Clinical anatomy Dentistry 1a. Mandible

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Clinical anatomy_Dentistry

1a. Mandible

  • Anatomy – repetition

  • Changes during life

  • Alveolar process, alveolus (compact and spongy bone, bundle bone, resorption, reconstruction)

  • Lingual foramen

  • Mandibular canal – topography, variations

  • Mental canal and foramen

  • Incisive canal

  • Orifices accessoria

  • Dentoalveolar topography (the transverse assymetry of alveolus; the rate of the compact and spongy bone; the relationship the root the lower jaw to neighbouring structures)

  • Nerve and blood supply – repetition

1b. Maxilla

  • Anatomy – repetition

  • Clinical notes – accessory maxillary ostia, maxillary sinus floor, maxillary sinus septa, Caldwell-Luc surgery, tuber maxillae, infraorbital canal, palatum (zones of mucous membrane; A and H line)

  • Dentoalveolar topography – the transverse assymetry of alveolus; the rate of the compact and spongy bone; the relationship the root the lower jaw to neighbouring structures

  • Nerve and blood supply (variation) – repetition

2a. Temporomandibular joint

  • Temporomandibular joint – generaly

  • Articular surfaces (articular fossa, articular eminence, postglenoid process, mandibular fossa) – description of each structure

  • Joint capsule (shape, attachment, layers, solidity) – description

  • Disc (shape, localization, function, structure, insertion, division on the parts, division of the posterior part, innervation, physiologic position, injury)

  • Zenker retroauricular pad (localization, structure, function on the opening and closing of the mouth)

  • Ligaments of the TMJ – localization, description, function

  • articular (medial, lateral)

  • extraarticular (stylomandibular, sphenomandibular)

  • additional (discomalleolar, Tanaka´s)

  • Movements of the TMJ – detailed explanation

  • Hinge and gliding movement

  • depression

  • elevation

  • protrusion

  • retrusion

  • laterotrusion

  • Hypomobility of the TMJ (ankylosis, pseudoankylosis) – explanation

  • Hypermobility of the TMJ (subluxation, luxation) – explanation

  • Innervation of the TMJ (branches of the mandibular nerve) – description

  • Arterial supply of the TMJ – description

  • Examination of the TMJ (palpation, compression, imaging procedure: x ray, CT, MRi, arthroscopy) – description

  • Topographical relationship of the TMJ – description

2b. muscles of mastication

  • Definition

  • Masseter muscle: parts (superficial, deep) – origo and insertion, course of muscle´s fibres, function, architecture, fascia, examination

  • Temporal muscle: origo, insertion, parts, course of muscle´s fibres, funtion, architecture, fascia, examination

  • Lateral pterygoid muscle: upper and lower heads - origo, insertion, course of muscle´s fibres, function, architecture, fascia, examination

  • Medial pterygoid muscle: origo (anterior and posterior parts), insertion, course of muscle´s fibres, architecture, fascia, examination

3. Basic of craniometry and cephalometry

  • Craniometry – definition, application

  • Cephalometry – definition, application

  • Craniometric points – localization

  • unpaired: nasion, glabella, bregma, akanthion, lambda, orale, basion, opisthocranion, staphylion

  • binate: pteryon, porion, euryon, zygion, gonion, endomolare

  • Frankfort horizontal plane – definition

  • Maxillary plane – definition; mandibular plane – definition

  • Dimensions between the craniometric points (size of the skull, face, palatum) – how are measurmened

  • Indexes of the skull (cephalic, facial and palatomaxillary) – how are counted and what indicate

  • Cephalometric points – localization:

sella, nasion, orbitale, porion, anterior nasal spine, posterior nasal spine, gonion, menton, A point, B point

  • Cephalometric lines (S-N, N-A, N-B) – generally; what does it indicate

  • Cephalometric angles (SNA, SNB, ANB) – generally; what does it indicate

  • Telerentgen – recognize, when is used

4a. Functional structure of the skull

  • Thickened parts of the skull (base): sagittal line, ventral and dorsal lateral line – localization

  • Thinner parts of the skull (base): articular fossa, cribriform plate, foramina, canals and fissures, anterior, medial and posterior cranial fossa – localization

  • Thickened parts of the skull (calvaria): parietal tuber, mastoid process, external and internal occipital protuberantia, temporal line, margin of sulcus sinus sagitalis sup. et transversus – localization

