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.

Variations in jaw bone neurovascularisation must be identified to decrease the potential risk for haemorrhages and neural disturbances during surgical procedures such as implant placement and orthognatic surgeries. The aim of this study is to characterise additional mental foramina (AMF) through cone beam computed tomography (CBCT) images, by describing their frequency, size, location and direction of their associated bony canals, as well as to assess their corresponding ipsilateral and contralateral mental foramina (MF). CBCT images from 285 patients were analysed. Prevalence of AMF was 9·4%. From 0 to 2 AMF were observed, with two bilateral cases. Two cases of unilateral absence of MF were registered. Patients presenting AMF did not differ significantly from those without AMF regarding gender, age or ethnicity. Diameters of AMF and their corresponding ipsilateral and contralateral MF were 1·9 mm (±0·7 mm), 3·8 mm (±0·6 mm) and 4·1 mm (±0·6 mm), respectively. Ratios between diameters of AMF and corresponding ipsilateral MF ranged between 0·24 and 0·99. Location of AMF was variable, with most cases located posteriorly, posterior-inferiorly, posterior-superiorly or anterior-superiorly to their respective MF. Significant anatomical variability regarding neurovascularisation was observed among patients and CBCT examinations presented as a valuable tool for individually assessing these anatomical features.

Objective The aim of this study was to evaluate the effectiveness of clinical criteria for the diagnosis of hyposalivation in hospitalized patients. Material and Methods A clinical study was carried out on 145 subjects (48 males; 97 females; aged 20 to 90 years). Each subject was clinically examined, in the morning and in the afternoon, along 1 day. A focused anamnesis allowed identifying symptoms of hyposalivation, like xerostomia complaints (considered as a reference symptom), chewing difficulty, dysphagia and increased frequency of liquid intake. Afterwards, dryness of the mucosa of the cheecks and floor of the mouth, as well as salivary secretion during parotid gland stimulation were assessed during oral examination. Results Results obtained with Chi-square tests showed that 71 patients (48.9%) presented xerostomia complaints, with a significant correlation with all hyposalivation symptoms (p<0.05). Furthermore, xerostomia was also significantly correlated with all data obtained during oral examination in both periods of evaluation (p<0.05). Conclusion Clinical diagnosis of hyposalivation in hospitalized patients is feasible and can provide an immediate and appropriate therapy avoiding further problems and improving their quality of life.

Sialolithiasis is a pathologic condition that affects 60 million people per year, which is caused by the presence of calcified structures, named sialoliths, inside the salivary glands and their salivary ducts. Despite the large incidence of sialolithiasis, its etiology is still unknown. In the present case report, a 47-year-old female patient, presenting with local pain and hampered mouth opening, underwent a surgical approach for the removal of a 20 mm sialolith, which was further analyzed through X-ray diffraction. In parallel, a radiographic registration of 8 years, covering all the period for sialolith formation, is presented along the case report.

Bisphosphonates are extensively used to treat bone metabolism disorders; meanwhile, these drugs have important side effects such as jaw osteonecrosis and femoral fracture. Therefore, studies have been conducted aimed at better understanding their mechanism of action and determining a course of action to avoid these side effects. We present here a literature review focusing on the laboratory methods available for investigating bisphosphonate effects on body tissues. There are many different methods available for this purpose, but the appropriate application of these methods and knowledge of their limitations are crucial for understanding the effects of bisphosphonates.

ObjectivesThe aim of this pilot study was to evaluate the effectiveness of cutting needle biopsy in the diagnosis of solid oral lesions.Material and MethodsThe biopsies were carried out on seven patients who presented with solid oral lesions with sizes ranging from 2 to 6 cm. Specimens were obtained from each lesion before conventional biopsies using a cutting needle with 18-gauge x 9 cm (MD TECH, Gainesville, FL, USA). A total of 64 specimens processed by hematoxylin-eosin staining method, were obtained. Afterwards, the analysis was performed by an oral pathologist, in two different stages, with and without the clinical history of each lesion. Then, these answers were compared with the final histological diagnosis.ResultsResults presented by the descriptive analysis showed that the correct diagnosis using cutting needle biopsy without the clinical history of lesions was registered in 37.5% of cases, while with the clinical history in 76.6%.ConclusionsDespite the promising results as a potential technique for biopsies and histological diagnosis of oral lesions, the cutting needle biopsy should be analyzed carefully in those cases.

Males with atherosclerosis of their carotid arteries as evidenced by PIs displaying calcified atheromas are significantly more likely to evidence a DELC+ than those without an imaged atheroma.

To the Editor Analgesia for anticoagulated patients requires substituting gabapentin for ibuprofen