Statement of problem. Anatomic landmarks have been used in the orientation of occlusal plane and the determination of vertical dimension for edentulous patients. Such as labial vestibules of anterior region and hamular notches, retromolar pads of posterior region are very useful anatomic landmarks for fabrication of occlusion rim because they are to be identified on master casts. Therefore, if average distances between landmarks of maxillae and mandible in dentate subjects are measured and applied, not only occlusal plane but also vertical dimension can be established initially. Purpose. The purpose of this study is to measure vertical distances between anatomic landmarks and to present a guide to the orientation of occlusal plane and the determination of vertical dimension of edentulous patients. Material and method. Upper and lower border-molded casts were made in 93 Korean dentulous subjects, mean age 25 years. Incisal edges of central incisors, bottoms of labial vestibules, hamular notches and the half level of retromolar pads were marked on casts. Measurements of vertical distances from incisal edge of central incisor to the bottom of labial vestibule, between upper and lower bottoms of labial vestibules, from hamular notch to retromolar pad and from hamular notch to the occlusal plane established by the incisal edge of maxillary central incisor and mesiopalatal cusps of both maxillary first molars were made on each cast. Results and conclusion. 1. The mean distance from the incisal edge of central incisor to the bottom of labial vestibule was 20.8mm(SD 1.7) on upper casts and 17.3mm(SD 1.4) on lower casts. 2. The mean distance between both bottoms of labial vestibules of upper and lower casts was 35.0mm(SD 2.7). 3 The mean distance from hamular notch to the half level of retromolar pad was 5.0mm(SD 1.3). 4. The mean distance from hamular notch to occlusal plane was 7.9mm(SD 1.5). 5. Distances from incisal edge of central incisor to labial vestibule on lower casts(P<0.01) and from hamular notch to retromolar pad(P<0.0001) were greater in male than in female.
The Purpose of this study were to examine the epidemiology of snoring, its associated factors and anatomic features on cephalogram according to the frequency of snoring in young adults. Epidemiological survey using questionaire was made to the 438 students (320 male, 118 female) aged 19 - 28 years, and cephalometric study of anatomic features on 14 habitual snorers, 31 occasional snorers and 30 non-snorers among men was done. The obtained results were as follows : 1. The prevalence snoring was 11.4% in the young adults, 15.0% in male and 1.7% female. 2. Of the young adults, 3.7% were habitual snorers and 7.8% were occasional snorers. 3. Smoking and drinking increased the frequency of snoring(p < 0.01), but didn't affec the differences in the frequency between habitual and occasional snoring. 4. No significant correlation was made between the frequency of snoring and the factors such as overweight, nasal disease and hypertension. 5. In the cephalometric comparison between snorers and non-snorers, snorers had inferiorly positioned hyoid bone(p < 0.05), longer soft palate(p < 0.01), steeper soft palate(p < 0.05) and narrower nasopharyngeal(p < 0.05) and oropharyngeal(p < 0.001) airway. 6. In the cephalometric comparison between habitual snorers and occasional snorers, habitual snorers had narrow nasopharyngeal airway(p < 0.05).
Objective : The precise intra- vs. extradural localization of aneurysms involving the paraclinoid internal carotid artery is critical for the evaluation of patients being considered for aneurysm surgery. The purpose of this study was to investigate the clinical usefulness of T2-weighted threedimensional (3-D) fast spin-echo (FSE) magnetic resonance (MR) imaging in the evaluation of unruptured paraclinoid aneurysms. Methods : Twenty-eight patients with unruptured cerebral aneurysms in their paraclinoid regions were prospectively evaluated using a T2- weighted 3-D FSE MR imaging technique with oblique coronal sections. The MR images were assessed for the location of the cerebral aneurysm in relation to the dural ring and other surrounding anatomic compartments, and were also compared with the surgical or angiographic findings. Results : All 28 aneurysms were identified by T2-weighted 3D FSE MR imaging, which showed the precise anatomic relationships in regards to the subarachnoid space and the surrounding anatomic structures. Consequently, 13 aneurysms were determined to be intradural and the other 15 were deemed extradural as they were confined to the cavernous sinus. Of the 13 aneurysms with intradural locations, three superior hypophyseal artery aneurysms were found to be situated intradurally upon operation. Conclusion : High-resolution T2-weighted 3-D FSE MR imaging is capable of confirming whether a cerebral aneurysm at the paraclinoid region is intradural or extradural, because of the MR imaging's high spatial resolution. The images may help in identifying patients with intradural aneurysms who require treatment, and they also can provide valuable information in the treatment plan for paraclinoid aneurysms.
