• Title/Summary/Keyword: Anterior region

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Skin Thickness of the Anterior, Anteromedial, and Anterolateral Thigh: A Cadaveric Study for Split-Skin Graft Donor Sites

  • Chan, Jeffrey C.Y.;Ward, John;Quondamatteo, Fabio;Dockery, Peter;Kelly, John L.
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.673-678
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    • 2014
  • Background The depth of graft harvest and the residual dermis available for reepithelization primarily influence the healing of split-skin graft donor sites. When the thigh region is chosen, the authors hypothesize based on thickness measurements that the anterolateral region is the optimal donor site. Methods Full-thickness skin specimens were sampled from the anteromedial, anterior, and anterolateral regions of human cadavers. Skin specimens were cut perpendicularly with a custom-made precision apparatus to avoid the overestimation of thickness measurements. The combined epidermal and dermal thicknesses (overall skin thickness) were measured using a digital calliper. The specimens were histologically stained to visualize their basement membrane, and microscopy images were captured. Since the epidermal thickness varies across the specimen, a stereological method was used to eliminate observer bias. Results Epidermal thickness represented 2.5% to 9.9% of the overall skin thickness. There was a significant difference in epidermal thickness from one region to another (P<0.05). The anterolateral thigh region had the most consistent and highest mean epidermal thickness ($60{\pm}3.2{\mu}m$). We observed that overall skin thickness increased laterally from the anteromedial region to the anterior and anterolateral regions of the thigh. The overall skin thickness measured $1,032{\pm}435{\mu}m$ in the anteromedial region compared to $1,220{\pm}257{\mu}m$ in the anterolateral region. Conclusions Based on skin thickness measurements, the anterolateral thigh had the thickest epidermal and dermal layers. We suggest that the anterolateral thigh region is the optimal donor site for split-skin graft harvests from the thigh.

Restoration of Upper Anterior Dentition using Customized Anterior Guide Table (Customized Anterior Guide Table을 이용한 상악 전치부 수복증례)

  • Oh, Woo-Shik;Jeong, Seung-Mi;Kim, Hyeong-Seob
    • Journal of Dental Rehabilitation and Applied Science
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    • v.19 no.4
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    • pp.317-323
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    • 2003
  • When making crown and bridges on anterior regions, many practitioners consider the esthetics the most. For this reason functional aspect are not considered as much as the esthetics. If the occlusion on the anterior region are not formed correctly, movement of the temporomandibular joint can be disturbed and excessive stress can be occur that pathologic condition can be under lied. On this case presentation will show the importance of the anterior guidance and suggest the appropriate protocol of using customized anterior guide table. A 45years old male had to remake both of the upper central and lateral PFM because of the porcelain fracture. The new PFM crowns were made conventional methods without considering the anterior guidance. After the temporary setting, the patient complained of discomfort and short looking upper anteriors. To solve these problems we had to restore the palatal contour and length of the new crowns by making customized anterior guide table using temporary crowns that contains patient's old anterior guidance. This procedure which is copying the pt's comfortable anterior guidance to the final prosthesis made them to be esthetic and patients to feel comfortable.

The relationship between clinical crown form and gingival feature in upper anterior region (상악 전치부에서 치관 형태에 따른 치은의 특성)

  • Kim, Soo-Hyung;Chung, Hyun-Ju
    • Journal of Periodontal and Implant Science
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    • v.35 no.3
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    • pp.761-776
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    • 2005
  • The purpose of the present study was to examine the relationship between the form of the clinical crowns in the maxillary anterior segment and the clinical feature of gingiva such as morphological characteristics and the gingival thickness. Fifty periodontally healthy subjects were clinically examined regarding the probing depth, the thickness of the free gingiva, and the width of the keratinized gingiva. From study models of the maxillary anterior region, the width at cervical third(CW) and the length(CL) of the clinical crown, the papillary height, and the gingival angle of the 6 anterior teeth were measured. Each tooth was classified into 4 groups (longnarrow, NL; narrow, N; wide, W; short-wide, WS) according to CW/CL ratio and all the data were compared between groups NL and WS using independent t-test. Stepwise multiple regression analysis was performed for each tooth region with the gingival thickness at the level of sulcus bottom, the width of keratinized gingiva, and gingival angle as the dependent variables. As the results, the NL group of the upper anterior teeth displayed, higher papilla height, and narrower keratinized gingiva, more acute gingival angle resulting in pronounced "scalloped" contour of the gingival margin, compared to the WS group. There was no significant difference between groups NL and WS with respect to probing depth and the gingival thickness. The regression analyses demonstrated that the gingival thickness in central incisors was significantly associated to the mesio-distal width and bucco-lingual width of the crown, and labial probing depth. The width of keratinized gingiva was significantly associated with labial probing depth in central incisors and with proximal probing depth and gingival angle in lateral incisors, and with labial and proximal probing depth, and gingival angle in canines. The gingival angle was significantly associated with papillary height and CW/CL ratio and additionally with proximal probing depth in central incisors, with the width of keratinized gingiva in lateral incisors, and with labial probing depth and the width of keratinized gingiva in canines. These results indicate that the form of clinical crown in upper anterior region could influence the clinical feature of gingiva and the influencing factors might be different according to the tooth region.

