Development and Evaluation of a GPT4-Based Orofacial Pain Clinical Decision Support System.

: Orofacial pain (OFP) encompasses a complex array of conditions affecting the face, mouth, and jaws, often leading to significant diagnostic challenges and high rates of misdiagnosis. Artificial intelligence, particularly large language models like GPT4 (OpenAI, San Francisco, CA, USA), offers potential as a diagnostic aid in healthcare settings. : To evaluate the diagnostic accuracy of GPT4 in OFP cases as a clinical decision support system (CDSS) and compare its performance against treating clinicians, expert evaluators, medical students, and general practitioners.

Open management of condylar head fractures. The first 50 cases: What have we learnt and where are we going?

This study evaluates a single surgeon's experience in the development of a practice in open treatment of intracapsular condylar fractures over three years at a tertiary maxillofacial trauma centre. An enhanced dynamic, peer-reviewed, longitudinal audit in keeping with the adoption of elements of new clinical practice was instituted. This aimed to record and analyse clinical and functional outcomes at both the surgeon and patient level.

Risk assessment of inferior alveolar nerve injury after wisdom tooth removal using 3D AI-driven models: A within-patient study.

Objective: To compare a three-dimensional (3D) artificial intelligence (AI)- driven model with panoramic radiography (PANO) and cone-beam computed tomography (CBCT) in assessing the risk of inferior alveolar nerve (IAN) injury after mandibular wisdom tooth (M3M) removal through a within-patient controlled trial.

Methods: From a database of 6,010 patients undergoing M3M surgery, 25 patients met the inclusion criteria of bilateral M3M removal with postoperative unilateral IAN injury. In this within-patient controlled trial, preoperative PANO and CBCT images were available, while 3D-AI models of the mandibular canal and teeth were generated from the CBCT images using the Virtual Patient Creator AI platform (Relu BV, Leuven, Belgium).

Accuracy of MR neurography as a diagnostic tool in detecting injuries to the lingual and inferior alveolar nerve in patients with iatrogenic post-traumatic trigeminal neuropathy.

Objectives: MR neurography has the ability to detect and depict peripheral nerve injuries. This study evaluated the potential of MR neurography in the diagnosis of post-traumatic trigeminal neuropathy.

Methods: Forty-one participants prospectively underwent MR neurography of the lingual and inferior alveolar nerves using a 3D TSE STIR black-blood sequence.

Prospective orofacial quantitative sensory testing data of the human face and mouth.

Quantitative sensory testing (QST) is a valuable tool in the assessment of orofacial somatosensory function and dysfunction. QST is a method where thermal and mechanical stimuli are applied to the area of interest in a noninvasive way. The QST technique can detect patterns of loss of sensation that may happen in case of hypoesthesia, hypoalgesia, anesthesia, or gain of sensation in the context of allodynia, hyperalgesia or spontaneous pain.

Is Surgical Repair With Nerve Allograft More Cost-Effective Than Non-Surgical Management for Persistent Trigeminal Neuropathy? Initial Assessment With Markov Model.

Purpose: Persistent trigeminal neuropathy (PTN) is associated with high rates of depression, loss of work, and decreased quality of life (QoL). Nerve allograft repair can achieve functional sensory recovery in a predictable manner; however, it bears significant upfront costs. In patients suffering from PTN, is surgical repair with allogeneic nerve graft, when compared to non-surgical therapy, a more cost-effective treatment option?

Materials And Methods: A Markov model was constructed with TreeAge Pro Healthcare 2022 (TreeAge Software, Massachusetts) to estimate the direct and indirect costs for PTN.

3D CRANI, a novel MR neurography sequence, can reliable visualise the extraforaminal cranial and occipital nerves.

Objectives: We aim to validate 3D CRANI, a novel high-field STIR TSE, MR neurography sequence in the visualisation of the extraforaminal cranial and occipital nerve branches on a 3-T system. Furthermore, we wish to evaluate the role of gadolinium administration and calculate nerve benchmark values for future reference.

Methods: Eleven consecutive patients underwent MR imaging including the 3D CRANI sequence before and immediately after intravenous gadolinium administration.

Posttraumatic Trigeminal Neuropathic Pain in Association with Dental Implant Surgery.

Posttraumatic trigeminal neuropathy in association with dental implant surgery is preventable, and this should be the emphasis for all clinicians considering this treatment for a patient. Once the nerve injury and posttraumatic neuropathy with or without pain ensues, there is very little the clinician can do to reverse it and the high pain and permanency of the neuropathy will have a significant functional and psychological impact on the patient. Immediate implant removal is required, and home check should be routine for all cases.

