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Raeisi M, Jafari SH, Karimi F, Namazi MR. Location of infraorbital and accessory infraorbital foramina in Iranian population: a retrospective radiological study with crucial clinical implications. Surg Radiol Anat 2024; 46:1047-1055. [PMID: 38761208 DOI: 10.1007/s00276-024-03373-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/22/2024] [Indexed: 05/20/2024]
Abstract
PURPOS The location of infraorbital foramen (IOF) and the prevalence of accessory IOF vary among different populations. It may lead to infraorbital nerve (ION) blockage during surgery. This study aimed to assess the IOF location and AIOF frequency in Iranian people. METHOD In this retrospective cross-sectional study, 500 paranasal sinus computed tomography scans of adults were examined using the INFINITT PACS system. RESULT The distance from IOF to infraorbital margin (IOM), mid-pupillary line (MPL), midsagittal line (MSL), canine eminence (CE), and skin thickness (ST) was 8.97 ± 1.79, 5.73 ± 1.84, 24.86 ± 2.23, 20.39 ± 3.47, and 10.90 ± 2.59 mm, respectively. The vertical and transverse diameters of the foramen were 3.03 ± 0.65 and 3.71 ± 0.76 mm, respectively. In addition, the shape of 63.5% of the foramina was oval. The prevalence of AIOF was 9%, and its most common location was superomedial to IOF. CONCLUSION We believe that in this study, landmarks like IOM, MPL, MSL, CE and ST could help the clinicians localize IOF and improve the ION anesthesia success rate. Furthermore, the occurrence of AIOF should be considered by physicians to reduce the chance of injuries to the infraorbital neurovascular complex.
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Affiliation(s)
- Morteza Raeisi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Hamed Jafari
- Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Karimi
- Department of Anatomy, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- Department of Dermatology, Molecular Dermatology Research Center, School of Medicine, Shiraz University of Medical Sciences, Zand Ave, Shiraz, 7134844119, Iran.
| | - Mohammad Reza Namazi
- Department of Dermatology, Molecular Dermatology Research Center, School of Medicine, Shiraz University of Medical Sciences, Zand Ave, Shiraz, 7134844119, Iran.
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Liu B, Su X, Chai H, Chen Q, Hu J, Wang Y. Three-point Method Nerve Block for Relieving Pain of Microbotox Injection in Middle and Upper Face. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5853. [PMID: 38841525 PMCID: PMC11150023 DOI: 10.1097/gox.0000000000005853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 04/01/2024] [Indexed: 06/07/2024]
Abstract
Background With the popularity of microbotox, pain caused by multiple microdroplets and subcutaneous injection of botulinum toxin is increasing. This study presents a new, refined, three-point nerve block technique that provides effective pain relief during minimally invasive injection therapy targeting the middle and upper face. Methods Fifty volunteers underwent facial ultrasonography to measure the locations of the supraorbital and infraorbital foramen. Following microdrop Botox injection of the middle and upper face, 100 patients underwent a self-controlled study to analyze whether a three-point nerve block surpasses topical anesthesia for reducing injection pain. The visual analog scale pain score, the time of the three-point method and botulinum toxin injection, and side effects were recorded. Results Among the volunteers, the location of the supraorbital and infraorbital foramen showed no statistical difference between the left and right sides. For the 100 patients (13 men, 87 women) who underwent the three-point nerve block, the visual analog scale pain scores on the experimental side were significantly lower than those on the control side, except in the frontotemporal region (2.46 ± 0.50, 2.42 ± 0.47, P > 0.05). The duration of the unilateral three-point nerve block was 74.8 ± 5.64 seconds. The total injection time was 189.86 ± 26.79 seconds (range 148-286 s). Conclusions The three-point method exerted prominent analgesic effects during middle and upper facial treatments, with benefits including a precise block region, high satisfaction, and simple operation technique. Therefore, clinicians can easily master and apply this method.
