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Objectives: To investigate the prevalence, location, size and course of the anastomosis between the dental branch of the posterior superior alveolar artery (PSAA), known as alveolar antral artery (AAA), and the infraorbital artery (IOA). Material and methods: The first part of the study was performed on 30 maxillary sinuses deriving from 15 human cadaver heads. In order to visualize such anastomosis, the vascular network afferent to the sinus was injected with liquid latex mixed with green India ink through the external carotid artery. The second part of the study consisted of 100 CT scans from patients scheduled for sinus lift surgery. Results: An anastomosis between the AAA and the IOA was found by dissection in the context of the sinus anterolateral wall in 100% of cases, while a well-defined bony canal was detected radiographically in 94 out of 200 sinuses (47% of cases). The mean vertical distance from the lowest point of this bony canal to the alveolar crest was 11.25±2.99 mm (SD) in maxillae examined by CT. The canal diameter was

Purpose The goal of this study was to investigate the incidence, location, and height of antral septa and to offer the clinician, through an accurate investigation of the anatomy of the maxillary sinus region, the tools to carry out sinus-lift procedures under safe conditions. Materials and Methods The study consisted of 60 sinuses from 30 human cadavers with an age range of 59 to 90 years. Only septa measuring 3.0 mm or greater in height were considered in our analysis. Results A total of 20 incomplete septa were found, showing an incidence of 33.3%, and no more than 1 septum per sinus was identified. All septa were located in the anterior-lateral wall and were either sagittal or transversal. Of the septa, 6 (30%) were located in the anterior region of the antral wall (between the second premolar and first molar roots), 8 (40%) were in the middle region (between the first and second molar roots), and 6 (30%) were in the posterior region (distal to the third molar roots). Antral septa height showed great variability, with a mean value of 8.72 mm (SD, 4.26; range, 3.7-18.4 mm). Our study also showed that 40% of our specimens (12 of 30 maxillas) have bony septa that can partially divide the sinus, and they were symmetric in 8 of 12 cases. Conclusions A sound knowledge of the maxillary sinus anatomy and of the possible anatomic variations is essential to prevent complications during surgical interventions involving this region.

Objective. This study traces the evolution of the scientific literature on pain published during the last 30+ years (1976–2007). Methods. Using the Web of Science®, pain-focused journal articles from the Science Citation Index Expanded™ published in 1977, 1987, 1997, and 2007 were retrieved and analyzed. Results. The number of pain-related publications rose from 1,562 articles for 1976–77 to 9,159 PubMed for 2006–2007, with slow growth for the period 1976–1995, and rapid increases from 1995–2007. The analysis of contributing countries showed two major players, the United States and the UK; the doubling of the number of countries involved in pain research from 40 in 1977 to 82 in 2007; and the appearance in 2007 of The Netherlands, Turkey, China, and Brazil among the top-15 most prolific contributors. During the 30-year period, the number of journals publishing pain-related research increased nearly 2.5-fold (363 journals in 1977 vs 972 in 2007), including 14 new, international pain-focused journals since 2000. Additionally, while there were only two pain journals (Pain and Headache) in 1977, 15 pain-focused journals were indexed in 2007 with the result that 17 of the top-20 pain-focused journals in 2007 did not exist in 1977. Conclusion. The rapid evolution and explosion of pain research in the last 30+ years was reflected in substantial changes in the landscape of the contributing countries and in the scientific journals targeted by pain researchers.

This study quantifies the utilization of acetaminophen in life sciences and clinical medicine using bibliometric indicators. A total of 1626 documents involving acetaminophen published by 74 countries during 2003-2005 in the Thompson-Scientific Life sciences and Clinical Medicine collections were identified and analyzed. The USA leads in the number of publications followed by the UK, and industrialized countries, including France, Japan and Germany; the presence of countries such as China, India and Turkey among the top 15 countries deserves to be noticed. The European Union stands as a comparable contributor to the USA, both in terms of number of publications and in terms of profile of papers distributed among subcategories of Life Sciences and Clinical Medicine disciplines. All documents were published in 539 different journals. The most prolific journals were related to pharmacology and/or pharmaceutics. All aspects of acetaminophen (chemistry, pharmacokinetics, metabolism, etc.) were studied with primary interest for therapeutic use (42%) and adverse effects (28%) comprising a large part of publications focusing on acetaminophen hepatotoxicity. This quantitative overview provides as to the interest of the scientific community in this analgesic and completes the various review documents that regularly appear in the scientific literature.

