Effect of different resin luting cements on the marginal fit of lithium disilicate pressed crowns

Publication date: Available online 15 November 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Radek Mounajjed, Thomas J. Salinas, Tomas Ingr, Basel Azar
Statement of problemThe vertical marginal discrepancy of restorations can increase upon cementation, and poor marginal fit can lead to cement dissolution, marginal discoloration, microleakage, and secondary caries. The amount of increase is related to the type of luting cement used, but how lithium disilicate pressed crowns are affected by different resin cements is unclear.PurposeThe purpose of this in vitro study was to compare the effect of using different resin luting cements on the vertical marginal discrepancy of lithium disilicate pressed crowns.Material and methodsA total of 18 intact extracted mandibular third molars were disinfected in a solution of 10% formalin for 7 days and were then prepared to receive a ceramic crown. Impressions were made with polyvinyl siloxane and lithium disilicate pressed crowns made and cemented with 1 of 3 resin luting cements. The marginal discrepancy was measured at 4 points on the finishing line of each tooth, with optical microscopy at ×200 magnification before and after cementation. Statistical analysis was done with the Kruskal-Wallis test to compare the median marginal increase among the 3 groups.ResultsThe least amount of marginal increase after cementation was with Harvard PremiumFlow cement, with an average marginal increase of 42 ±11 μm. RelyX Ultimate cement increased the margins by an average 45 ±29 μm. The highest marginal increase was found in the Enamel Plus HRi preheated composite resin group (116 ±47 μm).ConclusionsThe marginal increase of pressed crowns cemented with preheated composite resin (Enamel Plus HRi) exceeded the clinically acceptable range of marginal discrepancy.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zMnfr4
via IFTTT

Prosthodontic rehabilitation with monolithic, multichromatic CAD-CAM complete overdentures in an adolescent patient with ectodermal dysplasia: A clinical report

Publication date: Available online 15 November 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Hussain D. Alsayed, Nasser M. Alqahtani, Yasmin M. Alzayer, Dean Morton, John A. Levon, Nadim Z. Baba
Ectodermal dysplasia is a rare, hereditary, congenital disease that affects the normal development of certain tissues and structures of ectodermal origin. The disease is manifested to different degrees of severity and may involve the nose, eyes, hair, nails, sweat glands, and enamel. This report describes a 14-year-old boy with ectodermal dysplasia, rehabilitated with monolithic, multichromatic maxillary and mandibular computer-aided design and computer-aided manufacturing (CAD-CAM) acrylic resin complete overdentures.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hzYfZK
via IFTTT

Analysis of the golden proportion and width/height ratios of maxillary anterior teeth in Arab and Kurdish populations

Publication date: Available online 15 November 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Neda Al-Kaisy, Balkees Taha Garib
Statement of problemDentists providing anterior restorations are guided by the principles of anatomic tooth dimension. Dental biometrics should consider ethnicity to produce a more comprehensive evaluation.PurposeThe purpose of this clinical study was to analyze the anatomic crowns of maxillary central incisors (CI), lateral incisors (LI), and canines (C) with respect to the golden proportion (GP) and width/height (W/H) ratio in Kurdish and Arab populations.Material and methodsMaxillary gypsum casts were obtained from 100 participants (50 from a Kurdish and 50 from an Arab population). Standardized digital photographs of each cast were recorded. The apparent and actual anterior tooth dimensions were determined by ImageJ software for the calculation of the GP and W/H ratio. Data were statistically analyzed using ANOVA to investigate ethnic, sex, and arch side differences. The chi-square test was used to explore the GP, and the 1-sample t test was used to test the ideal W/H ratio (α=.05).ResultsThe GP was found in both the Kurdish and Arab groups in the LI/CI mean (0.62, 0.63), but not in the C/LI mean (0.69, 0.73). No difference due to sex was detected in the LI/CI in either ethnic group, but Kurdish men had significantly larger C/LI than women (0.73, 0.66, P=.006) and larger right-side LI/CI than left (0.63, 0.60, P=.049). The W/H ratio was higher than the predicted ideal ratio of 80% (range, 88% to 90%). The LI W/H ratio in Arabs was significantly larger than in Kurds (90.3% versus 82.7%, respectively; P<.001).ConclusionsThe GP was found to exist between the apparent widths of maxillary anterior teeth LI/CI for the both populations in both men and women but not for C/LI. No ideal ratio was detected for the W/H ratios. Specific population characteristics must be taken into consideration, especially when applying the proportions to Kurdish individuals.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zMndPY
via IFTTT

Modification of Makzoume vertical dimension recorder for individuals with a beard

Publication date: Available online 15 November 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Jitendra J. Mete, Ulhas E. Tandale, Vilas L. Rajguru, Sonali S. Dahiwale




from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hxWWKL
via IFTTT

Effect of coloring and sintering on the translucency and biaxial strength of monolithic zirconia

Publication date: Available online 15 November 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Nazmiye Sen, Ibrahim Bülent Sermet, Sevki Cinar
Statement of problemThe influences of coloring and sintering procedures on the optical and mechanical properties of monolithic zirconia have not been thoroughly investigated.PurposeThe purpose of this in vitro study was to investigate the effects of the coloring procedure and of varying final sintering temperatures on the translucency parameter (TP) and biaxial flexural strength (BFS) of monolithic zirconia.Material and methodsDisk-shaped specimens (N=210) of 2 different monolithic zirconia brands (Vita YZ HT^White [VYZa]; Vita YZ HT^Color A2 [VYZb]; Prettau Zirkonzahn [PZ]; Prettau Anterior Zirkonzahn [PZA]) with a diameter of 15 mm and a thickness of 1.0 ±0.05 mm were prepared. Half of the specimens prepared from noncolored blocks (VYZa, PZ, and PZA) received coloring liquid application. Then, the specimens were divided into 3 subgroups (n=10) according to the final sintering temperatures (1350°C, 1450°C, and 1600°C). The TP was determined by using a reflection spectrophotometer, and the BFS was tested with the piston-on-3-ball method in a universal testing machine. Data were statistically analyzed by multivariate multiple regression and Bonferroni tests (α=.05).ResultsSignificant differences were obtained among the groups based on the results of the TP and BFS (P<.05). The TP was affected by the changes in final sintering temperature. The varying final sintering temperatures demonstrated no significant effect on the BFS, except in group PZ (noncolored) that produced lower BFS when sintered at 1350°C than the subgroups sintered at 1450°C and 1600°C (P<.05). Coloring liquid application significantly decreased the TP of VYZa (sintered at 1350°C) but produced no significant effect on the groups PZ and PZA. Additionally, the coloring procedure had no significant effect on the BFS of tested materials (VYZa, PZ, and PZA) (P>.05).ConclusionsIncreased sintering temperature leads to increased translucency with minimal impact on the BFS. The coloring procedure should be considered at the time of material selection to avoid possible reduction in translucency.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zMmJJE
via IFTTT

Aluminum barrier laminate or plastic tube as a dispenser for modeling plastic impression compound for border molding

Publication date: Available online 15 November 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Jitendra J. Mete, Vilas L. Rajguru, Shankar P. Dange




from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwnqw5
via IFTTT

Marginal discrepancy of noble metal–ceramic fixed dental prosthesis frameworks fabricated by conventional and digital technologies

Publication date: Available online 15 November 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Ahmed Afify, Stephan Haney, Ronald Verrett, Michael Mansueto, James Cray, Russell Johnson
Statement of problemStudies evaluating the marginal adaptation of available computer-aided design and computer-aided manufacturing (CAD-CAM) noble alloys for metal–ceramic prostheses are lacking.PurposeThe purpose of this in vitro study was to evaluate the vertical marginal adaptation of cast, milled, and direct metal laser sintered (DMLS) noble metal–ceramic 3-unit fixed partial denture (FDP) frameworks before and after fit adjustments.Material and methodsTwo typodont teeth were prepared for metal–ceramic FDP abutments. An acrylic resin pattern of the prepared teeth was fabricated and cast in nickel-chromium (Ni-Cr) alloy. Each specimen group (cast, milled, DMLS) was composed of 12 casts made from 12 impressions (n=12). A single design for the FDP substructure was created on a laboratory scanner and used for designing the specimens in the 3 groups. Each specimen was fitted to its corresponding cast by using up to 5 adjustment cycles, and marginal discrepancies were measured on the master Ni-Cr model before and after laboratory fit adjustments.ResultsThe milled and DMLS groups had smaller marginal discrepancy measurements than those of the cast group (P<.001). Significant differences were found in the number of adjustments among the groups, with the milled group requiring the minimum number of adjustments, followed by the DMLS and cast groups (F=30.643, P<.001).ConclusionsMetal–ceramic noble alloy frameworks fabricated by using a CAD-CAM workflow had significantly smaller marginal discrepancies compared with those with a traditional cast workflow, with the milled group demonstrating the best marginal fit among the 3 test groups. Manual refining significantly enhanced the marginal fit of all groups. All 3 groups demonstrated marginal discrepancies within the range of clinical acceptability.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zMmG0q
via IFTTT

Stress generation in mandibular anterior teeth restored with different types of post-and-core at various levels of ferrule

Publication date: Available online 15 November 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Anatolii Savychuk, Marianthi Manda, Christos Galanis, Christofer Provatidis, Petros Koidis
Statement of problemPertinent evidence regarding the mechanical integrity of mandibular anterior teeth restored with a post-and-core is limited.PurposeThe purpose of this finite element analysis study was to compare the impact of the post type (glass fiber post-and-resin core or cast post-and-core) along with the ferrule effect on the stress fields generated in endodontically treated mandibular lateral incisors and canines.Material and methodsThree-dimensional models of the segmented mandible were developed. Mandibular incisors and canines with or without a 2-mm circular ferrule and restored with a cast post-and-core or glass fiber post-and-resin core were simulated and subjected to linear elastic static analysis. The principal stress values were calculated. von Mises equivalent stresses were used to evaluate the stress.ResultsMaximum principal stresses in dentin were highest in incisors, with a ferrule. Stress parameters in composite resin core in both incisors and canines were critically close to the tensile failure limit of the core material. Cast post-and-cores cemented in incisors without a ferrule accumulated the highest stresses, exceeding the tensile failure limit of resin-modified glass ionomer cement.ConclusionsTooth preparation with a ferrule led to a remarkable rise in stress in the dentin of mandibular incisors but favored the mechanical integrity of the restoration.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hxMgvH
via IFTTT