Many attempts for the compfrt, esthetics and improvement of Masticatory function of the patients with removable prosthesis have been made for several decades. The search for the ideal denture occlusion has been going on in an effort to find the tooth form which provides maximum denture stability and masticatory efficiency without damaging the health of the underlying bone. For the purpose, the basic concept of lingualized occlusion were suggested by payne(1941) and pound(1973) discussed a similar occlusal concept and used term " lingualized occlusion." The purpose of this literature study is to clarify and amplify a method to achieve bilateral balanced occlusion with the occlusal arrangement termed " lingualized occlusion." Lingualized occlusion can be achieved by use of anatomic teeth for the mandibular denture. Lingualized occlusion can be used in most denture combination. It is particulary helpful when the patient places high priority on esthetics but a nonanatomic occlusal scheme is indicated by oral conditions such a severe alveolar resorption, a class II jaw relationship or displaceable supporting tissue. Advantages of lingualized occlusion are summarized as follows : 1) Most of the advantages attributed to both the anatomic and nonanatomic forms are retained. 2) Cusp form is more natural in appearance compare to nonanatomic tooth form. 3) Good pnetration of the food bolus is possible. 4) Bilateral mechanical balanced occlusion is readily obtained for a region around arotric relation. 5) Bertical forces are centralized on the mandibular teeth. Lingualized occlusion provides a useful combination of several occlusal concept. Many. advantages of anatomic and nonanatomic occlusions are accomplished but the lingualized occlusal concept is not is not a panacea, and all other procedures still must be carefully excuted.
Purpose: This study evaluated the apical root canal system of maxillary second molars, in which conventional endodontic treatment had failed. Materials and Methods: One hundred eighteen extracted endodontically failed maxillary second molars were examined to investigate the root canal morphology using clinical photographs. High-resolution cross-sectional images at the 3mm level from the root apices were taken to evaluate the anatomic variations and canal cleanliness. The incidence of anatomic variations and canals containing debris were evaluated statistically. Results: One (0.85%) maxillary second molar had four separate roots, while 52 (44.07%) had three separate roots. The remaining 65 (55.08%) showed 6 different types of fusion in their roots. As the number of fused roots increased from none to three, the incidence of isthmuses in the cross-sectional images increased significantly from 43.40% to 76.92% in 2-root fusion and 88.46% in 3-root fusion. In addition, the occurrence of less-cleansed canals increased from 22.64% to 38.46% and 53.85%, respectively (p<0.05). Sixty four teeth (54.24%) had 3 canals while 38(32.2%) had additional canals; most of them were located in the MB roots (81.58%). Seventy six (64.41%) had isthmuses in the apical region and 58 out of 76 were located in MB roots. Condlusions: Logistic analysis indicated that the less division of roots was associated significantly with the occurrence of insufficient cleaning during endodontic treatment (OR=1.765, p<0.05), while the presence of an additional canal showed no association.
Objective : The purpose of this study was to compare computed tomographic angiography(CTA) with conventional cerebral angiography(CCA) and to assess usefulness of CTA in detection and anatomic definition of intracranial aneurysms of the circle of Willis in subarachnoid hemorrhage. Patients and Methods : Fifty consecutive patients with known or suspected intracranial saccular aneurysms underwent CTA with preoperative CCA from 1997 to 1999. Using surface shaded display post-processing technique, CTA was interpreted for the presence, location of aneurysms and anatomic features. The image obtained with CTA was then compared with CCA image. Results : In 47 patients, CCA revealed 57 cerebral aneurysms and CTA revealed 54 aneurysms. Two of the 57 cerebral aneurysms were located outside of the imaging volume of CTA and one case was misdiagnosed. The sensitivity of CTA was 94.7% and the specificity was 100%. The results obtained with CTA were, compared with the results obtained with CCA, equal in determining dome shape, direction and lobularity. However, CTA provided a 3-dimensional representation of aneurysmal lesion very useful for surgical planning. Moreover, CTA was useful for rapid and relatively noninvasive detection of aneurysms in the circle of Willis. Conclusion : CTA can be a diagnostic tool for the patients with acute subarachnoid hemorrhage due to a ruptured aneurysm of the circle of Willis and provides adequate anatomic detail for surgical planning, especially to complex cerebral aneurysms. However, we think CCA is necessary because of CTA limitations including its difficulty in detecting unusually located aneurysms(including those in cavernous sinus or distal artery) and combined vascular lesion (including arteriovenous malformation) and acquiring dynamic flow information.
