Effectiveness of Piezoelectric Surgery in Preparing the Lateral Window for Maxillary Sinus Augmentation in Patients with Sinus Anatomical Variations: A Case Series

Purpose: The present article sought to evaluate the effectiveness of a piezoelectric surgical unit for maxillary sinus augmentation surgeries in avoiding perforation of the sinus membrane and other possible procedural complications in patients with anatomical variations of the sinus. Materials and Methods: Twenty-five patients presenting sinus anatomical variations, who were indicated for a total of 40 sinus grafting procedures performed by the lateral window approach with a piezoelectric device, were analyzed. After 6 months of healing, implants were placed. Information collected included clinical and computed tomographic information on anatomical variations in the sinus bone walls, in the size of the sinus, and in the thickness of the sinus membrane. Occurrence of sinus membrane perforation and computed tomographic measurements of the amount of bone height gained with the grafting procedures were also recorded. Results: Only two patients presented a small perforation (less than 5 mm in diameter) of the sinus membrane, which occurred only after osteotomies of the lateral windows and did not compromise the surgical outcome. No implants were lost during a mean follow-up period of 19 months. Conclusion: The use of piezoelectric surgery allowed for the accomplishment of all rehabilitation treatments within the follow-up period of this study. INT J ORAL MAXILLOFAC IMPLANTS 2012;27:1211-1215

Neurovascular anatomical variations in the anterior palate observed on CBCT images

Objective: This study aimed to assess the presence of additional foramina and canals in the anterior palate region, through cone beam computed tomography (CBCT) images, describing their location, direction, and diameter. Materials & Methods: CBCT exams of 178 subjects displaying the anterior maxilla were included and the following parameters were registered: gender; age group; presence of additional foramina in the anterior palate (AFP) with at least 1 mm in diameter; location and diameter of AFP; and direction of bony canals associated with AFP. Results: Twenty-eight patients (15.7%) presented AFP and in total 34 additional foramina were registered. No statistical differences between patients with or without AFP were found for gender or age. The average diameter of AFP was 1.4 mm (range from 1 to 1.9 mm). Their location was variable, with most of the cases occurring in the alveolar process near the incisors or canines (n = 27). In 18 cases, AFP was associated with bony canals with upward or oblique direction toward the anterior nasal cavity floor. In 14 cases, the canal presented as a direct extension of the canalis sinuosus, in an upward direction laterally to the nasal cavity aperture. In two cases, the canal was observed adjacent to the incisive and joined the nasopalatine canal superiorly. Discussion: CBCT images have a crucial role in the recognition of anatomical variations by allowing detailed tridimensional evaluations. Additional foramina and canals in the anterior region of the upper jaw are relatively frequent. Practitioners should be aware and trained to identify these variations. Conclusions: Over 15% of the population studied had additional foramina in the anterior palate, between 1 mm and 1.9 mm wide, with variable locations. In most cases the canals associated with these foramina either presented as a direct extension of the canalis sinuosus, or coursed towards the nasal cavity floor.

Assessment of variations of the mandibular canal through cone beam computed tomography

The neurovascular bundle may be vulnerable during surgical procedures involving the mandible, especially when anatomical variations are present. Increased demand of implant surgeries, wider availability of three-dimensional exams, and lack of clear definitions in the literature indicate that features of anatomical variations should be revisited. The objective of the study was to evaluate features of anatomical variations related to mandibular canal (MC), such as bifid canals, anterior loop of mental nerve, and corticalization of MC. Additionally, bone trabeculation at the submandibular gland fossa region (SGF) was assessed and related to visibility of MC. Cone beam computed tomography exams from 100 patients (200 hemimandibles) were analyzed and the following parameters were registered: diameter and corticalization of MC; trabeculation in SGF region; presence of bifid MC, position of bifurcations, diameter, and direction of bifid canals; and measurement of anterior loops by two methods. Corticalization of the MC was observed in 59% of hemimandibles. In 23%, MC could be identified despite absence of corticalization. Diameter of MC was between 2.1 and 4 mm for nearly three quarters of the sample. In 80% of the sample trabeculation at the SGF was either decreased or not visible, and such cases showed correlation with absence of MC corticalization. Bifid MC affected 19% of the patients, mostly associated with additional mental foramina. Clinically significant anterior loop (> 2 mm of anterior extension) was observed in 22-28%, depending on the method. Our findings, together with previously reported limitations of conventional exams, draw attention to the unpredictability related to anatomical variations in neurovascularization, showing the contribution of individual assessment through different views of three-dimensional imaging prior to surgical procedures in the mandible.