The vascularization of the auricle is poorly documented, despite the developments in auriculotherapy and reconstructive surgery. The aim of this study was to describe its arterial distribution using two techniques: diaphanization and anatomical dissection. The study was conducted after intravascular injection of eight diaphanized auricles and ten that were dissected. Dissection showed that the auricle is vascularized by an anterior flow arising in the superficial temporal artery and also by a posterior flow arising in the posterior auricular artery in eight cases out of ten, and in the occipital artery in the remaining two. Diaphanization revealed the three-dimensional arterial distribution of preserved specimens. This technique has a didactic use to complement to standard anatomical dissection.

Objective The aim of this study was to develop a new technique for maxillary sinus floor elevation through the crestal approach, using trephines and osteotomes with stops, and to assess the risk of sinus membrane lesion. Study design The study was performed on 30 heads removed from fresh nonpreserved cadavers with subsinus bone height ≥5 mm. The anatomic specimens were sectioned axially on a plane passing 1 cm below the infraorbital foramen, to be able to see and film the sinus floor covered by the membrane. A total of 112 implants were placed using this technique (48 without grafting material and 64 with grafting material). Results Using this technique, we obtained a 4-6 mm elevation of the sinus membrane without impairing the mucosa. In the 13 cases where membrane lesions were observed, 9 had been performed without grafting material. The greater the initial subsinus bone height, the higher the elevation observed. Conclusions The success of this technique was due to stops on the trephines and osteotomes, which reduced the risk of invading the sinus cavity and made it possible to lift the membrane gently, fully controlling movements. This technique is indicated for large crests of type III or IV bone and with a minimal bone height of 5 mm.

Resume L’objectif de cette etude est de preciser l’environnement anatomique des minivis placees du cote palatin entre la deuxieme premolaire et la premiere molaire maxillaires. L’etude est menee sur 24 maxillaires dentes preleves sur des cadavres non traites apres injection de latex colore dans le reseau carotidien et sur 40 maxillaires dentes secs. Des minivis de 7 et 9 mm de longueur sont placees a 5 et 8 mm du sommet du septum alveolaire. Pour diminuer le risque de lesions dentaire, sinusienne, vasculaire et nerveuse, l’utilisation de minivis courtes de 7 mm est indispensable, associee a une insertion perpendiculaire au grand axe des dents, a 5 mm du sommet du septum alveolaire.

During the 1974–2004 period, the sleep literature had quadrupled (2384 publications in 1974, and 9721 in 2004) while overall scientific productivity had only doubled. The set of the seven most productive countries (USA, Japan, United Kingdom, Germany, France, Canada and Italy) in sleep research, and the geographical region distribution remained stable over the three decades. On the other hand several indicators appeared in the sleep research literature during the 1990s: the increasing productivity of sleep researchers; the growing number of countries publishing on sleep; the continuous creation of sleep-focused journals; the scattering of sleep publication among increasingly more scientific journals; the turnover among the leading journals; and the emergence of new entities such as China, Turkey, and the European Union.

A bibliometric analysis of the literature covering a one-year period (2003) was performed to evaluate the number of scientific publications on sleep and its distribution among the European Union countries. 912 articles appearing in Life Sciences and Clinical Medicine journals indexed in the Institute for Scientific Information databases were downloaded. These articles were authored by EU researchers; Germany, the United Kingdom, France, and Italy rank at the top of the EU countries. The output distribution of the most productive EU countries are also presented and discussed. Despite the limitations of the methods used, the present results give an interesting snapshot of the EU publishing behavior in sleep research.

This study provides an overview of the sleep research literature in medicine and biology through bibliometric analyses of the distribution of journal articles per country, the average journal impact factor of each country, the journal subject category of each article, and the population and gross domestic product of the top-producing countries. The authors of the 2325 articles were from 66 countries — the most prolific being the USA, Germany, Japan, The United Kingdom, France and Canada. This study complements continuing subject reviews on sleep research and offers readers a better understanding of the literature size and research richness in this field.

Introduction: In order to characterize a nonbehavioral model for assessing local anaesthetic (LA) activity, the effects of different LA agents (articaine, bupivacaine, procaine, and tetracaine) were measured in the conscious rat using the jaw-opening reflex (JOR). Methods: One hundred sixty rats were chronically implanted with stimulating electrodes in the dental pulp of the low incisor. While animals were conscious and unrestrained, the JOR threshold was measured electrophysiologically via electrodes wrapped around the digastric muscle. Each LA was administered in the infratemporal area. The increase of the JOR threshold was assessed during a 3-h period following injection. Results: Statistical analysis of the data showed a dose-dependent response to the four drugs tested. When the highest dose of each drug (articaine and procaine: 24 mg kg−1, bupivacaine: 6 mg kg−1, tetracaine: 3 mg kg−1) was administered (i) an immediate effect was observed for tetracaine and bupivacaine, whereas a 5-min delay was needed for articaine and procaine to act on the JOR threshold and (ii) an increase (>60%) of the JOR threshold was observed. The effects lasted 90 min for articaine, 45 min for procaine and bupivacaine, and 15 min for tetracaine before a return to baseline values. Discussion: The rat JOR response combined with infratemporal injection of test drugs can be used for the pharmacological evaluation of LAs.

