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Purpose: Primary bone tumors of the fibula are rare. Distal fibular resection has a significant impact on ankle biomechanics and gait, possibly leading to complications such as ankle instability, valgus deformity, and degenerative changes. Question: Is there a need for reconstructive surgery after distal fibular resection, and what reconstructive procedures are available? Materials and methods: The review is registered with the PROSPERO International Register of Systematic Reviews. Inclusion criteria consisted of all levels of evidence, human studies, patients of all ages and genders, publication in English, and resection of the distal portion of the fibula due to tumor pathology. The reviewers defined four different categories of interest by method of treatment. Additional articles of interest during full-text review were also added. Results: The initial search resulted with a total of 2958 records. After screening, a total of 50 articles were included in the study. Articles were divided into ‘No reconstruction’, ‘Soft tissue reconstruction’, ‘Bone and soft tissue reconstruction’, and ‘Arthrodesis, arthroplasty or other reconstruction options’ groups. Conclusion: Limb salvage surgery should be followed by reconstruction in order to avoid complications. Soft tissue reconstructions should always be considered to stabilize the joint after fibular resection. Bone reconstruction with reversed vascularized fibula is the preferred technique in young patients and in cases of bone defects more than 3 cm, while arthrodesis should be considered in adult patients. Whenever possible for oncologic reason, if a residual peroneal malleolus could be preserved, we prefer augmentation with a sliding ipsilateral fibular graft.

Abstract Background Angiosarcoma of the adrenal gland is a very rare malignant vascular neoplasm. The clinical symptoms are atypical or completely absent. Angiosarcomas of the adrenal gland are therefore often discovered incidentally, and the diagnosis is made histologically after resection. Case presentation A 46-year-old white Spanish male who was a previous smoker and nondrinker and was slightly overweight (92 kg, 176 cm, body mass index 29.7 kg/m2) with no relevant medical history presented to the internal medicine emergency department of our hospital with an unclear 12 cm tumor of the right adrenal gland. Prior to the computed tomography scan, he had had persistent evening fevers for 4 months and unintentional weight loss of 5 kg. The laboratory results showed anemia and an elevated C-reactive protein, but no hormone production. We performed an open adrenalectomy of the right adrenal gland. Finally, the histologic findings revealed an angiosarcoma of the adrenal gland. Conclusion Even though angiosarcomas of the adrenal gland are rare, the differential diagnosis of an angiosarcoma should be considered if a malignant tumor of the adrenal gland is suspected. Treatment decisions should be made on an interdisciplinary basis and preferably in a specialized center. Owing to the rarity of angiosarcomas of the adrenal gland, it is necessary to continue to share clinical experience to gain a better understanding of this particular tumor entity.

Abstract Background Soft tissue recurrence of giant cell tumor of bone (GCTB) is rare. This study aims to provide its prevalence, recurrent locations, risk factors, effective detection methods and a modified classification for this recurrence. Methods Patients with soft tissue recurrence after primary surgery for GCTB were screened from January 2003 to December 2022. General data, recurrence frequency, types according to an original classification (type-I: peripheral ossification; type-II: central ossification; type-III: without ossification), a modified classification with more detailed subtypes (type I-1: ≤ 1/2 peripheral ossification; type I-2: ≥ 1/2 peripheral ossification; type II-1: ≤ 1/2 central ossification; type II-2: ≥ 1/2 central ossification; type III: without ossification), locations, detection methods such as ultrasonography, X-ray, CT or MRI, Musculoskeletal Tumor Society (MSTS) scores were recorded. Multivariate regression analysis was conducted to identify risk factors for recurrence frequency. Results A total of 558 recurrent cases were identified from 2009 patients with GCTB. Among them, 32 were soft tissue recurrence. The total recurrence rate was 27.78% (558/2009). Soft tissue recurrence rate was 5.73% among 558 recurrent cases, and 1.59% among 2009 GCTB patients, respectively. After excluding one patient lost to follow-up, 10 males and 21 females with the mean age of 28.52 ± 9.93 (16–57) years were included. The definitive diagnosis of all recurrences was confirmed by postoperative pathology. The interval from primary surgery to the first recurrence was 23.23 ± 26.12 (2–27) months. Eight recurrences occurred from primary GCTB located at distal radius, followed by distal femur (6 cases). Recurrence occurred twice in 12 patients and 3 times in 7 patients. Twenty-seven recurrences were firstly detected by ultrasonography, followed by CT or X-ray (10 cases in each). Types at the first recurrence were 5 cases in type-I, 8 in type-II and 18 in type-III. According to the modified classification, 3 patients in type I-1, 2 in type I-2, 1 in type II-1, 7 in type II-2, and 18 in type III. The mean MSTS score was 26.62 ± 4.21 (14—30). Neither Campanacci grade nor recurrence type, modified classification and other characters, were identified as risk factors. Conclusions Soft tissue recurrence of GCTB may recur for more than once and distal radius was the most common location of primary GCTB that would suffer a soft tissue recurrence. Ultrasonography was a useful method to detect the recurrence. Since no risk factors were discovered, a careful follow-up with ultrasonography was recommended.

Flexible hydrogel polymers with excellent stretchability, high conductivity, and biocompatibility are widely used to prepare flexible sensing devices. However, it remains difficult to simultaneously combine excellent tensile capacity and high ion conducting ability into a simple hydrogel material. While PVA‐based hydrogels have been developed before, this work focuses on a unique preparation method. It solves the engineering problem of making hydrogels that have both high elongation at break and high ionic conductivity. In the study, we introduced cellulose nanofibers (CNFs) into polyvinyl alcohol (PVA)/chitosan (CS) cross‐linked polymer networks to form triple network (TN) composite hydrogel. The labyrinthine three‐dimensional (3D) honeycomb through‐hole network nanostructure generated by the addition of CNF provides the hydrogel with excellent mechanical properties. Then, the simple salting‐out strategy of muriate of potash (MOP) solution gives the hydrogel superior mechanical properties and high ionic conductivity. The prepared PVA/CS/CNF/MOP TN ionic conductive hydrogel not only exhibits excellent mechanical properties (toughness up to 2.39 MJ m−3, fracture strength up to 1.78 MPa, fracture strain up to 350%) but also has impressive ionic conductivity (highest to 8.4 S m−1). The flexible hydrogel strain sensor assembled from the PVA/CS/CNF/MOP TN ionic conductive hydrogel showed remarkable sensitivity (gauge factor for 6.9) and the ability to detect human motions reliably. Besides, the hydrogel also has maintained long‐term antimicrobial and antioxidant properties. The study provided a new perspective on designing multifunctional materials featuring strong mechanical properties and high ionic conductivity, contributing to the advancement of flexible sensor technologies. [ABSTRACT FROM AUTHOR]