Extensor indicis brevis Muscle: an Unusual Muscular Variant

Knowledge of anatomical variations of the musculoskeletal system is important for interpreting unusual clinical presentations. We observed the presence of an abnormal extensor indicis muscle in the left hand of an adult male cadaver. In this case, the muscle comes from the ligament and over the scaphoideum and trapezoideum bones and continues after the short muscle belly; it is attached to the dorsal aponeurosis of the indicis. This muscular disposition was described in other studies which demonstrated approximately 1.0% of incidence. Clinically, this anatomical variation may be associated with pain and swelling at the back of the hand. In these cases symptoms tend to increase due to mechanical stress and can be confused with the presence of a dorsal synovial cyst. This report will help clinicians, surgeons, occupational and physical therapists formulate better clinical or surgical decisions when presented with a rare anatomical variation.

Spatio-temporal variations in the diet and stable isotope composition of the Argentine hake Merluccius hubbsi Marini, 1933 of the continental shelf of southeastern Brazil

The feeding ecology of Merluccius hubbsi was investigated in 2 regions of SE Brazil. The major food sources for the hakes were fish, crustaceans, and squid. In the upwelling system of Cabo Frio, the diet was very similar in the summers of 2001/2002 and spring 2002; fish were the most important prey followed by crustaceans. In Ubatuba, euphausiids were an important prey during the winter 2001 (100 m), while in the summer 2002, fish and amphipods predominated in the diet in the shallower site (40 m) and squid in the deeper site (100 m). The hakes showed temporal differences in stable isotope signatures in both regions, while C:N ratios varied only in Cabo Frio. delta(15)N and delta(13)C (bulk and corrected for lipid content) increased with fish length, which seems to be related to the increasing importance of fish and decreasing importance of euphausiids and amphipods in the diet of larger hakes. The mean trophic level of 3.7 for M. hubbsi was estimated using delta(15)N of bivalves as baseline and the fractionation of 3.4aEuro degrees between trophic levels.

Cone photopigment variations in Cebus apella monkeys evidenced by electroretinogram measurements and genetic analysis

We investigated the color vision pattern in Cebus apella monkeys by means of electroretinogram measurements (ERG) and genetic analysis. Based on ERG we could discriminate among three types of dichromatic males. Among females, this classification is more complex and requires additional genetic analysis. We found five among 10 possible different phenotypes, two trichromats and three dichromats. We also found that Cebus present a new allele with spectral peak near 552 nm, with the amino acid combination SFT at positions 180, 277 and 285 of the opsin gene, in addition to the previously described SYT, AFT and AFA alleles. (C) 2009 Elsevier Ltd. All rights reserved.

Anatomical description of Solen cf. exiguus DUNKER from Thailand (Bivalvia: Solenidae)

An anatomical description of the solenid Solen cf. exiguus DUNKER 1862, collected in the Gulf of Thailand, is provided. The anatomical features include high antero-posterior elongation; mantle lobes widely fused with each other; powerful pallial muscles; fused siphons with capacity of autotomy; wide and partially hollow foot; complete separation between gastric style sac and adjacent portion of intestine; all possible common characters of the family. Some so far exclusive attributes include short anterior pallial tentacles; pair of muscular valves at base of siphons; and arrangement of tentacles at siphonal tip. A short discussion on the taxonomy of the Solen exiguus/leanus complex is also included.

COMPARATIVE ANATOMICAL STUDY OF TWO SPECIES OF SEMELE FROM THAILAND (BIVALVIA: TELLINOIDEA)

An anatomical description of two semelids from Thailand is presented, based on samples from Kungkrabaen Bay, Gulf of Thailand. The species are Semele sinensis A. Adams, 1853, and S. carnicolor (Hanley, 1845), both with Indo-Pacific distributions. Morphology in these two species is typically tellinoidean, each with a long internal ligamental element (resilium), a distance between the inner fold of the mantle edge and the other two folds, long and branched gastric ducts to the digestive diverticula, and a stomach diverticulum located in the posterodorsal corner of the gastric chamber, projecting posteriorly. The main anatomical differentiation between the two species is in the character of the labial palps.