Morphological assessment of the mandibular canal trajectory in edentate subjects.

BACKGROUND: The mandibular canal and its content represent the vital structure, which can complicate dentoalveolar surgical procedures in the posterior region of the mandible. The purpose of the present study was to determine the path the mandibular canal takes in relation to the horizontal and the vertical anatomical reference planes in edentate subjects, in order to minimize the risk of affecting its neurovascular content during various oral surgery procedures. MATERIALS AND METHODS: Morphometric evaluations were performed on 12 dried fully edentulous human mandibles and on cone-beam computed tomography (CBCT) cross-sectional images of the mandible, from 20 patients with either partial or complete edentulism. Both methods were utilized, in three target areas (corresponding to the second premolar, to the first molar and to the second molar regions), in order to measure the distance between the mandibular canal and the following reference points: (i) the lateral (buccal) surface of the mandible (MC-BS distance); (ii) the medial (lingual) surface of the mandible (MC-LS distance); (iii) the alveolar surface of the mandible (MC-AS distance). The results were statistically processed in Stata MP/13 software package using analysis of variance (ANOVA) test. RESULTS: The mandibular canal crossed the trabecular bone from the posterior towards the anterior, and from the lingual towards the buccal, reaching the premolar region, distal to the mental foramen, where it was located in the centre of the trabecular bone, main topographic pattern encountered in 27 (84.37%) of the cases. In five (15.63%) of the cases, in the premolar region, the mandibular canal was located near the buccal cortical plate. The mandibular canal descended from the second molar region towards the premolar region, main topographic pattern found in 28 (87.5%) of the cases. In four (12.5%) cases, the mandibular canal had a descending trajectory in the molar regions and it took a slightly ascending course in the premolar region. CONCLUSIONS: According to the results, the second molar region represents the highest risk area in the accidental injury to the content of the mandibular canal, during various oral surgery procedures.

Salivary biomarkers of inflammation in systemic lupus erythematosus.

Saliva is currently used as a reliable diagnostic fluid in a wide range of local and systemic diseases. However, the link between salivary diagnosis and the inflammatory process in autoimmune diseases has not yet been explored. The aim of our study is to assess possible correlations between salivary inflammatory markers and systemic lupus erythematosus (SLE). Patients fulfilling the Systemic Lupus International Collaborating Clinics (SLICC) diagnosis criteria were included. Salivary and serum levels of interleukin-6 (IL-6), leptin, monocyte chemoattractant protein-1 (MCP-1) and plasminogen activator inhibitor-1 (PAI-1) were determined using stochastic sensors. Serum leptin and IL-6 had significantly higher levels in SLE patients compared to non-SLE. Also, salivary IL-6 levels highly correlated with the serum IL-6 levels. A positive correlation was found between salivary and serum levels of IL-6, signaling salivary IL-6 as a reliable marker for assessing the inflammation process in SLE.

Morphological assessment of the mandibular canal trajectory in dentate subjects.

BACKGROUND: The mandibular canal is the most important vital structure within the mandibular body. The aim of the present study was to determine the course of mandibular canal in relation to external surfaces of the mandible (buccal, lingual) and to root apices of the lateral teeth, in order to minimize the risk of its content being injured during either conservative or radical treatment of the mandibular lateral teeth. MATERIALS AND METHODS: Morphometric evaluations were performed on 11 dried dentate human mandibles and on cone-beam computed tomography (CBCT) cross-sectional images of the mandible, from 18 dentate patients. By means of both methods, the following parameters were assessed: (i) the distance between the mandibular canal and the buccal (lateral) surface of the mandible (MC-BS distance); (ii) the distance between the mandibular canal and the lingual (medial) surface of the mandible (MC-LS distance); (iii) the distance between the mandibular canal and the root apices of the second premolar, the first and second molars (MC-T distance). The results were statistically processed in Stata MP÷13 software package using analysis of variance (ANOVA). RESULTS: With respect to buccal-lingual location, the mandibular canal passed horizontally through the mandibular trabecular bone, from posterior to anterior, and from lingual to lateral (buccal), and so at premolar level it approached the lateral (buccal) cortical bone plate, main topographic pattern found in 26 (89.65%) of the cases. The mandibular canal had a descending trajectory from the second molar to the first molar, after which it ascended slightly towards the second premolar, main topographic pattern found in 24 (82.75%) of the cases. CONCLUSIONS: According to the results, the second mandibular molar is the most common tooth involved in the accidental damaging of the content of the mandibular canal, during various therapeutic procedures. Overlooking the location of the mandibular canal can lead to complications in endodontic therapy and in dentoalveolar surgical procedures in the posterior region of the mandible.