3-dimensional reconstruction of mandibular canal at the interforaminal region using micro-computed tomography in Korean

  • Jeon, Yong Hyun;Lee, Chul Kwon;Kim, Hee-Jung;Chung, Jae-Heon;Kim, Heung-Joong;Yu, Sun-Kyoung
    • The Journal of Advanced Prosthodontics
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    • v.9 no.6
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    • pp.470-475
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    • 2017
  • PURPOSE. The purpose of this study was to identify the complex course of the mandibular canal using 3D reconstruction of microCT images and to provide the diagram for clinicians to help them understand at the interforaminal region in Korean. MATERIALS AND METHODS. Twenty-six hemimandibles obtained from cadavers were examined using microCT, and the images were reconstructed. At both the midpoint of mental foramen and the tip of anterior loop, the bucco-lingual position, the height from the mandibular inferior border, the horizontal distance between two points, and position relative to tooth site on the mandibular canal were measured. The angle that the mental canal diverges from the mandibular canal was measured in posterior-superior and lateral-superior direction. RESULTS. The buccal distance from the mandibular canal was significantly much shorter than lingual distance at both the mental foramen and the tip of anterior loop. The mandibular canal at the tip of anterior loop was significantly located closer to buccal side and higher than at the mental foramen. And the mental canal most commonly diverged from the mandibular canal below the first premolar by approximately $50^{\circ}$ posterior-superior and $41^{\circ}$ lateral-superior direction, which had with a mean length of 5.19 mm in front of the mental foramen, and exited to the mental foramen below the second premolar. CONCLUSION. These results suggest that it could form a hazardous tetrahedron space at the interforaminal region, thus, the clinician need to pay attention to the width of a premolar tooth from the mental foramen during dental implant placement.

Nutrient canals on mandibular anterior region in cone beam computed tomography (Cone beam형 전산화 단층영상을 이용한 하악전치부 영양관의 연구)

  • Kang Jung-Ho;Kim Gyu-Tae;Choi Yong-Suk;Hwang Eui-Hwan
    • Imaging Science in Dentistry
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    • v.36 no.3
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    • pp.137-143
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    • 2006
  • Purpose : To evaluate location, distribution, diameter, and length of the nutrient canals on mandibular anterior region using a cone beam computed tomography (CBCT). Materials and Methods : Mandibular CBCT was performed on 33 adults (18 males and 15 females) with no history of systemic disease, and any other dental surgery history Location, distribution, diameter, and length of the nutrient canals on mandibular anterior region were radiographically evaluated. A statistical comparison was done by SPSS. Results : In the location and distribution of nutrient canals, they were found in 6.8% at labial portion above root apex, in 93.28% at lingual portion above root apex in 46.2% at labial portion below root apex, and in 53.6% at lingual portion below root apex. Nutrient canals at lingual portion above root apex were most frequently observed between central and lateral incisors, and those at labial and lingual portion below root apex were most frequently observed between central incisors. The mean diameters of nutrient canals were 0.54 mm at labial portion above root apex, 0.61 mm at lingual portion above root apex, 0.66 mm at labial portion below root apex, and 0.76 mm at lingual portion below root apex. The mean lengths of nutrient canals were 2.63 mm at labial portion above root apex, 3.74 mm at lingual portion above root apex, 4.51 mm at labial portion below root apex, and 6.77 mm at lingual portion below root apex. Conclusion : CBCT is useful device to evaluate the anatomical structure of nutrient canals on mandibular anterior region.

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The Study of Asymmetrical of the Serratus Anterior and Lower Trapezius Muscles in Chronic Stroke Patients (만성 뇌졸중 환자의 앞 톱니근과 하부 등세모근의 비대칭성 연구)

  • Jeong, Ju-Ri;Lee, Wan-Hee
    • Journal of the Korean Society of Physical Medicine
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    • v.10 no.4
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    • pp.81-90
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    • 2015
  • PURPOSE: The purpose of this study was to compare the muscle architecture of serratus anterior and lower trapezius using rehabilitative ultrasound imaging (RUSI) in affected and unaffected side of chronic stroke patients. METHODS: The participants were thirty five patients with stroke hemiplegia in this study. RUSI was used to measure the muscle thickness of the serratus anterior and lower trapezius muscles. We compared the muscle thickness according to affected side and sex, determined the reliability of the measurement image. Independent t-test, intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were used for statistical analysis. RESULTS: Significant difference in muscle thickness of serratus anterior was observed between affected and unaffected side (p<.001). Muscle thickness according to gender showed a significant difference in unaffected side of serratus anterior (p<.05). Compare asymmetry ratio of serratus anterior and lower trapezius muscle thickness showed a significant difference (p<.001). ICC for intra-reliability was .944~.962 in serratus anterior and .873~.925 in lower trapezius muscle thickness, respectively. SEM was .001~.004 in serratus anterior and .002~.008 in lower trapezius muscle. CONCLUSION: This study, using RUSI, showed significant difference in muscle thickness of serratus anterior in affected and unaffected side of stroke patients. RUSI is a practical tool for measuring soft-tissue thickness in the scapular region muscle of stroke.

