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Routine custom trays are difficult to use to make impressions for patients with microstomia. Several types of split custom trays have been introduced to accommodate these situations. A method of fabricating mandibular and maxillary sectional special trays and impression technique for a patient with small oral opening is described. Sectional maxillary and mandibular custom trays can enhance its stabilization during border molding and final impression making. Thus it helps in fabricating a better fitting complete denture for such patients and also makes the impression procedure easy for patient with limited opening as the tray can easily be inserted in two pieces. Keywords: Impression, Microstomia, Sectional custom tray.

Limited oral opening is an acquired or congenital abnormal condition that compromises patient esthetics, nutrition, and quality of life. In addition, it may hinder conventional prosthetic procedures of edentulous patients, make it challenging, and present difficulties at all its stages. This clinical report presents different clinical treatment options suitable to be chosen by the prosthodontic carer in the case of reduced oral aperture.

espanolObjetivos: Describir y analizar la posible relacion entre las caracteristicas clinicas y radiologicas de los pacientes intervenidos de una disfuncion temporomandibular (DTM) y la presencia asociada de las principales comorbilidades vinculadas al dolor cronico orofacial segun la literatura; el trastorno de ansiedad, la depresion mayor, la migrana y la fibromialgia. Material y metodos: Se realizo un estudio retrospectivo y descriptivo de pacientes diagnosticados e intervenidos mediante artroscopia de una DTM de predominio articular entre los anos 2006-2016. Distribuidos en dos grupos en funcion de la presencia de las comorbilidades descritas. Se realizo un analisis y descripcion de las principales variables de exploracion clinicas y radiologicas como el dolor (EVA), la apertura oral y la presencia de ruidos articulares, asi como del desplazamiento discal, la presencia de cambios degenerativos, el componente miofascial y los estadios de Wilkes. Estas variables fueron evaluadas de forma preoperatoria. Resultados: Un total de 280 pacientes fueron incluidos en el estudio distribuidos en 2 grupos, formados mayoritariamente por mujeres (92,14 %) con una media de edad de 38,6 anos. Las comorbilidades mas frecuentemente observadas fueron el trastorno de ansiedad (42 %), la asociacion entre ansiedad y depresion (22,7 %) y la depresion (11,4 %). Se describio una peor situacion clinica en el grupo de pacientes con comorbilidades asociadas, con significacion estadistica en las variables sexo, dolor, ruidos articulares y estadios de Wilkes Avanzados (IV-V). Conclusiones: Segun nuestro trabajo la mayoria de los pacientes intervenidos de una DTM cronica mediante artroscopia presentaban alguna comorbilidad vinculada al dolor cronico, destacando el trastorno de ansiedad. En este grupo de pacientes se observo ademas una peor situacion clinica y funcional especialmente significativa en cuanto al dolor. EnglishObjectives: Describe and analyze the possible relationship between the clinical and radiological characteristics of patients on temporomandibular dysfunction (TMD) artroscopy and the associated presence of the main comorbidities related to chronic orofacial pain according to the literature; anxiety disorder, major depression, migraine, and fibromyalgia. Material and methods: A retrospective and descriptive study of patients diagnosed and operated by artroscopy on a predominantly joint TMD between the years 2006-2016 was carried out. Distributed into two groups based on the presence of the comorbidities described. An analysis and description of the main clinical and radiological examination variables such as pain (VAS), oral opening and the presence of joint noises, as well as disc displacement, the presence of degenerative changes, the myofascial component and the stages of Wilkes were performed. These variables were evaluated preoperatively. Results: A total of 280 patients were included in the study distributed in 2 groups, formed mainly by women (92.14 %) with a mean age of 38.6 years. The most frequently observed comorbidities were anxiety disorder (42 %), association between anxiety and depression (22.7 %) and depression (11.4 %). A worse clinical situation was described in the group of patients with associated comorbidities, with statistical significance in the variables sex, pain, joint noises, and advanced Wilkes stages (IV-V). Conclusions: According to our study, most of the patients operated on chronic TMD by arthroscopy had some comorbidity related to chronic pain, highlighting the anxiety disorder. In this group of patients, a particularly significant worse clinical and functional situation was observed in terms of pain.

Correction of microstomia is challenging with a high rate of recurrence. We report the successful treatment of microstomia using acellular dermal matrix (ADM) as an adjunct for intraoral lining with >1 year of follow-up.A 9-year-old international patient with severe immunodeficiency presented with severe microstomia because of recurrent oral infections. She had undergone 3 previous failed attempts to re-establish an adequate oral opening and was dependent on enteral nutrition via gastrostomy tube. She underwent release of the oral commissure scar contracture and orbicularis oris and the resultant mucosal defect was lined with ADM. A postoperative splint was used for 8 weeks. One-year follow-up demonstrated maintenance of the oral aperture with complete mucosalization of the ADM; the patient was able to resume oral diet and regular dental hygiene.Mucosal reconstruction with ADM is a viable alternative to local flaps and in this case exhibited minimal soft tissue contraction.

