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INTRODUCTION: The primary objective of this retrospective study was to document the normal variation of clinical mobility of the mandibular symphysis in cats and possible associations with bodyweight, age, sex, sexual status, breed and skull morphology. Secondarily, the radiographic appearance of the mandibular symphysis and possible associations with the analyzed data were evaluated. MATERIALS AND METHODS: Two hundred and sixteen cats of 15 different breeds that underwent maxillofacial, oral and dental procedures from April 2015 to December 2021 were included. Clinical mobility was evaluated under general anesthesia using a 0 to 3 scale in lateromedial (LM) and dorsoventral (DV) directions. The symphysis was radiographically classified on the occlusal radiographic view of the rostral mandibles as fused or open, and with parallel or divergent margins. RESULTS: Bodyweight ranged from 2.2 to 12.5 kg (median 4.0 kg), age from 4 months to 17 years and 4 months (median 6 years and 4 months). At the first evaluation DV symphyseal mobility was 0 in 177 cases (82%), 1 in 32 cases (14.8%) and 2 in 7 cases (3.2%), LM mobility was 0 in 61 cases (28.3%), 1 in 110 cases (50.9%) and 2 in 45 cases (20.8%). 81.1% of the radiographs were included in the statistical analysis. Three symphyses (1.6%) were classified as fused and 190 (98.4%) as open, 129 (68.8%) having divergent margins and 61 (31.6%) parallel. One hundred and forty-eight cases (76.7%) did not show the presence of odontoclastic replacement resorption on the canine teeth (TR subgroup 1), 23 (11.9%) showed stage ≤3 lesions (TR subgroup 2) and 22 (11.4%) stage 4 lesions (TR subgroup 3). Logistic regression models exploring factors that affected DV and LM mobility were statistically significant (p

Pubic symphysis, also known as osteitis pubis, is an inflammatory condition of the pubic symphysis, clinically characterized by severe pelvic pain, abnormal gait with the increased base of support, and bone destruction of the pubic symphysis margins. Initially associated with certain surgical interventions, speculation about its pathogenesis includes infection, trauma, local vascular anomalies, and reflex-sympathetic dystrophy. This confusion about its etiology is reflected in the wide variety of treatments that have been used over the years, including radiation, bed rest for long periods, infiltration with local anesthetics, anti-inflammatories nonsteroidal drugs, antibiotics, heparin, surgical debridement, wedge resection of the pubic symphysis, and autologous iliac bone transplantation. Both bony infection and inflammation of the pubic area are rare. In the medical literature these two entities have been frequently confused, so that many diagnosed cases of osteitis pubis have actually been shown to be misdiagnosed osteomyelitis pubis. For this reason, an aggressive diagnostic approach is recommended, especially in post-surgical cases, with biopsy and arthrocentesis of the symphysis guided by computed tomography. [ABSTRACT FROM AUTHOR]

Abstract Background Open reduction and plate fixation is a standard procedure for treating traumatic symphyseal disruptions, but has a high incidence of implant failure. Several studies have attempted to identify predictors for implant failure and discussed its impact on functional outcome presenting conflicting results. Therefore, this study aimed to identify predictors of implant failure and to investigate the impact of implant failure on pain and functional outcome. Methods In a single-center, retrospective, observational non-controlled cohort study in a level-1 trauma center from January 1, 2006, to December 31, 2017, 42 patients with a plate fixation of a traumatic symphyseal disruption aged ≥ 18 years with a minimum follow-up of 12 months were included. The following parameters were examined in terms of effect on occurrence of implant failure: age, body mass index (BMI), injury severity score (ISS), polytrauma, time to definitive treatment, postoperative weight-bearing, the occurrence of a surgical site infection, fracture severity, type of posterior injury, anterior and posterior fixation. A total of 25/42 patients consented to attend the follow- up examination, where pain was assessed using the Numerical Rating Scale and functional outcome using the Majeed Pelvic Score. Results Sixteen patients had an anterior implant failure (16/42; 37%). None of the parameters studied were predictive for implant failure. The median follow-up time was six years and 8/25 patients had implant failure. There was no difference in the Numerical Rating Scale, but the work-adjusted Majeed Pelvic Score showed a better outcome for patients with implant failure. Conclusion implant failure after symphyseal disruptions is not predictable, but appears to be clinically irrelevant. Therefore, an additional sacroiliac screw to prevent implant failure should be critically discussed and plate removal should be avoided in asymptomatic patients.

INTRODUCTION: The primary objective of this retrospective study was to document the normal variation of clinical mobility of the mandibular symphysis in dogs, and evaluate possible associations with breed, bodyweight, age, sex, and skull morphology. Secondarily, the radiographic appearance of the mandibular symphysis and possible associations with the analyzed data were also evaluated. METHODS: Medical records of dogs that underwent anesthetic procedures for maxillofacial, oral and dental evaluation from April 2015 to December 2021 were included. RESULTS: 567 dogs of 95 different breeds were included, with a total of 695 evaluations. Body weight ranged from 0.8 kg to 79 kg (median 14.4 kg) and age from 3 months to 16 years and 4 months (median 6 years and 9 months). Clinical mobility was evaluated under general anesthesia using a 0 to 3 scale, in lateromedial (LM) and dorsoventral (DV) directions. The symphysis was radiographically classified as being fused or open. The open symphyses were further radiographically divided in having parallel or divergent margins. At the time of the first evaluation DV mobility was 0 in 551 cases (97.2%) and 1 in 16 cases (2.8%). LM mobility was 0 in 401 cases (70.7%), 1 in 148 cases (26.1%) and 2 in 18 cases (3.2%). There was not a significant change in mobility over time for cases examined more than once (P= 0.76). All cases had an intraoral radiographic examination. 83.8% of the radiographs were included in the statistical analysis. Two symphyses (0.4%) were classified as fused and 473 (99.6%) as open, 355 (74.7%) having divergent margins and 118 (24.8%) parallel margins. Logistic regression models exploring factors that affected DV and LM mobility were statistically significant (P < 0.0001; P < 0.0001), with an increase in LM mobility predicting an increase in DV mobility, and vice versa. An increase in age and in bodyweight was associated with a decrease in mobility. There was no statistical difference in clinical mobility across specific breeds or sexes. Increased probability of a divergent symphysis and increased DV mobility was found to be associated with a brachycephalic conformation. The increase in LM mobility was comparatively higher in small brachycephalic breeds compared with larger brachycephalic breed. DISCUSSION: The majority of the cases showed little to no mobility of the mandibular symphysis and radiographically bony fusion can be rarely seen.