A 3D-printed guide for lateral approach sinus grafting: A dental technique

Publication date: Available online 15 November 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Brian J. Goodacre, Rajesh S. Swamidass, Jaime Lozada, Aladdin Al-Ardah, Erik Sahl
Lateral approach sinus grafting has become a routine and predictable surgical method of augmenting the pneumatized sinus for implant placement. Outlining the lateral window access can be a challenging task for the clinician to envision and execute. Improper extension and access to the maxillary sinus can prevent proper placement of graft materials and lead to complications. The purpose of this report was to demonstrate a technique that will allow the precise planning of the lateral approach using radiographic information and 3-dimensional (3D) software to 3D-print a surgical guide.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zMn2Ei
via IFTTT

Diagnostic accuracy of 4 intraoral radiographic techniques for misfit detection at the implant abutment joint

Publication date: Available online 15 November 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Pollyana Darós, Vinícius Cavalcanti Carneiro, Amanda Pasolini Siqueira, Sergio Lins de-Azevedo-Vaz
Statement of problemA misfit or gap at the implant–abutment joint (IAJ) requires detection as it may compromise the health of the peri-implant tissue. However, which radiographic technique provides the most orthogonal relationship between the central beam and the implant/image receptor is unclear.PurposeThe purpose of this in vitro study was to evaluate the diagnostic accuracy of 4 intraoral radiographic techniques on misfit detection at the IAJ.Material and methodsTwenty implants were placed in polyamide jaws, and customized dental implant abutments with a metal collar were installed. Different gaps were simulated by placing one or three 50-μm-thick polyester strips at the IAJ; the absence of the strip represented the control group (no gap). The 4 radiographic techniques were evaluated by using different film holders: a periapical with bisecting angle (PBA), a bitewing interproximal (BI), a periapical with standard paralleling (PSP), and a periapical with modified paralleling (PMP) holder (with a custom-made paralleling index). A total of 240 digital radiographs were evaluated by 4 clinicians experienced with dental implants. Differences were evaluated by using receiver operating characteristic (ROC) curves (Az) and Fisher tests (α=.05). Diagnostic values (sensitivity, specificity, accuracy, and positive and negative predictive values) were also obtained. The Kappa test was used to assess intra- and interevaluator reproducibility, which ranged from moderate to almost perfect.ResultsAll diagnostic values, except specificity, were lower for the PBA technique for both the 50- and 150-μm gaps. Az values for the PBA technique were significantly lower than those obtained for the other 3 techniques (P<.05), which did not differ from each other. The 150-μm gaps were more easily detected than the 50-μm gaps only for PBA (P<.05).ConclusionsThe BI, PSP, and PMP techniques detected misfits at the IAJ most accurately. The PBA technique is not recommended for this purpose.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwPEXJ
via IFTTT

Degree of conversion of resin cement with varying methacrylate compositions used to cement fiber dowels: A Raman spectroscopy study

Publication date: Available online 15 November 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Abdulelah M. BinMahfooz, Osama A. Qutub, Thamer Y. Marghalani, Mohammed F. Ayad, Abdulhamaid A. Maghrabi
Statement of problemStudies on the degree of conversion of dental cement in relation to the number of methacrylate components are lacking.PurposeThe purpose of this in vitro study was to evaluate the degree of conversion of single- and multicomponent methacrylate-containing dental cements around opaque and translucent fiber dowels at varying depths.Material and methodsTeeth were prepared for standard endodontic therapy, and a dowel space was created. Opaque and translucent fiber dowels consisting of Aestheti-Plus (AP) and FiberKleer were cemented with 4 methacrylate (MA)-containing cements, including RelyX U100 (R), which contains TEGDMA; Duolink (D), which contains TEGDMA and BisGMA; and Variolink N LC (V) and Breeze (B), which contain TEGDMA, BisGMA, and UDMA. Light-emitting diode polymerization was performed for 60 seconds. The specimens were immediately cut into halves and measured within the first hour at depths of 1, 3, and 5 mm using Raman spectroscopy, and the degree of conversion (DC) of resin cement was calculated. Data were analyzed using 3-way ANOVA and the Tukey multiple comparison test (α=.05).ResultsThe measured dowel regions were not significantly different at various depths (P=.10). The dowel and cement types significantly influenced the degree of conversion of the cement (P<.05). The V and B cements exhibited a higher DC than D and R cements. With AP dowels, the DC of cement D was lower than that of the V, B, and R cements.ConclusionsWithin the limitations of this in vitro study, the degrees of conversion of the tested resin cements were not affected by the tested dowel depths. Higher DC was found in cement with more than 2 types of flexible MA. Opaque dowels produced a lower DC than translucent dowels.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zMlU3x
via IFTTT

Esthetic abutment design for angulated screw channels: A technical report

Publication date: Available online 15 November 2017
Source:The Journal of Prosthetic Dentistry
Author(s): Satoshi Sakamoto, Munehiko Ro, Aladdin Al Ardah, Charles Goodacre
Angulated screw channel system abutments (ASCs) have recently been introduced to address the problem with visible screw access that may compromise esthetics. ASCs allow the screw access to be modified up to 25 degrees relative to the implant axis. However, a widened channel, which may cause thinning of the facial ceramic, is needed at the implant screw head to allow for proper engagement of the screwdriver. This technical report introduces a custom titanium insert design, the Satoshi Sakamoto (SS) abutment. The SS abutment consists of a custom titanium metal insert and zirconia coping in which the access hole is located in an esthetic position with an ASC system. The SS abutment results in a crown with more normal crown dimensions that also provides more space for the soft tissues. This SS abutment design allows clinicians to obtain screw-retained restorations with optimal esthetics and mechanical strength.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hxRwze
via IFTTT

A reflection and analysis about the tools in the assessment of bruxism

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zHOK5k
via IFTTT

Dopaminergic pathways for bruxism: a way forward?

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zKJWMk
via IFTTT

Asymmetric bone remodeling in mandibular and maxillary tori

Abstract

Objectives

Tori are frequent paucisymptomatic bony outgrowths of the oral cavity in three locations: torus palatinus (TP), mandibularis (TM), and maxillaris (TMax). Their usually described histological characteristics are unspecific: normal cortical bone with more or less trabecular bone. The aim of this study was to describe tori's specific morphological and histomorphometric characteristics.

Materials and methods

Histological characteristics in a series of 18 tori collected after surgical removal were analyzed. Microcomputed tomography provided a 3D analysis. Mineral apposition rate (MAR) was measured after double tetracycline labeling. Osteoid tissue was identified by Goldner's trichrome and osteoclasts by the tartrate resistant acid phosphatase identification in undecalcified sections. Iron and aluminum were detected by histochemical staining methods. Osteoid thickness and MAR were determined at the outer surface of the torus and in the Haversian canals.

Results

Tori appeared made of lamellar Haversian bone in 16/18 cases. Osteoid thickness did not differ between the outer surface and within the canals. An asymmetric bone remodeling was observed in the Haversian canals of 15 tori: osteoid seams were deposited on the side close to the free torus surface, and Howship's lacunae with numerous osteoclasts were observed on the opposite side. A high MAR was found at the surface of the tori and within the canals. There was no iron or aluminum deposit.

Conclusions

Tori may be characterized by a specific asymmetric bone remodeling which seems to determine their shape.

Clinical relevance

This finding could constitute a specific histological feature allowing to differentiate tori from exostoses.

Graphical abstract

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A7XJgK
via IFTTT

The elevated activation of NFκB and AP-1 is correlated with differential regulation of Bcl-2 and associated with oral squamous cell carcinoma progression and resistance

Abstract

Objectives

Oral cancer is the sixth most common cancer in the world. Failure of chemoradiation therapy is a major concern for treating oral cancer patients. The objective of this study is to determine the B cell lymphoma-2 (bcl-2) expression and its regulation by nuclear factor κB (NFκB) and activator protein 1 (AP-1) in oral cancer progression and chemoradiation resistance.

Materials and methods

In the present study, a total of 123 (n = 123) human samples were included. Briefly, 64 fresh samples were from adjacent normal (AN), primary oral tumors without treatment (PT), and tumors with resistance to chemoradiation therapy with local recurrence (RCRT). Fifty-nine samples were human tongue cancers and normal samples (TMA). Messenger RNA (mRNA) expression levels of bcl-2 and protein levels of bcl-2, NFκB, AP-1, and inactive GSK3α/β were measured by semiquantitative RT-PCR, immunohistochemistry, Western blot, and ChIP analysis.

Results

Increased bcl-2 expression was observed in PT compared to AN. The RCRT tumors showed maximum expression of bcl-2 mRNA and protein over the PT and AN groups. Bcl-2 protein and mRNA expression were positively correlated with NFκB and AP-1 expression. AP-1 expression was strongly correlated with bcl-2 in the RCRT group of tumors. Further, inactive GSK3α/β showed a positive trend with bcl-2 expression in oral tongue cancer specimens.