Introduction Temporomandibular joint internal derangement is a common disorder, which usually resolves with conservative management. However, 5% of patients require surgery and although many techniques have been described, a gold standard surgical procedure has not yet been established. Objectives The aim of this study was to compare the clinical outcome of disc repositioning plus temporal eminectomy versus disc repositioning alone, for the treatment of temporomandibular joint internal derangement. Methodology Matched case-control retrospective pilot study. Records of patients diagnosed with temporomandibular joint internal derangement from January 2010 to December 2015 were studied. Eleven patients treated with disc repositioning plus temporal eminectomy for the case group and 11 patients treated with disc repositioning alone for the age- and gender-matched control group. Results No difference was found in terms of pain, noise or blockage with the maximum oral opening between the groups at the first or sixth month after surgery. However, there were differences in movement restriction at the first and sixth month after surgery, in favor of the temporal eminectomy group. These differences were statistically significant only at the sixth month after surgery (P: 0.03). Conclusions Our results suggest that disc repositioning plus temporal eminectomy could be a short-term benefit in terms of mobility and oral opening. However, larger samples and prospective trials will be necessary to corroborate the current findings.

espanolEl trismus psicosomatico es una rara afectacion caracterizada por presentar grandes dificultades a la apertura oral como somatizacion debido a un estado de ansiedad y malestar. Apenas se encontro bibliografia al respecto debido a su baja prevalencia. Los autores describen el diagnostico, manejo y resultados de un caso concreto de trismus psicosomatico. EnglishThe psychosomatic trismus is a rare condition associated to the presentation of great difficulties to the oral opening as somatization due to a state of anxiety and discomfort. It was hardly to find bibliography related to it due to its low prevalence. The authors describe the diagnosis, management and results of a concrete case of psychosomatic trismus.

espanolIntroduccion: El tratamiento de las fracturas de condilo sigue generando controversia, optandose en la mayoria de los casos por reducciones cerradas con tratamientos suboptimos. Presentamos nuestros resultados en 26 pacientes con fracturas subcondileas o de cuello de condilo mandibular tratados mediante abordaje intraoral endoscopicamente asistido. Material y metodo: Seguimiento prospectivo observacional de 26 pacientes que fueron atendidos en nuestro Servicio de Cirugia Oral y Maxilofacial del Hospital Universitario Virgen del Mar de Cadiz, desde marzo de 2010 hasta enero de 2018. De estos 26 pacientes, 23 fueron hombres y 3 mujeres, con una edad media de 29 anos. Resultados: De los 26 casos operados, 6 fueron fracturas de cuello y 20 fueron fracturas subcondileas. Todos los pacientes salieron de quirofano con la boca abierta, una oclusion estable y buena apertura oral. La complicacion mas importante fue una infeccion que se resolvio con antibioterapia. Discusion: Nuestro equipo ha seguido la filosofia de otros autores de abordar todas las fracturas de condilo, incluso aquellas con un desplazamiento menor de 10°, atendiendo a la premisa de que si no se bloquean otras fracturas no desplazadas mandibulares que previamente a la introduccion de placas de osteosintesis se bloqueaban, ?por que hemos de realizar esta practica en las fracturas de condilo, con la consiguiente agresion a la articulacion? Conclusion: La reduccion abierta con abordaje intraoral asistido por endoscopia constituye una tecnica segura, reproducible y eficaz en la mayor parte de las fracturas extracapsulares. EnglishIntroduction: The treatment of condylar fractures continues to generate controversy, opting in most cases for closed reductions with suboptimal treatment. We present our results in 26 patients treated by endoscopically assisted intraoral approach as treatment for subcondylar and neck condyle fractures. Material and method: Prospective observational follow-up of 26 patients who were treated at our Oral and Maxillofacial Surgery Service at the Virgen del Mar University Hospital of Cadiz from March 2010 to January 2018. Of these 26 patients, 23 were men and 3 women, with an age average of 29 years. Results: Of the 26 operated cases, 6 were neck fractures and 20 were subcondylar. All the patients came out of the operating room with their mouths open, a stable occlusion and good oral opening. The most important complication was an infection that resolved with antibiotic therapy. Discussion: Our team has followed the philosophy of other authors to address all condylar fractures, even those with a displacement of less than 10°, following the premise that, if other non-displaced mandibular fractures are not blocked prior to the introduction of osteosynthesis plates were blocked, why should we perform this practice in the fractures of condyle with the consequent aggression to the joint? Conclusion: Open reduction with endoscopic assisted intraoral approach is a safe, reproducible and effective technique in most extracapsular fractures.

Microstomia is a definite prosthetic hindrance in the construction of complete removable prosthesis. To rehabilitate a patient with microstomia the methods and designs incorporated in the prosthesis have to be modified. This clinical report describes a modified sectional impression procedure and a method of approximating the sectional trays for a completely edentulous female patient with limited oral opening due to scleroderma. This article also presents a method of fabricating single piece collapsible record bases for jaw relation for the patient with microstomia.

