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Background: The coronavirus (COVID-19) pandemic significantly affected health care systems worldwide, and the field of dentistry is no exception. Odontogenic infections in pediatric patients pose unique challenges to treatment and diagnosis., Purpose: The purpose of this study was to evaluate the incidence, characteristics, and treatment of pediatric maxillofacial odontogenic infections during COVID-19 compared to pre-COVID-19., Study Design, Setting, Sample: This retrospective cohort study included all pediatric patients (0-18 years old) who visited the emergency department (ED) at Tzafon Medical Center, Israel, between March 2020 and February 2021 (COVID-19), or between March 2018 and February 2020 (pre-COVID-19), and were diagnosed with maxillofacial odontogenic infections. Patients with missing demographic data and patients who did not complete the medical examination were excluded., Predictor/exposure/independent Variable: The exposure variable was the date of presentation, categorized as COVID-19 or pre-COVID-19., Main Outcome Variable(s): The main outcome variables were the proportion of patients diagnosed with odontogenic infections, hospitalization rate, treatment methods, and length of hospital stay., Covariates: Covariates included patient demographics, involved dentition and associated spaces, and the administration of antibiotics before ED arrival., Analyses: The Fisher exact test and Pearson's χ 2 test were applied to assess differences in categorical variables. The Wilcoxon rank-sum test was used for independent variables. A logistic regression model was used to predict outcome variables. P values were two-tailed, and statistical significance was defined as P < .05., Results: The study sample comprised 471 patients: 357 (76%) in the pre-COVID-19 period and 114 (24%) during COVID-19. The relative risk of visits to the ED out of total oral and maxillofacial ED visits was lower during COVID-19 (relative risk = 0.65, P = .0001). The hospitalization rate increased from 72% (257 patients) pre-COVID-19 to 86.8% (99 patients) during the COVID-19 period (P = .001). Length of hospital stay during COVID-19 was significantly shorter than pre-COVID-19 (P < .001)., Conclusion and Relevance: The findings of this study reveal a significant reduction in odontogenic infection incidents referred to the ED during the pandemic. This implies that many of these incidents can be successfully treated in community health care settings without referral to the ED., (Copyright © 2024 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: To propose a reconstructive protocol based on surgical management experience of polymorphous low-grade adenocarcinoma (PLGA) and the location of the primary lesion., Methods: Data on the surgical management and the reconstructive technique of 14 histologically conformed patients with PLGA, all treated by the same surgeon, were analyzed and evaluated., Results: Mean follow-up period in our series was 6.2 years. Mean age at diagnosis was 55.5 years and female to male ratio was 2.2:1. The most common presenting sign was a nonpainful lump or mass in an intraoral location. Most patients were managed by wide local excision and reconstruction method varied from primary closure to the use of radial forearm graft. Recurrence appeared in one of the patients in this series, while 2 required further radiation therapy. A protocol for reconstruction of intraoral patients with PLGA is suggested based on our analysis., Conclusion: Surgical management is the gold standard for PLGA treatment. Neck dissection is recommended only in patients with presurgery fine-needle aspiration confirmed lymph node involvement. The reconstruction depends mainly on location and size of the primary lesion.

Background: Several types of human papillomavirus (HPV) have been found to be associated with oral squamous cell carcinoma (OSCC). Still, the significance of HPV infection and its relationship to patient prognosis remains an important matter of debate., Objectives: To investigate the incidence of HPV infection in OSCC patients in northern Israel populations to determine its role in the etiology and prognosis of OSCC., Methods: OSCC tissues were gathered from the pathology departments at Rambam and Padeh medical centers in northern Israel. HPV DNA typing and immunohistochemistry for p16INK4A antibodies were conducted to evaluate their incidence in OSCC tissues. Statistical analysis regarding its expression in the different sub-populations (Jews, Arabs, Druze) was conducted using chi-square and Fisher's exact tests., Results: The study included 82 patients: 53 men and 29 woman; median age 62.1 years; 54 Jews, 25 Arabs, and 3 Druze. The overall incidence of HPV expression was 45% (n=37). The median age of HPV-positive patients was 53 years vs. 65.8 in the negative group (P < 0.001). The 5 year overall survival of HPV-positive patients was not significantly higher than HPV-negative patients. A significant association was found between P16 expression and overall survival (log-rank P = 0.001)., Conclusions: HPV infection in OSCC was not found to be significant in this study; however, P16 expression in the tumor tissue was found to be a positive prognostic factor for better survival.

The clinical presentation of Burkitt's lymphoma in the maxillofacial area is variable. The objective of this study is to review and analyse all cases of Burkitt's lymphoma with oral or maxillofacial involvement diagnosed in our department. A retrospective review of patients with Burkitt's lymphoma in the facial area between the years 1978 and 1997 was undertaken. The patients, 8 male and 5 female, were from 7 to 50 years old (mean 15.3 years). Six patients were Stage I and 7 were Stage II. Five had abdominal involvement and 2 lymph node involvement besides the maxillofacial presentation. Three tumours were in the mandible, 3 in both mandible and maxilla, 2 in the palate, and 5 in the maxilla alone. In 5 patients the tumour presented as a facial swelling, in 3 as an exophytic mass, in 2 as an ulcer, 1 case presented as a hyperplastic lesion, and 2 were periapical lesions. Complaints included pain (7), swelling (5), and sensory disturbance (2). EBV titres were positive in 4 patients. Abdominal involvement was only seen in patients under 12 years old. All patients were treated with chemotherapy, while adjuvant radiotherapy was indicated in 3 cases. Follow-up of 1-20 years revealed a 2-year survival rate of 61.5%. It seems that the Israeli disease is between that of the African and American types, when considering age distribution.