Forensic Anthropology* Sutures of the SkullDeepali Panwar
This topic is a part of Forensic Anthropology.
Forensic Anthropology
Sutures of the Skull
The sutures are a type of fibrous joint, found in between many of the bones that make up the skull. Today we're going to take a look at three sutures; the coronal suture, the sagittal suture and the lambdoid suture.
*There are four major sutures that connect the bones of the cranium together: the frontal or coronal, the sagittal, the lambdoid, and the squamous. The frontal suture connects the frontal bone to the two parietal bones. The sagittal suture connects the two parietal bones.
Background: The spectrum of pathological bone lesions ranges from inflammatory to neoplastic conditions. Bone tumours are comparatively uncommon among wide array of lesions. The roentgenogram helps in defining exact location of lesion but becomes difficult to differentiate them. They often pose diagnostic problem as they constitute a small portion of diagnostic experience among pathologist.
Objective: To study histopathological spectrum of bone lesions & correlate them with age, gender and site of occurrence.
Results: All bone biopsies from January 2011 to December 2015 received at department of pathology, S.Nijalingappa Medical College, India. Total 121 cases of bone biopsies were analysed. They were decalcified & processed routinely. Out of 121 bone biopsies, 35 (28.9%) cases are non- neoplastic, 77 (63.6%) are neoplastic and 9 (7.4%) were inadequate for evaluation. The incidence of benign lesions are more than malignant with 51(66.2%) and 26(33.7%) cases respectively. Chronic osteomyelitis is the most common non-neoplastic lesion. Giant cell tumor and osteosarcoma are common benign and malignant lesions respectively. Femur is the common bone involved and metaphysis, the commonest site. The maximum numbers of cases are in the age group between 11-30 years with male preponderance.
Conclusion: Though bone lesions are less common, if viewed in perspective of clinico-radiology and histopathology, correct diagnosis can be reached.
Key-words- Bone lesions, Chronic osteomyelitis, Osteosarcoma, Giant cell tumor, Histopathology
Forensic Anthropology* Sutures of the SkullDeepali Panwar
This topic is a part of Forensic Anthropology.
Forensic Anthropology
Sutures of the Skull
The sutures are a type of fibrous joint, found in between many of the bones that make up the skull. Today we're going to take a look at three sutures; the coronal suture, the sagittal suture and the lambdoid suture.
*There are four major sutures that connect the bones of the cranium together: the frontal or coronal, the sagittal, the lambdoid, and the squamous. The frontal suture connects the frontal bone to the two parietal bones. The sagittal suture connects the two parietal bones.
Background: The spectrum of pathological bone lesions ranges from inflammatory to neoplastic conditions. Bone tumours are comparatively uncommon among wide array of lesions. The roentgenogram helps in defining exact location of lesion but becomes difficult to differentiate them. They often pose diagnostic problem as they constitute a small portion of diagnostic experience among pathologist.
Objective: To study histopathological spectrum of bone lesions & correlate them with age, gender and site of occurrence.
Results: All bone biopsies from January 2011 to December 2015 received at department of pathology, S.Nijalingappa Medical College, India. Total 121 cases of bone biopsies were analysed. They were decalcified & processed routinely. Out of 121 bone biopsies, 35 (28.9%) cases are non- neoplastic, 77 (63.6%) are neoplastic and 9 (7.4%) were inadequate for evaluation. The incidence of benign lesions are more than malignant with 51(66.2%) and 26(33.7%) cases respectively. Chronic osteomyelitis is the most common non-neoplastic lesion. Giant cell tumor and osteosarcoma are common benign and malignant lesions respectively. Femur is the common bone involved and metaphysis, the commonest site. The maximum numbers of cases are in the age group between 11-30 years with male preponderance.
Conclusion: Though bone lesions are less common, if viewed in perspective of clinico-radiology and histopathology, correct diagnosis can be reached.
