DOCSLIB.ORG

New Safety Margins for Chin Bone Harvesting Based on the Course Of

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
New Safety Margins for Chin Bone Harvesting Based on the Course Of Bernhard Pommer New safety margins for chin bone Gabor Tepper Andre´ Gahleitner harvesting based on the course of the Werner Zechner mandibular incisive canal in CT Georg Watzek Authors’ affiliations: Key words: augmentation, donor site morbidity, graft technique, mandibular nerve, Bernhard Pommer, Gabor Tepper, Andre´ symphysis Gahleitner, Werner Zechner, Georg Watzek, Department of Oral Surgery, Bernhard Gottlieb School of Dentistry, Medical University of Vienna, Abstract Vienna, Austria Objectives: Altered pulp sensitivity of anterior lower teeth is a frequent finding following Andre´ Gahleitner, Department of Diagnostic Radiology, Division of Osteoradiology, General chin bone harvesting. Persistent loss of tooth sensitivity has been reported in up to 20% of Hospital, Medical University of Vienna, Vienna, the patients. The aim of this study was to evaluate current recommendations for the Austria location of the harvest zone with respect to the course of the mandibular incisive canal Correspondence to: (MIC), the intrabony continuation of the mandibular canal mesial to the mental foramen. Dr Bernhard Pommer Department of Oral Surgery Material and methods: On computed tomographic (CT) scans of 50 dentate mandibles, the Bernhard Gottlieb School of Dentistry MIC was located and its distance to the root apices, to the labial bony surface, and to the Medical University of Vienna inferior margin of the mandible was assessed. The risk of nerve injury and the percentage of Waehringer Strasse 25a A-1090 patients suitable for chin bone grafting were calculated. Vienna Results: Respecting current recommendations for chin bone grafting, the content of the Austria Tel.: þ 43 1 4277 67011 MIC was endangered in 57% of the CTs. Therefore, new safety margins are suggested: the Fax: þ 43 1 4277 67019 chin bone should be harvested at least 8 mm below the tooth apices with a maximum e-mail: [email protected] harvest depth of 4 mm. Conclusions: Applying the new safety recommendations and proper patient selection in chin bone harvesting could reduce the risk of altered postoperative tooth sensitivity due to injury of the mandibular incisive nerve. Bone grafting procedures have become ductive, and nonimmunogenic properties standard care in patients with insufficient (Nkenke et al. 2002). Autotransplant bone bone volumes at potential implant recipi- grafts still provide the most rapid and pre- ent sites (Von Arx et al. 2005). Osseous dictable results in terms of resultant bone ridge deficiencies require restoration before quality and quantity (Raghoebar et al. implant surgery to enable reliable and es- 2001). A variety of extra- and intraoral thetic implant placement (Widmark et al. donor sites are available to the surgeon 1997). The need to repair dentoalveolar including the iliac crest, tibia, ribs, calvar- atrophy and bone defects has resulted in ium, zygoma, maxilla, and mandible the use of various techniques and sources of (Misch et al. 1992). The obvious advan- Date: graft material. Despite recent advances in tages of bone grafts from intraoral sites are Accepted 26 February 2008 bone-substitute technology, the use of convenient surgical access, avoidance of To cite this article: autogenous bone grafts continues to repre- cutaneous scarring, reduced operation Pommer B, Tepper G, Gahleitner A, Zechner W, Watzek G. New safety margins for chin bone harvesting based on sent the ‘gold standard’ in reconstructive time, use of local anesthesia on an out- the course of the mandibular incisive canal in CT. surgery of the oral and maxillofacial region patient basis, and therefore lower costs. Clin. Oral Impl. Res. 19, 2008; 1312–1316 doi: 10.1111/j.1600-0501.2008.01590.x because of their osteoinductive, osteocon- Furthermore, intraoral bone grafts are 1312 c 2008 The Authors. Journal compilation c 2008 Blackwell Munksgaard Pommer et al . New safety margins for chin bone harvesting favored because of the identical embryonic Jovanovic 1999). However, these safety deep) with the MIC were assessed, and the origin of donor and receptor sites, as ecto- recommendations are not based on knowl- percentage of patients carrying the risk of mesenchymal bone exhibits less resorption edge of the position and course of the nerve injury by these osteotomies was due to faster revascularization compared MIC. The aim of the present investigation calculated. The same risk estimation was with bone of mesenchymal origin (Koole was to evaluate the current safety recom- performed for harvesting bone at a distance 1994). mendations with the help of computed of 1–10 mm from the apices of the teeth. The mandibular symphysis is a very tomography (CT) and, from these results, Combining the two factors ‘depth of bone common intraoral donor site for autoge- derive strategies to prevent postoperative graft’ and ‘distance to the