Objectives: Ecogeographic variation in human nasal anatomy has historically been analyzed on skeletal morphology and interpreted in the context of climatic adaptations to respiratory air‐conditioning. Only a few studies have analyzed nasal soft tissue morphology, actively involved in air‐conditioning physiology. Materials and Methods: We used in vivo computer tomographic scans of (N = 146) adult individuals from Cambodia, Chile, Russia, and Spain. We conducted (N = 438) airflow simulations during inspiration using computational fluid dynamics to analyze the air‐conditioning capacities of the nasal soft tissue in the inflow, functional, and outflow tract, under three different environmental conditions: cold–dry; hot–dry; and hot–humid. We performed statistical comparisons between populations and sexes. Results: Subjects from hot–humid regions showed significantly lower air‐conditioning capacities than subjects from colder regions in all the three conditions, specifically within the isthmus region in the inflow tract, and the anterior part of the internal functional tract. Posterior to the functional tract, no differences were detected. No differences between sexes were found in any of the tracts and under any of the conditions. Discussion: Our statistical analyses support models of climatic adaptations of anterior nasal soft tissue morphology that fit with, and complement, previous research on dry skulls. However, our results challenge a morpho‐functional model that attributes air‐conditioning capacities exclusively to the functional tract located within the nasal cavity. Instead, our findings support studies that have suggested that both, the external nose and the intra‐facial soft tissue airways contribute to efficiently warming and humidifying air during inspiration. This supports functional interpretations in modern midfacial variation and evolution. [ABSTRACT FROM AUTHOR]

Anterior ankle impingement is a frequent cause of chronic ankle pain and swelling. A pathological examination has been reclassified as “anterior ankle impingement syndrome.” Soft tissue impingement is prevalent in the anterolateral compartment of the ankle, while a bony spur often causes impingement in the anteromedial compartment. Although open surgery has yielded good outcomes historically, it is associated with several complications. On the other hand, the development of ankle arthroscopy has reduced these risks significantly and has been used effectively in numerous studies to treat impingements caused by anterior bony spurs or soft tissue. An accurate preoperative clinical diagnosis and diagnostic imaging are critical for surgical planning, particularly for identifying bony spurs in front of the ankle. Narrowing joint space, large bone fragments, and other factors can influence the surgical outcomes. Computed tomography scans precisely evaluate the bony spur size, while magnetic resonance imaging scans help assess soft tissue lesions. Therefore, understanding diagnosis and treatment is important, and an accurate understanding of patient prognostic factors, such as osteoarthritis and degenerative osteoarthritis, eventually affects patient outcomes. This paper discusses the clinical symptoms, causes, diagnosis, surgical method, and postoperative rehabilitation of anteromedial and anterolateral ankle impingement syndrome and reports the results of arthroscopic surgery. [ABSTRACT FROM AUTHOR]

Scaffold-guided breast tissue regeneration (SGBTR) can transform both reconstructive and cosmetic breast surgery. Implant-based surgery is the most common method. However, there are inherent limitations, as it involves replacement of tissue rather than regeneration. Regenerating autologous soft tissue has the potential to provide a more like-for-like reconstruction with minimal morbidity. Our SGBTR approach regenerates soft tissue by implanting additively manufactured bioresorbable scaffolds filled with autologous fat graft. A pre-clinical large animal study was conducted by implanting 100 mL breast scaffolds (n = 55) made from medical-grade polycaprolactone into 11 minipigs for 12 months. Various treatment groups were investigated where immediate or delayed autologous fat graft, as well as platelet rich plasma, were added to the scaffolds. Computed tomography and magnetic resonance imaging were performed on explanted scaffolds to determine the volume and distribution of the regenerated tissue. Histological analysis was performed to confirm the tissue type. At 12 months, we were able to regenerate and sustain a mean soft tissue volume of 60.9 ± 4.5 mL (95% CI) across all treatment groups. There was no evidence of capsule formation. There were no immediate or long-term post-operative complications. In conclusion, we were able to regenerate clinically relevant soft tissue volumes utilizing SGBTR in a pre-clinical large animal model. [ABSTRACT FROM AUTHOR]

Background: The tunnel technique (TUN) preserves the integrity of the papilla by creating envelope flaps that allow for the insertion of a connective tissue graft, and/or biomaterials. Methods: (1) A comprehensive overview of tunneling flap procedures in the treatment of gingival recessions (GRs) for soft tissue coverage is presented and (2) A classification system for soft and hard tissue anatomy of GR sites which may aid the clinician in determining the surgical complexity is being introduced. Results: A novel clinical classification system is proposed to illustrate complexity levels determined by soft and hard tissue anatomy of GR sites such as the mucogingival junction proximity to the gingival margin, bone morphotype, and mucosal margin thickness. Conclusions: TUN is highly effective in treating single/multiple GRs. Its limitations are related to variability in surgical site anatomy and operator expertise. A classification system based on anatomical soft and hard tissue variations has been proposed to help identify complexity levels encountered during tunneling procedures. Key points: Site‐related factors directly impact the surgical variables related to tissue trauma, flap tension, soft tissue management, muscle pull, and wound stability during the healing of gingival recessions (GRs).The achievement of expedited and favorable wound healing is crucial to obtaining quantitative and qualitative success in the treatment of GR and the long‐term stability of root coverage.A classification system based on anatomical soft and hard tissue variations has been proposed to facilitate tunneling procedures while respecting surgical principles. [ABSTRACT FROM AUTHOR]

