International Expert-Based Consensus Definition, Classification Criteria, and Minimum Data Elements for Osteoradionecrosis of the Jaw: An Inter-Disciplinary Modified Delphi Study.

Purpose: Osteoradionecrosis of the jaw (ORNJ) is a severe iatrogenic disease characterized by bone death after radiation therapy (RT) to the head and neck. With over 9 published definitions and at least 16 classification systems, the true incidence and severity of ORNJ are obscured by lack of a standard for disease definition and severity assessment, leading to inaccurate estimation of incidence, reporting ambiguity, and likely under-diagnosis worldwide. This study aimed to achieve consensus on an explicit definition and phenotype of ORNJ and related precursor states through data standardization to facilitate effective diagnosis, monitoring, and multidisciplinary management of ORNJ.

The Feasibility and Outcome of Integra® Bilayer Matrix in the Reconstruction of Oral Cavity Defects.

Objective: To evaluate the feasibility, safety, and failure rate of Integra® Bilayer Wound Matrix (Integra) in the reconstruction of oral cavity defects.

Study Design: Retrospective cohort study.

Setting: All study information was collected from a single academic tertiary care hospital.

Effect of preradiation dental intervention on incidence of osteoradionecrosis in patients with head and neck cancer: A systematic review and meta-analysis.

Background: The purpose of this systematic review was to examine whether dental intervention involving bone or soft-tissue manipulation preradiotherapy (pre-RT) is associated with lower rates of osteoradionecrosis of the jaw (ORNJ) in patients with head and neck cancer (HNC).

Types Of Studies Reviewed: The authors included relevant studies from MEDLINE, Embase, and Cochrane Library, including observational studies published from 2007 through 2021 and involving adults who underwent dental intervention pre-RT for HNC. Authors assessed evidence certainty by using the Grading of Recommendations Assessment, Development, and Evaluation approach.

The oral microbiota of wild bears in Sweden reflects the history of antibiotic use by humans.

Following the advent of industrial-scale antibiotic production in the 1940s, antimicrobial resistance (AMR) has been on the rise and now poses a major global health threat in terms of mortality, morbidity, and economic burden. Because AMR can be exchanged between humans, livestock, and wildlife, wild animals can be used as indicators of human-associated AMR contamination of the environment. However, AMR is a normal function of natural environments and is present in host-associated microbiomes, which makes it challenging to distinguish between anthropogenic and natural sources.

Combined rehabilitation of a lower lip defect after resection of floor of mouth cancer: A clinical report.

This clinical report describes the successful prosthetic rehabilitation of a deficient lower lip in an edentulous patient who had undergone surgery for removal of a squamous cell carcinoma of the anterior floor of the mouth and vestibule. The rehabilitation used a combined approach of an extraoral lip prosthesis joined by 3 magnets to an intraoral implant-retained mandibular resection prosthesis. The outcome demonstrated rehabilitation of the lower third of the face by eliminating loss of fluids and by improving the facial profile, lip contour and competence, esthetics, the patient's eating ability, speech intelligibility, and reported quality of life.

Head and neck surgical oncology in the time of a pandemic: Subsite-specific triage guidelines during the COVID-19 pandemic.

Background: COVID-19 pandemic has strained human and material resources around the world. Practices in surgical oncology had to change in response to these resource limitations, triaging based on acuity, expected oncologic outcomes, availability of supportive resources, and safety of health care personnel.

Methods: The MD Anderson Head and Neck Surgery Treatment Guidelines Consortium devised the following to provide guidance on triaging head and neck cancer (HNC) surgeries based on multidisciplinary consensus.

Prosthodontic treatment of a patient with Ewing sarcoma of the left maxillary sinus: A clinical report.

This clinical report describes the prosthodontic rehabilitation of a 22-year-old woman with a substantial treatment history of Ewing sarcoma of the left maxillary sinus. The patient was diagnosed with Ewing sarcoma at the age of 7 years and went through chemotherapy, radiation, surgical resection, and free-flap reconstruction, initially without prosthodontic rehabilitation. The patient aged 22 years was referred to the oral oncology clinic at The University of Texas MD Anderson Cancer Center for prosthodontic treatment.

Modeling symptom drivers of oral intake in long-term head and neck cancer survivors.

Purpose: This study examined the relationship between self-reported symptom severity and oral intake in long-term head and neck cancer (HNC) survivors.

Methods: An observational survey study with retrospective chart abstraction was conducted. HNC patients who had completed an MD Anderson Symptom Inventory-Head and Neck (MDASI-HN) questionnaire and also had clinician graded oral intake ratings (Functional Oral Intake Scale [FOIS]) were included.

Symptom burden and dysphagia associated with osteoradionecrosis in long-term oropharynx cancer survivors: A cohort analysis.

Objective: The purpose is to examine the relationship between mandibular osteoradionecrosis (ORN) and chronic dysphagia in long-term oropharynx cancer (OPC) survivors, and to determine the perceived symptom burden associated with ORN.

Materials And Methods: Medical records of 349 OPC patients treated with bilateral IMRT and systemic therapy were reviewed. ORN was graded using a published 4-point classification schema.

Surgical preparation of nasal defects to enhance the implant-retained facial prostheses: A case report.

Background: Skin cancers requiring nasal resection may be surgically reconstructed and/or prosthetically reconstructed. Singular surgical reconstruction may be ideal for smaller defects in which the nasal bone and cartilaginous portions of the nose are maintained, but surgical reconstruction falls short of providing acceptable aesthetic results for more extensive nasal defects. Prosthetic rehabilitation, or a combination of surgical and prosthetic rehabilitation, is more appropriate for larger defects, but prosthesis retention can be challenging when adhesives are required on adjacent mobile and secreting skin.

