Facial Bones

面部骨骼
  • 文章类型: Journal Article
    初级纤毛是控制细胞发育和组织稳态的毛发状突起。尽管积累的研究确定了纤毛和纤毛相关疾病之间的分子联系,纤毛病的潜在病因尚未完全了解。在本文中,我们确定了Rab34的功能,一种小的GTP酶,作为控制颅面发育中纤毛发生和I型胶原蛋白运输的关键调节剂。机械上,Rab34需要形成控制成骨增殖的纤毛,生存,和通过纤毛介导的Hedgehog信号传导分化。此外,Rab34对于调节I型胶原蛋白从ER到高尔基体的运输是必不可少的。这些结果表明Rab34具有纤毛和非纤毛功能以调节成骨。我们的研究强调了Rab34的关键功能,这可能有助于理解与人类RAB34功能障碍相关的纤毛病的新病因。
    The primary cilium is a hair-like projection that controls cell development and tissue homeostasis. Although accumulated studies identify the molecular link between cilia and cilia-related diseases, the underlying etiology of ciliopathies has not been fully understood. In this paper, we determine the function of Rab34, a small GTPase, as a key regulator for controlling ciliogenesis and type I collagen trafficking in craniofacial development. Mechanistically, Rab34 is required to form cilia that control osteogenic proliferation, survival, and differentiation via cilia-mediated Hedgehog signaling. In addition, Rab34 is indispensable for regulating type I collagen trafficking from the ER to the Golgi. These results demonstrate that Rab34 has both ciliary and non-ciliary functions to regulate osteogenesis. Our study highlights the critical function of Rab34, which may contribute to understanding the novel etiology of ciliopathies that are associated with the dysfunction of RAB34 in humans.
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  • 文章类型: Journal Article
    目的:评估下颌管分叉(BMC)的存在,并通过将发现与性别相关联对这些变异进行分类,年龄和面部骨骼模式,进行了测量,包括高度,宽度,从分叉到解剖皮质骨的距离。
    方法:在301例患者的锥形束CT检查中确定了BMC,并根据其来源进行了分类。location,方向,配置和结束。分叉前后MC的高度和宽度;BMC的高度和宽度;从BMC到肺泡的距离(C1),颊(C2),测量舌(C3)和基底(C4)骨皮质。所有数据都与性别相关,年龄,和面部骨骼模式(第一类,II,III).显著性水平为5%。
    结果:在55例患者(18.28%)中发现67例BMC(22.26%)。分叉在女性中更为普遍(p=0.57),18-39岁(p=0.40),I类(p=0.77)。单分叉,位于下颌骨的后部,起源于MC,以上向和终止于磨牙孔后更普遍(p>0.05)。男性个体的平均皮质测量值较高,仅在C1处有显著差异(p=0.03)。BMC的平均高度和宽度分别为2.24(±0.62)和1.75(±0.45)mm。BMC分类与研究变量之间没有关联(p>0.05)。
    结论:大约1/5的研究人群患有BMC。BMC的存在或特征与性别没有关联,年龄,和面部骨骼模式。在男性个体中,从分叉到肺泡(上)皮质骨的距离更大。
    OBJECTIVE: To assess the presence of mandibular canal bifurcation (BMC) and classify these variations by correlating findings with sex, age and facial skeletal pattern, measurements were made, including height, width, and distance from bifurcation to anatomical cortical bones.
    METHODS: BMC was identified in cone beam CT exams of 301 patients and classified according to its origin, location, direction, configuration and ending. The height and width of the MC before and after the bifurcation; height and width of the BMC; and distance from BMC to alveolar (C1), buccal (C2), lingual (C3) and basal (C4) bone cortices were measured. All data were correlated with sex, age, and facial skeletal pattern (class I, II, III). The significance level was 5%.
    RESULTS: 67 BMC (22.26%) were identified in 55 patients (18.28%). Bifurcations were more prevalent in females (p = 0.57), aged 18-39 years (p = 0.40), class I (p = 0.77). Single bifurcations, located in the posterior region of the mandible, originating in the MC, with a superior direction and ending in the retromolar foramen were more prevalent (p > 0.05). Mean cortical measurements were higher in male individuals, with significant differences only at C1 (p = 0.03). The mean height and width of BMC were 2.24 (± 0.62) and 1.75 (± 0.45) mm. There was no association between BMC classification and the variables studied (p > 0.05).