Key-words- Bone lesions, Chronic osteomyelitis, Osteosarcoma, Giant cell tumor, Histopathology
A Study of Mastoid Foramina in Adult Human Skullsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Within a period from January 2010 to January 2016, there were total of 920 surgically treated patients of Orthopaedy and Traumatology Department, Dubrovnik County Hospital, Croatia, which is a single acute hospital in Dubrovacko-neretvanska County where all patients with proximal femoral fracture are treated within the Orthopaedic-Traumatology Department. The aim of this retrospective study is to compare used implants according to type of the proximal femoral region fracture (femoral neck, pertrochanteric , subtrochanteric) and used osteosynthetic implant depending on the type of fracture. A new surgical techniques were used more commonly. Osteoporotic proximal femoral fractures stayed the major and growing problem in the geriatric traumatology and the traumatollogy in general as well.
— Superior orbital fissure syndrome (SOFS) is a rare disease. So when a case of this came at Aravind Eye Institute, a detailed case report was prepared to publish. A 56 years old male patient, a known case of prostatic malignancy with skeletal metastasis presented with ptosis, exotropia, diminished pupillary reflex and limitations in extraocular movements of left eye. MRI brain revealed diffuse skull base and leptomeningeal metastasis. Whole body CT scan showed metastasis in ribs, scapula and in pelvic bones. He was diagnosed to have superior orbital fissure syndrome due to metastatic prostatic malignancy and was offered steroids and radiotherapy.
The Increased Femoral Neck Anteversion in Medieval Cemetery of Pecenjevce - Aetiology and Differential Diagnosis in Archaeological Context
Anteversión Femoral Aumentada en el Cementerio Medieval de Pecenjevce - Etiología y Diagnóstico Diferencial en el Contexto Arqueológico
Ksenija Djukic, Petar Milenkovic, Petar Milovanovic, Milos Dakic and Marija Djuric
Idiopathic scoliosis (IS), the most general form of spinal deformity, affects otherwise healthy children and adolescents during growth (Fig: 1). It usually presents as a rib hump visible at forward bending, together with unlevelled shoulders and an asymmetrical waist [1]. According to Cobb, the diagnosis is specifically confirmed by a standing spinal radiograph showing a lateral curvature of the spine exceeding 10° [2]. A main concern in IS is the absence of reliable means by which to predict risk of progression, leading to frequent follow-ups, radiographs, and potentially unnecessary brace treatments. A furthermore understanding of the pathogenesis and genetics in IS might aid in identifying at-risk individuals, leading to an earlier diagnosis and possibly better preventive and therapeutic options [3].
Study of Greater Sciatic Notch in Sex Determination of Hip Bone by Metric MethodMukesh Dhital
Dr. Suma Dnyanesh1, Dr. Dnyanesh DK2, Dr. Phaniraj S3, Dr. Mallikarjun M3, Dr. Vijayashri BH4, Dr. Kapil Amgain1
1Department of Anatomy, KLE University’s Jawaharlal Nehru Medical College, Belgaum-590010, Karnataka
2Department of Paediatrics, KLE University’s Jawaharlal Nehru Medical College, Belgaum-590010, Karnataka
3Department of Anatomy, VIMS, Bellary-583104, Karnataka, INDIA. 4Department of Physiology, KIMS, Hubli, Karnataka, INDIA.
Objective: To examine the oropharynx of patients with ectodermal dysplasia showing maxillary retrusion and mandibular protrusion with a short and concave facial structure using cone-beam computed tomography method. Ectodermal dysplasia refers to the congenital disorder defined by the abnormal development of the structure originating from the ectoderm.
Study Design: In order to examine the oropharynx airway, measurements and statistical evaluations were made in 3 levels in sagittal and transversal directions on three-dimensional cone beam computed tomography images obtained from 14 individuals divided into 2 groups as Ectodermal Dysplasia group (n=7) and Control group (n=7).
Results: As a result of statistical analysis, no statistically significant difference was found between the groups at any level or direction in metric measurements performed on all 3 planes taken at the sagittal and transversal levels (p>0.05).
Conclusion: Our findings on ectodermal dysplasia are similar to Class III malpositions that show similarity with ectodermal dysplasia.
Call for case report,review and research article for journals
1.International journal of medical and applied sciences.
Volume 6 issue2,2018
2.IRO International journal of medical and applied sciences.