Conclusion

Collectively, our results demonstrated cumulative effect of AP-1 and NFĸB for bcl-2 gene regulation in overall PT progression and chemoradiation resistance. The study provides evidence of increased bcl-2 mRNA/protein fueled by NFĸB in PT and AP-1 in RCRT. These regulations of bcl-2 by NFκB and AP-1 are important in OSCC progression and chemoradiation resistance.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A6bk8b
via IFTTT

Four-year outcomes of restored posterior tooth surfaces—a massive data analysis

Abstract

Objectives

There is only sparse knowledge concerning the outcomes of treatments with posterior permanent restorations in general practice settings. This study aimed at evaluating outcomes based on a large dataset by using a novel approach on a tooth surface basis.

Materials and methods

The study based on routine data from a major German national health insurance company. Respective treatment fee codes allowed for tracking the clinical courses on a tooth surface level. The study intervention was defined as the placement of a restoration on an interproximal or occlusal posterior tooth surface regardless of its actual extension and material on which no information was available. All surfaces restored between January 1st, 2010 and December 31st, 2013 were included. Kaplan-Meier survival analyses were conducted to estimate four-year survival. The primary outcome was a restorative re-intervention on the same tooth surface. Separate analyses were performed for the secondary outcomes "crowning" and "extraction".

Results

Over ten million interproximal surfaces and eight million occlusal surfaces in nine million posterior teeth had been restored. At 4 years, the cumulative survival rates concerning the primary outcome "re-intervention" for mesial surfaces (81.4%; CI 81.3–81.5%) and distal surfaces (81.2%; CI 81.1–81.2%) differed significantly from those for occlusal surfaces (77.0%; CI 76.9–77.0%). Restored surfaces in premolars showed significantly higher survival rates compared to molars. Four-year survival rates for the secondary outcome "crowning" were 91.9% (CI 91.8—91.9%) for mesial surfaces, 92.1% (CI 92.1–92.2%) for distal surfaces and 93.3% (CI 93.2–93.3%) for occlusal surfaces. The respective rates for the secondary outcome "extraction" were 94.5% (CI 94.5–94.5%) for mesial surfaces, 94.8% (CI 94.7–94.8%) for distal surfaces and 95.4% (CI 95.4–95.5%) for occlusal surfaces.

Conclusions

Re-interventions after restorative treatment play a significant role in general practice settings. Surface-related survival rates of restorations reveal a need for improvement.

Clinical relevance

This study allows the estimation of the probability of re-interventions after restoring posterior tooth surfaces. It is based on several million cases from general practises under the terms and conditions of a national health insurance system.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A6TQsy
via IFTTT

Choto Family Dentistry coming

Darrel Clabough, D.D.S., left, and Tommy Spears, D.D.S., both of Maryville, are partnering to open Choto Family Dentistry in Markets at Choto. They said they hope to be open in March.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2j0qm4u
via IFTTT

Halitosis: effect of periodontal treatment

Eight low quality studies were included in this review of the effect of scaling and root planing, professional tooth cleaning together with oral hygiene instructions on halitosis. All the studies demonstrated a positive effect but the findings need to be interpret cautiously.

The post Halitosis: effect of periodontal treatment appeared first on National Elf Service.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zHJUoG
via IFTTT

How does sinus surgery affect topical irrigation distribution?.

Purpose of review: The current article reviews the literature on the distribution of nasal irrigation in the treatment of chronic sinusitis, especially in how sinus surgery and irrigation techniques affect its delivery to the nasal cavity and paranasal sinuses. Recent findings: Nasal irrigation has become a useful tool in the treatment of chronic sinusitis. Used after endoscopic surgery of the paranasal sinuses, irrigation has shown to be effective in improving edema and removing crusts and secretions in that place. However, some relevant points have been considered in the surgical technique and in the postoperative period to improve irrigation access to the paranasal sinuses such as the amplitude of the sinus ostial opening, irrigation volume and device used, as well as head position during irrigation. Summary: Postoperative lavage of the paranasal sinus is a recognized adjuvant in the treatment of chronic rhinosinusitis, reducing morbidity and improving local healing, besides allowing the association of topical medications that can be carried to the paranasal sinuses along with the saline increasing the reach of these drugs. Detailed attention to the techniques described in this review improves the distribution of irrigation in the paranasal sinuses after sinus surgery and considerably increases the efficacy of this therapy. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zNBmtT
via IFTTT

Potential Effect of Leukocyte-Platelet-Rich Fibrin in Bone Healing of Skull Base: A Pilot Study

Background. Reconstruction of surgical defects following cranial base surgery is challenging. Others have demonstrated that leukocyte-platelet-rich fibrin (L-PRF) stimulates tissue healing and bone regeneration. However, these studies have addressed mostly maxillofacial surgical wounds. Objective. The objective of this study was to assess the possible adjuvant role of L-PRF in inducing neoossification of the surgical bone defect in anterior skull base surgery. Methods. We identified patients who had undergone an endoscopic endonasal surgery of the anterior skull base in which L-PRF membranes were used for the reconstruction of the bone defect and who were followed up with postoperative CT scans. CT findings were then correlated with baseline scans and with the CT scans of a patient who had undergone imaging and histologic analysis after maxillofacial surgery in which L-PRF was used and in which we demonstrated bone formation. Results. Five patients fulfilled the inclusion criteria. In four patients, the CT scan demonstrated closure of the bony defect by neoosteogenesis; however, the bone appeared less dense than the surrounding normal bone. A comparison with the control patient yielded similar radiological features. Conclusion. This case series suggests that L-PRF may induce bone healing and regeneration at the surgical site defect. Multi-institutional studies with a larger series of patients are required to confirm this possibility.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwfv1I
via IFTTT

Cancer-related hypercalcemia in oral cancer

Cancer-related hypercalcemia (CRH) is a critical paraneoplastic disorder in advanced cancer patients. In clinical practice, patients with CRH have a poor prognosis. The medical records of 3198 oral cancer patients with CRH diagnosed at Taichung Veterans General Hospital from 1 January 2003 to 31 December 2015 were reviewed. The criteria for patient enrolment were a diagnosis of hypercalcemia or the use of antihypercalcemia medication. Patients who met any of the following criteria were excluded: use of total parenteral nutrition, incomplete serum calcium data, and unknown date of death. (Source: International Journal of Oral and Maxillofacial Surgery)

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2myBQBn
via IFTTT

Buccal Mucosal Epithelial Cells Downregulate CTGF Expression in Buccal Submucosal Fibrosis Fibroblasts

Abstract

Introduction

Oral submucosal fibrosis (OSMF) is a chronic debilitating fibrotic disease of the oral cavity and is a serious health hazard in south Asia and, increasingly, the rest of the world. The molecular basis behind various treatment modalities to treat OSMF still remains unclear. In this study, we have investigated the in vitro ability of the buccal mucosal cells to reduce the proliferation of the fibroblasts of the fibrotic area in co-culture of cells and also at the molecular levels to reduce the level of connective tissue growth factor (CTGF) in the OSMF fibroblasts (SMF-F).

Materials and Methods

The study compares isolation, morphological and proliferation kinetics of SMF-F and BMF cells with and without co-culturing with BMEs. In addition, we have compared the mRNA expression levels of CTGF in SMF-F co-cultured BME and non-co-cultured SMF-F cells using validated real-time quantitative PCR (RT-qPCR) method.

Results

The basic morphological characteristics of SMF-F were similar to BMF, but the former cells had higher proliferation rate in early passages compared to late passage state. We also observed that the CTGF expression levels in SMF-F under co-culture conditions of BME were consistently and significantly downregulated in all four different SMF-F-derived cells from four different patients.

Conclusion

Rapid proliferation and collagen synthesis in SMF-F as against BMF cells are the factors that confirm the innate nature of fibrosis fibroblasts (SMF-F). Further, the CTGF expression level in SMF-F was significantly suppressed by BME in co-culture conditions against controls (BMF). Considered together, this suggests that the cell therapeutic candidate of BME could be used in treating OSMF.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2APCkFc
via IFTTT

Piezoelectric versus conventional implant site preparation: A systematic review and meta-analysis

Abstract

Background

The use of a piezoelectric device (PED) for implant site preparation (ISP) has been introduced to overcome the limitations of using conventional drills (CDs). With little and inconsistent information in the literature regarding their efficiency for preparing implant osteotomies, the objective of this systematic review was to compare the use of CDs to PEDs for ISP with regard to implant stability values, marginal bone level changes, operating time, and dental implant failure rate.

Methods

The systematic review was prepared according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The literature was searched for studies that assessed the use of CDs and PEDs for ISP. The Cochrane Collaboration risk of bias tool was used to evaluate the selected studies and meta-analyses were performed using statistical software.

Results

A total of 755 citations were identified. Of these, 4 studies with 178 implant osteotomies in 80 participants were included. The pooled estimates for the implant stability showed significant differences between the 2 surgical techniques in favor of PEDs at baseline, 8 and 12 weeks. A statistically significant difference in the operating time was also shown between the 2 techniques with more time required using PED. The differences in marginal bone level changes or implant failure rate were not statistically significant.

Conclusions

With the limitations of this review in mind, PEDs appear to be a viable alternative to traditional drilling techniques for ISP. With the exception of prolonged operating time associated with the use of PEDs, both techniques were comparable in terms of the marginal bone level changes and the risk of implant failure. The favorable influence of the implant stability pattern related to the use of PEDs on the predictability of immediate and early loading protocols need to be confirmed in future studies.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hG90Nx
via IFTTT

Assessment of interleukin-1β, interleukin-6, and tumor necrosis factor-Α levels in the peri-implant sulcular fluid among waterpipe (narghile) smokers and never-smokers with peri-implantitis

Abstract

Background

It is hypothesized that levels of interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α are significantly higher in the peri-implant sulcular fluid (PISF) of waterpipe-smokers (WS) compared with never-smokers with peri-implantitis.

Purpose

The aim of the present convenience sample case-control study was to compare the levels of IL-6, IL-1β, and TNF-α in the PISF of WS and never-smokers with peri-implantitis.