This case report introduces an innovative approach for tissue regeneration post-total excision of basal cell carcinoma utilizing a xenogeneic collagen matrix coupled with injectable platelet-rich fibrin. The clinical outcome underscores the efficacy and predictability of this protocol in soft tissue regeneration. While further investigation on a larger patient cohort is warranted to fully elucidate its effects and advantages, this technique holds promise in streamlining surgical procedures following excision of extraoral neoplasms. Notably, its simple handling, minimal resource requirements, and potential to mitigate donor site morbidity and patient comorbidities post-surgery signify its value in clinical practice. [ABSTRACT FROM AUTHOR]

Soft tissue is an important operation object in robot-assisted surgery and its mechanical response is of great significance to the precision of surgical operation. Accurate prediction of soft tissue mechanical properties can effectively avoid the potential damage of biological tissue caused by excessive operating force. In this paper, three typical mechanical responses of soft tissue were obtained by no-slip compression experiments of liver tissue. Second, the prediction model of soft tissue mechanical response based on gray prediction was established, and the influence of key parameters of the model on the precision of mechanical response prediction was analyzed. The results show that the gray prediction model can accurately predict the mechanical response of soft tissue, and the prediction accuracy is the highest when the number of historical data is 7. The prediction method of soft tissue mechanical response proposed in this paper will provide important data reference for accurate operation of surgery. [ABSTRACT FROM AUTHOR]

Autotransplanted teeth in the maxillary anterior region should be restored or reshaped as soon as possible for functional and esthetic reasons as well as the well‐being of the patient. However, such tooth restorations are frequently not carried out immediately after tooth transplantation because the process could have a negative impact on the healing process. The development of a simple, immediate, and atraumatic esthetic interim restoration would be of great benefit to both the clinician and patient and address all the concerns caused by immediately preparing the tooth postoperatively and cementing a permanent restoration. This report describes the use of CAD‐CAM technology to create poly (methyl methacrylate) veneers preoperatively that can be cemented extraorally on the extracted donor tooth for the immediate and interim recontouring of autotransplanted anterior teeth. [ABSTRACT FROM AUTHOR]

Classification of tumors of the head and neck has evolved in recent decades including a widespread application of molecular testing in tumors of the sinonasal tract, salivary glands, and soft tissues with a predilection for the head and neck. The availability of new molecular techniques has allowed for the definition of multiple novel tumor types unique to head and neck sites. Moreover, an expanding spectrum of immunohistochemical markers specific to genetic alterations facilitates rapid identification of diagnostic molecular abnormalities. As such, it is currently possible for head and neck pathologists to benefit from a molecularly defined tumor classification while making diagnoses that are still based largely on histopathology and immunohistochemistry. This review covers the principal molecular alterations in sinonasal malignancies, such as alterations in DEK, AFF2, NUTM1, IDH1-2, and SWI/SNF genes in particular, that are important from a practical standpoint for diagnosis, prognosis, and prediction of response to treatment. [ABSTRACT FROM AUTHOR]

Background: Angiosarcoma of the adrenal gland is a very rare malignant vascular neoplasm. The clinical symptoms are atypical or completely absent. Angiosarcomas of the adrenal gland are therefore often discovered incidentally, and the diagnosis is made histologically after resection. Case presentation: A 46-year-old white Spanish male who was a previous smoker and nondrinker and was slightly overweight (92 kg, 176 cm, body mass index 29.7 kg/m2) with no relevant medical history presented to the internal medicine emergency department of our hospital with an unclear 12 cm tumor of the right adrenal gland. Prior to the computed tomography scan, he had had persistent evening fevers for 4 months and unintentional weight loss of 5 kg. The laboratory results showed anemia and an elevated C-reactive protein, but no hormone production. We performed an open adrenalectomy of the right adrenal gland. Finally, the histologic findings revealed an angiosarcoma of the adrenal gland. Conclusion: Even though angiosarcomas of the adrenal gland are rare, the differential diagnosis of an angiosarcoma should be considered if a malignant tumor of the adrenal gland is suspected. Treatment decisions should be made on an interdisciplinary basis and preferably in a specialized center. Owing to the rarity of angiosarcomas of the adrenal gland, it is necessary to continue to share clinical experience to gain a better understanding of this particular tumor entity. [ABSTRACT FROM AUTHOR]

Background: Bone-anchored maxillary protraction (BAMP) aims to correct midfacial deficiencies, with proven positive skeletal changes without potential unwanted side effects. However, the influence of BAMP treatment on facial soft tissues, particularly in subjects with complete unilateral cleft lip, alveolus, and palate (CUCLAP), remains unclear. Methods: This single-center longitudinal cohort study examined the effects of 1.5 years of BAMP treatment on facial soft tissues in growing subjects with complete unilateral cleft lip, alveolus, and palate. The sample consisted of 25 patients, age range 9.7 to 12.6 years. Three-dimensional surface models derived from CBCT scans were superimposed on stable structures of the anterior cranial base and on the occipital area posterior of the foramen magnum to assess three-dimensional changes due to growth and BAMP therapy. Results: The results revealed a moderate positive correlation (Pearson's correlation coefficient from 0.203 to 0.560) between changes in hard tissue and soft tissue; some correlations were found to be weak (<0.300). Linear changes in soft tissue following BAMP were in the same direction as skeletal changes, showing downward, forward, and outward displacement. The only exception was in the vertical dimension. The lower facial third showed a slight but significant reduction, mainly in lip length (−1.2 mm), whereas the middle facial third showed a small increase (1.1 mm). Conclusions: It was concluded that during BAMP, soft tissue changes occur in the same direction as skeletal changes, although with a larger variability and less pronounced effects. [ABSTRACT FROM AUTHOR]