The osseointegrated implant conducts the stress directly to the bone due to lack of cushoning effect of periodontal ligament. So, the design and material quality of superstructure plays an important role in resolution and diffusion of stress. Recently, the various superstructures have been developed to improve esthetics and resolve various complicated conditions. The purpose of this study was to evaluate the stress induced by various system on the osseointegrated implant using UCLA abutment, EsthetiCone abutment, Anatomic abutment as well as Branemark conventional abutment. The stress distribution was evaluated by the photoelastic method which can simultaneously observe all around stress distribution. The superstructures embedded in epoxy resin specimen were loaded at various angle with a force of 15Kg to analyse the stress distribution of the fixture. The results of this study were obtained as follows : 1. Under vertical loading, the large and broad stress was distributed below the fixture in all systems. 2. The fringe order of the stress was increased in proportion to tillting the specimen. The largest stress was shown in 25 angled degree tilting case. 3. The Branemark conventional abutment showed the lowest value, and EsthetiCone abutment, Anatomic abutment and UCLA abutment showed the stress value in accending order.
The Purpose of this Study was to examine the anatomic differences in the upper airway according to severity of respiratory disturbance index of habitual snorers. Forty-three male habitual snorers, aged 28-68, were examined by polysomnography and divided into 4 groups according to severity determined by polysomnography. Anatomic differences in the upper airway were assessed by lateral cephalograms in upright position, and epidemiological surveys were done by using questionnaires. The obtained results were as follows : 1. All subjects were habitual snorers and 35 patients (81.4%) complained the loudness of snoring as severe as be heard outside of the room. 2. According to the results of polysomnography, the number of the primary snoring patients was 7(16.3%), mild obtrusive sleep apnea 7(16.3%), moderate 7(16.3%), and severe 22(51.2%). 3. The respiratory disturbance index (RDI) of subjects was 39.5$\pm$24.4 and the body mass index(BMI) was 26.2$\pm$2. 4. More inferiorly positioned hyoid bone according to the degree of respiratory disturbace index (RDI) was observed. (p<0.001) 5. The width of superior oropharyngeal airway space was according to the degree of RDI. (p<0.001)
Ko, Tin Sui;Tse, Michael Siu Hei;Wong, Kam Kwong;Wong, Wing Cheung
Asian Spine Journal
/
제12권6호
/
pp.1123-1126
/
2018
Study Design: Observational study. Purpose: To assess the correlational accuracy between the traditional anatomic landmarks of the neck and their corresponding vertebral levels in Southern Chinese patients. Overview of Literature: Recent studies have demonstrated discrepancies between traditional anatomic landmarks of the neck and their corresponding cervical vertebra. Methods: The center of the body of the hyoid bone, the upper limit of the lamina of the thyroid cartilage, and the lower limit of the cricoid cartilage were selected as representative surface landmarks for this investigation. The corresponding vertebral levels in 78 patients were assessed using computed tomography. Results: In both male and female patients, almost none of the anatomical landmarks demonstrated greater than 50% correlation with any vertebral level. The most commonly corresponding vertebra of the hyoid bone, the lamina of the thyroid cartilage, and the cricoid cartilage were the C4 (47.5%), C5 (35.9%), and C7 (42.3%), respectively, which were all different from the classic descriptions in textbooks. The vertebral levels corresponding with the thyroid and cricoid cartilage were significantly different between genders. Conclusions: The surface landmarks of the neck were not accurate enough to be used as the sole determinant of vertebral levels or incision sites. Intra-operative fluoroscopy is necessary to accurately locate each of the cervical vertebral levels.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
제45권3호
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pp.158-166
/
2019
Objectives: Inferior alveolar nerve block (IANB) is the most frequently used treatment for mandibular molars. Successful IANB requires insertion of the dental needle near the mandibular foramen. In this study, we aimed to analyze the anatomic location of the mandibular lingula and evaluate the effects of internal oblique ridge (IOR)-guided IANB. Materials and Methods: The location of the mandibular lingula was measured using cone-beam computed tomography images of the mandibles obtained from 125 patients. We measured the distances from the occlusal plane to the lingula and from the IOR to the lingula in 250 mandibular rami. Based on the mean of these distances, alternative anesthesia was carried out on 300 patients, and the success rate of the technique was evaluated. Results: The mean vertical distance was $8.85{\pm}2.59mm$, and the mean horizontal distance was $14.68{\pm}1.44mm$. The vertical (P<0.001) and the horizontal (P<0.05) distances showed significant differences between the sex groups. The success rate of the IOR-guided technique was 97.3%. Conclusion: IANB-based location of mandibular lingula showed a high success rate. From this study, we concluded that analysis of the anatomic locations for mandibular lingula and IOR-guided IANB are useful for restorative and surgical dental procedures of the mandibular molars.
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