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Affiliation(s)
- Bing Liu
- From the Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueshang Su
- From the Department of Plastic and Reconstructive Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongli Chai
- Department of Ultrasonography, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qi Chen
- The Second School of Clinical Medicine, Xinjiang Medical University, Xinjiang, China
| | - Jintian Hu
- Department of Cosmetic Injection Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yongqian Wang
- Department of Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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An D, K C K, Vorakulpipat C, Ngamsom S, Kumchai T, Ruangsitt S, Chaiyasamut T, Wongsirichat N. Accessory infraorbital foramen location using cone-beam computed tomography. J Dent Anesth Pain Med 2023; 23:257-264. [PMID: 37841517 PMCID: PMC10567540 DOI: 10.17245/jdapm.2023.23.5.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/24/2023] [Accepted: 08/28/2023] [Indexed: 10/17/2023] Open
Abstract
Background Accessory infraorbital foramen (AIOF) can change the normal course of emerging branches of the infraorbital nerve and blood vessels exiting the infraorbital foramen (IOF). This study aimed to examine the AIOF, number of foramina, and their position in relation to IOF using cone-beam computed tomography (CBCT). Methods We performed a retrospective CBCT assessment of hospital records between January 2018 and August 2022. The CBCT of 507 patients were examined to extract information on the prevalence, number, position, linear distance from the IOF, and diameter of AIOF in relation to demographic factors. Descriptive statistics were used to evaluate the prevalence of AIOF. Mean and standard deviation were used to calculate the linear distance and diameter of the AIOF, respectively. The AIOFs, its distribution, and number were compared between sexes and sides using the chi-square test. The independent t-test and Mann-Mann-Whitney test were used to compare the mean difference between the sexes and sides. Statistical significance was set at P < 0.05. Results In this current study, the prevalence of AIOF was 7.1% (36 of the 507 patients). Additionally, the current study examined the number of foramina using a single foramen on each side and double foramina located bilaterally at a distance from the AIOF to the IOF. The mean AIOF diameter was also studied, and the AIOF position with respect to the IOF on CBCT was superomedial or inferomedial. There were no statistically significant associations between any of the parameters assessed in this study when comparing sex and sides. Conclusions A greater number of patients with AIOF presented with a single foramen and unilateral occurrence, without a statistically significant difference. The AIOF was most commonly located superomedial to the IOF.
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Affiliation(s)
- Daesung An
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Kumar K C
- Department of Oral and Maxillofacial surgery, OM Samaj Dental Hospital, Naikap, Kathmandu, Nepal
| | - Chakorn Vorakulpipat
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Supak Ngamsom
- Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Thongnard Kumchai
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Bangkokthonburi University, Bangkok, Thailand
| | - Sunya Ruangsitt
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Bangkokthonburi University, Bangkok, Thailand
| | - Teeranut Chaiyasamut
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Natthamet Wongsirichat
- Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Bangkokthonburi University, Bangkok, Thailand
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Mrożek K, Marchewka J, Leszczyński B. A morphological study and the variability in the number of infraorbital foramina in the African green monkey (Grivet) (Chlorocebus aethiops) using microcomputed tomography. J Morphol 2023; 284:e21607. [PMID: 37458084 DOI: 10.1002/jmor.21607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/18/2023] [Accepted: 05/28/2023] [Indexed: 07/18/2023]
Abstract
Knowledge of the nonhuman primate morphology and anatomy related to craniofacial mechanoreception is essential for a fundamental understanding of the incidents that have occurred during the evolution of craniofacial features. The present study focuses on the variability in the number of infraorbital foramina and associated anatomical structures such as the infraorbital canal (IOC) and the infraorbital groove (IOG), as they are considered to play an important role in the behavioral ecology of these animals. A total of 19 skulls of Chlorocebus aethiops were analyzed. The number of infraorbital foramina was assessed macroscopically using a magnifying glass and a small diameter probe. Three dimensional (3D) projections and morphometric analysis of the infraorbital foramina, IOCs, and IOGs were performed using microcomputed tomography (micro-CT) for two skulls that represent one of the most common morphological types. Regardless of sex and body side, the most common morphological type observed in the studied species is the presence of three infraorbital foramina. The IOC takes a funnel or pinched shape. 3D projections were made to assess the course of the infraorbital vascular and nerve bundles in selected individuals. The results indicate a high morphological diversity within the species, although there appears to be a consistent distribution pattern of infraorbital neurovascular bundles in species of the Cercopithecidae family. The use of X-ray micro-CT allowed 3D visualization of the maxillary region to determine the variability of the infraorbital foramina and to track the division of the infraorbital neurovascular bundle in the case of the most common macroscopic expression of the number of the infraorbital foramen in C. aethiops, as well as the morphometric of the IOCs and IOGs which are related to mechanoreception of the primate's snout.
