{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T14:13:53Z","timestamp":1778595233350,"version":"3.51.4"},"reference-count":28,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>The safety of mandibular anesthesia is directly dependent on a precise understanding of the spatial relationships in the pterygomandibular space, particularly the risk of injury to the highly vascularized pterygoid venous plexus (PVP). In vivo studies of PVP displacement during mandibular movements face significant technical challenges. Objective: The study aims to study the spatial displacements of the pterygoid venous plexus during various physiological positions of the mandible using computer modeling with the finite-element method (FEM). Materials and Methods: A three-dimensional finite-element model was developed based on computed tomography data and the BodyParts3D anatomical atlas. The model included the bony structures of the skull, mandible, temporomandibular joint, masticatory muscles, and blood vessels. Simulations were performed for vertical displacements of the jaw at 15, 25, and 35 mm, as well as horizontal displacements of 5 mm to the left and right. Results: It was found that the magnitude of PVP displacement is proportional to the degree of mouth opening. The maximum total displacement (1.24 mm) was recorded at a 35 mm opening along the \u201cposterior\u2013medial\u2013inferior\u201d vector. Lateral excursions revealed asymmetry: displacement to the right caused plexus movement posteriorly, medially, and inferiorly (0.66 mm), while displacement to the left resulted in movement anteriorly, laterally, and superiorly (0.64 mm). Conclusions: This study demonstrates the significant mobility of the pterygoid venous plexus, which depends on the direction and amplitude of mandibular movements. The obtained data have important practical implications for planning regional anesthesia and minimizing the risk of iatrogenic complications. From a biomechanical perspective, maximum mouth opening produces the greatest displacement of the PVP, which may hypothetically reduce the risk of vascular puncture. Clinical studies are required to confirm this.<\/jats:p>","DOI":"10.3390\/jpm16050258","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T12:33:37Z","timestamp":1778589217000},"page":"258","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Finite-Element Computer Modeling of Spatial Displacement of the Pterygoid Venous Plexus During Mandibular Movements"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1899-1282","authenticated-orcid":false,"given":"Hadi","family":"Darawsheh","sequence":"first","affiliation":[{"name":"First Moscow State Medical University (Sechenov University), N.V. Sklifosovsky Institute of Clinical Medicine, 119435 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6855-2860","authenticated-orcid":false,"given":"Dmitry","family":"Leonov","sequence":"additional","affiliation":[{"name":"First Moscow State Medical University (Sechenov University), N.V. Sklifosovsky Institute of Clinical Medicine, 119435 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1273-0356","authenticated-orcid":false,"given":"Sergey","family":"Dydykin","sequence":"additional","affiliation":[{"name":"First Moscow State Medical University (Sechenov University), N.V. Sklifosovsky Institute of Clinical Medicine, 119435 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1667-5355","authenticated-orcid":false,"given":"Beatrice","family":"Volel","sequence":"additional","affiliation":[{"name":"First Moscow State Medical University (Sechenov University), N.V. Sklifosovsky Institute of Clinical Medicine, 119435 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6196-0422","authenticated-orcid":false,"given":"Ellina","family":"Velichko","sequence":"additional","affiliation":[{"name":"First Moscow State Medical University (Sechenov University), Institute of Digital Biodesign and Artificial Intelligence in Medicine, 119435 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Usmanova","sequence":"additional","affiliation":[{"name":"Therapeutic Dentistry Department, BSMU, 450000 Ufa, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9876-9202","authenticated-orcid":false,"given":"Irina","family":"Lakman","sequence":"additional","affiliation":[{"name":"Laboratory of Research of Socio-Economic Problems of Regions, Ufa University of Science and Technology, 450076 Ufa, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8947-4357","authenticated-orcid":false,"given":"Anzhela","family":"Brago","sequence":"additional","affiliation":[{"name":"Medical