    CONCLUSIONS: Approximately 1/5 of the population studied had BMC. There were no associations of BMC presence or characteristics with sex, age, and facial skeletal pattern. The distance from bifurcation to alveolar (superior) cortical bone is greater in male individuals.
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  • 文章类型: Journal Article
    自动密集3D表面配准是一种用于全面3D形状分析的强大技术,已在人体颅面形态学研究中成功应用,特别是在下颌和颅骨拱顶区域。然而,在探索人类头骨的正面时存在明显的差距,很大程度上是由于其颅骨解剖的复杂和独特的性质。为了更好地检查这个地区,这项研究介绍了一种简化的单表面颅面骨面罩,包括6707个准地标,这可以帮助分类和量化人类面部骨骼表面的变化。在通过锥形束计算机断层扫描(CBCT)成像获得的31个颅骨扫描数据集上进行了自动颅面骨表型鉴定。MeshMonk框架促进了构建的颅面骨面罩与每个单独的目标网格的非刚性对准。为了衡量这个自动化过程的准确性和可靠性,由三个独立的观察者在同一组图像上手动放置20个解剖面部标志三次。使用均方根(RMS)距离进行观察者内部和观察者之间的误差评估,显示出一贯的低分。随后,计算了相应的自动地标,并将其与手动放置的地标并列。这两个界标集之间的平均欧氏距离为1.5mm,而质心大小表现出值得注意的相似性。类内系数(ICC)表现出高水平的一致性(>0.988),自动地标显示出较低的误差和变化。这些结果强调了这种新开发的单表面颅面骨面罩的实用性,结合MeshMonk框架,作为一种高度准确和可靠的方法,用于从CBCT和CT图像对人类头骨的面部区域进行自动表型分析。MeshMonk工具箱的这种颅面模板骨面罩扩展不仅增强了我们研究颅面骨变异的能力,而且还具有明显的遗传潜力,发展,以及人类颅面整体结构的进化基础。
    Automatic dense 3D surface registration is a powerful technique for comprehensive 3D shape analysis that has found a successful application in human craniofacial morphology research, particularly within the mandibular and cranial vault regions. However, a notable gap exists when exploring the frontal aspect of the human skull, largely due to the intricate and unique nature of its cranial anatomy. To better examine this region, this study introduces a simplified single-surface craniofacial bone mask comprising of 6707 quasi-landmarks, which can aid in the classification and quantification of variation over human facial bone surfaces. Automatic craniofacial bone phenotyping was conducted on a dataset of 31 skull scans obtained through cone-beam computed tomography (CBCT) imaging. The MeshMonk framework facilitated the non-rigid alignment of the constructed craniofacial bone mask with each individual target mesh. To gauge the accuracy and reliability of this automated process, 20 anatomical facial landmarks were manually placed three times by three independent observers on the same set of images. Intra- and inter-observer error assessments were performed using root mean square (RMS) distances, revealing consistently low scores. Subsequently, the corresponding automatic landmarks were computed and juxtaposed with the manually placed landmarks. The average Euclidean distance between these two landmark sets was 1.5 mm, while centroid sizes exhibited noteworthy similarity. Intraclass coefficients (ICC) demonstrated a high level of concordance (> 0.988), with automatic landmarking showing significantly lower errors and variation. These results underscore the utility of this newly developed single-surface craniofacial bone mask, in conjunction with the MeshMonk framework, as a highly accurate and reliable method for automated phenotyping of the facial region of human skulls from CBCT and CT imagery. This craniofacial template bone mask expansion of the MeshMonk toolbox not only enhances our capacity to study craniofacial bone variation but also holds significant potential for shedding light on the genetic, developmental, and evolutionary underpinnings of the overall human craniofacial structure.
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  • 文章类型: Journal Article
    目的:关于口腔颌面外科医疗事故索赔原因的研究很少。这项研究的目的是调查颅面骨折相关医疗事故索赔中永久性伤害的原因和患病率。
    方法:设计并实施了一项回顾性注册研究。包括所有主诉和诊断为面部或颅骨骨折的患者。主要结果是存在永久性伤害,预测变量是投诉的原因。卡方检验用于统计显著性的估计。
    结果:正确诊断的延迟是医疗事故索赔的主要原因(63.2%),在23.1%的人口中发现了永久性伤害。总人口中面部骨折占82.4%。65.3%(n=98)的面部创伤与延迟诊断有关(p<0.001)。诊断延迟的患者(71.4%)比没有诊断的患者(60.7%,p=0.299)。
    结论:颅面外伤的索赔与诊断不足有关,和未诊断的面部骨折可导致高比率的永久性伤害。建议进行系统的临床评估和面部创伤专家咨询,以早期正确诊断并改善颅面创伤患者的治疗。
    OBJECTIVE: Research on reasons for malpractice claims in oral and maxillofacial surgery is scarce. The aim of this study was to investigate the causes and prevalence of permanent harm among craniofacial fracture related malpractice claims.