Resume Depuis une vingtaine d'annees, les reseaux de neurones ont progressivement ete employes dans le champ de la recherche biomedicale. L'ectroencephalographie a largement trouve sa place parmi les nombreux domaines d'application de ces outils. Dans cet article, nous presentons les principales caracteristiques des reseaux de neurones qui conferent a ces outils des capacites particulierement adaptees au traitement de l'electroencephalogramme. Cette presentation est accompagnee d'une bibliographie etoffee qui apportera au lecteur une vue d'ensemble des travaux menes dans ce domaine et qui pourra servir de point de depart pour de nouvelles recherches.

New methods of data processing combined with advances in computer technology have revolutionized monitoring of patients under anesthesia. The development of systems based on analysis of brain electrical activity (EEG or evoked potentials) by neural networks has provided impetus to many investigators. Though not claiming to be the end-all in patient monitoring, the potential and efficiency of the combination does indeed stand out. Various strategies are presented and discussed, as well as suggestions for further investigation.

The authors carried out an anatomic and magnetic resonance imaging study of the architecture of the elevator muscles of the mandible in 169 cadavers. The aim of this study was to define the architectural organization of the human masseter muscle, temporalis and pterygoid muscles. Layered dissections and anatomic sections in different spatial planes showed that the masseter muscle exhibited a typical pennate structure consisting of a succession of alternating musculoaponeurotic layers. The muscle had three well-differentiated parts: the superficial, intermediate and deep masseter muscles. The same pattern was constantly found: 1) for the superficial masseter, two alternate musculoaponeurotic layers oriented at 60 degrees in relation to the plane of occlusion, 2) for the intermediate masseter, a single musculo-aponeurotic layer oriented at 90 degrees in relation to the occlusal plane, 3) for the deep masseter, three musculoaponeurotic layers whose general orientation was at 90 degrees for the bounding layers and 110 degrees for the intermediate layer. The MRI study confirmed the reality of this architectural arrangement.

To investigate the prevalence, location, size and course of the anastomosis between the dental branch of the posterior superior alveolar artery (PSAA), known as alveolar antral artery (AAA), and the infraorbital artery (IOA).The first part of the study was performed on 30 maxillary sinuses deriving from 15 human cadaver heads. In order to visualize such anastomosis, the vascular network afferent to the sinus was injected with liquid latex mixed with green India ink through the external carotid artery. The second part of the study consisted of 100 CT scans from patients scheduled for sinus lift surgery.An anastomosis between the AAA and the IOA was found by dissection in the context of the sinus anterolateral wall in 100% of cases, while a well-defined bony canal was detected radiographically in 94 out of 200 sinuses (47% of cases). The mean vertical distance from the lowest point of this bony canal to the alveolar crest was 11.25 ± 2.99 mm (SD) in maxillae examined by CT. The canal diameter was1 mm in 55.3% of cases, 1-2 mm in 40.4% of cases and 2-3 mm in 4.3% of cases. In 100% of cases, the AAA was found to be partially intra-osseous, that is between the Schneiderian membrane and the lateral bony wall of the sinus, in the area selected for sinus antrostomy.A sound knowledge of the maxillary sinus vascular anatomy and its careful analysis by CT scan is essential to prevent complications during surgical interventions involving this region.

Objectives: To evaluate prevalence, size, location and content of foramina and bony canals located on the lingual side of the mandibular midline. Material and methods: The prevalence and the size of midline lingual foramina and canals visible above and/or below genial spines and their distances from the mandibular base were measured in 60 dry mandibles from adult human cadavers. In addition, macro-anatomic dissections were performed on another 20 mandibles injected with red latex to investigate the vascular canal contents associated with these midline lingual foramina and canals. Results: A total of 118 foramina were detected. All mandibles investigated had at least one lingual foramen at the midline above the genial spines, located at a mean height of 12.5±2.1 mm (SD) from the inferior border of the mandible. Macro-anatomic dissections showed a clear vascular branch entering the mandibular midline as a single vessel from a sublingual-sublingual anastomosis in 19 out of 20 mandibles studied (95%). Conclusion: Blood vessels in the floor of the mouth may be in close proximity to the lingual cortical plate of the mandibular midline in most cases. This implies that bleeding can occur when the mandibular cortical plate is perforated even minimally. As a consequence, the authors suggest a careful planning of implant positioning at mandibular midline, possibly opting for the use of an even number of implants in the interforaminal region, avoiding the risk of surgical trauma to the lingual cortical plate of the mandibular midline.

