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Aim: Obstructive sleep apnea syndrome (OSAS) is a disorder characterised by repeated obstructions of the upper airway, with consequent episodes of apnea and hypopnea during sleep, snoring, and daytime sleepiness. Recently, a role of edentulism in the occurrence or in the worsening of this disorder was suspected. The aim of the study was to assess, through a cephalometric analysis, if the removal of denture induces, and where, modifications that can favour the pharynx collapse., Methods: A total of 27 subjects with complete or partial loss of teeth and with heavy loss of the vertical dimension, were examined. The patients were submitted to radiographs of the cranium in supine position, to simulate as much as possible the night condition, with the denture in intercuspal position (ICP), and in relaxed position both with denture (D-RP) and without it (edentule-relaxed position, E-RP). The radiographs were analysed through specific measures for OSA evaluating the parameters that could be modified by the denture., Results: The pharyngeal airway space (PAS) decreases, at the level of uvula, from ICP (6.7 mm) to RP (5.3 mm) (P< 0.05). The distance between the base and the tip of the tongue significatively decreased both from ICP vs E-RP (7.35 mm vs 6.87 mm; P< 0.05), both from D-RP to E-RP (7.22 mm vs 6.87 mm; P< 0.005)., Conclusions: From the data obtained from the cephalometric analysis it seems that wearing denture induces modifications in the position of the tongue, of the jaw and of the pharyngeal airway space that can favour the reduction of apnea episodes.

Purpose: To assess the anatomy of the mandibular lingual vascular canals with the use of computed tomography (CT)., Materials and Methods: Seventy consecutive patients underwent preimplantation CT of the mandible. CT images were obtained on axial plane by using a bone reconstruction algorithm and then processed with dedicated software (Dentascan). The number of lingual vascular canals, the diameter of their entrance foramina and the distance of the foramina from the symphysis menti and from the lower edge of the mandible were measured in each patient. The median superior canal (MSC), the median inferior canal (MIC), the lateral mesial canals (LMC) and the lateral distal canals (LDC) were evaluated separately., Results: 0 to 5 canals were found in each patient. The MSC was found to be present in 98.6% of cases; the mean diameter of the entrance foramen was 0.85+/-0.28 mm located adjacent the symphysis menti and 11.3+/-2.6 mm from the inferior margin of the mandible. The MIC was found to be present in 32.9% of cases; the mean diameter of the entrance foramen was 0.58+/-0.21 mm located adjacent the symphysis menti and 5.5+/-2.2 mm from the inferior margin of the mandible. LMCs were found to be present in 38.6% of cases; the mean diameter of their entrance foramina was 0.60+/-0.24 mm located 5.1+/-2.5 mm from the symphysis menti and 6.3+/-3.2 mm from the inferior margin of the mandible. LDCs were found to be present in 48.6% of the patients; the mean diameter of their entrance foramina was 0.58+/-0.19 mm located 19.3+/-7.3 mm from the symphysis menti and 6.6+/-5.4 mm from the inferior margin of mandible., Conclusions: Dental CT detects the lingual vascular canals of the mandible in a high percentage of subjects and allows a good demonstration of their number, location and entrance foramen diameter. The evaluation of these canals is important in the preoperative planning of dental implants or in the planning of dental surgery in general so as to avoid bleeding due to damage of the vessels present in these canals.

Fifty-three patients with oral cavity and tongue tumors were studied with MRI, 18 with CT and 10 with US. MR results were compared with postoperative and clinical results relative to the T variable of the TNM classification of oral cavity tumors. MRI demonstrated 51 of 53 tumors; it was in agreement with surgery, relative to T, in 43 of 48 cases and with clinics in 5 of 5 cases. In 5 patients MRI understaged: two lesions were classified as T0 because the tumors developed on the surface (p T4, for alveolar ridge infiltration). Moreover, MRI staged another lesion as T2 instead of T3 because of its superficial component, while in 2 cases the infiltration of the cortical bone of the jaw was not demonstrated (T1 at MRI, T4 at p; T2 at MRI, T4 at p). MRI was reliable enough to evaluate the relationships between the lesions and the surrounding structures but it was limited in demonstrating superficial lesions and in evaluating the infiltration of the alveolar ridge and of the cortical bone of the jaw in the early stage. The use of gadolinium proved to be especially useful for the exact definition of the size of the lesions and of their relationships with the surrounding structures. CT proved better than MRI to evaluate bone involvement in one case, even though neither technique could identify bone involvement in another patient. US yielded accurate information on the presence of lesions, their size and relationships with midline and floor of the mouth muscles, while its demonstration of the relationships between tumors and bone structures was poor, especially relative to tumor spread outside the oral cavity.

The videotape recording of the cinefluorographic images obtained with barium swallowing, proved to be very useful in studying pharyngo-esophageal motility. On the contrary, the method failed to be exhaustive in the study of the oral phase of swallowing. In 1983 Shawker et al. were the first authors to suggest the use of US to record tongue motility and the upward movement of hyoid bone. In a previous paper the authors had reported on the value of US videorecording in the dynamic study of oral swallowing, and of lingual bolus development and shape. In the present paper, the authors investigated how frequently the formation of lingual bolus can be recorded by means of US in patients with no dysphagic disorders. Sagittal and transverse scans were acquired in all patients with US units with 5 MHz probes connected to a U-matic videorecorder. In 98% of 50 examined patients, US demonstrated the presence of a lingual bolus in the preparatory phase of oral swallowing. Since lingual bolus formation in the oral phase of swallowing can be considered quite a normal event, the authors believe this finding to be a reliable reference-point in the study of oral swallowing.

The study was carried out on 28 dysgnathic patients submitted to surgical correction of malocclusion with the use of latero-lateral X-rays pre- and postoperatively. Cephalometry included a tongue and hyoid bone profiles and changes were assessed and quantified. It was interesting to note that aspecific evaluation of progenia patients confirmed the raising of the tongue and the lowering of the hyoid bone. Evaluation of the type of operation carried out led to further considerations. In patients undergoing combined operation there was a prevalence of a raising of the two components; mandible operation alone influences the downward shift of the tongue and hyoid bone. The advance of the upper maxillary, on the other hand, particularly when associated with segmentary osteotomy, is accompanied by a combined shift upwards of both tongue and hyoid bone.