To describe pediatric costochondral graft reconstruction of the absent mandibular condyle and to report the short-term and long-term outcomes and complications associated with performing this procedure in young children.Case series with a retrospective chart review.Pediatric otolaryngology clinic and tertiary children's hospital in a metropolitan area.All children treated for an absent mandibular condyle with a costochondral graft at Children's Hospitals and Clinics of Minnesota were identified from 2002 through 2011, and a retrospective chart review was performed.Ten patients aged 3 to 11 years were identified. The most common diagnosis, in 8 of 10 patients, was oculo-auriculo-vertebral syndrome. Three of the patients had a tracheostomy, of which 1 was decannulated following condylar reconstruction. Functional improvement, defined as improved symmetry, chewing, or better oral opening, was observed in 8 of 10 patients. Five patients have required no further surgeries to date, with a mean follow-up time of 3.9 years. Severe overgrowth of the graft was noted in 1 case, and partial or complete resorption of the graft was also noted in 3 cases. Overgrowth occurred after 5.7 years, whereas resorption occurred after an average of 2.5 years.Costochondral grafts are an excellent surgical treatment option for children with severe mandibular malformations. Short-term results show particular improvement in function and mandibular alignment. The mean follow-up time with no revision surgery was substantial and indicates that rib grafting is a good addition to the armamentarium of treatment for this patient population.

Restricted mouth opening is a definite prosthodontic hindrance to carry out treatment successfully. Restricted mouth opening can be due to many reasons such as microstomia, oral submucous fibrosis, some genetic disorder, and as a result of some surgical treatment. In the past, various techniques for prosthetic rehabilitation of limited oral opening have been tried such as surgeries, use of dynamic opening devices, magnetic devices, and modification of denture design. Here we present; a simplified technique and simple design for fabrication of maxillary hinged and mandibular hinged and sectional complete denture for a patient with restricted mouth opening due to oral submucous fibrosis.

Pterygodermatites (Paucipectines) hymanae n. sp. (Rictulariidae) collected from the Incan shrew opossum, Lestoros inca, from Peru is described herein. These nematodes show a subapical, slightly dorsal oral opening and a laterally compressed buccal capsule with 2 conspicuous lateral walls and a dorsal wall. Each lateroventral wall possesses 4 relatively large denticles, and the dorsal wall has 6 denticles. Females are characterized by a conspicuously large postvulvar 37th spine, which may reach 1 mm. This is the first record of endoparasites in the Incan shrew opossum and the fifth species of Pterygodermatites recorded in New World marsupials.

A restricted mouth opening in hemimaxillectomy patient can create a significant problem with the insertion and the removal of the obturator prosthesis. Even it poses a problem in impression making due to small oral opening. A modification of the standard impression procedure is often necessary to accomplish an acceptable impression in the fabrication of a successful prosthesis. Sectional trays are a good option for such patients. This paper describes a novel technique of impression procedure and a method of fabricating a sectional tray with the anterior and the posterior locking mechanism for a hemimaxillectomy patient with limited oral opening.

Vase-shaped microfossils (VSMs) described herein mainly occur as isolated individuals in thin bedded siltstone and silty carbonate of the Gaojiashan Member of the upper Ediacaran Dengying Formation (ca. 551–541 Ma). Although these fossils are abundant, chained tests or other types of colonial aggregates have not been observed. Specimens in the siltstones can easily be isolated from the host rocks by ultrasonic vibrators. Compared with the co-occurring fossils Gaojiashania and Conotubus, VSMs are rarely pyritized, yet they are always three-dimensionally persevered with little deformation, suggesting that their tests were sturdy and possibly mineralized. Petrological observation and elemental mapping reveal two types of tests that are respectively calcareous and siliceous in composition. Calcareous tests typically consist of two to three crypto-crystal laminae, somewhat resembling bilamellar walls of foraminifers. Siliceous tests consist of fine-grained particles agglutinated with siliceous cement, similar to agglutinated walls of foraminifers. The Gaojiashan VSMs are broadly similar, at least in gross morphology, to the testate amoebae-like VSMs, but their relative large sizes (600–2400 μm) and possibly mineralized (rather than organic) tests argue against this comparison. They also show some similarities to other protozoans, especially tintinnids. However, tintinnids have robust pesudochitinous loricae consisting of both secreted and agglutinated materials. Moreover, tintinnid loricae differ in shape from the Gaojiashan VSM tests in having a constricted aboral end (sometimes with a caudal appendix) and a flaring oral opening. If the Gaojiashan VSMs are indeed related to foraminifers, they indicate that foraminifers were important players in late Ediacaran communities.

