Surgical correction of dentofacial deformities in juvenile idiopathic arthritis: a systematic literature review.

The aim of this study was to assess current evidence for the surgical correction of dentofacial deformities in patients with temporomandibular joint (TMJ) involvement from juvenile idiopathic arthritis (JIA). A systematic literature review, according to the PRISMA guidelines, was conducted. Meta-analyses, randomized controlled trials, cohort studies, observational studies, and case reports were eligible for inclusion.

Standardizing Terminology and Assessment for Orofacial Conditions in Juvenile Idiopathic Arthritis: International, Multidisciplinary Consensus-based Recommendations.

Objective: To propose multidisciplinary, consensus-based, standardization of operational terminology and method of assessment for temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA).

Methods: Using a sequential expert group-defined terminology and methods-of-assessment approach by (1) establishment of task force, (2) item generation, (3) working group consensus, (4) external expert content validity testing, and (5) multidisciplinary group of experts final Delphi survey consensus.

Results: Seven standardized operational terms were defined: and CONCLUSION: Definition of 7 operational standardized terms provides an optimal platform for communication across healthcare providers involved in JIA-TMJ arthritis management.

Imaging of the Temporomandibular Joint in Juvenile Idiopathic Arthritis: How Does Quantitative Compare to Semiquantitative MRI Scoring?

Purpose: Contrast-enhanced magnetic resonance imaging (MRI) is commonly used to evaluate temporomandibular joint (TMJ) disease in patients with juvenile idiopathic arthritis (JIA). However, MRI assessments have been limited by qualitative reporting, the presence of enhancement in normal joints, and a lack of standardized protocols. The purpose of the present study was to compare a quantitative MRI analysis using an enhancement ratio (ER) to a new semiquantitative system developed by Outcome Measures in Rheumatology and Clinical Trials (OMERACT).

Early Management of Infants With Robin Sequence: An International Survey and Algorithm.

Purpose: There is no widely accepted protocol for management of infants with Robin sequence (RS) who present with airway obstruction and feeding impairment. The purposes of this study were to evaluate diagnostic and treatment preferences of clinicians from the United States and non-US countries and to use these data to propose an algorithm for early management of infants with RS.

Materials And Methods: A cross-sectional study was implemented using a survey, which was distributed to craniofacial surgeons and non-surgeon physicians involved in management of infants with RS.

Is Amniotic Fluid Level a Predictor for Syndromic Diagnosis in Robin Sequence?

Objective: The purpose of this study was to determine whether gestational amniotic fluid level abnormalities were associated with postnatal syndromic status in a series of patients with Robin sequence (RS).

Design: Retrospective study of participants with RS at Boston Children's Hospital from 1967 to 2017. Participants were divided into syndromic and nonsyndromic groups.

Is Tongue-Lip Adhesion or Mandibular Distraction More Effective in Relieving Obstructive Apnea in Infants With Robin Sequence?

Purpose: Tongue-lip adhesion (TLA) and mandibular distraction osteogenesis (MDO) are the most common operations for obstructive apnea (OA) in infants with Robin sequence (RS). The purpose of this study was to compare early outcomes of TLA and MDO on resolution of OA.

Materials And Methods: This is a retrospective cohort study of infants with RS treated with TLA or MDO from 2005 through 2018.

Virulent Factor ESAT-6 Drives Macrophage Differentiation Toward the Pro-inflammatory M1 Phenotype and Subsequently Switches It to the Anti-inflammatory M2 Phenotype.

Tuberculosis, a human infectious disease caused by (), is still a major cause of morbidity and mortality worldwide. The success of as a pathogen relies mainly on its ability to divert the host innate immune responses. One way by which maintains a persistent infection in a "silent" granuloma is to inhibit inflammation and induce an immunoregulatory phenotype in host macrophages (MΦs).

Telogen hair loss and androgenetic-like alopecia in GAPO syndrome.

Growth retardation, Alopecia, Pseudoanodontia and Optic atrophy (GAPO) syndrome is a rare autosomal recessive condition whose cardinal features include a recognizable craniofacial dysmorphosis, growth retardation, alopecia, pseudoanodontia, and premature aging. We report on a 2-year-old Pakistani man affected with GAPO syndrome who additionally shows an androgenetic-like alopecia with normal testosterone levels and telogen hair loss. These are novel findings in GAPO syndrome.

