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Supernumerary teeth may be encountered as an incidental finding on a radiograph. When impacted, they may be associated with clinical signs related to different problems such as failure of eruption, teeth displacement, root resorption or cystic lesions. They may occur in primary and permanent dentition, in both the maxilla and mandible and can be single or multiple in patients with syndromes. Mesiodens is the most commonly impacted tooth and appears between the central maxillary incisors in pediatric ages. Supernumerary teeth distal to the third molar are rare, usually impacted and referred to as a distomolar. A 46-year-old male consulted with the main complaint of pain on the left side of the maxilla. A panoramic radiograph revealed a right impacted maxillary fourth molar located posterior to the third molar associated with a pericoronal radiolucency. The supernumerary tooth was removed surgically under local anesthesia and the pericoronal lesion enucleated. Histopathological examination was consistent with the diagnosis of a dentigerous cyst associated with an impacted distomolar. Healing was uneventful, and the patients remained asymptomatic. The occurrence of an impacted maxillary distomolar is rare and even rarer the association with a dentigerous cyst.

Objective: Oral pathological lesions in the mouth vary greatly. However, few studies have evaluated these lesions with long-term data. This study aimed to analyze the demographic parameters (i.e., age, gender, anatomical location, and incidence) of oral pathologies in the Aegean Region. Materials and Methods: In this retrospective study, histopathological reports of 30 years in the Department of Oral Pathology, Faculty of Dentistry, Ege University, were analyzed. Data on sex, age, lesion location, and histopathologic diagnosis were analyzed. Results: The histopathological data of 6,330 patients were evaluated. Most of the pathological oral lesions were osseous lesions (n=3,858), and 2,472 soft tissue pathologies were identified. The posterior mandible was the most common location of these lesions (n=2,011). Conclusion: Determining the variety and frequency of oral pathological lesions at a societal level is important for the management of these lesions.

Complex interaction of incisors of the multi-element system “jaw – tooth – periodontium – enamel – dentinˮ is considered in the present work. The model was created on the basis of tomographic images taking into account previous studies of the human dental apparatus for a simplified model of three molars. The aim of the work is to determine the stress-strain states of the “jaw – periodontium – tooth – dentinˮ system for a different number of incisors and their location using three-dimensional computer finite-element modeling. The results of the study allow obtaining a more complete and accurate assessment of the state of the human dentofacial apparatus as a whole and each of its elements separately in order to improve the technologies and methods of prosthetics.

Background: The objective of this study was to evaluate the accumulation of ions in blood and organs caused by Ti metal particles in a mandibular defect in rats, together with a description of the local reaction of oral tissues to these titanium alloy debris. Methods: Twenty Sprague-Dawley rats were randomly distributed into three groups: an experimental group with a mandibular bone defect filled with metallic debris obtained by implantoplasty; a positive control group; and a negative control group. Thirty days after surgery, the rats were euthanized and perilesional tissue surrounding the mandibular defect was removed, together with the lungs, spleen, liver and brain. Two blood samples were collected: immediately before surgery and before euthanasia. The perilesional tissue was histologically analyzed using hematoxylin-eosin staining, and titanium, aluminum and vanadium ion concentrations in blood and organs were measured by TQ-ICP-MS. Descriptive and bivariate analyses of the data were performed. Results: All rats with implanted metal debris showed metal particles and a bone fracture callus on the osseous defect. The metal particles were surrounded by a foreign body reaction characterized by the presence of histiocytes and multinucleated giant cells. The experimental group had a significant higher concentration of Ti ions in all studied organs except lung tissue (p < 0.05). In addition, there were more V ions in the brain in the experimental group (p = 0.008). Conclusions: Although further studies are required to confirm the clinical relevance of these results, Ti metal particles in the jaw might increase the concentration of metal ions in vital organs and induce a foreign body reaction. This article is protected by copyright. All rights reserved. Keywords: Ion release; Ti6Al4V; implantoplasty; metal particles; peri-implantitis; titanium.

Background: One of the most frequent complications in guided bone regeneration (GBR) is wound dehiscence, which compromises treatment outcomes. Thus, primary tension-free suture is essential to avoid wound dehiscence. The purpose of this study was to compare the extension of 2 different mandibular flaps in human cadaveric specimens, and to measure the size of the supraperiosteal blood vessels. Material and methods: Five freshly unfrozen human cadaveric specimens were used. Arteries and veins were marked and bilateral classical lingual flaps (extending from the second premolar to the retromolar area) were prepared. In one side, the mylohyoid muscle was detached to increase the coronal extension of the flap. An implant drill was used to measure the extension of the flap after exerting 30 g of traction, before and after detaching the mylohyoid muscle. The size of the largest vascular structures of the flap was measured using a periodontal probe. Results: The classical flap extension was 5.99 mm (95% confidence interval (CI): 5.08 to 6.90), while the coronally advanced flap extension with mylohyoid muscle detachment was 14.96 mm (95%CI: 10.81 - 19.11). A statistically significant difference was found between the 2 groups (p= 0.0002), with a mean extension difference was 8.97 mm (95%CI: 5.02 to 12.91). The mean largest artery had 0.20 mm of diameter (95%CI: 0.15 - 0.26). Conclusions: The detachment of the mylohyoid muscle from the lingual flap allows to significantly increase its extension by 2.5 times. The superficial arteries found in the lingual flap have a small diameter (around 0.2mm).

Radiopaque lesions and lesions of mixed density are less frequent than radiolucent lesions of the jawbones. They comprise a spectrum of odontogenic and non-odontogenic lesions. The latter group includes inherited and developmental disorders, osteomyelitis, and benign and malignant primary bone tumors and metastases. Most odontogenic radiopaque or mixed lesions are either related to the apex or more rarely to the crown of the tooth, although there are exceptions to this rule. Some lesions, such as a torus mandibularis and torus palatinus, have a characteristic location, whereas others show no relationship to the dentition. This article describes the most characteristic and prevalent radiopaque and mixed lesions of the jaws and their imaging characteristics. Paget's disease, fibrous dysplasia, and rare sclerotic bone diseases of the maxillofacial bones are discussed elsewhere in this issue. Careful correlation of clinical presentation, panoramic radiographs, cone beam computed tomography, and histopathology are the cornerstones for appropriate lesion characterization. ispartof: SEMINARS IN MUSCULOSKELETAL RADIOLOGY vol:24 issue:05 pages:558-569 ispartof: location:United States status: published

During the last years, feeding mechanisms of sharks have been documented mainly based on their stomach contents supplemented by video footages of feeding behaviours in some species. Rare kinematic analyses of shark jaws contributed additionally to our knowledge. However, not all structures important to prey capture in sharks have been investigated yet. Here, we summarize the current knowledge about labial cartilages in sharks and compare them on a morphological base. Labial cartilages are considered a plesiomorph character found in extinct and extant species and their number and size varies a lot between species. We identified labial cartilages in representatives of 27 from 36 shark families and detected different numbers, sizes and forms of labial cartilages, as well as differing positioning along the jaws. The morphology of labial cartilages can help to identify suction-feeding in sharks and to estimate the quality of the suction generated by a species. We were able to summon different shark taxa according to their morphology and positioning of labial cartilages into eight groups, which we consider morphological modules. To determine if these modules bare a phylogenetic signal further testing with rigorous methodologies and more shark species as well as batomorphs needs to be done. This study therefore only can represent a first starting point providing future research pathways.

O osteossarcoma é uma neoplasia de origem mesenquimal maligna agressiva, caracterizada pela produção de matriz osteóide e céulas fusiformes estromais. O presente trabalho realizado na forma de revisão narrativa da literatura tem como objetivo identificar as informações sobre o osteossarcoma oral, enfatizando, também, a importância do diagnóstico precoce da doença feito pelo profissional de saúde, minimizando sua reação recidivante e metastática. Foi realizada uma busca na base de dados Scielo, Lilacs, Google Acadêmico e Rsd Journal. A literatura investigada mostrou que o osteossarcoma é o tumor maligno primário mais comum do osso, responsável por 20% dos sarcomas, sendo que 5% destes ocorrem na região maxilofacial mais frequentemente na mandíbula. Os principais sinais e sintomas são tumefação, dor, parestesia, mobilidade dentária e limitação funcional. Os fatores etiológicos estão associados a características do paciente como idade e sexo, e também por fatores genéticos e anomalias ósseas pré-existentes. O diagnóstico é obtido através de exames imaginológicos e histopatológicos. O melhor tratamento para o osteossarcoma corresponde em ressecção cirúrgica da lesão minimizando seu comportamento recidivante e metastático. Diante dessa realidade, reafirma-se a importância do conhecimento do dentista sobre a lesão e do diagnóstico precoce. Osteosarcoma is an aggressive malignant mesenchymal neoplasm characterized by the production of osteoid matrix and stromal spindle cells. The present work carried out in the form of a narrative review of the literature aims to identify information about oral osteosarcoma, also emphasizing the importance of early diagnosis of the disease made by the health professional, minimizing its recurrence and metastatic reaction. A search was carried out in the Scielo, Lilacs, Google Scholar and Rsd Journal databases. The investigated literature showed that osteosarcoma is the most common primary malignant tumor of the bone, responsible for 20% of sarcomas, with 5% of these occurring in the maxillofacial region, most often in the mandible. The main signs and symptoms are swelling, pain, paresthesia, tooth mobility and functional limitation. Etiological factors are associated with patient characteristics such as age and sex, as well as genetic factors and pre-existing bone anomalies. The diagnosis is obtained through imaging and histopathological examinations. The best treatment for osteosarcoma is surgical resection of the lesion, minimizing its recurrence and metastatic behavior. Given this reality, the importance of the dentist's knowledge of the lesion and early diagnosis is reaffirmed. El osteosarcoma es una neoplasia mesenquimatosa maligna agresiva caracterizada por la producción de matriz osteoide y células fusiformes del estroma. El presente trabajo realizado en forma de revisión narrativa de la literatura tiene como objetivo identificar información sobre el osteosarcoma bucal, enfatizando además la importancia del diagnóstico precoz de la enfermedad realizado por el profesional de la salud, minimizando su recurrencia y reacción metastásica. La búsqueda se realizó en las bases de datos Scielo, Lilacs, Google Scholar y Rsd Journal. La literatura mostró que el osteosarcoma es el tumor maligno primario más común del hueso, responsable del 20% de los sarcomas, con un 5% de estos ocurriendo en la región maxilofacial, con mayor frecuencia en la mandíbula. Los principales signos y síntomas son tumefacción, dolor, parestesias, movilidad dentaria y limitación funcional. Los factores etiológicos están asociados a características del paciente como la edad y el sexo, así como a factores genéticos y anomalías óseas preexistentes. El diagnóstico se obtiene a través de exámenes de imagen e histopatológicos. El mejor tratamiento del osteosarcoma es la resección quirúrgica de la lesión, minimizando su recurrencia y comportamiento metastásico. Ante esta realidad, se reafirma la importancia del conocimiento de la lesión por parte del odontólogo y su diagnóstico precoz.

This report intends to compare classic presentations of odontogenic myxoma in contrast to our case. We also suggest a comprehensive evaluation of lesions and strongly advocate against premature treatments before reaching a definitive diagnosis.

