Abstract Accessory auricles are rare congenital abnormalities embryologically derived from the first branchial arch. Presentation may be variable with locations grouped into anatomical zones based on the frequency of location found in the literature. This study reviewed the papers between 1981 and 2017. Findings included an association with syndromes including Goldenhar, VACTERL, Treacher–Collins, Townes–Brocks, and Wolf–Hirschhorn. Based on histological and embryological evidence, the term "accessory auricle" is best used as an umbrella term to define this difference. Finally, indications are provided for imaging and laboratory investigations to guide the physician treating patients with accessory auricles. Address correspondence and reprint requests to Mark S. Lloyd, MPhil, FRCS(Plast), Department of Plastic Surgery, Autologous Ear Reconstruction Service, Birmingham Children's and Women's Hospital NHS Trust, 4th Floor, Ladywood House, Steelhouse Lane, Birmingham B4 6NH, UK; E-mail: marklloyd1@nhs.net Received 11 July, 2017 Accepted 1 September, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.
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Τετάρτη 13 Δεκεμβρίου 2017
A Rare Complication After Septoplasty: Visual Loss Due to Right Retinal Artery Spasm
Abstract Septoplasty is a commonly used procedure for correcting septal cartilage deformities. Hemorrhage, abscesses, scaling, adhesions, and scar tissue are often seen after the operation of the septoplasty, but temporary or permanent visual loss due to local anesthetic use has been reported very rarely in the literature. The authors also aimed to present a female patient with retinal artery spasm in the right eye after septoplasty in this article. A 27-year-old female patient was admitted to the authors' clinic with long-standing nasal obstruction and postnasal drip. There was no feature in her history and also no sign other than nasal septal deviation on physical examination. The patient was informed about the operation and the operation was planned. Emergency eye consultation was requested after the patient said that the right eye of the patient had never seen in the postoperative wake-up hall. Examination by an ophthalmologist; mild exotropia and total loss of vision in the right eye (including loss of light reflex) was detected. The light reaction in the affected eye was negative and indirect reaction was positive. After enlargement of the pupil, fundus examination revealed that the right posterior pole region (inside of the macula and vessel arches) was pale and no central retinal artery pulsation was observed. The patient was diagnosed with central retinal artery occlusion and emergency intervention was performed. The right eye massage, paracentesis, and hyperbaric oxygen therapy returned to the patient's visual function. Address correspondence and reprint requests to Dr Celal Günay, MD, Department of Otolaryngology, Head and Neck Surgery, Medipol University Hospital, Istanbul, Turkey; E-mail: gunaycelal@gmail.com Received 28 July, 2017 Accepted 27 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.
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Inferiorly Pedicled Nasolabial Flap for Reconstruction of Anterior Maxilla Defects Class I and II
Objectives: The aim of this study was to present the use of inferiorly pedicled nasolabial flap (IPNF) in the reconstruction of anterior maxilla defects class I and II. Methods: Seven patients, 4 females and 3 males, aging from 38 to 75 (mean = 55.9) years old, from 2014 to 2017 reconstructed anterior part of maxilla with or without oronasal communication were included in this study. Five patients diagnosed with squamous cell carcinoma, 1 patient presented with epithelial-myoepithelial carcinoma, and 1 patient had ameloblastoma. The IPNFs were harvested in 7 patients. Follow-up data were collected for a period ranging from 9 to 26 months. Speech, mastication, and aesthetic outcomes were evaluated with a questionnaire in interview. Results: All patients healed without infection, flap loss, and flap failure. Five patients without prothetic treatment had little pronunciation problem (score: 1 to 3 points), while 2 patients with removable partial denture had excellent speech clarity (score: 1 to 2 points). All patients had no problem with mastication (score: 1 to 2 points). Aesthetic outcomes were acceptable in all patients (score: 1 to 3 points). Conclusion: The IPNF is a good option for reconstruction of anterior maxilla defects class I and II. Address correspondence and reprint requests to Zhongcheng Gong, PhD, DDS, Chairman and Professor of Oncological Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Xinjiang Medical University, Stomatology School of Xinjiang Medical University, Stomatology Research Institute of Xinjiang Province, No. 137 South Liyushan Road, Wulumuqi, Xinjiang Uyghur Autonomous Region 830054, China; E-mail: gump0904@aliyun.com Received 12 May, 2017 Accepted 30 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.
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Critical Appraisal in Plastic Surgery: Nullius in Verba
No abstract available
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Primary Closure of Oroantral Communication Using Pedicled Buccal Fat Pad Following Maxillary Cyst Enucleation
Abstract Odontogenic keratocyst (OKC) is a clinically aggressive developmental odontogenic cyst with a high recurrence rate as 62%. Oroantral communication (OAC) is a gateway through the maxillary sinus and the oral cavity, which, if not treated, will develop into oroantral fistula or chronical sinus diseases. Different methods for closure of OAC were described but only few of them have common usage. In recent years, the use of a pedicled buccal fat pad (BFP) in closure of large oroantral defects has been become popular. In our patient, the OAC resulted from the surgical removal of OKC was closed with BFP. Address correspondence and reprint requests to Yusuf Emes, DDS, PhD, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul University 34093 Çapa, Istanbul, Turkey; E-mail: yusufemes@yahoo.com Received 27 July, 2017 Accepted 21 September, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.
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A Novel Method to Calculate the Volume of Alveolar Cleft Defect Before Surgery
Background: This study aimed to evaluate a novel subtractive method for the precise calculation of alveolar cleft defect volume before surgery using the three-dimensional imaging software Mimics. Methods: Ten patients (3 female, 7 male, age range 8–12 years) with unilateral alveolar cleft were enrolled in the study. Preoperative helical computed tomography scans were performed for all patients. A new subtractive method was introduced to precisely calculate the alveolar cleft defect volume before surgery with the aid of Mimics. The DICOM data of every patient were processed using the subtractive method. Statistical analyses were performed using Pearson's correlation test and t test. Results: The mean volume of the alveolar cleft defect was 1811.97 ± 817.90 mm3. The mean time spent to calculate an alveolar cleft defect volume was 60.60 ± 11.67 minutes. The Pearson correlation test (r = 0.38, P = 0.279) indicated a poor correlation between alveolar cleft defect volume and calculation time. Conclusions: Preoperative knowledge of defect volume is crucial in alveolar cleft repair. Accurate estimation of graft volume in alveolar cleft patients can be performed using this new subtractive method. Compared with previous methods, this new subtractive method is time-saving and suitable for both unilateral and bilateral clefts. Surgeons can use this method to design a surgical plan for each patient before surgery within a short time, and with less cost. Address correspondence and reprint requests to Hai D. Li, MD, Department of Cleft Lip and Palate, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing 100144, China; E-mail: 15910775061@yeah.net Received 2 June, 2017 Accepted 30 August, 2017 This study was supported by the Capital Clinical Feature Applied Research Fund of China (Z161100000516155). The study was approved by the ethics committee of the Plastic Surgery Hospital affiliated to Peking Union Medical College. The authors report no conflicts of interest. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (http://ift.tt/2iuFjMi). © 2017 by Mutaz B. Habal, MD.
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The Validity of Training Endoscopic Sinus and Skull Base Surgery Techniques on the Experimental Head Model
Objectives: The aim of this study was to better understand the usual learning curve in acquiring endonasal endoscopic sinus and skull base surgery (ESSBS) techniques during the novice training on the lamb's head model. Methods: Ten novices were asked to perform 10 bilateral dissections on the particular lamb's head each. The dissections were uniform, consisted of 10 well-defined steps, beginning from the simple removal of the inferior turbinate, and ending with more complicated procedures like cerebrospinal fluid leak repair, Draf 3 procedure for the frontal sinus and elevation of the nasal septal flap. The dissections have been supervised by experienced surgeons. A set of standard ESSBS instruments and 0° and 45° endoscopes have been used under the navigational system. The time required to complete each step has been measured in minutes. Results: In general and quite expectedly, time rates have been obviously lowering as the number of the dissections performed has been growing in each of the participants. Conclusion: Training of the endonasal ESSBS techniques on the lamb's head proved to be useful for novices in getting basic surgical skills in the field. Because of the high degree of anatomic similarity and high level of the anatomic dimensions congruency between the lamb's head and human head (sheep's head has bigger dimensions!) it proved to be an essential preparation for the human cadaveric dissection. The median values of the time rates having been needed to complete the particular of the 10 steps in the last novices' dissections could be accepted as an orientation, just suggesting that once the time needed to complete 1 of the 10 steps has been and achieved by the particular novice, this could be an approximate sign of the maturity for the exercises on human cadaver head. Address correspondence and reprint requests to Nuray Bayar Muluk, MD, Birlik Mahallesi, Zirvekent 2. Etap Sitesi, C-3 Blok, No 6-3/43, 06610 Çankaya, Ankara, Turkey; E-mail: nuray.bayar@yahoo.com; nurayb@hotmail.com. Received 23 August, 2017 Accepted 20 September, 2017 The authors report no conflicts of interest. Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (http://ift.tt/2iuFjMi). © 2017 by Mutaz B. Habal, MD.