Print journal
Volume 1 issue2, 2018
email: earthjournals@gmail.com
www.earthjournals.in
Chondroblastic osteosarcoma of the left zygomatic bone rare case report and ...Prashant Munde
Chondroblastic osteosarcoma (COS), a subgroup of intramedullary
osteosarcoma (OS), is the most common osteosarcoma that occurs in
adolescents and early adulthood. The COS has similar clinical and radiological
features to those of conventional OS. We present a case of 20‑year‑old male
patient with the chief complaint of pain and swelling in the left zygomatic region.
The computed tomography (CT) and three‑dimensional (3D) CT face showed
erosion, calcific foci, sunray type of spicules suggestive of OS. On fine‑needle
aspiration cytology (FNAC) examination, initial diagnosis was malignant
chondroid lesion, with differential diagnosis of mesenchymal chrondrosarcoma,
COS on incisional biopsy and finally COS on excisional biopsy. The patient
underwent radical resection of left zygomatic arch, followed by chemotherapy.
Although clinically unsuspected in this unusual site, histopathology along with
immunohistochemistry (IHC) results confirmed the COS. Because zygomatic
location of COS is very rare, this report aimed to discuss clinical, radiographic,
histopathologic, IHC findings and diagnostic pitfalls of COS in light of the
literature.
A Study of Interparietal Bones in Adult Human Skullsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
A Study of Mastoid Foramina in Adult Human Skullsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Within a period from January 2010 to January 2016, there were total of 920 surgically treated patients of Orthopaedy and Traumatology Department, Dubrovnik County Hospital, Croatia, which is a single acute hospital in Dubrovacko-neretvanska County where all patients with proximal femoral fracture are treated within the Orthopaedic-Traumatology Department. The aim of this retrospective study is to compare used implants according to type of the proximal femoral region fracture (femoral neck, pertrochanteric , subtrochanteric) and used osteosynthetic implant depending on the type of fracture. A new surgical techniques were used more commonly. Osteoporotic proximal femoral fractures stayed the major and growing problem in the geriatric traumatology and the traumatollogy in general as well.
— Superior orbital fissure syndrome (SOFS) is a rare disease. So when a case of this came at Aravind Eye Institute, a detailed case report was prepared to publish. A 56 years old male patient, a known case of prostatic malignancy with skeletal metastasis presented with ptosis, exotropia, diminished pupillary reflex and limitations in extraocular movements of left eye. MRI brain revealed diffuse skull base and leptomeningeal metastasis. Whole body CT scan showed metastasis in ribs, scapula and in pelvic bones. He was diagnosed to have superior orbital fissure syndrome due to metastatic prostatic malignancy and was offered steroids and radiotherapy.
The Increased Femoral Neck Anteversion in Medieval Cemetery of Pecenjevce - Aetiology and Differential Diagnosis in Archaeological Context
Anteversión Femoral Aumentada en el Cementerio Medieval de Pecenjevce - Etiología y Diagnóstico Diferencial en el Contexto Arqueológico
Ksenija Djukic, Petar Milenkovic, Petar Milovanovic, Milos Dakic and Marija Djuric
Idiopathic scoliosis (IS), the most general form of spinal deformity, affects otherwise healthy children and adolescents during growth (Fig: 1). It usually presents as a rib hump visible at forward bending, together with unlevelled shoulders and an asymmetrical waist [1]. According to Cobb, the diagnosis is specifically confirmed by a standing spinal radiograph showing a lateral curvature of the spine exceeding 10° [2]. A main concern in IS is the absence of reliable means by which to predict risk of progression, leading to frequent follow-ups, radiographs, and potentially unnecessary brace treatments. A furthermore understanding of the pathogenesis and genetics in IS might aid in identifying at-risk individuals, leading to an earlier diagnosis and possibly better preventive and therapeutic options [3].
Study of Greater Sciatic Notch in Sex Determination of Hip Bone by Metric MethodMukesh Dhital
Dr. Suma Dnyanesh1, Dr. Dnyanesh DK2, Dr. Phaniraj S3, Dr. Mallikarjun M3, Dr. Vijayashri BH4, Dr. Kapil Amgain1
1Department of Anatomy, KLE University’s Jawaharlal Nehru Medical College, Belgaum-590010, Karnataka
2Department of Paediatrics, KLE University’s Jawaharlal Nehru Medical College, Belgaum-590010, Karnataka
3Department of Anatomy, VIMS, Bellary-583104, Karnataka, INDIA. 4Department of Physiology, KIMS, Hubli, Karnataka, INDIA.
