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Background: This study evaluated the accuracy of the CBCT reconstruction model compared to the natural tooth and the accuracy of the replica tooth compared to the natural tooth., Objective: The hypothesis was that a replica tooth could be used as a surgical guide in autotransplantation., Methods: Three teeth were chosen and a CBCT reconstruction model was formed from each tooth. STL-data was transferred to a milling machine and replica teeth were milled from PEEK. A digitized surface model was prepared from the natural and the replica teeth by a stereophotogrammetry scanner. The surface model from the optical scan of the natural tooth was compared to the CBCT reconstruction model and the surface model of the replica tooth. The models were matched on each other, and surface-based rigid registration was performed between the surface models. Distances were calculated and visualized by MATLAB., Results: The CBCT reconstruction model and the natural tooth were compared. The largest euclidean distance was found at the root tip in the premolar (0.93 mm) and at the furcation area in the molar (2.3 mm). When the natural tooth and the replica tooth were compared, the largest euclidean distance was found at the root tip in the premolar (1.5 mm) and at the furcation area in the molar (1.9 mm)., Conclusion: A CBCT scan maintains sufficient image quality for tooth autotransplantation planning. The replica tooth corresponded in size and shape to the natural tooth in terms of clinically expected need of precision., (© 2024 The Author(s). Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Objective: To identify mechanisms and types of injuries in patients having sustained craniofacial fractures under the influence of alcohol, and to compare the frequencies of them between males and females., Materials and Methods: Patients included were adults who had been diagnosed with craniofacial fractures at Töölö Hospital Emergency Department, Helsinki University Hospital, Finland, and who had been under the influence of alcohol at the time of injury. The primary outcome variables were assault-related and fall-related injury mechanisms. The secondary outcome variables were other injury mechanisms, time of accident, type of craniofacial fracture and severity of facial fracture. The primary predictor variable was sex. The control variable was age at the time of injury. The statistical modelling was executed using logistic regression., Results: Of the total of 2,859 patients with craniofacial fractures, 1,014 patients (35.5%) fulfilled the inclusion criteria. Males predominated (84.6%). Assault (38.0%) was the most frequent aetiology. Compared to the odds of females, males had 2.8 times greater odds for assault, 2.4 times greater odds for isolated cranial fracture and 1.7 times greater odds for a facial injury severity score of ≥ 3. Females had 2.0 times greater odds for any fall compared to the odds of males., Conclusions: Particularly male patients are frequently under the influence of alcohol at the time of injury, predisposing them to assault and severe facial fractures more often than females. Codes of practice on how to identify unhealthy alcohol use and how to intervene are recommended.

The safety of children's living environment is affected by several factors. Safer living environments have been offered as one explanation to decreases in children's fractures. Earlier studies provide evidence of a decreasing trend in children's fractures in the past decades. The objective of this study was to investigate demographic and clinical features of paediatric maxillofacial fractures during three time periods. A retrospective cross-sectional single-centre study was designed. The study included 474 patients aged ≤ 15 years admitted to Helsinki University Hospital in Finland with maxillofacial fractures during 1980-1989, 1993-2002 and 2013-2018. Maxillofacial fractures increased by 25% during the study period. The increase was greater in boys (28%) than in girls (19%), and significant in age groups 0-5 years (71%) and 13-15 years (32%). Exclusively mandibular fractures decreased by 20%, while exclusively midfacial fractures increased more than four-fold and exclusively upper-third fractures five-fold. Being hit by object and falls from height increased more than two-fold. A temporary increase in assaults and decrease in bicycle accidents in the middle period of the study was observed. During the three decades, paediatric maxillofacial fractures have increased and both fracture type and underlying aetiology have changed. These findings reflect improvements in diagnostics, traffic safety, regulations and technology. The role of factors such as interpersonal violence and economic fluctuation on the incidence of childhood maxillofacial fractures is discussed., (© 2024. The Author(s).)

The COVID-19 pandemic illustrated many of the challenges with using science to guide planning and policymaking. One such challenge has to do with how to manage, represent and communicate uncertainties in epidemiological models. This is considerably complicated, we argue, by the fact that the models themselves are often instrumental in structuring the involved uncertainties. In this paper we explore how models 'domesticate' uncertainties and what this implies for science-for-policy. We analyse three examples of uncertainty domestication in models of COVID-19 and argue that we need to pay more attention to how uncertainties are domesticated in models used for policy support, and the many ways in which uncertainties are domesticated within particular models can fail to fit with the needs and demands of policymakers and planners., Competing Interests: We declare we have no competing interests., (© 2024 The Authors.)