Materials and methods

Demographic data was collected using a questionnaire. Peri-implant probing depth (PPD) was measured and crestal bone loss (CBL) was measured on digital bitewing radiographs. PISF samples were collected using paper strips and the collected PISF volume was determined. levels of IL-6, IL-1β, and TNF-α were measured using enzyme linked immunosorbent assay. Study sample-size was estimated and statistical analysis was performed. P values less than .05 were considered statistically significant.

Results

Sixty-six individuals (33 individuals in group-1 and 33 in group-2) were included. In groups 1 and 2, 41 and 44 implants, respectively were placed. The mean total PPD (P < .001) and peri-implant CBL (P < .001) was statistically significantly higher around implants affected by peri-implantitis in group-1 compared with group-2. The PISF volume (P < .05) collected and levels of IL-1β (P < .01), IL-6 (P < .01), and TNF-α (P < .01) were statistically significantly higher among individuals in group-1 compared with group-2.

Conclusion

WS with peri-implantitis present increased expression of local proinflammatory cytokines in the PISF than never-smokers.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jypoQQ
via IFTTT

Peri-implant parameters and C-reactive protein levels among patients with different obesity levels

Abstract

Background

It is hypothesized that peri-implant conditions are worse with increasing severity of obesity, because systemic low-grade inflammatory marker (C-reactive protein [CRP]) is higher in severe form of obese individuals.

Purpose

The aim of the cross-sectional retrospective study was to compare clinical and radiographic peri-implant inflammatory parameters in patients with different levels of obesity and correlate these parameters with CRP levels.

Materials and methods

Eighty-four patients who participated in this study were divided into 4 groups: class I obese (group 1), class II obese (group 2), class III obese (group 3), and nonobese individuals (group 4) were included. Clinical (plaque index [PI], bleeding on probing [BOP], probing depth [PD]) and radiographic (marginal bone loss [MBL]) peri-implant parameters were recorded. Serum CRP were quantified using enzyme-linked immunosorbent assay (ELISA). Clinical peri-implant parameters and serum CRP concentrations were analyzed using 1-way analysis of variance. The Pearson correlation coefficient was used to analyze correlations of CRP levels with any of the clinical and radiographic parameters assessed.

Results

Peri-implant PI, BOP, PD, and MBL were significantly higher in group-1, -2, and -3 patients as compared to nonobese individuals (P < .05). Peri-implant PI, BOP, PD, and MBL were significantly higher in obese patients of group-2 and group-3 as compared to obese patients in group-1 (P < .01). Mean PI, BOP, PD, and MBL were comparable between group-2 and group-3 patients (P > .05). A significant positive correlations were found between CRP levels and BOP (P = .0148) and PD (P = .0425); and significant negative correlation was found for MBL in group 3, respectively (P = .0212).

Conclusion

Clinical and radiographic peri-implant inflammatory parameters and serum CRP were significantly high in patients with severe form of obesity. Serum CRP levels correlated with peri-implant bleeding in obese patients. These findings are preliminary and long-term controlled trials are recommended to support these outcomes.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hG5mmQ
via IFTTT

LGR5 expression is regulated by EGF in early colorectal adenomas and governs EGFR inhibitor sensitivity

LGR5 expression is regulated by EGF in early colorectal adenomas and governs EGFR inhibitor sensitivity

LGR5 expression is regulated by EGF in early colorectal adenomas and governs EGFR inhibitor sensitivity, Published online: 16 November 2017; doi:10.1038/bjc.2017.412

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hxeqqt
via IFTTT

Cumulative incidence rates for CNS and non-CNS progression in two phase II studies of alectinib in ALK-positive NSCLC

Cumulative incidence rates for CNS and non-CNS progression in two phase II studies of alectinib in ALK-positive NSCLC

Cumulative incidence rates for CNS and non-CNS progression in two phase II studies of alectinib in <i>ALK</i>-positive NSCLC, Published online: 16 November 2017; doi:10.1038/bjc.2017.395

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zJJ7Dj
via IFTTT

Reply to ‘Comment on ‘Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study’’

Reply to 'Comment on 'Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study''

Reply to 'Comment on 'Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study'', Published online: 16 November 2017; doi:10.1038/bjc.2017.406

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwYODl
via IFTTT

Comment on ‘Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study’

Comment on 'Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study'

Comment on 'Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study', Published online: 16 November 2017; doi:10.1038/bjc.2017.342

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zMBqMA
via IFTTT

Treponema denticola chymotrypsin-like proteinase may contribute to orodigestive carcinogenesis through immunomodulation

Treponema denticola chymotrypsin-like proteinase may contribute to orodigestive carcinogenesis through immunomodulation

<i>Treponema denticola</i> chymotrypsin-like proteinase may contribute to orodigestive carcinogenesis through immunomodulation, Published online: 16 November 2017; doi:10.1038/bjc.2017.409

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hvJIhv
via IFTTT

NPDS Seeking Patients needing Root Canal Treatment

The Endodontics Department at the Naval Postgraduate Dental School, Bethesda, MD, is currently accepting new patients in need of root canal treatment by our residents. If your dentist has told you that you need a root canal or you are having tooth pain and you have been putting off having a root canal, contact us for a consultation.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hzqYOk
via IFTTT

Fruit and vegetable intake and cognitive impairment: a systematic review and meta-analysis of observational studies

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A6ByYn
via IFTTT

Editorial board

Publication date: December 2017
Source:Calphad, Volume 59





from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zKuCiO
via IFTTT

The use of fibrin glue to stabilize geometry of free-flaps vascular pedicle

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A4Dgcx
via IFTTT

Alveolar Osteitis and Third Molar Pathologies

We read with great interest the article published in your valuable journal, "Does Administration of Oral Versus Intravenous Antibiotics for Third Molar Removal Have an Effect on the Incidence of Alveolar Osteitis or Postoperative Surgical Site Infections?" by Reiland et al.1 Antibiotics administration in third molar (3M) surgery is an endearing concept in oral surgery and we commend the authors for their excellent literature review and study population. However, we would like to raise some important points.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ANitH3
via IFTTT

Alveolar Osteitis and Third Molar Pathologies

We read with great interest the article published in your valuable journal, "Does Administration of Oral Versus Intravenous Antibiotics for Third Molar Removal Have an Effect on the Incidence of Alveolar Osteitis or Postoperative Surgical Site Infections?" by Reiland et al.1 Antibiotics administration in third molar (3M) surgery is an endearing concept in oral surgery and we commend the authors for their excellent literature review and study population. However, we would like to raise some important points.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ANitH3
via IFTTT

Surgical Treatment of Fibroosseous Lesion in Young Patient with Reduced Mouth Opening

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1608697

Fibrous dysplasia is a benign fibroosseous disorder that can affect the maxillary bones, causing aesthetic deformity and functional impairment. This article reports the case of a 13-year-old male patient at the time of diagnosis. The patient showed increased facial volume with relevant asymmetry, having reported the onset of the condition 12 months before. Upon examination, the patient presented an 8-mm mouth opening and an acute inflammatory process associated with tooth 37 pericoronal hood. Upon imaging exam, exuberant bone growth in the left mandibular ramus area of ground glass aspect was observed. After incisional biopsy, fibrous dysplasia was diagnosed and sequentially treated with osteoplasty and coronoid process removal. The patient evolved to a 43-mm mouth opening and favorable aesthetics without recurrence in a 3-year follow-up period. In this case, coronoidectomy and bone plasty proved to be effective, returning aesthetics and function. The patient is supposed to be followed up in the long term.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ANG36p
via IFTTT

Treponema denticola chymotrypsin-like proteinase may contribute to orodigestive carcinogenesis through immunomodulation

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jxuEEm
via IFTTT

Reply to ‘Comment on ‘Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study’’

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hFwPVI
via IFTTT

Comment on ‘Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study’

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jxuE7k
via IFTTT

LGR5 expression is regulated by EGF in early colorectal adenomas and governs EGFR inhibitor sensitivity

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hFrePi
via IFTTT

Cumulative incidence rates for CNS and non-CNS progression in two phase II studies of alectinib in ALK-positive NSCLC

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jyKWNh
via IFTTT

Pathology and management of mass in accessory parotid gland region: 24-year experience at a single institution

Masses in the accessory parotid gland (APG) region are clinically rare and their management can lead to conflicts between the need for tumor resection and facial cosmesis. The aim of this study was to analyze the pathological classifications and management of APG lesions in our hospital.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yPhsh3
via IFTTT

Anticoagulants are dental friendly

The Clinicians Report newsletter is an invaluable resource for cutting-edge clinical and scientific information for practicing dentists throughout the United States and the world. While we appreciate that the important issue of dental surgery in anticoagulated patients was the topic of "Anticoagulants: are they dental friendly or not?" in the September 2017 issue,1 this article overstates the bleeding risk in anticoagulated dental patients and understates the embolic risks with interruption of anticoagulation for dental procedures, and we respectfully take issue with it for the reasons below.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zJzO6M
via IFTTT

Letter to the editor: Comments in relation to the CPC case entitled: “Submucosal nodule in buccal mucosa” Oral Surg Oral Med Oral Pathol Oral Radiol 2016;122:660-665.1

We read with great interest the clinicopathological conference published by Dairot et. al. entitled "Submucosal nodule in buccal mucosa". We reviewed the virtual slides. Histologically, the tumor shows a cribriform pattern with capsular invasion and extra-capsular invasion, the latter is evident in the virtual slides, but not in the published pictures. Basal Cell Adenoma (BCA) of the minor salivary glands is a rare, and we were able to find a single article2 describing capsular invasion. Wilson and Robinson (2014)3 have reported that morphologic observation of local tissue invasion is the best parameter for differentiation BCA from Basal Cell Adenocarcinoma.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A5oYIN
via IFTTT

A symptomatic swelling of the upper lip

A 67-year-old woman presented to the School of Dentistry of the Federal University of Pelotas, Brazil, complaining about a slightly painful swelling of the upper lip, lasting around 5 years. The pain was not triggered or aggravated by cold or touch. Intraoral examination showed a 1.0-cm well-defined, sessile, slightly mobile, fibrous submucosal nodule on the right upper lip. The color of the lesion was similar to the adjacent normal mucosa (Figure 1). No other contributing information was collected from the anamnesis.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zInGTx
via IFTTT

Fruit and vegetable intake and cognitive impairment: a systematic review and meta-analysis of observational studies

Fruit and vegetable intake and cognitive impairment: a systematic review and meta-analysis of observational studies

Fruit and vegetable intake and cognitive impairment: a systematic review and meta-analysis of observational studies, Published online: 17 November 2017; doi:10.1038/s41430-017-0005-x

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2j07933
via IFTTT

Comparison of three different adenoidectomy techniques in children - has the conventional technique been surpassed?