Simple Summary: Radiation-associated sarcomas pose a significant clinical challenge due to their complexity, aggressiveness, and poor prognosis. Our retrospective study is one of the largest descriptions of radiation-associated sarcomas, aiming to shed light on their clinicopathologic characteristics and highlight treatment approaches. Our research found a significant association between high radiation-associated sarcoma histologic grade and inferior clinical outcomes. We also found that localized radiation-associated sarcoma patients who underwent margin-negative resections lived significantly longer than their counterparts. Our analysis thus confirms the paramount role of tumor grade and the central importance of margin-negative oncologic resection in determining clinical outcomes for radiation-associated sarcomas. Radiation-associated sarcomas (RASs) are rare tumors with limited contemporary data to inform prognostication and management. We sought to identify the clinical presentation, patterns of care, and prognostic factors of RASs. RAS patients treated at a single institution from 2015 to 2021 were retrospectively reviewed for clinicopathologic variables, treatment strategies, and outcomes. Thirty-eight patients were identified with a median follow-up of 30.5 months. The median age at RAS diagnosis was 68.4 years (27.9–85.4), with a median latency from index radiotherapy (RT) of 9.1 years (3.7–46.3). RAS histologies included angiosarcoma (26%), undifferentiated pleomorphic sarcoma (21%), and osteosarcoma (18%). Most were high-grade (76%). Genomic profiling revealed low tumor mutational burden, frequent inactivating TP53 mutations (44%), CDKN2A deletions (26%), and MYC amplifications (22%), particularly in breast angiosarcomas. Of 38 patients, 33 presented with localized disease, 26 of whom were treated with curative intent. Overall, the median progression-free survival (PFS) was 9.5 months (1.4–34.7), and the overall survival (OS) was 11.1 months (0.6–31.6). Patients with localized vs. metastatic RASs had a longer PFS (HR, 3.0 [1.1–8.5]; p = 0.03) and OS (HR, 3.0 [1.04–8.68]; p = 0.03). Among localized RAS patients, high grade was associated with shorter OS (HR, 4.6 [1.04–20.30]; p = 0.03) and resection with longer OS (mean 58.8 vs. 6.1 months, HR, 0.1 [0.03–0.28]; p < 0.001). Among patients undergoing resection, negative margins were associated with improved OS (mean 71.0 vs. 15.5 months, HR, 5.1 [1.4–18.2]; p = 0.006). Patients with localized disease, particularly those undergoing R0 resection, demonstrated significantly better outcomes. Novel strategies are urgently needed to improve treatment outcomes in this challenging group of diseases. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the upper incisors (U1), lower incisors (L1), and soft tissue profiles of bimaxillary protrusion (BM) adult patients among skeletal Class I (BM1), II (BM2) and III (BM3). Understanding these characteristics would be useful for incisor and lip diagnostics in different skeletal classifications. Fourteen linear and twelve angular variables of the incisors and lips were evaluated in 214 lateral cephalograms (BM1 = 91, BM2 = 84, BM3 = 39). ANOVA and Bonferroni tests compared the measurements. BM1 and BM3 exhibited a greater U1 position and U1 inclination than the norms, while BM2 presented only a greater U1 position than the norms but normal U1 inclination. BM1 and BM3 had a significantly greater U1 position than BM2. BM1 and BM2 demonstrated a greater L1 position and L1 inclination than the norms, whereas BM3 displayed only a greater L1 position than the norms but normal L1 inclination. BM2 had the most anterior L1 position, whereas BM3 had the least anterior position. Only BM2 had a longer anterior dental height (ADH) than the norms, while BM1 and BM3 had a normal ADH and the significantly shortest ADH, respectively. Only BM1 had a normal upper incisor display at rest (U1R), while BM2 and BM3 displayed an increased and decreased U1R, respectively, with significant differences among the three groups. The most significantly protruded upper and lower lips were presented in BM2, but these were exhibited the least in BM3. The most significant acute nasolabial angle (NLA) was found in BM3, whereas BM2 presented the least acute NLA. A normal lip–chin–throat angle (LCTA) was observed in BM1 and BM3, while only BM2 had a greater LCTA than the norms. The most significant obtuse LCTA was found in BM2, while BM3 had the least obtuse LCTA. Therefore, both U1 and L1 in all groups presented protrusion and proclination, except for U1 in BM2, while L1 in BM3 exhibited normal inclination. The ADH and U1R were increased in BM2 but decreased in BM3. The most acute NLA was found in BM3, whereas the least acute was found in BM2. The most obtuse LCTA was in BM2, while the least was in BM3. [ABSTRACT FROM AUTHOR]

In this paper, a sliding mode control method based on improved intelligent decision (IID-SMC) algorithm is proposed to improve the accuracy of the puncture needle to reach the target and reduce the time required in the puncture process. First of all, around the straight line of the puncture needle and the direction of the rotation of the needle, the independent control law is designed to realise the mutual decoupling and reduce the mutual interference. Secondly, the error range of this method in the process of puncture is analysed, and the upper bound of the error in the process of puncture is given. Finally, the method is verified by simulation and experiment platform. [ABSTRACT FROM AUTHOR]

Herein, state‐of‐the‐art multiscale modeling methods have been described. This research includes notable molecular, micro‐, meso‐, and macroscale models for hard (polymer, metal, yarn, fiber, fiber‐reinforced polymer, and polymer matrix composites) and soft (biological tissues such as brain white matter [BWM]) composite materials. These numerical models vary from molecular dynamics simulations to finite‐element (FE) analyses and machine learning/deep learning surrogate models. Constitutive material models are summarized, such as viscoelastic hyperelastic, and emerging models like fractional viscoelastic. Key challenges such as meshing, data variability and material nonlinearity‐driven uncertainty, limitations in terms of computational resources availability, model fidelity, and repeatability are outlined with state‐of‐the‐art models. Latest advancements in FE modeling involving meshless methods, hybrid ML and FE models, and nonlinear constitutive material (linear and nonlinear) models aim to provide readers with a clear outlook on futuristic trends in composite multiscale modeling research and development. The data‐driven models presented here are of varying length and time scales, developed using advanced mathematical, numerical, and huge volumes of experimental results as data for digital models. An in‐depth discussion on data‐driven models would provide researchers with the necessary tools to build real‐time composite structure monitoring and lifecycle prediction models. [ABSTRACT FROM AUTHOR]

Soft tissue injuries are common in the military, generally producing simple hematomas without the need for intensive evaluation and management. In certain situations, a shearing effect between fascial planes whereby a disruption of the vasculature and lymphatic systems creates a "closed degloving injury" is more generally referred to as a Morel-Lavallée Lesion (MLL). With a consistent pool of blood, lymph, and pieces of soft tissue, an M7LL can cause significant poor cosmesis, chronic pain, and risk secondary infection if left undetected and untreated. Proper diagnosis can be made through the effective use of ultrasound and, if detected early enough, through conservative measures to include needle aspiration and compression sleeves. Prior cases describe chronic MLLs existing for extended periods of time, in some cases years, requiring operative intervention, and in some cases poor outcomes. We present two cases of active duty soldiers presenting with seemingly innocuous injuries found on closer evaluation to have MLL, treated in one case with needle aspiration and compression, in the other with operative management. [ABSTRACT FROM AUTHOR]