    METHODS: A retrospective register study was designed and implemented. All patients with a complaint and a diagnosis of facial or cranial fracture were included. The main outcome was the presence of permanent harm, and the predictor variable was the cause of complaint. Chi-square test was used for estimation of statistical significance.
    RESULTS: Delay in correct diagnosis was the leading cause of malpractice claims (63.2%), and permanent harm was found in 23.1% of the population. 82.4% of injuries were facial fractures in total population. 65.3% (n = 98) of facial trauma were related with delayed diagnostics (p < 0.001). Permanent harm was more frequent in patients with delayed diagnosis (71.4%) than those without (60.7%, p = 0.299).
    CONCLUSIONS: Claims of craniofacial trauma are related with under-diagnostics, and un-diagnosed facial fracture can lead to a high rate of permanent harm. Systematic clinical evaluation and facial trauma specialist consultation is recommended to set early correct diagnosis for and improve treatment of craniofacial trauma patients.
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  • 文章类型: Journal Article
    目的:说明在正常和病理条件下,使用斑马鱼了解Fgf信号通路在颅面骨骼发育过程中的作用的价值。
    结果:从斑马鱼研究中获得的最新数据已经证明了Fgf信号通路的遗传冗余,并在颅面骨骼发育的早期阶段确定了该信号的新分子伴侣。斑马鱼模型的研究表明,Fgf信号通路参与颅面发育的每个阶段。他们特别强调Fgf信号通路在发育早期的中心作用,这极大地影响了构成颅面骨骼的各种结构的形成。这部分解释了在与FGF信号传导相关的疾病中观察到的颅面异常。未来的研究工作应该集中在更晚期阶段的斑马鱼Fgf信号研究上,特别是通过建立斑马鱼模型,表达与颅骨滑膜病等疾病有关的突变。
    OBJECTIVE: To illustrate the value of using zebrafish to understand the role of the Fgf signaling pathway during craniofacial skeletal development under normal and pathological conditions.
    RESULTS: Recent data obtained from studies on zebrafish have demonstrated the genetic redundancy of Fgf signaling pathway and have identified new molecular partners of this signaling during the early stages of craniofacial skeletal development. Studies on zebrafish models demonstrate the involvement of the Fgf signaling pathway at every stage of craniofacial development. They particularly emphasize the central role of Fgf signaling pathway during the early stages of the development, which significantly impacts the formation of the various structures making up the craniofacial skeleton. This partly explains the craniofacial abnormalities observed in disorders associated with FGF signaling. Future research efforts should focus on investigating zebrafish Fgf signaling during more advanced stages, notably by establishing zebrafish models expressing mutations responsible for diseases such as craniosynostoses.
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  • 文章类型: Journal Article
    背景:人脸是由许多不同组件组合形成的复杂区域,并且根据性别在个体之间有所不同,年龄,和种族。
    目的:本研究的目的是评估两种性别的大量样本中与年龄相关的面部和颅骨的变化。
    方法:回顾性研究包括280名土耳其成年人的非创伤性脑计算机断层扫描。参与者分为7个十年组,年龄从20岁到89岁不等。记录面部和颅骨的测量值,计算颅骨体积。检查了这些参数与年龄和性别的关系。
    结果:在所有面部和颅骨测量中观察到统计学上的显着差异,除了头部的横向直径,随着男女年龄的增长。不管年龄,性别之间在面部和颅骨测量中没有发现显着差异。此外,在生命的第七个十年后,两种性别的颅骨体积均显着减少。
    结论:面部和颅骨的结构在整个生命过程中持续变化和分化。在手术和面部年轻化过程中考虑这些变化可以帮助预测结果并避免使用不正确的技术。
    BACKGROUND: The human face is a complex area formed by the combination of many different components and varies among individuals according to gender, age, and ethnicity.