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Anti-Neutrophil Cytoplasmic Antibody-Negative Central Nervous System Granulomatosis With Polyangiitis and Its Clinical Characteristics
Abstract Granulomatosis with polyangiitis (GPA) is a necrotizing granulomatous vasculitis occasionally affecting central nervous system (CNS), and GPA patients with initial CNS symptoms are even rarer, whose diagnosis is further confused by an absence of positive antineutrophil cytoplasmic antibody. The authors described the characteristics of antineutrophil cytoplasmic antibody -negative GPA with CNS onset in a patient and discussed on its management, which may contribute to future diagnosis and treatment of patients with similar conditions. Address correspondence and reprint requests to Dr Yongming Qiu, MD, PhD, Department of Neurosurgery, Ren Ji Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai 200127, China; E-mail: qiuzhoub@126.com; Dr Longtian Chen, MD, Department of Rheumatology, Longyan First Hospital Affiliated to Fujian Medical University, Fujian Province, China; E-mail: LT_chen@163.com Received 20 July, 2017 Accepted 24 August, 2017 The authors report no conflicts of interest. © 2017 by Mutaz B. Habal, MD.
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Sequencing of bimaxillary surgery in the correction of vertical maxillary excess: retrospective study
The aim of this study was to evaluate the precision of bimaxillary surgery performed to correct vertical maxillary excess, when the procedure is sequenced with mandibular surgery first or maxillary surgery first. Thirty-two patients, divided into two groups, were included in this retrospective study. Group 1 comprised patients who received bimaxillary surgery following the classical sequence with repositioning of the maxilla first. Patients in group 2 received bimaxillary surgery, but the mandible was operated on first. (Source: International Journal of Oral and Maxillofacial Surgery)
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Comparative study of volumetric changes and trabecular microarchitecture in human maxillary sinus bone augmentation with bioactive glass and autogenous bone graft: a prospective and randomized assessment
The aim of this study was to compare the volumetric changes and the new bone microarchitecture in human maxillary sinuses augmented with bioactive glass (Biogran) alone, bioactive glass combined with autogenous bone graft (1:1), or autogenous bone graft alone. Twelve maxillary sinuses were grafted with bioactive glass (group 1), nine with bioactive glass mixed with autogenous bone graft 1:1 (group 2), and 12 with autogenous bone graft (group 3). Patients underwent cone beam computed tomography 15days after the procedure to determine the initial volume of the graft (T1) and again 6 months later (T2). (Source: International Journal of Oral and Maxillofacial Surgery)
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Signs of electrocochleography on endolymphatic sac decompression for patients with Ménière's Disease: our experience in 12 patients
Abstract
Endolymphatic hydrops (ELH) is a well-established histological marker of Ménière's Disease (MD). The diagnosis of MD still depends on clinical symptoms complemented with inner ear function tests. Thus far, definitive diagnosis remains difficult. It is necessary for clinicians to explore an objective examination to diagnose MD and to monitor patients' ELH.
This article is protected by copyright. All rights reserved.
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Superoxide dismutase from Helicobacter pylori suppresses the production of pro-inflammatory cytokines during in vivo infection
Abstract
Background
Helicobacter pylori has undergone considerable adaptation to allow chronic persistence within the gastric environment. While H. pylori-associated diseases are driven by an excessive inflammation, severe gastritis is detrimental to colonization by this pathogen. Hence, H. pylori has developed strategies to minimize the severity of gastritis it triggers in its host. Superoxide dismutase (SOD) is well known for its role in protecting against oxidative attack; less recognized is its ability to inhibit immunity, shown for SOD from mammalian sources and those of some bacterial species. This study examined whether H. pylori SOD (HpSOD) has the ability to inhibit the host immune response to these bacteria.
Materials and Methods
The ability of recombinant HpSOD to modify the response to LPS was measured using mouse macrophages. A monoclonal antibody against HpSOD was generated and injected into H. pylori-infected mice.
Results
Addition of HpSOD to cultures of mouse macrophages significantly inhibited the pro-inflammatory cytokine response to LPS stimulation. A monoclonal antibody was generated that was specific for SOD from H. pylori. When injected into mice infected with H. pylori for 3 months, this antibody was readily detected in both sera and gastric tissues 5 days later. While treatment with anti-HpSOD had no effect on H. pylori colonization at this time point, it significantly increased the levels of a range of pro-inflammatory cytokines in the gastric tissues. This did not occur with antibodies against other antioxidant enzymes.
Conclusions
SOD from H. pylori can inhibit the production of pro-inflammatory cytokine during in vivo infection.
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Τρίτη 12 Δεκεμβρίου 2017
The dentist's office gets the urgent care treatment
A few doors down from the CityMD near Union Square, Dental365's glass storefront sports a glowing blue-and-white logo of a giant tooth with a heart inside it. Passers-by can peek through the window into the tidy waiting room with the company's signature blue chairs.
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Coronectomy – a safe option for deeply impacted mandibular third molars?
This review of coronectomy for management of impacted mandibular third molars included 14 studies suggesting that it is safe and reliable with a low failure rate (7%).
The post Coronectomy – a safe option for deeply impacted mandibular third molars? appeared first on National Elf Service.
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Adenotonsillectomy for Obstructive Sleep Apnea in Children with Complex Chronic Conditions
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Metformin Effects on Metabolic Coupling and Tumor Growth in Oral Cavity Squamous Cell Carcinoma Coinjection Xenografts
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Analysis of Reported Balloon Malfunctions and Proposed Rescue Strategy for Malfunction during Airway Dilation
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Olfactory cortex and Olfactory bulb volume alterations in patients with post-infectious Olfactory loss
Abstract
Upper respiratory tract infection (URI) is one of the most common etiology of olfactory loss. Previous studies demonstrated that both olfactory bulb (OB) volume and sulcus (OS) depth decreased in patients with post-infectious olfactory loss (PIOL) compared to normal controls. The aim of our study was to observe alterations of central olfactory pathways in patients with PIOL. T1 weighted magnetic resonance images were acquired in 19 PIOL patients and 19 age- and sex-matched control subjects on a 3 T scanner. Voxel-based morphometry (VBM) was performed using VBM8 toolbox and SPM8 in a Matlab environment. We also analyzed OB volume in coronal T2-weighted images. Whole-brain analysis revealed a significant gray matter volume loss in the right orbitofrontal cortex (OFC) in patients group. Further analysis with region of interest exhibited a significant negative correlation between gray matter volume in right OFC as well as OB volume and the duration of olfactory loss in these patients (r = -0.566 and r = -0.535 both P < 0.05, respectively). In conclusion, the morphological alterations in the right OFC and OB might contribute to the pathogenic mechanism of olfactory dysfunction after upper respiratory tract infection.
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Assessment of Bone Dimensions in the Anterior Maxilla: A Cone Beam Computed Tomography Study
Abstract
Purpose
To evaluate labial and palatal bone thickness at the maxillary anterior teeth as well as distance from cemento-enamel junction (CEJ) to bone crest using cone beam computed tomography (CBCT).
Materials and Methods
Measurements were obtained for maxillary anterior teeth of 120 subject CBCT volumes including thickness of labial and palatal plates of bone (coronal, middle, and apical thirds), and distance between CEJ and alveolar bone crest mid-labially, mesially, and distally.
Results
The mean value of bone thickness at coronal, middle, and apical thirds of the labial side for central incisor roots were respectively: 0.73, 0.69, 0.60 (mm), for lateral incisors: 0.70, 0.61, 0.49 (mm), and for canines: 0.74, 0.53, 040 (mm). The thickness of palatal bone was significantly larger. The mean distance between CEJ and mid-labial bone crest for all sites was 2.16 mm.
Conclusion
Labial bone thickness is thin in the vast majority of maxillary anterior teeth. Use of CBCT facilitates planning for immediate implant placement and is helpful in the decision-making process when further bone augmentation is needed.
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The Effect of Surface Treatment on Shear Bond Strength between Y-TZP and Veneer Ceramic: A Systematic Review and Meta-Analysis
Abstract
Purpose
The objective of this systematic review with meta-analysis was to evaluate surface treatment in yttria-stabilized tetragonal zirconia polycrystal ceramic (Y-TZP) on the shear bond strength (SBS) values between Y-TZP (core ceramic) and veneer ceramic, compared to untreated specimens.