Osteoradionecrosis in patients with salivary gland malignancies.

Purpose: The present study was undertaken to evaluate osteoradionecrosis (ORN) in patients with salivary gland malignancies (SGM) after treatment with radiation therapy.

Materials And Methods: The medical records of 172 patients treated with radiation therapy for SGM during a 12-year period (August 2001 to November 2013) were reviewed. Incidence, time to event, staging and management of ORN were analyzed.

Osseointegrated implant-based dental rehabilitation in head and neck reconstruction patients.

Background: Dental restoration is an integral part of head and neck cancer reconstruction.

Methods: We evaluated the success rate of osseointegrated implants in patients with head and neck cancer, comparing outcomes between implants placed in fibula free flaps to those placed in native mandibular and maxillary bone.

Results: A total of 1132 implants were placed in 246 patients.

The multiple oral presentations of multiple myeloma.

Purpose: The purpose of this case series is to show the varied oral presentations of multiple myeloma, illustrating the importance of carefully surveying the oral cavity for suspicious lesions that could be indicative of palpable disease and/or recurrence. The diagnostic criteria and prognostic features for multiple myeloma were also reviewed.

Case Series Summary: This report focuses on five patients with myeloma manifestations involving the oral cavity, in which the oral presentation of multiple myeloma was an early indication of disease relapse.

Craniofacial reconstruction following oncologic resection.

The ability to reliably reconstruct complex and sizable wounds has decreased the morbidity of skull base surgery substantially, preventing major complications and allowing treatment of tumors previously considered inoperable. Addressing facial nerve function with static and dynamic procedures as well as fabrication of craniofacial prostheses to replace delicate facial landmarks has further increased surgeons' ability to restore the appearance and function of the face.

Osteoradionecrosis and radiation dose to the mandible in patients with oropharyngeal cancer.

Purpose: To determine the association between radiation doses delivered to the mandible and the occurrence of osteoradionecrosis (ORN).

Methods And Materials: We reviewed the records of 402 oropharyngeal cancer patients with stage T1 or T2 disease treated with definitive radiation between January 2000 and October 2008 for the occurrence of ORN. Demographic and treatment variables were compared between patients with ORN and those without.

Prosthodontic treatment and medical considerations for a patient with Turner syndrome: a clinical report.

This clinical report describes a multidisciplinary approach in the rehabilitation of a 23-year-old Caucasian woman affected with Turner's syndrome and subsequently diagnosed with T4 Giant cell reparative granuloma of the right maxillary sinus. The surgical treatment included a maxillectomy and infratemporal fossa dissection followed by a free fibula palatal reconstruction, fibula bone graft of the orbital floor, dental implant placement, and prosthodontic rehabilitation. Prosthodontic planning and treatment considerations in an adult patient with Turner Syndrome are discussed.

CT imaging features of obturator prostheses in patients following palatectomy or maxillectomy.

Palatal tumors are often treated with palatectomy or maxillectomy. The resulting surgical defect produces an oroantral communication. An obturator is a removable prosthesis used to close the palatal or maxillectomy defect.

Diagnostic considerations and prosthetic rehabilitation of a cocaine-induced midline destructive lesion: A clinical report.

The intranasal inhalation of cocaine has numerous complications. In addition to its systemic effects, cocaine can cause extensive destruction of the osteocartilaginous midline structures of the palate, nose, and sinuses. Without an accurate social and clinical history, a cocaine-induced midline destructive lesion can cause diagnostic difficulties, because its clinical presentation closely mimics other diseases.

Maxillofacial rehabilitation of a 7-year-old boy with osteosarcoma of the mandible using a free fibula flap and implant-supported prosthesis: a clinical report.

This clinical report describes the multidisciplinary approach in the maxillofacial rehabilitation of a 7-year-old boy diagnosed with osteosarcoma of the mandible. Following surgical resection of the left half of the mandible from the angle to the parasymphyseal region, a free osseocutaneous flap from the fibula was used to successfully reconstruct the mandible. Dental implants were subsequently placed, and an implant-supported, removable mandibular resection prosthesis was fabricated.

Prostatic abscess in a neutered cat.

A 6-year-old, male castrated domestic shorthair cat was presented for evaluation of lethargy, vomiting, anorexia, and constipation. Physical examination revealed an elevated body temperature and an extramural colonic mass. Abdominal ultrasonography demonstrated a hypoechoic mass measuring 2.

Single-tooth replacement: bridge vs. implant-supported restoration.

Options for restoring a single tooth include fixed partial denture, resin-bonded restoration and single-tooth implant. In this paper, we discuss the advantages and disadvantages of these methods and factors that must be considered when choosing between them for the replacement of a single tooth. Although in some cases a fixed partial denture is the most appropriate choice, implants have the advantage of allowing preservation of the integrity of sound teeth adjacent to the edentulous area.

Influence of metal surface finishing on porcelain porosity and beam failure loads at the metal-ceramic interface.

Statement Of The Problem: Investigators suggest that metals should be finished in 1 direction before porcelain application to minimize metal irregularities and trapped contaminants. These irregularities are thought to be focal points for porosity and crack propagation.

Purpose: This study investigated the influence of metal finishing and sandblasting on (1) porosity production at the porcelain-metal interface, and (2) porcelain-metal beam failure load.

Alternative complete-arch cement-retained implant-supported fixed partial denture.

Early implant prostheses designs, which used screw-retained metal and acrylic resin structures, frequently left a space between the prosthesis and the soft tissue. Common deficiencies of this design included phonetic and esthetic problems and screw loosening. Cement-retained implant prostheses are also used in partially and completely edentulous patients, and are thought to have optimal occlusion and esthetics.