Background: Open reduction and plate fixation is a standard procedure for treating traumatic symphyseal disruptions, but has a high incidence of implant failure. Several studies have attempted to identify predictors for implant failure and discussed its impact on functional outcome presenting conflicting results. Therefore, this study aimed to identify predictors of implant failure and to investigate the impact of implant failure on pain and functional outcome. Methods: In a single-center, retrospective, observational non-controlled cohort study in a level-1 trauma center from January 1, 2006, to December 31, 2017, 42 patients with a plate fixation of a traumatic symphyseal disruption aged ≥ 18 years with a minimum follow-up of 12 months were included. The following parameters were examined in terms of effect on occurrence of implant failure: age, body mass index (BMI), injury severity score (ISS), polytrauma, time to definitive treatment, postoperative weight-bearing, the occurrence of a surgical site infection, fracture severity, type of posterior injury, anterior and posterior fixation. A total of 25/42 patients consented to attend the follow- up examination, where pain was assessed using the Numerical Rating Scale and functional outcome using the Majeed Pelvic Score. Results: Sixteen patients had an anterior implant failure (16/42; 37%). None of the parameters studied were predictive for implant failure. The median follow-up time was six years and 8/25 patients had implant failure. There was no difference in the Numerical Rating Scale, but the work-adjusted Majeed Pelvic Score showed a better outcome for patients with implant failure. Conclusion: implant failure after symphyseal disruptions is not predictable, but appears to be clinically irrelevant. Therefore, an additional sacroiliac screw to prevent implant failure should be critically discussed and plate removal should be avoided in asymptomatic patients. [ABSTRACT FROM AUTHOR]

Symphysis (symphysis pubica) is the connection of the two pubic bones and anatomically represents a synchondrosis. In the normal state, there is little mobility of the symphysis in adults with a rotation of 3° and a physiological width of 2-6 mm. Osteitis pubis (symphysitis) occurs especially in athletes with shooting, rapid acceleration and deceleration movements as well as changes in the direction of movement. The incidence of pregnancy-associated symphyseal instability is up to 1:300. Both conditions should initially be treated intensively conservatively, including immobilization with a pelvic or symphysis compression belt. Surgical treatment of sports-associated symphysitis is (mini-) open or endoscopic curettage/partial resection of the symphysis, symphyseodesis with bone graft or wedge resection. Surgical treatment of pregnancy-associated symphyseal instability is indicated after unsuccessful conservative therapy of 6 months or if the symphysis pubis width is > 2.5 cm or if instability recurs after removal of the pelvic belt. [ABSTRACT FROM AUTHOR]

Introduction, aim: This article provides an overview of current knowledge on the relationship between orthodontic treatment and the emergence of gingival recession. It summarises the results of available studies published since 1973. The views of various authors are different. Gingival recession is multifactorial in origin, with the following cited as risk factors: dehiscence of the alveolar bone, gingival phenotype, thin biotype of the bone of the alveolar process, the shape of symphysis, dental malposition, the articulation of the dentition, inappropriate oral hygiene technique, tension of the mucosal folds and many others.Methodology: The scientific databases PubMed, Science Direct, Google Scholar, Embase, and Web of Science were used for the research. Key words (gingival recession, orthodontic treatment, incisor protrusion, symphysis, gingival biotype) were entered into the search and articles were studied. Important facts and results of individual studies were written down. Conclusion: The issue of recessions is complex and multifactorial. It is important to correctly assemble a treatment plan with regard to the condition of the periodontium, gingival phenotype, bone biotype of the alveolar process, facial skeleton (shape of the symphysis), level of dental hygiene as well as regular check-ups in the retention phase of treatment in order to avoid possible complications of fixed retainers.

IntroductionThe primary objective of this retrospective study was to document the normal variation of clinical mobility of the mandibular symphysis in cats and possible associations with bodyweight, age, sex, sexual status, breed and skull morphology. Secondarily, the radiographic appearance of the mandibular symphysis and possible associations with the analyzed data were evaluated.Materials and methodsTwo hundred and sixteen cats of 15 different breeds that underwent maxillofacial, oral and dental procedures from April 2015 to December 2021 were included. Clinical mobility was evaluated under general anesthesia using a 0 to 3 scale in lateromedial (LM) and dorsoventral (DV) directions. The symphysis was radiographically classified on the occlusal radiographic view of the rostral mandibles as fused or open, and with parallel or divergent margins.ResultsBodyweight ranged from 2.2 to 12.5 kg (median 4.0 kg), age from 4 months to 17 years and 4 months (median 6 years and 4 months). At the first evaluation DV symphyseal mobility was 0 in 177 cases (82%), 1 in 32 cases (14.8%) and 2 in 7 cases (3.2%), LM mobility was 0 in 61 cases (28.3%), 1 in 110 cases (50.9%) and 2 in 45 cases (20.8%). 81.1% of the radiographs were included in the statistical analysis. Three symphyses (1.6%) were classified as fused and 190 (98.4%) as open, 129 (68.8%) having divergent margins and 61 (31.6%) parallel. One hundred and forty-eight cases (76.7%) did not show the presence of odontoclastic replacement resorption on the canine teeth (TR subgroup 1), 23 (11.9%) showed stage ≤3 lesions (TR subgroup 2) and 22 (11.4%) stage 4 lesions (TR subgroup 3). Logistic regression models exploring factors that affected DV and LM mobility were statistically significant (p

Purpose: Does the cylindrical shaped bone block allow a stable construct for the arthrodesis of the pubic symphysis compared to a rectangular shaped bone block. The cylindrical shaped bone block stabilized by a 3.5 symphyseal plate is inferior to the stabilization with an internal fixator. Methods: This study analyzed the arthrodesis of the pubic symphysis on 24 synthetic pelvises, using a rectangular shaped bone block (control group) or a cylindrical shaped bone block, stabilized with a symphysis locking plate (n = 8) as the standard clinical procedure. Additionally we analyzed the stability using an internal fixator. Results: This study showed that utilizing a cylindrical shaped synthetic bone graft results in a significant higher contact area and compression force compared to the classical rectangular shaped graft. Furthermore, the stabilization with an internal fixator had the tendency for increases of compression force and contact area, yet without a statistical significance, when compared to the plate fixation. Conclusion: The novel method of cylindrical symphysis resection and cylindrical bone block implantation allowed an increased biomechanical stability compared to using a classical rectangular bone graft, also resulting in higher contact area. Moreover, this technique would also allow a minimally invasive approach for this purpose, which in turn could preserve perisymphyseal ligaments, thereby improving healing in a clinical context. [ABSTRACT FROM AUTHOR]

Mandibular fractures are very rare in the paediatric age group; however, they remain the most common maxillofacial trauma occurring in children. A paediatric mandibular fracture can cause severe pain and discomfort for the patient. Due to the complex anatomy of the developing mandible, such as the presence of permanent tooth buds and its small size, the treatment of mandibular fractures in the paediatric age group differs markedly from that in adults. Treatment of maxillofacial fractures in the paediatric population has always been a challenge for the operating surgeon. Different treatment modalities for managing paediatric mandibular fractures include closed reduction or surgical intervention. Open/closed cap splint provides closed reduction and stabilisation of paediatric mandibular fractures without any risk of damage to permanent tooth buds. It is more commonly preferred over Open Reduction and Internal Fixation (ORIF) of the fractures. However, for highly displaced fractures, ORIF is the preferred treatment. In the present case report, the author present and describe the management of a mandibular symphyseal and medial pole of the right condyle fracture in a seven-year-old patient. Since the bone fragments were highly displaced and occlusion was severely deranged with an anterior open bite, conservative treatment using a cap splint was not considered. ORIF was performed under general anaesthesia. At the oneyear follow-up, complete clinical and radiological bone healing was observed. Occlusion was satisfactory, and mouth opening was maintained. There was normal eruption of permanent teeth with no complications or delays associated with the eruption pattern.

