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Background: The aim of this study was to examine the morphologic features of the stylohyoid complex (SHC) and its relation to maxillomandibular position using three-dimensional cone beam computed tomography (CBCT) images. Materials and methods: CBCT images from 157 individuals (74 females, 83 males) were analysed in this study. SHC length, width, and sagittal and transverse angles were measured. The subjects were grouped as skeletal class I, II, and III in order to determine the relative positions of the maxilla and mandible in the sagittal plane and as hypodivergent, normodivergent, and hyperdivergent according to the vertical rotation of the mandible in relation to the skull base. Mann-Whitney U and Kruskal-Wallis H tests were used for statistical analysis. Results: Mean SHC length was 23.56 ± 8.05 mm on the right side and 22.0 ± ± 6.51 mm on the left; mean SHC width was 3.31 ± 1.40 mm on the right and 2.93 ± 1.30 mm on the left. Mean sagittal angle was 27.43 ± 6.75° on the right side, 27.70 ± 6.51° on the left; mean transverse angle was 70.39 ± 4.59° on the right side and 71.79 ± 4.99° on the left. The only significant difference based on skeletal classification was greater SHC length among males compared to females in the class III group (p < 0.05). Conclusions: No significant relationship was observed between SHC morphology and position of the maxilla or mandible. However, the gender difference observed among class III subjects suggests that SHC morphology may be affected by craniofacial morphology. Maxillofacial surgeons should investigate this anatomical landmark variation before surgical interventions involving this region, such as temporomandibular joint procedures. (Folia Morphol 2020; 79, 1: 148–155)
Background: We identified the vidian canal (VC) in a Turkish subpopulation on cone-beam computed tomography (CBCT) images and explored its anatomic relationships; the canal serves as an anatomic pathway during endonasal surgical approaches. Materials and methods: Coronal and axial CBCT images of 100 patients (50 males and 50 females) were evaluated (slice thickness and interval, 0.5 mm). We measured the length of the VC length, extent of VC pneumatisation into the sphenoid sinus, position of the VC relative to the medial pterygopalatine plate (MPP), pterygopalatine fossa (PPF) depth, and VC-VC, VC-MPP, and VC-foramen rotundum (FR) distances, the angle between the posterior end of the middle turbinate and the lateral part of the VC anterior opening, and the angle between the VC and the palatovaginal canal. Results: The mean VC length was 13.09 ± 2.07 and 13.01 ± 2.12 mm on the right and left sides, respectively. Relative to the MPP, the VC was located medially in 54.5% of patients, on the same level in 36%, and laterally in 9.5%. Pneumatisation was of grade I in 24% of patients, grade II in 33%, grade III in 23.5%, and grade IV in 19.5%. The VC-FR and VC-MPP distances were significantly greater on the left side. The angle between the posterior end of the middle turbinate and the lateral part of the anterior VC opening was significantly greater on the right side. The VC-VC distance was significantly greater when the VC lay lateral to the MPP. Conclusions: Anatomic characteristics of the VC on CBCT images unique to Turkish populations should be kept in mind during surgery. (Folia Morphol 2020; 79, 2: 366–373)
Background: The anatomical variation of the anterior superior alveolar nerve described as canalis sinuosus (CS) is a less known structure of anterior maxilla. Due to the fact that it contains anterior superior alveolar nerve as well as veins and arteries, exact localisation of this structure will allow surgeons to avoid complications. Hence, the aim of this study was to verify the presence, reveal the frequency and characteristics of accessory canals of CS. Materials and methods: This study was based on retrospective evaluation of cone beam computed tomography (CBCT) scans. A total of 1460 CBCT images were analysed and collected data were noted. The following parameters were recorded: age, sex, presence or absence of CS, location in relation to the adjacent teeth and impaction of canine teeth. Results: A total of 6668 accessory canals were found in 1460 CBCT images. Of these, 672 (46.0%) were from female patients, and 788 (54.0%) were from male patients. 1034 (70.8%) of 1460 images had at least one accessory canal of CS. Maxillary intercentral region is the area where accessory canals were seen most frequently (n = 653, 44.72%). Conclusions: Canalis sinuosus is a bony canal which is incidentally found and less known structure of anterior portion of maxilla. Knowing the accessory canals deriving from this structure will allow surgeons to avoid complications and non- -integration after dental implant procedures. Conventional imaging modalities have limited value in detecting this neurovascular structures. Therefore CBCT may have an important role for accurate diagnosis to reveal anatomical variations. (Folia Morphol 2018; 77, 3: 551–557)
Background: To examine the detailed anatomy of the normal temporomandibular joint (TMJ) in a large series of patients divided into different age groups. Materials and methods: Cone-beam computed tomography images of 100 patients included in the study. Morphometric analysis regarding mandibular condyle and mandibular fossa, articular tubercle and the zygomatic arch was done. The volumetric and surface measurements of mandibular condyles (total tissue volume [TV], total bone volume [BV], bone surface area [BS] and percentage of bony tissue of the mandibular condyle [BV/TV]) were also measured. Results: Statistical analysis was performed and statistically significant differences according to the side of the joint, sex, and age groups were reported. Additionally, correlations between aging and all of these parameters were also determined. Conclusions: TV, BV, BS and BV/TV parameters according to side, age, and sex groups were defined for normal TMJ which may help to understand the onset and progress of TMJ disorders. (Folia Morphol 2019; 78, 1: 174–181)
Background: The aim of this study was to determine whether paranasal sinus dimensions and volume can be useful to identify gender and age estimation for ancient skulls using cone-beam computed tomography (CBCT) images. Materials and methods: CBCT scans of 32 ancient skulls of approximately 1000 years of age were included in this retrospective study. The gender and age estimation of the skulls were made by an independent anthropologist, which was considered as the gold standard. Paranasal sinuses’ dimensions (width and height) and volumes of each sinus were measured from the CBCT data set that was linked to the three-dimensional rendering software (Anatomage, Invivo 5.2). All measurements were performed by an independent observer. Intra-observer analysis was made. Mann-Whitney and Kruskal-Wallis tests were used to compare paranasal sinus parameters in terms of age estimation and gender (p < 0.05). Results: The results demonstrated no statistically significant difference between measurements (p < 0.05). The measurements were found to be highly reproducible. The mean volumes of frontal and sphenoid sinus were found to be higher in males. The distance from anterior-posterior wall of sphenoid sinus in axial sections is larger in males (p > 0.05). The frontal sinus width and volume increased statistically with age above 60 years of age (p > 0.05). Conclusions: The paranasal volume and dimensions’ measurements from CBCT data can be a promising technique to determine gender and age of ancient skulls because of its lower voxel sizes and higher resolution. (Folia Morphol 2019; 78, 2: 344–350)
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