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  1. Lannette Paynes says:

    I have the Bluem mouthwash but I can’t find the toothpaste. Where can I buy it at?

  2. Pooja ahluwalia sethi says:

    Congratulations commendable work. There are only very few who can see into what others can’t see or accept. Keep up the good work.

  3. Dr.Revathy Mohan says:

    Wow .. that’s amazing..Thank you for discovering and researching on this anatomic variations.This gave me the answers for those rare cases in which IANB not worked perfectly..and this finding helped me to regain my lost confidence while I encountered such cases…👍

  4. Dr. Nyer Firdoose says:

    @Prof. Narayana Kilarkaje, My script is not about foramina on ramus, this was a additional feature. The original script is about a huge isolated foramina in the coronoid process bilaterally which has never been seen or documented in literature until now. And about the discussion part we will surely consider adding your theories in our upcoming scripts on series of such similar patients.

    ( the link to my original script published in Surgical and Radilogical Anatomy dated Feb 2018. Kindly give it a read.

  5. Dr. Nyer Firdoose says:

    @Prof Puneet Wadhwani, Firstly, the first patient to be identified from my series of patients had accessory foramina on the lateral aspect of ramus bilaterally and not the coronoid process. And moreover i have not claimed it a groundbreaking finding all by myself, this script was presented in the international event “World congress of anatomists” held in Gadag in Sep 2017, plus the official journal of clinical anatomy peer review members and the editors suggested to be mentioned it as discovery which is a “never before seen/documented entitiy either in live humans or even in osteology studies”. And a discovery always begins with one isolated case which has now been validated using 3D reconstructed CBCT scans in over 30 such patients (case) globally and counting.

    If it were to be only just an isolated case one can consider it a coincidence but when the same truth keeps repeating itself its hard to pretend its just a coincidence. Moreover once you see a pattern you can’t unsee it.

    Finally the thing about the Langlais 1985 classification of mandibular canal bifurcation, u may be partly right about my pt falling under the category type 4 but not exactly. Moreover my script is not about the mandibular canal bifurcation or its variations rather it mainly about the presence of a huge foramen in the coronoid process bilaterally which is occupied with distinct isolated neurovascular bundle the structures of which remain debatable.

    ( the link to my original script published in Surgical and Radilogical Anatomy dated Feb 2018. Kindly give it a read.

  6. Dr. Nyer Firdoose says:

    @Yak Lindy. Yes maybe, but firstly one has to identify the presence of such a feature before attempting any change in the conventional local anesthesia techniques. 🙂

  7. Dr. Nyer Firdoose says:

    @Dr. Ninad jamdade. The clinical significance of any new structure identified or isolated depends on extensive studies on patients having such a feature. Presently we can only give hypothesis based on previous studies. As no such feature is ever been recorded on cadavers or osteology studies so far, we are currently researching on the demographic patterns and environmental factors which may be contributing towards such a feature.

    Pertaining to the pain control its already well established that activation of nerves (small or big) by any stimulus can interfere with signals from pain fibers, thereby inhibiting pain. So it is preferred to anesthetise even accessory nerve fibres for painfree procedures in and around the aforementioned structures.

  8. Prof. Narayana Kilarkaje says:

    Previously, I reported accessory foramina, including retromolar foramen and canal, and accessory mandibular foramina in mandibles (please see my papers in google). Cortex of mandible has numerous inconstant foramina. The inconstant foramen on ramus may be pierced by some nerve fibers from messeteric nerve after it supplies the masseter. However, these branches do not reach the mandibular teeth as they are far away. When I reviewed this paper, I did not see that discussion. Early branching of IAN in the case of mandible or accessory alveolar nerves in the case of maxilla may be responsible for anesthesia escape theory and the nerve fibers passing through the foramina are unlikely to be the reason.

  9. Prof Puneet Wadhwani says:

    Dr Nyer, is one isolated case on the lateral aspect of coronoid enough to state it as a ground breaking finding?.. If you look at Langlais(1985)classification of bifid inferior alveolar canals, this falls under a Type 4 category (LA MALAMED PG 183) the only difference being present on the lateral aspect of the mandible.. bifid inf alv canals are known to have different origin (openings)on various levels of ramus and are notorious for incomplete anaesthesia because of differential distribution of the the inferior alv nerve bundle.
    My concern is that in todays world everything present on internet is being taken verbatim.

  10. antonello falco says:

    I want to have information if there is a machine in italy to prove and costs to buy for an education center

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