Giant cell-rich lesions of bone represent a heterogeneous group of entities which classically include giant cell tumor of bone, aneurysmal bone cyst, nonossifying fibroma, and Brown tumor of hyperparathyroidism. A recently described subset of giant cell-rich tumors involving bone and soft tissue has been characterized by recurrent HMGA2::NCOR2 fusions and keratin expression. The overlapping clinical, radiographic, and morphological features of these giant cell-rich lesions provide a unique diagnostic challenge, particularly on biopsy. We present 2 additional cases of keratin-positive giant cell-rich tumor of bone with HMGA2::NCOR2 fusions, including 1 patient who developed metastatic disease. [ABSTRACT FROM AUTHOR]

Sport injuries, including the anterior crucial ligament rupture (ACLR) seem to be related to complex genetic backgrounds, including the genes responsible for inflammatory response. This review and meta-analysis investigated the contribution of the polymorphisms of genes encoding inflammatory cytokines and their receptors to the risk of ACLR. The scientific databases Science Direct, EBSCO host, Scopus, PubMed, and Google Scholar were screened (completed on 14 June 2023) according to the established inclusion/exclusion criteria (only fully accessible, original, human case–control studies written in English concerning the effect of interleukin genes' polymorphisms on the occurrence of ACL injury were included) and statistical meta-analysis using R version 4.0.3 was performed. The PRISMA methodology was used to review articles. The review protocol was registered under the number CRD42024514316 in the Prospero database. Eighty-nine studies were identified and narrowed down to three original case–control studies used for the meta-analysis. The studies analyzed Polish, South African, and Swedish cohorts, altogether 1282 participants. The candidate polymorphisms indicated in the studies involved IL6 rs1800795, IL6R rs2228145 and IL1B rs16944. The systematic review showed the relationships between IL6 rs1800795 polymorphism and ACLR in the Polish subpopulation, and IL6R rs2228145 and IL1B rs16944 in the South African subpopulations. The meta-analysis revealed that the IL6 rs1800795 CG genotype was over-represented (OR = 1.30, 95% CI 1.02–1.66), while the CC genotype was under-represented (OR = 0.75, 95% CI 0.54–1.03) in ACLR subjects, but no significant impact of IL6R rs2228145 was shown. Additionally, a tendency of the IL1B rs16944 CT genotype to be protective (OR 0.89, 95% CI 0.70–1.14), while the TT to be a risk genotype (OR 1.19, 95% CI 0.84–1.68) was observed. Thus, the relationship between the interleukin receptor IL6R rs2228145 and ACLR risk was not confirmed. However, the impact of genes coding pleiotropic IL6 rs1800795 on the incidences of ACLR was clear and the effect of pro-inflammatory IL1B rs16944 was possible. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ege University School of Dentistry / Ege Üniversitesi Dis Hekimligi Fakültesi Dergisi is the property of Ege University Faculty of Dentistry and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Case: A 40-year-old man was evaluated for a painful mass on his right calf, and a 36-year-old woman presented with a painless mass on her right foot. Final pathology revealed marked nuclear atypia and positivity for S100/SOX10 and AE1/AE3 confirming diagnoses of myoepithelial carcinoma. Both patients underwent surgical resection and are without evidence of local recurrence or metastatic disease at 1-year follow-up. Conclusion: Soft-tissue tumors presenting in the extremities warrant careful evaluation and timely histopathologic diagnosis. Myoepithelial carcinomas are rare, aggressive tumors with a propensity for local recurrence and metastasis. Treatment of these tumors should be discussed by a multidisciplinary tumor team. [ABSTRACT FROM AUTHOR]

Objective: Increasing aesthetic demands require that the color and contour of the peri‐implant soft tissues be in harmony with the neighboring teeth. Recession, migration toward the apical, is a frequent clinical finding. Its presence can lead to inflammation and increased marginal bone loss. These complications, in addition to affecting the aesthetic results of our treatment, are difficult to treat and can threaten the survival of the implant. There are fewer studies showing the outcome of treatment of soft‐tissue defects around implants. The aim of this article is to describe the treatment of a soft‐tissue defect around an implant‐supported prosthesis treatment, performed on two neighboring implants, in the esthetic zone in a patient with a high smile and to evaluate both the coverage achieved and the patient's esthetic satisfaction. Clinical Considerations: This study showed that a mucogingival approach, using a surgical technique designed for the treatment of alveolar ridge defects, together with tissue management with temporaries and a new restoration, achieved an optimal result. Conclusions: The case has been closely followed up, for 10 years, and the authors have been able to confirm the long‐term stability of the result. Clinical Significance: The following paper shows the result of an innovative approach. Connective tissue platform technique, usually performed for soft‐tissue augmentation, was used for a defect in soft‐tissue dehiscence. The authors followed the results for 10 years, and the results achieved were satisfactory in terms of esthetic. [ABSTRACT FROM AUTHOR]

Non-rhabdomyosarcoma soft-tissue sarcoma ("RMS-like" and "non-RMS-like" tumours-NRSTS) of childhood is a highly heterogeneous group of tumours. Within the subgroup of undifferentiated sarcomas (UDS), new entities have been described based on molecular markers found through increasingly available genetic analysis in the new 2020 classification of the World Health Organization (WHO). In recent years, the importance of genetic analysis and the detection of molecular tumour markers has been growing due to the possibility of targeted therapy application and the determination of prognosis or disease course. We will present two patients with soft tissue sarcoma and neurotrophic tyrosine receptor kinase (NTRK) gene rearrangement, focusing on excellent therapeutic response to NTRK inhibitor targeted therapy with good drug tolerance. [ABSTRACT FROM AUTHOR]

