Anatomical study of the distal course of the posterior tibial artery: A cadaver study.

OBJECTIVE: This study aimed to describe the course, branches, and variances of the posterior tibial artery, which provides the arterial supply of the plantar surface of the foot, starting from the tarsal tunnel level to provide descriptive information for all surgical interventions, diagnostic radiological procedures, and promising endovascular therapies in the tarsal region. METHODS: In this study, a dissection of 48 feet was performed on 25 formalin-fixed cadavers (19 males and 6 females). Surgical instruments and a digital caliper were used for dissection and measurements, and the critical structures were recorded by a Canon 250D camera to be illustrated later. RESULTS: All parameters were significantly longer in male cadavers compared to females. According to the correlation analysis, while there was a significant and robust correlation between the axial line and pternion-deep plantar arch (R=.830, P .05), a moderate correlation was found between the axial line and sphyrion-bifurcation (R=.575; P < .05), axial line and deep plantar arch-2nd interdigital commissure (R=.457; P < .05), and sphyrion-bifurcation and pternion-deep plantar arch (R=.480; P < .05). Variation in any branch of the posterior tibial artery was observed in 27 of the 48 studied sides. CONCLUSION: In our study, the branching and variability of posterior tibial artery on the plantar surface of the foot were described in detail with the determined parameters. In conditions that cause tissue and function loss and require reconstruction, such as diabetes mellitus and atherosclerosis, the most critical factor in increasing treatment success is a better understanding of the region's anatomy.

The effects of stabilization splint treatment on the volume of masseter muscle in sleep bruxism patients.

OBJECTIVE: The aim of this study was to evaluate, quantitatively, the volumetric effects of stabilization splint therapy on the masseter muscle of sleep bruxism (SB) patients. METHODS: The magnetic resonance (MR) images of 16 SB patients diagnosed by polysomnography (PSG) who used stabilization splints for four months were obtained before and after the therapy. The masseter muscle volume was calculated using Cavalieri's principle on the MR images. RESULTS: After the splint therapy, the mean volume of the masseter muscle did not reduce significantly. The fat and/or water content of the muscles did not change either. DISCUSSION: The stabilization splint therapy had no effect on the volume, fat and/or water content of the masseter muscle; however the discomfort was reduced in the patients. Although the effect of splint therapy is not fully understood, the non-invasive and reversible stabilization splint can be used in SB patients because of its relaxation effect on muscles.

Multiple morphological variations in a human mandible / Múltiples variaciones morfológicas en una mandíbula humana

Bilateral mylohyoid bridging, hyperplasia of the coronoid process and bifid condylar process were detected in a human mandible. It is of great interest that such rare morphological anomalies can occur in the same mandible. Since sound understanding of the anatomical variations of the mandible, in conjunction with a careful pre-operative review of radiographs, are essential in the safe and complete performance of surgical and prosthetic rehabilitation, the authors of the present report believe that this case may add to the existing literature.

En una mandíbula humana se detectó puente milohioideo bilateral, hiperplasia del proceso coronoides y el proceso condilar bífido. Es de interés que se puedan producir dichas anomalías morfológicas en la misma mandíbula. Es esencial un conocimiento sólido de las variaciones anatómicas de la mandíbula, en conjunción con una revisión preoperatoria cuidadosa de las radiografías, en el desempeño seguro y completo de la rehabilitación quirúrgica y protésica. Los autores del presente estudio estiman que este caso puede aportar información a la literatura existente.

Topical Single-dose Vascular Endothelial Growth Factor has No Effect on Soft Tissue Healing.