Sexuality and intimacy after head and neck cancer treatment: An explorative prospective pilot study.

Background: While sexuality and intimacy are suggested to contribute to quality of life (QoL), it is striking that the sexual problems of head and neck cancer patients have not been adequately studied.

Objectives: Our aim was to prospectively assess the impact of head and neck cancer and its treatment on sexuality and intimacy.

Material And Methods: A questionnaire study with a 6-month follow-up period was conducted at the University Hospitals Leuven, Belgium, using the Maudsley marital questionnaire (MMQ), the sexual adjustment questionnaire (SAQ) and the short sexual functioning scale (SSFS) to prospectively assess the impact of head and neck cancer and its treatment on sexuality and intimacy.

Healthcare costs of post-traumatic trigeminal neuropathy in Belgium - A retrospective analysis.

The present aim was to estimate direct health care costs of patients suffering from post-traumatic trigeminal neuropathy (PTTN) and to compare the use of health care services, medications, and costs between temporary and persistent (>3 months) PTTN cohorts. A pre-existing clinical dataset of PTTN patients visiting a tertiary orofacial pain clinic in Belgium was utilized, including symptoms and quality of life measurements. Cost and resource utilization data were obtained by Belgium's largest health insurance provider for a period of 5 years after onset.

Correlation of MRI and arthroscopic findings with clinical outcome in temporomandibular joint disorders: a retrospective cohort study.

Background: Arthroscopy is a minimally invasive diagnostic tool and treatment strategy in patients suffering from temporomandibular disorders (TMD) when conservative treatment fails. This study aimed to find specific variables on pre-operative MRI or during arthroscopy that could predict success of arthroscopic lysis and lavage.

Methods: This retrospective analysis compared pre-operative maximum interincisal opening (MIO), pain and main complaint (pain, limited MIO or joint sounds) with results at short-term and medium-term follow-up (ST and MT respectively).

Facial Paresthesia, a Rare Manifestation of Hereditary Neuropathy With Liability to Pressure Palsies: A Case Report.

Trigeminal sensory neuropathy can be caused by a variety of conditions, including local, traumatic, iatrogenic, or systemic causes. Diagnosis and management remain a challenge for maxillofacial surgeons and neurologists. Therefore, a good clinical examination and objective tests and imaging are needed when diagnosing patients who present with facial numbness.

Exploring the roles of neuropeptides in trigeminal neuropathic pain: A systematic review and narrative synthesis of animal studies.

Objective: This systematic review aims to explore the changes in expression of neuropeptides and/or their receptors following experimental trigeminal neuropathic pain in animals.

Design: MEDLINE, Embase, and Scopus were searched for publications up to 31st March 2021. Study selection and data extraction were completed by two independent reviewers based on the eligibility criteria.

Prognostic factors, symptom evolution, and quality of life of posttraumatic trigeminal neuropathy.

Neurosensory disturbances (NSDs) caused by injury to the trigeminal nerve can affect many aspects of daily life. However, factors affecting the persistence of NSDs in patients with posttraumatic trigeminal neuropathies (PTTNs) remain largely unknown. The identification of such risk factors will allow for the phenotyping of patients with PTTNs, which is crucial for improving treatment strategies.

Case Report: Spontaneous Remission of an Infraorbital Follicular B-Cell Lymphoma: Case Report and Review of the Literature.

Non-Hodgkin lymphomas comprise a heterogeneous group of malignancies, with a wide scope of clinical, radiological and histological presentations. In this paper, a case is presented of a 59-year-old white male with an infraorbital follicular B-cell lymphoma, which appeared as a painless mass in the left cheek. The lymphoma achieved spontaneous remission five and a half months after his diagnostic incision biopsy.

Post-traumatic trigeminal neuropathy: correlation between objective and subjective assessments and a prediction model for neurosensory recovery.

Background: Post-traumatic trigeminal neuropathy (PTN) can have a substantial effect on patient well-being. However, the relation between the neuropathic symptoms and their effect on psychosocial functioning remains a matter of debate. The purpose of this study was to evaluate the association between objective and subjective assessments of neurosensory function in PTN and predict neurosensory outcome using baseline measurements.

The Diagnostic Value of Magnetic Resonance Imaging in Posttraumatic Trigeminal Neuropathic Pain.