apices,’ the risk nous bone grafts and has been used success- sensitivity impairment in patients sub- of injuring the MIC in the generally recom- fully in a variety of clinical applications jected to chin bone harvesting. mended harvest zone (5 mm anterior to the (Raghoebar et al. 2001). The chin graft mental foramen, 5 mm below the tooth provides both cortical and medullary bone apices, and 5 mm above the lower border necessary for osteoinduction and osteocon- Material and methods of the mandible) was computed. Various duction (Cranin et al. 2001). The mandib- settings of these two factors were likewise ular interforaminal region is generally tested to identify the configuration Routine CT scans of 50 dentate mandibles considered a safe surgical area, involving featuring the minimal risk of nerve injury. were acquired with a conventional CT few risks of damage to vital anatomic Each setting was analyzed for sufficient scanner (Tomoscan SR-6000, Philips, structures. However, the anterior mandible symphyseal bone height for harvesting Eindhoven, the Netherlands) using a stan- contains intrabony vascular canals (Gah- bone blocks with a diameter of either 6, dard dental CT investigation protocol leitner et al. 2001; Tepper et al. 2001) as 8, or 10 mm. (1.5 mm slice thickness, 1.0 mm table well as the mandibular incisive canal feed, 120 kV, 75 mA, 2 s scan time, 100– (MIC), the intrabony continuation of the 120 mm field of view, high-resolution bone mandibular canal mesial to the mental filter). The age of the patients (18 men and Results foramen (Mardinger et al. 2000). This little 32 women) ranged between 25 and 71 noticed anatomic structure carries a major years, with a mean age of 47.2 years. The mean distance (Æ standard deviation) neurovascular bundle, the mandibular in- Exclusion criteria involved poor visibility of the MIC to the apices of the first pre- cisive nerve, and accompanying vessels, for of the MIC in CTand partial edentulism or molar, the canine, the lateral, and middle innervation and vascular supply of the pathologic findings in the interforaminal incisor amounted to 5.6 Æ 2.4, 5.2 Æ 2.4, lower anterior dentition, i.e. incisors, ca- region. Orthoradial images were refor- 6.6 Æ 2.4, and 5.3 Æ 2.2 mm, respec- nine, and first premolar (De Andrade et al. matted from the axial slices bilaterally at tively. The mean distances of the MIC to 2001). Therefore, the position of the MIC the position of the middle and lateral the labial bony surface of the mandible at has to be kept in mind during chin bone incisor, the canine, and the first premolar. these positions were 3.4 Æ 1.1, 4.2 Æ 1.5, harvesting procedures (Obradovic et al. 1993). On these reformatted images, the MIC was 4.2 Æ 1.5, and 4.4 Æ 1.4 mm, respec- Even though the mandibular symphysis located and the following distances were tively. The distance of the MIC to the is considered to have an excellent risk– assessed: (a) distance from the MIC to the lower margin of the symphysis averaged benefit ratio, frequent complications have tooth apex, (b) distance from the MIC to 10.7 Æ 1.9, 10.3 Æ 2.2, 11.1 Æ 2.5, and been described following chin bone har- the labial bony surface, and (c) distance 14 Æ 2.8 mm, respectively. No statisti- vesting (Hoppenreijs et al. 1992; Nkenke from the MIC to the lower margin of the cally significant difference between the et al. 2001). Donor site morbidity involves symphysis (Fig. 1). Measurements were left and the right patient side was observed intraopertive bleeding, wound dehiscence, performed by two independent observers (P40.05). mental nerve injury, pulp canal oblitera- (B. P. and G. T.) using the Easy Vision Table 2 demonstrates the positive corre- tion, as well as loss of pulp sensitivity of Workstation (Philips) with a technical ac- lation between the depth of the bone graft the anterior lower teeth, the latter repre- curacy of 0.1 mm and a maximum inter- and the risk of nerve injury, and the nega- senting neuropraxia of the mandibular in- observer variability of 0.5 mm. tive correlation between the distance to the cisive nerve (Raghoebar et al. 2001). Utilizing these data, possible interfer- root apices and the risk of nerve injury. Review of the literature shows that nega- ences of imaginary osteotomies (1–10 mm Table 3 shows that application of the current tive pulp sensitivity has been reported postoperatively in up to 80% of patients after chin bone harvesting. Up to 20% of Table 1. Prospective studies reporting postoperative and persistent loss of sensitivity in patients demonstrated persistent loss of the anterior lower teeth (percentage per patient) after chin bone harvesting tooth sensitivity (Table 1). These neurosen- Publication Sample size Postoperative (%) Persistent (%) sory disturbances occurred while respecting Chiapasco et al. (1999) 15 80 13.3 the generally recommended safety margins Do¨ rtbudak et al. (2002) 31 32.3 6.5 defining the harvest zone as being 5 mm Joshi (2004) 27 18.5 7.4 anterior to the mental foramen, 5 mm Misch (1997) 31 29 0 Nkenke et al.