Materials and Methods
This review was registered at PROSPERO platform under the number CRD42016036493. The systematic review of the extracted publications was performed to compare the effect of surface treatment on SBS between Y-TZP ceramic and veneering ceramic. A comprehensive review of the literature from the earliest available dates through January 2017 was performed in the PubMed/Medline, Embase, Scopus, and Cochrane Library databases.
Results
A total of 15 studies were identified for the inclusion of data, with only in vitro studies. A random-effect model found statistically significant differences between untreated and treated surfaces of Y-TZP (p < 0.00001; MD: 2.84; 95% CI: 2.19 to 3.49). In another analysis, a random-effect model found statistically significant differences between the groups that only performed the associations of treatments and control group (p < 0.00001; MD: 3.19; 95% CI: 2.11 to 4.28).
Conclusions
Surface treatment in Y-TZP improved the values of SBS between the Y-TZP and veneer ceramic. The associations between two or more treatments also showed positive effect on the bond strength due the cumulative effect of the treatments.
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Three-Dimensional Static Articulation Accuracy of Virtual Models – Part I: System Trueness and Precision
Abstract
Purpose
To evaluate the 3D static articulation accuracy of 3 model scanner-CAD systems (Ceramill Map400 [AG], inEos X5 [SIR], Scanner S600 Arti [ZKN]) using a coordinate measuring machine (CMM). Trueness and precision for each system will be reported in Part I.
Materials and Methods
The master model simulated a single crown opposing a 3-unit fixed dental prosthesis. Five mounted stone cast sets were prepared, and one set was randomly selected. Reference values were obtained by measuring interarch and interocclusal reference features with the CMM. The stone cast set was scanned 5 times consecutively and articulated virtually with each system (3 test groups, n = 5). STL files of the virtual models were measured with CMM software. dRR, dRC, and dRL, represented interarch global distortions at right, central, and left sides, respectively, while dRM, dXM, dYM, and dZM represented interocclusal global and linear distortions between preparations.
Results
For trueness values, mean interarch global distortions ranged from 13.1 to 40.3 μm for dRR, –199.0 to –48.1 μm for dRC, and –114.1 to –47.7 μm for dRL. Mean percentage error of interarch distortion did not exceed 0.6%. Mean interocclusal distortions ranged from 16.0 to 117.0 μm for dRM, -33.1 to 101.3 μm for dXM, 32.9 to 49.9 μm for dYM and –32.0 to 133.1 μm for dZM. ANOVA of trueness found statistically significant differences for dRC, dRL, dRM, dXM, and dZM. For precision values, absolute mean difference between the 10 superimposition combinations ranged from 25.3 to 91.0 μm for dRR, 21.5 to 85.5 μm for dRC, 24.8 to 70.0 μm for dRL. Absolute mean difference ranged from 49.9 to 66.1 μm for dRM, 20.7 to 92.1 μm for dXM, 86.8 to 96.0 μm for dYM, and 36.5 to 100.0 μm for dZM. ANOVA of precision of all test groups found statistically significant differences for dRR, dRC, dRL, dXM and dZM, and the SIR group was the least precise.
Conclusion
The overall interarch global distortion of all three model scanner-CAD systems was low and did not exceed 0.6%. Variations in scanner technology, virtual articulation algorithm, and use of physical articulators contributed to the differences in distortion observed among all three groups.
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Influence of Implant Position in Implant-Assisted Removable Partial Denture: A Three-Dimensional Finite Element Analysis
Abstract
Purpose
To determine the ideal position of a dental implant to assist a posterior extended partial removable dental prosthesis (PRDP), through stress values, displacement values, and deformation of periodontal ligament (PDL).
Materials and Methods
A finite element analysis of different implant positions was analyzed using a 3D mandible model from a human patient. Test models were created: model A (implant in second molar area), model B (implant in the first molar area), and model C (implant in premolar area). A control model without implant support was also created. Overall displacement values, von Mises stress distribution maps, and nonlinear deformations were evaluated.
Results
Some differences could be observed between test models. The introduction of an implant in the edentulous area, unlike a conventional removable partial denture without implant support, decreases stress values in the biological structures such as: mandible, tooth, soft tissue, and PDL. Placing the implant in the first molar area resulted in improved displacement values, and reduced maximum stress values at the peri-implant bone area, metal structure, and implant were observed.
Conclusions
Within the limitations of this study we can conclude that placing the implant in the position of the first molar improves biomechanical behavior of implant-assisted PRDPs.
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Influence of Particle and Air-Abrasion Moment on Y-TZP Surface Characterization and Bond Strength
Abstract
Purpose
To evaluate the influence of particle and air-abrasion on the surface characterization and shear bond strength (SBS) of a Y-TZP ceramic with a resin cement.
Materials and Methods
Y-TZP specimens were air-abraded with 50 μm alumina particles; 120 μm alumina particles; 30 μm silica-coated alumina particles (Rocatec Soft); 110 μm silica-coated alumina particles (Rocatec Plus). Air-abrasion was performed before (BS); after (AS); before and after (BAS) zirconia sintering. Surface characterization included roughness (n = 10), wettability (n = 10), morphology (n = 2), and elemental composition (n = 2). For SBS (n = 11), composite resin discs were bonded to the air-abraded and silane-treated zirconia surface, with the resin cement RelyX ARC. Failure mode was determined. Roughness, wettability, and SBS data were analyzed by two-way ANOVA with pairwise interaction and Tukey's test (α = 0.05).
Results
Air-abrasion performed with coarser particles at BS and BAS moments provided the highest roughness values, while the lowest roughness values were observed with particles combined with AS moment (p < 0.01). Rocatec Plus provided lower contact angle than the 120 μm alumina particles (p = 0.013), and BAS exhibited lower contact angle than BS (p = 0.002). The combinations 120 μm/BS and the silica-coated alumina particles/AS and /BAS showed the highest SBS (p < 0.05). The combination of each particle/BAS was statistically similar to the same particle/AS. Failure mode was 100% adhesive for all groups. The interaction particle size/air-abrasion moment determined the morphological pattern. Silicon was observed only in the Rocatec groups.
Conclusions
Roughness was influenced by the particle size and was higher when the zirconia was air-abraded in its green stage. The particle composition played an important role in the wettability and both studied air-abrasion moments provided similar wettability than the one in which air-abrasion is usually performed. The highest SBS values were observed in the three moments, by using certain particles for each moment.
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Dimethyloxalylglycine-embedded Poly(ε-caprolactone) Fiber Meshes Promote Odontoblastic Differentiation of Human Dental Pulp–derived Cells
The in vivo effect of prolyl hydroxylase inhibitors on the regeneration of the pulp-dentin complex is unclear. The purpose of this study was to investigate the effect of dimethyloxalylglycine (DMOG)-embedded poly(ε-caprolactone) fiber (PCLF/DMOG) on odontoblastic differentiation of human dental pulp–derived cells (hDPCs) by transplantation of the dentin slice model.
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Effects of Photodynamic Therapy on the Adhesive Interface of Fiber Posts Cementation Protocols
The aim of this study was to evaluate the effects of photodynamic therapy (PDT) on the bond strength and dentinal penetrability of cementation protocols using conventional resin cement (Relyx ARC; 3M ESPE, St Paul, MN) or self-adhesive (Relyx U200, 3M ESPE) after the glass fiber post cementation.
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Evaluation of Related Factors in the Failure of Endodontically Treated Teeth: A Cross-sectional Study
The aim of this study was to review the factors related to the failure and extraction of unsuccessful endodontically treated teeth.
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Corrigendum
Corrigendum to 'Outcome of Direct Pulp Capping with Mineral Trioxide Aggregate: A Prospective Study' [Journal of Endodontics 41 (2015) 1026–1031]
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Periodontal Blood Flow Protects the Alveolar Bone from Thermal Injury during Thermoplasticized Obturation: A Finite Element Analysis Study
The purpose of this study was to investigate the heat transfer during thermoplastic obturation and the cooling capacity of blood flow in the periodontal ligament (PDL) using finite element analysis (FEA).
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John I. Ingle, DDS, MSD, 1919–2017: The Legacy of an Extraordinary Leader
A beloved American Association of Endodontists (AAE) past president and an endodontic leader, Dr John I. Ingle, passed away on September 25, 2017 in San Diego at the age of 98. He was predeceased by his wife, Joyce Ledgerwood Ingle, who passed away on March 8, 2014. They had been married for nearly 74 years and leave 3 children, 5 grandchildren, and 2 great grandchildren.