Aims: To evaluate the diagnostic value of non-nerve-selective MRI sequences in posttraumatic trigeminal neuropathic pain (PTNP).

Methods: This study retrospectively analyzed all MRI protocols performed between February 2, 2012 and June 20, 2018 commissioned by the Department of Oral and Maxillofacial Surgery, University Hospitals Leuven. Demographic, clinical, and radiologic data were extracted from the records of patients with an MRI in the context of PTNP.

Magnetic resonance neurography of the head and neck: state of the art, anatomy, pathology and future perspectives.

Magnetic resonance neurography allows for the selective visualization of peripheral nerves and is increasingly being investigated. Whereas in the past, the imaging of the extracranial cranial and occipital nerve branches was inadequate, more and more techniques are now available that do allow nerve imaging. This basic review provides an overview of the literature with current state of the art, anatomical landmarks and future perspectives.

Signs and symptoms, quality of life and psychosocial data in 1331 post-traumatic trigeminal neuropathy patients seen in two tertiary referral centres in two countries.

Background: Post-traumatic trigeminal neuropathy (PTN) is a disturbance of function or pathological change of the trigeminal nerve branches following trauma and has an important impact on patient's quality of life (QoL).

Objectives: To provide diagnostic data on PTN and illustrate differences in aetiology, injured nerve, pain distribution, sensory profile and QoL between PTN subgroups.

Methods: 1331 patients with painful or non-painful PTN were retrospectively reviewed in two centres, extracting demographic data, time and cause of trauma, clinical findings including signs and symptoms, basic neurosensory testing, imaging modalities, treatments, and QoL or psychosocial assessment.

Orofacial quantitative sensory testing: Current evidence and future perspectives.

Background And Objective: Orofacial quantitative sensory testing (QST) is an increasingly valuable psychophysical tool for evaluating neurosensory disorders of the orofacial region. Here, we aimed to evaluate the current evidence regarding this testing method and to discuss its future clinical potential.

Data Treatment: We conducted a literature search in Medline, Embase and Scopus for English-language articles published between 1990 and 2019.

A systematic review on diagnostic test accuracy of magnetic resonance neurography versus clinical neurosensory assessment for post-traumatic trigeminal neuropathy in patients reporting neurosensory disturbance.

Objectives: To perform a systematic review of published studies on diagnostic accuracy of magnetic resonance neurography (MRN) clinical neurosensory testing (NST) for post-traumatic trigeminal neuropathy (PTTN) in patients reporting neurosensory disturbances (NSD).

Methods: Human studies except case reports, reviews, systematic reviews and meta-analyses were included. PubMed, Embase, Web of Science and Cochrane Library were consulted.

Validation of a 3D CBCT-based protocol for the follow-up of mandibular condyle remodeling.

Objectives: Three-dimensional models of mandibular condyles provide a way for condylar remodeling follow-up. The overall aim was to develop and validate a user-friendly workflow for cone beam CT (CBCT)-based semi-automatic condylar registration and segmentation.

Methods: A rigid voxel-based registration (VBR) technique for registration of two post-operative CBCT-scans was tested.

Metal debris after dental implant placement: A proof-of-concept study in fresh frozen cadavers using MRI and histological analysis.

Purpose: This report originated from the finding of metal artefacts on magnetic resonance images (MRI) which were not detected on panoramic radiography or cone beam computed tomography (CBCT) imaging. It was hypothesised that drills or implants might release metal particles during surgical procedures in the jawbones. Therefore, the aim was to assess whether dental implants or surgical drills might cause metal debris in the surrounding tissues.

The Biomechanical Effect of the Sagittal Split Ramus Osteotomy on the Temporomandibular Joint: Current Perspectives on the Remodeling Spectrum.

The sagittal split ramus osteotomy is a key approach for treating dentofacial deformities. Although it delivers excellent results, the sagittal split ramus osteotomy is believed to induce stress to the temporomandibular joint. Potential stress inducers could be classified as intra- and postoperative factors resulting in an inflammatory response and molecular cascades, which initiate physiological remodeling.

Neurophysiological aspects of the trigeminal sensory system: an update.

The trigeminal system is one of the most complex cranial nerve systems of the human body. Research on it has vastly grown in recent years and concentrated more and more on molecular mechanisms and pathophysiology, but thorough reviews on this topic are lacking, certainly on the normal physiology of the trigeminal sensory system. Here we review the current literature on neurophysiology of the trigeminal nerve from peripheral receptors up to its central projections toward the somatosensory cortex.