Pharyngeal tonsil hyperplasia is the most frequent cause of nasal obstruction and chronic mouth breathing during childhood. Adenoidectomy is the procedure of choice for the resolution of these symptoms. It is not yet known, however, whether the conventional technique ("blind curettage") has been surpassed by more modern adenoidectomy techniques (video-assisted, with the aid of instruments). This study aimed to compare the conventional adenoidectomy technique with two other emerging techniques, performed in a reference otorhinolaryngology center.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zRfv57
via IFTTT

Germinal mosaicism of PAX3 mutation caused Waardenburg syndrome type I

Waardenburg syndrome mutations are most often recurrent or de novo. The rate of familial recurrence is low and families with several affected children are extremely rare. In this study, we aimed to clarify the underlying hereditary cause of Waardenburg syndrome type I in two siblings in a Chinese family, with a mother affected by prelingual mild hearing loss and a father who was negative for clinical symptoms of Waardenburg syndrome and had a normal hearing threshold.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2j0raWZ
via IFTTT

Musculo-mucous web velum and velopharyngeal dysfunction associated with 8q22.1–22.2 microduplication

This report presents a rare case of isolated non-cleft velopharyngeal dysfunction (VPD). An eight-year-old child presented 1. aphenotypically unique band-gap pattern of the velar musculature with anteroposterior insertion; 2. a mosaic partial trisomy on chromosome 19 as well as microduplications on chromosomes 8 and 22. Following cytogenetic analysis, microduplication on chromosome 8 was found in another member of her family. A family history of VPI with hypernasality and nasal regurgitation was reported over three different generations on the patient's maternal side.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zOqps2
via IFTTT

Diagnosis of Mesiodistal Vertical Root Fractures in Teeth with Metal Posts: Influence of Applying Filters in Cone-beam Computed Tomography Images at Different Resolutions

The aim of this article was to evaluate the influence of applying filters in cone-beam computed tomography (CBCT) images at different resolutions. These CBCT images were obtained for diagnosing mesiodistal vertical root fractures (VRFs) in teeth with metal posts.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ip5Z1j
via IFTTT

Influence of Mixed Additives on the Physicochemical Properties of a 5.25% Sodium Hypochlorite Solution: An Unsupervised Multivariate Statistical Approach

This article reports for the first time the effects of multiple additives (polyethylene glycol 400, Triton X-100, benzalkonium chloride, and ethyl formate) on the surface tension, pH, and viscosity of 5.25% sodium hypochlorite (NaOCl) irrigant solution. Advanced statistical approaches based on unsupervised multivariate analysis (cluster analysis and principal component analysis) were used to quantify the variability of the physicochemical properties of the modified NaOCl solution for the first time in dentistry.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ANAm8x
via IFTTT

A judge decided this Brampton dentist is allowed to practise despite...

A court has reinstated the licence of a Brampton dentist and part-time standup comedian who, according to the judge's ruling, admitted to police and a psychiatrist that he masturbated in front of teenage girls in Florida this year. In a decision that has left Ontario's dental regulator "very disappointed," Superior Court Justice Nancy Spies ordered last week that a suspension on the licence be lifted immediately and that the Royal College of Dental Surgeons of Ontario pay Dr. Ron Rohringer $20,000 in court costs.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ATcxwO
via IFTTT

Cancer-related hypercalcemia in oral cancer

Cancer-related hypercalcemia (CRH) is a critical paraneoplastic disorder in advanced cancer patients. In clinical practice, patients with CRH have a poor prognosis. The medical records of 3198 oral cancer patients with CRH diagnosed at Taichung Veterans General Hospital from 1 January 2003 to 31 December 2015 were reviewed. The criteria for patient enrolment were a diagnosis of hypercalcemia or the use of antihypercalcemia medication. Patients who met any of the following criteria were excluded: use of total parenteral nutrition, incomplete serum calcium data, and unknown date of death.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLb51p
via IFTTT

Submental tracheal intubation: A useful alternative during orthognathic surgery in an acromegalic patient with a history of cranial base surgery

Publication date: Available online 15 November 2017
Source:Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
Author(s): Ryosuke Kita, Seiji Kondo, Mika Seto, Masayasu Hirase, Kyoichi Narihira, Ryosuke Mano, Shiho Tanaka, Toshihiro Kikuta
Submental tracheal intubation is an alternative technique for use in patients with airway difficulties in whom oro- or naso-tracheal intubation is contraindicated. Here, a planned submental tracheal intubation was used during orthognathic surgery in an acromegalic patient who had previously undergone trans-sphenoidal surgery (TSS) for removal of a pituitary adenoma, which involves removal of the sellar bone covering the anterior surface of the cavernous sinus. This helped prevent serious complications, such as intracranial penetration during nasotracheal intubation. Submental tracheal intubation can reduce the morbidity associated with repeated attempts at tracheal intubation in acromegalic patients who have undergone cranial base surgery and in whom orthognathic surgery is planned.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zHWyDZ
via IFTTT

Peripheral facial palsy after set-forward orthognathic surgery: A case report and review of literature

Publication date: Available online 15 November 2017
Source:Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
Author(s): Eiji Mitate, Jun-Nosuke Hayashida, Takeshi Toyoshima, Takeshi Noguchi, Toru Kitahara, Ichiro Takahashi, Tetsuro Ikebe, Seiji Nakamura
The complications of orthognathic surgery may include but are not limited to postoperative unexpected bleeding, abnormal fractures, infections, and nerve damages. Peripheral facial palsy is rare. We report a case of 23-year-old woman with signs of malocclusion, including pectus excavatum, wrist sign, and thumb sign for Marfan syndrome (MFS) underwent peripheral facial palsy after orthognathic surgery with mandibular advancement. Because cardiovascular, thoracic, and ocular abnormalities were absent, she was suspected of having MFS but not definitively diagnosed. On the other hand, she was diagnosed with a maxillary protrusion with mandibular retrognathism. After presurgical orthodontic treatment, we performed Le Fort I osteotomy and 8mm advancement by bilateral sagittal split ramus osteotomy. Because the periosteum is vulnerable, we checked the bleeding more are fully and frequently during the operation than usual. The day after the operation, peripheral facial palsy with inability to wrinkle the forehead, blink, and grimace were found. The patient was administered mecobalamin, linear polarized infrared irradiation, and stellate ganglion blocks. The patient was also administered valacyclovir for 6days and steroid pulse therapy for 7days. Six months after the operation, the facial palsy had disappeared completely.In 58 previous reports, the facial palsy was induced by the reasons, including the operative procedure, postoperative hematoma, edema, perioperative stress, and tissue vulnerability. In the present case, because of the suspected MFS, tissue vulnerability was considered to be one of the major cause of facial palsy, which should be paid attention more carefully in addition to general causes.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A5RmdX
via IFTTT

A novel method to prevent biting through nasolabial flap: Modified oral screen

Publication date: Available online 15 November 2017
Source:Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
Author(s): Zainab Chaudhary, Ranjeet Bodh, Pankaj Sharma, Sujata Mohanty, Anjali Verma
ObjectiveOral submucous fibrosis (OSMF) is a chronic, progressive precancerous condition of oral mucosa, predominantly seen in the Indian subcontinent. This technical note describes the use of oral screen prosthesis used as an adjunct to surgery to prevent relapse following surgical correction.MethodsThe modified oral screen appliance was inserted in the patient's labial and buccal vestibule as oral screen. The appliance was intended to be used as an oral stent along with mouth exercises to counteract relapse of the corrected mouth opening.ResultsThe possibility of flap shrinkage and interference with occlusion results in surgical failure of the treatment of OSMF. Securing the flap in position using oral screen prosthesis has been tried as an adjunct to treat such cases.ConclusionsThis modified approach can be performed in routine clinical practice, making the rehabilitation of such a case possible with relative ease.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zHXnwP
via IFTTT

A case of chondrosarcoma in the temporomandibular joint

Publication date: Available online 15 November 2017
Source:Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
Author(s): Kenji Fukada, Toshihiro Okamoto, Noriyuki Shibata, Tomohiro Ando
We report a case of a 78-year-old woman with chondrosarcoma in the temporomandibular joint. On examination, swelling of the right preauricular region and pain when opening the mouth was observed. Imaging revealed an irregular-shaped radiopaque mass in the right mandibular condyle with bone resorption. After performing tumorectomy under general anesthesia, histopathological examination revealed that tumor cells had slightly hyperchromatic nuclei that lacked significant pleomorphism, displayed polygonal or stellate profiles of the soma, and formed nodular nests in the homogeneous fibrous cartilage matrix. The pathological diagnosis was chondrosarcoma, Grade II of the right temporomandibular joint.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zHW9Bt
via IFTTT