Does Mandibular Distraction Change the Laryngoscopy Grade in Infants With Robin Sequence?

Purpose: To review a series of infants with Robin sequence (RS) who underwent mandibular distraction osteogenesis (MDO) at the authors' institution and document changes in pre- and postoperative laryngoscopy grades.

Materials And Methods: Consecutive patients with RS who underwent MDO from March 2005 to June 2017 were identified. Patients were included if they had a preoperative polysomnogram confirming obstructive sleep apnea, had failed nonoperative airway management, had undergone MDO by the senior author (C.

Temporomandibular Joint Ankylosis After Ramus Construction With Free Fibula Flaps in Children With Hemifacial Microsomia.

Purpose: Patients with hemifacial microsomia (HFM) and Kaban-Pruzansky type III mandibular deformities require ramus construction with autologous tissue. The free fibula flap, an alternative to the costochondral graft, has favorable characteristics for this construction but may be associated with temporomandibular joint ankylosis. The purposes of this study were to present a series of patients with HFM who underwent free fibula flap ramus construction, to determine the incidence of ankylosis, and to identify perioperative factors associated with ankylosis.

Time to Reconsider Management of the Temporomandibular Joint in Juvenile Idiopathic Arthritis.

The temporomandibular joints are often affected by juvenile idiopathic arthritis, but few evidence-based management strategies exist. Intra-articular steroid injection (IASI) is a common intervention and is associated with pain reduction and improved mandibular function. Emerging evidence, however, suggests that IASI may actually impair rather than improve mandibular growth.

An algorithm for predicting Robin sequence from fetal MRI.

Background: Infants with Robin sequence (RS) may present with airway compromise at delivery. Prenatal diagnosis would improve preparation and postnatal care. The purpose of this study was to devise a predictive algorithm for RS based on fetal magnetic resonance imaging (MRI).

Maxillary Sagittal Position in Relation to the Forehead: A Target for Orthognathic Surgery.

The relationship of the maxillary incisor to forehead position and angulation may be a predictor for the esthetic antero-posterior maxillary position in orthognathic surgery, but this has not been fully explored in the existing literature. Additionally, this analysis requires a lateral smiling photograph, which is not typically included in orthodontic/orthognathic records. This is a bidirectional study of Caucasian orthodontic patients with malocclusions correctable with nonsurgical and nonextraction treatment.

Pathogenesis of Cleft Palate in Robin Sequence: Observations From Prenatal Magnetic Resonance Imaging.

Purpose: The etiology of the palatal cleft in Robin sequence (RS) is unknown. The purpose of this study was to assess the position of the fetal tongue at prenatal magnetic resonance imaging (MRI) and to suggest a potential relation between tongue position and development of the cleft palate seen in most patients with RS.

Materials And Methods: This is a retrospective case-and-control study including fetuses with prenatal MRIs performed in the authors' center from 2002 to 2017.

Micrognathia and Oropharyngeal Space in Patients With Robin Sequence: Prenatal MRI Measurements.

Purpose: Micrognathia is the initiating feature of Robin sequence (RS) and leads to airway obstruction. Prenatal identification of micrognathia is currently qualitative and has not correlated with postnatal findings in previous studies. Oropharyngeal airway space has not been evaluated prenatally.

Precise osteotomies for mandibular distraction in infants with Robin sequence using virtual surgical planning.

Mandibular distraction osteogenesis (MDO) has become the first-line operation in many centers for the management of obstructive sleep apnea (OSA) in infants with (Pierre) Robin sequence (RS) not relieved by non-surgical approaches. Preoperative virtual surgical planning (VSP) may improve precision and decrease complications for this operation. This article reports a retrospective study of RS infants who underwent MDO for OSA using preoperative VSP and three-dimensionally printed cutting guides performed by one surgeon.

Oral Health Integration Into a Pediatric Practice and Coordination of Referrals to a Colocated Dental Home at a Federally Qualified Health Center.