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Affiliation(s)
- Kamil Mrożek
- Nature Education Center, Jagiellonian University, Krakow, Poland
- Laboratory of Anthropology, Institute of Zoology and Biomedical Research, Jagiellonian University, Krakow, Poland
| | - Justyna Marchewka
- Department of Human Biology, Institute of Biological Sciences, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Bartosz Leszczyński
- Department of Medical Physics, Marian Smoluchowski Institute of Physics, Jagiellonian University, Krakow, Poland
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Mahajan A, Verma R, Razdan SK, Passey J. Morphological and Morphometric Relations of Infraorbital Foramen in North Indian Population. Cureus 2023; 15:e34525. [PMID: 36874344 PMCID: PMC9981513 DOI: 10.7759/cureus.34525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction The evidence regarding the anatomy of the infraorbital foramen in the Indian population is limited. It mainly focuses on its shape, size, and incidence in the Indian population. The current study aimed to evaluate morphometric parameters of infraorbital foramen that can help clinicians during surgery and procedures around it. Methods We evaluated 90 dry adult human hemi-skulls. The morphological parameters studied included the assessment of the shape of the infraorbital foramen, its horizontal and vertical diameters, and its relation to the teeth of the upper jaw. In addition, we measured the distance of the infraorbital foramen from the anterior nasal spine, nasion, infraorbital margin, and the lower extent of the alveolar margin. The length of the infraorbital canal till the inferior orbital fissure and the infraorbital groove and the infraorbital canal orientation angles in different planes were also measured. The measurement values were compared between the right and left side hemi-skulls. Results The oval-shaped infraorbital foramen was most commonly noticed. The mean vertical and transverse diameters were 3.8 mm and 2.6 mm, respectively, on the right side. The left side's mean vertical and transverse diameters were 3.9 mm and 2.5 mm, respectively. The most common location of infraorbital foramen was in line with the maxillary second premolar tooth. The distances of infraorbital foramen from the alveolar margin were 29.6 mm and 29 mm on the right and left sides, respectively. The distances of the infraorbital foramen from the anterior nasal spine were 34.3 mm and 34.2 mm on the right and left sides, respectively. The distances of infraorbital foramen from the nasion were 42.3 mm and 42.2 mm on the right and left sides, respectively. The distances of infraorbital foramen from the inferior orbital margin were 5.8 mm and 6.2 mm on the right and left sides, respectively. The distances between the inferior orbital margin and infraorbital groove were 12.7 mm and 12.7 mm on the right and left sides, respectively. The distances between the inferior orbital margin and inferior orbital fissure were 27.5 mm and 27.1 mm on the right and left sides, respectively. The orientation angles of infraorbital foramen were 48.31° in the horizontal plane, 34.07° in the Frankfurt plane, and 14.4° in the parasagittal plane. Conclusion Our findings suggest that the location of the infraorbital foramen is difficult to standardize, considering the wide interindividual variations in the foramen relations. Further research should be performed to investigate the parameters related to the distance and orientation of the infraorbital foramen in relation to nearby bony landmarks that are least affected by individual variations in skull morphology.
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Affiliation(s)
- Arpita Mahajan
- Anatomy, Hamdard Institute of Medical Sciences and Research, New Delhi, IND
| | - Ranjana Verma
- Anatomy, Government Institute of Medical Sciences, Greater Noida, IND
| | - Shayama K Razdan
- Anatomy, Hamdard Institute of Medical Sciences and Research, New Delhi, IND
| | - Jigyasa Passey
- Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, IND
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Çelebi A, Gülsün B. Evaluation of accessory mental foramen and accessory infraorbital foramen with cone-beam computed tomography in Turkish population. AUST ENDOD J 2022; 49:13-19. [PMID: 36177731 DOI: 10.1111/aej.12693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 09/04/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022]
Abstract
It was aimed to evaluate the frequency of accessory mental foramen (AMF) and accessory infraorbital foramen (AIOF) and analyse the correlation between these two foramina using cone-beam computed tomography (CBCT). The retrospective study reviewed the CBCT images of 1020 patients. The rates of AMF and AIOF were evaluated according to sex and age distributions. Correlations between the localizations of AMF and AIOF in the right and left jaws and the correlations between the occurrences of these foramina were evaluated. In the CBCT images of the 1020 patients, AMFs were detected in 48 patients, among which 14 were in the right half jaw, and 34 were in the left half jaw. AIOFs were detected in 143 patients, among which 65 were in the right half jaw, and 78 were in the left half jaw. Recognising and detecting AMF and AIOF with CBCT is important in terms of preventing complications that may occur in surgical procedures.