Institute, RUDN University, 119311 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5493-9214","authenticated-orcid":false,"given":"Seyedamirhossein","family":"Hosseini","sequence":"additional","affiliation":[{"name":"First Moscow State Medical University (Sechenov University), N.V. Sklifosovsky Institute of Clinical Medicine, 119435 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9386-6236","authenticated-orcid":false,"given":"Evgeniy","family":"Sosnin","sequence":"additional","affiliation":[{"name":"First Moscow State Medical University (Sechenov University), N.V. Sklifosovsky Institute of Clinical Medicine, 119435 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuriy","family":"Vasil\u2019ev","sequence":"additional","affiliation":[{"name":"First Moscow State Medical University (Sechenov University), N.V. Sklifosovsky Institute of Clinical Medicine, 119435 Moscow, Russia"},{"name":"MIREA\u2014Russian Technological University, Lomonosov Institute of Fine Chemical Technologies, Department of Cellular Systems Engineering, 125993 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"125","DOI":"10.17245\/jdapm.2019.19.3.125","article-title":"Alternative techniques for failure of conventional inferior alveolar nerve block","volume":"19","author":"Lee","year":"2019","journal-title":"J. Dent. Anesth. Pain Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1007\/s00784-020-03525-9","article-title":"Evaluation of different mandibular blocks for the removal of lower third molars: A meta-analysis of randomised clinical trials","volume":"25","author":"Cavallini","year":"2021","journal-title":"Clin. Oral Investig."},{"key":"ref_3","first-page":"e53277","article-title":"Efficacy of Different Techniques of the Inferior Alveolar Nerve Block for Mandibular Anesthesia: A Comparative Prospective Study","volume":"16","author":"Krishna","year":"2024","journal-title":"Cureus"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"507","DOI":"10.17245\/jdapm.2021.21.6.507","article-title":"Adverse effects following dental local anesthesia: A literature review","volume":"21","author":"Ho","year":"2021","journal-title":"J. Dent. Anesth. Pain Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1007\/s00276-025-03602-2","article-title":"A case of a large venous ring around the mandibular condyle","volume":"47","author":"Nishi","year":"2025","journal-title":"Surg. Radiol. Anat."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"46","DOI":"10.17116\/stomat20199805146","article-title":"Comparative evaluation of P.M. Egorov and modified G. Gow-Gates mandibular block efficacy","volume":"98","author":"Sokhov","year":"2019","journal-title":"Stomatologiia"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Wang, X.C., Zhao, C., Wu, K.Y., and Marchand, M. (2025). Ophthalmic Complications After Dental Procedures: Scoping Review. Diseases, 13.","DOI":"10.3390\/diseases13080244"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.asjsur.2021.10.019","article-title":"The \u201cHand as Foot\u201d teaching method in anatomy of the pterygoid plexus","volume":"45","author":"Zhang","year":"2022","journal-title":"Asian J. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1097\/SCS.0000000000006174","article-title":"Course of the Maxillary Vein and its Positional Relationship with the Mandibular Ramus Require Attention During Mandibuloplasty","volume":"31","author":"Odaka","year":"2020","journal-title":"J. Craniofac. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e70191","DOI":"10.1111\/tct.70191","article-title":"Exploring Virtual Reality as a Tool for Enhancing Teaching and Learning Anatomy to Medical Students: A Feasibility and Acceptability Study","volume":"22","author":"Walsh","year":"2025","journal-title":"Clin. Teach."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e3851","DOI":"10.1002\/cnm.3851","article-title":"Accuracy and efficiency of finite element head models: The role of finite element formulation and material laws","volume":"40","author":"Gomes","year":"2024","journal-title":"Int. J. Numer. Methods Biomed. Eng."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1111\/edt.12933","article-title":"Methods and applications of finite element analysis in dental trauma research: A scoping review","volume":"40","author":"Atif","year":"2024","journal-title":"Dent. Traumatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"152055","DOI":"10.1016\/j.aanat.2023.152055","article-title":"Choosing the optimal mandible position for inferior alveolar nerve block (IANB) using finite element analysis","volume":"247","author":"Darawsheh","year":"2023","journal-title":"Ann. Anat."