BACKGROUND: Vascular endothelial growth factor (VEGF) production in dermal wounds has been evaluated for evidence that it plays a probable role in wound healing. Events such as increased vascular permeability and concentration of inflammatory cells on the site of injury, produced by VEGF, were linked to tissue repair. AIM: The present study aimed to evaluate the effects of single-dose topical administration of VEGF on wound healing. MATERIALS AND METHODS: A total of 30 male Wistar albino rats weighing 250-280 g were used in this study. In addition, 2-cm-long skin incisions were created over bilaterally exposed skin of the tibia region in each rat. VEGF plasmid 2 µg was administered locally into the right side wound bed of each animal. No other procedure besides skin closure was administered on the left side. To determine histologic assessments, skin samples were obtained from six anesthetized rats at each interval (4, 8, 12, 16 and 30 days) through excisional biopsy. The tissues were fixed in 10% neutral-buffered formalin for 1 week and then embedded in paraffin wax. Transverse sections of the embedded tissue 5-7 µm thick were stained with hematoxylin and eosin (H and E). RESULTS: There was no significant difference regarding necrosis, epithelialization, inflammation, fibroblast activity, ulcerative formation, or hemorrhage between experimental and control groups. No statistically significant difference was found between the groups regarding granulation tissue formation and epidermal thickness. CONCLUSION: The administration method and dosage of VEGF is a major factor in terms of its effectiveness. The results of the present study did not evaluate the effectiveness of single-dose 2 µg topical administration of VEGF; however, various doses of VEGF plasmid should be tested in future studies in order to provide beneficial effects from topical administration of VEGF.

Horizontal migration of pre- and postnatal mental foramen: an anatomic study.

OBJECTIVE: To evaluate the horizontal migration of the human mental foramen before and after birth. METHODS: 54 formalin-fixed fetuses between 17 and 32 weeks of gestation, and 94 panoramic radiographs of children aged between 4 and 12 years were investigated. The distances between the mental foramen and mental symphysis, and the distances between the posterior border of the mandibular ramus and mental foramen were determined according to development periods. RESULTS: Our results confirm that the mental foramen moves in a posterior direction during the development of the mandible. CONCLUSION: The horizontal location of the pre- and postnatal mental foramen changes in a posterior direction as the development progresses, however, prenatal mental foramen features an irregular behavior, while the postnatal mental foramen gradually migrates posteriorly in a regular pattern.

A Morphometric Study of the Maxillary Artery and Lingula in Relation to Mandibular Ramus Osteotomies and TMJ Surgery.

OBJECTIVES: Mandibular osteotomies and resection of the temporomandibular joint (TMJ) ankylosis are the mostly performed surgical procedures in the infratemporal fossa, which is in close proximity with the main trunk of the maxillary artery (MA). It is imperative to avoid the trunk or branches of the maxillary artery, otherwise, massive intraoperative or postoperative hemorrhage may develop. The goal of the study was to investigate the position of the maxillary artery in the infratemporal fossa and the lingula of the mandible. METHODS: Significant landmarks were selected on the mandibles of formalin fixed cadavers, and the distances were measured between the maxillary artery and the bony landmarks with a digital caliper. RESULTS: The average distances between the MA and the articular eminence, the medial cortex of the mandibular ramus, the inferior border of the pterygoid fovea and the mandibular notch were 1.67+/-0.48 mm, 5.38+/-2.47 mm, 16.84+/-1.74 mm, 2.94+/-0.52 mm, respectively. Course pattern of the MA at the subcondylar level was also mapped. In order to determine the position of the lingula, the average distances between the tip of the lingula and the mandibular notch, the inferior border of the ramus, the anterior margin of the ramus and posterior margin of the ramus were measured and found as 15.4+/-2.1 mm, 49.5+/-4.3 mm, 18.1+/-2.7 mm, 16.6+/-2.5 mm, respectively. No significant differences were found between the right and left sides, for all parameters. CONCLUSIONS: The studied parameters will assist and navigate clinicians to determine the anatomic proximity to the maxillary artery, and, minimize the risk of damaging the vessel.

Accessory mental foramen.

CONTEXT: Accessory mental foramen is a rare anatomical variation. Even so, in order to avoid neurovascular complications, particular attention should be paid to the possible occurrence of one or more accessory mental foramen during surgical procedures involving the mandible. CASE REPORT: A 3-dimensional computed tomography (3D-CT) scan of a female patient revealed an accessory mental foramen on the right side of her mandible. CONCLUSION: A 3D-CT scan should be obtained prior to mandibular surgeries so that the presence of accessory mental foramen can be detected, and so that the occurrence of a neurosensory disturbance or hemorrhage can be avoided. Although this anatomical variation is rare, it should be kept in mind that an accessory mental foramen may exist.