Surgical anatomy & pathology of the popliteal fossa

The requirement to use the posterior approach to the knee is uncommon, and many orthopaedic surgeons may not be familiar with the surgical anatomy. However, it is relatively common for a candidate in final professional examinations to be asked to describe the posterior approach to the knee joint, with reference to the relationship of major vessels and nerves. This article will cover the anatomy of the posterior knee and popliteal fossa, the surgical approach used and the common pathologies encountered in the posterior knee and popliteal fossa.     

Key aspects of anatomy,surgical approaches and clinical examination of the hand

Knowledge of the functional anatomy of the hand is essential to be able to successfully clinically examine and operate on it. The topic of hand anatomy, clinical examination and surgical approaches is therefore closely linked and discussed in this article. The focus will be on detailed functional anatomy of the joints, tendons, and other soft tissue structures of the hand, related to the clinical examination and surgical approaches. Particular attention will be paid to the superficial and deep flexor tendons and how to examine them; the extensor mechanism and examination of the central slip; and surgical approaches to the finger. The pathoanatomy of Dupuytren's disease and fingertip infections are also discussed.     

Conventional and surgical endodontic retreatment of a maxillary lateral incisor with unusual anatomy

AIM: To describe conventional and surgical endodontic treatment of a maxillary right lateral incisor with an unusual root dilaceration and to discuss the treatment outcome. SUMMARY: Root dilacerations refer to severe curvature or angulations that may occur anywhere along the length of a root. This anatomical deviation may present an unfavourable outcome if clinicians fail to recognize the difficulties. The following case report describes conventional and surgical endodontic treatment of a maxillary right lateral incisor with an unusual root dilaceration. *Root morphology may present a challenge for clinicians during root canal treatment. *Clinicians should be aware of the importance of surgical endodontics and be familiar with microsurgery principals and techniques.     

咽旁间隙巨大肿瘤的手术径路探讨

目的:探讨咽旁间隙巨大肿瘤切除的最佳手术径路。方法:2009-11—2011-05,笔者对6例咽旁间隙巨大肿瘤患者施行肿瘤切除手术,其中4例采用下颌正中截骨径路,2例采用了颏孔前截骨径路。结果:采用下颌正中截骨及颏孔前截骨径路,术野暴露充分,肿瘤切除安全、完整,术后愈合良好,无1例术后出现咬合关系紊乱。平均随访22个月(14～31个月),均未发现肿瘤复发。除1例下颌神经血管束因与瘤体粘连而切除外,无任何神经损伤症状。结论:下颌正中截骨和颏孔前截骨径路是咽旁间隙巨大肿瘤切除术的理想手术径路,符合肿瘤外科、美容外科和功能外科原则。     

Imaging of the foot and ankle

There are a number of imaging modalities available to assist in assessment of the foot and ankle. The variety of techniques will be described with emphasis on the particular advantages and limitations of each. Recent advances and variations relating to the individual modalities are reviewed together with specific clinical scenarios.     

无托槽隐形矫治系统的相关生物力学研究及病例

无托槽隐形矫治技术自20世纪90年代进入正畸临床后,以其美观性、舒适性、便捷性和疗效可预测性备受国内外正畸医生和患者的青睐。本文将主要就无托槽隐形矫治系统的生物力学特点,对国内外研究进展进行综述,以期为正畸医生在临床使用中提高工作效率和患者的满意度。     

Dynamic modeling and jaw biomechanics

Bioengineered simulations of dynamic events in the human masticatory system are relatively new. A primary advantage is their ability to integrate structure and function in cause-and-effect scenarios. By permitting detailed analyses of these interactions, and the prototyping of prosthetic additions, the models generate working hypotheses. Significant issues in their use include the importation and measurement of structural geometry, the choice of parameters affecting dynamics (e.g. inertial properties and viscoelasticities) and the nature of the modeling process (e.g. whether models are kinetically driven by muscle contraction, or kinematically defined by movement channels). Presently, there are few accepted standards or conventions for managing these computational data in the human jaws, and the data used are often derived from multiple and disparate sources. This review focuses on the approaches, assumptions, and key applications of dynamic modeling in the human masticatory system. It considers the role of imaging, the restrictions imposed by assumptions of unknown or unverifiable data, and how modeling can be a useful research technique despite these hurdles. The review concludes with a comment on creating virtual models for educational purposes.     

自锁托槽矫治系统相关生物力学的研究进展

与传统托槽矫治相比,自锁托槽正以其排齐整平时低系统摩擦力,而受到越来越多正畸患者及临床医生的青睐。本文将主要就自锁托槽的矫治原理及其生物力学性质,对国内外研究进展进行综述,以期为正畸医生在临床使用中提高工作效率和患者的满意度。     

Apical root canal anatomy in the dog

Abstract 240 permanent teeth from 8 different dogs aged 1, 3, 8, 10, 15 years, were used for an anatomic study. The teeth were cleaned, their root canal system was stained with dye, then the teeth were decalcified and cleared to determine the root canal anatomy. The apical root canal anatomy in dogs can be described as a “sprinkler-rose” anatomy: at the tip of the pulpal canal, the canal is divided in numerous narrow channels radiating peripherally through the dentin and the cementum and ending in numerous apical foramina on the cementum surface. This architecture constitutes a very complex apical delta.     