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Single-staged implant placement using bone ring technique with and without membrane placement: An experimental study in the Beagle dog
Abstract
Aim
To evaluate the impact of a collagen membrane on bone remodeling and osseointegration of implants placed simultaneously with a bone ring technique.
Material and Methods
Standardized, vertical alveolar bone defects in the mandibles of six dogs were created. Tapered dental implants designed for two-stage subcrestal placement were inserted simultaneously with a bone ring technique. On one side of the mandible, the augmented sites were covered with a collagenous membrane. Implants with (M Group) and without membranes (NM Group) were left for an osseointegration period of 3 and 6 months, respectively. Block biopsies of the implants with surrounding bone were harvested and analyzed histologically.
Results
Implant exposure was a common finding (2/3) concomitantly with loss of healing caps. It appeared to be related to advanced bone loss around the implants. Exposure of implants was more frequent in M Group, however, without significant differences when compared to NM Group. The total bone area within the region of the bone ring was greater in the NM Group compared to the M Group. Moreover, in the region of the pristine bone of the M Group, the total bone was greater than at the corresponding NM Group sites at both observation periods. A nonparametric analysis of variance (ANOVA) revealed no significant effects of membrane placement or healing period on the total area of the bone. The total bone-to-implant contact (BIC) for the two groups was similar at each observation time point. However, BIC increased significantly at 6-month compared with 3-month observation period (p = .0088) in both groups.
Conclusions
In vertical bone augmentation applying the bone ring technique, the disruption of soft tissue was a frequent complication. Membrane placement yielded no significant advantage on the osseointegration (BIC) of implants or bone characteristics.
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The Surprising Gift I Received One Christmas That Keeps on Giving
Growing up, we had only one rule at my house regarding our letters to Santa: You can ask for three things. Granted, Santa usually surprised us with gifts numbering far beyond what we'd asked for, but when it came to what we could actually put on our wish lists, well, that number was limited to three.
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Immune response profiling of primary monocytes and oral keratinocytes to different Tannerella forsythia strains and their cell surface mutants
Summary
The oral pathogen Tannerella forsythia possesses a unique surface (S-) layer with a complex O-glycan containing a bacterial sialic acid mimic in the form of either pseudaminic acid or legionaminic acid at its terminal position. We hypothesize that different T. forsythia strains employ these stereoisomeric sugar acids for interacting with the immune system and resident host tissues in the periodontium. Here, we show how T. forsythia strains ATCC 43037 and UB4, displaying pseudaminic acid and legionaminic acid, respectively, and selected cell surface mutants of these strains, modulate the immune response in monocytes and human oral keratinocytes (HOK) using a multiplex immunoassay. When challenged with T. forsythia, monocytes secrete pro-inflammatory cytokines, chemokines and VEGF with the release of IL-1β and IL-7 being differentially regulated by the two T. forsythia wild-type strains. Truncation of the bacteria's O-glycan leads to significant reduction of IL-1β and regulates MIP-1. HOK infected with T. forsythia produce IL-1Ra, chemokines and VEGF. While the two wild-type strains elicit preferential immune responses for IL-8, both truncation of the O-glycan and deletion of the S-layer results in significantly increased release of IL-8, GM-CSF and MCP-1. Through immunofluorescence and confocal laser scanning microscopy of infected HOK we additionally show that T. forsythia is highly invasive and tends to localize to the perinuclear region. This indicates, that the T. forsythia S-layer and attached sugars, particularly pseudaminic acid in ATCC 43037, contribute to dampening the response of epithelial tissues to initial infection and, therefore, play a pivotal role in orchestrating the bacterium's virulence.
This article is protected by copyright. All rights reserved.
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Regarding “Is It Time to Reexamine Reexamination?”
On behalf of the American Board of Oral and Maxillofacial Surgery (ABOMS) Board of Directors, I would like to thank Hupp1 for his kind words regarding the ABOMS certification and recertification process. As usual, he rightfully identifies an area of interest to stimulate engaging discussion. We agree that achieving board certification remains a widely accepted acknowledgment that a surgeon possesses the knowledge, wisdom, and critical thought processes to offer safe and ethical care to our patients.
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Lactose intolerance and gastrointestinal cow’s milk allergy in infants and children – common misconceptions revisited
Lactose is the main carbohydrate in human and mammalian milk. Lactose requires enzymatic hydrolysis by lactase into D-glucose and D-galactose before it can be absorbed. Term infants express sufficient lactase ...
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Prognosticating hearing outcome in patients with idiopathic sudden sensorineural hearing loss by means of otoacoustic emissions and auditory brainstem response
Masoud Motasaddi Zarandy, MD; Mohammad Taghi Khorsandi Ashtiani, MD; Shahin Bastaninejad, MD; Sasan Dabiri Satri, MD; Sevil Nasirmohtaram, MD; Nourullah Agha Ebrahimi, BSC
Abstract
This is an analytic-descriptive study, parallel with a randomized, controlled trial performed at Amir'Alam Hospital, a tertiary referral center, with the aim of evaluating the correlation between otoacoustic emission (OAE) and auditory brainstem response (ABR) findings with hearing outcome after treatment of idiopathic sudden sensorineural hearing loss (SSNHL). Sixty patients with idiopathic SSNHL who presented to the emergency services and otology clinics between 2012 and 2014, and whose symptoms had begun <10 days previously, enrolled in this study. Before commencing treatment, distortion-product OAE (DP-OAE) and ABR were performed for all patients. They also underwent magnetic resonance imaging ± gadolinium. Therapeutic intervention was done in a parallel randomized, controlled trial, and responders to the medical therapy were selected for our final analysis. There was no significant correlation between the OAE record and responsiveness to treatment, but there was a correlation between ABR presence and the probability of responsiveness in patients with profound hearing loss who responded to medical therapy and had at least wave V ABR. However, in those who had no recorded wave, the response to treatment was variable. In conclusion, in patients with profound hearing loss, studying the waves of ABR could be a factor in predicting hearing loss resolution after treatment.
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Endoscopic endonasal management of recurrent maxillary mucoceles using biliary T-tube stenting
Noritsugu Ono, MD; Shin Ito, MD; Hirotomo Homma, MD; Hiroko Okada, MD; Junko Murata, MD; Katsuhisa Ikeda, MD, PhD
Abstract
Mucoceles of the paranasal sinus can be managed endoscopically with an extremely low recurrence rate. Frontal sinus mucoceles can sometimes be prevented from closing and reforming by stenting, which to the best of our knowledge has not yet been reported in the maxillary sinus. We describe the cases of 5 patients-3 men and 2 women, aged 47 to 75 years (mean: 59.6)-with a recurrent and intractable maxillary sinus mucocele that was managed with biliary T-tube stenting. The indications for stenting included recurrent episodes of mucocele with or without a lateral location with a relatively thick bony wall. A latex rubber pediatric biliary T-tube was endoscopically inserted through a window opening into the marsupialized mucocele. The stent was removed 6 to 14 months postoperatively in 4 cases; in the other case, the stent remained adequately positioned for 35 months. None of the patients experienced signs or symptoms of recurrence. We conclude that a T-tube stent can be used successfully to maintain long-term patency in patients with a recurrent and intractable maxillary mucocele, with patency being maintained even after removal of the stent.
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Head and neck surgical reconstruction in Operation Iraqi Freedom and Operation Enduring Freedom-Afghanistan: A systematic review
Samantha J. Mikals, MD; Joshua M. Jabaut, MD; Art A. Ambrosio, MD
Abstract
Historically, head and neck injuries constituted 16 to 20% of all nonfatal combat injuries. However, advances in body and vehicle armor in the context of the use of ambushes and improvised explosive devices by enemy combatants have resulted in fewer fatalities from head and neck wounds, and thus the incidence of nonfatal head and neck injuries has risen to as high as 52%. Despite this increase, data regarding specific injury distributions, surgical cases, and approaches to repair are lacking in the current literature. We conducted a study to systematically review the current literature regarding head and neck injuries and reconstructions during Operation Iraqi Freedom and Operation Enduring Freedom-Afghanistan. We found 44 articles that met our inclusion criteria. These articles covered 17,461 head and neck wounds sustained by 12,105 patients. Superficial soft-tissue facial injuries were most common wounds (31.7% of cases), followed by wounds to the neck (25.2%) and midface (17.9%). The 44 articles listed 5,122 discrete surgical reports covering 5,758 procedures. Of these procedures, simple facial laceration repairs (25.2%) and ophthalmologic surgeries (12.1%) were the most common soft-tissue repairs, and mandibular reconstructions (11.3%) were the most common type of bony reconstruction. Major flap reconstructions for coverage were required in only 0.4% of procedures. This information will be valuable for educating those involved in otolaryngology training programs, as well as civilian otolaryngologists regarding the types of injury patterns they should expect to see and treat in the returning veteran population.