Objective: To examine the oropharynx of patients with ectodermal dysplasia showing maxillary retrusion and mandibular protrusion with a short and concave facial structure using cone-beam computed tomography method. Ectodermal dysplasia refers to the congenital disorder defined by the abnormal development of the structure originating from the ectoderm.
Study Design: In order to examine the oropharynx airway, measurements and statistical evaluations were made in 3 levels in sagittal and transversal directions on three-dimensional cone beam computed tomography images obtained from 14 individuals divided into 2 groups as Ectodermal Dysplasia group (n=7) and Control group (n=7).
Results: As a result of statistical analysis, no statistically significant difference was found between the groups at any level or direction in metric measurements performed on all 3 planes taken at the sagittal and transversal levels (p>0.05).
Conclusion: Our findings on ectodermal dysplasia are similar to Class III malpositions that show similarity with ectodermal dysplasia.
Call for case report,review and research article for journals
1.International journal of medical and applied sciences.
Volume 6 issue2,2018
2.IRO International journal of medical and applied sciences.
Print journal
Volume 1 issue2, 2018
email: earthjournals@gmail.com
www.earthjournals.in
Chondroblastic osteosarcoma of the left zygomatic bone rare case report and ...Prashant Munde
Chondroblastic osteosarcoma (COS), a subgroup of intramedullary
osteosarcoma (OS), is the most common osteosarcoma that occurs in
adolescents and early adulthood. The COS has similar clinical and radiological
features to those of conventional OS. We present a case of 20‑year‑old male
patient with the chief complaint of pain and swelling in the left zygomatic region.
The computed tomography (CT) and three‑dimensional (3D) CT face showed
erosion, calcific foci, sunray type of spicules suggestive of OS. On fine‑needle
aspiration cytology (FNAC) examination, initial diagnosis was malignant
chondroid lesion, with differential diagnosis of mesenchymal chrondrosarcoma,
COS on incisional biopsy and finally COS on excisional biopsy. The patient
underwent radical resection of left zygomatic arch, followed by chemotherapy.
Although clinically unsuspected in this unusual site, histopathology along with
immunohistochemistry (IHC) results confirmed the COS. Because zygomatic
location of COS is very rare, this report aimed to discuss clinical, radiographic,
histopathologic, IHC findings and diagnostic pitfalls of COS in light of the
literature.
A Study of Interparietal Bones in Adult Human Skullsiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Abstract
Juvenile ossifying fibroma is an uncommon clinical entity, its aggressive local behaviour and high recurrence rate mean that it is important to make an early diagnosis, apply the appropriate treatment and, especially, follow the patient up over the long term. In the current article we report a case of juvenile ossifying fibroma-WHO type in 12yr old patient which was clinical and histopathologically challenging as it was asymptomatic and at an unusual location.
CLINICOPATHOLOGICAL FEATURES OF PERIPHERAL OSSIFYING FIBROMA IN A SERIES OF 4...ishita1994
Peripheral ossifying fibromas are benign mesenchymal lesions that usually arise in the anterior maxilla of young female patients. Histologically they consist of spindle cell proliferation with focal mineralization. We reviewed 48 specimens from 41 patients and recorded the clinical data, sex, and age of the patients, site, and size of the lesions, treatment, and postoperative outcome. Histologically the presence of mature, woven bone, cementum, and calcifications was evaluated and evaluated immunohistochemically. Lesions were more frequent in female patients in the third and fourth decade and were usually in the lower maxilla and smaller than 2 cm. All lesions were conservatively excised, and they relapsed in eight patients. Histopathologically, the lesions were poorly circumscribed, with moderately cellular proliferation, and with no discernible architectural pattern. All tumors showed some degree of mineralization, the presence of immature bone being the most common. Immunohistochemical examination showed staining of tumoral cells for smooth muscle actin and CD68. Lesions tended to occur more commonly in female patients, but one decade later than usually reported. We found a higher recurrence rate in lesions that contained cementum-like material but without bone formation, suggesting a lack of maturation in this group. Immunohistochemical results were consistent with myofibroblastic differentiation but they added no information about the behavior of the lesions.
Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot with ladies.Omaxe Reviews get lot of hits on omaxe reviews official omaxe reviews introducing omaxe reviews and Mr. Anil Kumar get set go. Omaxe Reviews at next month but all over get hot. oma
Position of the Mental Foramen in a Northern Regional Palestinian PopulationAbu-Hussein Muhamad
Background: The mental foramen is one of important anatomical features frequently encountered
in maxillofacial surgical procedures in premolars area. Its position has been shown to vary according to
race. In this study researchers aim to study the position, shape, and appearance of the mental foramen,
as seen on panoramic radiographs of Palestinians, and to compare our findings with international
values.
Materials and methods: A randomly selected panoramic radiographs (368 with 736 sides)
from the records of dental patients attending three dental services in north of Palestine, the mental
foramina’s anterior–posterior position, shape, and radiologic appearance were subjected to analysis.
Results: The most frequent anterior–posterior position was in the area between the long axes of
first and second mandibular premolar teeth. The most frequent appearance was the continuous type
and majority of foramina were rounded in shape.
Conclusion: The position of the mental foramen on panoramic radiographs in this selected group
of Palestinians was most commonly between the mandibular premolars. The continuous type and
rounded shape of the mental foramen was founded in majority of cases. These results are similar to
previous findings in Caucasian populations.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Analytical Study of Clinicopathological Data of Saudi Patients with Osteoarth...Prof. Hesham N. Mustafa
SUMMARY: Knee osteoarthritis (OA) is a common disabling disease. Epidemiological studies have revealed various risk
factors for OA, including sex, aging, obesity, occupational illnesses, and chronic diseases. Here we evaluate the clinical, pathological,
and radiological findings of knee OA in a subset of Saudi patients who were subjected to total knee replacement (TKA). The study
population included 30 Saudi patients with knee OA who were operated by TKA (from June 2014 to December 2015) in the Department
of Orthopedics, Faculty of Medicine, King Abdulaziz University, Saudi Arabia. Patient’s clinical and radiological data were collected
from the hospital files. Pathological examination of the excised superior articular surface of tibia and femoral condyles were done.
Pearson Chi-squared analysis was used to test for differences between the variables in associated risk factors. There were more women
than men. Sixty per cent of patients were older than 60 years [mean age, 59.2 (females) and 61.7 (men) years-old]. All patients exceeded
obesity class 1, with females being more obese than males. Pathological examination of the superior articular surface of tibia and femoral
condyles showed high score lesions, which was more apparent in females than in males. Radiological findings showed that most lesions
were high grade. The findings of this study will help to understand the pathogenesis of OA and improve treatment decision making
relevant to TKA in knee OA in Saudi Arabia and elsewhere.
KEY WORDS: Osteoarthritis; Knee; Arthroplasty.
1. ORIGINAL ARTICLE
Journal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 27/ July 8, 2013 Page 4974
THE MYLOHYOID BRIDGING: INCIDENCE AND CLINICAL IMPLICATIONS.
Rajesh Kumar1, Alok Kumar Choudhary2, S.K. Jain3, Anurag4, Shashi Munjal5, Puja Chauhan6.
HOW TO CITE THIS ARTICLE:
Rajesh Kumar, Alok Kumar Choudhary, S.K. Jain, Anurag, Shashi Munjal, Puja Chauhan. “The mylohyoid
bridging: incidence and clinical implications”. Journal of Evolution of Medical and Dental Sciences 2013; Vol2,
Issue 27, July 8; Page: 4974-4982.
ABSTRACT: The evaluation of non-metrical traits of mandible can be used for the assessment of the
existence of parental structures within a community or as taxonomic indicators. The non-metric
traits are categorised into three types: foraminal, hyperostotic/ hypoostotic and fusion. In the
mandible the mylohyoid bridge is a hyperostotic variant where the mylohyoid groove becomes
variably ossified. The occurrence of this trait, independent of sex, is consistent with the assumption
that genetic background is relevant to its formation. AIM & OBJECTIVE: The study was planned to
investigate the incidence and types of mylohyoid bridging in the mandibles of Uttarakhand region.