Background: Soft tissue recurrence of giant cell tumor of bone (GCTB) is rare. This study aims to provide its prevalence, recurrent locations, risk factors, effective detection methods and a modified classification for this recurrence. Methods: Patients with soft tissue recurrence after primary surgery for GCTB were screened from January 2003 to December 2022. General data, recurrence frequency, types according to an original classification (type-I: peripheral ossification; type-II: central ossification; type-III: without ossification), a modified classification with more detailed subtypes (type I-1: ≤ 1/2 peripheral ossification; type I-2: ≥ 1/2 peripheral ossification; type II-1: ≤ 1/2 central ossification; type II-2: ≥ 1/2 central ossification; type III: without ossification), locations, detection methods such as ultrasonography, X-ray, CT or MRI, Musculoskeletal Tumor Society (MSTS) scores were recorded. Multivariate regression analysis was conducted to identify risk factors for recurrence frequency. Results: A total of 558 recurrent cases were identified from 2009 patients with GCTB. Among them, 32 were soft tissue recurrence. The total recurrence rate was 27.78% (558/2009). Soft tissue recurrence rate was 5.73% among 558 recurrent cases, and 1.59% among 2009 GCTB patients, respectively. After excluding one patient lost to follow-up, 10 males and 21 females with the mean age of 28.52 ± 9.93 (16–57) years were included. The definitive diagnosis of all recurrences was confirmed by postoperative pathology. The interval from primary surgery to the first recurrence was 23.23 ± 26.12 (2–27) months. Eight recurrences occurred from primary GCTB located at distal radius, followed by distal femur (6 cases). Recurrence occurred twice in 12 patients and 3 times in 7 patients. Twenty-seven recurrences were firstly detected by ultrasonography, followed by CT or X-ray (10 cases in each). Types at the first recurrence were 5 cases in type-I, 8 in type-II and 18 in type-III. According to the modified classification, 3 patients in type I-1, 2 in type I-2, 1 in type II-1, 7 in type II-2, and 18 in type III. The mean MSTS score was 26.62 ± 4.21 (14—30). Neither Campanacci grade nor recurrence type, modified classification and other characters, were identified as risk factors. Conclusions: Soft tissue recurrence of GCTB may recur for more than once and distal radius was the most common location of primary GCTB that would suffer a soft tissue recurrence. Ultrasonography was a useful method to detect the recurrence. Since no risk factors were discovered, a careful follow-up with ultrasonography was recommended. [ABSTRACT FROM AUTHOR]

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Peri-implant buccal soft tissue dehiscences (BSTD) not only impact the aesthetic appearance of the implant- restorations but also pose a threat to the long-term survival of the implants. This comprehensive narrative review aims to provide a concise overview of the epidemiology, classification, risk indicators, current surgical and prosthetic therapeutic approaches of peri‑implant BSTD. Although BSTD is a common finding, the different study design, case definitions and follow-up periods difficult the estimation of a representative prevalence. Implants placed too buccal and thin peri‑implant phenotype are viewed as the major factors associated with the occurrences of BSTD. The most reported and scientifically-supported surgical technique is coronally advanced flap plus connective tissue graft, although other surgical techniques have been evaluated in the long-term. Further randomized clinical trials are needed to assess the efficacy of each surgical technique in the management of BSTD.

Background: Trabectedin is an antineoplastic drug approved for patients (pts) with advanced soft tissue sarcomas (STS). Interestingly, the radiological evaluation of response during trabectedin therapy is peculiar.Methods: The aim of this single-center retrospective study is to analyze the concordance of response assessment according to RECIST compared with Choi criteria in patients with STS treated with trabectedin between 2009 and 2020 at Regina Elena National Cancer Institute in Rome.Results: We present the preliminary data collected in the last 2 months (mos) on 37 pts who received the diagnosis between 2015 and 2020, with a median age of 52.5 years (range 32–78). The median number of trabectedin cycles administered was four (range 2–50) for a median follow up of 5.83 months (range 1–60). Histological subtypes of STS were five (13.5%) leiomyosarcoma, 14 (37.8%) liposarcoma, nine (24.3%) undifferentiated pleomorphic sarcoma, three (8.1%) synovial sarcoma, and six (16.2%) other rare histological subtypes. Eight pts (21.6%) received trabectedin in the first line setting, 21 (56.8%) in the second line, and seven (18.9%) received it in subsequent lines. One pt received trabectedin as neoadjuvant therapy in a clinical trial (ISG-STS 1001). Median progression-free survival was 3.6 months (CI95% 2.7–4.6); median overall survival was 34.3 months (CI95% 0–75.4). The radiological responses were evaluated with both RECIST and Choi criteria; responses matched in 33 pts (89.2%) but not in four (10.8%). The best responses obtained according to RECIST criteria were two (5.4%) partial response (PR), 13 (35.1%) stable disease (SD), and 22 (59.5%) progressive disease (PD). Instead, two (5.4%), 13 (35.1%), and 22 (59.5%) pts obtained PR, SD, and PD respectively, according to Choi criteria. Cohen’s kappa coefficient of concordance was 0.792 (p-value

The evaluation of maxillary teeth and soft tissue profiles is a critical component of orthodontic diagnosis and treatment planning. This study aimed to evaluate the correlation between the sagittal position of maxillary anterior teeth and facial profile esthetics among Tibetan and Han Chinese adult females for optimizing orthodontic diagnosis and treatment planning. A total of 100 Tibetan Chinese and 100 Han Chinese adult females with good facial symmetry were recruited. The smiling facial profile images with the maxillary central incisors and forehead in full view were taken based totally on the same standard. The photo measurement and head position were adjusted using the picture-enhancing software. The reference traces associated with forehead inclinations were utilized to assess the anteroposterior (AP) positions of the maxillary central incisors. The results showed that a round forehead was the dominant forehead shape for Tibetan (93%) and Han (55%) Chinese females. In Tibetan females, 85% of the maxillary central incisors were found to be located between the forehead's anterior limit line (the Gall line) and the goal anterior limit line (the Fall line), with 15% located posterior to the Fall line. This distribution manifested a strong association with incisor position and forehead inclination (R2 = 0.742). In Han females, 83% of the maxillary central incisors were located between the Fall line and the Gall line, with 12% posterior to the Fall line and 5% anterior to the Gall line. The positions of the maxillary central incisors exhibited a strong relationship with forehead inclination (R2 = 0.827). The maxillary central incisors were close to the aesthetic line in both ethnic groups, while forehead inclinations were correlated with AP maxillary incisor position. These findings demonstrated that there was a close relationship between the incisor position of Tibetan and Han females with facial symmetry and the forehead FFA factor, indicating a reference in oral hard and soft tissues for optimizing orthodontic diagnosis and treatment planning in terms of facial contour.