种植体-骨界面的生物力学研究进展

种植体-骨界面的生物力学反应是影响种植义齿远期成功率的重要因素之一。过大或过小的应力都会引起种植体周围的骨发生吸收或是萎缩从而导致种植失败。种植体周的应力分布受颌骨骨质、种植体形态、上部结构设计、力和材料等多方面的影响。下面就上述几方面对种植体-骨界面的生物力学特性作一综述。     

Automation and apps for clinical dental biomechanics

Objectives: The aim of this research summary is to introduce the current and ongoing work using smartphone video, tracking markers to measure musculoskeletal disorders of cranial and mandibular origin, and the potential significance of the technology to doctors and therapists.

Method: The MPA? biomechanical measuring apps are in beta trials with various doctors and therapists. The technique requires substantial image processing and statistical analysis, best suited to server-side processing. A smartphone environment has enabled a virtual laboratory, which provides automated generation of graphics and in some cases automated interpretation. The system enables highly accurate real-time biomechanics studies using only a smartphone and tracking markers.

Result: Despite the technical challenges in setting up and testing of the virtual environment and with interpretation of clinical relevance, the trials have enabled a demonstration of real-time biomechanics studies. The technology has prompted a lot of discussion about the relevance of rapid assessment tools in clinical practice. It seems that a prior bias against motion tracking and its relevance is very strong with occlusion related use cases, yet there has been a general agreement about the use case for cranial movement tracking in managing complex issues related to the head, neck, and TMJ.

Discussion: Measurement of cranial and mandibular functions using a smartphone video as the input have been investigated. Ongoing research will depend upon doctors and therapists to provide feedback as to which uses are considered clinically relevant.     

牙周膜的生物力学性能

口腔正畸学的生理机制之一就是牙周膜（PDL）回应正畸力量使牙齿运动,PDL的生物力学性能会直接影响牙周组织的结构、功能和健康,与正畸矫治过程息息相关,但是有关正畸过程中PDL生物力学方面的国内研究较少,故本文对牙周膜生物力学性能的研究进展作一综述。     

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优良的种植体应具有良好的生物力学相容性,过大或过小的应力均可引起牙周骨组织的吸收或萎缩,从而导致种植义齿的失败.本文对生物力学研究在牙种植体设计中的应用进展做一综述.     

(iii) Arthroscopy of the foot and ankle

The role of arthroscopy in the management of articular pathology is now well established. Its use in the management of foot and ankle pathology is relatively new, but with innovative techniques and modern equipment, the indications are expanding. Procedures that were previously performed through an open approach can now be done using a pure arthroscopic, or arthroscopically assisted, method with the aim of earlier rehabilitation, reducing complications and scarring, and improving outcome. We describe the history, current role and potential future uses of arthroscopy in the treatment of foot and ankle conditions.     

Diagnosis and management of the acute hot diabetic foot

Diabetes is an increasing problem in the modern world. Along with the rise in prevalence of the disease the number of diabetic complications presenting is increasing and amongst these is diabetic foot issues. Foot infection and Charcot arthropathy are the two key pathologies that present acutely with a hot swollen foot. Both require timely diagnosis and management to prevent disastrous long-term sequelae.Acutely presenting foot infections are both limb and life threatening and require urgent intervention to improve the chance of limb salvage. The ability to recognize and acutely deal with a diabetic foot requiring urgent surgical drainage is relevant to all orthopaedic surgeons with an on-call commitment and not solely to the foot and ankle specialist.Charcot arthropathy results in foot deformity that increases the likelihood of future ulceration and infection. The differentiation and acute management of the two conditions will be discussed.     

The influence of the connection,length and diameter of an implant on bone biomechanics

Abstract

Background. Regardless of the multiple options of connections, diameters and heights for dental implants, the clinician should know the biomechanical behavior of the bone to plan the treatment according to the biological and anatomical conditions of each patient, without risk to the long-term treatment success. Review. The following review attempts to summarize the relevant literature to establish guidelines for clinicians based on the scientific evidence regarding the influence by the implant’s connection, diameter and length on the bone biomechanics. Conclusions. The length, diameter and connection of each implant have a degree of influence in bone biomechanics. Despite the influence of different implant connections, diameters and lengths on peri-implant bone stress and strain, these characteristics should remain within the physiological limits to avoid a pathological overload, bone resorption and consequent risk to the long-term success of implant-prosthetic treatment.     

颧弓解剖测量及其应用解剖

目的测量成年人的颧弓解剖参数,为研制一种新型的颧弓骨折固定器提供解剖依据。方法用游标卡尺测量107个干颅骨标本(男56个,女51个)的颧弓。测量内容包括颧弓上下缘弦长、颧弓深度、颧弓厚度、颧弓宽度和颧弓下缘厚度。结果男性、女性颧弓相关测量的各项结果左右比较,男性、女性颧弓左右差异无显著性。男女性颧弓相关测量的各项结果男女比较,有显著性差异。男性颧弓的上下缘弦长、宽度、深度、厚度和下缘厚度均大于女性颧弓。结论颧弓下缘处不宜行钛板钛钉坚强内固定,坚强内固定的位置应是颧弓外表面中轴线上。