Load more

Recommended publications
  • The Cat Mandible (II): Manipulation of the Jaw, with a New Prosthesis Proposal, to Avoid Iatrogenic Complications
    animals Review The Cat Mandible (II): Manipulation of the Jaw, with a New Prosthesis Proposal, to Avoid Iatrogenic Complications Matilde Lombardero 1,*,† , Mario López-Lombardero 2,†, Diana Alonso-Peñarando 3,4 and María del Mar Yllera 1 1 Unit of Veterinary Anatomy and Embryology, Department of Anatomy, Animal Production and Clinical Veterinary Sciences, Faculty of Veterinary Sciences, Campus of Lugo—University of Santiago de Compostela, 27002 Lugo, Spain; [email protected] 2 Engineering Polytechnic School of Gijón, University of Oviedo, 33203 Gijón, Spain; [email protected] 3 Department of Animal Pathology, Faculty of Veterinary Sciences, Campus of Lugo—University of Santiago de Compostela, 27002 Lugo, Spain; [email protected] 4 Veterinary Clinic Villaluenga, calle Centro n◦ 2, Villaluenga de la Sagra, 45520 Toledo, Spain * Correspondence: [email protected]; Tel.: +34-982-822-333 † Both authors contributed equally to this manuscript. Simple Summary: The small size of the feline mandible makes its manipulation difficult when fixing dislocations of the temporomandibular joint or mandibular fractures. In both cases, non-invasive techniques should be considered first. When not possible, fracture repair with internal fixation using bone plates would be the best option. Simple jaw fractures should be repaired first, and caudal to rostral. In addition, a ventral approach makes the bone fragments exposure and its manipulation easier. However, the cat mandible has little space to safely place the bone plate screws without damaging the tooth roots and/or the mandibular blood and nervous supply. As a consequence, we propose a conceptual model of a mandibular prosthesis that would provide biomechanical Citation: Lombardero, M.; stabilization, avoiding any unintended (iatrogenic) damage to those structures.
    [Show full text]
  • Why Fuse the Mandibular Symphysis? a Comparative Analysis
    AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 112:517–540 (2000) Why Fuse the Mandibular Symphysis? A Comparative Analysis D.E. LIEBERMAN1,2 AND A.W. CROMPTON2 1Department of Anthropology, George Washington University, Washington, DC 20052, and Human Origins Program, National Museum of Natural History, Smithsonian Institution, Washington, DC 20560 2Museum of Comparative Zoology, Harvard University, Cambridge, Massachusetts 02138 KEY WORDS symphysis; mammals; primates; electromyograms; mandible; mastication ABSTRACT Fused symphyses, which evolved independently in several mammalian taxa, including anthropoids, are stiffer and stronger than un- fused symphyses. This paper tests the hypothesis that orientations of tooth movements during occlusion are the primary basis for variations in symph- yseal fusion. Mammals whose teeth have primarily dorsally oriented occlusal trajectories and/or rotate their mandibles during occlusion will not benefit from symphyseal fusion because it prevents independent mandibular move- ments and because unfused symphyses transfer dorsally oriented forces with equal efficiency; mammals with predominantly transverse power strokes are predicted to benefit from symphyseal fusion or greatly restricted mediolateral movement at the symphysis in order to increase force transfer efficiency across the symphysis in the transverse plane. These hypotheses are tested with comparative data on symphyseal and occlusal morphology in several mammals, and with kinematic and EMG analyses of mastication in opossums (Didelphis virginiana) and
    [Show full text]
  • Identification Notes &~@~-/~: ~~*~@~,~ 'PTILE
