Recent studies investigating accessory mental foramina using developments in diagnostic imaging have primarily defined the morphology of the foramina; however, few studies have described the structures passing through them. Additional clinical knowledge of the foramina is therefore required for preoperative diagnosis prior to surgery, including implant, periodontal and periapical surgery. In this study, we investigated the accessory mental foramina and the associated nerves and arteries in donated cadaveric mandibles using anatomical and radiological observation methods. We examined 63 mandibles with overlying soft tissue by cone-beam computed tomography and noted the existence of the accessory mental foramina. Mandibles with accessory mental foramina were subsequently analyzed. Additionally, the neurovascular bundles passing through these foramina were dissected using anatomical methods.The incidence of accessory mental foramina was 14.3%. The larger foramina tended to be located anteriorly or superiorly and proximal to the mental foramen, while the smaller foramina tended to be located posterosuperiorly and distal to the mental foramen. The mental foramen ipsilateral to the accessory mental foramen was smaller than the one contralateral to it. The comparatively distant and large accessory mental foramen included an artery.This study elucidated the relationship between accessory mental foramina and the associated nerves and arteries. We believe that the results will contribute to the clinical dentistry field.
The fabella is a sesamoid bone located in the proximal tendon of the gastrocnemius muscle. In rare cases, its presence may lead to a variety of clinical problems, including fabella syndrome and common fibular (CF) nerve palsy. The purpose of this study was to analyze the morphology of the fabella and CF nerve and discuss the influence of any existing fabellae on the size of the CF nerve. The morphology of the fabella and CF nerve in the popliteal region of the lateral head of the gastrocnemius muscle was investigated in 102 knees of 51 Japanese cadavers. The maximum circumference of the thigh, knee, and calf and the frequency, position, and size of the fabella were measured. In addition, the CF nerve width and thickness were measured proximal to the fabellar region and again as the CF nerve passed posterior, lateral, or medial to the region. A fabella was observed in 70 knees (68.6%). The CF nerve adjacent to the fabella was significantly wider and thinner than in the region proximal to the fabella (P < 0.001). In cases in which a bony fabella was present, there was a significant relationship between the thickness of the CF nerve and the circumference of the thigh and knee. The following factors were observed to contribute to the presence of a fabella causing alterations in the size of the CF nerve: a bony fabella, a CF nerve path posterior or lateral to the fabella, and subjects with a thin physique and bony fabella.
Since three-dimensional computed tomography was developed, many researchers have described accessory mental foramina. The anatomical and radiological findings have been discussed, but details of accessory mental nerves (AMNs) have only been researched in a small number of anatomical and clinical cases. For this article, we reviewed the literature relating to accessory mental foramina (AMFs) and nerves to clarify aspects important for clinical situations. The review showed that the distribution pattern of the AMN can differ according to the position of the accessory mental foramen, and the reported incidence of AMFs differs among observation methods. A review of clinical cases also revealed that injury to large AMF can result in paresthesia. This investigation did not reveal all aspects of AMNs and AMFs, but will be useful for diagnosis and treatment by many dentists and oral and maxillofacial surgeons.
To chew, it is necessary to maintain harmony between the masseter muscle and other organs. Various studies have been conducted on the masseter muscle, but none has examined the relationships among masseter muscle form, occlusal support of remaining teeth, and maxillofacial morphology. Thus, we conducted the present study using cadavers donated to anatomy practice. After the masseter muscle was extracted, its length, width, thickness, and volume were measured; histological observations were conducted; and the muscle fiber cross-sectional area and muscle density were calculated. In addition, denture use and non-use were examined. The results showed that when regional support loss occurs, muscle fiber thickness and density decrease. This in turn causes masseter muscle thickness and volume to decrease, resulting in muscle atrophy. Furthermore, excluding Eichner class A cases (all regions intact), the thickness of the masseter muscle is greatest when the premolar support region remains. The premolar support region was shown to have the most impact on masseter muscle morphology. These results suggest that atrophy of the masseter muscle can be arrested or improved with the use of dentures in the case of tooth loss.
Recent studies using cone-beam computer tomography (CBCT) have added to our understanding of anatomical variation in the mandible of humans. However, the distribution of nerves cannot be revealed by CBCT. There have been investigations of the distribution of nerves relating to the mandible, but some proposed causes of these variations remain controversial. In this study, we observed a total of 10 sides from five mandibles of Macaca fascicularis of unknown age and sex using CBCT and dissection under stereomicroscopy. Nine of the 10 sides had two mental foramina in each side. Innervation by the mental nerves depended on the locations of those foramina. The long branch to the mandibular angle ran with a branch of the facial artery, which joined the mental artery in all 10 sides. Five specimens had a median perforating canal in the mandibular bone. In addition, a branch of the sublingual artery, which joined with the small branches of the submental artery, entered the mandibular bone from the median lingual foramen. This foramen was located in the lower part of the mandibular symphysis and passed via the median perforating canal to exit from the median labial foramen, also located in the lower part of the mandibular symphysis. We speculate that the median perforating canal of the mandible, rarely found in humans, is the remnant of the feeding artery of the fetal mandible, and in M. fascicularis is seen in all specimens because they have no mental protuberance. Anat Rec, 300:1464-1471, 2017. © 2017 Wiley Periodicals, Inc.
The COVID‐19 pandemic has brought difficult times to anatomy educators and medical/dental students. Under normal circumstances, gross anatomy classes give students opportunities to touch and observe human bones and cadaveric tissues, thus enhancing their understanding; such morphology is difficult to learn from textbooks alone. As many studies have shown, three‐dimensional (3D) technologies used in online lectures can serve as alternatives to real specimens for providing knowledge of anatomy. However, such technologies are often expensive. The goal of this study was to create 3D anatomy models for online lectures using a free cellphone app. Free application software (Qlone) was used to create 3D anatomical models. The extracranium and intracranium of adult skull, fetal skull, mandible, temporal bone, second cervical vertebra, and ilium were all scanned and exported to the computer in 3D format. A total of 53 anatomical structures were evaluated by nine observers. Although the 53 structures used in this study did not include all the structures that students need to learn, visibility was good/acceptable for most of the 53. The free and simple 3D scanning app used in this study could enable anatomy educators to provide better content to students during online lectures.
A tortuous common carotid artery poses a high risk of injury during tracheotomy. Preoperative diagnosis is therefore important to avoid serious complications. We found four cases of tortuous common carotid artery during an anatomical dissection course for students. The first case was a 91-year-old woman who had bilateral tortuous common carotid arteries without arteriosclerosis. Case 2 was a 78-year-old woman who had bilateral tortuous common carotid arteries without arteriosclerosis. Case 3 was an 86-year-old woman who died from bladder cancer and who also had a right tortuous common carotid artery without arteriosclerosis. Case 4 was an 89-year-old woman who had bilateral tortuous common carotid arteries and a tortuous brachiocephalic artery with severe arteriosclerosis. Case 4 was also examined using computed tomography to evaluate the arteriosclerosis. Computed tomography revealed severe calcification of the vascular wall, which was confirmed in the aortic arch and origins of its branches. In all four cases, the tortuosity was located below the level of the thyroid gland. Based on prior study results indicating that fusion between the carotid sheath and visceral fascia was often evident at the level of the thyroid gland, we speculated that the major region in which tortuosity occurs is at the same level or inferior to the level of the thyroid gland.
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