|
|||||||||||||||||
|
Letter: Importance of Amalgamating Oral Anatomy with Dental Surgery |
|||||||||||||||||
|
Daisy Loyola, Surraj Susai 1. Consultant, Department of Oral and Maxillo-facial Surgery, "Spreading Smiles" Dental Clinic- A Unit of Rani Hospital, Puducherry, India. 2. Senior Resident, Department of Anatomy, JIPMER, Puducherry, India. |
|||||||||||||||||
|
Correspondence Address : Dr. Surraj Susai, 53/54, Udayam Galaxy Apartment 2C, 1st Cross Street, Manakula Vinayagar Nagar, Puducherry-605005, India. E-mail: surraj18@gmail.com |
|||||||||||||||||
|
|||||||||||||||||
| ABSTRACT |  | ||||||||||||||||
: Morphometry of body and neural arch of lumbar vertebrae is very crucial in manufacturing screws, interspinous implants as well as preoperative planning of surgeries involving dorsolumbar spine. Aim: To determine various dimensions of typical and atypical lumbar vertebrae. Materials and Methods: A descriptive osteological study was carried out which included 66 intact adult dry human lumbar vertebrae (53 typical and 13 atypical) which were free of any deformity or pathological features. All the 53 typical vertebrae were randomly obtained. The following parameters were measured with slide callipers- superior transverse diameter and superior antero-posterior diameters of vertebral foramen; transverse diameter, antero-posterior diameter and anterior height of vertebral body; width, height of pedicles; interpedicular distance; maximum thickness of lamina; length of transverse process; maximum length, maximum height and maximum central thickness of spinous process. The data was tabulated and analysed using Microsoft Excel software. Mean and standard deviation was calculated for each parameter. Unpaired t-test was applied and p-value was derived for parameters like width and height of pedicles, thickness of lamina and length of transverse process. The p-value<0.05 were considered as significant. Results: The vertebral foramen (superior transverse diameter- 20.41±2.54 mm, superior antero-posterior diameter- 13.3±2.04 mm); vertebral body (transverse diameter- 44.43±5.91 mm, antero-posterior diameter- 30.17±3.19 mm, anterior height- 24.01±1.84 mm); pedicle (width- 10.85±3.94 mm on left side and 11.04±4.01 mm on right side, height- 13.84±4.01 mm on left side and 13.8±1.93 mm on right side, interpedicular distance- 29.17±5.06 mm); lamina (thickness- 6.6±1.36 mm on left side and 6.85±1.34 mm on right side); transverse process (length- 20.94±4.01 mm on left side and 21.51±4.5 mm on right side); spinous process (maximum length- 26.01±3.73 mm, maximum height- 19.92±4.03 mm, maximum central thickness- 6.42±1.41 mm). The mean transverse diameter and antero-posterior diameter of vertebral foramen of atypical lumbar vertebrae were higher than those of the typical lumbar vertebrae and these differences were significant (p-value of 0.0001 for transverse diameter and p-value of 0.005 for antero-posterior diameter). Conclusion: Most of the parameters of atypical lumbar vertebrae were found to be more compared to those of typical lumbar vertebrae. This inference should be kept in mind during fixation of lumbar inter-spinous implants, designing of pedicular screws and spinal grafting. | |||||||||||||||||
|
|
|||||||||||||||||
| Keywords : Applied anatomy, Integration, Surgical dentistry | |||||||||||||||||
|
|
|||||||||||||||||
| INTRODUCTION |
| ||||||||||||||||
Sir, With the growing rise in the number of dentists, it is seen that more and more dental professionals either opt for private practice after under-graduation or join post-graduation preferably by choosing a surgical dental course (1). In either case, it has been observed that the knowledge acquired by them in anatomy is either inadequate or too traditional that may not be suited for them to handle the current challenging surgical practises in the field of Dentistry (1),(2). Studies have also shown that the neglect of anatomically oriented case-based approaches to patient-care setting in the final year and penultimate final year training sessions of dental under-graduate students has resulted in the expanding lacunae in anatomical knowledge for the dentists of the current generation (2),(3). The underlying error lies not on the dentists, per se, but in the mode of teaching of oral anatomy in the dental curriculum (2),(3). The methods of oral anatomy taught to dentists in India, the subcontinent nations, the middle-eastern gulf nations and even in some of the European nations are similar and are still in their naïve stages owing to the fact that traditional dental anatomy is being preferred and taught only in the first year (4),(5). The use of traditional methods of anatomy in India and the like nations, still limits the expansive knowledge for the applications of surgical techniques to a dental surgeon (4),(5),(6),(7). Though Mitchell J and Brackett M (6) had shown in their study, the effectiveness of innovative flipped classroom techniques- where a portion of the students are exposed to a lecture and the remaining portion are given an assignment and vice versa and interactive feedback sessions – that may include quiz sessions, debates and webinars on hands-on anatomy skill-based training evenly to the first year and final year undergraduates in dentistry. These approaches still remain in their early testing stages and have not yet been applied to a larger and regular domain (5),(7). Though the situation in the medical curriculum is similar to that of the dental curriculum, the use of integrated modular sessions in the medical field, between the pre-clinical and clinical departments have marginally reduced the gap in clinically oriented anatomy among practicing medical surgeons as compared to dental surgeons (4),(5),(6),(7). However, this doesn’t justify the credibility of the method of teaching anatomy in the medical curriculum as there are a lot of shortcomings in the methodology of anatomical training in the medical field too, as pointed out by Lavelle CL in his study (4). As highlighted by Habbal O in his article (3), this existing dearth in acquiring skill-based anatomical knowledge is further deepened, owing to the paucity of impetus bestowed upon anatomists as being mere basic medical researchers or medical teachers, by the students or other health care professionals both in medical and dental fields, that indirectly influences the working potential of anatomists to do basic innovative advancements in the field of medical education and applying them to advancements and techniques in the surgical and dental fields (3). This in turn may affect the acquisition of appropriate skill-based anatomical knowledge to the dental surgeon for confidently performing common dental procedures or fixing implants (2),(3),(4),(7). In conclusion, the authors would like to admit that for a practicing dental surgeon to adapt, it requires a sound knowledge of practically applicable anatomy, that can be obtained only through a mutual co-operation between anatomists and dental surgeons in conducting skill-based workshops- that includes cadaveric oral mucosal flap repositioning workshops, oral and buccal arterial repair dissectional workshops on a cadaver and root canal workshops on cadaveric teeth (6),(7) by implementing them throughout the dental curriculum. | |||||||||||||||||
|
|||||||||||||||||
| TABLES AND FIGURES |
|
||||||||||||||||
|
|||||||||||||||||
|
|
|||||||||||||||||
Letter to Editor
|