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Affiliation(s)
- Adalet Çelebi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mersin University, Mersin, Turkey
| | - Belgin Gülsün
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
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Prevalence of canalis sinuosus and accessory canals of canalis sinuosus on cone beam computed tomography: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2022; 52:118-131. [PMID: 35840447 DOI: 10.1016/j.ijom.2022.06.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 06/19/2022] [Accepted: 06/22/2022] [Indexed: 11/22/2022]
Abstract
The aim of this systematic review was to determine the prevalence of the canalis sinuosus (CS) and accessory canals of the canalis sinuosus (ACCS) as identified on cone beam computed tomography (CBCT). Online searches were conducted in the MEDLINE (via PubMed), Scopus, LILACS, Cochrane CENTRAL, Web of Science, and SIGLE (via OpenGrey) databases. Primary studies that determined the prevalence of canalis sinuosus and/or its anatomical variations using CBCT were included. The risk of bias assessment was performed using the AQUA tool. The quality effects model using double arcsine transformation was used for the meta-analysis of prevalence. Heterogeneity, publication bias, and sensitivity analyses were performed. Of 3237 initial results, 17 papers were included for systematic review. The meta-analysis comprising 1994 patients showed a pooled prevalence of CS of 0.80 (95% confidence interval (CI) 0.51-0.99; P = 0.001; I2 = 99%). Publication bias analysis revealed minor asymmetry (LFK index 1.84). The meta-analysis of 4605 patients showed a pooled prevalence of ACCS of 0.54 (95% CI 0.38-0.69; P = 0.001; I2 = 99%). The sensitivity analysis showed a pooled prevalence of ACCS of 0.53 (95% CI 0.32-0.74; P = 0.001; I2 = 99%) for studies with ≥ 1000 patients and 0.55 (95% CI 0.33-0.76; P = 0.001; I2 = 98%) for studies with< 1000 patients. Canalis sinuosus showed a pooled prevalence of 0.80 and ACCS showed a pooled prevalence of 0.54; hence both should be considered as anatomical structures, which means that they are present in most people. Surgeons must be aware of the CS and ACCS on CBCT analysis during pre-surgical planning. PROSPERO REGISTRATION NUMBER: CRD42020154195.
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Suntiruamjairucksa J, Chentanez V. Localization of infraorbital foramen and accessory infraorbital foramen with reference to facial bony landmarks: predictive method and its accuracy. Anat Cell Biol 2022; 55:55-62. [PMID: 35131950 PMCID: PMC8968235 DOI: 10.5115/acb.21.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 11/27/2022] Open
Affiliation(s)
| | - Vilai Chentanez
- Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Hester KM, Rahimi OB, Fry CL, Nation HL. The relative locations of the supraorbital, infraorbital, and mental foramina: A cadaveric study. J Anat 2021; 239:782-787. [PMID: 34120334 PMCID: PMC8450472 DOI: 10.1111/joa.13482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 12/22/2020] [Accepted: 05/22/2021] [Indexed: 11/28/2022] Open
Abstract
The purpose of this study is to investigate the applicability of the current surgical guideline stating that the main facial foramina that transmit cutaneous nerves to the face (supraorbital notch/foramen, infraorbital foramen, and mental foramen) are equidistant from the midline in European and Hispanic populations. Previous studies suggest this surgical guideline is not applicable for all ethnicities; however, to our knowledge, no data have been published regarding the accuracy of this guideline pertaining to the Hispanic population. An experimental study was performed on 67 cadavers donated to the Human Anatomy Program at UT Health San Antonio. The supraorbital, infraorbital, and mental foramina were dissected and midline structures including the crista galli, internasal suture, anterior nasal spine, and mandibular symphysis were identified. The distance from each foramen to midline was recorded using a digital caliper. For all cadavers/ethnicities studied, the supraorbital, infraorbital, and mental foramina were 25.32 mm, 29.57 mm, and 25.55 mm to the midline, respectively. Thus, the infraorbital foramen is located significantly more lateral compared to the supraorbital (p < 0.0001) and mental foramina (p < 0.0001). After dividing the sample based on ethnicity, this relationship was also true for the European sample and tended to be true for the Hispanic sample. Significant anatomical variations exist in the current surgical guideline stating that the supraorbital foramen, infraorbital foramen, and mental foramen are equidistant from the midline. Clinicians may need to adjust their methodology during surgical procedures of the face in order to optimize patient care.