The data may be useful for the anthropologists, and its clinical implications may guide the dental
surgeons in nerve block injections. MATERIAL AND METHOD: A collection of 69 male and 52
female mandibles (total samples = 121), available in the department of Anatomy at Sri Guru Ram Rai
Institute of Medical & Health Sciences, Dehradun, Uttarakhand were used as the material for the
study. ANALYTICAL TEST: Fisher's exact probability test. RESULT: Neither total nor superior and
inferior type of mylohyoid bridging was observed in any mandible included in the present study.
Only distal-partial, proximal-trace and trace type of bridging was found. Only 9 mandibles showed
the presence of mylohyoid bridging (9/121; 7.43%). Bilateral bridging was found in 5 mandibles and
4 had unilateral incidence of mylohyoid bridging [3 (1.24% of the total 242 sides examined) on left
side in male mandibles and 1 (0.41%) on right side in female mandible. CONCLUSION: The presence
of mylohyoid bridging can be used for the assessment of the existence of parental structures within a
community or as a taxonomic indicator. Clinically, the entrapment of the nerve to mylohyoid may
lead to poorly localized deep pain from the muscles it innervates. Moreover, the nerve may also
escape the local anaesthesia which may be overcome by other recent techniques of nerve block.
KEYWORDS: Non-metrical traits, hyperostotic, taxonomic indicators, mylohyoid bridging.
INTRODUCTION: Mandible is the largest and strongest bone of the facial skeleton and is
preferentially preserved in archaeological and paleontological deposits. Furthermore, this bone has
provided useful information in studies of sexual dimorphism, geographical variations and
evolutionary changes in the morphology.
The expression of non-metric traits is more influenced by the genetic factors as compared to
non-genetic factors. Therefore, in anthropological and paleo-anthropological studies, the evaluation
of non-metrical traits of mandible can be used for the assessment of the existence of parental
structures within a community or as taxonomic indicators. (1) The non-metric traits are categorised
into three types: foraminal, hyperostotic/hypostotic and fusion.(2) The hyperostotic traits represent
variable ossification of connective tissue, which separates or encloses nerve fibers and vessels. (3) In
the mandible the mylohyoid bridge is a hyperostotic variant where the mylohyoid groove becomes
variably ossified. (4-6) This variant has been otherwise referred to using several terms such as
ponticulus mylohyoideus, canalis mylohyoideus, mylohyoid arch and arcus mylohyoideus. (7-10)
2. ORIGINAL ARTICLE
Journal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 27/ July 8, 2013 Page 4975
Ossenberg (4) suggests that the precursor of this bridge is a membrane continuous
proximally with the sphenomandibular ligament and stretching the ligament of the mylohyoid
groove medial to the contained neurovascular structures. According to the investigator, this
membrane and its bony variant may be derived from Meckel’s cartilage.
Mylohyoid groove, beginning antero-inferior to the mandibular foramen and containing the
neurovascular bundle, is normally closed over to become a connective tissue canal, which is the
extension of the sphenomandibular ligament attached to the lingula. Either or both parts of this
tissue may become partially or completely transformed into bone, forming bridges or an elongated
canal, which may extend above the foramen. (11)
Mylohyoid bridging is classified by Hauser and De Stefano (10) according to:
1. Location of bridging
a) Proximal = in the vicinity of the mandibular foramen.
b) Distal = approximately at the centre of the mylohyoid groove.
c) Superior and Inferior = interrupted canal formation, appearing as two separate bridges.
2. Degree of bridging
a) Trace = formation of two spicules or lipping protruding from the edges of the mylohyoid
groove.
b) Partial bridging.
c) Total bridging of the mylohyoid groove.
We planned this study to investigate the incidence and types of mylohyoid bridging in the
mandibles of Uttarakhand region; at the same time a note was made to its clinical implications along
with a comparison to the incidences of mylohyoid bridging in different Indian populations.