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e3862","DOI":"10.1002\/cnm.3862","article-title":"Biomechanical behavior of temporomandibular joint movements driven by mastication muscles","volume":"40","author":"Cheng","year":"2024","journal-title":"Int. J. Numer. Methods Biomed. Eng."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1016\/j.jbiomech.2004.10.014","article-title":"Combined finite-element and rigid-body analysis of human jaw joint dynamics","volume":"38","author":"Koolstra","year":"2005","journal-title":"J. Biomech."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.1016\/j.jbiomech.2009.05.005","article-title":"Discretization error when using finite element models: Analysis and evaluation of an underestimated problem","volume":"42","author":"Schmidt","year":"2009","journal-title":"J. Biomech."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1080\/10255842.2023.2290455","article-title":"Effect of pre-stress on dynamic finite element analysis of the temporomandibular joint","volume":"28","author":"Teng","year":"2025","journal-title":"Comput. Methods Biomech. Biomed. Engin."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.cmpb.2016.07.021","article-title":"Biomechanical comparison between concentrated, follower, and muscular loads of the lumbar column","volume":"135","author":"Shih","year":"2016","journal-title":"Comput. Methods Programs Biomed."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1080\/10255840601160484","article-title":"Verification, validation and sensitivity studies in computational biomechanics","volume":"10","author":"Anderson","year":"2007","journal-title":"Comput. Methods Biomech. Biomed. Engin."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e204","DOI":"10.7717\/peerj.204","article-title":"Beware the black box: Investigating the sensitivity of FEA simulations to modelling factors in comparative biomechanics","volume":"1","author":"Walmsley","year":"2013","journal-title":"PeerJ"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1243\/09544119JEIM649","article-title":"Validation of computational models in biomechanics","volume":"224","author":"Henninger","year":"2010","journal-title":"Proc. Inst. Mech. Eng. H"},{"key":"ref_22","unstructured":"Golub, B., and Bordoni, B. (2023). Neuroanatomy, Pterygoid Plexus. StatPearls [Internet], StatPearls Publishing."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"317","DOI":"10.5115\/acb.25.024","article-title":"The maxillary vein: An anatomical narrative review with clinical implications for oral and maxillofacial surgeons","volume":"58","author":"Raeburn","year":"2025","journal-title":"Anat. Cell Biol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1002\/ar.23358","article-title":"The Effect of Varying Jaw-elevator Muscle Forces on a Finite Element Model of a Human Cranium","volume":"299","year":"2016","journal-title":"Anat. Rec."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1002\/ca.21047","article-title":"Anatomical relationships within the human pterygomandibular space: Relevance to local anesthesia","volume":"23","author":"Khoury","year":"2010","journal-title":"Clin. Anat."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/j.1834-7819.2011.01312.x","article-title":"Applied anatomy of the pterygomandibular space: Improving the success of inferior alveolar nerve blocks","volume":"56","author":"Khoury","year":"2011","journal-title":"Aust. Dent. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"37","DOI":"10.17116\/operhirurg2022604137","article-title":"Clinical experience of the use of anatomically guided inferior alveolar nerve blockage in the mandibular teeth treatment","volume":"6","author":"Rabinovich","year":"2022","journal-title":"Russ. J. Oper. Surg. Clin. Anat."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.joms.2018.08.034","article-title":"Is the Vazirani-Akinosi Nerve Block a Better Technique Than the Conventional Inferior Alveolar Nerve Block for Beginners?","volume":"77","author":"Ravi","year":"2019","journal-title":"J. Oral Maxillofac. Surg."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/5\/258\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T13:13:29Z","timestamp":1778591609000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/5\/258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":28,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["jpm16050258"],"URL":"https:\/\/doi.org\/10.3390\/jpm16050258","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,12]]}}}