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Affiliation(s)
- Kathylin M. Hester
- Department of Cell Systems and AnatomyUT Health San AntonioSan AntonioTexasUSA
| | - Omid B. Rahimi
- Department of Cell Systems and AnatomyUT Health San AntonioSan AntonioTexasUSA
| | - Constance L. Fry
- Department of OphthalmologyUT Health San AntonioSan AntonioTexasUSA
| | - Haley L. Nation
- Department of Cell Systems and AnatomyUT Health San AntonioSan AntonioTexasUSA
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Abstract
BACKGROUND Improved understanding of the microanatomy of the paranasal sinuses, including its individual variations, makes a substantial contribution to current progress in endonasal endoscopic microsurgery. Microanatomy of the sinuses is an active field of present scientific investitations. MATERIALS AND METHODS A comprehensive review on microanatomy of the maxillary sinus is presented from the perspective of contemporary endonasal endoscopic microsurgery. RESULTS The range of variation of the individual microanatomy of all sections of the maxillary sinus is presented, in particular to minimize secondary sugical tissue trauma, to avoid complications (e.g. on orbital tissues) and as a basis for the prelacrimal access to the maxillary sinus. CONCLUSION Improved understanding of the range of microanatomical variations reduced the burden on the patient while opimizing the effectiveness of the necessary surgical manipulations.
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Affiliation(s)
- W Hosemann
- Klinik für Hals-Nasen-Ohrenkrankheiten, Kopf- und Hals-Chirurgie, Universitätsmedizin Greifswald, Sauerbruchstraße, 17475, Greifswald, Deutschland.
| | - A Grimm
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Semmelweis Universität, Budapest, Ungarn.,Anatomisches, Histologisches und Embryologisches Institut, Semmelweis Universität, Budapest, Ungarn
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Cucchi A, Bianchi A, Calamai P, Rinaldi L, Mangano F, Vignudelli E, Corinaldesi G. Clinical and volumetric outcomes after vertical ridge augmentation using computer-aided-design/computer-aided manufacturing (CAD/CAM) customized titanium meshes: a pilot study. BMC Oral Health 2020; 20:219. [PMID: 32758217 PMCID: PMC7409710 DOI: 10.1186/s12903-020-01205-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022] Open
Abstract
Background One of the most recent innovations in bone augmentation surgery is represented by computer-aided-design/computer-aided-manufacturing (CAD/CAM) customized titanium meshes, which can be used to restore vertical bone defects before implant-prosthetic rehabilitations. The aim of this study was to evaluate the effectiveness/reliability of this technique in a consecutive series of cases. Methods Ten patients in need of bone augmentation before implant therapy were treated using CAD/CAM customized titanium meshes. A digital workflow was adopted to design virtual meshes on 3D bone models. Then, Direct Metal Laser Sintering (DMLS) technology was used to produce the titanium meshes, and vertical ridge augmentation was performed according to an established surgical protocol. Surgical complications, healing complications, vertical bone gain (VBG), planned bone volume (PBV), lacking bone volume (LBV), regenerated bone volume (RBV), average regeneration rate (RR) and implant success rate were evaluated. Results All augmented sites were successfully restored with definitive implant-supported fixed partial dentures. Measurements showed an average VBG of 4.5 ± 1.8 mm at surgical re-entry. Surgical and healing complications occurred in 30% and 10% of cases, respectively. Mean values of PBV, LBV, and RBV were 984, 92, and 892 mm3, respectively. The average RR achieved was 89%. All 26 implants were successfully in function after 1 year of follow-up. Conclusions The results of this study suggest that the bone augmentation by means of DMLS custom-made titanium meshes can be considered a reliable and effective technique in restoring vertical bone defects.