Objectives: Ameloblastoma is a benign, locally aggressive odontogenic tumor with high recurrence rates. Matrix metalloproteinases (MMPs) mediate extracellular integrity in normal and pathological conditions, and exert multiple functions coordinating inflammation and tumor progression. E-cadherin and beta-catenin are adherence junction molecules in cell-to-cell connections. We investigated the involvement of MMP-7, -8, -9, E-cadherin, and beta-catenin in ameloblastoma and the surrounding extracellular matrix., Material and Methods: Our material consisted of 30-34 tissue samples from ameloblastoma patients of Helsinki University Hospital. We used immunohistochemistry to detect the expression of the biomarkers. Two oral pathologists independently scored the immunoexpression intensities and statistical calculations were made based on the results., Results: E-cadherin expression was weaker in the maxillary than in mandibular ameloblastomas. Beta-catenin was expressed in the ameloblastoma cell membranes. We detected MMP-8 and -9 expression in polymorphonuclear neutrophils in the extracellular area and these MMPs correlated positively with each other. Osteoclasts lining bone margins and multinuclear giant cells expressed MMP-9. Neither MMP-8 nor MMP-9 immunoexpression could be detected in ameloblastoma cells. MMP-7 expression was seen in some apoptotic cells., Conclusion: The fact that E-cadherin immunoexpression was weaker in maxillary compared to mandibular ameloblastomas might associate to earlier recurrences. It promotes the idea of mandibular and maxillary ameloblastoma exerting differences in their biologies. We detected MMP-8 and -9 in polymorphonuclear neutrophils which relates to these MMPs participating in extracellular remodeling through a mild inflammatory process. Bone degradation around ameloblastoma may be due to MMP-9 in osteoclasts but this phenomenon might be an independent process and needs further investigations., (© 2020 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Background: The objective was to evaluate health-related quality of life (HRQoL) before and after surgical treatment of zygomatic complex fracture and assess patients' perceptions of the aesthetic and functional outcomes of surgery., Material and Methods: A prospective study of 79 adult patients before and after surgery for zygomatic complex fracture was conducted. HRQoL was measured using the generic 15-dimensional (15D) instrument, and patient satisfaction was assessed by an additional questionnaire., Results: The mean preoperative 15D score for patients was lower than for general population that was matched for age and gender (p=0.011). The mean 15D score was lowest on the first postoperative day (p<0.001) when patients were worse off for 6 of the 15 dimensions of the HRQoL instrument and better off for three dimensions. However, patients achieved, and even exceeded, the mean 15D score of the general population during the first month following surgery. Infraorbital sensory loss at the end of the six-month follow-up appeared to be the single most important factor that plagued the patients., Conclusions: HRQoL is significantly reduced after trauma but improves a few weeks after surgery. Infraorbital nerve sensory loss is a notable long-term factor that affects patients after zygomatic complex fracture.

Unlabelled: Backround: The aim of this study was to assess changes in bone volume after block bone augmentation and placement of dental implants and further evaluate the aesthetic outcome of the treatment., Material and Methods: 9 patients with atrophied anterior maxilla were included in this study. They received total of 21 implants. Dimensions of the alveolar ridge were measured from cone-beam computed tomography x-rays. The bone level at the implant sites was analysed from intraoral x-rays and the aesthetic outcome was assessed from clinical photographs using a pink aesthetic score (PES) scaling., Results: The mean gained horizontal bone width at the marginal crest and 5 mm apically was accordingly 2.7mm and 5.0 mm. The mean PES rating was 9.8/14. The survival rate of., Conclusions: Reconstruction of the atrophied anterior maxilla with bone blocks and dental implants is a safe procedure with high survival rate and acceptable aesthetic outcome., Competing Interests: The authors have declared that no conflict of interest exist.

Background: The aim was to clarify the occurrence of delayed union after surgical treatment of mandibular fracture and investigate whether an association exists between perioperative use of dexamethasone and delayed union., Material and Methods: Thirty-seven patients were included in a prospective randomized study. Of these patients, 19 (51.4%) were randomized to receive a total dose of 30 mg of dexamethasone and 18 (48.6%) served as controls. Patients underwent clinical and radiological investigation immediately, one month, three months and six months postoperatively. Radiographs were evaluated by an experienced, blinded senior oral radiologist., Results: Delayed fracture union was found in 9 patients (24.3%). It was associated significantly with angle fractures (p=0.012). Delayed union occurred more frequently in patients who received dexamethasone (36.8%) than in those who did not (11.1%) (p=0.068). The association of infection with delayed union was significant (p=0.027). Moreover, dexamethasone was significantly (p=0.019) associated with delayed fracture union with concomitant infection. Gender, age group, smoking habit, treatment delay and duration of surgery were not associated with delayed union., Conclusions: Infection was associated with delayed union. Short-term high-dose dexamethasone predisposed to complicated fracture union, especially in patients with angle fractures. The relationship between dexamethasone and delayed bone healing without infection remains unresolved.

Purpose: The two major causative factors for mandibular fractures, as stated in the literature, are either interpersonal violence or motor vehicle accidents. The purpose of this study was to describe epidemiological trends of mandibular fractures in Switzerland. A special emphasis was directed towards the potential impact of socio-economic standards on the mechanism and pattern of mandible fractures., Patients and Methods: A database of patients aged over 16 years who had been diagnosed with a mandibular fracture between January 2000 and December 2007 at the University Hospital of Bern, Switzerland's largest Cranio-Maxillofacial-Surgery Centre, was retrospectively reviewed. Patients' data including gender, age, mechanism of accident, fracture site and associated injuries were analysed and compared with previously published data., Results: There were a total of 420 patients with 707 mandibular fractures. The two most common causes of injury were road traffic accidents (28%) and various types of sports injuries (21%). A total of 13% of the patients were under the influence of alcohol or drugs at admission. Fractures were predominantly situated in the condyle/subcondyle (43%) and in the symphysis/parasymphysis region (35%). Occurrences of fractures in the angle and in the body were low, at 12% and 7% respectively., Conclusion: In contrast to other highly developed countries, sports- and leisure-related accidents outnumbered motor vehicle accidents and altercations. The data presented here supports the assumption of a correlation of trauma cause and fracture pattern.