Objetivo: Relacionar los hábitos parafuncionales y las características clínicas de la articulación temporomandibular. Métodos: Se evaluaron 125 pacientes de 18 a 50 años, se diagnosticó la presencia de ruido articular, características clínicas como restricción de la apertura bucal, irregularidad en el movimiento de apertura y cierre, dolor de músculos masticadores, dolor articular, facetas de desgastes y hábitos parafuncionales como bruxismo, masticación unilateral y mordedura de objetos. Resultados: El 34% de los pacientes presentaron ruido en la articulación temporomandibular. El bruxismo, presentó relación significativa con restricción de la apertura bucal (p=0,0013), irregularidad en el movimiento de apertura y cierre (p=0,0065), dolor muscular (p, Objective: Relate the parafunctional habits and the clinical characteristics of the temporomandibular joint. Methods: 125 patients aged 18 to 50 years were evaluated, the presence of joint noise was diagnosed, clinical characteristics such as restriction of the mouth opening, irregularity in the movement of opening and closing, pain of chewing muscles, joint pain, wear facets and parafunctional habits such as bruxism, unilateral chewing and biting of objects. Results: 34% of the patients presented noise in the temporomandibular joint. The bruxism, presented significant relationship with restriction of the mouth opening (p=0.0013), irregularity in the movement of opening and closing(p=0.0065), muscle pain (p

A description is provided for Gracilioxyuris agilisis n. g., n. sp. found in the cecum of Gracilinanus agilis Burmeister, 1854 (Gardner, 2005) (Didelphidae) in Brazilian Pantanal. The new species can be distinguished from Didelphoxyuris thylamisis by a dome-shaped anterior end, a weakly developed cephalic vesicle, males with no postcloacal ornamentation, and operculate eggs with 3 longitudinal ridges. Gracilioxyuris n. g. is characterized by a small and apical oral opening and double-crested lateral alae. Males possess an area rugosa as a ventral, keellike elevation with transverse striations, 4 pairs of genital papillae, the first and second pairs of which are adanal, and a third minute pair just posterior to cloacal aperture; the last pair are at the caudal end with no tail tip. Females possess a thick muscular vagina, a didelphic genital tract, and operculated eggs with ridges.

Objective: Patients with oral submucous fibrosis (OSF) suffer from the limitation of the oral opening. The aim of this study was to develop a simple and rapid method to improve the opening of the oral cavity and determine its effect on the incidence of developing oral carcinoma. Methods: We first induced an OSF-like lesion in rabbits which histopathologically resembles OSF in betel nut chewers and evaluated the effects of exogenous collagenase on these lesions. We then applied the collagenase treatment regimen to patients with OSF. Results: Endogenous collagenase activities in normal oral mucosa of patients exhibited 3- to 5-fold higher levels than that of OSF tissues. The collagenase treatment not only resulted in a significant improvement of oral opening, but patients also experienced a striking reduction in hypersensitivity to spices, sour, cold, and heat which helped restore eating function. Sub-mucosal fibrous proliferation, persistently good vascularization, and a mild increase in thickness of the sub-mucosal fibrous tissues were noticed 10 months after collagenase treatment. Within the 2-year follow-up period none of the treated patients developed an oral squamous cell carcinoma. Conclusion: A reduced content of functional collagenase observed in OSF mucosa of patients might be one mechanism responsible for collagen accumulation. Intervention of OSF by collagenase treatment at the early stage may reduce the incidence of developing oral carcinoma.

Microstomia is the term used to describe a condition of reduction in the size of oral aperture which can be either acquired or congenital and affects the quality of life. Dentists occasionally come across patients with constricted oral openings. Limited oral opening makes access to the oral cavity for any dental procedure difficult. It’s the duty of a dentist to provide every possible care to the patient with microstomia. This paper describes the treatment of a microstomia patient requiring complete dentures using sectional dentures. The cause of microstomia in the indexed patient was developmental in nature as all other causes of related conditions were ruled out. Finally upper and lower complete denture with sectional components were given to the patient after modification in conventional steps of its construction.

This article describes a modified impression procedure and a method of fabricating a 2-piece collapsible denture for a patient with limited oral opening as a result of the resection of a precancerous lesion on the maxillary lip. Fabricating the denture in 2 pieces (a smaller anterior piece and a larger, hinged, collapsible posterior piece) enabled the patient to place and remove the denture.

The development and growth of a feather star Decametra tigrina from Notojima Island, Japan, is reported. This is the first record describing the complete development, from early embryos to juveniles, in the family Colobometridae. Their larval development was observed to progress independently from the adults, and was similar to other feather star species. Embryos hatched as uniformly ciliated gastrulae, which turned into doliolaria larvae when four narrow circumferential ciliated bands were formed. Skeletal ossicles began to form inside the doliolaria larvae, which subsequently settled to the substrate, proceeding to the cystidean stage. The protrusion of the arms from the oral opening marked the beginning of the pentacrinoid stage. About 45 days after hatching, they autotomized their stalks and became juvenile comatulids with arms about 6 mm long. These early juveniles apparently differ from the adults in morphological characters, such as having no pairs of tubercles or spines on the dorsal of their cirrals, and no proximal pinnules except for the first pinnule (P1). Both features are prominent in adults and are used for the classification of D. tigrina. Morphological differences between juveniles and the adults may also occur in other feather star species. A revision of the classification of comatulids, which considers morphological changes with growth, is required.