IntroductionThe primary objective of this retrospective study was to document the normal variation of clinical mobility of the mandibular symphysis in dogs, and evaluate possible associations with breed, bodyweight, age, sex, and skull morphology. Secondarily, the radiographic appearance of the mandibular symphysis and possible associations with the analyzed data were also evaluated.MethodsMedical records of dogs that underwent anesthetic procedures for maxillofacial, oral and dental evaluation from April 2015 to December 2021 were included.Results567 dogs of 95 different breeds were included, with a total of 695 evaluations. Body weight ranged from 0.8 kg to 79 kg (median 14.4 kg) and age from 3 months to 16 years and 4 months (median 6 years and 9 months). Clinical mobility was evaluated under general anesthesia using a 0 to 3 scale, in lateromedial (LM) and dorsoventral (DV) directions. The symphysis was radiographically classified as being fused or open. The open symphyses were further radiographically divided in having parallel or divergent margins. At the time of the first evaluation DV mobility was 0 in 551 cases (97.2%) and 1 in 16 cases (2.8%). LM mobility was 0 in 401 cases (70.7%), 1 in 148 cases (26.1%) and 2 in 18 cases (3.2%). There was not a significant change in mobility over time for cases examined more than once (P= 0.76). All cases had an intraoral radiographic examination. 83.8% of the radiographs were included in the statistical analysis. Two symphyses (0.4%) were classified as fused and 473 (99.6%) as open, 355 (74.7%) having divergent margins and 118 (24.8%) parallel margins. Logistic regression models exploring factors that affected DV and LM mobility were statistically significant (P < 0.0001; P < 0.0001), with an increase in LM mobility predicting an increase in DV mobility, and vice versa. An increase in age and in bodyweight was associated with a decrease in mobility. There was no statistical difference in clinical mobility across specific breeds or sexes. Increased probability of a divergent symphysis and increased DV mobility was found to be associated with a brachycephalic conformation. The increase in LM mobility was comparatively higher in small brachycephalic breeds compared with larger brachycephalic breed.DiscussionThe majority of the cases showed little to no mobility of the mandibular symphysis and radiographically bony fusion can be rarely seen.

Introduction, aim: This article provides an overview of current knowledge on the relationship between orthodontic treatment and the emergence of gingival recession. It summarises the results of available studies published since 1973. The views of various authors are different. Gingival recession is multifactorial in origin, with the following cited as risk factors: dehiscence of the alveolar bone, gingival phenotype, thin biotype of the bone of the alveolar process, the shape of symphysis, dental malposition, the articulation of the dentition, inappropriate oral hygiene technique, tension of the mucosal folds and many others. Methodology: The scientific databases PubMed, Science Direct, Google Scholar, Embase, and Web of Science were used for the research. Key words (gingival recession, orthodontic treatment, incisor protrusion, symphysis, gingival biotype) were entered into the search and articles were studied. Important facts and results of individual studies were written down. Conclusion: The issue of recessions is complex and multifactorial. It is important to correctly assemble a treatment plan with regard to the condition of the periodontium, gingival phenotype, bone biotype of the alveolar process, facial skeleton (shape of the symphysis), level of dental hygiene as well as regular check-ups in the retention phase of treatment in order to avoid possible complications of fixed retainers. [ABSTRACT FROM AUTHOR]

Mandibular fractures are very rare in the paediatric age group; however, they remain the most common maxillofacial trauma occurring in children. A paediatric mandibular fracture can cause severe pain and discomfort for the patient. Due to the complex anatomy of the developing mandible, such as the presence of permanent tooth buds and its small size, the treatment of mandibular fractures in the paediatric age group differs markedly from that in adults. Treatment of maxillofacial fractures in the paediatric population has always been a challenge for the operating surgeon. Different treatment modalities for managing paediatric mandibular fractures include closed reduction or surgical intervention. Open/closed cap splint provides closed reduction and stabilisation of paediatric mandibular fractures without any risk of damage to permanent tooth buds. It is more commonly preferred over Open Reduction and Internal Fixation (ORIF) of the fractures. However, for highly displaced fractures, ORIF is the preferred treatment. In the present case report, the author present and describe the management of a mandibular symphyseal and medial pole of the right condyle fracture in a seven-year-old patient. Since the bone fragments were highly displaced and occlusion was severely deranged with an anterior open bite, conservative treatment using a cap splint was not considered. ORIF was performed under general anaesthesia. At the oneyear follow-up, complete clinical and radiological bone healing was observed. Occlusion was satisfactory, and mouth opening was maintained. There was normal eruption of permanent teeth with no complications or delays associated with the eruption pattern. [ABSTRACT FROM AUTHOR]

Effective treatment strategies for a mandibular fracture, especially a condylar fracture, have yet to be established. The purpose of the present study was to examine characteristics and treatment management practices to compare between bilateral and unilateral condyle fractures combined with a symphysis fracture. This retrospective study included 30 patients with a mandibular condyle fracture combined with a symphysis fracture. They were divided into the unilateral and bilateral condyle fracture groups. Variables noted included fracture etiology, fracture sites, treatment methods, and functional evaluations. In patients with a mandibular condyle fracture combined with a symphysis fracture, the most common cause of injury was a fall. High condyle fractures accounted for the majority of bilateral fracture cases, with low condyle fractures seen in the majority of those with a unilateral fracture. Moreover, in the bilateral fracture group, in not only patients with a low condyle fracture but also those with a high condyle fracture, ORIF was performed on at least one side, with IR used for the other side, resulting in early postoperative recovery of range of mouth opening and reduction in temporomandibular joint pain. The results of the present study indicated that while the causes were common, condyle fracture sites differed between cases with a bilateral and those with a unilateral condyle fracture when combined with a symphysis fracture. The findings in the present study suggest that treatment with a combination of ORIF and IR may be better for obtaining good functional recovery in the bilateral fractures pattern. [ABSTRACT FROM AUTHOR]

Abstract Purpose Does the cylindrical shaped bone block allow a stable construct for the arthrodesis of the pubic symphysis compared to a rectangular shaped bone block. The cylindrical shaped bone block stabilized by a 3.5 symphyseal plate is inferior to the stabilization with an internal fixator. Methods This study analyzed the arthrodesis of the pubic symphysis on 24 synthetic pelvises, using a rectangular shaped bone block (control group) or a cylindrical shaped bone block, stabilized with a symphysis locking plate (n = 8) as the standard clinical procedure. Additionally we analyzed the stability using an internal fixator. Results This study showed that utilizing a cylindrical shaped synthetic bone graft results in a significant higher contact area and compression force compared to the classical rectangular shaped graft. Furthermore, the stabilization with an internal fixator had the tendency for increases of compression force and contact area, yet without a statistical significance, when compared to the plate fixation. Conclusion The novel method of cylindrical symphysis resection and cylindrical bone block implantation allowed an increased biomechanical stability compared to using a classical rectangular bone graft, also resulting in higher contact area. Moreover, this technique would also allow a minimally invasive approach for this purpose, which in turn could preserve perisymphyseal ligaments, thereby improving healing in a clinical context.