MATERIAL AND METHODS: The material for this study consisted of a collection of 69 male and 52
female mandibles (total samples = 121), available in the department of Anatomy at Sri Guru Ram Rai
Institute of Medical & Health Sciences, Dehradun, Uttarakhand.
Sex determination of mandibles was done according to the following criteria:
MALE FEMALE
1) Gonial eversion - Marked Slight/absent
2) Chin - Square Pointed/rounded
3) Robustness - Larger, broader Slender, smaller
Thicker, heavier
All were adult mandibles, the exact ages of which were unknown. Both the medial surfaces
of each mandible were inspected for the presence of the bony bridges along the mylohyoid groove.
Fisher's exact probability test was applied to the sex related incidences of mylohyoid
bridging in the test samples, with the level of significance set at p < 0.05. Data obtained from the
mandibles were evaluated using GraphPad Prism version 5.00 for Windows, GraphPad Software, San
Diego California USA, www.graphpad.com.
A comparison of the present results was made with the incidences of mylohyoid bridging
reported by earlier authors in different Indian populations.
3. ORIGINAL ARTICLE
Journal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 27/ July 8, 2013 Page 4976
RESULTS: Altogether 121 mandibles were examined for the presence of mylohyoid bridging on both
the sides, out of which 101 mandibles were dentulous and rest were edentulous.
According to the classification cited above, neither total nor superior and inferior type of
mylohyoid bridging was observed in any mandible included in the present study. Only distal-partial
(fig. 1), proximal-trace (fig. 2) and trace (fig. 3) type of bridging was found. The proximal type is just
the extension of the sphenomandibular ligament, as is apparent by the ossified backward projection
of the lingula (fig. 4).
Only 9 mandibles showed the presence of mylohyoid bridging (9/121; 7.43%) (table.1).
Bilateral bridging was found in 5 mandibles and 4 had unilateral incidence of mylohyoid bridging [3
(1.24% of the total 242 sides examined) on left side in male mandibles and 1 (0.41%) on right side in
female mandible (fig. 5)].
FIGURE 5: Side distribution of incidences of mylohyoid bridging in male and female mandibles.
Sex Presence Absence Row Total Percentage
males 06 63 69 8.69%
females 03 49 52 5.76%
Column Total 09 112 121 7.43%
Table 1: The incidence of mylohyoid bridging according to sex
In respect to the incidence of mylohoid bridging in relation to sex, the results indicated that
the difference between male and female mandibles is statistically not significant as P < .05.
4. ORIGINAL ARTICLE
Journal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 27/ July 8, 2013 Page 4977
DISCUSSION: The mylohyoid bridge, a hyperostotic variant is formed under some genetic
background and is one of the useful genetic markers for researching populational relationships. (12)
However, certain reports disagree to this concept. (13) Mechanical forces too are believed to take
part in the formation of mylohyoid bridging. (14)
The results of the present study indicate that the incidence of mylohyoid bridging did not
show any sex difference. The occurrence of the trait, independent of sex, is consistent with the
assumption that genetic background is relevant to its formation. (12) Though, slight male
predominance in the incidence was noted by Ossenberg (9) and Dodo (15) while Sawyer et al. (5)
distinctly reported a predominance of females in Euro-Americans. However, non-metrical traits, on
the whole did not diverge (or very little if at all) on the account of sex as reported by several
researchers. (16-18)
Contrary to the results of K. Narayana et al. (19), mylohyoid bridge seems to be expressed
more on the left side than on the right in the present study. Though, there was statistically no
significant difference (P < .05) between frequencies on sides.
Total bridging of the mylohyoid groove is rarely found as indicated by the results of this
study, although this trait has been reported in some mandibles in earlier studies. (20) The incidence
reported by Kaul, S.S. and Pathak, R.K. (6) in north Indian sample (2.98–7.14%) and Narayana, K.
(19) in Indians (pooled) coincides with the results of the present study (table. 2). However, the total
incidence of 7.43% as found in this study is less than that in another study on north Indians (8.63%).