    CATEGORY Identification Notes &~@~-/~: ~~*~@~,~ ‘PTILE for wildlife law enforcement ~ C.rnrn.n N.rn./s: Al@~O~, c~~~dil., ~i~.xl, Gharial PROBLEM: Skulls of Crocodilians are often imported as souvenirs. nalch (-”W 4(JI -“by ieeth ??la&ularJy+i9 GUIDE TO PRELIMINARY IDENTIFICATION OF CROCODILL4N SKULLS 1. Nasal bones separated from nasal aperture; mandibular symphysis extends to the 15th tooth. 2. Gavialis gangeticus Nasal bones entering the nasal aperture; mandibular symphysisdoes not extend beyond the8th tooth . Tomistoma schlegelii 2. Nasal bones separated from premaxillary bones; 27 -29maxi11aryteeth,25 -26mandibularteeth Nasal bones in contact with premaxillaq bo Qoco@khs acutus teeth, 18-19 mandibular teeth . Tomiitomaschlegelii 3. Fourth mandibular tooth usually fitting into a notch in the maxilla~, 16-19 maxillary teeth, 14-15 mandibular teeth . .4 Osteolaemus temaspis Fourth mandibular tooth usually fitting into a pit in the maxilla~, 14-20 maxillary teeth, 17-22 mandibular teeth . .5 4. Nasal bones do not divide nasal aperture. .. CrocodylW (12 species) Alligator m&siss@piensh Nasalboncx divide nasal aperture . Osteolaemustetraspk. 5. Nasal bones do not divide nasal aperture. .6 . Paleosuchus mgonatus Bony septum divides nasal aperture . .. Alligator (2 species) 6. Fiveteethinpremaxilla~ bone . .7 . Melanosuchus niger Four teeth in premaxillary bone. ...Paleosuchus (2species) 7. Vomerexposed on the palate . Melanosuchusniger Caiman crocodiles Vomer not exposed on palate . ...”..Caiman (2species) Illustrations from: Moo~ C. C 1921 Me&m, F. 19S1 L-.. Submitted by: Stephen D. Busack, Chief, Morphology Section, National Fish& Wildlife Forensics LabDate submitted 6/3/91 Prepared in cooperation with the National Fkh & Wdlife Forensics Laboratoy, Ashlar@ OR, USA ‘—m More on reverse side>>> IDentMcation Notes CATEGORY: REPTILE for wildlife law enforcement -- Crocodylia II CAmmom Nda Alligator, Crocodile, Caiman, Gharial REFERENCES Medem, F.
    [Show full text]
  • Illustrated Review of the Embryology and Development of the Facial
    REVIEW ARTICLE Illustrated Review of the Embryology and Development of the Facial Region, Part 2: Late Development of the Fetal Face and Changes in the Face from the Newborn to Adulthood P.M. Som and T.P. Naidich ABSTRACT SUMMARY: The later embryogenesis of the fetal face and the alteration in the facial structure from birth to adulthood have been reviewed. Part 3 of the review will address the molecular mechanisms that are responsible for the changes described in parts 1 and 2. art 1 of this 3-part review primarily dealt with the early em- first make contact, each is completely covered by a homoge- Pbryologic development of the face and nasal cavity. Part 2 will neous epithelium. A special epithelium arises at the edge of discuss the later embryonic and fetal development of the face, and each palatal shelf, facilitating the eventual fusion of these changes in facial appearance from neonate to adulthood will be shelves. The epithelium on the nasal cavity surface of the palate reviewed. will differentiate into columnar ciliated epithelium. The epi- thelium on the oral cavity side of the palate will differentiate Formation of the Palate into stratified squamous epithelium. Between the sixth and 12th weeks, the palate is formed from 3 The 2 palatal shelves also fuse with the triangular primary pal- primordia: a midline median palatine process and paired lateral ate anteromedially to form a y-shaped fusion line. The point of palatine processes (Fig 1). In the beginning of the sixth week, fusion of the secondary palatal shelves with the primary palate is merging of the paired medial nasal processes forms the intermax- marked in the adult by the incisive foramen.
