Sexual dimorphisms in three-dimensional masticatory muscle attachment morphometry regulates temporomandibular joint mechanics.

Temporomandibular joint (TMJ) disorders disproportionally affect females, with female to male prevalence varying from 3:1 to 8:1. Sexual dimorphisms in masticatory muscle attachment morphometry and association with craniofacial size, critical for understanding sex-differences in TMJ function, have not been reported. The objective of this study was to determine sex-specific differences in three-dimensional (3D) TMJ muscle attachment morphometry and craniofacial sizes and their impact on TMJ mechanics.

Sub-clinical dose of bone morphogenetic protein-2 does not precipitate rampant, sustained inflammatory response in bone wound healing.

Large bone injuries, defects, and chronic wounds present a major problem for medicine. Several therapeutic strategies are used clinically to precipitate bone including a combination therapy delivering osteoinductive bone morphogenetic protein 2 (rhBMP-2) via an osteoconductive scaffold (absorbable collagen sponge [ACS], i.e.

How well do we manage the odontogenic keratocyst? A multicenter study.

Objective: The aim of this study was to answer the following clinical questions: Among patients treated for odontogenic keratocysts (OKCs), what is the overall 5-year disease-free rate, and what factors are associated with disease recurrence?

Study Design: We implemented a multicenter retrospective cohort study composed of patients presenting for the evaluation and management of previously untreated OKCs. The predictor variables were grouped into demographic, medical, radiographic, and operative categories. The primary outcome variable was time to lesion recurrence.

Perineurioma of the Tongue: A Case Report and Review of the Literature.

A perineurioma (PN) is a rare benign peripheral nerve sheath tumor derived from perineurial cells. Based on clinical and pathologic features, PNs can be classified into 2 major subtypes: intraneural PN (IPN) and the more common extraneural PN (EPN). EPNs and IPNs are extremely rare in the oral cavity, and there have been only 38 reported cases (21 EPNs, 17 IPNs).

Optimizing bone wound healing using BMP2 with absorbable collagen sponge and Talymed nanofiber scaffold.

Background: Bone is a highly vascularized and resilient organ with innate healing abilities, however some bone injuries overwhelm these attributes and require intervention, such as bone tissue engineering strategies. Combining biomaterials and growth factors, such as bone morphogenetic protein 2 (BMP2), is one of the most commonly used tissue engineering strategies. However, use of BMP2 has been correlated with negative clinical outcomes including aberrant inflammatory response, poor quality bone, and ectopic bone.

Three-dimensional temporomandibular joint muscle attachment morphometry and its impacts on musculoskeletal modeling.

In musculoskeletal models of the human temporomandibular joint (TMJ), muscles are typically represented by force vectors that connect approximate muscle origin and insertion centroids (centroid-to-centroid force vectors). This simplification assumes equivalent moment arms and muscle lengths for all fibers within a muscle even with complex geometry and may result in inaccurate estimations of muscle force and joint loading. The objectives of this study were to quantify the three-dimensional (3D) human TMJ muscle attachment morphometry and examine its impact on TMJ mechanics.

Effect of Measurement Technique on TMJ Mandibular Condyle and Articular Disc Morphometry: CBCT, MRI, and Physical Measurements.

Purpose: Accurate description of the temporomandibular size and shape (morphometry) is critical for clinical diagnosis and surgical planning and the design and development of regenerative scaffolds and prosthetic devices and to model the temporomandibular loading environment. The study objective was to determine the 3-dimensional morphometry of the temporomandibular joint (TMJ) condyle and articular disc using cone-beam computed tomography (CBCT), magnetic resonance imaging (MRI), and physical measurements of the same joints using a repeated measures design and to determine the effect of the measurement technique on temporomandibular size and shape.

Materials And Methods: Human cadaveric heads underwent a multistep protocol to acquire physiologically meaningful measurements of the condyle and disc.

Testing a novel nanofibre scaffold for utility in bone tissue regeneration.

Many variables serve to alter the process of bone remodelling and diminish regeneration including the size and nature of the wound bed and health status of the individual. To overcome these inhibitory factors, tissue-engineered osteoconductive scaffolds paired with various growth factors have been utilized clinically. However, many limitations still remain, for example, bone morphogenetic protein 2 (BMP2) can lead to rampant inflammation, ectopic bone formation, and graft failure.

Involvement of calvarial stem cells in healing: A regional analysis of large cranial defects.

Large craniofacial defects present a substantial clinical challenge that often requires the use of osteoconductive matrices and osteoinductive cues (i.e., bone morphogenetic proteins [BMP2]) to augment healing.

Warfarin and Newer Agents: What the Oral Surgeon Needs to Know.