Residual cementoblastoma: An unusual presentation of a rare odontogenic tumor

Publication date: Available online 15 November 2017
Source:Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology
Author(s): Lucas Ribeiro Teixeira, Jessica Luana dos Santos, Luciana Yamamoto Almeida, Carla Bento Nelem-Colturato, Ricardo Ferreira de Paula, Fernando Radaelli Osório Oliveira, Jorge Esquiche León
Cementoblastoma is a benign ectomesenchymal odontogenic tumor characterized by the formation of cementum mass continuous with the tooth root, preferentially a permanent mandibular first molar. Clinically, the tumor shows a tender, sometimes painful, cortical plate expansion, frequently in male patients under 30 years old. Radiographically, the lesion exhibits a radiopaque mass, surrounding by a thin radiolucent rim, and attached to the tooth root. Microscopically, it is visualized a calcified matrix lined by large hyperchromatic cementoblasts with radiating columns at the periphery. Treatment of choice is surgery. Interestingly, rare cases of residual (after tooth extraction only) and recurrent (after tumor removal plus tooth extraction) cementoblastomas have been reported, which can be misdiagnosed if an appropriate clinicopathological correlation is not considered. Here, we present a rare case of residual cementoblastoma affecting an 18-year-old male patient at level of permanent mandibular first molar. Thus, residual cementoblastoma is an unusual presentation which should be included in the differential diagnosis of cementum-forming and bone-forming tumors affecting the jaws.



from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A5Ft7D
via IFTTT

Exposure to a community-wide campaign is associated with physical activity and sedentary behavior among Hispanic adults on the Texas-Mexico border

Despite evidence for the use of community-wide campaigns to promote physical activity, few evaluations of community–wide campaigns in Hispanic communities exist. This study assessed the associations of exposur...

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2z8Hwbf
via IFTTT

Impact of a decision aid about stratified ovarian cancer risk-management on women’s knowledge and intentions: a randomised online experimental survey study

Risk stratification using genetic and other types of personal information could improve current best available approaches to ovarian cancer risk reduction, improving identification of women at increased risk o...

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2mxqb5T
via IFTTT

Cosmetic and Reconstructive Surgery of Congenital Ear Deformities

It is my privilege and great pleasure to introduce this issue of Facial Plastic Surgery Clinics of North America with a comprehensive focus on cosmetic and reconstructive surgery of congenital ear deformities. First and foremost, I wish to thank sincerely our many wonderful authors who graciously offered their time, commitment, and world-class expertise in this specialty subject for the benefit of our readership.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jyU9p2
via IFTTT

Forthcoming Issues

Controversies in Facial Plastic Surgery

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hEFW9b
via IFTTT

Cosmetic Otoplasty

Otoplasty for prominent ears is a rewarding yet exacting surgery that demands the precise application of anatomic knowledge, anthropometric norms, and surgical creativity. The practitioner must be able to use a variety of different techniques to provide durable and acceptable cosmetic results to patients. This article provides an in-depth description of normal and abnormal auricular anatomy, the historical context for modern otoplasty, and describes in detail the common otoplastic procedures currently performed.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jt1oyB
via IFTTT

Contents

Scott Stephan

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hEFV57
via IFTTT

Autologous Rib Microtia Construction

Nagata technique becomes most popular method of autologous rib microtia construction. To achieve successful outcome, 3 keys must be perfect: skin envelope, 3D cartilage framework, and proper location of the construct. The first step of the surgery is to identify "auricular rectangle." Relationship between the auricular rectangle and the vestige will determine if the vestige is usable for surgery. Rib cartilage must be harvested without perichondrium to prevent chest deformity. Lobule split technique is the hallmark of the Nagata technique, which allows skin envelope expansion, and allows deeper conchal cavity. Surgeons must master 3D framework construct before clinical cases.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2js9F5M
via IFTTT

Contributors

J. REGAN THOMAS, MD, FACS

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hEFTu1
via IFTTT

Surgical Otoplasty

Otoplasty is one of the first procedures learned during residency. A myriad of surgical techniques and nuances exist. Many have merit, some are ineffective, some destructive, and some frankly fanciful. Adopting an effective and safe technique should be based on proven efficacy and effectiveness to avoid early disappointments. We present a review of traditional otoplasty techniques and more recent innovations. Their pros and cons are discussed in view of the relative risks/benefits balance. Recurrence rates are low for most techniques. Some techniques carry a higher risk of significant complications. A ladder approach preferring techniques that minimize cartilage damage appears advisable.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jtpVU7
via IFTTT

Copyright

ELSEVIER

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hEFR5n
via IFTTT

Auricular Prostheses in Microtia

The progress made in the development of the silicones and percutaneous titanium implants allow for rehabilitation of patients with microtia with an inconspicuous auricular prosthesis. The art of making the prosthesis by the dedicated anaplastologist is the key for the success of this approach. Most patients with microtia desire camouflage. The greatest advantage of the auricular prosthesis is that it can be manufactured as a mirrored replica of the opposite side. The outcome is predictable. Computer science with virtual planning and rapid prototyping is about to revolutionize the process of prosthetic auricular rehabilitation.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jvf102
via IFTTT

Cosmetic and Reconstructive Surgery of Congenital Ear Deformities

FACIAL PLASTIC SURGERY CLINICS OF NORTH AMERICA

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hD4OhC
via IFTTT

Atresiaplasty in Congenital Aural Atresia

Patients with microtia and congenital aural atresia should have a comprehensive hearing assessment early in life. Options for hearing habilitation should be presented, and children with bilateral aural atresia should be fitted with a bone conducting hearing device to support normal speech and language development. If atresia surgery is pursued, the microtia surgeon must be aware of certain principles. This article presents recommendations on options for potentially improving hearing in children with congenital aural atresia: assessing surgical candidacy; chronology and timing of surgeries; functional importance of certain ear structures; and understanding the possible locations of an aberrant facial nerve to avoid injury in these patients.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jvBqdQ
via IFTTT

Otoplasty for Congenital Auricular Malformations

Among the less common congenital auricular anomalies are cryptotia, Stahl ear, constricted ear, and macrotia. The vast majority of these occur spontaneously without accompanying syndromes or other deformities. This article provides a comprehensive overview of these anomalies, as well as common techniques to correct these anomalies.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jwmxaZ
via IFTTT

Pediatric Microtia Reconstruction with Autologous Rib

Reconstruction of the microtic ear is one of the most challenging, yet gratifying surgical experiences. Careful planning, attention to detail, and conservative tissue management are necessary for excellent results. Technologies continue to evolve; with the advancement of cartilage tissue engineering, the future of ear reconstruction is very promising.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hEFJmp
via IFTTT

Nonsurgical Management of Congenital Auricular Anomalies

Congenital auricular deformities often can be corrected by neonatal ear molding techniques, which have evolved significantly over a 25-year period with commercially available molding systems now available. Indications for molding and methodology for best optimizing results have been well described in the literature, although recent studies have explored methodology for reduction in the cost of technique and also called for increased awareness among pediatric practitioners of the importance of early institution of therapy.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2juGijx
via IFTTT

Lipari Foods, LLC. Issues Voluntary Product Recall of Specific Dark Chocolate Products Due to Undeclared Milk Allergen

Lipari Foods, LLC has issued a voluntary recall of specific dark chocolate products packaged by sister company JLM due to an undeclared milk allergen. People who have an allergy or severe sensitivity to milk run the risk of a serious or life-threatening allergic reaction if they consume these products. The products are safe for consumption by those who do not have an allergy or severe sensitivity to milk.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zId1rR
via IFTTT

Faster tectonic-plate collisions spell bigger earthquakes

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLoLta
via IFTTT

Arecibo telescope wins reprieve from US government

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zK2AUE
via IFTTT

In reply

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2juZxsZ
via IFTTT

Europe sets priorities for hunting cosmic particles

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zJX3gE
via IFTTT

Comparison of diagnostic methods for early interproximal caries detection with near-infrared light transillumination: an in vivo study

Abstract

Background

Although numerous studies have used digital intraoral imaging, only a few studies have used photo-optical methods for the diagnosis of caries. Moreover, several limitations exist in terms of observers (experience and specialty) and the caries lesion itself. Hence, the aims of this study were to evaluate the diagnostic capability of near-infrared light transillumination (NILT) and PSP-Bitewing radiographs and to compare the interobserver and intraobserver differences in addition to observers' experience level to detect early interproximal caries lesions in vivo.

Methods

A total of 52 untreated posterior teeth with and without varying degrees of early interproximal carious lesions were included. Bitewing radiographs using digital phosphor plates (PSP-Bitewing) and NILT were used to clarify the diagnosis. An oral and maxillofacial radiologist and a restorative dentistry consultant evaluated the images twice. A separate appointment for clinical validation and restoration was made. Kappa coefficients were calculated to assess both intraobserver and interobserver agreements for each evaluation method. Scores obtained from PSP-Bitewing and NILT were compared with the clinical validation via receiver operating characteristic (ROC) analysis.

Results

No significant differences were found between PSP-Bitewing radiography and NILT for detecting early interproximal carious lesions with high average Az results. Both intraobserver and interobserver agreement values were relatively higher for NILT evaluation. The Az values increased at second evaluations for both caries detection methods.