Analysis of Isometric Position of the Anterior Cruciate Ligament During the Knee Flexion-Extension (무릎 굴신 운동과 전십자 인대의 등장위치 해석)

  • Park J.H.;Son K.;Moon B.Y.;Suh J.T.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2005.06a
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    • pp.1933-1936
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    • 2005
  • The isometric area of the anterior cruciate ligament was calculated during knee flexion-extension. Flexion-extension motion data of the joint were obtained using Fastrak and a three-dimensional motion measurement system. A total of five subjects were seated on a flat table and the tibia sensor position was measured with the femur fixed on the table. A three-dimensional knee model was constructed using a graphic tool to simulate the knee motion. Twenty seven positions of the tibia region and forty two positions of the femur region were selected and the distances between the determined tibial and femoral points were calculated. Highly isometric areas were found and displayed as three dimensional aspects.

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Bone height measurements of implant sites : Comparison of panoramic radiography and spiral computed tomography (임플란트 매식부의 고경 평가 : 파노라마 촬영법과 나선형 전산화 단층촬영법의 계측 비교)

  • Cho Bong-Hae
    • Imaging Science in Dentistry
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    • v.32 no.2
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    • pp.61-66
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    • 2002
  • Purpose: To compare the bone height of implant sites measured using panoramic radiography and spiral CT. Materials and Methods : The available bone height was determined for 263 maxillary and mandibular implant sites in 59 patients. Distortion was calculated using the metal bar for the panoramic radiographs. Results: Significant differences in mean bone height between the two imaging modalities were found in maxillary and mandibular anterior regions (p<0.05). The mean difference in bone height recorded by the two techniques was smallest in the maxillary and mandibular molar areas (0.8 mm), and greatest in the mandibular anterior region (1.3 mm). With the exception of the mandibular anterior region, ninety percent of all the sites showed measurement differences within 2 mm. Conclusion: A safety margin of 2 to 3 mm is called for when utilizing panoramic radiography, otherwise additional imaging modality such as computed tomography is necessary to obtain accurate measurements.

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Assessment of the anterior loop of the mandibular canal: A study using cone-beam computed tomography

  • Nascimento, Eduarda Helena Leandro do;Pontual, Maria Luiza dos Anjos;Pontual, Andrea dos Anjos;Perez, Danyel Elias da Cruz;Figueiroa, Jose Natal;Frazao, Marco Antonio Gomes;Ramos-Perez, Flavia Maria de Moraes
    • Imaging Science in Dentistry
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    • v.46 no.2
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    • pp.69-75
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    • 2016
  • Purpose: Sufficient area in the interforaminal region is required for dental implant placement, and the anterior loop of the mandibular canal is located within the limits of this area. The aim of this study was to evaluate the prevalence and extent of the anterior loop in a Brazilian sample population using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images from 250 patients (500 hemimandibles) obtained for various clinical indications were randomly selected and evaluated to determine the presence and length of the anterior loop. The length of the anterior loop was then compared based on gender, age, and the side of the mandible. The data were analyzed using the Pearson chi-square test and linear regression analysis. Results: An anterior loop was identified in 41.6% of the cases, and its length ranged from 0.25 mm to 4.00 mm (mean, $1.1{\pm}0.8mm$). The loop had a greater mean length and was significantly more prevalent in males (p=0.014). No significant differences were found between the right and left sides regarding length (p=0.696) or prevalence (p=0.650). Conclusion: In this study, a high prevalence of the anterior loop of the mandibular canal was found, and although its length varied greatly, in most cases it was less than 1 mm long. Although this is a prevalent anatomical variation, safety limits for the placement of implants in this region cannot be established before an accurate evaluation using imaging techniques in order to identify and preserve the neurovascular bundles.

3 keys for successive direct esthetic restoration (성공적 직접 심미 수복을 위한 3가지 열쇠)

  • Cho, Sang Ho
    • The Journal of the Korean dental association
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    • v.54 no.1
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    • pp.16-20
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    • 2016
  • There is a difficulty for many practioner in anterior direct restroation with composit resin. Because its result is various according to patient, a practioner have a fear about that unpromisable result. Moreover in esthetic region, there is difference in satisfaction by patient character. That is one of difficulty in this practice. But if we make a manual for parctice it will be easier. So I will summarize the process and things to note in direct anterior composite resin restoration.

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