The new direct oral anticoagulants-dabigatran etexilate, rivaroxaban, and apixaban- have predictable pharmacokinetic and pharmacodynamic profiles and are alternatives to warfarin. However, many surgeons are wary of these drugs, as there is limited evidence on how to manage bleeding in patients taking them, and only recently has a specific antidote been developed to reverse their anticoagulant effect. Management of the newer agents requires careful adherence to primary measures of bleeding care, knowledge of their mechanism of action, and familiarity with the unapproved and untested reversal strategies that may be required in patients with life-threatening bleeding.

The indications for third-molar extractions.

Background: Defining the indications for third-molar extraction continues to be a topic of controversy.

Methods: The dentist's management of third molars commonly hinges on identifying the presence of symptoms or disease that clearly is attributable to the third molar. Use of a guide that serves as a systematic and unambiguous way to classify third molars has been advocated.

Surgical ophthalmologic examination.

Maxillofacial trauma involving injury to the eye and periorbital structures is not uncommon. Oral and maxillofacial surgeons are frequently called on to assess and operate in and around the orbit; it is thus critical to be proficient around the eye because surgical interventions and even physical examinations can cause injury and loss of vision. This article reviews the systematic and accurate assessment of the eye and adnexal structures in a manner appropriate for the oral and maxillofacial surgeon, with a focus on proper examination technique and a high sensitivity for potentially critical abnormalities.

Microsurgical repair of the inferior alveolar nerve: success rate and factors that adversely affect outcome.

Purpose: The objectives of this study were to determine the likelihood of regaining functional sensory recovery (FSR) after microsurgical repair of the inferior alveolar nerve (IAN), and which variables significantly affected the outcome of that surgery in a large series of patients.

Materials And Methods: This was a retrospective cohort study that evaluated all patients who had undergone microsurgical repair of the IAN by 1 of the senior surgeons (R.A.

Advances in bioengineered conduits for peripheral nerve regeneration.

Although resorbable NGCs have been developed for peripheral nerve grafting, there has been little published on their use as a material for trigeminal nerve repair. Advances in engineered guidance channels and modifications to the single-lumen conduit with growth-permissive substrates, ECM proteins, neurotrophic factors, and supportive Schwann or stem cells, and anisotropic placement of these within the NGC may translate from animal models to clinical human use in the future. A great deal of research is still needed to optimize the presently available NGCs, and their use in peripheral trigeminal nerve repair and regeneration remains yet to be explored.

Peripheral nerve response to injury.

Oral and maxillofacial surgeons caring for patients who have sustained a nerve injury to a branch of the peripheral trigeminal nerve must possess a basic understanding of the response of the peripheral nerves to trauma. The series of events that subsequently take place are largely dependent on the injury type and severity. Regeneration of the peripheral nerve is possible in many instances and future manipulation of the regenerative microenvironment will lead to advances in the management of these difficult injuries.

The accuracy of virtual surgical planning in free fibula mandibular reconstruction: comparison of planned and final results.

Purpose: The concept of virtual surgery uses surgical simulation rather than relying exclusively on intraoperative manual approximation of facial reconstruction. The purpose of this study was to evaluate the degree to which surgical outcomes in free fibula mandibular reconstructions planned with virtual surgery and carried out with prefabricated surgical plate templates and cutting guides correlated to the virtual surgical plan in a series of 11 patients.

Materials And Methods: This retrospective study evaluated 11 consecutive patients (6 males and 5 females) with an average age of 50.

Microsurgical repair of the peripheral trigeminal nerve after mandibular sagittal split ramus osteotomy.

Purpose: Injuries to the inferior alveolar nerve (IAN) and lingual nerves (LNs) have long been known complications of the mandibular sagittal split ramus osteotomy (SSRO). Most postoperative paresthesias resolve without treatment. However, microsurgical exploration of the nerve may be indicated in cases of significant persistent sensory dysfunction associated with observed or suspected localized IAN or LN injury.

Retrospective review of microsurgical repair of 222 lingual nerve injuries.

Purpose: Injury to the lingual nerve (LN) is a known complication associated with several oral and maxillofacial surgical procedures. We have reviewed the demographics, timing, and outcome of microsurgical repair of the LN.

Materials And Methods: A retrospective chart review was completed of all patients who had undergone microsurgical repair of the LN by one of us (R.

Microsurgical repair of peripheral trigeminal nerve injuries from maxillofacial trauma.

Purpose: Injuries to the peripheral branches of the trigeminal nerve from maxillofacial trauma can have distressing sensory or functional sequelae. The present study reports the results of trigeminal microneurosurgical repair in a series of patients with maxillofacial trauma.

Materials And Methods: A retrospective chart review was completed of all patients who had undergone microneurosurgical repair of peripheral trigeminal nerve injuries caused by maxillofacial trauma and who had been treated by one of us (R.