In guinea pigs (Cavia porcellus), dystocia is a common occurrence. Several factors have been identified in the literature, including the ossification of the pubic symphysis following failure to breed before 9-12 months of age. The objective of this study was to investigate the ossification of pubic symphysis and its evolution during growth in two groups of females. The first group consisted of non-breeding females, while the second group comprised females introduced to breeding at 4-6 months of age. Twelve pairs of sows were selected for comparison, with one non-breeding and one breeding sow in each pair. Symphysis width and tissue density were assessed using micro-computed tomography. Measurements included the distance between the acetabula, width and bone density of the pubic symphysis. Serial computed tomography scans were performed on each sow over several months, both before and after parturition. The results revealed a significantly higher symphysis width in females that had bred. In addition, symphysis ossification was absent in both breeding and non-breeding sows, contrary to previous descriptions of this species. Therefore, dystocia in guinea pigs may not be attributable to ossification of the pubic symphysis., (© 2024 The Author(s). Veterinary Medicine and Science published by John Wiley & Sons Ltd.)

Objective: To analyze the factors of the course and outcome of pregnancy in women with pubic joint dysfunction (DLS).Materials and Methods: Th e authors performed a retrospective analysis of the course of pregnancy and the outcome of childbirth in women with pubic joint dysfunction (DLS) observed in 2016 – 2019. As a result, data on the clinical course of pregnancy and childbirth in 75 women with DLS were obtained. All women underwent routine clinical and biochemical examinations, ultrasound diagnostics (US), dopplerometry (DPM), and cardiotocography (CTG). Th e analysis of all the above parameters was carried out according to the data of birth histories for 2016-2018. Statistical processing of the obtained results was carried out using the programs Statistica 10 and Microsoft Excel 2013.Results: Clinical manifestations, as well as changes in ultrasound data, became the main factor in deciding on the method of delivery. All patients with second-degree DLS delivered by elective Caesarean section at 39 – 40 weeks of gestation. Women with the fi rst degree of DLS had a vaginal birth. Ultrasound examination in the postpartum period did not reveal an increase in the diastasis of the pubic joint in any woman. All the postpartum women had no complications during the postpartum period.Conclusion: DLS is a serious complication, which can lead to serious consequences in some cases in the postpartum period. It may require surgical treatment and subsequent long-term rehabilitation. For early diagnostics of DLS, it may be advisable to conduct a mandatory ultrasonic examination of the pubic joint, which is the “gold standard” for the diagnosis of this pathology, to all patients during screening ultrasonic examination.

Objective: The present study aimed to assess the morphology of symphysis and alveolar bone thickness (ABT) surrounding mandibular incisors in thalassemic patients, as compared to unaffected individuals. Methods: This case-control study was conducted on lateral cephalograms of 60 thalassemic and 60 unaffected patients with Class II malocclusion seeking orthodontic treatment at Dental School, Shiraz University of Medical Sciences. The sample was divided into three subgroups including hyperdivergent, normodivergent, and hypodivergent, according to the Jarabak index. Symphysis dimensions and alveolar bone thickness surrounding mandibular incisors were measured using AutoCad software. Finally, the correlation between alveolar bone thickness and symphysis morphology was assessed. Results: In general, chin dimensions and bone thickness at different levels of mandibular incisor roots (cervical, middle, apical) were smaller in thalassemic adolescents than controls. Concerning the total sample as well as the normodivergent subgroup, significantly lower values were observed in thalassemic patients for symphysis width, total ABT at the cervical, and lingual ABT at the apical root area compared to controls (p < 0.05). The hypodivergent growth pattern was not associated with any statistical differences between the groups (p > 0.05). In both thalassemic and control subjects, symphysis width showed a weak to moderate positive correlation with ABT of lower incisors (p < 0.05), whereas symphysis height showed a moderate positive correlation with cervical ABT in only ß-thalassemia patients (p < 0.05). Conclusions: Compared to controls, ß-thalassemia patients showed thinner alveolar bone at different levels of lower incisor roots and smaller symphysis dimensions. There were significant correlations between symphysis dimensions and alveolar bone thickness of mandibular incisors in the sample. [ABSTRACT FROM AUTHOR]

Midline clefts of mandible and lower lip are rare congenital facial deformities. Non-union of bone in the symphysis of the mandible, median cleft of the lower lip and tongue adherence in the midline to the floor of the mouth are the principle features of the anomaly. Early surgical correction of both hard and soft tissue defects resulted in excellent function such as mastication and speech. 12-yr follow-up shows total bony fusion of the symphysis and normal growth of mandible as per the chronologic age of patient. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: The present study aimed to assess the morphology of symphysis and alveolar bone thickness (ABT) surrounding mandibular incisors in thalassemic patients, as compared to unaffected individuals. Methods: This case-control study was conducted on lateral cephalograms of 60 thalassemic and 60 unaffected patients with Class II malocclusion seeking orthodontic treatment at Dental School, Shiraz University of Medical Sciences. The sample was divided into three subgroups including hyperdivergent, normodivergent, and hypodivergent, according to the Jarabak index. Symphysis dimensions and alveolar bone thickness surrounding mandibular incisors were measured using AutoCad software. Finally, the correlation between alveolar bone thickness and symphysis morphology was assessed. Results: In general, chin dimensions and bone thickness at different levels of mandibular incisor roots (cervical, middle, apical) were smaller in thalassemic adolescents than controls. Concerning the total sample as well as the normodivergent subgroup, significantly lower values were observed in thalassemic patients for symphysis width, total ABT at the cervical, and lingual ABT at the apical root area compared to controls (p < 0.05). The hypodivergent growth pattern was not associated with any statistical differences between the groups (p> 0.05). In both thalassemic and control subjects, symphysis width showed a weak to moderate positive correlation with ABT of lower incisors (p< 0.05), whereas symphysis height showed a moderate positive correlation with cervical ABT in only ß‐thalassemia patients (p< 0.05). Conclusions: Compared to controls, ß-thalassemia patients showed thinner alveolar bone at different levels of lower incisor roots and smaller symphysis dimensions. There were significant correlations between symphysis dimensions and alveolar bone thickness of mandibular incisors in the sample.

Background: Distances between anatomic landmarks and anatomic structures at risk are often underestimated by surgeons.Purpose: The goal of the study was to evaluate the distances between anatomic landmarks and the spermatic cord in case of anterior plating of the symphysis.Methods: A total of 25 pelves (50 hemipelves) of male embalmed cadavers were dissected. A 5-hole 3.5mm locking compression plate (Synthes GmbH) was fixed from directly anterior on the symphysis. Measurements were taken 1) distance between the tips of both pubic tubercles, 2) horizontal interval between the lateral border of the plate and the medial margin of the SC (bilateral), 3) distances between the medial border of the SC and the tip of the pubic tubercle (bilateral), 4) distances between the medial border of the SC and the lateral basis of the pubic tubercle (bilateral).Results: The distance between the pubic tubercles was 60.3mm in average (SD: 5.7). The interval between the lateral border of the plate and the medial margin of the SC was on average 4.5mm (SD: 1.9) on the right and 4.7mm (SD: 2.6) on the left side. The distance between the tip of the pubic tubercle and the medial border of the SC was in average 11.2mm (SD: 2.7) on the right, and 11.0mm (SD: 2.7) on the left side. The average distance between the medial border of the SC and the lateral basis of the pubic tubercle was 8.1mm (SD: 2.4) on the right and 8.2 mm (SD: 2.4) on the left side.Conclusion: The SC is at risk not only during dissection but also during anterior plating of the symphysis, because of its close relation to the SC.Clinical Relevance: Average distances between the palpable pubic tubercle and the SC are below one finger breadth (as reference). [ABSTRACT FROM AUTHOR]