Insertion of a denture is especially difficult for patents with a constricted oral opening. This report describes the fabrication of a collapsible removable partial denture with a cast iron-platinum attachment for a partially edentulous woman with a constricted oral opening resulting from rheumatoid arthritis and a craniotomy for a subarachnoid hemorrhage.

Pseudomaryna australiensis and Colpoda brasiliensis were discovered in floodplain soils from Australia and Brazil and studied in vivo and in silver preparations. They have a common feature, viz., a sheath of clay (mineral) particles embedded in a slimy matrix. Such sheaths, which evolved convergently in various ciliates, are termed “mineral envelopes” and make cells appear like inorganic soil particles, possibly protecting them from predators. The new genus Pseudomaryna belongs to the family Colpodidae and is characterized by the preoral suture which extends for the whole body length right of the oral opening due to the widely projecting left side ciliary rows. Maryna antarctica Foissner, 1993 has the same ciliary pattern and is thus transferred to the new genus: Pseudomaryna antarctica (Foissner, 1993) nov. comb. Both, P. australiensis and P. antarctica are small (length 25–60 μm), reniform soil ciliates differing in the macronuclear structure (with vs. without central nucleolus), the mineral envelope (present vs. absent), and details of the somatic and oral ciliary pattern. Colpoda brasiliensis is also a small ciliate (about 33 × 18 μm), differing from the congeners by the mineral envelope and a combination of ordinary features, viz., the location and structure of the macronucleus and the preoral ciliary pattern. Probably, it is related to the Colpoda steinii group.

Microstomia may result from surgical treatment of orofacial neoplasms, cleft lips, maxillofacial trauma, burns, radiotherapy or scleroderma. A maximal oral opening that is smaller than the size of a complete denture can make prosthetic treatment challenging. This clinical report presents the prosthodontic management of a total edentulous patient with microstomia. Sectional mandibular and maxillary trays and foldable mandibular and maxillary denture were fabricated for the total edentulous patient.

Complex zygomaticomandibular syngnathia is an extremely rare condition with an unknown etiology. The main goal of the surgery is to release the ankylosis, establish good functioning mandible, and prevent reankylosis, if possible. In our case, we offer a new solution to have an adequate oral opening and to prevent reankylosis. After the release of bony syngnathia, we placed a distractor between mandibular segment and maxillozygomatic complex. To our best knowledge, this is the only syngnathia case in the literature treated using distraction techniques. There is a major improvement in the patient's status. Distraction may broaden our horizons in this rare and difficult-to-treat deformity.

Oral submucous fibrosis (OSMF) is a potentially malignant disorder of the oral cavity. The surgical management of this condition involves excision of the fibrotic bands and interpositional grafts to retain the increased oral opening. Various procedures and graft material have been utilised with differing success rates.The present review aims to collate and analyze from world literature the different modalities utilized in the surgical management of OSMF. The reasons for the choice of a particular surgical procedure, the study protocol, the average follow-up period and the results were scrutinized.The PRISMA protocol was followed for the systematic review. Search engines and medical databases like Ovid, Medline, Pubgate, Researchgate, PubMed, Google etc. were tapped for information related to the subject. The search words "OSMF", "surgical interventions in OSMF", "flaps and grafts in treatment of OSMF" were employed for retrieval of data. An analysis of the treatment modalities, the reason for the selection of a particular modality, the organization of the sample selection and the follow-up periods including the proclaimed success rates was done.The review resulted in a total of 56 articles on the subject from the sources mentioned above. A total of 995 surgically treated cases were included in the analysis. Interestingly the review revealed very few controlled clinical trials, most being random trials on surgical procedures in small groups of patients with very short follow up periods. The choice of procedure seems to be determined entirely by the preference of the operator/s.There exist no definite protocols for the adoption of a particular treatment mode in OSMF. Adequate documentation and follow up need to be established to statistically analyse the results and proclaimed successes of various treatment modalities.

Forensic dentistry plays an essential role in personal identification procedures. An adequate interincisal space of cadavers with rigor mortis is required to obtain detailed dental findings. We have developed intraoral and two directional approaches, for myotomy of the temporal muscles. The intraoral approach, in which the temporalis was dissected with scissors inserted via an intraoral incision, was adopted for elderly cadavers, females and emaciated or exhausted bodies, and had a merit of no incision on the face. The two directional approach, in which myotomy was performed with thread-wire saw from behind and with scissors via the intraoral incision, was designed for male muscular youths. Both approaches were effective to obtain a desired degree of an interincisal opening without facial damage.

To describe airway management of children with limited oral opening that does not allow for routine orotracheal intubation by direct laryngoscopy. To analyze the incidence and outcome of airway compromise or loss in patients without a tracheostomy in place.Case series with chart review.Tertiary children's hospital.Children with limited oral opening that does not allow for routine orotracheal intubation.Children treated at Children's Hospitals and Clinics of Minnesota from 1997 to 2012 with severe trismus were identified and included in the study. Hospital and clinic records were reviewed.Ten children (mean age, 13 years; range, 7-17 years) were identified for inclusion into the study. A total of 109 operations requiring general anesthesia (average of 10.9 per patient; range, 0-23) were performed on patients without a tracheostomy in place. Flexible fiber-optic nasotracheal intubation was performed in 58 cases. The remainder of airway control was by mask ventilation (33 cases), various methods of orotracheal intubation (10 cases), unknown (6 cases), and laryngeal mask airway (2 cases). There was a total of 118 patient-years of follow-up without a tracheostomy tube in place (average of 11.8 years per patient). During this period, there were no episodes of acute airway compromise that resulted in neurologic deficits.Children with limited oral opening that does not allow for routine orotracheal intubation with direct laryngoscopy may be safely managed without a tracheostomy, even when the child requires frequent procedures under general anesthesia.