Bisphosphonates are inorganic pyrophosphate agents that reduce bone turnover. These agents reduce bone pain and delay skeletal complications, such as fractures in patients with metastatic lytic lesions, malignant-related hypercalcemia, multiple myeloma, Paget's disease of bone, and osteoporosis. Osteonecrosis, developing in the jaw bones specifically, has been described as a complication associated with the use of bisphosphonates. In this report, we presented osteonecrosis-like magnetic resonance imaging findings that can be confused with bone metastasis in two patients who underwent long-term bisphosphonate treatment and the value of bone scan andBisfosfonatlar, kemik döngüsünü azaltan inorganik pirofosfat maddelerdir. Bu ajanlar, metastatik litik lezyonları, malign ilişkili hiperkalsemi, multipl miyelom, kemik Paget hastalığı ve osteoporozu olan hastalarda kemik ağrısını azaltmak ve kırık gibi iskelet komplikasyonlarını geciktirmek için kullanılır. Özellikle çene kemiklerinde gelişen osteonekroz, bisfosfonatların kullanımı ile ilişkili bir komplikasyon olarak tanımlanmıştır. Bu bildiride, uzun dönem bifosfonat tedavisi almış iki olguda kemik metastazını taklit eden osteonekroza ait olabilecek manyetik rezonans görüntüleme bulguları ile birlikte kemik sintigrafisi ve

Background/purpose: Radiological examination is indispensable in the diagnosis and follow-up of cemento-osseous dysplasia (COD). The aim of this retrospective study was to describe a series of COD cases, identify the frequencies of COD subtypes, and investigate the demographic and radiological characteristics in relation to subtypes. Materials and methods: Cone beam computed tomography (CBCT) images/reports of patients with a diagnosis of COD were included in the study. The data collected included information on the age, sex, subtype of COD, location of COD, and region involved. Information regarding the internal density, effects on surrounding structures, and presence of concomitant lesions was also collected. The data obtained were evaluated statistically. Results: The study group included CBCT images of 142 patients (130 females (91.5%) and 12 males (8.5%)) with a mean age of 46.97 +/- 10.57 years. The mandible was involved in almost all cases (99.3%). The most common subtype was florid COD (51.4%) and lesions with hyper dense internal density (81.7%) were more commonly observed. Cortical thinning (78.2%) was a prominent feature. The frequency of root resorption in periapical COD cases (57.1%) was observed to be significantly higher (p < 0.05). All hypercementosis cases were associated with florid subtype (p < 0.05). In a minority of cases (6.3%), the lesions were associated with bone cysts and osteomyelitis. Conclusion: CBCT images clearly demonstrated the effect of COD lesions on surrounding structures. CBCT is an appropriate imaging modality for the diagnosis and follow-up of COD which is the most common fibro-osseous lesion in clinical practice. (c) 2021 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons. org/licenses/by-nc-nd/4.0/).

Ameloblastomas are benign but locally invasive odontogenic tumors most frequently located in the mandible. The gold standard of treatment is the surgical resection of the tumor with safety margins. Postsurgical defects generate a significant morbidity that needs reconstruction and oral rehabilitation to restore the oral functions. This case report describes the prosthetic rehabilitation of a 42-year-old male after resection of a mandibular ameloblastoma. Excision of the lesion by segmental mandibulectomy and mandibular reconstruction by microvascularized fibula flap was performed. After placement of 6 dental implants, the patient was rehabilitated with a lower hybrid prosthesis fabricated using computer-aided design-computer-aided manufacturing. During a 7-year and 5-month follow-up, some clinical complications were observed.

Phylogenetic analysis of morphological data proceeds from a fixed set of primary homology statements, the character-by-taxon matrix. However, there are cases where multiple conflicting homology statements can be justified from comparative anatomy. The upper jaw bones of placoderms have traditionally been considered homologous to the palatal vomer-dermopalatine series of osteichthyans. The discovery of ‘maxillate’ placoderms led to the alternative hypothesis that ‘core’ placoderm jaw bones are premaxillae and maxillae lacking external (facial) laminae. We introduce a BEAST2 package for simultaneous inference of homology and phylogeny, and find strong evidence for the latter hypothesis. Phenetic analysis of reconstructed ancestors suggests that maxillate placoderms are the most plesiomorphic known gnathostomes, and the shared cranial architecture of arthrodire placoderms, maxillate placoderms and osteichthyans is inherited. We suggest that the gnathostome ancestor possessed maxillae and premaxillae with facial and palatal laminae, and that these bones underwent divergent evolutionary trajectories in placoderms and osteichthyans.

Radiolucent lesions in the jaw bones comprise a whole spectrum of odontogenic and nonodontogenic lesions. Although the imaging appearance is not always specific, careful radiologic analysis may contribute to characterization of these lesions. A useful approach is to first analyze the absence or presence of a relationship of the lesion to the teeth. The relation may be either near the tooth apex or crown of the tooth. Other lesions may or may not show any specific anatomical location. After analysis of the primary location of the lesion, additional criteria that may help in further imaging characterization are lesion demarcation and morphology, involvement of the cortex and periosteum, and soft tissue changes. This article describes the most characteristic and prevalent radiolucent lesions of the jaws at each location. In routine clinical practice, cone beam computed tomography is sufficient for appropriate lesion characterization, although magnetic resonance imaging may be useful in selected cases. ispartof: SEMINARS IN MUSCULOSKELETAL RADIOLOGY vol:24 issue:05 pages:549-557 ispartof: location:United States status: published

The relationship between posture, spine, and temporomandibular joint (TMJ) is still a hotly debated topic in medicine. TMJ takes part in different physiological functions of the organism, starting from its embryological development, it is possible that it influences different vital functions. There is a strong connection between the respiratory tract and dental/maxillary occlusion or anatomy. The altered physiology of this district leads to pathologies that could affect the whole organism. On the contrary, it is also possible to highlight some symptoms of distant organism districts. Knowing well the pathophysiology of this district and semiotics, it is also possible to diagnose pathologies affecting other organs.

