Objectives The shape of the anterior region of the maxilla is critical when planning implant treatment. The purpose of the present study was to assess the typical morphology of the incisive canal and surrounding bone. Methods In total, 70 maxillae of Japanese dry skulls were used after being divided into dentate and edentulous groups. Cone-beam computed tomography (CBCT) images of the maxilla were acquired by using standardized methods. Using the anterior nasal spine as a reference point, the change in position was measured and analyzed statistically. Also, three-dimensional (3-D) images of the incisive canal were classified into five subsets: cylinder, groove, penetration, bifurcation at the superior portion, and bifurcation at the inferior portion. Results The quantity of alveolar bone in the incisor region was greatly reduced from the alveolar ridge and labial surface. Moreover, the vertical position of the incisive foramen was significantly (P \ 0.05) superior in the edentulous groups. Regarding the classification of maxillae by the 3-D shape of the incisive canal, many canals were cylindrical. Conclusions Horizontal bone reduction from the labial side and vertical bone reduction from the alveolar crest were conspicuous; thus, the angle of the anterior alveolar bone changed after the loss of teeth. The incisive canal diameter in the edentulous group was larger than in the dentate group. The nondestructive assessment of the incisive canals and surrounding bone with CBCT showed two typical shapes for the presence or absence of the incisors. These findings indicate the importance of image diagnosis before esthetic restoration.
The mental artery displays several branches internal to the anterior region of the mandible as confirmed by macroscopic observation and computed tomography. The inferior alveolar artery formed complex branches and divided into mental and incisive branches, which were found in the right internal side of the mandible of one male cadaver (88 years old). The branches of these two arteries ran through the bony lingual canal to the lingual foramen between the canine and premolar region of the inner surface of the mandible body, where they emerged to enter the mylohyoid and anterior belly of the digastric muscles and communicate with the submental artery. The observation of the anastomotic artery is considered important for surgical placement of dental implants in the mandibular region.
The width and morphology of the mandible with impacted teeth and the location of the mandibular canal at the third molar region could be clearly determined using cross-sectional CBCT images.
The discomallear ligament (DML) runs through a narrow space of bony petrotympanic fissure, which joins the articular disc of the temporomandibular joint (TMJ) and the malleus in the tympanic cavity. Previous report suggest that an anatomical feature gives rise to TMJ pain and dysfunction. Recently, the movement of the malleus caused by hypertension on the discomallear ligament is important to the function of the TMJ. The purpose of this study is to define its morphological features using the cone beam CT (CBCT) and anatomical dissection of Japanese cadavers. Petrotympanic fissure and DML were observed in 14 cadavers (eight males and six females). It is revealed that a wide tunnel-like structure was found on CBCT images in the middle region of the petrotympanic fissure to the malleus in the tympanic cavity consisting of mainly three types: a wide tunnel-shaped structure (29.2%, 7/24, type 1), a tunnel-shaped structure widely open in the entrance of the petrotympanic fissure to the mandibular fossa and gradually thinning out in the tympanic cavity (20.8%, 5/24, type 2), and a tunnel-shaped structure widely open in the entrance of the mandibular fossa, middle region with flat-shaped tunnel structure and narrow exit in the tympanic cavity (41.7%, 10/24, type 3). These structures between the entrance of the petrotympanic fissure and the exit at the tympanic cavity are important to define the limited movement of the malleus. Therefore, morphological feature of the ligaments in malleus may relate to TMJ pain, dysfunction and hearing function.
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