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 o vertical buttress: nasomaxillary, zygomaticomaxillary, pterygomaxillary o horizontal buttress: glabella, orbital rims, zygomatic processes, maxillary palate o 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 o fractures of the body o angle fractures o symphyseal and parasymphyseal fractures o condylar process fractures · Lower midface (Le Fort I) * Upper midface o naso-orbitoehmoid o zygomaticomaxillary complex o orbital o Le Fort II o 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