Objective The aim of this study was to evaluate the anatomy of the nasopalatine canal in a Lebanese population using cone-beam computed tomography (CBCT) technology. Materials and methods CBCT images of 63 Lebanese adult patients were included in this study. The length, shape, diameter of the oral opening corresponding to the incisive foramen and inclination in relation to the hard palate of the nasopalatine canal were analyzed. Results Of all canals assessed, 13 were hourglass-shaped, 23 were cylindrical-shaped, 23 were funnel-shaped and 4 were spindle-shaped. The mean canal length and the incisive foramen anteroposterior diameter were respectively 11.52 mm and 4.91 mm. The average canal inclination related to the hard palate was 17.09 degrees. Conclusion Within the limits of this study, we conclude that in Lebanese patients, the shape of the nasopalatine canal is variable. No statistical significance was noticed between genders except for the canal length which was found shorter in our female sample.

A new genus Loveninema gen. n., with two new species L. tubulosa gen. n., sp. n. and L. unicornis gen. n., sp. n. is de-scribed from bottom sediments collected in Skagerrak off the west coast of Sweden. Loveninema gen. n. is unique amongother genera of Plectida by possessing a midventral labial projection located on the ventral edge of the oral opening andprotruding anteriorly. Other diagnostic characters include: sclerotised labial framework in the shape of a conoid ring withthree projections extending posteriorly: one mid-dorsal, one left-subventral and one right-subventral; papilliform outer la-bial and cephalic sensilla; amphidial fovea a transverse slit located anterior to cephalic sensilla bases; excretory pore open-ing on the ventral side of the labial region; pharynx uniformly muscular, cylindrical; female reproductive systemdidelphic, amphidelphic; male reproductive system monorchic, with reflexed testis; spicules present; gubernaculum pres-ent or absent; either alveolar or tubular supplements present in males, absent in females; caudal glands and spinneret pres-ent. L. tubulosa gen. n., sp. n. is particularly characterised by the 0.66–1.12 mm long body; short midventral labialprojection; straight vagina without sclerotisations; male without alveolar and with 12–15 tubular supplements, 15.0–21.5µm long spicules, and with gubernaculum. L. unicornis gen. n., sp. n. is particularly characterised by the 0.65–0.98 mmlong body; long midventral labial projection; straight vagina without sclerotisations; male with up to 20 alveolar and without tubular supplements, 11.5–14.0 µm long spicules, and without gubernaculum.

Objective: 1) Describe pediatric costochondral graft reconstruction of the absent mandibular condyle. 2) Report the short-term and long-term outcomes and complications associated with performing this procedure in young children.Method: All children treated for an absent mandibular condyle with a costochondral graft from 2002 to 2011 at Children’s Hospitals and Clinics of Minnesota were identified and a retrospective chart review was performed. Outpatient charts, hospital records, and operative reports were reviewed.Results: Ten patients aged 3 to 11 years old were identified. The most common diagnosis in 7 out of 10 patients was oculo-auriculo-vertebral syndrome. Three of the patients had a tracheostomy, of which one was decannulated following condylar reconstruction. Functional improvement, defined as improved symmetry, chewing, or better oral opening, was observed in 8 out of 10 patients. Five patients have required no further surgeries to date, with a mean follow-up time of 3.9 years. Severe overgrowth...

Microstomia may result from surgical treatment of orofacial neoplasms, cleft lips, maxillofacial trauma, burns, radiotherapy, or scleroderma. A maximal oral opening that is smaller than the size of a complete denture can make prosthetic treatment challenging. This clinical paper presents the prosthodontic management of a total edentulous patient with microstomia. Sectional mandibular and maxillary trays and foldable mandibular and maxillary denture were fabricated for the total edentulous patient.

Rhabdias odilebaini n. sp. is described on the basis of specimens found in the lungs of 2 species of agamid lizards: the Philippine flying lizard Draco spilopterus and the marbled bloodsucker Bronchocela marmorata. Specimens were collected in Aurora Province, Luzon Island, Philippines. The new species of Rhabdias is characterized by presence of 4 submedian lips, inconspicuous lateral lips, rounded cross-shaped oral opening, and tail end bent dorsally. This species is morphologically distinct from other Rhabdias spp. that parasitize reptilian and amphibian hosts, including 3 other species known to parasitize lizards of the Agamidae.