This thesis was created as a subproject of the Berlin-Brandenburg Research Platform, with the integrated graduate school "Innovations in the 3R Research - Genetic Engineering, Tissue Engineering and Bioinformatics". BB3R was established under the umbrella of the Dahlem Research School (DRS) of Freie Universit��t Berlin and aims to provide substantial progress in 3R alternatives by intensive systematic research. The overarching objective of this thesis was to establish an anatomical data collection with detailed and age-related data of the mandible and the mandibular canal of growing G��ttingen Minipigs using 3D Computed Tomography and to compare this data with human mandibular anatomy. Therefore, it could be determined, whether the G��ttingen Minipig represents an anatomically suitable animal model for orofacial surgery. In order to refine and avoid intra- and postoperative complications in the sense of the 3Rs, this data collection should be prospectively used in dental and orofacial experiments. Chapter 1 generally introduces the market size, sales figures and the utilization of dental implants in dentistry and orofacial reconstructive surgery. It also focusses on the required preclinical testing procedures to proof the implants��� biocompatibility and safety in order to be authorized for clinical testing in humans. This involves in vivo testing in large animal models. Due to stricter legal requirements over the use of primates for scientific purposes, the G��ttingen Minipig is nowadays extensively used as animal model in pre-clinical dental and orofacial research. Nevertheless, several authors have raised concerns over the use of the G��ttingen Minipig in this research area, observing complications and success rates below 60%. Chapter 2 gives a literature review about the development of different minipig breeds, their general scientific use and the corresponding German and European animal research numbers. Then the reader is introduced to the role of the G��ttingen Minipig in dental and orofacial research, how the in vivo procedures are performed and what complications can occur. In addition, the European law, the definitions of the 3Rs and their implementation in research are elucidated. At the end of the chapter, the technical methodologies (CT, 2D and 3D reconstruction, Cephalometry and visualization software) used in this study, are explained. Chapter 3 lists the detailed objectives of the thesis. Chapter 4 covers the publication ���Refining experimental dental implant testing in the G��ttingen Minipig using 3D computed tomography ��� A morphometric study of the mandibular canal���. In this study, morphometric and age-related data of the mandibular canal and the alveolar ridge of the G��ttingen Minipig was reported and compared with the human anatomy, in order to avoid complications during in vivo testing of endosseous dental implants. Using 3D computed tomography, six parameters of the mandibular canal as well as the alveolar bone height and the alveolar ridge width were measured in G��ttingen Minipigs aged 12, 17 and 21 months. The study found that the volume, length and depth of the mandibular canal all increased with age. The width of the canal did not change significantly with age. There were high individual differences within each age group, for example within the 21 months old group the animal with the lowest canal volume of 4.7ml was 14kg heavier than the animal with the significantly highest volume of 13.4ml. In contrast to humans, minipigs possess a significantly larger mandibular canal. With higher age and increasing canal volume, loss of deep spongy bone in the posterior premolar and molar regions could be observed, which potentially results in the inferior alveolar neurovascular bundle coming into close proximity with the tooth roots. This reduced the available space for dental implants and could negatively affect implant stability and the integrity of the inferior alveolar neurovascular bundle. This problem is aggravated by the minipigs��� narrower alveolar ridge width in comparison with healthy humans. Surprisingly, the body mass does not have an influence on any of the measured parameters. When one images the inferior alveolar vein, two basic patterns occur. One being a straight traverse, the other being a variable undulating route where it rises and falls as it travels through the length of the canal. Dynamic anatomical changes could be proven until the age of 21 months. Due to ongoing growth it is inadvisable to use minipigs younger than 21 months in experimental implant dentistry. Paradoxically, the measurements of the 12 months old pigs indicate a closer alignment of their mandibular anatomy to that of humans, suggesting that they may be better models for implant studies. Given the variability in mandibular canal dimensions in similar age cohorts, the use of imaging techniques is essential for the selection of individual minipigs for the interventions and thus higher success rates. Chapter 5 covers the publication ���Cephalometric studies of the mandible, its masticatory muscles and vasculature of growing G��ttingen Minipigs ��� A comparative anatomical study to refine experimental mandibular surgery���. This study elucidated how comparable the mandible of G��ttingen Minipigs and humans are, and whether the frequently reported complications could be caused by specific anatomical characteristics of the minipigs��� mandible, its masticatory muscles and associated vasculature. Therefore, twenty-two mandibular cephalometric parameters were measured on CT scans of G��ttingen Minipigs aged between 12 and 21 months. Of the 22 parameters measured, only four were found to be highly comparable, whilst the others were not. Again, especially younger minipigs showed a closer alignment to human anatomy. Minipigs generally showed a higher mandibular ramus, anterior mentum height and a significantly longer mandible with a much steeper mandibular angle. They in contrast possess a shorter superior ramus length and a lower coronoid process volume. The 3D examinations of the minipigs��� vasculature pictured a large, tortuous network medial to the mandibular ramus, mainly consisting of the very prominent deep facial vein and maxillary artery. This vascular complex interferes with the principal sectional plane for MDO that could cause strong and inaccessible bleeding. The morphology and dimensions of the mandibular body in humans and minipigs are very different. Whilst humans have a mandibular body with an ovoid cross-section, that of minipigs can be pear-shaped. Consequently, bicortical screws that are positioned in the inferior part of the mandibular body as routinely performed in humans, could, when placed in a similar way in a G��ttingen Minipig, cause trauma to the inferior alveolar nerves and vessels. Bicortical screws implanted in the inferior cortex would probably have impaired stability, due to the thin inferior bone thickness. Literature revealed that the dynamics of mastication in pigs and in humans differ greatly. Pigs have a higher crushing force and closing velocity than humans. In addition, they postoperatively grind their teeth extensively as well as bite on hard objects such as their cages that could potentially impair wound healing and implant stability. Based on the results of this study, the authors consider the G��ttingen Minipig not to be an anatomically ideal animal model for experimental mandibular surgery research. The minipig mandible not only differs greatly from that of humans but also is highly variable in its morphology within animals of the same age group. This raises concerns, that extrapolating acquired scientific results of G��ttingen Minipigs to humans could be misleading or incorrect. Due to the lack of alternative large animal models, the authors recommend to precisely plan mandibular surgical experiments based on radiographic techniques, such as Computed Tomography, and to choose suitable age groups and use customized implants based on the mandibular dimensions as reported in this study. Chapter 6 more precisely discusses the suitability of G��ttingen Minipigs as an animal model for dental and orofacial research. In addition, alternative animal models for the G��ttingen Minipigs, with their anatomical and physiological advantages and disadvantages are, in regards to the recommendations of the ISO 7405:2018, discussed. The chapter ends with conclusive remarks, while giving an outlook on a database planned in the future., Die vorliegende Doktorarbeit entstand als Teilprojekt der Berlin-Brandenburger Forschungsplattform BB3R mit integriertem Graduiertenkolleg ���Innovationen in der 3RForschung - Gentechnik, Tissue Engineering und Bioinformatik���, welche unter dem Dach der Dahlem Research School (DRS) der Freien Universit��t Berlin gegr��ndet wurde. Das Ziel von BB3R ist die breite Implementierung von Alternativmethoden und tierschonenden Verfahren in der Forschung. ��bergeordnetes Ziel dieser Dissertation war es, eine anatomische Datensammlung mit detaillierten und altersbezogenen Daten des Unterkiefers und des Unterkieferkanals von heranwachsenden G��ttinger Minischweinen mittels 3DComputertomographie zu erstellen und diese Daten mit solchen der menschlichen Unterkieferanatomie zu vergleichen. Dadurch konnte festgestellt werden, ob das G��ttinger Minischwein ein anatomisch geeignetes Tiermodell f��r die orofaziale Chirurgie darstellt. Um ein Refinement im Sinne der 3R zu erzielen und intra- und postoperative Komplikationen zu vermeiden, sollte diese Datensammlung prospektiv in der experimentellen dentalen und orofazialen Chirurgie an G��ttinger Minischweinen eingesetzt werden. Kapitel 1 stellt das Marktvolumen, die Verkaufszahlen und die Verwendung von Implantaten in der Zahnheilkunde und der orofazialen rekonstruktiven Chirurgie vor. Ebenso werden die erforderlichen pr��klinischen Testverfahren zum Nachweis der Biokompatibilit��t und Sicherheit von Implantaten erl��utert, um f��r die klinische Erprobung am Menschen zugelassen zu werden. Hierf��r werden h��ufig in-vivo-Tests an Gro��tiermodellen durchgef��hrt. Aufgrund strengerer gesetzlicher Vorgaben an Tierversuche mit Primaten, wird das G��ttinger Minischwein heute sehr h��ufig als Tiermodell in der pr��klinischen zahn��rztlichen und orofazialen Forschung eingesetzt. Trotz allem haben sich mehrere Autoren hinsichtlich der Verwendung des G��ttinger Minischweins in diesem Forschungsbereich kritisch ge��u��ert, da sehr viele Komplikationen und ein geringer Prozentsatz erfolgreicher Setzungen von Implantaten, teilweise unter 60%, beobachtet wurden. Kapitel 2 gibt eine Literatur��bersicht ��ber die Entwicklung der verschiedenen Minipig-Rassen, ihre allgemeine wissenschaftliche Verwendung und die entsprechenden deutschen und europ��ischen Tierversuchszahlen. Anschlie��end wird der Leser in die Rolle des G��ttinger Minipigs in der dentalen und orofazialen Forschung eingef��hrt und mit den Abl��ufen von invivo-Eingriffen und deren Komplikationen vertraut gemacht. Dar��ber hinaus werden das europ��ische Recht, die Definitionen der 3Rs und deren Umsetzung in der Forschung erl��utert. Am Ende des Kapitels werden die technischen Methoden (CT, 2D- und 3D-Rekonstruktion, Kephalometrie und Visualisierungssoftware) erkl��rt, die in dieser Studie verwendet wurden. Kapitel 3 listet die detaillierten Ziele der Arbeit auf. Kapitel 4 beinhaltet die Publikation ���Refining experimental dental implant testing in the G��ttingen Minipig using 3D computed tomography ��� A morphometric study of the mandibular canal���. In dieser Studie wurden morphometrische und altersbezogene Daten des Unterkieferkanals und des Alveolarkamms des G��ttinger Minischweins gemessen und mit der menschlichen Anatomie verglichen, um Komplikationen bei in-vivo-Tests enossaler Zahnimplantate zu vermeiden. Mittels 3D-Computertomographie wurden an G��ttinger Minischweine im Alter von 12, 17 und 21 Monaten sechs Parameter des Unterkieferkanals, sowie die H��he des Alveolarknochens und die Breite des Alveolarkamms gemessen. Die Studie ergab, dass Volumen, L��nge und Tiefe des Unterkieferkanals mit dem Alter zunahmen. Die Breite des Kanals ��nderte sich mit dem Alter nicht signifikant. In jeder Altersgruppe konnten gro��e individuelle Unterschiede festgestellt werden. Aus der Gruppe der 21 Monate alten Minischweine war das Tier mit dem niedrigsten Kanalvolumen von 4,7 ml 14 kg schwerer als das Tier mit dem h��chsten gemessenen Volumen von 13,4 ml. Minischweine besitzen im Gegensatz zum Menschen einen deutlich gr����eren Unterkieferkanal. Mit zunehmendem Alter und zunehmendem Kanalvolumen konnte ein Verlust von tiefem spongi��sem Knochen im hinteren Pr��molar- und Molarbereich beobachtet werden, was m��glicherweise dazu f��hrt, dass sich die Gef����e und der dazugeh��rige Nerv des Unterkieferkanals unmittelbar an die Zahnwurzel ann��hert. Dies f��hrt zur Reduktion von verf��gbarem Knochen f��r die Setzung von Zahnimplantaten und zu verringerter Stabilit��t und Integrit��t und kann die Verletzungsgefahr der Leitungsstrukturen im Unterkieferkanal erh��hen. Dieses Problem wird durch einen, im Vergleich zum gesunden Menschen schmaleren Alveolarkamm noch einmal versch��rft. ��berraschenderweise hat das K��rpergewicht keinen Einfluss auf die gemessenen Parameter. Bei der Visualisierung der Vena alveolaris inferior, treten zwei Konfigurationsmuster auf. Einerseits ein gerader, andererseits ein variabler Verlauf mit korkenzieherartigen Windungen, die sich w��hrend der Route durch den Kanal auf und ab bewegen. Kieferwachstum konnte bis zum Alter von 21 Monaten nachgewiesen werden. Aufgrund des anhaltenden Wachstums ist es daher nicht ratsam, Minischweine die j��nger als 21 Monate sind, in Studien zu Zahnimplantaten einzusetzen. Paradoxerweise zeigen die Messungen an 12 Monate alten Minischweinen eine bessere anatomische Vergleichbarkeit, was diese Altersgruppe f��r Zahnimplantatsstudien potenziell geeigneter macht. Angesichts der hohen Variabilit��t der Unterkieferkanaldimensionen in Tieren gleicher Altersklassen, ist der Einsatz bildgebender Verfahren zur Auswahl einzelner Minischweine und zur Erh��hung der Erfolgsaussichten von chirurgischen Interventionen von entscheidender Bedeutung. Kapitel 5 befasst sich mit der Ver��ffentlichung ���Cephalometric studies of the mandible, its masticatory muscles and vasculature of growing G��ttingen Minipigs ��� A comparative anatomical study to refine experimental mandibular surgery���. In dieser Studie wurde untersucht, wie vergleichbar der Unterkiefer von G��ttinger Minischweinen und Menschen ist und ob die h��ufig auftretenden Komplikationen bei G��ttingen Minipigs durch spezifische anatomische Merkmale des Unterkiefers, seiner Kaumuskulatur und Gef����e verursacht werden. Daher wurden 22 zephalometrische Parameter an CT-Aufnahmen des Unterkiefers G��ttinger Minischweine im Alter zwischen 12 und 21 Monaten gemessen. Von diesen 22 Parametern erwiesen sich nur vier als gut vergleichbar, die anderen dagegen nicht. Wiederum zeigten insbesondere j��ngere Minischweine eine bessere ��bereinstimmung zur menschlichen Anatomie. Minipigs hatten im Allgemeinen einen h��heren Kieferast, ein h��heres Kinn und einen signifikant l��ngeren Unterkiefer mit deutlich steilerem Unterkieferwinkel. Sie besitzen im Gegensatz zum Menschen einen k��rzeren oberen Kieferastbereich und ein geringeres Volumen des Processus coronoideus. Die 3D-Visualisierung des Gef����systems der Minischweine zeigten ein ausgedehntes, gewundenes Netzwerk medial des Unterkieferastes, das haupts��chlich aus der sehr ausgepr��gten, tiefen Gesichtsvene und der Oberkieferarterie bestand. Dieser Gef����komplex interferiert mit der Schnittf��hrung von Unterkiefer-Distraktionsosteogenesen, was starke und unzug��ngliche Blutungen zur Folge haben kann. Die Morphologie und Dimensionen des Unterkieferk��rpers von Mensch und Minischwein sind sehr unterschiedlich. W��hrend Menschen einen Unterkieferk��rper mit hochovalem Querschnitt besitzen, kann der von Minischweinen Birnenform annehmen. Infolgedessen k��nnten bikortikale Schrauben, die beim Menschen im unteren Teil des Unterkiefers routinem����ig eingesetzt werden, bei vergleichbarer Positionierung im Minischwein, zu Verletzungen des Unterkiefernerv und der Gef����e f��hren. Bikortikale Schrauben, die in die untere Kortikalis implantiert werden, w��rden zudem h��chstwahrscheinlich aufgrund der d��nnen Wandstruktur eine beeintr��chtigte Stabilit��t besitzen. Der Fachliteratur war zu entnehmen, dass die Dynamik des Kauvorgangs von Schweinen und Menschen sehr unterschiedlich ist. Schweine haben eine h��here Mahlkraft und Schlie��geschwindigkeit Au��erdem knirschen sie postoperativ ausgiebig mit den Z��hnen und kauen auf harten Gegenst��nden wie K��figstangen, was m��glicherweise die Wundheilung und die Stabilit��t des Implantats beeintr��chtigen k��nnte. Basierend auf den Ergebnissen dieser Studie bewerten die Autoren das G��ttinger Minischwein als ein anatomisch nur bedingt geeignetes Tiermodell f��r die experimentelle dentale und orofaziale Forschung. Der Unterkiefer des Minipigs unterscheidet sich nicht nur stark von dem des Menschen, sondern ist in seiner Morphologie auch bei Tieren gleicher Altersgruppen sehr unterschiedlich. Dies gibt Anlass zur Sorge, dass die ��bertragbarkeit der von G��ttingen Minischweinen erworbenen wissenschaftlichen Ergebnisse auf den Menschen, irref��hrend oder falsch sein k��nnten. Aufgrund des Fehlens alternativer Gro��tiermodelle, empfehlen die Autoren die sorgf��ltige Planung chirurgischer Eingriffe am Unterkiefer mittels bildgebenden Verfahren wie der Computertomographie, um auf Grundlage der in dieser Dissertation angegebenen Dimensionen ma��geschneiderte Implantate und geeignete Altersklassen zu entwerfen und auszuw��hlen. In Kapitel 6 wird die Eignung des G��ttinger Minischweins als Tiermodell f��r die dentale und orofaziale Forschung diskutiert. Dar��ber hinaus werden alternative Tiermodelle mit ihren anatomischen und physiologischen Vor- und Nachteilen aufgef��hrt und mit den Empfehlungen der ISO 7405:2018 diskutiert. Das Kapitel endet mit abschlie��enden Bemerkungen und Denkanst����en und gibt einen Ausblick auf eine geplante Datenbank.