This study presents a detailed documentation of a total endoscopic anterior pelvic approach (TAPA) for plate fixation of a symphyseal disruption. The purpose of this work is to describe a minimally invasive technique as a possible method for reducing complications and hospitalization. Other goals included giving technical recommendations and assessing potential pitfalls and problems of this new surgical approach. Surgery was performed in an interdisciplinary setting by an experienced orthopaedic and general surgeon. The first endoscopic approach used to visualize the injury was the same as is used for endoscopic hernia surgery. The repositioning of the symphysial rupture was achieved either through external fixation or indirectly with traction and a pelvic binder. Plate positioning and fixation were achieved through two additional, minimally invasive incisions. The endoscopic approach shows multiple advantages, such as no detachment of the rectus abdominis muscle and smaller skin incisions. Furthermore, this approach could lessen the incidence of hernia and postoperative pain. We see the presented technique as a simple and innovative surgical method for treating symphyseal disruption. [ABSTRACT FROM AUTHOR]

Abstract Background With the aid of implants, Björk identified two-dimensional mandibular stable structures in cephalograms during facial growth. However, we do not know what the three-dimensional stable structures are with certainty. The purpose of this study was to identify the most stable mandibular landmarks in growing patients using three-dimensional images. Methods The sample was comprised of two cone-beam computed tomography (CBCT) scans taken about 4.6 years apart in 20 growing patients between the ages of 12.5 (T1) and 17.1 years (T2). After head orientation, landmarks were located on the chin (Pog), internal symphysis (Points C, D and E), and mandibular canals, which included the mental foramina (MF and MFA) and mandibular foramina (MdF). The linear distance change between Point C and these landmarks was measured on each CBCT to test stability through time. The reliability of the suggested stable landmarks was also evaluated. Results The total distance changes between Point C and points D, E, Pog, MF, and MFA were all less than 1.0 mm from T1 to T2. The reliability measures of these landmarks, which were measured by the Cronbach alpha, were above 0.94 in all three dimensions for each landmark. From T1 to T2, the distance changes from Point C to the right and left mandibular foramina were 3.39 ± 3.29 mm and 3.03 ± 2.83 mm, respectively. Conclusions During a growth period that averaged 4.6 years, ranging from 11.2 to 19.8 years old, the structures that appeared relatively stable and could be used in mandibular regional superimpositions included Pog, landmarks on the inferior part of the internal symphysis, and the mental foramen. The centers of the mandibular foramina and the starting points of the mandibular canal underwent significant changes in the transverse and sagittal dimensions.

Objective: To compare the morphological symphysis in normodivergent patients of short and normal mandible attending outpatient department of large public sector dental hospital of Karachi, Pakistan. Methods: This was a prospective observational study that was carried out at the outpatient department of the orthodontics, Sindh Institute of Oral Health Sciences, from June-2020 to December-2020. The study included 70 (35 in each group) patients with a normal angle MMA over the range of 25.5° ± 5.3°. McNamara analysis has been carried out including all the patients and dividing into two group's i.e., normal mandible and short mandible. On cephalogram, perpendicular distance from Pog to B-Me line, angle symphysis vertical dimension (B-B1-Gn), and angle symphysis convexity (B-Pog-Me), were measured for all patients. Results: Of 70 patients, there were 24 (34.3%) males and 46 (65.7) females. Patients were equally divided into two groups, i.e., short 35 (50.0%) and normal mandible 35 (50.0%). The mean angle of symphysis convexity, symphysis vertical dimension, and anterior prominence of symphysis of participants were 124.6 ± 42.8, 49.9 ± 4.7, and 4.1 ± 1.1 respectively. Patients of short mandibular were found significantly higher in symphysis convexity as compared to patients of normal mandibular, i.e., 136.54 ± 3.55 and 112.74 ± 58.53 respectively, (p- value= 0.022). Conclusion: Symphysis convexity was found greater in short mandible patients showing that in short mandible patients, symphysis was flatter anteriorly, less convex, and less prominent.

Background and Objectives: Malignant pleural effusions (MPE) are a frequent and major turning point in neoplastic disease usually leading to poor life expectancy. Improve quality of life and relieve the dyspnea are the main objectives in this palliative care setting. This can be achieved by the placement of an indwelling catheter (IPC) or talc pleurodesis ideally performed by thoracoscopy route (talc poudrage). Beside to misidentify a trapped-lung, the latter requires a prolonged hospital stay and the IPC placement does not allow a high pleurodesis rate. To overcome these drawbacks, a combination of both technique could be proposed for the management of recurrent malignant pleural effusions. Safety and efficacy of this pragmatic approach are reported., Methods: Consecutive patients who have been managed for recurrent MPE by a combination of talc poudrage for pleural symphysis by thoracoscopy route ending with the insertion of IPC using the same thoracic point of entry. Demographic data, hospital length of stay (LOS), procedural-related complications, patients' quality of life (QoL) and success of pleurodesis were collected. Patients were followed-up for 6 months., Results: The data of twenty-five consecutive patients undergoing the procedure were analyzed. Successful pleurodesis was obtained for 14/25 patients (66 %) at one month, 17/20 patients (85 %) at 3 months and 13/15 patients (86 %) at 6 months respectively. On average, the hospital LOS after the procedure was 3.24 days (IQR 1-4) with a median of 1 day. A prolonged hospitalization (>1 day) was never due to the procedure except for one patient (pneumothorax). No IPC related infection or procedure related deaths were noted., Conclusion: Among patients with recurrent MPE, the combination of talc poudrage symphysis by thoracoscopy route and IPC placement on the same time results in a shortened hospital LOS and higher rate of pleurodesis. Further randomized clinical trials are needed to confirm these results., Competing Interests: Declaration of competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

ABSTRACT Objectives: This study aimed to (I) assess the morphology of the symphysis and soft tissue chin associated with sex, age and sagittal/vertical skeletal patterns, and (II) identify the individual and combined contributions of these variables to different portions of the symphysis. Methods: This cross-sectional study included 195 lateral cephalometric radiographs from untreated adults. Alveolar, basal, and soft tissue of the symphysis were measured by an X/Y cranial base coordinate system, and divided in accordance to four predictor variables: sex, age, and sagittal/vertical skeletal patterns. Parametric tests were conducted for comparison and correlation purposes, while multiple regression analysis was performed to explore combined interactions. Results: Alveolar inclination is related to sagittal and vertical patterns, and both explained 71.4% of the variations. Alveolar thickness is weakly predicted and poorly influenced by age. Symphysis height was 10% higher in males, and associated with a vertical skeletal pattern and sex, and both explained 43.6% of variations. Basal symphyseal shows an individual thickness, is larger in males, and vertically short-positioned with age. Soft tissue chin is not necessarily related to the size of the underling skeletal pattern, and enlarges with age, even in adulthood. Conclusions: The symphysis and surrounding tissues are influenced by sex, age, and sagittal and vertical patterns, acting differently on the alveolar, basal and soft tissue portions. Sagittal and vertical skeletal patterns are the strongest association on alveolar symphysis inclination, whereas sex and age acts on the vertical symphysis position and soft tissues thickness.