In stomatogenesis of Bursellopsis a new circumoral kinety as well as three brush rows have to be formed in the opisthe. The formation of these structures occurs in a stomatogenic field of six to twelve somatic kineties. These stomatogenic kineties can be separated into two groups: a left one of three to seven kineties, forming the brush primordia, and a right one of three to five kineties, forming the primordia of the circumoral kinety. Between both groups the presumptive oral opening develops. In the stomatogenic kineties forming the brush primordia, dikinetids develop by kinetosome proliferation. These dikinetids arrange side by side into three horizontal rows. By an excessive kinetosome proliferation in the somatic kineties lying left to these rows the whole organelle gets vertically orientated later on in stomatogenesis. In the right group of stomatogenic kineties short fragments, consisting of dikinetids, develop. These fragments undergo a clockwise circular migration around the presumptive oral opening. By joining head to tail they arrange into the circumoral kinety. The primordia of the brush and of the circumoral kinety originate in front of only a few somatic kineties on the ventral side of the cell ("merotelokinetal stomatogenesis"). The apical ("prostome") position of the oral apparatus is the result of the cell division and has to be considered as secondary. The term "prostome" is therefore not correct in a phylogenetic view. According to the "merotelokinetal" type of stomatogenesis a sister group relationship of the prorodontid and some colpodid ciliates is assumed.

The purpose of this study was to analyze the condylar position in the maximum mouth opening in a group of individuals with and without temporomandibular joint disorders (TMD) using corrected magnetic resonance imaging (MRI). It was analyzed the MRIs of 200 temporomandibular joint (TMJ) of 100 adults (25 males and 75 females). The images protocol of the MRIs were in corrected sagittal plane T1, with the patient kept at a maximum mouth opening without pain. All the images were obtained parallel to the Frankfurt plane. The images were split by two lines parallel to the upper base of the image which was obtained parallel to the Frankfurt plane, tangential to the articular tubercle and the condyle of each TMJ, and set along the discrepancy of the condylar position on both sides and the position with regard to the articular tubercle. The discrepancy was 45% overall, the most common condylar position types were 5 and 6 on the right and left sides in both the male and female TMJ patients. In this regard, the highest mean values were found for the maximum mouth opening. Our results support the hypothesis that the condylar position is not directly related to the magnitude of the oral opening.

espanolLa cirugia de terceros molares constituye en la practica de la cirugia oral y maxilofacial, una de las intervenciones mas realizadas. Las indicaciones son variadas, desde medidas profilacticas hasta grandes lesiones oste-oliticas. Algunas de las consecuencias despues de dicha intervencion son; edema, trismus y dolor postoperatorio. En la tecnica quirurgica, el colgajo cobra gran importancia a la hora de minimizar estas consecuencias. El objetivo del presente estudio es evaluar el postoperatorio de la cirugia de terceros molares mandibulares incluidos, utilizando un colgajo lineal en un lado y un colgajo triangular en el otro lado del mismo paciente. Se realizo un estudio prospectivo en 15 pacientes de la Facultad de Odontologia de la Universidad Mayor. Se tomaron registros fotograficos estandarizados y se midio la apertura bucal maxima pre-quirurgica de cada paciente. Se registro el edema, la limitacion de apertura bucal y el dolor a las 48 horas y a los 7 dias, ademas del tiempo intraoperatorio. Todos los datos fueron analizados estadisticamente. No existen diferencias significativas en el edema, limitacion de la apertura ni dolor al utilizar ambos colgajos. Tampoco existe correlacion entre el tiempo operatorio y las tres variables estudiadas. El postoperatorio de la cirugia de terceros molares mandibulares incluidos es similar al utilizar un colgajo lineal o un colgajo triangular. El cirujano puede optar por uno o el otro indistintamente, segun su preferencia. EnglishOne of the most common procedures in the field of Oral and Maxillofacial Surgery is third molar surgery. From prophylactic measures to large osteolytic lesions, there are various indications. Some of the consequences of this procedure are; edema, trismus and postoperative pain. Flap design is an important feature of surgical technique that plays a vital role in minimizing these consequences. The objective of this study is a post operative evaluation of included third molar iaw surgery using a linear flap on one side and a triangular flap on the other side of the same patient. A prospective study of 15 patients from the Dentistry College at the Major University was carried out. Before surgery standard photos were taken and maximum oral opening was measured for each patient. The edema, maximum oral opening and pain were measured 48 hours and 7 days after surgery. All of the data were analyzed statistically. There are no significant differences in the edema, ability to open the mouth or the level of pain using the two types of flap. There a/so is no correlation between the operation time and the three variables studied. The postoperative edema, pain and trismus after included third molar surgery are similar when using linear or triangular flap designs. The surgeon can choose one or the other indistinctly, according to his/her preference.