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Clouds of different colors: A prospective look at head and neck surgical resident call experience
Jonathan Melzer, MD, LCDR, MC, USN
Abstract
Graduate medical education programs typically set up call under the assumption that residents will have similar experiences. The terms black cloud and white cloud have frequently been used to describe residents with more difficult (black) or less difficult (white) call experiences. This study followed residents in the department of head and neck surgery during call to determine whether certain residents have a significantly different call experience than the norm. It is a prospective observational study conducted over 16 months in a tertiary care center with a resident training program in otolaryngology. Resident call data on total pages, consults, and operative interventions were examined, as well as subjective survey data about sleep and perceived difficulty of resident call. Analysis showed no significant difference in call activity (pages, consults, operative interventions) among residents. However, data from the resident call surveys revealed perceived disparities in call difficulty that were significant. Two residents were clearly labeled as black clouds compared to the rest. These residents did not have the highest average number of pages, consults, or operative interventions. This study suggests that factors affecting call perception are outside the objective, absolute workload. These results may be used to improve resident education on sleep training and nighttime patient management in the field of otolaryngology and may influence otolaryngology residency programs.
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Intracranial abscess formation following sphenoid sinus occlusion with nasoseptal flap skull base reconstruction: A cautionary tale
George S. Tarasidis, MD; Jeremiah A. Alt, MD, PhD; Richard R. Orlandi, MD
Abstract
The formation of an intracranial abscess secondary to sphenoid sinus occlusion after nasoseptal flap skull base reconstruction has not been previously described. We report such a case that occurred at our institution in a 23-year-old man who underwent flap reconstruction for a cerebrospinal fluid leak. We determined that occlusion of the sphenoid sinus outflow might have played a role in this complication. The patient was treated via a combined surgical and medical approach that entailed a bur-hole craniotomy and endoscopic debridement followed by administration of an intravenous antibiotic. The patient recovered without long-term deficit. When closing a defect of the posterior ethmoid and sphenoid skull base, especially with a pedicled graft, care must be taken to reduce the potential for retention of secretions and blood because this may lead to an intracranial complication.
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Preoperative evaluation and intraoperative protection of the facial nerve in congenital aural atresia
Jie Li, MD; Shouqin Zhao, PhD; Lin Yang, MD; Yi Li, PhD; Xiaobo Ma, PhD; Danni Wang, PhD; Ran Ren, MD; Ying Li, MD
Abstract
We conducted a prospective study to assess the value of high-resolution computed tomography (HRCT) in identifying facial nerve variations in patients with congenital aural atresia and to determine how they affect otologic reconstruction surgery. Our study population was made up of 65 patients (69 ears) aged 6 to 22 years (mean: 13.7) without regard to sex. They were classified into three groups according to their scores on the Jahrsdoerfer grading scale: 46 ears scored 8 or more, 18 had a score of 6 or 7, and 5 scored 5 or less. The course of each facial nerve as determined intraoperatively was compared with the preoperative HRCT findings. HRCT revealed that in most of the facial nerves, the tympanic segments overlapped the oval window partly or completely; this was confirmed by surgical findings in most cases. Three of the 69 facial nerves (4.3%) were bifurcated. It is interesting that in 1 ear in which the facial nerve completely covered the oval window, the angle of the second genu was acute, exhibiting a "sharp turn." We conclude that HRCT is undoubtedly of value in identifying the course of the facial nerve and is of critical importance in helping surgeons make correct decisions in otologic reconstruction surgery.
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Nasopharyngeal papillary adenocarcinoma
Lester D. Thompson, MD
Nasopharyngeal papillary adenocarcinoma may appear grossly as an exophytic, nodular, or polypoid mass, sometimes gritty if psammoma bodies are present.
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Multidisciplinary management of a giant cervico-mediastinal liposarcoma: A case report and literature review
Andrea Galli, MD; Leone Giordano, MD; Piergiorgio Muriana, MD; Alessandro Bandiera, MD; Giampiero Negri, MD; Piero Zannini, MD; Mario Bussi, MD
Abstract
Liposarcomas are rare mesenchymal tumors that usually develop in lower extremities or retroperitoneum; cervico-mediastinal presentation is quite uncommon. These neoplasms are commonly diagnosed at a late stage because they remain asymptomatic until nearby structures are compressed. This makes radical excision particularly challenging. To date, alternative chemoradiotherapy protocols have not yet been standardized. We report a case of a 55-year-old man with a right laterocervical mass and without substantial symptoms. Fine-needle aspiration cytology results were compatible with a well-differentiated liposarcoma. Contrast-enhanced magnetic resonance imaging revealed the magnitude of the mass, which was expanding into the mediastinum; displacing the trachea, esophagus, cervical neurovascular bundle, and thoracic aorta; and encasing the brachiocephalic artery. Compression of the left brachiocephalic vein resulted in a focal enhancement spot in the fourth liver segment, the expression of superior vena cava compression, which can promote the development of collateral venous pathways, such as the caval-mammary-phrenic-hepatic capsule-portal venous pathway. The mass was successfully excised by a team of surgical subspecialists (otorhinolaryngologists and thoracic, cardiac, and vascular surgeons). Adjuvant tomotherapy was administered to increase local disease control. The patient remained disease-free 38 months postoperatively. This case underlines the importance of accurate preoperative radiologic evaluation in patients presenting with neck masses but without substantial symptoms. Because of the involvement of many critical structures, the cooperation of many surgical subspecialties is mandatory to achieve a satisfying oncologic outcome.
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Skin necrosis in a magnet-based bone-conduction implant
Sara Gallant, MD; Judy Lee, MD; Daniel Jethanamest, MD
Patients with complicated wound sites or multiple surgeries should be counseled to carefully monitor their skin as they have reduced sensation.
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Proliferative pilomatricoma of the eyebrow in a 94-year-old patient
Christopher P. Nyte, DO
While pilomatricomas affect both the young and elderly, it is the elderly that tend to experience the advancing proliferative tumor type.
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Impact of age on the anatomy of the pediatric pterygopalatine fossa and its relationship to the suprazygomatic maxillary nerve block
The suprazygomatic maxillary nerve block is associated with improved post-operative pain management after select craniofacial surgical procedures. This study's objective is to better define the impact of pediatric facial skeletal growth on techniques for accessing the pterygopalatine fossa (PPF).
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A clinical pathway for the postoperative management of hypocalcemia after pediatric thyroidectomy reduces blood draws
Postoperative calcium management is challenging following pediatric thyroidectomy given potential limitations in self-reporting symptoms and compliance with phlebotomy. A protocol was created at our tertiary children's institution utilizing intraoperative parathyroid hormone (PTH) levels to guide electrolyte management during hospitalization.The objective of this study was to determine the effect of a new thyroidectomy postoperative management protocol on two primary outcomes: (1) the number of postoperative calcium blood draws and (2) the length of hospital stay.
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EXIT (ex utero intrapartum treatment) in a growth restricted fetus with tracheal atresia
Congenital high airway obstruction syndrome (CHAOS) encompasses a heterogeneous group of pathologies leading to poor lung development and difficulty oxygenating the newborn after delivery. While previously uniformly fatal, the ex utero intrapartum therapy (EXIT) procedure has provided a method to treat these patients and provide an airway to potentiate survival. We present a patient diagnosed prenatally with CHAOS secondary to tracheal atresia complicated by severe intra-uterine growth restriction (IUGR) who was successfully delivered via an EXIT procedure at 33-weeks.
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Validity of automated threshold audiometry in school aged children
Automated hearing tests have the potential to reduce the burden of disease amongst learners by introducing such services within the school context.
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Sensorineural and conductive hearing loss in infants diagnosed in the program of universal newborn hearing screening
The aim of this study was to analyze infants diagnosed with sensorineural or conductive hearing deficit and to identify risk factors associated with these defects.
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“Effects of Leukocyte- and Platelet-rich Fibrin alone and Combined with Hyaluronic Acid on Pain, Oedema, and Trismus after Surgical Extraction of Impacted Mandibular Third Molars”
In this prospective randomised double-blind controlled study, we evaluated the effects of leukocyte- and platelet-rich fibrin (L-PRF) alone and combined with hyaluronic acid (HA) sponge on pain, oedema, and trismus after mandibular third molar (M3) surgery.
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Risk factors affecting the prognosis of descending necrotizing mediastinitis from odontogenic infection
Descending necrotizing mediastinitis (DNM) is a serious complication of head and neck infections, and has an excessively high mortality rate due to the lack of understanding of DNM. Assessing the clinical characteristics, diagnosis, treatment, outcomes of odontogenic DNM, and evaluating the risk factors affecting the prognosis of DNM to provide an up-to-date overview for clinical practice.