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Affiliation(s)
- Alessandro Cucchi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy.
| | - Alessandro Bianchi
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | | | - Lisa Rinaldi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Francesco Mangano
- Department of Prevention and Communal Dentistry, Sechenov First State Medical University, Moscow, Russia
| | - Elisabetta Vignudelli
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Giuseppe Corinaldesi
- Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
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Marchewka J, Mrożek K, Leszczyński B, Wróbel A, Głąb H. Variability in the number of infraorbital foramina in rhesus macaques (Macaca mulatta) and cynomolgus macaques (Macaca fascicularis). Anat Rec (Hoboken) 2020; 304:818-831. [PMID: 32558307 DOI: 10.1002/ar.24478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/14/2020] [Accepted: 04/28/2020] [Indexed: 11/11/2022]
Abstract
This study aimed to determine the number of infraorbital foramina in monkeys of the Papionini tribe. The authors performed a μCT analysis of the morphology of the infraorbital foramina. A total number of 52 simian skulls belonged to two macaque species: Macaca mulatta and Macaca fascicularis were used in the study. The number of infraorbital foramina was counted macroscopically and with the use of a magnifying glass. Next, the skull representing the most common morphological type was selected and scanned by micro-computed tomography (μCT). The Shapiro-Wilk normality test was used in the study. To compare the differences in the number of infraorbital foramen between species, sex and sides, the Mann-Whitney U test was applied. Three infraorbital foramina were present in most individuals from the test group. The Mann-Whitney test revealed no statistically significant difference between the number of foramina on the right- and left-hand side. Likewise, no statistically significant differences between the numbers of infraorbital foramina across sexes were observed. Volumetric reconstructions revealed the presence of separate infraorbital canals for each infraorbital foramen. Craniofacial innervation in macaques is formed by complex branching patterns of cranial nerves. Variability in the number of infraorbital foramina suggests a variable maxillary innervation pattern in these animals. Based on the analysis of volumetric projections, the presence of two labial branches and a single nasal branch of the infraorbital nerve is suggested. Detailed descriptions are supported by quantitative data and μCT evidence.
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Affiliation(s)
- Justyna Marchewka
- Department of Human Biology, Institute of Biological Sciences, Cardinal Stefan Wyszynski University, Warszawa, Poland
| | - Kamil Mrożek
- Nature Education Centre, Jagiellonian University, Krakow, Poland.,Department of Anthropology, Institute of Zoology and Biomedical Research, Jagiellonian University, Krakow, Poland
| | - Bartosz Leszczyński
- Department of Medical Physics, Marian Smoluchowski Institute of Physics, Jagiellonian University, Krakow, Poland
| | - Andrzej Wróbel
- Department of Medical Physics, Marian Smoluchowski Institute of Physics, Jagiellonian University, Krakow, Poland
| | - Henryk Głąb
- Department of Anthropology, Institute of Zoology and Biomedical Research, Jagiellonian University, Krakow, Poland
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Location of the accessory infraorbital foramen with reference to external landmarks and its clinical implications. Sci Rep 2020; 10:8566. [PMID: 32444685 PMCID: PMC7244752 DOI: 10.1038/s41598-020-65330-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 05/01/2020] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to define the location of the accessory infraorbital foramen (AIOF) with reference to accessible external landmarks in order to facilitate orbital and oculoplastic surgical procedures in the maxillofacial region. Forty-four hemifaces from 25 cadavers were dissected. The lateral canthus, subnasal point, and lacrimal caruncle were used as anatomic reference points. The AIOF was observed in 8 of the 44 hemifaces (18.2%) and was situated at a mean distance of 7.2 mm superomedial to the IOF. The horizontal distance from the lacrimal caruncle to the AIOF was 0.3 mm. In all cases the AIOF was situated at a point that was no more than 8 mm from the intersection point of a vertical line passing through the lacrimal caruncle and an oblique line joining the lateral canthus and the subnasal point. Surgeons anesthetizing or performing surgical procedures in the maxillofacial region should be aware of the frequency of the AIOF (18.2%) and its location (on the superomedial side of the IOF). We propose that injecting at the intersection point of a vertical line passing through the lacrimal caruncle and an oblique line joining the lateral canthus and the subnasal point would successfully block the accessory branch of the infraorbital nerve. Likewise, surgeons operating in this region should be aware of the location of the AIOF in order to avoid inadvertent iatrogenic injury to a duplicated infraorbital nerve.