The somatic and buccal infraciliature of Lagynus elegans are described, and aspects of its division and conjugation are reported. Its somatic infraciliature is made up of 37–46 meridianal kineties composed of isolated kinetosomes that have thick and long kinetodesmal fibers. In the anterior zone of the cell, the circumoral infraciliature can be observed: it is composed of short, slightly oblique kinetal segments, which are formed of three kinetosomes each. The brosse of this species consists of 3 or 4 groups that possess 4 to 6 ciliated kinetosomes each; these kinetosomes lack kinetodesmal fibers. On the apical pole of the cell, surrounding the oral opening, a crown of nematodesmata is observed; these nematodesmata are connected to each other by a fibrillar structure. Taking into account these features, we propose that this genus be transferred from the order Prostomatida to a new family, Lagynidae, of the order Prorodontida.

A new method of correcting extracapsular temporomandibular joint ankylosis with a cervical subcutaneous pedicle flap is described. In this procedure, a cervical subcutaneous pedicle flap with or without platysma is introduced into the oral cavity through a tunnel to repair the defect after the buccal scar is excised and the normal oral opening is restored. Sixteen consecutive patients underwent the surgery, and good results were obtained.

WOS: 000231146500012 PubMed: 16102084 Hardening of the skin around the mouth causes the oral opening to become limited in scleroderma patients. A maximal oral opening that is smaller than the size of a complete denture can make prosthetic treatment challenging. This clinical report presents the prosthodontic management of a total edentulous patient with microstomia induced by scleroderma. Sectional mandibular and maxillary trays and a collapsed mandibular denture were fabricated for the total edentulous patient. With the use of lingual midline hinge, the collapsed denture was successfully and easily inserted and provided adequate function in the patient's mouth. The cast hinge design reduced the overall costs and simplified the laboratory technique.

We describe the indications, advantages, and complications of the buccal fat pad (BFP) flap and report our clinical experience with the flap for intraoral reconstruction after tumour removal. Methods. From 1993 to 2002, a pedicled BFP flap was used to reconstruct oral defects after tumour removal in 15 patients, prospectively analysed. Results. Adequate closure of the defect was achieved. In seven cases there was some retraction of the BFP. Conclusions. The BFP, as a flap, offers a good and simple option in the reconstruction of small to medium defects in the oral cavity, above all in older patients. The greatest disadvantage is that reduction in oral opening could occur, to an unpredictable degree. © 2004 The British Association of Plastic Surgeons. Published by Elvesier Ltd. All rights reserved.

Severe limitation in the oral opening, though an uncommon clinical presentation, makes gaining access to the oral cavity difficult for any dental procedure. This article describes the maxillofacial prosthetic management of a patient with a midfacial defect complicated by postsurgical microstomia. Intraoral and extraoral prostheses restored the patient's speech, dental articulation, mastication, lip support, esthetics, and anterior oral seal. (J Prosthet Dent 2001;85:432-7.)

An intraoral tongue shield appliance for unconscious patients is described. This appliance has advantages over other such appliances in that it does not require impressions for its fabrication, can be made quickly, and placed and retained in a patient with a limited oral opening. Its use is demonstrated in a pharmacologically paralyzed and sedated patient with tongue trauma.

Oral submucous fibrosis (OSF) is an affliction of the oral cavity, endemic to the Indian subcontinent and usually attributed to the habits of consuming areca nuts. Various techniques and methods have been tried in the management of OSF; which includes medical management with steroids, hyaluronidase and collagenase and surgical management involving excision of fibrous bands with or without inter-positional grafts, coronoidectomy and release of temporalis attachments. We report a case of OSF in a 38-year-old female, which was treated at a different center with surgical excision and inter-positional grafts resulting in a rather unusual and extensive fusion of the lower and upper commissures of the lips bilaterally due to the proliferation of the graft. This case was treated in phases, in our institution, where the graft was excised along with the fibrous bands after an initial course of intra-lesional steroids, an interim inter-positional stent to maintain oral opening and final replacement with a complete denture, with appreciable esthetic and functional results.

We examined the relationship between commonly measured features of cranial muscle activity and the magnitude of sub-and superambient pressure measured inside the buccal cavity of the striped burrfish Chilomycterus schoepfi during inflation behavior. Buccal pressure was recorded simultaneously with electromyographic (EMG) records of activity from three expansive-phase muscles (levator operculi, levator pectoralis and hyohyoideus abductor) and three compressive-phase muscles (adductor mandibulae, protractor hyoideus and protractor pectoralis) in eight individuals. We quantified EMG activity in approximately 30 inflation cycles per fish by measuring the burst duration, rectified integrated area, intensity of activity (area divided by duration) and onset time relative to the onset of subambient pressure at the beginning of the cycle. Multiple regressions were calculated separately for data from each fish to investigate the relationships between pressure and EMG variables. The percentage of variation in minimum buccal pressure or area under the subambient pressure curve explained by the multiple-regression models ranged among individuals from approximately 52 to 84 %. The regression models accounted for more variation in peak pressure and the integrated area of superambient pressure; r2 ranged from 76 % to 97 %. The strong relationship between EMG activity and superambient buccal pressure suggests that the latter is probably a direct function of the strength of compressive-muscle contraction. In contrast, the magnitude of subambient pressure is a complex function of the area of the oral opening and the rate of buccal expansion, factors that do not appear to be as directly indicated by the degree of muscle activity.