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Background Free tissue transfer is commonly used in the reconstruction of post-ablative defects of the mandible. Due to lack of statistical power, comparing the survival of various free flaps, even in large studies, is challenging. The purpose of this study was to perform a meta-analysis comparing the survival of the most commonly used free flaps for mandibular reconstruction. Methods We searched PubMed, EMBASE, and SCOPUS for relevant studies. A meta-analysis using the Peto one-step odds ratio (OR) with 95% confidence intervals (CI) was used to compare the pooled survival of the most commonly used free flaps for mandibular reconstruction. Results Of the 25,303 studies reviewed, 17 were selected for data extraction. A total of 1,221 subjects received 1,262 free flaps. Sixty-five free flaps failed. The pooled survival of all free flaps used for mandibular reconstruction was 94.8%. The deep circumflex iliac artery (DCIA) flap was associated with a seven-fold increase in failure when compared to the radial forearm free flap (Peto OR 7.40; 95% CI 1.38, 39.75, P = 0.02). There was no difference in survival when comparing other commonly used free flaps. Conclusions The results of this study suggest that free flap reconstruction of the mandible is highly successful. With the exception of the increased survival of the radial forearm when compared to the DCIA, there is no difference in recipient site survival when comparing various free flaps for mandibular reconstruction. © 2015 Wiley Periodicals, Inc. Microsurgery 35:576–587, 2015.

In contrast to sleep-related oral parafunctional behaviors, little is known about waking oral parafunctional behaviors. The Oral Behaviors Checklist contains terms referring to a variety of non-observable behaviors that are reliable when prompted (e.g. 'clench') but validity data are absent. Our goal was to assess whether (i) each behavioral term is distinct electromyographically, and (ii) temporomandibular disorder (TMD) subjects differ from non-TMD subjects in their performance. Surface electromyographic (EMG) activity was used to measure bilateral masseter, temporalis, and suprahyoid muscles while subjects (27 patients with TMD; 27 healthy controls) performed ten oral behaviors without explanation. Electromyographic data were averaged between bilateral muscles and two trials. A multivariate construct (jaw muscle activity) was analyzed using Wilks lambda within multivariate analysis of variance (manova). Obvious behaviors (e.g. clench, read, tongue press) exhibited expected EMG patterns, and patients and controls produced identical profile plots of the EMG data. Of 10 tested behaviors, nine were found to be associated with significantly differing proportions of amplitudes across muscles and were thus unique. Behaviors with similar terms were associated with different EMG patterns. The present data support the specificity of behavioral terms and performances. Implications include causation related to TMD based on subtle behaviors that occur at a high frequency.

This article presents the academic qualifications of matriculating dental students (as indicated by overall undergraduate GPA, undergraduate science GPA, average DAT scores, and average PAT scores) and total cost of education for students at U.S. dental schools according to geographic location and funding sources. Dental schools were divided on the basis of geographic location (Northeast, South, Central, or West) and principal means of funding (public versus private). Average four-year total educational expenses as reported in the 1996-97 and 2000-01 matriculation years were compared as well as undergraduate overall GPA, science GPA, DAT academic average, and PAT score. Public dental schools in the southern region cost significantly less than any other region of any funding type. Public dental schools in the western region had significantly higher average GPA, average science GPA, DAT academic average, and PAT scores among their matriculating classes than did any other region. Public dental schools from the western region also had the least amount of increase in projected four-year expenses between the two matriculation years compared. Excluding PAT scores, western public dental schools had the highest academic admission criteria of any region of either funding type.