    [Show full text]
  • Variation in Chin and Mandibular Symphysis Size and Shape in Males and Females: a CT-Based Study
    International Journal of Environmental Research and Public Health Article Variation in Chin and Mandibular Symphysis Size and Shape in Males and Females: A CT-Based Study Tatiana Sella Tunis 1,2,3,* , Israel Hershkovitz 1,2 , Hila May 1,2, Alexander Dan Vardimon 3, Rachel Sarig 2,3,4 and Nir Shpack 3 1 Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel; [email protected] (I.H.); [email protected] (H.M.) 2 Dan David Center for Human Evolution and Biohistory Research, Shmunis Family Anthropology Institute, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel; [email protected] 3 Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel; [email protected] (A.D.V.); [email protected] (N.S.) 4 Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel * Correspondence: [email protected]; Tel.: +972-3-640-7310 Received: 12 May 2020; Accepted: 11 June 2020; Published: 14 June 2020 Abstract: The chin is a unique anatomical landmark of modern humans. Its size and shape play an important role from the esthetic perspective. However, disagreement exists in the dental and anthropological literature regarding the sex differences in chin and symphysis morphometrics. The “sexual selection” theory is presented as a possible reason for chin formation in our species; however, many other contradictory theories also exist.
    [Show full text]
  • Printing 3D Models of Canine Jaw Fractures for Teaching Undergraduate Veterinary Medicine1
    ACTA CIRÚRGICA BRASILEIRA EDUCATION Printing 3D models of canine jaw fractures for teaching undergraduate veterinary medicine1 Agnes de Souza LimaI , Marcello MachadoII , Rita de Cassia Ribeiro PereiraIII , Yuri Karaccas de Carvalho I M.Sc., Postgraduate Program in Health and Animal Production, Universidade Federal do Acre (UFAC), Rio Branco-AC, Brazil. Acquisition, analysis and interpretation of data; manuscript preparation and writing. II D.Sc., Department of Anatomy, Universidade Federal do Paraná (UFPR), Curitiba-PR, Brazil. Scientific and intellectual content of the study. III M.Sc., Health and Sports Science Center, UFAC, Rio Branco-AC, Brazil. Technical procedures. IV D.Sc., Biological and Natural Sciences Center, UFAC, Rio Branco-AC, Brazil. Manuscript writing, critical revision, final approval. Abstract Purpose: To develop 3D anatomical models, and corresponding radiographs, of canine jaw fractures. Methods: A base model was generated from a mandibular bone scan. With this model it was possible to perform fracture planning according to the anatomical location. Results: The 3D base model of the canine mandible was similar in conformation to the natural bone, demonstrating structures such as canine tooth crowns, premolars and molars, mental foramina, body of the mandible, ramus of the mandible, masseteric fossa, the coronoid process, condylar process, and angular process. It was not possible to obtain detail of the crown of the incisor teeth, mandibular symphysis, and the medullary channel. Production of the 3D CJF model took 10.6 h, used 150.1 g of filament (ABS) and cost US$5.83. Conclusion: The 3D canine jaw fractures models, which reproduced natural canine jaw fractures, and their respective radiographic images, are a possible source of educational material for the teaching of veterinary medicine.
    [Show full text]
  • UC Berkeley Paleobios
    UC Berkeley PaleoBios Title Leidyosuchus (Crocodylia: Alligatoroidea) from the Upper Cretaceous Kaiparowits Formation (late Campanian) of Utah, USA Permalink https://escholarship.org/uc/item/0q11x9vs Journal PaleoBios, 30(3) ISSN 0031-0298 Authors Farke, Andrew A. Henn, Madison M. Woodward, Samuel J. et al. Publication Date 2014-01-30 DOI 10.5070/P9303016247 Peer reviewed eScholarship.org Powered by the California Digital Library University of California PaleoBios 30(3):72–88, January 31, 2014 © 2014 University of California Museum of Paleontology Leidyosuchus (Crocodylia: Alligatoroidea) from the Upper Cretaceous Kaiparowits Formation (late Campanian) of Utah, USA ANDREW A. FARKE,1* MADISON M. HENN,2 SAMUEL J. WOODWARD,2 and HEENDONG A. XU2 1Raymond M. Alf Museum of Paleontology, 1175 West Baseline Road, Claremont, CA 91711 USA; email: afarke@ webb.org. 2The Webb Schools, 1175 West Baseline Road, Claremont, CA 91711 USA Several crocodyliform lineages inhabited the Western Interior Basin of North America during the late Campanian (Late Cretaceous), with alligatoroids in the Kaiparowits Formation of southern Utah exhibiting exceptional diversity within this setting. A partial skeleton of a previously unknown alligatoroid taxon from the Kaiparowits Formation may represent the fifth alligatoroid and sixth crocodyliform lineage from this unit. The fossil includes the lower jaws, numerous osteoderms, vertebrae, ribs, and a humerus. The lower jaw is generally long and slender, and the dentary features 22 alveoli with conical, non-globidont teeth. The splenial contributes to the posterior quarter of the mandibu- lar symphysis, which extends posteriorly to the level of alveolus 8, and the dorsal process of the surangular is forked around the terminal alveolus.