Summary: Transrectal ultrasonography of the lumbosacroiliac area is routinely performed for the diagnosis of the cause of low back pain and poor hindlimb impulsion and engagement. The ventral aspect of the caudal lumbar intervertebral discs and vertebrae can be easily assessed transrectally with ultrasound while other imaging modalities have limitations for diagnosis of intervertebral disc injuries. This paper is a review of the ultrasonographic procedure for imaging the ventral aspect of the caudal lumbar and lumbosacral symphyses, especially the intervertebral discs. Normal images, findings and lesions of the three caudalmost lumbar intervertebral discs are described (between the 4th lumbar and the 1st sacral vertebrae). [ABSTRACT FROM AUTHOR]

Objective: To compare the morphology of symphysis in normodivergent patients of short and normal mandible attending outpatient department of large public sector dental hospital of Karachi, Pakistan. Methods: This was a prospective observational study that was carried out at the outpatient department of the orthodontics, Sindh Institute of Oral Health Sciences, from June-2020 to December-2020. The study included 70 (35 in each group) patients with a normal angle MMA over the range of 25.5° ± 5.3°. McNamara analysis has been carried out including all the patients and dividing into two group's i.e., normal mandible and short mandible. On cephalogram, perpendicular distance from Pog to B-Me line, angle symphysis vertical dimension (B-B1-Gn), and angle symphysis convexity (B-Pog-Me), were measured for all patients. Results: Out of seventy (70) patients, there were 24 (34.3%) males and 46 (65.7) females. Patients were equally divided into two groups, i.e., short 35 (50.0%) and normal mandible 35 (50.0%). The mean angle of symphysis convexity, symphysis vertical dimension, and anterior prominence of symphysis of participants were 124.6 ± 42.8, 49.9 ± 4.7, and 4.1 ± 1.1 respectively. Patients with short mandible were found to have significantly higher in symphysis convexity as compared to patients of normal mandibular, i.e., 136.54 ± 3.55 and 112.74 ± 58.53 respectively, (p-value= 0.022). Conclusion: Symphysis convexity was found greater in short mandible patients showing that in short mandible patients, symphysis was flatter anteriorly, less convex, and less prominent. [ABSTRACT FROM AUTHOR]

Achieving optimal aesthetics, function and phonetics with implant-supported restorations depends largely on the amount of bone present at the site where implant has to be placed. Sometimes, patient reports with compromised conditions which makes the implant placement difficult. Today, reconstruction procedures such as autogenous bone graft and guided bone regeneration make the implant placement possible in different ridge deficient cases. This case report describes step-by-step procedure of restoring the missing maxillary right central incisor with implant-supported prostheses. In missing left central incisor region, the alveolar bony defect was corrected by autogenous bone graft obtained from symphysis region, for restoration with implant prostheses.

Objectives: Variation in primate masticatory form and function has been extensively researched through both morphological and experimental studies. As a result, symphyseal fusion in different primate clades has been linked to either the recruitment of vertically directed balancing‐side muscle force, the timing and recruitment of transversely directed forces, or both. This study investigates the relationship between jaw muscle activity patterns and morphology in extant primates to make inferences about masticatory function in extinct primates, with implications for understanding the evolution of symphyseal fusion. Materials and methods: Three‐dimensional mandibular landmark data were collected for 31 extant primates and nine fossil anthropoids and subfossil lemur species. Published electromyography (EMG) data were available for nine of the extant primate species. Partial least squares analysis and phylogenetic partial least squares analysis were used to identify relationships between EMG and jaw shape data and evaluate variation in jaw morphology. Results: Primates with partial and complete symphyseal fusion exhibit shape‐function patterns associated with the wishboning motor pattern and loading regime, in contrast to shape‐function patterns of primates with unfused jaws. All fossil primates examined (except Apidium) exhibit jaw morphologies suggestive of the wishboning motor pattern demonstrated in living anthropoids and indriids. Discussion Partial fusion in Catopithecus, similar to indriids and some subfossil lemurs, may be sufficient to resist, or transfer, some amounts of transversely directed balancing‐side muscle force at the symphysis, representing a transition to greater reliance on transverse jaw movement during mastication. Furthermore, possible functional convergences in physiological patterns during chewing (i.e., Archaeolemur) are identified. [ABSTRACT FROM AUTHOR]

Meckel's Diverticulum is a sac-like protrusion of the intestinal wall. It is located at 40–60 cm from the caecum. In the majority of cases, Meckel's Diverticulum is clinically silent, while complications are found in 4% of the population. Complicated diverticulitis is associated with the formation of abscess, fistula, bowel obstruction or frank perforation. We present a case of a 63-year-old woman with a distended abdomen, pain in the lower right abdominal quadrant, fever 37°C and where emergency exploratory laparotomy revealed that obstruction was caused by a bowel loop trapped by a mesenterium-diverticular band. [ABSTRACT FROM AUTHOR]

This study tests whether three species of fossorial, scratch-digging mammals – Dasypus novemcinctus, Ictidomys tridecemlineatus, and Taxidea taxus – show commonality in pelvic anatomies inferred to be adaptive for this behavior and, correspondingly, divergence in these anatomies from nonfossorial species. The fossorial and nonfossorial species are in the same superorder or family; the comparative sets of species are D. novemcinctus with Bradypus variegatus and Choloepus hoffmanni, I. tridecemlineatus with Sciurus carolinensis, and Ta. taxus with Gulo gulo, Martes americana, and Neovison vison. Fossorial species are hypothesized to show higher prevalence of fusion of sacroiliac and sacroischial (if present) joints, reduction in size or loss of pelvic symphysis, greater number of sacral vertebrae, greater number of vertebrae in articulation with ilium and ischium, and longer ischium. Only males were used in the study; total sample size was 318 adults and 135 subadults. Results show commonality among fossorial species in greater number of sacral vertebrae and rigidity of the pelvis. One inconsistency with expectations is that the pelvic symphysis in fossorial species is as sturdy as in nonfossorial species, based on prevalence of symphyseal fusion and relative length and breadth of pelvic symphysis. Greater number of sacral vertebrae may be due to assimilation of a lumbar vertebra(−e) with the sacrum in fossorial species associated with their slow running speed. A rigid pelvis, due to fusion of pelvic joints and relatively longer or broader pelvic symphysis, effectively transfers forces between vertebral column and hind limb. [ABSTRACT FROM AUTHOR]