Abstract To investigate and compare the facial asymmetry (hard and soft tissues) among skeletal Class I, II, and III patients. A total of 221 subjects, including skeletal Class I (n = 80), skeletal Class II (n = 75), and skeletal Class III (n = 66), were included in the study. CBCT, 22 skeletal landmarks, and 10 soft tissue landmarks were used for the measurements and the asymmetry index was calculated to assess the facial asymmetry. Statistical analyses included one-way ANOVA, Kruskal–Wallis test, and Spearman correlation analysis. The skeletal Class III patients presented greater asymmetry than Class II patients for 10 hard tissue landmarks and 3 soft tissue landmarks (p 0.86). The ANS and Me in 21.3% patients deviated to contralateral sides. The skeletal Class III patients had more facial asymmetry than the Class II patients. Soft tissues showed similar asymmetry as the underlying hard tissues rather than a compensation of the hard tissue asymmetry. The inconsistency in the deviation of Me and ANS may exacerbate facial asymmetry.

Abstract Background Glomus tumors are benign mesenchymal tumors of the neuromyoarterial glomus bodies. They are generally localized at the subungual area of the fingers. Extradigital or non-subungual glomus tumors are less common. Their diagnosis can be challenging because of their lower incidence, nonspecific symptoms, and the fact that they can be missed during the physical examination. The aim of this case series is to provide an overview of non-subungual glomus tumors, including the patients’ epidemiology characteristics, tumor localization and size, their varied imaging manifestations in ultrasound and magnetic resonance imaging, differential diagnosis and histopathological features. Main body of the abstract Our report included 64 patients with the diagnosis of non-subungual glomus tumor in the Pathology Department at the La Paz University Hospital in Madrid from January 1966 to September 2022. There were 44 men and 20 women (mean age, 55.8 years; range, 8–85 years). The tumors had a mean size of 1 cm and were located in the lower limbs in most cases (59.3%). In 17 cases (27%) a diagnostic imaging test was performed (US, MRI or both). The radiological appearance of a glomus tumor on ultrasound was in most cases a circumscribed hypoechoic oval nodule located in the subcutaneous layer. Spectral Doppler can demonstrate both venous and arterial intralesional flow and in some cases a “Vascular stalk sign,'' seen in 4/9 cases. MRI assists in providing a more detailed characterization of these lesions, which present as T2-weighted hyperintense nodules with avid enhancement. Short conclusion Glomus tumors are considered rare neoplasms, accounting for a small percentage of all tumors. Our report brings together the most up-to-date information available regarding the imaging findings and differential diagnosis of this entity. Although ultrasound images are not specific, they are crucial for early diagnosis, provide precise location information, and serve as a guide for tumor excision. MRI study helps to better characterize these tumors. The diagnosis is mostly clinical, with confirmation in the histopathologic study.

We report the case of a 34-year-old female who was evaluated for a right lower extremity soft-tissue mass, found to be a large cystic lesion bound by fibrous tissue containing innumerable, freely mobile nodules of fat. Her presentation suggested the diagnosis of nodular cystic fat necrosis (NCFN), a rare entity that likely represents a morphological subset of fat necrosis potentially caused by vascular insufficiency secondary to local trauma. Her lesion was best visualized using MRI, which revealed characteristic imaging features of NCFN including nodular lipid-signal foci that suppress on fat-saturated sequences, intralesional fluid with high signal intensity on T2-weighted imaging, and a contrast-enhancing outer capsule with low signal intensity on T1-weighted imaging. Ultrasound imaging offered the advantage of showing mobile hyperechogenic foci within the anechoic cystic structure, and the lesion was otherwise visualized on radiography as a nonspecific soft-tissue radiopacity. She was managed with complete surgical excision with pathologic evaluation demonstrating, similar to the radiologic features, innumerable free-floating, 1–5 mm, smooth, nearly uniform spherical nodules of mature fat with widespread necrosis contained within a thick fibrous pseudocapsule. Follow-up imaging revealed no evidence of remaining or recurrent disease on postoperative follow-up MRI. The differential diagnosis includes lipoma with fat necrosis, lipoma variant, atypical lipomatous tumor, and a Morel-Lavallée lesion. There is overlap in the imaging features between fat necrosis and both benign and malignant adipocytic tumors, occasionally making this distinction based solely on imaging findings challenging. To our knowledge, this is the largest example of NCFN ever reported. [ABSTRACT FROM AUTHOR]

Low-grade fibromyxoid sarcoma is a rare mesenchymal neoplasm with distinctive histopathological features. Although it typically arises in the deep soft tissues of the trunk and extremities, its occurrence in the head and neck region is exceedingly rare. We present the first documented case of low-grade fibromyxoid sarcoma in the laryngopharynx, expanding the spectrum of this rare tumor's anatomical localization. The clinical, radiological, and histopathological features of this unique case are discussed, highlighting the diagnostic challenges and therapeutic considerations associated with this uncommon presentation. [ABSTRACT FROM AUTHOR]

Objectives: Patellar instability is one of the most common pathologies in children and adolescents. The objective of this study is to present the functional and diagnostic results after performing modified Roux-Goldthwait procedure for habitual patellar dislocation in pediatric population. Materials & methods: A retrospective analysis was performed on 17 patients, under the age of 18 years, from September 2007 to March 2023. For diagnostic results were evaluated congruence angle, sulcus angle and Caton-Deschamps index. Functional results were evaluated by modified Lysholm score and Cox grading system. Results: Excellent and good results were reported for 82%, fair and poor results for 18%. No statistical significance was reported on the topic of congruence angle and sulcus angle. Conclusions: Modified Roux-Goldthwait procedure for habitual patellar dislocation in pediatric population is safe and effective as it is entirely soft tissue operation that leaves the growth plate intact. [ABSTRACT FROM AUTHOR]