    [Show full text]
  • Bone Quality and Quantity of the Mandibular Symphyseal Region In
    Safi et al. Head & Face Medicine (2021) 17:26 https://doi.org/10.1186/s13005-021-00282-2 RESEARCH Open Access Bone quality and quantity of the mandibular symphyseal region in autogenous bone grafting using cone- beam computed tomography: a cross- sectional study Yaser Safi1, Reza Amid2, Mahdi Kadkhodazadeh2, Hamed Mortazavi3, Mohamad Payam Sharifi4 and Shiva Gandomi1* Abstract Background: Bone volume plays a pivotal role in the success of dental implant treatment. Autogenous bone grafts should be harvested from reliable sites in the maxillofacial region. This study sought to assess the quantity and quality of bone in the mandibular symphysis for autogenous bone graft harvesting using cone-beam computed tomography (CBCT). Methods: This cross-sectional study evaluated the CBCT scans of 78 adults presenting to three oral and maxillofacial radiology centers. The vertical (VD) and horizontal (HD) alveolar bone dimensions, cortical thickness (CT), and cancellous to cortical bone ratio (C/C) were measured in the interforaminal region of the mandible at the sites of central incisor to first premolar teeth. The interforaminal distance (ID) and the anterior loop length were also measured. Nonparametric statistical tests were used to analyze the data with respect to sex, age, and tooth position. Results: The median VD, HD, and CT of the symphysis were 20.21 (3.26), 4.13 (0.37), and 2.25 (0.23) mm, respectively. The median C/C was 1.51 (0.11). The median ID was 52.24 (8.24) mm, and the median anterior loop length was 1.82 (1.06) mm. Significant differences were observed in all parameters among different teeth.
    [Show full text]
  • Supplemental Digital Content 1. Definition of Landmarks
    Supplemental Digital Content 1. Definition of landmarks Abbreviation Variable Definition A A Point point of maximum concavity in the midline of the alveolar process of the maxilla AGR/AGL Antegonial notch the highest point of the concavity of the lower border of the ramus where it joins the body of the mandible ANS Anterior nasal spine the tip of the median, sharp bony process of the maxilla at the lower margin of the anterior nasal opening ARR/ARL Articulare the most posterior point of the mandibular condyle B B Point point of maximum concavity in the midline of the alveolar process of the mandible BA Basion most inferior and posterior point on the most anterior margin of the foramen magnum COR/COL Condylion most posterosuperior point of each mandibular condyle in the sagittal plane Corneae R/L Corneae the most anterior point of cornea ES Ethmo-sphenoid most superior point of the suture between ethmoid and sphenoid at the midline FZR/FZL Frontozygomatic Point the most medial and anterior point of each frontozygomatic suture at the level of the lateral orbital rim halfway between pogonion and menton on the symphysis, it is the most anterior/inferior point of the symphysis of the Gn Gnathion mandible point on the mandibular angle representing the intersection of the lines of the posterior ramus and the inferior border of GOR/GOL Gonion the mandible JR/JL J point the deepest point in the concavity of the maxilla on both sides Men Menton most inferior midpoint of the chin on the outline of the mandibular symphysis N Nasion Junction of the frontonasal suture at the most posterior point on the curve at the bridge of the nose NcR/L Nasal cavity point nasal cavity widest points OFR/OFL Optic foramen point the midpoint of the rim of optic foramen OP Opisthion posterior midsagittal point on the posterior margin of foramen magnum ORR/L Orbitale most inferior point of each infraorbital rim PNS Posterior Nasal Spine most posterior midpoint of the posterior nasal spine of the palatine bone.