The goal of this study was the investigation of the arterial blood supply to the maxillary sinus to give clinicians the basis for a better understanding of the origin of vascular complications that can derive from surgical procedures at this level. The study consisted of 30 sinuses from 15 human cadavers with an age range of 59 to 90 years. To define the complex vascularization of the maxillary sinus, the afferent vascular network was injected with liquid latex mixed with red india ink through the external carotid arteries. An intraosseous anastomosis between the dental branch of the posterior superior alveolar artery, also known as alveolar antral artery, and the infraorbital artery was found in 100% of cases. Such an anastomosis seemed to guarantee the blood supply to the sinus membrane, to the periosteal tissues, and especially to the anterior lateral wall of the sinus. Moreover, the gingival branch of the posterior superior alveolar artery was found to anastomose an extraosseous branch of the infraorbital artery in 10 sinuses. The examination of the maxillary sinus also showed a close anatomic relationship among the sinus posterior wall, the descending palatine artery, and the sphenopalatine artery in all 30 sinuses. Small branches deriving from the posterior lateral nasal arteries have been found to perforate the nasal wall laterally and reach the mucosa of the maxillary sinus. A sound knowledge of the maxillary sinus vascularization is essential to prevent vascular complications during surgical operations involving this region.

Surgical procedures carried out between the chin foramina at the anterior mandible level are usually considered free of severe neurovascular complications, due to the excellent bone density in that region and the absence of important neurovascular structures. However, the international scientific literature on this issue reports rare but severe hemorrhagic complications following implant surgery at this level. The aim of this review article is to offer the clinician, through an accurate investigation of the anatomy of the median mandibular region, the tools to carry out oral surgery operations at this level under safe conditions, reducing the possible intraoperative risks to a minimum.

This paper is devoted to the construction of a complete database which is intended to improve the implementation and the evaluation of automated facial reconstruction. This growing database is currently composed of 85 head CT-scans of healthy European subjects aged 20-65 years old. It also includes the triangulated surfaces of the face and the skull of each subject. These surfaces are extracted from CT-scans using an original combination of image-processing techniques which are presented in the paper. Besides, a set of 39 referenced anatomical skull landmarks were located manually on each scan. Using the geometrical information provided by triangulated surfaces, we compute facial soft-tissue depths at each known landmark positions. We report the average thickness values at each landmark and compare our measures to those of the traditional charts of [J. Rhine, C.E. Moore, Facial Tissue Thickness of American Caucasoids, Maxwell Museum of Anthropology, Albuquerque, New Mexico, 1982] and of several recent in vivo studies [M.H. Manhein, G.A. Listi, R.E. Barsley, et al., In vivo facial tissue depth measurements for children and adults, Journal of Forensic Sciences 45 (1) (2000) 48-60; S. De Greef, P. Claes, D. Vandermeulen, et al., Large-scale in vivo Caucasian facial soft tissue thickness database for craniofacial reconstruction, Forensic Science International 159S (2006) S126-S146; R. Helmer, Schodelidentifizierung durch elektronische bildmischung, Kriminalistik Verlag GmbH, Heidelberg, 1984].

The aim of this study was to provide a quantitative view of the utilisation of the c-fos immunohistochemical method. Articles including the term "c-fos" in their title, abstract or keywords and published in 2004 were retrieved from the Current Content/Life Sciences or Current Content/Clinical Medicine collection of the SCI database. The 933 article-type documents retained were distributed in almost all the sub-disciplines of the Life Sciences and Clinical Medicine, but were principally published in the field of neuroscience. They were authored by researchers from 44 countries - the most prolific were the USA (435 articles), Japan (135) and the UK (55). The 933 articles were published in 283 different journals; all but one of the top-20 most prolific journals are in the Life Sciences discipline, and their Impact Factors ranged from 2.0 to 7.9. A comparison of the USA and the European Union scientific profiles is also made.