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Temporomandibular Joint Disc Repositioning by suturing through open incision: A technical note
It is technically difficult to arthroscopically reposition and suture the temporomandibular joint disc to the auricular cartilage. This article introduces a straightforward method to reposition the disc and suture it to the auricular cartilage through a small incision.
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Utilization of Intraoperative CT in Craniomaxillofacial Trauma Surgery
The utilization of technology to aid in assessment, planning and management of complex craniomaxillofacial injuries is increasingly common. Pre-operative CT evaluation is considered standard of care and intraoperative imaging is becoming increasingly accessible. Limited data exists regarding the implication of intraoperative CT on decision making in management of all sites of facial fractures. The purpose of this study was to characterize the utilization of the intraoperative CT scanner for craniomaxillofacial surgery within our institution, to quantify the effect of intraoperative CT on surgical decision-making and to attempt to provide guidance on when to utilize this technology.
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The Utilization of Computer Aided Design and Manufacturing in Acute Mandibular Trauma Reconstruction
Virtual surgical planning (VSP) with subsequent computer aided design and manufacturing (CAD/CAM) have proved efficacious in improving efficiency and outcomes of a plethora of surgical modalities including mandibular reconstruction and orthognathic surgery.
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Custom implant for reconstruction of mandibular continuity defect
The purpose of this study was to compare the daily food intake rate and the rate of screw loosening between two groups of rabbits with mandibular continuity defects: a custom implant group and a 5-hole mini-plate group.
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Melanotic neuroectodermal tumor of infancy (MNTI) of the head and neck: A French multicenter study
Melanotic neuroectodermal tumor of infancy (MNTI) of the head and neck is a rare entity with uncertain clinical behavior. Radical surgical resection is the current recommended treatment, however this can cause severe aesthetic and functional sequelae. The aim of this study was to clinically characterize MNTIs and to stratify risk factors that may influence locoregional recurrence.
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The hypoxia marker CAIX is prognostic in the UK phase III VorteX-Biobank cohort: an important resource for translational research in soft tissue sarcoma
The hypoxia marker CAIX is prognostic in the UK phase III VorteX-Biobank cohort: an important resource for translational research in soft tissue sarcoma
The hypoxia marker CAIX is prognostic in the UK phase III VorteX-Biobank cohort: an important resource for translational research in soft tissue sarcoma, Published online: 12 December 2017; doi:10.1038/bjc.2017.430
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Alcohol and oestrogen metabolites in postmenopausal women in the Women’s Health Initiative Observational Study
Alcohol and oestrogen metabolites in postmenopausal women in the Women's Health Initiative Observational Study
Alcohol and oestrogen metabolites in postmenopausal women in the Women's Health Initiative Observational Study, Published online: 12 December 2017; doi:10.1038/bjc.2017.419
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Targeting the Raf kinases in human cancer: the Raf dimer dilemma
Targeting the Raf kinases in human cancer: the Raf dimer dilemma
Targeting the Raf kinases in human cancer: the Raf dimer dilemma, Published online: 12 December 2017; doi:10.1038/bjc.2017.399
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Anthropometric measurements and survival after a prostate cancer diagnosis
Anthropometric measurements and survival after a prostate cancer diagnosis
Anthropometric measurements and survival after a prostate cancer diagnosis, Published online: 12 December 2017; doi:10.1038/bjc.2017.440
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ALDH1A3 affects colon cancer in vitro proliferation and invasion depending on CXCR4 status
ALDH1A3 affects colon cancer in vitro proliferation and invasion depending on CXCR4 status
ALDH1A3 affects colon cancer <i>in vitro</i> proliferation and invasion depending on CXCR4 status, Published online: 12 December 2017; doi:10.1038/bjc.2017.363
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Targeting negative regulation of p53 by MDM2 and WIP1 as a therapeutic strategy in cutaneous melanoma
Targeting negative regulation of p53 by MDM2 and WIP1 as a therapeutic strategy in cutaneous melanoma
Targeting negative regulation of p53 by MDM2 and WIP1 as a therapeutic strategy in cutaneous melanoma, Published online: 12 December 2017; doi:10.1038/bjc.2017.433
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Cell and molecular biology: a new section joins the fight against cancer
Cell and molecular biology: a new section joins the fight against cancer
Cell and molecular biology: a new section joins the fight against cancer, Published online: 12 December 2017; doi:10.1038/bjc.2017.443
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Influence of induction chemotherapy in trimodality therapy-eligible oesophageal cancer patients: secondary analysis of a randomised trial
Influence of induction chemotherapy in trimodality therapy-eligible oesophageal cancer patients: secondary analysis of a randomised trial
Influence of induction chemotherapy in trimodality therapy-eligible oesophageal cancer patients: secondary analysis of a randomised trial, Published online: 12 December 2017; doi:10.1038/bjc.2017.423
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What Is the Outcome of an Incision and Drainage Procedure in Endodontic Patients? A Prospective, Randomized, Single-blind Study
There are no prospective endodontic studies to determine the outcome of an incision and drainage (I&D) procedure for swelling in healthy, endodontic patients. The purpose of this prospective, randomized, single-blind study was to compare the postoperative course of I&D with drain placement versus a mock I&D procedure with mock drain placement after endodontic debridement in swollen emergency patients with symptomatic teeth and a pulpal diagnosis of necrosis.
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Comparative study of volumetric changes and trabecular microarchitecture in human maxillary sinus bone augmentation with bioactive glass and autogenous bone graft: a prospective and randomized assessment
The aim of this study was to compare the volumetric changes and the new bone microarchitecture in human maxillary sinuses augmented with bioactive glass (Biogran) alone, bioactive glass combined with autogenous bone graft (1:1), or autogenous bone graft alone. Twelve maxillary sinuses were grafted with bioactive glass (group 1), nine with bioactive glass mixed with autogenous bone graft 1:1 (group 2), and 12 with autogenous bone graft (group 3). Patients underwent cone beam computed tomography 15days after the procedure to determine the initial volume of the graft (T1) and again 6 months later (T2).
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Sequencing of bimaxillary surgery in the correction of vertical maxillary excess: retrospective study
The aim of this study was to evaluate the precision of bimaxillary surgery performed to correct vertical maxillary excess, when the procedure is sequenced with mandibular surgery first or maxillary surgery first. Thirty-two patients, divided into two groups, were included in this retrospective study. Group 1 comprised patients who received bimaxillary surgery following the classical sequence with repositioning of the maxilla first. Patients in group 2 received bimaxillary surgery, but the mandible was operated on first.
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Different Maturational Changes of Fast and Slow Sleep Spindles in The First Four Years of Life
Massive changes in brain morphology and function in the first years of life reveal a postero-anterior trajectory of cortical maturation accompanied by regional modifications of NREM sleep. One of the most sensible marker of this maturation process is represented by electroencephalographic (EEG) activity within the frequency range of sleep spindles. However, direct evidence that these changes actually reflect maturational modifications of fast and slow spindles still lacks.Our study aimed at answering the following questions:1.
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Increased dopaminergic function in the thalamus is associated with excessive daytime sleepiness
Excessive daytime sleepiness (EDS) is a common disorder, which can manifest in isolation or in combination with other neurological or psychiatric disorders. We know relatively little about the mechanisms underlying the development of EDS and the clinical management of patients with EDS remains an unmet need. In this study, we hypothesised that thalamic dopaminergic function would be altered in subjects with EDS and we sought to investigate this by assessing [123I]FP-CIT Single Photon Emission Computed Tomography (SPECT) data, which is a molecular imaging marker of dopamine transporter (DAT).
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Media consumption and sleep quality in early childhood: results from the Ulm SPATZ Health Study
Media use is increasingly becoming common in preschoolers and starting before the age of 3 years. While several studies have documented the effects of screen time on sleep duration in this age group, investigations including sleep quality are scarce and mainly cross-sectional. Moreover, they are limited by investigating sleep across broader age ranges or in older preschoolers, which may blur early effects and the ideal time for intervention.
