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Anatomical Variations from the Point of View of the Periodontist

  • Daniel E. ShinEmail author
Chapter

Abstract

Periodontal surgery encompasses a wide range of surgical therapies that are designed to restore and regenerate the natural form and function to lost and damaged structures of the teeth. Common types of periodontal surgical therapies include, but are not limited to, open flap debridement, osseous resective surgery, guided tissue regeneration (GTR), and soft tissue augmentation. It is important for a periodontist to have sound clinical judgment and proficient skills to perform the aforementioned surgical procedures, but it is equally important for the periodontist to have a keen anatomical mind with the means to appreciate the subtle nuances or the overt and pronounced anatomical variations that lie in the vicinity of the periodontal surgical field. Furthermore, it is important for the periodontist to anticipate these anatomical variations and the role they may play in determining the scope of the planned surgical procedure. Thus, in order to safely and properly execute the surgical procedure, the periodontist must have a strong understanding of the precise location of anatomical structures but also be aware of variations with respect to size, shape, and location of vital oral anatomical structures and landmarks. The focus of this chapter is to highlight common variations in anatomical oral structures, which are regularly encountered in periodontal surgery and implant surgery. The reader is referred to subsequent chapters in this textbook for a more in-depth description of these anatomical structures and landmarks.

References

  1. Anderson LC, Kosinski TF, Mentag PJ (1991) A review of the intraosseous course of the nerves of the mandible. J Oral Implantol 17:394–403PubMedGoogle Scholar
  2. Behnia H, Kheradvar A, Shahrokhi M (2000) An anatomic study of the lingual nerve in the third molar region. J Oral Maxillofac Surg 58:649–651CrossRefGoogle Scholar
  3. Boyne PJ, James RA (1980) Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Surg 38:613–616PubMedGoogle Scholar
  4. Dario LJ (2002) Implant placement above a bifurcated mandibular canal: a case report. Implant Dent 11:258–261CrossRefGoogle Scholar
  5. De Andrade E, Otomo-Corgel J, Pucher J et al (2001) The intraosseous course of the mandibular incisive nerve in the mandibular symphysis. Int J Periodontics Restorative Dent 21:591–597PubMedGoogle Scholar
  6. Fishel D, Buchner A, Hershkowith A et al (1976) Roentgenologic study of the mental foramen. Oral Surg Oral Med Oral Pathol 41:682–686CrossRefGoogle Scholar
  7. Fu JH, Hasso DG, Yeh CY et al (2011) The accuracy of identifying the greater palatine neurovascular bundle: a cadaver study. J Periodontol 82:1000–1006CrossRefGoogle Scholar
  8. Greenstein G, Cavallaro J, Tarnow D (2008) Practical application of anatomy for the dental implant surgeon. J Periodontol 79:1833–1846CrossRefGoogle Scholar
  9. Harris RJ, Miller R, Miller LH et al (2005) Complications with surgical procedures utilizing connective tissue grafts: a follow-up of 500 consecutively treated cases. Int J Periodontics Restorative Dent 25:449–459PubMedGoogle Scholar
  10. Kim MJ, Jung UW, Kim CS et al (2006) Maxillary sinus septa: prevalence, height, location, and morphology. A reformatted computed tomography scan analysis. J Periodontol 77:903–908CrossRefGoogle Scholar
  11. Klosek SK, Rungruang T (2009) Anatomical study of the greater palatine artery and related structures of the palatal vault: considerations for palate as subepithelial connective tissue graft donor site. Surg Radiol Anat 31:245–250CrossRefGoogle Scholar
  12. Krennmair G, Ulm CW, Lugmayr H et al (1999) The incidence, location, and height of maxillary sinus septa in the edentulous and dentate maxilla. J Oral Maxillofac Surg 57:667–671CrossRefGoogle Scholar
  13. Mogensen C, Tos M (1977) Quantitative histology of the maxillary sinus. Rhinology 15:129–140PubMedGoogle Scholar
  14. Ngeow WC, Yuzawati Y (2003) The location of the mental foramen in a selected Malay population. J Oral Sci 45:171–175CrossRefGoogle Scholar
  15. Pogrel MA, Goldman KE (2004) Lingual flap retraction for third molar removal. J Oral Maxillofac Surg 62:1125–1130CrossRefGoogle Scholar
  16. Reiser GM, Bruno JF, Mahan PE et al (1996) The subepithelial connective tissue graft palatal donor site: anatomic considerations for surgeons. Int J Periodontics Restorative Dent 16:130–137PubMedGoogle Scholar
  17. Tidwell JK, Blijdorp PA, Stoelinga PJ et al (1992) Composite grafting of the maxillary sinus for placement of endosteal implants. A preliminary report of 48 patients. Int J Oral Maxillofac Surg 21:204–209CrossRefGoogle Scholar
  18. Tomaszewska IM, Tomaszewski KA, Kmiotek EK et al (2014) Anatomical landmarks for the localization of the greater palatine foramen – a study of 1200 head CTs, 150 dry skulls, systematic review of literature and meta-analysis. J Anat 225:419–435CrossRefGoogle Scholar
  19. Turner W (1864) On some variations in the arrangement of the nerves of the human body. Nat Hist Rev 4:612–617Google Scholar
  20. Uchida Y, Noguchi N, Goto M et al (2009) Measurement of anterior loop length for the mandibular canal and diameter of the mandibular incisive canal to avoid nerve damage when installing endosseous implants in the interforaminal region: second attempt introducing cone beam computed tomography. J Oral Maxillofac Surg 67:744–750CrossRefGoogle Scholar
  21. Underwood AS (1910) An inquiry into the anatomy and pathology of the maxillary sinus. J Anat Physiol 44:354–369PubMedPubMedCentralGoogle Scholar
  22. Wang TM, Shih C, Liu JC et al (1986) A clinical and anatomical study of the location of the mental foramen in adult Chinese mandibles. Acta Anat (Basel) 126:29–33CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of PeriodonticsIndiana University School of DentistryIndianapolisUSA

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