The authors have studied the medial pterygoid muscle on 179 fresh cadavers using anatomical dissection and magnetic resonance imaging (MRI). The aim of this study was to define the general morphology and architectural organisation of the human medial pterygoid. Plane by plane dissection, anatomical sections in different spatial planes on half heads and isolated blocks demonstrated that the medial pterygoid has different architectural disposition and insertional zones from those which are normally described. The study has shown that the muscle has a typical penniform structure made up of seven alternating muscular/aponeurotic layers and that the tendinous intramuscular sheets were particularly well developed. This allows supporting a future functional study.

This is a histological study of the human temporo-mandibular joint and its surrounding muscles. Using a microscopic study of serial sections from anatomical specimens from six subjects, the detailed anatomy of the joint is presented with particular regard to the histology. This study has allowed, in particular, the description of the ligaments and capsule as well as the insertions of the masticatory muscles (temporalis, masseter, lateral pterygoid) on this joint. These observations are then compared with the anatomical and histological data already reported on this subject. This study shows that the bulk of the muscular fibres of the lateral pterygoid passes under the foot of the disc is attached over the whole height of the condylar, unite and extend as far as the medial pole of the joint under the insertion of the articular disc. An insertion of the temporo-masseter musculo-tendinous complex on the anterior and lateral capsulo-discal structures was observed. The lateral pterygoid is composed of a succession of tendinous and fleshy fibres. This study confirms the thickening of the lateral capsule that corresponds to a lateral collateral ligament, and the absence of a medial collateral ligament. Medial stability is conferred by the lateral ligament of the contralateral joint.

New methods of data processing combined with advances in computer technology have revolutionized monitoring of patients under anesthesia. The development of systems based on analysis of brain electrical activity (EEG or evoked potentials) by neural networks has provided impetus to many investigators. Though not claiming to be the end-all in patient monitoring, the potential and efficiency of the combination does indeed stand out. Various strategies are presented and discussed, as well as suggestions for further investigation.

Statement of Problem. Little is known about tissue displacement at the tissue/denture base interface during impression making. Purpose. This study used a new 3-dimensional measurement system to analyze and compare 2 complete denture reline impression techniques (1 occluding and 1 digital) to determine which resulted in less displacement of the tissue/denture base interface during impression making. Material and Methods. The experiment included 10 completely edentulous subjects. For each subject, 3 mandibular casts were obtained: (1) a reference cast of the existing denture base, (2) a cast made with an occluding reline impression technique, and (3) a cast made with a digital reline impression technique. With the use of an optical 3-dimensional measurement system, the corresponding casts in a common coordinate system were analyzed geometrically. For each cast, the coordinates of the barycentric point and the high point were determined. For the same subject, the differences between the coordinates of the barycentric points of the 3 casts were calculated 2-by-2. The same calculation was performed for the high points. To determine whether these differences, which represent the displacements of the barycentric points and the high points, were statistically significant, the Wilcoxon signed-rank test for paired group comparisons was applied ( P Results. The uncertainty of measurement for the location of the barycentric and highest point was ±57 μm. The uncertainty in the differences among the cartographic displays was ±0.1 mm. Vertically, the mean distance that separated the barycentric points obtained with the 2 impression methods was 0.04 mm. Cartography data showed that the greatest dimensional differences between the 2 impression techniques (minimum 0.25 mm; maximum 1.5 mm) were located near the retromolar pad and along the lingual flange. Conclusion. Within the limitations of this 3-dimensional in vivo study, displacement of the tissue/denture base interface was essentially equivalent with the use of an occluding and a digital mandibular impression technique. (J Prosthet Dent 2002;87:603-12.)

A magnetic resonance imaging (MRI) study of the layout of the aponeurotic layers of the masseter muscle was done on a series of 18 patients, aged from 6 to 79 years. The study was undertaken in parallel with a study on 169 cadavers to correlate the anatomical dissection and MRI findings. The aims were as follows. On the cadavers, the results of dissection were compared with the results of MRI: the layer-by-layer dissections and the anatomical dissections of the different spatial planes have shown that the masseter muscle displays a penniform structure typically characterized by the presence of alternating muscular/aponeurotic layers. The anatomical sections and the MRI section in the same plane allowed the appearance of the intra-muscular aponeurotic layers on MRI to be defined. The patients were then divided into four age cohorts, and the arrangement and variations of the human masseter muscle defined as a function of age. This double study has brought new elements to the understanding of the timing of the development of the intra-muscular aponeurotic structures and the modifications which they undergo with ageing. It appears that the aponeurotic structures only become individually identifiable towards the age of 17 years and that ageing is accompanied by a reduction in the transverse muscular mass accompanied by a verticalization of the aponeurotic layers.