Background: Sinus augmentation can be performed with or without grafting biomaterials, and to date, there is no quality evidence regarding the augmentation of the sinus floor using only platelet concentrates, which can improve the healing period and enhance bone regeneration by stimulating angiogenesis and bone formation. The main objective of this paper was to assess the effect of the sole use of platelet concentrates in sinus augmentation in terms of newly formed bone, augmented bone height, and clinical outcomes and to assess the additional beneficial effects of platelet-rich fibrin (PRF) in combination with other grafting biomaterials. Methods: A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Pooled analyses were performed with the Review Manager software. Results: For sinus elevation only using platelet concentrates, 11 studies met the inclusion criteria and were included for qualitative synthesis. Only one study was a clinical trial, which reported improved outcomes for the allograft group compared to the titanium-PRF (T-PRF) group. A total of 12 studies where PRF was used in addition to grafting biomaterials met eligibility criteria and were included in the review. Results from meta-analyses provided no additional beneficial effects of PRF in sinus augmentation in terms of bone height and percentage of soft tissue area. There was a statistically significant lower percentage of residual bone substitute material in the PRF (+) group compared to the PRF (−) group. The percentage of newly formed bone was slightly higher in the PRF (+) group, but this was not statistically significant. Conclusion: There is no robust evidence to make firm conclusions regarding the beneficial effects of the sole use of platelet concentrates in sinus augmentation. However, studies have shown favorable outcomes regarding implant survival, bone gain, and bone height. The use of PRF with other grafting biomaterials appears to provide no additional beneficial effects in sinus lift procedures, but they may improve the healing period and bone formation. Well-conducted randomized clinical trials (RCTs) are necessary to confirm the available results to provide recommendations for the clinical practice

Objetivo: el objetivo de esta revisión es determinar si el tratamiento con Bifosfonatos u otros medicamentos antirresortivos y antiangiogénico influye en el éxito de la regeneración y / o tratamiento implantológico. Material y Métodos: se realizó una revisión bibliográfica en la base de datos PubMed en los últimos 5 años utilizando las siguientes palabras: "Sinus Floor Augmentation"[Mesh] OR "Dental Implants"[Mesh]) OR "Guided Tissue Regeneration"[Mesh]) AND "Osteonecrosis"[Mesh]. Los artículos seleccionados según los criterios de inclusión y exclusión fueron evaluados utilizando los 22 ítems de la declaración STROBE. Aplicamos la siguiente pregunta clínica PICO: ¿influye la terapia con agentes asociados a la Osteonecrosis medicamentosa en el éxito de los tratamientos regeneradores y implantológicos?. Resultados: en la búsqueda inicial se obtuvieron un total de 27 artículos. Tras eliminar los que no hacían referencia al tema, estaban duplicados o no cumplían los criterios de inclusión/exclusión se realizó una lectura completa de los artículos y evaluamos su calidad metodológica, obtuviendo 6 estudios de elevada calidad metodológica y 2 de moderada. Conclusiones: La literatura que trata este tema es escasa, serían necesarios ensayos clínicos randomizados para establecer protocolos de actuación relativos al tratamiento implantológico, en pacientes en tratamientos antirresortivos. El riesgo de desarrollar una Osteonecrosis asociada a la regeneración/colocación de implantes en pacientes con enfermedades óseas benignas y con tratamiento antirresortivo es escaso, pero existe y no debe subestimarse. Sobre todo, en las áreas posteriores de la mandíbula/maxilar, si la duración del tratamiento con bifosfonatos es de más de 3 años, y si el paciente está bajo tratamiento con corticosteroides.

Aneurysmal bone cyst (ABC) is an uncommon, non-neoplastic, expansive and erosive bone lesion. Considered as a pseudocyst due the lack of epithelial lining, the presence of giant cells and similarity to other lesions can make preoperative diagnosis difficult; biopsy findings must be co-related to complete clinical and radiological assessment. ABC’s controversial etiopathogenesis and variable clinicopathological presentations have been widely described, but to date, there are just a few reports in literature describing the development of fibrous dysplasia (FD) from an ABC, and even less cases occurring in the jaws. We describe the case of an ABC in an 8 year-old male patient, affecting the body of the mandible, which showed accelerated growth associated to thinning of the buccal, lingual and lower cortical plates. The treatment consisted of repetitive surgical resection, curettage of the lesion and mandibular reinforcement with osteosynthesis reconstruction plates. A 16-month follow-up showed self-limitation of the overgrowth. The final histopathological and radiological analysis confirmed the FD diagnosis. First described by Van Arsdale in 1893 as ossifying hamartoma, but renamed later by Jaffe and Liechtenstein, the aneurysmal bone cyst (ABC) is a non-neoplastic, expansive and erosive bone lesion [1]. Infrequent within the craniofacial skeleton, the ABC was initially described as a long bone and cervical column pathology [2]. In 1958, Bernier and Bhaskar reported the first case occurring on the jaws, and until 2012, only 121 cases were described involving facial bones [3]. The etiopathogenesis of this entity remains controversial, but it has been described as a consequence of traumatism, as hemodynamic alteration, or as a secondary phenomenon associated to the presence of primary bone lesions [4]. It can be classified as primary or secondary, depending on the presence or absence of associated pre-existing histopathological conditions, such as the ossifying fibroma or the central giant cell granuloma, among others, being the first and the most frequently involved [5]. Several articles tried to describe the association between the ABC and the fibrous dysplasia (FD), another type of fibro-osseous lesion; however, cases occurring within the jaws are difficult to find; moreover, the development of a FD from an ABC is even harder to find. This article presents an extensive mandibular ABC case in a pediatric patient, which followed an unexpected behavior after more than 2 years, 4 interventions, and a 16 month follow-up period. The final histopathologic analysis and its current stabilization (that suggests self-limiting of the growth process) are strongly indicative of FD conversion.

The southern alligator lizard (Elgaria multicarinata) exhibits a courtship behaviour during which the male firmly grips the female's head in his jaws for many hours at a time. This extreme behaviour counters the conventional wisdom that reptilian muscle is incapable of powering high-endurance behaviours. We conductedin situexperiments in which the jaw-adductor muscles of lizards were stimulated directly while bite force was measured simultaneously. Fatigue tests were performed by stimulating the muscles with a series of tetanic trains. Our results show that a substantial sustained force gradually develops during the fatigue test. This sustained force persists after peak tetanic forces have declined to a fraction of their initial magnitude. The observed sustained force duringin situfatigue tests is consistent with the courtship behaviour of these lizards and probably reflects physiological specialization. The results of molecular analysis reveal that the jaw muscles contain masticatory and tonic myosin fibres. We propose that the presence of tonic fibres may explain the unusual sustained force properties during mate-holding behaviour. The characterization of muscle properties that facilitate extreme performance during specialized behaviours may reveal general mechanisms of muscle function, especially when done in light of convergently evolved systems exhibiting similar performance characteristics.

A new analysis of a 415-million-year-old fossil fish head originally described as from an early osteichthyan (bony fish) puts it instead as the sister group of the gnathosomes (jawed vertebrates), and suggests that the extinct acanthodians were relatives of cartilaginous fishes. The early evolution of the jawed vertebrates (gnathostomes) is a hot topic in palaeontology. Here Brazeau and colleagues use computed tomography scanning to take a new look at a 415-million-year-old braincase and skull roof from the Early Devonian of Siberia, originally described in 1992 by Hans-Peter Schultze as coming from an early osteichthyan (bony fish). They find that the underlying braincase shows a mixture of features seen separately in osteichthyans, chondrichthyans or in neither. Phylogenetic analysis places the fish at base of the gnathostomes and suggests that the enigmatic acanthodians — a wholly extinct group of fossil fishes — were relatives of cartilaginous fishes. The phylogeny of Silurian and Devonian (443–358 million years (Myr) ago) fishes remains the foremost problem in the study of the origin of modern gnathostomes (jawed vertebrates). A central question concerns the morphology of the last common ancestor of living jawed vertebrates, with competing hypotheses advancing either a chondrichthyan-1,2,3 or osteichthyan-like4,5 model. Here we present Janusiscus schultzei gen. et sp. nov., an Early Devonian (approximately 415 Myr ago) gnathostome from Siberia previously interpreted as a ray-finned fish6, which provides important new information about cranial anatomy near the last common ancestor of chondrichthyans and osteichthyans. The skull roof of Janusiscus resembles that of early osteichthyans, with large plates bearing vermiform ridges and partially enclosed sensory canals. High-resolution computed tomography (CT) reveals a braincase bearing characters typically associated with either chondrichthyans (large hypophyseal opening accommodating the internal carotid arteries) or osteichthyans (facial nerve exiting through jugular canal, endolymphatic ducts exiting posterior to the skull roof) but lacking a ventral cranial fissure, the presence of which is considered a derived feature of crown gnathostomes7,8. A conjunction of well-developed cranial processes in Janusiscus helps unify the comparative anatomy of early jawed vertebrate neurocrania, clarifying primary homologies in ‘placoderms’, osteichthyans and chondrichthyans. Phylogenetic analysis further supports the chondrichthyan affinities of ‘acanthodians’, and places Janusiscus and the enigmatic Ramirosuarezia9 in a polytomy with crown gnathostomes. The close correspondence between the skull roof of Janusiscus and that of osteichthyans suggests that an extensive dermal skeleton was present in the last common ancestor of jawed vertebrates4, but ambiguities arise from uncertainties in the anatomy of Ramirosuarezia. The unexpected contrast between endoskeletal structure in Janusiscus and its superficially osteichthyan-like dermal skeleton highlights the potential importance of other incompletely known Siluro-Devonian ‘bony fishes’ for reconstructing patterns of trait evolution near the origin of modern gnathostomes.

It is a major problem for visually impaired people to access to information readily. Although, there are a plenty of written sources, the number of recorded sources are limited. So how can we make visually impaired to use online educational material? In this study, it is aimed to develop a distance education portal that makes educational materials and sources easily accessible to visually impaired. It enables an easy access to a variety of education packages with different contents and durations. The distance education portal developed in this study is coded in PHP, and MySQL is used for the database. JAWS is used as the screen reading software. HTML pages are coded using HTML5 and CSS3 technologies, and are designed to be compatible with JAWS. Distance education portal for visual impaired is designed using new tools, and successful results are obtained with help of JAWS screen reading software. The portal will provide the visually impaired with many dynamic and interactive educational opportunities. Therefore, it would be reasonable to use the portal to offer all or part of any special or vocational education in varying content.