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The value of ASSR threshold-based bilateral hearing aid fitting in children with difficult or unreliable behavioral audiometry
Abstract We conducted an analysis to assess the relative contribution of auditory brainstem response (ABR) testing and auditory steady-state response (ASSR) testing in providing appropriate hearing aid fitting in hearing-impaired children with difficult or unreliable behavioral audiometry. Of 150 infants and children who had been referred to us for hearing assessment as part of a neonatal hearing screening and cochlear implantation program, we identified 5 who exhibited significant discrepancies between click-ABR and ASSR testing results and difficult or unreliable behavioral audiometry. Hearing aid fitting in pediatric cochlear implant candidates for a trial period of 3 to 6 months is a common practice in many implant programs, but monitoring the progress of the amplified infants and providing appropriate hearing aid fitting can be challenging. If we accept the premise that we can assess the linguistic progress of amplified infants with an acceptable degree of certainty, the auditory behavior that we are monitoring presupposes appropriate bilateral hearing aid fitting. This may become very challenging in young children, or even in older children with difficult or unreliable behavioral audiometry results. This challenge can be addressed by using data from both ABR and ASSR testing. Fitting attempts that employ data from only ABR testing provide amplification that involves the range of spoken language but is not frequency-specific. Hearing aid fitting should also incorporate and take into account ASSR data because reliance on ABR testing alone might compromise the validity of the monitoring process. In conclusion, we believe that ASSR threshold-based bilateral hearing aid fitting is necessary to provide frequency-specific amplification of hearing and appropriate propulsion in the prelinguistic vocalizations of monitored infants.
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Outcomes of adenotonsillectomy in severe pediatric obstructive sleep apnea
Abstract We conducted a retrospective chart review to examine the efficacy of adenotonsillectomy for the treatment of severe obstructive sleep apnea (OSA) in children. Our study population was made up of 85 patients-58 boys and 27 girls, aged 1 to 17 years (mean: 6.9 ± 4.4)-with severe OSA who had undergone adenotonsillectomy and pre- and postoperative attended polysomnography (PSG) over a 4-year period. Severe OSA was defined as an apnea-hypopnea index (AHI) of >10 events per hour of sleep. Patients who had an underlying genetic or craniofacial anomaly were excluded. In addition to demographic and PSG data, we compiled information on selected characteristics of patients according to postoperative residual AHIs of ≤5 and >5. Finally, information on body mass index z score was available on 72 patients; the mean score was 1.55 ± 1.51, with 36 patients (50.0%) fulfilling the criteria for obesity. In the group as a whole, we found that adenotonsillectomy resulted in a significant reduction in AHI from 35.4 to 7.1 (p < 0.001). We also found an improvement in mean oxygen saturation nadir from 75.2 to 85.5 (p < 0.001). Postoperatively, only 8 patients (9.4%) achieved an AHI of ≤1; AHIs were >1 to ≤5 in 39 patients (45.9%), >5 to ≤10 in 24 patients (28.2%), and >10 in 14 patients (16.5%). A significantly higher proportion of boys had a residual AHI of >5 after surgery compared with those whose postoperative AHI was ≤5 (78.9 vs. 59.6%; p = 0.04). We conclude that adenotonsillectomy leads to a significant improvement in sleep-disordered breathing in children with severe OSA, but residual disease is common so close postoperative follow-up is essential.
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Exploring knowledge and attitudes toward non-communicable diseases among village health teams in Eastern Uganda: a cross-sectional study
Community health workers are essential personnel in resource-limited settings. In Uganda, they are organized into Village Health Teams (VHTs) and are focused on infectious diseases and maternal-child health; h...
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Prevalence and correlates of substance use among health care students in Nepal: a cross sectional study
Substance use among health care students threatens professional standards and the delivery of quality services, potentially placing the public at risk. Therefore, our study aims to determine the prevalence and...
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Effectiveness of two community-based strategies on disease knowledge and health behaviour regarding malaria, diarrhoea and pneumonia in Ghana
Ghana has developed two community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and suspected pneumonia, and to improve household and family practices: integrated Com...
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Development and validation of college students’ tuberculosis knowledge, attitudes and practices questionnaire (CS-TBKAPQ)
China faces many challenges in controlling tuberculosis (TB). One significant challenge is the control of college students' TB. In particular, cross-sectional studies of college students' knowledge, attitudes ...
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Double Up Food Bucks program effects on SNAP recipients' fruit and vegetable purchases
To encourage the consumption of more fresh fruits and vegetables, the 2014 United Sates Farm Bill allocated funds to the Double Up Food Bucks Program. This program provided Supplemental Nutrition Assistance Pr...
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Honey recommended for tongue lump that turned out to be cancer
Peter Liston has been formally condemned by the Health Practitioners' Disciplinary Tribunal for delaying the diagnosis of a cancer on a patient's tongue. A man whose cancerous tongue lesion was not properly diagnosed for nearly two years was once told by his oral surgeon to apply honey to ease the pain.
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Inonotosis in Patient with Hematologic Malignancy
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Dengue Fever in Burkina Faso, 2016
Z. Tarnagda et al.
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Changing Geographic Patterns and Risk Factors for Avian Influenza A(H7N9) Infections in Humans, China
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Increasing Virulence in Leprosy Indicated by Global Mycobacterium spp.
W. Levis et al.
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Of Rats and Men: Poussin’s Plague at Ashdod
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Costs of Conjunctivitis Outbreak, Réunion Island, France
L. Filleul et al.
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Rodent Abundance and Hantavirus Infection in Protected Area, East-Central Argentina
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Federal prosecutors seek higher restitution in fraud case
Federal prosecutors are seeking higher restitution from a western Idaho woman who authorities say performed work as dentist despite being licensed as a dental hygienist. The Idaho Statesman reports 62-year-old Cherie R. Dillon pleaded guilty in January to multiple counts of health care fraud and aggravated identity theft.
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Global Dentistry 3D Printing Markets 2018-2028 - 3D Printing Entering the Mainstream of Dental Care
In 2017, 3D printing went mainstream in the dental industry. A number of high profile business ventures and acquisitions have continued to propel dental applications utilizing 3D printing technologies firmly into the sights of the largest dental services and solutions providers in the world.
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The clinical significant of pre-surgical imaging in oral squamous cell carcinoma compared with lymph node status: a comparative retrospective study
Publication date: Available online 11 December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Elias Mazzawi, Imad Abu El-naaj, Yasmine Ghantous, Salim Balan, Edmond Sabo, Adi Rachmiel, Yoav Leiser
AimThe accuracy and sensitivity of commonly used imaging modalities in evaluating oral cavity cancer was evaluated by comparing the pre-surgical radiological findings and the post-surgical pathological report.MethodsOral squamous cell carcinoma patients, who had undergone at least one imaging test 2 weeks before the surgery, were included. Radiological findings were compared with the dissected neck to assess the lymph node status. Sensitivity and specificity of the imaging modalities were calculated using the Chi-square test.ResultsSensitivities for detecting metastatic neck lymph nodes at a threshold of 1cm were 48% (P = 0.02) and 43.8% (P = 0.3) for CT and MRI respectively. Specificities were 76.3% and 70% respectively. As for the 1.5cm threshold sensitivities were 36% (P = 0.002) and 31.3% (P = 0.5) respectively, and specificities were 91.5% and 76.7% respectively. PET-CT was the most sensitive modality in the present study, with a P value 0.02.ConclusionThe different studied imaging modalities used for pre-operational neck staging are not sensitive enough and would lead to underdiagnoses of a respectful proportion of patients. Thus prophylactic neck dissection for occult neck disease is of extreme importance and remains the gold-standard for oral cancer treatment.
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Relationship between sjögren's syndrome and periodontal status- a systematic review
Publication date: Available online 11 December 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Luana de Goés Soares, Ricardo Lopes Rocha, Elizabete Bagordakis, Endi Lanza Galvão, Dhelfeson Willya Douglas-de-Oliveira, Saulo Gabriel Moreira Falci
ObjectiveThis study aimed to evaluate if Sjögren's syndrome is related to periodontal status.Study DesignA systematic review was performed based on PRISMA (PROSPERO: CRD42017055202). The search was performed in the PubMed/MEDLINE, LILACS, Web of Science and Science Direct databases. Hand searches and gray literature were also performed. Three researchers independently selected studies, extracted data and assessed methodological quality. Studies that correlated primary and/or secondary SS, with plaque index, gingival index, probing depth and bleeding on probing were included. The risk of bias was estimated based on the Newcastle-Ottawa scale.ResultsSeventeen studies were included, and nine included in the meta-analysis, with a total of 518 and 544 patients, with and without Sjögren's Syndrome, respectively. The mean difference of plaque index (0.29; CI95% 0.17-0.41), gingival index (0.52; CI95% 0.14-0.89) and bleeding on probing (9.92; CI95%4.37-15.47) were larger in SS patients than controls. In primary SS (0.47; CI95% 0.10-0.83) and secondary SS (0.74 CI95% 0.10-1.38), only gingival index mean was larger than in control group. The majority of the included studies were judged as high risk of bias.ConclusionThe present review does not provide strong evidence to ensure that the periodontal status is affected by Sjögren's syndrome.