We have integrated preventive oral health measures into preventive care visits for children at a federally qualified health center in Boston, Massachusetts. The program, started in 2015, covers 3400 children and has increased universal caries risk screening in primary care to 85%, fluoride varnish application rates to 80%, and referrals to a dental home to 35%. We accomplished this by minimizing pressures on providers' workflow, empowering medical assistants to lead the initiative, and utilizing data-driven improvement strategies, alongside colocated coordinated care.

Virtual Surgical Planning for Mandibular Distraction in Infants with Robin Sequence.

Mandibular distraction osteogenesis (MDO) successfully relieves obstructive sleep apnea in many infants with Robin sequence. Preoperative virtual surgical planning and fabrication of three-dimensionally printed cutting guides may lead to further improvements in the MDO technique and decrease the risk for damage to adjacent structures such as developing teeth and the inferior alveolar nerve. This report presents an algorithm for virtual surgical planning and three-dimensionally printing of cutting guides for MDO in infants with RS.

Evaluation of Oral and Maxillofacial Surgery Residents' Operative Skills: Feasibility and Engagement Study Using SIMPL Software for a Mobile Phone.

Purpose: There are no universally accepted tools to evaluate operative skills of surgical residents in a timely fashion. The purpose of this study was to determine the feasibility of using a smartphone application, SIMPL (System for Improving and Measuring Procedural Learning), developed by a multi-institutional research collaborative, to achieve a high rate of timely operative evaluations and resident communication and to collect performance data. The authors hypothesized that these goals would be achieved because the process is convenient and efficient.

Tissue-engineered bone with 3-dimensionally printed β-tricalcium phosphate and polycaprolactone scaffolds and early implantation: an in vivo pilot study in a porcine mandible model.

Purpose: Deep bone penetration into implanted scaffolds remains a challenge in tissue engineering. The purpose of this study was to evaluate bone penetration depth within 3-dimensionally (3D) printed β-tricalcium phosphate (β-TCP) and polycaprolactone (PCL) scaffolds, seeded with porcine bone marrow progenitor cells (pBMPCs), and implanted early in vivo.

Materials And Methods: Scaffolds were 3D printed with 50% β-TCP and 50% PCL.

Resolvin D1 and its aspirin-triggered 17R epimer. Stereochemical assignments, anti-inflammatory properties, and enzymatic inactivation.

We recently uncovered two new families of potent docosahexaenoic acid-derived mediators, termed D series resolvins (Rv; resolution phase interaction products) and protectins. Here, we assign the stereochemistry of the conjugated double bonds and chirality of alcohols present in resolvin D1 (RvD1) and its aspirin-triggered 17R epimer (AT-RvD1) with compounds prepared by total organic synthesis. In addition, docosahexaenoic acid was converted by a single lipoxygenase in a "one-pot" reaction to RvD1 in vitro.

Assessment of bone formation in a porcine mandibular distraction wound by computed tomography.

The purpose of this study was to document the progression of bone formation in a porcine mandibular distraction wound, at various distraction rates and fixation times, using three-dimensional computed tomography. Bone formation was assessed in a 0-day latency model (n=24 minipigs) using distraction rates of 1, 2, or 4 mm/day to create a 12 mm distraction gap. Animals were sacrificed at 0, 8, 16, or 24 days fixation.

Ultrasound: assessment of the distraction osteogenesis wound in patients undergoing mandibular lengthening.

Purpose: Common methods of assessment of the clinical distraction osteogenesis (DO) wound consist of serial physical examinations, plain radiographs, and computed tomography (CT). Ultrasound (US) is an inexpensive and efficient method of imaging that provides detailed assessment of bone formation across a defect. It has proved to be useful for the evaluation of long bone DO healing.

Dedifferentiation of odontogenic keratocyst epithelium after cyst decompression.

Purpose: Cytokeratin-10 expression by cystic epithelium has been shown in the suprabasilar layers of odontogenic keratocyts (OKCs) but not in dentigerous cysts. Cyst decompression and irrigation result in the loss of keratinization. In this study, we used cytokeratin-10 antibody staining to evaluate changes in OKC epithelium to determine if decompression/irrigation treatment results in an epithelial modulation that may be associated with lower long-term recurrence.