Species diverge eco-morphologically through the continuous action of natural selection on functionally important structures, producing alternative adaptive morphologies. In cichlid fishes, the oral and pharyngeal jaws are such key structures. Adaptive variation in jaw morphology contributes to trophic specialization, which is hypothesized to fuel their rapid speciation in the East African Great Lakes. Much is known about the genes involved in cichlid jaw and craniofacial development. However, it is still unclear what salient sources of variation gave rise to trophic-niche specialization, facilitating adaptive radiation. Here, we explore two sources of transcriptional variation that may underlie species-specific disparities in jaw morphology. Using whole transcriptome RNA-sequencing, we analyze differences in gene expression and alternative splicing, at the end of postlarval development, in fully functional jaws of six species of cichlids from the Lake Tanganyika tribe Tropheini. Our data reveal a surprisingly high degree of alternative splicing events compared with gene expression differences among species and trophic types. This suggests that differential trophic adaptation of the jaw apparatus may have been shaped by transcriptional rewiring of splicing as well as gene expression variation during the rapid radiation of the Tropheini. Specifically, genes undergoing splicing across most species were found to be enriched for pharyngeal jaw gene ontology terms. Overall, jaw transcriptional patterns at postlarval developmental stage were highly dynamic and species-specific. In conclusion, this work indicates that shifts in alternative splicing could have played a more important role in cichlid adaptive radiation, and possibly adaptive radiation in general, than currently recognized. published

Background and Aim: A rapid aging of the human population has taken place in recent years. Aging associates with numeral changes in oral and maxillofacial structures. The aim of this study was to quantify the frequency of panoramic radiographic findings in the elderly. Materials and Methods: Panoramic radiographs from 196 patients aged 60 years and older were evaluated at the private clinic for the presence of items such as alveolar bone loss, dental caries, retained roots, impacted teeth, radiolucencies, and radiopacities. Results: One or more of these radiographic observations were found in 94.9 % of the examined films. The most frequent findings were alveolar bone loss (79.6 %) and dental caries (79.43%). The total number of natural teeth in men was significantly higher than women (P = 0.047). Conclusion: These results showed the importance of panoramic examination of elderly patients in detecting potential problems before the treatments such as complete denture and also for assessment of overall oral health in the elderly

Objective: To review published data on oral manifestations of multiple myeloma. Methods: An electronic database search was performed of articles published from 1971 to November 2016 in order to identify studies that reported oral manifestations of patients with multiple myeloma. Case reports and case series with oral manifestations of multiple myeloma in English were included in the study. An additional search was performed of the references of the selected articles. Results: Thirty-seven articles that reported 81 patients with oral manifestations of multiple myeloma were selected: 30 case reports (82%) and seven case series (18%). The most common clinical features in the dental cavity were swelling (65.4%), bone pain (33.3%), paresthesia (27.1%) and amyloidosis lesions (11.1%). Osteolytic lesions detected on imaging exams were reported in the majority of the patients (90.1%) as plasmacytomas or ‘punched-out’ lesions. Conclusions: Swelling and osteolytic lesions represent the most common clinical and radiographic signs of the jaws relating to multiple myeloma, respectively. Keywords: Multiple Myeloma, Oral Manifestations, Mouth, Jaws

AIMS To determine the success rates of the surgical and non-surgical treatments in the management of bisphosphonate-related osteonecrosis of the jaws (BRONJ). MATERIAL AND METHODS A systematic review of the literature was made. A PubMed Medline database search was performed in order to include clinical studies published in English,between2004 and 2014 with the following key-words: "BRONJ AND treatment" and "NOT osteoporosis". The following data was gathered: authors, title, year of publication, aim of study, level of evidence, sample size, treatment performed, treatment outcomes and follow-up. Studies including more than 20 patients with at least 6 months of follow-up, and that specify the different treatment approaches and their outcomes were included. Systematic reviews were excluded.All studies were classified according to the SORT criteria (Strength of Recommendation Taxonomy). RESULTS The initial electronic search yielded 169 papers, and 13 studies were added after a manual search (total of 182 studies). After analysing the title and abstract and removing duplicates, 31 full-texts were obtained. A total of 12 papers were finally included. Two were classified as level 3 evidence and 9 as level 2. The quality of the selected studies and the risk of bias were also reported. CONCLUSIONS Surgical treatments like sequestrectomy, surgical debridement and bone osteotomies provide successful treatment outcomes, with success rates ranging from 58 to 100%. Controlled randomized clinical trials with larger samples and longer follow-up are needed to support these findings. Key words:BRONJ, treatment.

[spa] ANTECEDENTES: la asimetría en la oclusión es una condición que se caracteriza por la falta de una oclusión idéntica en ambos lados, de tal manera que se produce una desviación de la línea media y una asimetría en el encaje entre las mandíbulas superior e inferior. Aunque se han propuesto varias hipótesis acerca del origen de esta condición, los estudios morfométricos intentan establecer un vínculo entre la simetría de la cara, la falta de ajuste en la oclusión mandibular y la presión plantar como posible factor etiológico implicado en el origen de esta condición. El objetivo de este estudio es analizar la relación existente entre la presión plantar, la asimetría facial y la maloclusión. MÉTODOS: se diseñó un estudio descriptivo, transversal, comparativo con dos grupos: grupo con asimetría en la oclusión (n = 16) y grupo sin asimetría (n = 27). Los participantes fueron seleccionados en la ciudad de Colonia (Alemania), con una edad media de 11,7 años (DT = 3,0 años). Se realizó una evaluación de la oclusión dental, de la simetría facial y de la presión plantar. RESULTADOS: las pruebas aplicadas no indican un vínculo entre la asimetría en la oclusión, la simetría facial y la presión plantar. CONCLUSIÓN: la asimetría en la oclusión no parece tener como factor etiológico las diferencias de presión plantar, lo que implica la búsqueda de nuevos factores que puedan explicar el origen de la maloclusión., [eng] BACKGROUND: Asymmetric occlusion is a condition characterized by lack of symmetric occlusion of the teeth, so that a midline shift is created between the upper and lower jaws and a different occlusion on one compared to the other side. Although several hypotheses have been proposed regarding the origin of this condition, the morphometric studies try to establish a link between the symmetry of the face, the lack of fit in the occlusion and the implanted pressure as a possible etiological factor involved in the origin of this condition. The aim of this study is to analyze the relationship between plantar pressure, facial asymmetry and malocclusion. METHODS: A descriptive, transversal, comparative study was designed with two groups: group with asymmetry in occlusion (n = 16) and group without asymmetry (n = 27). Participants were selected in the city of Cologne (Germany), with a mean age of 11.7 years (SD = 3.0 years). An evaluation of dental occlusion, facial symmetry and plantar pressure was performed. RESULTS: Applied tests do not indicate a link between asymmetry in occlusion, facial symmetry and plantar pressure. CONCLUSION: Asymmetry in occlusion does not seem to have as etiologic factor differences in plantar pressure, which implies the search for new factors that allow to explain the origin of malocclusion.

Context: Odontogenic tumors (OTs) represent a rare subset of pathologies of the oral and maxillofacial region. The classification of OTs has undergone several changes over the years due to a lack of uniform international identification criteria. The histomorphological similarity and the many variations in behavioral patterns elaborated by these lesions warrant research. Aims: Using the update from the fourth edition of the World Health Organisation Classification of Head and Neck Tumors (2017), this dental institution carried out an epidemiological study on OTs in the state of Goa (India) and compared the data obtained with similar studies on OTs done within India. Materials and Methods: The clinical and pathological data of OTs from August 1996 to December 2016 was retrieved from the oral and maxillofacial pathology department archives, belonging to the lone dental college and hospital in the state of Goa, India. Demographic data such as frequency, age, gender, and site along with pathological subtype was analysed. Statistical Analysis Used: Descriptive analysis (i.e. frequency of age, gender, and location), Chi-Square Test and Fischer Exact test. Results: The relative frequency of OTs was 2.61% of all oral biopsied specimens. The most common OT encountered was ameloblastoma (57.9%). The posterior aspect of the mandible was the most favored site (77.2%). The frequency of OTs decreased after the fourth decade. An overall marginal male predilection (55%) was seen. Conclusions: This study contributes to the establishment of a comprehensive loco-regional epidemiological database on OTs in India, aiding research on their aetio-pathogenesis and diagnosis.

Evolution of Developmental Control Mechanisms.-- et al., The acquisition of jaws constitutes a landmark event in vertebrate evolution, one that in large part potentiated their success and diversification. Jaw development and patterning involves an intricate spatiotemporal series of reciprocal inductive and responsive interactions between the cephalic epithelia and the cranial neural crest (CNC) and cephalic mesodermal mesenchyme. The coordinated regulation of these interactions is critical for both the ontogenetic registration of the jaws and the evolutionary elaboration of variable jaw morphologies and designs. Current models of jaw development and evolution have been built on molecular and cellular evidence gathered mostly in amniotes such as mice, chicks and humans, and augmented by a much smaller body of work on the zebrafish. These have been partnered by essential work attempting to understand the origins of jaws that has focused on the jawless lamprey. Chondrichthyans (cartilaginous fish) are the most distant group to amniotes within extant gnathostomes, and comprise the crucial clade uniting amniotes and agnathans; yet despite their critical phylogenetic position, evidence of the molecular and cellular underpinnings of jaw development in chondrichthyans is still lacking. Recent advances in genome and molecular developmental biology of the lesser spotted dogfish shark, Scyliorhinus canicula, make it ideal for the molecular study of chondrichthyan jaw development. Here, following the 'Hinge and Caps' model of jaw development, we have investigated evidence of heterotopic (relative changes in position) and heterochronic (relative changes in timing) shifts in gene expression, relative to amniotes, in the jaw primordia of S. canicula embryos. We demonstrate the presence of clear proximo-distal polarity in gene expression patterns in the shark embryo, thus establishing a baseline molecular baüplan for branchial arch-derived jaw development and further validating the utility of the 'Hinge and Caps' model in comparative studies of jaw development and evolution. Moreover, we correlate gene expression patterns with the absence of a lambdoidal junction (formed where the maxillary first arch meets the frontonasal processes) in chondrichthyans, further highlighting the importance of this region for the development and evolution of jaw structure in advanced gnathostomes., This work was supported by funding to M.J.D. from the Royal Society, the Dental Institute of King’s College London, and Friends of Guy’s Hospital. C.C. and J.G. were funded by Marie Curie Early Training Fellowships (MEST-CT-2004-504025). J.L.F. was assisted by a HFSP Long Term Fellowship (LT 01061/2007-L). S.M. was funded by Région Centre, Région Bretagne (EVOVERT grant number 049755), National Research Agency (grant ANR-09-BLAN-026201), CNRS, Université d’Orléans and the Université Pierre et Marie Curie. M.C. benefited from a doctoral fellowship from CNRS.