Conclusions

NILT examination has an appropriate sensitivity and diagnostic accuracy for detecting early interproximal caries lesions and can be considered as a method of choice for detecting caries without the use of ionizing radiation.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2mwecFH
via IFTTT

Peak Airflow Measurement in Patients With Glottic Insufficiency After Vocal Fold Augmentation

This case series study evaluates changes in peak airflow after vocal fold augmentation among patients with glottic insufficiency.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwo8JT
via IFTTT

Implementing Quality Improvement and Patient Safety in Residency Education

This Viewpoint discusses practical strategies for implementing successful resident-led patient safety and quality improvement initiatives in otolaryngology–head and neck surgery residency education.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLOge0
via IFTTT

Association of Enrollment in an Aerodigestive Clinic With Reduced Hospital Stay

This study examines the association of enrollment in a multidisciplinary aerodigestive clinic with comprehensive and coordinated care with reduced frequency of inpatient admissions and overall hospital days for children with special health care needs.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2xQyb20
via IFTTT

Anesthesia Exposure and Neurotoxicity in Children

This Viewpoint discusses the implications for otolaryngologists of a recent US Food and Drug Administration warning about the association between anesthesia exposure and neurocognitive deficits in children.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLOdik
via IFTTT

November 2017 Issue Highlights

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwo6BL
via IFTTT

The End of the Road

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLftxs
via IFTTT

Survival Outcomes for T3N0M0 Squamous Cell Carcinoma of the Glottic Larynx

This cohort study defines outcomes in patients with clinical T3N0M0 glottic laryngeal cancer treated with definitive surgical and radiotherapy-based approaches.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yzBLkW
via IFTTT

Reporting of Effect Size and Confidence Intervals

This study evaluates the frequency of reporting effect sizes and confidence intervals in the results of analytical studies from JAMA Otolaryngology–Head & Neck Surgery.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLfotE
via IFTTT

Error in Byline

In the Observation titled "Double Parathyroid Adenomas in Monozygotic Twins," published online September 28, 2017, there was an error in the byline. Where it previously read Brendan R. Stack, it now correctly reads Brendan C. Stack Jr. This article was corrected online.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwo1hr
via IFTTT

Laryngoscopic Findings and Response to Gabapentin

This cohort study examines the use of gabapentin in patients with chronic cough when vocal fold motion asymmetry is noted on videostroboscopy.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLfmC2
via IFTTT

Measuring Institutional Quality in Head and Neck Surgery Using Hospital-Level Data

Using data from the National Cancer Database, this study examines the association of negative margin rate and lymph node yield with survival in patients with head and neck squamous cell carcinomas at the hospital level.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yzJLCi
via IFTTT

Prognosis of 5-Year Survival of Chemoradiotherapy-Treated Patients With Nasopharyngeal Carcinoma

This cohort study evaluates outcomes data and the American Joint Committee on Cancer staging system to improve the accuracy of the 5-year survival prognosis for patients with nasopharyngeal carcinoma who underwent chemoradiotherapy.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwnSdT
via IFTTT

Nationwide Variation in Rates of Thyroidectomy Among US Medicare Beneficiaries

This cross-sectional analysis of Medicaid data examines variability across US regions for rates of thyroid surgery among Medicaid beneficiaries.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2xQk9gS
via IFTTT

Extracapsular Dissection vs Superficial Parotidectomy

This study reviews all parotidectomies at a single institution conducted by head and neck surgeons to compare extracapsular dissection with superficial parotidectomy for benign parotid tumors with respect to surgical outcomes and cost-effectiveness.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwyk55
via IFTTT

Interferon-γ Treatment of Human Laryngotracheal Stenosis–Derived Fibroblasts

This in vitro controlled study assesses whether the helper T cell 1 cytokine interferon-γ inhibits laryngotracheal stenosis–derived fibroblast function in patients undergoing surgical subglottic and tracheal dilation.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zO6s4M
via IFTTT

Minimal Important Difference in Voice Handicap Index–10

This cohort study estimates the minimal important difference in the Voice Handicap Index–10 total score among patients at a university voice clinic.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2xQihow
via IFTTT

Double Parathyroid Adenomas in Monozygotic Twins

This is a report of a case of primary hyperparathyroidism in a pair of genetically identical individuals.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2xQjYSX
via IFTTT

Krouse Classification for Sinonasal Inverted Papilloma With Recurrence

This systematic review and meta-analysis evaluates the existing literature on sinonasal inverted papilloma to assess the association between the Krouse classification and the rate of recurrence.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yzNSOO
via IFTTT

JAMA Otolaryngology–Head & Neck Surgery

Mission Statement:JAMA Otolaryngology–Head & Neck Surgery provides timely information for physicians and scientists concerned with diseases of the head and neck. Given the diversity of structure and function based in this anatomic region, JAMA Otolaryngology–Head & Neck Surgery publishes clinical, translational, and population health research from an array of disciplines. We place a high priority on strong study designs that accurately identify etiologies, evaluate diagnostic strategies, and distinguish among treatment options and outcomes. Our objectives are to (1) publish original contributions that will enhance the clinician's understanding of otolaryngologic disorders, benefit the care of our patients, and stimulate research in our field; (2) forecast important advances within otolaryngology—head and neck surgery, particularly as they relate to the prevention, diagnosis, and treatment of disease through clinical and translational research, including that of the human genome and novel imaging techniques; (3) address questions of clinical outcomes and cost-effectiveness that result from clinical intervention, which grow in importance as health care providers are increasingly challenged to provide evidence of enhanced survival and quality of life; (4) provide expert reviews of topics that keep our readers current with true advances and also to provide a valuable educational resource for trainees in the several disciplines that treat patients with diseases of the head and neck; (5) serve as a forum for the concerns of otolaryngologists such as socioeconomic, legal, ethical, and medical issues; (6) provide helpful critiques that enable contributing authors to improve their submissions. We encourage a concise presentation of information and employ an abstract format that efficiently assesses validity and relevance from a clinical perspective. This approach promotes succinct yet complete presentation for our readers and electronic information resources. We believe this approach typifies the commitment of JAMA Otolaryngology–Head & Neck Surgery to providing important information that is easily interpreted by its diverse readership.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zNPX8N
via IFTTT

Unusual Cause of Recurrent Meningitis

This case report describes a synchronous cerebrospinal fluid fistulae through the oval and round window membranes in a patient with recurrent meningitis.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hwsHUk
via IFTTT

Analysis of the Growth Pattern of Thyroid Cancer in Young Patients

This observational study evaluates the change in diameter and volume of malignant thyroid tumors in children after a nuclear accident in Fukushima, Japan.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zJ17xD
via IFTTT

Rethinking the Growth Pattern of Thyroid Cancer in Young Patients Based on the Fukushima Database

In response to public concern over radiation exposure after the Fukushima Daiichi nuclear power plant accident of March 11, 2011, the Health Survey of Fukushima Prefecture offered thyroid ultrasonography screening to the 360 000 residents 18 years or younger living in the prefecture at the time of the accident. Approximately 300 000 patients underwent preliminary screening in the 2011 to 2013 period during which radiation effects on thyroid nodules development were expected to be nonexistent. Approximately 2000 individuals in the initial screening met criteria for subsequent screening and approximately 550 of those met criteria for fine-needle biopsy. With biopsy results, approximately 110 patients were identified with cancer or suspected cancer and most of these patients underwent surgery. Consistent with published series of pediatric thyroid cancer, the majority of pathologic diagnoses were papillary carcinoma. The prevalence of carcinoma in this largest-to-date pediatric screening series was 37 cases per 100 000 patients—a number far larger than expected from previous published estimates of pediatric thyroid carcinoma. The overall radiation exposure from the Fukushima accident was much less than that from the Chernobyl accident in 1986 and the high incidence of carcinoma detected was believed to be a result of the unprecedented scope of the ultrasonography screening program rather than from any radiation effects. These findings potentially create cancer risk anxiety in the affected region and possibly imply that a significant proportion of pediatric well-differentiated thyroid carcinomas become dormant or quiescent and never present with clinical disease.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hvkfET
via IFTTT

Birth weight, sex, and celiac disease: a nationwide twin study

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yN5t3r
via IFTTT

Editorial Board

Publication date: November–December 2017
Source:American Journal of Otolaryngology, Volume 38, Issue 6





from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ALiVW2
via IFTTT

Table of Contents

Publication date: November–December 2017
Source:American Journal of Otolaryngology, Volume 38, Issue 6





from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ilI7vp
via IFTTT

Guidelines for Contributing Authors

Publication date: November–December 2017
Source:American Journal of Otolaryngology, Volume 38, Issue 6





from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AMixXh
via IFTTT

Progress and Opportunities for Strengthening Global Health Security

F. J. Angulo et al.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ATHelD
via IFTTT

Newly Recognized Pediatric Cases of Typhus Group Rickettsiosis, Houston, Texas, USA

T. Erickson et al.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2yNaclQ
via IFTTT

Earlsgate Dental Practice in Folkestone closes

A dentist who suddenly closed his doors to patients was under investigation by dental and health authorities, we can reveal. The Earlsgate Dental Practice in Folkestone closed unexpectedly but it has emerged Dr Miodrag Mitic was issued with a warning by the General Dental Council earlier this year.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2jwpSaa
via IFTTT

Proceedings of the 2017 WAO Symposium on Hot Topics in Allergy: Pediatric & Regulatory Aspects

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zLUcl7
via IFTTT

Reply to Letter to the Editor regarding “Systematic review and meta-analysis of venous thromboembolism in otolaryngology-head and neck surgery”

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2z739sn
via IFTTT

CBD College Launches Inaugural Dental Assistant Program Including...

CBD College, the Los Angeles-based non-profit education institution that has been providing quality education and training to students in the medical field for more than 30 years, has launched its newest offering to students-the Dental Assistant program. Classes are scheduled to commence Tuesday, November 14 under the direction of Dental Assistant program director Nicole Alvarez.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2A4V5bG
via IFTTT

Secondary resistance to tolvaptan in two patients with SIAD due to small cell lung cancer

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ingnGK
via IFTTT

Analysis of Surface Roughness, Fracture Toughness, and Weibull Characteristics of Different Framework—Veneer Dental Ceramic Assemblies after Grinding, Polishing, and Glazing

Abstract

Purpose

To compare the surface roughness and biaxial flexural strength of dental ceramics obtained after chairside surface modification by mechanical polishing procedures, versus laboratory reglazing.