    OBJECTIVE: The aim of this study was to evaluate age-related changes in the facial and calvarial bones in a large sample of both genders.
    METHODS: The retrospective study included nontraumatic brain computed tomography scans of 280 Turkish adults. Participants were divided into 7-decade groups with the age ranging from 20 to 89 years. Measurements of the face and calvaria were recorded, and calvarial volume was calculated. The relationship of these parameters with age and gender was examined.
    RESULTS: Statistically significant differences were observed in all the facial and calvarial measurements, except the transverse diameter of the head, with increasing age in both genders. Regardless of age, no significant differences were found in facial and calvarial measurements between genders. In addition, there was a significant decrease in the calvarial volume in both genders after the seventh decade of life.
    CONCLUSIONS: The structure of the face and calvarium continues to change and differentiate throughout life. Taking these changes into account during surgical and facial rejuvenation procedures can help predict outcomes and avoid the use of incorrect techniques.
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  • 文章类型: Journal Article
    颅面纤维骨病变代表了多种病理状况,其中纤维组织取代了健康的骨骼,导致不规则的形成,编织的骨头。他们更常见于年轻人,治疗策略取决于临床行为和骨骼成熟度。本文讨论了颅面纤维骨性病变的例子,根据最新的分类,以及他们的诊断标准和管理。
    Craniofacial fibro-osseous lesions represent a diverse spectrum of pathologic conditions where fibrous tissue replaces healthy bone, resulting in the formation of irregular, woven bone. They are more commonly diagnosed in young people, with treatment strategies dependent on clinical behavior and skeletal maturity. This article discusses the examples of craniofacial fibro-osseous lesions, based on the latest classifications, along with their diagnostic criteria and management.
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  • 文章类型: Journal Article
    在护理多发性创伤或患有颅面骨折的医学受损患者时,解剖学上复杂的颅面骨骼需要特别考虑。本文利用系统综述和多学科观点,为颅面骨折患者的医院护理创建了一种算法(颅底,轨道,鼻旁窦,和下颌骨)需要无创通气(NIV)。每个骨折位置对不同类型的肺气肿和相关发病率都有独特的倾向。患肺气肿的风险,结合其潜在的严重性,针对不为患者的整体护理提供NIV的危害进行分层。本文的目的是通过对现有文献的系统回顾和多学科观点来综合证据,以开发一种简洁的算法,概述需要NIV的颅面骨折患者的最佳治疗方法。
    The anatomically complex craniofacial skeleton demands special consideration when caring for cases of polytrauma or medically compromised patients with craniofacial fractures. This paper utilises a systematic review and multidisciplinary opinions to create an algorithm for the hospital-based care of patients with craniofacial fractures (base of skull, orbit, paranasal sinus, and mandible) who require non-invasive ventilation (NIV). Each fracture location has a unique predisposition to a different type of emphysema and associated morbidity. The risk of developing emphysema, combined with its potential severity, is stratified against the harm of not providing NIV for the holistic care of the patient. The aim of this paper is to synthesise evidence from a systematic review of existing literature with multidisciplinary opinions to develop a concise algorithm that outlines the optimal treatment of patients with craniofacial fractures who require NIV.
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  • 文章类型: Journal Article
    Craniofacial hard tissue mainly includes craniofacial bone and tooth, which is one of the important parts of the mouth-jaw system. Congenital aplasia, tumors and trauma can cause large craniofacial hard tissue defects, which are detrimental to the facial appearance and function of patients, and affect the physical and mental health of patients. Histone acetylation modification is the earliest and most widely studied histone modification, which is an epigenetic modification mechanism jointly regulated by histone acetyltransferase and histone deacetylase. In this paper, we will review the research progress of histone acetylation mediated by histone acetyltransferase and histone deacetylase in the development and regeneration of craniofacial hard tissue.
    口腔颅颌面硬组织主要包括颅颌面骨及牙齿组织,是口腔颅颌面系统的重要组成部分。发育畸形、肿瘤、外伤等疾病可造成颅颌面硬组织大面积缺损,严重损害患者面部形貌与功能,影响患者生活质量与身心健康。组蛋白乙酰化修饰是研究最早、最广的组蛋白修饰方式,是由组蛋白乙酰转移酶和组蛋白去乙酰化酶共同调控的表观遗传修饰机制。本文对组蛋白乙酰转移酶和组蛋白去乙酰化酶介导的组蛋白乙酰化修饰在颅颌面硬组织发育与再生修复中的研究现状进行评述,以期为颅颌面硬组织发育缺陷以及缺损的再生修复提供新线索。.