OBJETIVOS: Establecer un patrón de tensión acumulada en diferentes partes de un disyuntor tras realizar una expansión rápida del maxilar (ERM) y relacionarlo con los diferentes patrones de crecimiento vertical. El estudio clínico fue realizado con 40 pacientes que presentabanmordida cruzada posterior y requerían una ERM. A continuación, se desarrolló un modelo de elementos finitos (MEF) de las fuerzas que se soportan tras una ERM, validando los datos con un test mecánico y posteriormente calculando las fuerzas que habían soportado los aparatos ERM de los pacientes. Finalmente, se evaluó la eficacia de laterapia láser de baja intensidad (LLLT) en la reparación de la sutura maxilar mediopalatina tras una ERM. Para profundizar sobre el remodelado óseo, se realizó una revisión bibliográfica con el fin de organizar la literatura existente publicada sobre el movimiento dentario durante el tratamiento de ortodoncia tratada con LLLT. EMPLAZAMIENTO: Área de ortodoncia del Hospital Odontològic de Bellvitge, Universitatde Barcelona, L’Hospitalet de Llobregat (Barcelona). APROBACIÓN ÉTICA: El Comité Êtic de Recerca Clinica del Hospital Odontològic de Bellvitge, L’Hospitalet de Llobregat, asignándole al ensayo el número de referencia 11/2011 y seguro de Responsabilidad Civil para ensayos núm. CE000343677. MATERIAL Y MÉTODOS: Las galgas extensiométricas fueron colocadas en los brazos del tornillo Hyrax del aparato RME para registrar la deformación (tensión) durante la fase de expansión (T0-T1) y la fase de retención durante 75 días (T2-T7) de 40 pacientes (edad media de 8,48 años). Se realizó un MEF para emplazar la galga en el punto del disyuntor que mejor expresaba la tensión. El coeficiente de variación de VERT se utilizó para clasificar a los pacientes por su patrón de crecimiento vertical. Posteriormente, se modeló y se realizó el discretizado del diseño asistido de los modelos computarizados del tornillo metálico y de la placa polímera. Se generaron dos fuerzas que oscilaban entre 2,5 N y 55 Ny fueron consideradas independientemente, F1 en los molares temporales y F2 en los molares permanentes. Los resultados de análisis de elementos finitos (AEF) fue utilizado para definir los valores de deformación de las galgas A y B como una función lineal de las fuerzas F1 y F2, por el cálculo del coeficiente de tensión-fuerza δij. Las dos galgas extensiométricas fueron adheridas al aparato ERM el cual fue colocado en una placa motorizada 531.PD para reproducir las mismas fuerzas utilizadas en el AEF.Una vez validado el sistema, se invirtió la matriz para determinar las F1 y F2 utilizando los valores de tensión de los pacientes. Antes de iniciar la aplicación laser en el ensayo se realizó una revisión bibliográfica en estudios sobre animales y humanos para estudiar la eficacia de la aplicación LLLT como acelerador del movimiento dentario y remodelado óseo. Se seleccionaron a tres revisores para cribar y los artículos. Los estudios seleccionados fueron analizados de acuerdo a los parámetros de aplicación láser y a los cambios clínicos e histopatológicos hallados. Finalmente, a 39 individuos del ensayo (rango de edad 6,2-12,4) quienes completaron la ERM, se les realizó el análisis radiológico, 20 fueron irradiados y 19 actuaron como placebo. Al finalizar la fase activa de la expansión (T0-T1) se les realizó un escáner CBCT. Se trataron con un láser diodo, según el siguiente protocolo: 660 nm, 200 mW, CW, InGaAlP laser, una área iluminada de 0.26cm2, 665 mW/cm2, 60 segundos para 4 puntos a lo largo de la sutura medio palatina y 30 segundos por punto a cada lado de la sutura, 6.0 J, 40 J/cm2 and 3.0 J, 20 J/cm2 respectivamente. Un total de 7 aplicaciones fueron realizadas en los días 1, 7, 14, 28, 42, 56 y 70 durante la fase de retención (T2-T7). Un segundo escáner CBCT se realizó el día 75. Dos radiólogos calibrados analizaron los cortes axiales de los escáneres. Una P-valor=0,05 se consideró estadísticamente significativa. RESULTADOS: Durante la fase de expansión, los valores más altos de tensión fueron acumulados en la zona posterior de los aparatos RME para todos los biotipos faciales, trasladándose a la zona anterior al finalizar la fase de retención en los pacientes braquicefálicos y mesocefálicos. Existió diferencias estadísticamente significativas en la tensión acumulada de los brazos posteriores según el patrón de crecimiento vertical (P=0,05) entre la diferencia de tensión en los tiempos T7-T2. A los 75 días de retencíón, el 61,25% de los brazos ya habían iniciado la disipación de tensión. El AEF muestra que los efectos de las fuerzas sobre el estrés en la localización de los brazos fueron notablemente diferentes. Había una correlación satisfactoria entre las predicciones AEF y los valores experimentales del test mecánico. La disipación de F1 y F2 de los pacientes fue predicha en un 62,5% y 80%, respectivamente, tras 75 días de retención. En cuanto a la revisión, se analizaron 84 estudios, seleccionando 5 en humanos, en los que se traccionaba el canino tras la extracción del premolar, y 11 en ratas, en los que se realizaba la tracción del primer premolar. Existieron diferencias estadísticamente significativas en los resultados para 4 estudios humanos y 8 estudios animales. En el análisis radiológico, a los 75 días la sutura se describió que había habido cambios en la aproximación de los márgenes significativamente en ambos grupos. Los pacientes irradiados presentaban aproximación en la zona antero-superior (p=0,008) y supero-posterior (p=0,001) y menos distancia en la sutura postero-superior (p=0,040) que el grupo placebo. LIMITACIONES: No se valoró el espacio entre los márgenes de la sutura de los huesos palatinos. CONCLUSIONES: Los patrones de tensión acumulada en los aparatos ERM pueden variar dependiendo del biotipo facial. Los resultados respaldan el modelo del AEF para la predicción de fuerza a través de los valores experimentales. De acuerdo con la revisión, variando la longitud de onda con una dosis razonable en la zona diana se puede obtener los efectos biológicos deseados y alcanzar una reducción en el tiempo de tratamiento ortodóncico, aunque algunos estudios no demuestren que existe beneficio según sus resultados. Sin embargo, de acuerdo a nuestros resultados, LLLT parece estimular la reparación del proceso durante la fase de retención tras una ERM. CONFLICTO DE INTERÉS: Los autores declaran que no han tenido conflicto de interés. FINANCIACIÓN: No ha habido ningún tipo de financiación. REGISTRO: No se ha realizado ningún registro del ensayo clínico., OBJECTIVE: The aim of this study is to establish an accumulated strain pattern in different parts of rapid maxillary expansion (RME) appliances and relate them to different vertical growth patterns. A clinical study was conducted on 40 patients with posterior crossbite who required RME. Then, a finite element model (FEM) of the forces that patients with RME bear is developed, validating the aforementioned with an in vitro mechanical test and calculating the forces to which the RME appliances of a group of patients were exposed. Finally, to evaluate the effectiveness Low Level Laser Therapy (LLLT) on the repair of the midpalatal suture, after RME. To understand a remodeling bone a review was performed to organize the existing published literature regarding tooth movement in orthodontic treatment when low-level laser therapy (LLLT). SETTING: The Orthodontic Department atthe Dental Hospital of Bellvitge.Barcelona University, Hospitalet de Llobregat, Spain. ETHICAL APPROVAL: The Ethics Committee for Clinical Research of the Dental Hospital of Bellvitge, Hospitalet de Llobregat, adopted the trial under reference number 11/2011 and an insurance liability policy numbered CE000343677 was contracted. PROTOCOL: The protocol was not published prior to trial commencement. MATERIAL AND METHODS: Strain gauges were placed on the arms of the RME Hyrax screw appliance to record deformation (strain) during the expansion (T0-T1) and the retention phases for 75 days (T2-T7) of 40 patients (mean age of 8.48 years). A FEM was used to place the gauge at the point where the strain was most expressed. The VERT coefficient of variation was used to classify patients by their vertical growth pattern. Posteriorly, computer-aided design models of the metallic screw and polymeric splint were modelled and discretized. Two forces were generated and considered independently, F1 at the temporary molar (2.5N to 55N), and F2 at the permanent molar (2.5N to 55N). The results of the finite element analysis (FEA) were used to define the strain values which the anterior and posterior arms of the RME appliance bore as a linear function of F1-F2, by calculating the strain-force coefficient δij. Two strain gauge rosettes were attached to a RME appliance which was placed in an XY motorized stage 531.PD to reproduce the same forces used in the FEA. Once the system was validated, the matrix was inverted to determine forces F1 and F2 using strain values of patients. Before to start with the laser application, studies in humans and animals in which LLLT was applied to increase the dental movement were reviewed. Three reviewers selected the articles. The resulting studies were analyzed according to the parameters used in the application of laser and existing changes clinically and histopathologically. Finally, 39 children (range 6-12 years old), completed RME and were randomized to received active LLLT (n=20) or placebo (n=19). After RME a CBCT-scan was carried out. The laser parameters and dose were: 660nm, 200mW, CW, InGaAlP laser, illuminated area 0.26cm2, 665mW/cm2, 60 seconds to four points along mid-palatal suture and 30 seconds to a point each side of the suture, 6.0 J, 40 J/cm2 and 3.0 J, 20 J/cm2 respectively. A total of 7 applications were made on days 1, 7, 14, 28, 42, 56 and 70 of the retention phase RME a CBCT-scan was carried out on the day of the first laser treatment and at. At day 75, a second CBCT-scan was performed. Two radiologists synchronized the slices of two scans to be assessed. P=0.05 was considered to be statistically significant. RESULTS: During the expansion phase, the highest values of accumulated strain were measured in the posterior part of the appliance for all facial biotypes, but said values passed to the anterior area at the end of the retention phase on mesocephalic and brachycephalic patients. There were statistically significant differences in the strain of the posterior arms in accordance with the vertical growth pattern (P = 0.05) between the T7 -T2 times. At 75 days’ retention, 61.25% of the arms had already begun strain dissipation. FEA showed that the effects of the forces on stress at the location of the arms were notably different. There was a satisfactory correlation between FEA predictions and in vitro values. Dissipation of F1 and F2 in patients was predicted to be 62.5% and 80%, respectively, after 75 days of retention. 84 studies were analized. 5 human studies were selected in which canine traction had been performed after removing a premolar and 11 studies in rats were selected in which firstpremolar traction was realized. There were statistically significant changes in four human studies and eight animal studies. In our study, at day 75 the suture was described as significantly approximate change in both groups. Irradiated patients presented approximation in the anterior (p=0.008) and posterior (p=0.001) superior suture and less distance in the posterior superior suture (p=0.040) that placebo group. LIMITATIONS: Gaps between suture margins of the palatine bones were not assessed. CONCLUSIONS: The accumulated strain pattern in the RME appliance can vary depending on the facial biotype.These results back the FEA model for force prediction from experimental strain values.According the review, varying the wavelength with a reasonable dose in the target zone leads to obtaining the desired biological effect and achieving a reduction of the orthodontic treatment time, althoughthere are studies that do not demonstrate any benefit according to their values.However, according the results of our study, LLLT appears to stimulate the repair process during retention phase after RME. CONFLICT OF INTEREST: The authors declare that they have no conflict of interest. FUNDING: No funding sources were used. REGISTRATION: No registration was carried out.

