimensional software imaging. The RCC from the coronal to apical thirds of the root as well as the main foramina number were described by using a four-digit system code. The literature review follows the PRISMA guideline analyzing randomized controlled trials and cross-sectional, cohort, comparative, validation, and evaluation studies on RCC in Embase, grey literature, PubMed, and Scopus. ResultsMost frequently observed RCCs of Mx2Ps were 1-1-1/1 (35.3%), 1-1-1/2 (21.6%), and 2-1-1/1 (14.7%). Another 11 less frequent RCCs were observed. All Mx2Ps had 1 root. One main foramen was observed in 59.5% and two in 37.9%. Accessory foramina were observed in 46.6%. Thirty-one percent of the Mx2Ps showed accessory canals. One connecting canal between the buccal and palatal was observed in 12.1%. ConclusionsDetailed RCC information of Mx2Ps in a Swiss-German population and the results of a systematic literature review of different populations and research methods used to investigate root canal morphology and configuration of Mx2Ps are given. Within the limitations of the study, a high RCC, connecting and accessory canals variability occur in maxillary second premolars.