Background: With the aid of implants, Björk identified two-dimensional mandibular stable structures in cephalograms during facial growth. However, we do not know what the three-dimensional stable structures are with certainty. The purpose of this study was to identify the most stable mandibular landmarks in growing patients using three-dimensional images. Methods: The sample was comprised of two cone-beam computed tomography (CBCT) scans taken about 4.6 years apart in 20 growing patients between the ages of 12.5 (T1) and 17.1 years (T2). After head orientation, landmarks were located on the chin (Pog), internal symphysis (Points C, D and E), and mandibular canals, which included the mental foramina (MF and MFA) and mandibular foramina (MdF). The linear distance change between Point C and these landmarks was measured on each CBCT to test stability through time. The reliability of the suggested stable landmarks was also evaluated. Results: The total distance changes between Point C and points D, E, Pog, MF, and MFA were all less than 1.0 mm from T1 to T2. The reliability measures of these landmarks, which were measured by the Cronbach alpha, were above 0.94 in all three dimensions for each landmark. From T1 to T2, the distance changes from Point C to the right and left mandibular foramina were 3.39 ± 3.29 mm and 3.03 ± 2.83 mm, respectively. Conclusions: During a growth period that averaged 4.6 years, ranging from 11.2 to 19.8 years old, the structures that appeared relatively stable and could be used in mandibular regional superimpositions included Pog, landmarks on the inferior part of the internal symphysis, and the mental foramen. The centers of the mandibular foramina and the starting points of the mandibular canal underwent significant changes in the transverse and sagittal dimensions. [ABSTRACT FROM AUTHOR]

In this study, the topographic microscopic structure of the symphysis and cartilage disc of the human spine is illuminated. The synchondrosis of the spine consists of a symphysis between the vertebrae, a cartilage disc, a fibrous ring around it, and a resurrected core. On the surface of the upper and lower joints, the cartilage disc is densely adjacent to the articular surface of the spine. The inner surface of the cartilage disc is rather thick and consists of dense collagen fibers; the fibrous surface is relatively thin, surrounded by a fibrous layer about 2 times thinner. In different areas of the topography of the disc, a variety of histological structure of the cartilage tissue was observed. It was found out that in the dense cartilage layer of the edge, fibrous bunches are located along the circumference, in the inner layer of it in the radial direction, in the layer close to the resurrected core in the direction of chaos. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the pulp sensitivity and vitality of mandibular incisors and canines before and after bone harvesting in the symphysis. Materials and Methods: In 20 patients requiring bone grafts from the symphysis, pulp sensitivity (carbon dioxide [CO2]) and pulpal blood flow (laser Doppler flowmetry [LDF]) of mandibular incisors and canines were evaluated preoperatively, postoperatively, and 6 months after surgery. Teeth were allocated to 1 of 3 groups according to their initial and final reaction to CO2 (group A = teeth with a positive reaction throughout the study, group B = teeth that exhibited a sensitivity change from positive to negative, and group C = teeth with a negative reaction throughout the study). Results: Preoperative flux measurements (LDF) did not differ between groups A, B, and C. Teeth with sensitivity changes (group B) showed the greatest decrease (a statistically significant decrease) of pulpal blood flow over time, whereas teeth in groups A and C demonstrated an insignificant reduction of flux over time. Discussion and Conclusions: LDF was purely used as an experimental tool in the present study. Pulpal blood flow measurements using LDF demonstrated a decrease of flux over time in anterior mandibular teeth following bone harvesting in the symphysis. A significant change of flux, however, was only observed for teeth that also demonstrated a loss of pulp sensitivity during the same study period. Loss of pulp sensitivity appeared to be correlated to a significant decrease of blood flow assessed by LDF. [ABSTRACT FROM AUTHOR]

Purpose: The objectives of this study were (1) to compare the stability, evaluated by means of resonance frequency analysis (RFA), of implants placed posterior mandibles augmented with autogenous bone harvested from the mandibular symphysis with that of implants placed in nongrafted edentulous posterior mandibles and (2) to compare peri-implant marginal bone height changes and implant failure for the 2 groups. Materials and Methods: Eight patients with thin posterior mandibular ridges (buccolingual crestal width less than 4 mm) underwent labial onlay alveolar grafting with symphyseal bone blocks 4 months prior to placement of 17 implants. Seven nongrafted patients received 18 implants in the edentulous posterior mandible; these patients served as a control group. RFA was performed the day of implant placement (baseline), 1 month postplacement, 4 months postplacement (after prosthesis delivery), and 12 months postloading. Peri-implant bone height changes at a level of 0.01 mm were assessed using periapical radiographs at baseline, the 1-month follow-up, and the 4-month follow-up. Analysis of variance was used to evaluate statistical differences within the groups, and t test was used to make comparisons between groups. Results: None of the patients presented postoperative complications or implant failure. Mean implant stability quotient (ISQ) was 63.0 ± 6.0 to 70.2 ± 3.5 for the grafted group and 64.1 ± 4.1 ISQ to 70.1 ± 3.9 for the nongrafted group. No significant difference was found in mean ISQ between the grafted and nongrafted groups at baseline, the 1-month follow-up, 4 months postplacement, or 12 months postloading (P = .211, P = .873, P = .925, P = . 735, respectively). Mean peri-implant bone loss was 0.16 ± 0.04 mm mesially and 0.16 ± 0.05 mm distally. Conclusion: RFA revealed no difference in implant stability between mandibular ridges augmented with autologous bone grafts at baseline or after loading. [ABSTRACT FROM AUTHOR]

Introduction: Exposure to anterior mandible via conventional approach by either cervicular or vestibular incision is normally carried out for trauma or orthognathic surgery. Transection of mentalis muscle and reposition of the muscle is a key step. This prevents post-operative lip ptosis. Material and methods: A modified dissection technique is presented in the article to identify the bilateral mentalis muscles at its insertion and isolate it in order to preserve it if feasible for access or to transect it after demarcating so that it can be reoriented in its native position. Conclusion: The modified method is an anatomically direct functional approach to the anterior mandible. [ABSTRACT FROM AUTHOR]

Introduction: The primary objective of this retrospective study was to document the normal variation of clinical mobility of the mandibular symphysis in cats and possible associations with bodyweight, age, sex, sexual status, breed and skull morphology. Secondarily, the radiographic appearance of the mandibular symphysis and possible associations with the analyzed data were evaluated., Materials and Methods: Two hundred and sixteen cats of 15 different breeds that underwent maxillofacial, oral and dental procedures from April 2015 to December 2021 were included. Clinical mobility was evaluated under general anesthesia using a 0 to 3 scale in lateromedial (LM) and dorsoventral (DV) directions. The symphysis was radiographically classified on the occlusal radiographic view of the rostral mandibles as fused or open, and with parallel or divergent margins., Results: Bodyweight ranged from 2.2 to 12.5 kg (median 4.0 kg), age from 4 months to 17 years and 4 months (median 6 years and 4 months). At the first evaluation DV symphyseal mobility was 0 in 177 cases (82%), 1 in 32 cases (14.8%) and 2 in 7 cases (3.2%), LM mobility was 0 in 61 cases (28.3%), 1 in 110 cases (50.9%) and 2 in 45 cases (20.8%). 81.1% of the radiographs were included in the statistical analysis. Three symphyses (1.6%) were classified as fused and 190 (98.4%) as open, 129 (68.8%) having divergent margins and 61 (31.6%) parallel. One hundred and forty-eight cases (76.7%) did not show the presence of odontoclastic replacement resorption on the canine teeth (TR subgroup 1), 23 (11.9%) showed stage ≤3 lesions (TR subgroup 2) and 22 (11.4%) stage 4 lesions (TR subgroup 3). Logistic regression models exploring factors that affected DV and LM mobility were statistically significant ( p  < 0.0001; p  < 0.0001) with an increase in LM mobility predicting an increase in DV mobility, and vice versa. An increase in DV mobility was associated with an increase in age and in having resorptive lesions. A decrease in LM symphyseal mobility was associated with being brachycephalic., Conclusion: The great majority of cases showed some degree of LM symphyseal mobility, and 18% showed DV mobility. Symphyseal bony fusion is rare but possible., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Minei, Auriemma, Bonacini, Kent and Gracis.)