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Iwanaga J, Kikuta S, Kusukawa J, Tomaszewski KA, Walocha JA, Tubbs RS. Anatomic Study of Accessory Infraorbital Nerves and Foramina: Application for a Better Understanding of Complications of Le Fort Fractures and Osteotomy. J Oral Maxillofac Surg 2020; 78:717-723. [PMID: 32035836 DOI: 10.1016/j.joms.2020.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 01/06/2020] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE Neurosensory disturbance of the infraorbital nerve is one of the many complications of the Le Fort osteotomy. An accessory infraorbital foramen (AIOF) can be one reason for such complications. Therefore, the purpose of the present study was to elucidate the distribution of the accessory infraorbital nerve (AION) arising from the AIOF. MATERIALS AND METHODS We dissected 60 sides from 30 fresh-frozen cadaveric heads. RESULTS An AIOF was found in 36.7% of the heads examined. When an AIOF was detected, the nerve was traced distally and proximally. The mean horizontal and vertical diameters of the AIOF were 1.64 ± 0.88 and 1.75 ± 0.87 mm, respectively. The largest AIOF was 3.42 × 3.79 mm. All AIOFs were located medial to the infraorbital foramen. Most of the AIONs (87.5%) had branches to the external nose. CONCLUSIONS The AION should always be remembered by surgeons to allow for improved outcomes and better understanding of the complications such as those occurring after Le Fort osteotomy.
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Affiliation(s)
- Joe Iwanaga
- Associate Professor, Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA; Associate Professor, Dental and Oral Medical Center and Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Japan.
| | - Shogo Kikuta
- Assistant Professor, Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan
| | - Jingo Kusukawa
- Professor, Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Japan
| | - Krzysztof A Tomaszewski
- Associate Professor, Department of Anatomy, Jagiellonian University Medical College; Associate Professor, International Evidence-Based Anatomy Working Group; and Associate Professor, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Jerzy A Walocha
- Professor, Department of Anatomy, Jagiellonian University Medical College; and Professor, International Evidence-Based Anatomy Working Group, Krakow, Poland
| | - R Shane Tubbs
- Professor, Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA; Professor, Department of Anatomical Sciences, St. George's University, St. George's, Grenada; and Professor, Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA
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False and true accessory infraorbital foramina, and the infraorbital lamina cribriformis. Morphologie 2020; 104:51-58. [PMID: 31924470 DOI: 10.1016/j.morpho.2019.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 11/23/2022]
Abstract
The infraorbital nerve (ION) and artery (IOA) course in the infraorbital canal (IOC) to exit through the infraorbital foramen (IOF). Few previous studies brought evidence of accessory IOF. Evaluation of the IOF in Cone Beam Computed Tomography (CBCT) is more accurate to determine whether or not foramina of maxilla are supplied by canaliculi deriving from the IOC. We performed a retrospective anatomical study of the CBCT files of 200 patients. An accessory infraorbital foramen located inferior to the infraorbital margin (AIOF) was found in 18/200 right maxillae and in 13/200 left ones. Canaliculi deriving from the IOC supplied accessory foramina in the sutura notha- AIOF(SN) - in 15 maxillae. Noteworthy, the AIOF(SN)-negative maxillae displayed the SN and the vascular foramina of Macalister. In 94% of cases the AIOF were unique. A single maxilla (3%) had a double AIOF. In a different case (3%) were found three accessory infraorbital foraminules transforming the anterior wall of the antrum into a veritable lamina cribriformis infraorbitalis. A single prior study distinguished AIOF from AIOF(SN), while most of different other ones were performed on dry bones. Therefore, the reports of prevalence for the number and location of AIOF should be regarded with caution. Foramina of the SN could equally get intraosseous and extraosseous supply, this distinction being accurately made in CBCT.
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