Statement of problem Although the visual analog scale (VAS) is a simple tool for quantitatively measuring symptom perception, no studies have used the VAS to assess the degree of subjective masticatory laterality. Purpose The purpose of this study was to assess the reliability of the VAS for determining the preferred mastication side (PMS) and to compare it with other methods. Material and methods A cross-sectional study was conducted in which 42 adults with natural dentition performed 2 masticatory sessions. Eight different methods were used to determine the PMS by combining different definitions, food tests, measurements, and number of cycles assessed. A test-retest was performed in 10 participants to evaluate the reliability of each method using the intraclass correlation coefficient. To assess the validity of the different methods, the Pearson correlations were performed (α=.05) between the 8 methods. Results Self-assessment using the VAS had the highest reliability; it also had a positive and significant relationship with 6 of the 7 other methods. The method that showed the best validity used bagged silicone as the test food, determined the PMS by video recording, and assessed all masticatory cycles using the asymmetry index. Low reliability was found for methods using the location of gum bolus at standardized time intervals or electromyographic recordings. Conclusions The VAS provided a highly reliable means of assessing the degree of masticatory laterality perceived by the participant, with a positive and significant correlation with the majority of the other methods.

Bisphosphonates are used to treat osteoporosis. Paget disease of bone and other metabolic bone diseases, multiple myeloma, and skeletal events associated with metastatic neoplasms- In 2003, the first reports describing osteonecrosis of the jaw (ONJ) in patients receiving bisphosphonates were published. About 95% of these cases occurred among cancer patients receiving high-dose intravenous bisphosphonates. Approximately 5% of the reported cases have been in osteoporosis patients receiving low dose bisphosphonate therapy. The mandible is more commonly affected than the maxilla (2:1 ratio), and 60% of cases are preceded by a dental surgical procedure. Oversuppression of bone turnover is probably the primary mechanism for the development of this condition, although there may be contributing comorbid factors. All sites of potential jaw infection should be eliminated before bisphosphonates therapy is initiated in these patients to reduce the necessity of subsequent dentoalveolar surgery. Conservative debridement of necrotic bone, pain control, infection management, use of antimicrobial oral rinses, and withdrawal of bisphosphonates are preferable to aggressive surgical measures for treating this condition. The purpose of the present article is to enlighten the dental fraternity about this frequently prescribed class of drugs with regard to its types and mode of action, and the implication of bisphosphonates-induced ONJ.

Aim: To evaluate fundamental cell functions, such as adhesion, IL-6 production and proliferation of human gingival keratinocytes cultured on a newly engineered collagen matrix (CM-10826) and to assess the degree of specific biocompatibility of this new device. Materials and methods: Primary cultures of human keratinocytes were derived “in vitro” from biopsies of independent donors. Their true epithelial origin was ensured by the expression of cytokeratin 14. Adhesion, proliferation and production of IL-6 cytokine was then measured in the presence or absence of CM-10826 activity or of its relevant components. Results: Functional tests revealed that keratinocytes adhered to CM-10826 and up-regulated their basal IL-6 production. The type of keratinocytes used expressed cytokeratin 14. Proliferation experiments demonstrated that the best cellular response was observed in the presence of Collagen I, the main component of CM-10826. No undesired effects were observed as for keratinocyte viability, morphology or differentiation. Conclusions: Our results demonstrate that CM-10826 has a favourable biological effect on the “in vitro” response of gingival keratinocytes in terms of IL-6 production, cell growth and adhesion. These findings may encourage a possible use of this collagen membrane as a tissue which, alone, may substitute for autologous gingival grafts thereby overcoming the limitations of autologous

Objectives: To compare the clinical anesthetic efficacy of 0.5% bupivacaine and 4% articaine (both with 1:200.000 adrenaline) for anterior maxillary infiltration in healthy volunteers. Material and methods: A triple-blind split-mouth randomized clinical trial was carried out in 20 volunteers. A supraperiosteal buccal injection of 0.9 ml of either solution at the apex of the lateral incisor was done in 2 appointments separated 2 weeks apart. The following outcome variables were measured: latency time, anesthetic efficacy (dental pulp, keratinized gingiva, alveolar mucosa and upper lip mucosa and tissue) and the duration of anesthetic effect. Hemodynamic parameters were monitored during the procedure. Results: Latency time recorded was similar for both anesthetic solutions (p>0.05). No statistically significant differences were found in terms of anesthetic efficacy for dental pulp, keratinized gingiva or alveolar mucosa. Articaine had a significant higher proportion of successful anesthesia at 10 minutes after infiltration in lip mucosa and lip skin (p=0.039). The duration of anesthesia was 336 minutes for bupivacaine and 167 minutes for articaine. (p

The study of craniofacial growth is a complex and essential process for the diagnosis and treatment of malocclusions. The formation of craniofacial structures has been explained over time through theories that different researchers have proposed in their interest to argue their postulates; thus we find theories such as Scott’s cartilaginous dominance; Sutural Sicher; Functional of Moss; Petrovic Servosystem; All regulated in one way or another by genetic theory. To talk about growth and development it is important to understand that these two terms are not synonymous, but they are very related. Growth is known as the process of increasing the mass of a living being, which is produced by the increase in the number of cells (hyperplasia) or cell mass (hypertrophy). Development is the process by which organisms achieve greater functional capacity of their systems through the phenomena of maturation, differentiation and integration of functions. This review describes the most important theories of craniofacial growth, and the factors that regulate them. El estudio del crecimiento craneofacial es un proceso complejo y esencial para el diagnóstico y tratamiento de las maloclusiones. La formación de las estructuras craneofaciales se han explicado a lo largo del tiempo por medio de teorías que diferentes investigadores han propuesto en su interés de argumentar sus postulados; así encontramos las teorías de la dominancia cartilaginosa de Scott; Sutural de Sicher; Funcional de Moss; Servosistema de Petrovic; todas reguladas de una u otra manera por la teoría genética. Para hablar de crecimiento y desarrollo es importante comprender que estos dos términos no son sinónimos, pero están muy relacionados. Por crecimiento se entiende el proceso de incremento de la masa de un ser vivo, que se produce por el aumento del número de células (hiperplasia) o de la masa celular (hipertrofia), por otro lado, el desarrollo es el proceso por el cual los seres vivos logran mayor capacidad funcional de sus sistemas a través de los fenómenos de maduración, diferenciación e integración de funciones. En la presente revisión se describen las teorías más importantes del crecimiento craneofacial y los factores que las regulan.

The present study describes some of the applications of ultrasound in bone surgery, based on the presentation of two clinical cases. The Piezosurgery® ultrasound device was used (Tecnología Mectron Medical, Carasco, Italy). In one case the instrument was used to harvest a chin bone graft for placement in a bone defect at level 1.2, while in the other case a bony window osteotomy was made in the external wall of the maxillary sinus, in the context of a sinus membrane lift procedure. The Piezosurgery® device produces specific ultrasound frequency modulation (25-29 kHz), and has been designed to secure increased precision in application to bone surgery. This instrument produces selective sectioning of the mineralized bone structures, and causes less intra- and postoperative bleeding. One of the advantages of the Piezosurgery® device is that it can be used for maxillary sinus lift procedures in dental implant placement. In this context it considerably lessens the risk of sinus mucosa laceration by preparing the bony window in the external wall of the upper maxilla, and can be used to complete the lifting maneuver. The use of ultrasound in application to hard tissues can be regarded as a slow technique compared with the conventional rotary instruments, since it requires special surgical skill and involves a certain learning curve.

A series of 49 patients diagnosed with osteonecrosis and all treated with latest-generation bisphosphonates was reviewed retrospectively to evaluate the use of erbium-doped: yttrium, aluminum, and garnet laser (Er:YAG) in terms of clinical outcome, and examine current trends from the clinical-therapeutic standpoint. Pathology reports on specimens submitted over the previous 7 years from either the mandible or the maxilla were reviewed; 49 patients were identified as having osteonecrosis of the jaws. For each of these cases, the medical history and profile were evaluated; 19 were treated with conservative therapy, 20 with radical surgery, and 10 with Er:YAG laser (2,940 nm). Of the 20 patients treated surgically (bone baquette, curettage, sequestrectomy of the necrotic bone), some required re-treatment, which resulted in bone fracturing. None of the patients were treated successfully. The 19 cases treated conservatively produced an improvement in symptoms, but not remission of the lesions. Of the ten patients treated with Er:YAG laser, six achieved total remission of signs and symptoms, four an improvement, and re-treatment was required in one case. Our present approach is to recommend intensive prophylactic care before the administration of bisphosphonates, and great caution is advised even in simple maneuvers like curettage, because this may exacerbate the avascular process. The use of Er:YAG laser appears to be promising (within the limits of our experience). It can be concluded that at 1 year of laser surgery, the treatment led to significant improvements in clinical parameters, and may represent a valid alternative, although studies on a larger scale are needed.

Background Some Mayan peasant-hunters across the Yucatan Peninsula in Mexico still carry out a hunting ritual –Loojil Ts’oon, Loj Ts’oon or Carbine Ceremony– in which they renew the divine permission for hunting in order to continue deserving the gift of prey after a period of hunt. Thus they are granted access to game by the gods and the Lords of the Animals, particularly the spirit/evil-wind call. This paper focuses on the acts within the Loojil Ts’oon –which is performed in the X-Pichil community and surrounding area– that make it unique among the hunting rituals performed in other parts of the Peninsula. Methods The Loojil Ts’oon hunting ritual was observed and registered in audiovisual format in two different occasions in X-Pichil (Friday 04/29/2011 and Friday 07/29/2011). Afterwards, we delivered digital videodisks (DVD) to hunters and their families and to the j-men (the magic-medic-ritual specialist) who participated in these ceremonies. This delivery produced confidence among participants to talk more openly and in-depth about the Loojil Ts’oon, revealing symbolic, psychological, and material details previously unknown to outsiders. Qualitative information was obtained through the ethnographic method using techniques such as participant observation and guided tours. Semi-structured interviews were carried out to obtain complementary information. Results and discussion On one hand, we describe the preparation and cleansing of the “Sip soup”, as well as its parading and distribution –delivery to the spirit/evil-wind Sip– on the streets of the community (highlingting the role of the rooster as a counter-gift). On the other hand, the cleansing of the jaws (of deer: Odocoileus virginianus, Mazama spp.; and peccaries: Tayassuidae) and their return to the Lords of Animals in the hills so that they may give these animals new life. Conclusions By performing the Loojil Ts’oon, the act of killing an animal is legitimized. The kill transforms into an exchange to perpetuate life, in which gods and Lords of animals grant the hunter the solicited new game if he has completed his ritual duties and has not broken the prescribed hunting rules. The Loojil Ts’oon does not only represent the continuity and regeneration of animals, that is, fauna as a resource, but also of the whole hunting cycle. The hunter does so to maintain and recreate order and equilibrium in one’s relationship with nature as a whole, with the rest of one’s social group, and with oneself. Thus, hunting transcends the exclusively material dimension of a subsistence activity.

Material para el curso de capacitación sobre lectores de pantalla para el Proyecto ÁGORA - FENCE, los días 2 y 22 de abril de 2015.

