Evaluation of the Size and Location of the Genial Plexus,Related to Age,Sex and Dental Presence,in Implant Surgeries

Generally being considered as a safe area for surgical approaches, the region between the mental foramina presents important anatomical structures. The objective of this study was to measure the dimensions of the genial plexus and its three-dimensional location in CBCT images, correlating the characteristics of this structure with dental presence, sex and age of patients. A total of 149 cone beam computer tomography (CBCT) scans of dentate (n = 74) and edentulous patients (n = 75) were selected, 59 male and 90 female, aged 18 - 86 years. Measurements of width and length of the genial canal were performed, and the shortest distances of the genial plexus were determined in relation to the alveolar bone crest, the buccal cortical bone and the base of the mandible. The results indicated significant differences between the dentate and edentulous groups for the mandibular canal length (p = 0.030), distance from alveolar crest (p < 0.001), and distance from buccal cortical bone (p < 0.001), with significantly higher values in dentate patients. As for gender, the distances between the genial plexus and the alveolar bone crest (p < 0.001) and the buccal cortical bone (p = 0.028) were significantly shorter for females. Regarding age, only the distance between the genial plexus and the alveolar crest showed a significant difference (p < 0.001), and the smallest values were measured in the older patients. It can be concluded that there are variations of the genial plexus in relation to gender, age and between edentulous and dentate patients. Therefore, the anterior region of the mandible, especially the midline should be observed with caution when undergoing surgical procedures, such as removal of bone grafts and installation of dental implants.

Apolipoprotein E polymorphism influences orthotopic liver transplantation outcomes in patients with hepatitis C virus-induced liver cirrhosis

BACKGROUND Hepatitis C virus(HCV)infection is responsible for a chronic liver inflammation,which may cause end-stage liver disease and hepatocellular carcinoma.Apolipoprotein E(protein:ApoE,gene:APOE),a key player in cholesterol metabolism,is mainly synthesized in the liver and APOE polymorphisms may influence HCV-induced liver damage.AIM To determine whether APOE alleles affect outcomes in HCV-infected patients with liver cirrhosis following orthotopic liver transplantation(OLT).METHODS This was a cohort study in which 179 patients,both genders and aged 34-70 years,were included before or after(up to 10 years follow-up)OLT.Liver injury severity was assessed using different criteria,including METAVIR and models for endstage liver disease.APOE polymorphisms were analyzed by quantitative real-time polymerase chain reaction.RESULTS The APOE3 allele was the most common(67.3%).In inflammation severity of biopsies from 89 OLT explants and 2 patients in pre-transplant,the degree of severe inflammation(A3F4,0.0%)was significantly less frequent than in patients with minimal and moderate degree of inflammation(≤A2F4,16.2%)P=0.048,in patients carrying the APOE4 allele when compared to non-APOE4.In addition,a significant difference was also found(≤A2F4,64.4%vs A3F4,0.0%;P=0.043)and(A1F4,57.4%vs A3F4,0.0%;P=0.024)in APOE4 patients when compared to APOE3 carriers.The fibrosis degree of the liver graft in 8 of 91 patients and the lack of the E4 allele was associated with more moderate fibrosis(F2)(P=0.006).CONCLUSION Our results suggest that the E4 allele protects against progression of liver fibrosis and degree of inflammation in HCV-infected patients.