    [Show full text]
  • Understanding Primate Mandibular Symphyseal Fusion: Function, Integration, and Ontogeny
    UNDERSTANDING PRIMATE MANDIBULAR SYMPHYSEAL FUSION: FUNCTION, INTEGRATION, AND ONTOGENY A DISSERTATION SUBMITTED TO THE FACULTY OF THE UNIVERSITY OF MINNESOTA BY RYAN P. KNIGGE IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY DR. KIERAN P. MCNULTY December 2017 @ Ryan P. Knigge 2017 Acknowledgements First, I am deeply indebted to my advisor and mentor, Kieran McNulty, for many years of patience and support. He opened my eyes to exciting and innovative areas of scientific research and has challenged me to become a better student of anthropology, biology, and statistical practices. I am also particularly grateful for my committee members, Martha Tappen, Michael Wilson, and Alan Love, for so many interesting discussions and insights over the years. I thank the Department of Anthropology and my many friends and colleagues within for years of emotional and academic support. Many data collection and field work trips were funded through department block grants. Surely without these contributions, I would not have been able to succeed as a graduate student. I would like thank the previous and current managers of the Evolutionary Anthropology Labs at the University of Minnesota, John Soderberg and Matt Edling, for access to the collections and technical support. Without their help and generosity, data collection and analysis would not have been possible. I thank the University of Minnesota for supporting my research in many ways during my graduate school career. Portions of my data collection were funded through the University of Minnesota Graduate School Thesis Research Travel Grant. Dissertation writing support was provided through the Doctoral Dissertation Fellowship.
    [Show full text]
  • Resident Manual of Trauma to the Face, Head, and Neck
    Resident Manual of Trauma to the Face, Head, and Neck First Edition ©2012 All materials in this eBook are copyrighted by the American Academy of Otolaryngology—Head and Neck Surgery Foundation, 1650 Diagonal Road, Alexandria, VA 22314-2857, and are strictly prohibited to be used for any purpose without prior express written authorizations from the American Academy of Otolaryngology— Head and Neck Surgery Foundation. All rights reserved. For more information, visit our website at www.entnet.org. eBook Format: First Edition 2012. ISBN: 978-0-615-64912-2 Preface The surgical care of trauma to the face, head, and neck that is an integral part of the modern practice of otolaryngology–head and neck surgery has its origins in the early formation of the specialty over 100 years ago. Initially a combined specialty of eye, ear, nose, and throat (EENT), these early practitioners began to understand the inter-rela- tions between neurological, osseous, and vascular pathology due to traumatic injuries. It also was very helpful to be able to treat eye as well as facial and neck trauma at that time. Over the past century technological advances have revolutionized the diagnosis and treatment of trauma to the face, head, and neck—angio- graphy, operating microscope, sophisticated bone drills, endoscopy, safer anesthesia, engineered instrumentation, and reconstructive materials, to name a few. As a resident physician in this specialty, you are aided in the care of trauma patients by these advances, for which we owe a great deal to our colleagues who have preceded us. Additionally, it has only been in the last 30–40 years that the separation of ophthal- mology and otolaryngology has become complete, although there remains a strong tradition of clinical collegiality.
    [Show full text]
  • Laboratory 1 Worksheet: the Skull Objective: Learn About The
    Skull_Skeleton_Lab3.doc 09/15/09 page 1 of 48 Laboratory 1 Worksheet: The Skull Objective: Learn about the mammalian skull, and be able to define and/or identify on a specimen all underlined terms. Assignment: Turn in two photos/drawings of a skull with bones and structures labeled. Use a skull of a coyote (Canis latrans) or red fox (Vulpes vulpes) and identify the following bones and other features. Canids have a fairly "primitive" skull large enough to identify different bones. For comparative purposes other skulls are shown in the figures to illustrate differences among groups or features missing from the canid skull. After identifying features on a canid skull, you should be able to find the same bones or features on skulls of other mammals. Main features of mammal skulls are the zygomatic arches (the bars on both sides of the skull) under which the jaw muscles reach from the lower jaw to the back of the head, a secondary palate that separates the mouth from the nasal passages, and a mandible (lower jaw) consisting of a single dentary bone on the left and right sides. Cranium The cranium is divided into two regions: braincase and rostrum. The braincase, more developed in mammals than in other vertebrates, contains the brain. The rostrum corresponds to the snout or muzzle. Dorsal aspect of the cranium.—Bones seen from a dorsal aspect on a canid skull are shown in Fig. 3. The nasal bones are paired bones forming a “roof” over the nasal passages. The paired premaxillary bones form the lower margin of the nasal openings (nares) and the anteriormost part of the bony palate at the anterior upper jaw.
    [Show full text]