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  • 文章类型: Journal Article
    背景:尽管在城市医院中,颅面(CMF)骨折的流行病学已经得到了很好的证明,这些骨折在农村医院的特点还没有得到很好的研究。
    目的:本研究的目的是报告在伊利诺伊州中部一个为大量农村人口服务的地区一级创伤中心的CMF骨折的流行病学。
    这是一个以社区为基础的区域三级转诊中心的回顾性队列研究,主要服务于农村人口。纳入标准包括2015年至2019年间放射学证实为CMF骨折的患者。排除病历不完整的患者。
    方法:预测器变量包括人口统计学(年龄,录取来源,种族,和性别)和CMF骨折的病因(攻击/家庭暴力,全地形车/越野,falls,与农场有关,机动车碰撞,枪伤,和其他人)。
    方法:主要结果变量是CMF解剖位置,包括鼻骨,轨道,下颌骨,颌骨/上颌,和其他CMF骨折。
    协变量不适用。
    方法:使用描述性统计来总结人群特征的样本。Wilcoxon排名符号检验和χ2独立性检验用于评估所选感兴趣变量之间的统计学显着关联。统计学显著性定义为P<0.05。
    结果:在2015年至2019年之间,共有2,334例因CMF骨折而被急诊就诊。在应用纳入/排除标准后,最终样本由1,844例患者组成,治疗2,405例CMF骨折.相对于所有其他年龄组,大多数患者为男性(62.0%),年轻人(18-39岁)的CMF骨折数量最高(819)。最常见的骨折病因是跌倒(37.3%),鼻骨骨折是最常见的骨折部位(41.6%)。χ2分析显示CMF骨折发生的解剖位置之间有统计学意义的关联,和不同的年龄类别,录取来源,种族,性别,和病因。
    结论:我们的研究表明,在我们的中西部一级创伤中心看到的患者更容易出现由于跌倒引起的鼻骨和颌骨/上颌骨骨折。在基于城市中心的研究中,患者可能由于跌倒和攻击而出现眼眶和下颌骨骨折。
    BACKGROUND: Though the epidemiology of craniomaxillofacial (CMF) fractures has been well documented at urban hospitals, the characteristics of these fractures in rural hospitals have not been well studied.
    OBJECTIVE: The purpose of this study is to report on the epidemiology of CMF fractures at a regional Level 1 trauma center serving a large rural population in central Illinois.
    UNASSIGNED: This is a retrospective cohort study at a community-based regional tertiary referral center that serves a predominantly rural population. Inclusion criteria comprised patients with radiologically confirmed CMF fractures between 2015 and 2019. Patients with incomplete medical records were excluded.
    METHODS: Predictor variables included demographics (age, admission source, race, and sex) and etiology of CMF fracture (assault/domestic violence, all-terrain vehicle/off-road, falls, farm-related, motor vehicle collisions, gunshot wound, and others).
    METHODS: The primary outcome variable was the CMF anatomic location including nasal bone, orbit, mandible, malar/maxillary, and other CMF fractures.
    UNASSIGNED: The covariates are not applicable.
    METHODS: Descriptive statistics were used to summarize a sample of the population characteristics. Wilcoxon ranked sign tests and χ2 tests of independence were used to assess for statistically significant associations between select variables of interest. Statistical significance was defined as P < .05.
    RESULTS: Between 2015 and 2019, a total of 2,334 patients presented to the emergency department with a CMF fracture. After applying the inclusion/exclusion criteria, the final sample was composed of 1,844 patients for the management of 2,405 CMF fractures. The majority of patients were male(62.0%) and young adults (aged 18-39) had the highest number of CMF fractures (819) relative to all other age groups. The most common fracture etiology was fall(37.3%), and nasal bone fractures represented the most common fracture location(41.6%). χ2 analyses revealed statistically significant associations between the anatomic location of CMF fracture incurred, and differing categories of age, admission source, race, sex, and etiology.
    CONCLUSIONS: Our study shows that patients seen at our Midwestern Level 1 trauma center are more likely to present with nasal bone and malar/maxillary fractures due to falls. In studies based in urban centers, patients are likely to present with orbital and mandibular fractures due to falls and assault.
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