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Akili Labs makes medical field testing ten times cheaper using 3D printing
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Evaluation of Direct and Indirect Methods of Sub-Neoglottic Pressure Measurement in Tracheoesophageal Speakers: A Systematic Review and Meta-Analysis
Objective: Tracheoesophageal (TE) prosthetic voice is one of the voice restoration options for individuals who have undergone a total laryngectomy. Aerodynamic analysis of the TE voice provides insight into the physiological changes that occur at the level of the neoglottis with voice prosthesis in situ. The present study is a systematic review and meta-analysis of sub-neoglottic pressure (SNP) measurement in TE speakers by direct and indirect methods. Patients and Methods: The screening of abstracts and titles was carried out for inclusion of articles using 10 electronic databases spanning the period from 1979 to 2016. Ten articles which met the inclusion criteria were considered for meta-analysis with a pooled age range of 40–83 years. Results: The pooled mean SNP obtained from the direct measurement method was 53.80 cm H2O with a 95% confidence interval of 21.14–86.46 cm H2O, while for the indirect measurement method, the mean SNP was 23.55 cm H2O with a 95% confidence interval of 19.23–27.87 cm H2O. Conclusion: Based on the literature review, the various procedures followed for direct and indirect measurements of SNP contributed to a range of differences in outcome measures. The meta-analysis revealed that the "interpolation method" for indirect estimation of SNP was the most acceptable and valid method in TE speakers.
Folia Phoniatr Logop 2016;68:282–289
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Folia Phoniatr Logop 2016;68:282–289
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Use of a Novel Device to Assess Intraoral and Intrapharyngeal Baropressure during Sound Production
Objective: We developed a novel device that simultaneously measures oral and intrapharyngeal baropressure. The transducer has the advantage that it can be placed in any region. We determined the effect of different speech samples on baropressure in these regions. Patients and Methods: Seven healthy individuals produced speech samples comprising vowels and consonants (e.g., /aka/, /apa/, and /ash/). Two transducers were installed into the experimental plate at the incisive papillae and center of the Ah-line; a third transducer was placed in the mid-pharyngeal cavity. During each task, 3 parameters were analyzed: peak pressure, mean pressure, and the temporal relationship between sound signals and pressure changes. Results: The mean pressure did not change during the production of a single vowel; however, the pressure transiently increased during the production of the speech samples, depending on the place of articulation. Moreover, the place of articulation affected the onset and peak timing of pressure changes. Conclusions: These findings indicate that pressure changes during the production of speech samples reflect the functional aspects of speech production. In particular, simultaneous pressure recordings at multiple locations would provide precise information about speech production, compared to pressure studies that used a single pressure transducer.
Folia Phoniatr Logop 2016;68:274–281
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Folia Phoniatr Logop 2016;68:274–281
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Speech and Language Pathologists’ Voice Use in Working Environments: A Field Study Using Ambulatory Phonation Monitoring
Objective: The aim of this study was to evaluate the speech and language pathologists' (SLPs) voice production during a typical working day. Patients and Methods: A total of 28 SLPs, all females, were enrolled. According to the type of treated disease, the cohort of SLPs was divided into 4 groups (7 SLPs focused on the rehabilitation of dysphagic adult clients; 7 SLPs focused on the rehabilitation of deaf children; 7 SLPs focused on the rehabilitation of dysphonic adult clients; and 7 SLPs focused on the rehabilitation of aphasic adult clients). The voice production evaluation was performed using ambulatory phonation monitoring (APM). Results: Significant differences in the APM results were found between the 4 groups of SLPs. In particular, SLPs focusing on the treatment of dysphonic and deaf clients experienced a higher vocal load than SLPs focusing on the treatment of aphasic and dysphagic clients. Conclusion: SLPs may experience heavy vocal loads during working hours. In addition, it seems that some rehabilitation settings could be more vocally demanding than others.
Folia Phoniatr Logop 2016;68:268–273
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Folia Phoniatr Logop 2016;68:268–273
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Validation of the Hebrew Version of the Eating Assessment Tool-10 (H-EAT-10)
Background and Objectives: Dysphagia is a common disability with different etiologies. In order to measure dysphagia symptom severity and effects on quality of life, the Eating Assessment Tool (EAT-10) was developed and validated in the English language. We aimed to develop a Hebrew version of the EAT-10 and to evaluate its internal consistency, test-retest reliability, and validity in Hebrew-speaking adults with dysphagia. Subjects and Methods: The Hebrew EAT-10 (H-EAT-10) questionnaire was completed by 132 patients: 56 patients with dysphagia and 76 controls. Internal consistency analysis was calculated using Cronbach α, and test-retest reliability was calculated using intraclass correlation coefficient in order to assess clinical validity. Results: Internal consistency and test-retest reliability were found to be high in the H-EAT-10 (Cronbach α = 0.955 and intraclass correla tion = 0.98). In addition, H-EAT-10 scores in the dysphagia group were found to be significantly higher than those in the control group (p #x3c; 0.001). Conclusion: This study demonstrated that H-EAT-10 is a reliable and valid tool that may be implemented for clinical practice and research on dysphagia in a Hebrew-speaking population.
Folia Phoniatr Logop 2016;68:261–267
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Folia Phoniatr Logop 2016;68:261–267
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Prevalence of Epstein-Barr virus DNA and Porphyromonas gingivalis in Japanese peri-implantitis patients
Abstract
Background
Peri-implantitis (PI) is an inflammatory reaction associated with functional deterioration of supporting bones around the dental implant. Recent studies suggested Epstein–Barr virus (EBV) is involved in the pathogenesis of periodontitis. We investigated the association between EBV and Porphyromonas gingivalis in Japanese PI patients.
Methods
Fifteen periodontally healthy individuals, 15 healthy implant patients and 15 PI patients were recruited. Forty five subgingival plaque samples were collected from the deepest probing pocket depth (PPD) site from each patient. Real-time PCR was used to detect EBV DNA and P. gingivalis.
Results
EBV and P. gingivalis were detected in 7 and 3 PPD sites of the healthy controls, in 9 and 4 PPD sites of the healthy implants, and in 13 and 14 PPD sites of the PI patients. P. gingivalis and coexistence of EBV and P. gingivalis were detected significantly higher in the PI patients than healthy controls and healthy implant patients. EBV was detected significantly higher in the PI patients than healthy controls.
Conclusions
Higher levels of EBV and P. gingivalis were detected in PPD sites of PI patients. These results suggest that coexistence of EBV and P. gingivalis may serve pathogenic factors cause for PI in Japanese dental patients.
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"Oral Oncol"[jour]; +28 new citations
28 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
These pubmed results were generated on 2017/12/12
PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
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Response to letter to the editor ‘Mortality due to refeeding syndrome? You only find what you look for, and you only look for what you know’
Response to letter to the editor 'Mortality due to refeeding syndrome? You only find what you look for, and you only look for what you know'
Response to letter to the editor 'Mortality due to refeeding syndrome? You only find what you look for, and you only look for what you know', Published online: 11 December 2017; doi:10.1038/s41430-017-0025-6
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Esophageal Dysmotility in Patients following Total Laryngectomy
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Apical periodontitis in southern Estonian population: prevalence and associations with quality of root canal fillings and coronal restorations
Abstract
Background
Apical periodontitis (AP) is an inflammatory disease around the apex of a tooth root. Reported prevalence of AP ranges from 27% to 83% while the data about most post-Soviet countries are still missing. Knowing the prevalence of AP within a certain population helps to plan the treatment need and evaluate the success of endodontic interventions. We aimed to collect data about prevalence and determining factors of AP for the first time in Estonia.
Methods
The cross-sectional study included 6552 patients (age 35.5±19.2 years). Radiographic examination was applied to investigate the prevalence of AP and quality of endodontic treatment.
Results
AP was diagnosed in 54.7% of subjects. Endodontically treated teeth were present in 58.2% of subjects. Periapical finding was present in 44.6% of endodontically treated and in 30.8% of untreated teeth.
Out of 181,495 teeth, 52.7% were intact. AP was diagnosed in 6.3% of teeth, 6.9% of teeth were endodontically treated.
Risk factors for AP included caries (OR = 2.30), male gender (OR = 1.44), too short (OR = 1.76) or too long root canal filling (OR = 2.51), root canal filling of low density (OR = 1.61) while not orthodontic appliance. Lower AP risk was associated with restoration of the tooth – filling (OR = 0.45), crown (OR = 0.34) and bridge (OR = 0.33).
Conclusions
AP is highly prevalent in Southern Estonian population. Most cases are associated with root canal-treated teeth. The overall quality of root canal fillings tends to be low, consistent with the mediocre outcome of treatment. Considerable efforts are required to improve the standards of endodontic treatment.
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