INTRODUÇÃO: O cisto odontogênico calcificante (COC) é uma lesão odontogênica de natureza benigna considerada por alguns autores como uma lesão exclusivamente cística, enquanto outros admitem uma contraparte neoplásica benigna. Vários estudos têm pesquisado a natureza das células fantasmas características do COC, porém permanece obscuro o conhecimento sobre a expressão dos constituintes da matriz extracelular (MEC) nessa lesão. OBJETIVO: Realizar uma avaliação imuno-histoquímica da expressão de proteínas constituintes da MEC (fibronectina, tenascina e colágeno I) em espécimes de COCs, a fim de verificar se há diferenças significativas em tal expressão ou se esses padrões representam um espectro da mesma entidade. MATERIAL E MÉTODOS: Foram utilizados dez casos de COCs, representados por cinco do tipo unicístico simples, três do tipo produtor de odontoma e dois com proliferação ameloblastomatosa, que foram submetidos à técnica imuno-histoquímica da estreptoavidina-biotina com anticorpos monoclonais anti-fibronectina, anti-tenascina e anti-colágeno I. RESULTADOS: Verificou-se que houve uma expressão variável das proteínas pesquisadas, tanto entre as lesões do mesmo grupo, como entre os três grupos estudados, sendo notável a reatividade para os três anticorpos apresentada pelas células fantasmas. CONCLUSÃO: Não foi possível observar um padrão de marcação que denotasse diferenças entre o tipo unicístico simples, o produtor de odontoma e o com proliferação ameloblastomatosa. Esse achado reforça a visão de que os vários tipos histológicos do COC podem, simplesmente, representar espectros histológicos diferentes de uma só entidade com comportamento biológico semelhante. BACKGROUND: The calcifying odontogenic cyst (COC) is an odontogenic lesion of benign nature considered by some authors as an exclusively cystic lesion, while others admit a benign neoplastic counterpart. Some studies have studied the nature of the characteristic ghost cells of the COC. However, the understanding of the expression of the extracellular matrix (MEC) components in this lesion remains unclear. OBJECTIVE: To carry out an immunohistochemical evaluation of the expression of some proteins of the MEC in specimens of COCs, in order to verify wheather there are significant differences in this expression, or these patterns represent a spectrum of the same entity. METHODS: Ten cases of COCs were selected, representing the following diagnosis: Five cases of simple unicystic type, three odontoma producing type and two with ameloblastomatous proliferating type. The specimens were processed for immunohistochemical staining by the streptavidin-biotin method with monoclonal antibodies anti-fibronectin, tenascin and collagen I. RESULTS: A variable expression of the proteins studied was verified, not only in the lesions of the same group, but also among the three studied groups. There was a notable reactivity for the three antibodies in ghost cells. CONCLUSION: It was not possible to observe a characteristic staining profile that denoted differences between the simple unicystic type, the odontoma producing type and the ameloblastomatous proliferating type. This finding supports the concept that the histologic types of the COC might represent different specters of the same entity with similar biological behavior.

Summary Central mucoepidermoid carcinoma of the jaws is a rare lesion, up to date 100 cases had been reported in the English literature. We retrieved all the available data from the literature and analyzed them. There were several data lacking in previous reports that precluded a thorough Meta-analysis of these cases. The old criteria were evaluated and we propose a new guideline to report future cases by reporting case no 101.

Numb chin syndrome (NCS) is characterized by facial neuropathy along the distribution of the mental branch of the trigeminal nerve. We report a case of NCS in a 65 year old woman who initially presented to her dentist with nonspecific symptoms that she thought were related to a tooth infection. The patient was otherwise healthy and her medical history was significant for breast cancer treated 20 years prior; her cancer was thought to be in complete remission. Upon clinical examination and conventional dental radiography, no pathology was seen such as odontogenic, periodontal, or jawbone infection. Only paresthesia and hypoesthesia was noted unilaterally in her left chin, jaw and lower lip. A computed tomography scan was obtained for further evaluation and revealed lytic metastatic disease involving the right mandible at the level of the mandibular foramen; lytic lesions of the thoracic vertebrae and multiple pulmonary nodules were also noted. Oncologic referral was made immediately which confirmed a diagnosis of metastatic breast cancer. Familiarity with NCS is important for oral health care providers in order to identify etiology and differential diagnosis, as well as to provide appropriate referral and management.

Osteonecrosis of the jaw (ONJ) is a site specific osseous pathology, characterized by chronic exposed bone in the mouth, which needs to be reinforced periodically within the medical literature. ONJ is a clinical entity with many possible aetiologies and its pathogenesis is not well understood. The risk factors for ONJ include bisphosphonates treatments, head and neck radiotherapy, dental procedures involving bone surgery, and trauma. Management of ONJ has centred on efforts to eliminate or reduce severity of symptoms, to slow or prevent the progression of disease, and to eradicate diseased bone. This case describes a rare case of ONJ in a 64-year-old Caucasian male diagnosed with multiple myeloma stage III. The lesion was related to a traumatic injury during mastication. Eighteen months ago in the same area the molar 37 was extracted, achieving a complete satisfactory healing, when only 2 doses of zoledronic acid had been administered.Actinomycesbacterial aggregates were also identified in the microscopic analysis. The management of this osteonecrotic lesion included antibiotic treatment and chlorhexidine topical gel administration. The evolution was monitored every two weeks until patient’s death. The authors provide a discussion of the etiology, pathogenesis, diagnosis, and management. This case report may shed light on the controversies about concomitant factors and mechanisms inducing ONJ.

La fisura petrotimpánica (FPT), que se establece entre la porción timpánica y petrosa del hueso temporal, se sitúa en la región posteromedial de la fosa mandibular y representa una vía de comunicación entre el oído medio y la ATM. Actualmente esta relación anatómica ha adquirido gran importancia por su posible implicación en la fisiopatología de la otitis media y de los procesos inflamatorios y degenerativos (artritis inflamatoria y artrosis) que afectan a la ATM. Objetivos: Los objetivos del estudio fueron estudiar las características morfométricas de la FPT desde un punto de vista anatómico y radiológico, correlacionar las imágenes sagitales de la FPT por tomografía computarizada multicorte helicoidal (TCMH) con la criosección anatómica correspondiente, analizar las relaciones existentes entre las mediciones de las variables y presentar la FPT como posible vía de propagación de procesos infecciosos o inflamatorios entre el oído medio y la ATM. Material y métodos: Hemos utilizado 15 especímenes cadavéricos a los que hemos realizado un estudio radiológico mediante un tomógrafo computarizado multidetector de 16 coronas y un estudio anatómico a partir de criosecciones en el plano sagital. Se han anotado las principales características morfométricas y morfodescriptivas obteniendo 52 registros para cada espécimen. El método estadístico para analizar los resultados incluye análisis bivariado para determinar la variabilidad intra y entre observadores así como el coeficiente de correlación intraclase, la concordancia entre los observadores y la correlación y concordancia entre las variables del estudio anatómico y radiológico. Resultados: Los resultados indican que la FPT es un conducto óseo a partir del cual se establece una relación anatómica por continuidad entre la ATM y el oído medio. La TCMH permite identificar la FPT en los planos sagital, axial y coronal oblicuo, siendo las imágenes sagitales comparables a la anatomía seccional correspondiente ya que no existen diferencias estadísticamente significativas entre las variables morfométricas del estudio radiológico y anatómico, presentando además una correlación significativa. Conclusiones: Las dimensiones que presenta la FPT la habilitan como una posible vía de propagación por continuidad de procesos infecciosos o inflamatorios entre el oído medio y la ATM, especialmente en fisuras cortas y anchas., Vestigial foramen and fissures between the TMJ and the middle ear account for possible reciprocal spread of infection between these two anatomical regions. The petrotympanic fissure represents an important anatomical feature that connects the mandibular fossa and the middle ear. Purpose: The purpose of this study was to evaluate the morphology of petrotympanic fissure with multislice helical computed tomography (MHCT) and frozen sagittal anatomic sections. Material and methods: we selected 15 unoperated cadaver temporal bones for the study. All of these bones had intact middle ear and mandibular fossa. Imaging was performed with fresh preparations. Subsequent the specimens were frozen and sectioned on the sagittal plane. The sagittal anatomy of the mandibular fossa and the petrotympanic fissure were correlated with MHCT images. Results: The petrotympanic fissure is a tunnel-shaped structure that connects the mandibular fossa and the middle ear. The study found that the sagittal frozen sectional anatomy correlated with MHCT images coincidentally to describe the petrotympanic fissure. Conclussions: The course and the dimensions of the petrotympanic fissure represents a possible pathway for spread of infection from the middle ear to the temporomandibular joint, specially in short and wide open fissures.

An unusual presentation of a focal osteoporotic bone marrow defect (FOBMD) of the mandible mimicking a cystic lesion is documented. A definitive diagnosis could be established only on the basis of the histopathologic evaluation. A 66-year-old Brazilian woman was referred by her dentist for well-defined radiolucency of the mandibular molar region suggesting a cystic lesion of odontogenic origin. The computed tomography scan confirmed that the lesion did not affect the corticals. The biopsy confirmed the diagnosis of FOBMD. The diagnostic difficulty in the current case is obvious, because FOBMD, usually exhibiting an ill-defined radiolucency, is seldom suspected preoperatively when a differential diagnosis is considered for focal well-defined radiolucent areas in the jaws Fechado

Growth factors seem to be part of a complex cellular signalling language, in which individual growth factors are the equivalents of the letters that compose words. According to this analogy, informational content lies, not in an individual growth factor, but in the entire set of growth factors and others signals to which a cell is exposed. The ways in which growth factors exert their combinatorial effects are becoming clearer as the molecular mechanisms of growth factors actions are being investigated. A number of related extracellular signalling molecules that play widespread roles in regulating development in both invertebrates and vertebrates constitute the Fibroblast Growth Factor (FGF) and type beta Transforming Growth Factor ((TGF beta). The latest research literature about the role and fate of these Growth factors and their influence in the craniofacial bone growth ad development is reviewed

El objetivo fue verificar la eventual relacion entre la agenesia de los incisivos lLaterales maxilares (AILM) y los biotipos faciales establecidos en clinica. Se realizo un analisis en tres grupos de sujetos: (i) pacientes afectos de AILM, (ii) sus familiares y (iii) una poblacion control no afecta, definida como normal. Entre los grupos tambien se comparo a los sujetos en periodo de crecimiento con los adultos. El biotipo dolicofacial fue descrito principalmente en ninos con agenesias bilaterales, mientras que los pacientes con agenesias unilaterales y la poblacion control presentaban mayoritariamente un patron mesofacial. El patron braquifacial fue prevalente en ninos no afectos de agenesia pero miembros de la familia de pacientes afectos de agenesia. Lo mismo se observo en todos los pacientes adultos, aunque la prevalencia del biotipo braquifacial resulto similar a la del biotipo mesofacial en pacientes no afectos de agenesia, pero con relacion familiar a pacientes afectos. La notable variabilidad en el grupo sometido a estudio, evidente por los elevados valores de DE obtenidos en cada grupo, no permite establecer de manera definitiva una correlacion positiva entre la AILM y un biotipo morfologicos facial, al menos con los datos hasta ahora disponibles.