  • Facial buttresses system – definition, description, significance, drawing

    • vertical buttress: nasomaxillary, zygomaticomaxillary, pterygomaxillary

    • horizontal buttress: glabella, orbital rims, zygomatic processes, maxillary palate

    • free places between the framework: orbit, maxillary sinus, nasal cavity

  • Transmission of the masticatory forces to the skull: trajectory lines, vertical buttresses system – explaining, drawing

4b. Fractures of the skull

Neurocranial fractures (linear, depressed, basilar) – generally, fracture lines

Symptoms and complication of the cranial fractures (cranial nerve lesion, otorrhea, rhinorrhea, Battle´s sign, Raccoon eyes, intracranial hemorrhage, cranial oedema) – basic description

Craniofacial fractures - detailed description:

  • Mandible

  • fractures of the body

  • angle fractures

  • symphyseal and parasymphyseal fractures

  • condylar process fractures

  • Lower midface (Le Fort I)

  • Upper midface

    • naso-orbitoehmoid

    • zygomaticomaxillary complex

    • orbital

    • Le Fort II

    • Le Fort III

  • Craniobasal-facial

5. radiography of the head

  • Types of imaging methods (x ray, magnetic resonance, ultrasonography)

  • Summation imaging x storeyed imaging, differences

  • Conventional and digital radiography, differences, advantages

  • Intraoral radiography (bisecting, paralleling and bitewing technique, occlusal radiograph)

  • Full mouth x ray

  • Reading of x ray

  • Extraoral radiography (ortopantomography, cephalometry, conventional – lateral, postero-anterior, sumbentovertical, Hirtz, Waters, Clementschitsch)

  • Special radiography (Stenvers and Schullers projection, Albert-Schonberg view)

  • Contrast imaging (sialography, arthrography, antrography, cystography, fistulography, angiography)

  • Computerized tomography – generally

  • Magnetic resonance imaging – generally

  • Ultrasonography – generally

6. Odontogenic infection pathway

For understanding of this chapter it is necessary repeat following topographic boundaries of these spaces: temporal; infratemporal; sublingual; submental; submandibular; pterygomandibular; parapharyngeal

  • Odontogenic infection – definition, causations, influence of the degree of infection

  • Types of odontogenic infections (localized, diffused) – differences, barriers of spreading

  • General signs of infection (rubor, tumor, calor, dolor, functio laesa) general description, reasons

  • The possibility of spreading of dental infection (per continuitatem, by vascular, by lymphatic) – explanation

  • Abscess – causal tooth, localization, barriers of spreading, spreading, risk

  • vestibular; palatal

  • Diffused infection – causal tooth, localization, barriers of spreading, spreading, risk (buccal space; temporal space; infratemporal space; infraorbital space; submental space; submandibular space; sublingual space (Ludvig´s angine); masseteric space; pterygomandibular space; lateral pharyngeal space; maxillary sinus

  • Infection in neck space (pretracheal, prevertebral, visceral neck spaces) – description

  • abscess: subcutaneous, suprasternal, pretracheal, parapharyngeal, retropharyngeal) – explanation of origin, spreading

  • Bacteriemia – explanation

  • Infected thrombus – explanation

  • Ventral and dorsal pathway of spreading infection in venous system of the head – description

7. dental anesthesia

For understanding of this chapter it is necessary repeat trigeminal nerve. Student can draw areas of innervation and anesthetic into the pictures.

  • Pain – definition, causation

  • Local anestetic – definition, how they act on the peripheral nerve

  • Vasoconstrictors – definition, reason for its additing, advantages

  • Complication of dental anesthesia - description

  • nerve injury (paresthesia, hyperesthesia, dysesthesia, dysgeusia, xerostomia, ocular and extraocular symptoms

  • bleeding

  • intraglandular injection

  • trauma of muscle

  • systematic complication

  • Types of local anesthesia - basic description

  • Local infiltration – technique, localisation in upper and lower jaw

  • Nerve block – technique, localisation, description

  • PSA, MSA, ASA, infraorbital, great palatine, nasopalatine, alveolar inferior (Haldstead, Gow- Gates, Akinosi), mental, lingual, buccal

  • Alternative delivery methods (intraosseous, intraligamentary and intrapulpar injection, topical anesthetic patches - description

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