Materials and Methods

Discs (16 × 1.5 ± 1.6 mm) (N = 90) of various framework-veneering combinations were fabricated: D/FC: lithium disilicate/feldspathic ceramic; Z/AL: zirconium dioxide/aluminous ceramic; N/FC: noble alloy/feldspathic ceramic; N/FF: noble alloy feldspathic with fluorapatite; B/FC: base alloy/feldspathic ceramic; B/FF: base alloy/feldspathic ceramic with fluorapatite. In each group 10 specimens were ground using a diamond bur (46 μm) and five were polished with silicone-reinforced disc polishers (25 μm). Surface roughness (Ra) was measured using contact profilometry. After thermocycling in artificial saliva (6000 cycles, 5 to 55 ± 5°C), biaxial flexural strength was measured using "piston-on-three ball" test. The data (N) were analyzed using one-way ANOVA, Bonferroni, and Tukey's posthoc tests. Weibull distribution values were calculated.

Results

Surface roughness was significantly higher in the ground group only (p < 0.0001). Mean fracture toughness was significantly lower for chipping (RK: 287, HS: 22, ISO: 1099 MPa) than for total fracture (p < 0.05), (RK: 841, HS:64, ISO: 3222 MPa). For chipping, Weibull distribution presented the highest shape value (m) for D/FC (3.82-5.07) and for total fracture for B/FC (3.69-4.6).

Conclusion

Chairside surface polishing restored veneer ceramic roughness and mechanical strength to the level of glazing. Feldspathic ceramic with fluorapatite presented better polishing results than conventional feldspathic ceramic did. Ceramic fused to metal was more resistant than lithium disilicate or zirconium dioxide framework-veneer assemblies. Lithium disilicate framework veneered with feldspathic ceramic presented more durability against chipping. Clinical implications: After chairside occlusal modifications in the surfaces of cemented all-ceramic or fused-to-metal FDPs, mechanical polishing procedures should always be carried out.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2ALaCd5
via IFTTT

Special issue on advanced manipulation

Volume 31, Issue 19-20, October 2017, Page 1029-1029
.


from ! Medicine by Alexandros G. Sfakianakis via Αλέξανδρος Σφακιανάκης on Inoreader http://ift.tt/2ilF3Qf
via IFTTT

Accounting for Time-varying Confounding in the Relation between Obesity and Coronary Heart Disease: Analysis with G-estimation, the Atherosclerosis Risk in Communities (ARIC) study

Abstract

In longitudinal studies, standard analysis may yield biased estimates of exposure effect in the presence of time-varying confounders that are also intermediate variables. We aimed to quantify the relationship between obesity and coronary heart disease (CHD) by appropriately adjusting for time-varying confounders. This study performed on a subset of the Atherosclerosis Risk in Communities Study (1987-2010). General obesity defined as body mass index ≥30 kg/m², abdominal obesity (AOB) defined as waist circumference ≥102 cm in men and ≥88 cm in women, and waist to hip ratio categorized at ≥0.9 in men and ≥0.85 in women. The effect of obesity on CHD was estimated by G-estimation and compared with accelerated failure time models using three specifications. The first model adjusted for baseline covariates excluding metabolic mediators of obesity showed increased risk of CHD for all measures of obesity. Further adjustment for metabolic mediators in the second model and time-varying variables in the third model showed negligible hazard ratios. The hazard ratios estimated by G-estimation were 1.15 (95%CI: 0.83-1.47) for General obesity, 1.65 (95%CI: 1.35-1.92) and 1.38 (95%CI: 1.13-1.99) for AOB based on waist circumference and waist to hip ratio, respectively, suggesting that AOB increased the risk of CHD. The G-estimated hazard ratio of both measures was further from the null than standard models.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2my3AWE
via IFTTT

A novel strategy to address unmeasured confounding when comparing opioid agonist therapies in pregnancy

Abstract

Opioid addiction in pregnancy is a growing concern that has recently received a lot of attention. When comparing recommended opioid agonist therapies, many currently published studies guiding practice may be impacted by unmeasured confounding by indication. Populations of women who receive methadone are generally different from those treated with buprenorphine. Women treated with methadone frequently have more severe and uncontrolled addiction compared with buprenorphine treated patients; however, these factors are typically unmeasured or unavailable in large observational data sets. Consequently, findings of superior perinatal outcomes with buprenorphine may in truth be a result of an overall healthier profile of women taking this medication. In this issue of the American Journal of Epidemiology, Brogly et al. describes an approach utilizing detailed data from an External Cohort (n = 113) to account for confounding by indication in a larger Medicaid population (n = 1,020) to more accurately compare opioid agonist therapies in pregnancy. Authors found that the decreased risk of preterm birth and infant length of hospitalization associated with buprenorphine compared with methadone were attenuated after accounting for the additional confounding. These authors should be commended for providing a novel method to address this bias in future studies.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2z7AmUx
via IFTTT

Early Pregnancy Perfluoroalkyl Substance Plasma Concentrations and Birth Outcomes in Project Viva: Confounded by Pregnancy Hemodynamics?

Abstract

Associations of prenatal exposure to perfluoroalkyl substances (PFASs), ubiquitous chemicals used in stain and water resistant products, with adverse birth outcomes may be confounded by pregnancy hemodynamics. We measured plasma concentrations of four PFASs in early pregnancy (median, 9 weeks) among 1,645 women in Project Viva, a Boston-area cohort recruited 1999–2002. We fit multivariable models to estimate PFAS associations with birth weight-for-gestational age z score and gestation length adjusting for sociodemographic confounders and two hemodynamic markers: 1) plasma albumin, a measure of plasma volume expansion, and 2) plasma creatinine, used to estimate glomerular filtration rate. Perfluorooctane sulfonate (PFOS) and perfluorononanoate (PFNA) were weakly inversely associated with birth weight-for-gestational age z scores (adjusted β = −0.04 (95% confidence interval (CI): −0.08, 0.1) and −0.06 (95% CI: −0.11, −0.01) per interquartile increase, respectively). PFOS and PFNA were also associated with higher odds of preterm birth (e.g., highest vs. lowest PFOS quartile adjusted odds ratio = 2.4 (95% CI: 1.3, 4.4)). Adjusting for markers of pregnancy hemodynamics (glomerular filtration rate and plasma albumin), to the extent that they accurately reflect underlying pregnancy physiology, did not materially impact associations. These results suggest that pregnancy hemodynamics may not confound associations with birth outcomes when PFASs are measured early in pregnancy.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2mwnYYi
via IFTTT

Associations Between Divorce and Onset of Drug Abuse in a Swedish National Sample

Rates of drug abuse are higher among divorced than married individuals, but it is not clear whether divorce itself is a risk factor for drug abuse or if the observed association is confounded by other factors. We examined the association between divorce and onset of drug abuse in a population-based Swedish cohort born 1965–1975 (n = 651,092) using Cox proportional hazard methods, with marital status as a time-varying covariate. Potential confounders (e.g., demographics, adolescence deviance, family history of drug abuse) were included as covariates. Parallel analyses were conducted for widowhood and drug abuse onset. In adjusted models, divorce was associated with a substantial increase in risk of drug abuse onset in both sexes (hazard ratios >5). Co-relative analyses were consistent with a partially causal role of divorce on drug abuse onset. Widowhood also increased risk of drug abuse onset, though to a lesser extent. Divorce is a potent risk factor for onset of drug abuse, even after adjusting for deviant behavior in adolescence and family history of drug abuse. The somewhat less pronounced association with widowhood, particularly among men, suggests that the magnitude of association between divorce and drug abuse may not be generalizable to the end of a relationship.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2z7VRV2
via IFTTT

Exposure Biomarkers Indicate More than Just Exposure

Abstract

Biomarkers of environmental exposures have notable strengths in integrating across diverse sources and routes of exposure and providing a marker reflecting biological dose. However, the physiologic determinants of biomarker toxicokinetics and measured levels may also affect or be affected by disease determinants and thus introduce confounding. Sagiv et al. (1) sought empirical evidence on the role of renal clearance in biasing the association between perfluoroalkyl compounds measured in plasma during pregnancy and infant birth weight and found little empirical support for such bias. The risk of such bias is greater when the exposure and health outcome are assessed closely in time, when physiologic differences are large relative to variability in environmental levels, and when the physiologic determinant has diverse functions and implications. While empirical examination has value, the potential bias is difficult to measure and control when the underlying associations among exposure biomarker, health outcome, and physiologic determinant are weak.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2mwaLi1
via IFTTT

Long Term Risk of Cardiovascular Death With Use of Clarithromycin and Roxithromycin – a Nationwide Cohort Study

Abstract

Recent studies have raised concern that macrolide antibiotics may be associated with a long-term increased risk of cardiovascular death. This study examines the one-year risk associated with treatment with clarithromycin (n = 751,543) and roxithromycin (n = 698,899) compared with penicillin V (n = 2,721,538), matched 1:4 on propensity score, in a nationwide registry-based cohort study in Danish outpatients, 1997–2011. Among clarithromycin courses, the rate ratio (RR) of cardiovascular death was 1.24; 95% CI: 0.96, 1.59). Among roxithromycin courses, the RR was 0.99 (0.86, 1.16). In analyses by time after treatment start, the RR associated with clarithromycin was 1.66 (0.98, 2.79) during days 0–7; this was attenuated in later time periods, RR days 8–89: 1.30 (0.88, 1.94) and RR days 90–364: 0.96 (0.63, 1.47). For roxithromycin, the RRs were 0.88 (0.59, 1.32) during days 0–7, 1.17 (0.92, 1.48) during days 8–89 and 0.88 (0.70, 1.10) during days 90–364. This study found no increased risk of cardiovascular death in a general outpatient population. With clarithromycin, we observed a transient increased risk during days 0–7 after treatment start, which corresponds to the period of active treatment. This association was absent in later time periods, which is consistent with no long-term toxicity resulting in cardiovascular death.

from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2z74AHh
via IFTTT