(20) Differences in the incidence of mylohyoid bridging may be due to variations related to era,
climate, diet, geography, or race, as non-metrical variants are known to depend on these factors. (21,
22)
Table 2: Percentage incidences of mylohyoid bridging in various Indian populations.
As the mylohyoid nerve passes through the tunnel formed by the mylohyoid bridge, it may
be unusually entrapped against the bone, imparting poorly localized deep pain from the muscles it
innervates. Chronic compression of the nerve results in muscular paresis. This symptom would be
subclinical unless the nerve entrapment is bilateral; then swallowing difficulties may ensue. (24)
Due to the variability in location of branching and the potential barriers formed by both the
pterygomandibular fascia and the sphenomandibular ligament, the nerve to the mylohyoid may
escape anaesthesia in an inferior alveolar nerve block. (25) The failed local anaesthesia may be
overcome either by high block (Gow- Gates or Akinosi techniques) or by lingual infiltration. (26) The
Gow-Gates and Akinosi methods are best reserved for those cases where the conventional block
methods fail.
Population Incidence of mylohyoid bridging Percentage Reference no.
North Indians 8.63 20
North east Indians 2.98–7.14 6
South Indians 6.39 Manjunath, K.Y. (23)
Indians 7.20 19
Uttarakhand population 7.43 Present study
5. ORIGINAL ARTICLE
Journal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 27/ July 8, 2013 Page 4978
In conclusion, the total type of mylohyoid bridging is not commonly found in the mandibles
of Uttarakhand region. The relevance of genetic background in its formation confers that this trait
can be used for the assessment of the existence of parental structures within a community or as a
taxonomic indicator. Clinically, the unusual entrapment of the nerve to mylohyoid against the bone
may lead to poorly localized deep pain from the muscles it innervates. Moreover, the nerve may also
escape the local anaesthesia which may be overcome by other recent techniques of nerve block.
ACKNOWLEDGEMENT: It gives me great pleasure to acknowledge, with heartfelt gratitude, the
inspiration, guidance and help I have received from my teachers in preparing this article. I would
also like to thank the statistician of SGRRIM & HS for helping me in statistical analysis.
Last but not the least; I am really indebted and grateful to my family for supporting me
spiritually throughout because without their encouragement, this article would not have
materialized.
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7. ORIGINAL ARTICLE
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FIGURE.1: Distal-partial type of mylohyoid bridging with probe passing through the tunnel.
FIGURE.2: Proximal-trace type of mylohyoid bridging.
8. ORIGINAL ARTICLE
Journal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 27/ July 8, 2013 Page 4981
FIGURE.3: Trace type of mylohyoid bridging.
FIGURE.4: Ossified backward projection of the lingula.
9. ORIGINAL ARTICLE
Journal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 27/ July 8, 2013 Page 4982
AUTHORS:
1. Rajesh Kumar
2. Alok Kumar Choudhary
3. S.K. Jain
4. Anurag
5. Shashi Munjal
6. Puja Chauhan
PARTICULARS OF CONTRIBUTORS:
1. Post graduate student, Department of Anatomy,
Shri Guru Ram Rai Institute of Medical & Health
Sciences.
2. Lecturer, Department of Anatomy, Shri Guru
Ram Rai Institute of Medical & Health Sciences.
3. Professor & Head, Department of Anatomy, Shri
Guru Ram Rai Institute of Medical & Health
Sciences.
4. Professor, Department of Anatomy, Shri Guru
Ram Rai Institute of Medical & Health Sciences.
6. Associate Professor, Department of
Anatomy, Shri Guru Ram Rai Institute of
Medical & Health Sciences.
7. Associate Professor, Department of
Anatomy, Shri Guru Ram Rai Institute of
Medical & Health Sciences.
NAME ADRRESS EMAIL ID OF THE
CORRESPONDING AUTHOR:
Dr. Alok Kumar Choudhary,
Lecturer,Department of Anatomy,
SGRRIM& HS,Patel Nagar,
Dehradun.Pin- 248001.
Uttarakhand.
Email:dr_alokchoudhary@yahoo.com
Date of Submission: 27/06/2013.
Date of Peer Review: 28/06/2013.
Date of Acceptance: 05/07/2013.
Date of Publishing: 08/07/2013