The purpose of this study was to identify the factors that impact the quality of life (QOL) scores of patients undergoing mandibulectomy. All patients with a diagnosis of an oral cavity neoplasm involving the mandible who underwent a mandibulectomy between January 1, 2000 and December 31, 2015 and completed a University of Washington QOL questionnaire (UW-QOL) were included in the study. Fifty-eight patients fulfilled all inclusion criteria and completed the UW-QOL questionnaire. Forty patients (69%) underwent a segmental mandibulectomy and 18 patients underwent a marginal mandibulectomy. Forty-eight patients (82.7%) had a free flap reconstruction. There was no significant difference in the QOL scores between patients who underwent a marginal or a segmental mandibulectomy. In contrast, patients who underwent symphysial resection reported significantly worse scores in various domains compared to patients with body or ramus segmental mandibulectomy. Patients who underwent a segmental mandibulectomy that included the symphysis had worse outcomes in chewing, recreation, health-related and social QOL domains compared to those whose mandibulectomy did not include the symphysis. [ABSTRACT FROM AUTHOR]

Background: Minimally invasive surgical approaches to reduce approach-associated morbidity are an interdisciplinary goal in surgery. In principle, the endoscopic approach for the extraperitoneal repair of groin hernias is the minimally invasive variant of the modified Stoppa-approach, which is used for the treatment of pelvic ring injuries in traumatology. Method: Anatomical feasibility study regarding the plate osteosynthesis of the anterior pelvic ring via a minimally invasive variant of the modified Stoppa-approach. Results: We present the minimally invasive variant of the modified Stoppa-approach in a human cadaver step by step, both photographically and radiologically. Feasibility of the plate osteosynthesis of the symphysis is presented in a patient with open book injury via the minimally invasive approach using standard laparoscopic instruments. Conclusion: The plate osteosynthesis of the anterior pelvic ring via the minimally invasive variant of the modified Stoppa-approach is feasible with existing standard laparoscopic instruments. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of the study is to assess the effectiveness of lag screw fixation in mandibular fractures with respect to parameters such as stability of the occlusion, functional stability, infection rates, neurosensory deficit, ease of technique, and maximum interincisal opening. Materials and Methods: Our study was carried out on 13 patients with mandibular fractures. Selected cases were treated with lag screw technique and 2.7 mm titanium screws were used. Postoperative complications such as wound dehiscence, infection, neurosensory disturbance, nonunion, malocclusion, postoperative mouth opening, and occlusal discrepancies were assessed. Results: All the patients were male, aged between 17 and 50 years. The cause of the injury was road traffic accidents in all, except for two assaults. Our study of 13 cases of fractured mandible included five symphyses, five parasymphyses, two angle, and one body fracture cases. Our observation with open reduction and rigid internal fixation with 1-2 lag screws revealed close approximation of fractured fragments in all the cases, except in three patients who had mild discrepancy of occlusion. Conclusion: Lag screw technique provides good interfragmentary compression and restoration of premorbid anatomic alignment of fracture fragments. In displaced mandibular fractures, especially in oblique fractures, the use of lag screw has proven to be ideal. The complications were found to be low. It was concluded that the lag screw provided excellent stability and occlusion. [ABSTRACT FROM AUTHOR]

Introduction: The uncertainty about the morphological classification of the manubriosternal joint is historical in the field of Anatomy and is still under discussion. This makes it difficult to teach and diagnosing related matters, especially those that require radiological images. In fact, this subject lacks specific data.Purpose: This study aims to describe the morphology of the manubriosternal joint and its age-related changes.Methods: Thirty specimens were divided in three groups: young adults up to 35 years of age, middle-aged adults ranging from 36 to 55, and older adults over 56 years. The subjects were labeled, and blind analysis were performed using the macroscopic and microscopic analysis.Results: The large presence of isolated fibroblasts and chondrocytes and the lower degree of isogenic groups proved that the manubriosternal joint is a symphysis. Its age-related changes involve the reduction of thickness and hydrated characteristics, loss of uniformity and arrangement of the collagen fibers, hyalinization and the presence of focal lesions, that corroborate with the degenerative process.Conclusion: The manubriosternal joint is classified as symphysis and the main age-related changes is the relative thickness of the tissue. [ABSTRACT FROM AUTHOR]

Summary: Background: Single injection ultrasound‐guided rectus sheath blocks are used for postoperative analgesia after midline abdominal incisions, but the ultrasonographic spread of medication posterior to the rectus muscle has not been investigated. Aims: The primary goal of this study was to determine the ultrasound‐measured medication spread superiorly and inferiorly after single injection ultrasound‐guided rectus sheath blocks and to calculate the incidence of cases with spread up to the subcostal margin and below of umbilicus. The secondary goals were to correlate the spread with the volume of medication administered and with the patient's age, weight, height, sex, and body mass index. Methods: Pediatric patients who underwent single injection ultrasound‐guided rectus sheath blocks and underwent data collection of ultrasonographic information on medication spread along the plane of the posterior rectus sheath were identified retrospectively from an acute pain service database at UPMC Children's Hospital of Pittsburgh. Results: Sixty‐eight children, 10.2 ± 4.2 (mean ± SD) years old, 41.7 ± 17.9 kg, 140 ± 24.6 cm, had complete data collection. Mean injected volume of ropivacaine was 8.3 ± 2.8 mL (right) and 8.2 ± 2.8 mL (left). The average spread was measured as 3.9 ± 1.4 cm (right) and 3.4 ± 1.3 cm (left) cranial to the umbilicus, and 1.5 ± 1.6 cm (right) and 1.6 ± 1.4 cm (left) caudal to the umbilicus. Complete spread up to the level of the subcostal margin was observed in 52.9% (n = 36; right) and 36.8% (n = 25; left) of cases. The spread correlated closely with the volume of injected ropivacaine (right: 0.556, P < 0.001; left: 0.541, P < 0.001). The spread below umbilicus was 70.6% (n = 48, right) and 80.9% (n = 55, left). There was a positive strong correlation (P < 0.001) between total medication spread and age (right: 0.608; left: 0.538), weight (right: 0.600; left: 0.540), and height (right: 0.593; left: 0.526). Conclusion: After single injection ultrasound‐guided rectus sheath blocks, incomplete cephalocaudal medication spread can be expected within the posterior rectus sheath. [ABSTRACT FROM AUTHOR]

Fifty patients with inadequate bone volume for implant placement were treated with mandibular bone grafts from the symphysis or ramus. The choice of donor site was determined by defect morphology and recipient site location. Although the harvest of bone was associated with low morbidity, the ramus donor site resulted in fewer complications. Implants were placed secondarily following a 4- to 6-month healing period. The onlay grafts exhibited minimal resorption and maintained their dense quality. The symphysis grafts were larger in overall volume, with a corticocancellous morphology. The ramus area provided essentially a cortical graft that was well suited for veneering ridge deficiencies; however, the surgical access in some cases was more difficult than in the anterior mandible. [ABSTRACT FROM AUTHOR]