Background: Most methods for soft tissue stiffness assessment require high financial resources, significant technical effort, or extensive therapist training. The PACT Sense device was developed to be used in a wide range of applications and user groups. However, to date, there are no data on its validity and reliability. The aim of this study was to investigate the validity and reliability of the PACT device. Methods: A polyurethane phantom tissue model (PTM) mimicking the mechanical properties of the fascia profunda and the erector spinae muscle was used. Stiffness measurements with PACT were conducted by two independent investigators. For construct validity, correlations were calculated between the known stiffness of the PTM and values obtained with PACT. For concurrent validity, we determined the association between the PACT values and additional measurements with the established MyotonPRO device. To estimate interrater and intrarater (two measurements with an interval of 7 days) reliability, we used the intraclass correlation coefficient (ICC). Results: Correlation analysis (PTM/PACT) revealed very high concurrent validity (r = 0.99; p < 0.001), construct validity (PACT/MyotonPRO) was 0.87, p < 0.001. Both, interrater reliability (ICC = 0.85; p = 0.036) and intrarater reliability were good (ICC = 0.89; p < 0.001). Conclusions: The PACT provides valid and reliable stiffness measurements in tissue phantoms. Further studies in humans are needed to confirm its physiometric properties under in vivo conditions. [ABSTRACT FROM AUTHOR]

To quantitatively evaluate the possible advantages of quantifying and differentiating various soft tissues using virtual monochromatic images (VMI) derived from different dual-energy computed tomography (DECT) technologies. This study involved four DECT scanners with different technologies. CIRS phantom images were acquired in single-energy (SECT) and DECT modes with each scanner. The analysis focused on five equivalent soft-tissue inserts: adipose, breast, liver, muscle, and bone (200 mg). The signal-to-noise ratio (SNR) was calculated for each equivalent soft-tissue insert. Finally, the contrasts of tissue pairs between DECT and SECT images were compared using Wilcoxon signed-rank tests adjusted for multiple comparisons. Average CT numbers and noise showed a significant difference pattern between DECT with respect to SECT for each CT scanner. Generally, energy levels of 70 keV or higher led to improved SNR in VMI for most of the equivalent soft-tissue inserts. However, energy levels of 40–50 keV showed significantly higher contrasts in most of the equivalent soft-tissue insert pairs. DECT images at low energies, especially at 40–50 keV, outperform SECT images in discriminating soft tissues across all four DECT technologies. The combined use of DECT images reconstructed at different energy levels provides a more comprehensive set of information for diagnostic and/or radiotherapy evaluation compared to SECT. Some differences between scanners are evident, depending on the DECT acquisition technique and reconstruction method. [ABSTRACT FROM AUTHOR]

Background: Yokenella regensburgei is a gram-negative, opportunistic pathogen that is ubiquitous in natural environments. It commonly affects immunocompromised patients. Methods: The patient was a 71-year-old female with skin and soft tissue wound caused by trauma. The surgical debridement and abscess drainage were performed by surgeons. The specie of infected organism was identified by the D2Mini semi-automated system and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF). Results: The result of bacterium culture showed gram-negative bacillus was moist, grey-white, semitransparent, and regular shape. Then the D2Mini semi-automated system and MALDI-TOF revealed that the colonies are Y. regensburgei. According to the result for drug sensitivity, antibiotic therapy was switched to cefoperazone/sulbactam and levofloxacin. Conclusions: Cooperation between clinical microbiology laboratories and surgeons is essential for the infected patient without typical symptoms. Agricultural activities and stab wounds may be related to Y. regensburgei infection. [ABSTRACT FROM AUTHOR]

Purpose: Anterior segmental osteotomy (ASO) following the surgery-first approach is a long-established treatment modality to resolve lip protrusion in patients with skeletal class II patterns. However, the indications and effectiveness of ASO still remain uncertain. The objective of this study is to investigate the effectiveness of ASO in Asian skeletal class II patients by evaluating the skeletal and soft tissue changes and analyzing pre-treatment variables that determine successful outcomes in occlusal as well as esthetic aspects. Methods: The lateral cephalograms of 44 skeletal class II patients who underwent ASO and orthodontic treatment for resolving lip protrusion were retrospectively collected. Hard and soft tissue variables of two groups, normalized (NG) and unnormalized (UNG) ANB after treatment were compared and analyzed. The rotational effect of the anterior segment on the hard and soft tissue was also investigated. Results: ASO was successful in correcting the skeletal class II relationship and lip protrusion (ΔANB − 2.3°, 4–5 mm lips retraction) in most cases. However, for patients with severely camouflaged skeletal class II incisors involving a large ANB and SNA, a large ANB still remained post-treatment. The study also found that rotation of the upper and lower anterior segments further augmented the amount of lip retraction. Conclusions: ASO was found to successfully correct ANB of skeletal class II patients under the following conditions (ANB 5.3° ± 1.5°, SNB 77.3° ± 4.5°, U1 to FH 115° ± 7.5, L1 to FH 48.0° ± 4.6). However, patients with larger ANB and SNA values may require bi-maxillary surgery. In addition, ASO has limitations in correcting gummy smile in cases of extreme maxillary excess. For patients requiring a large amount of lip retraction, rotation of the anterior segment may be beneficial in conjunction with bi-maxillary surgery. [ABSTRACT FROM AUTHOR]

Aim To investigate whether the use of ion resonance and bromelain- vitamin C or bromelain-vitamin C is the best to prevent ankle complications in post operative bimalleolar surgery. Methods A total of 61 patients treated with bimalleolar surgery were enrolled. The patients were divided into three groups: the first group (n=22) treated only with the surgery, the second group (n=18) treated by ion resonance and bromelain-vitamin C, and the third group (n=21) was treated with bromelain-vitamin C. All patients in the second and third group underwent adjuvant therapy for 50 days. The criteria to evaluate the three groups during the clinical and radiological follow-up were as follows: complications and soft tissue status. Bone healing measured by the Radiographic Union Score Ankle (RUSA), and functional results were evaluated according to the American Foot & Ankle Score (AFAS). Results In the first group nine (out of 22; 40.90%) patients developed complications, in the second group three (out of 18; 16.67%) and in the third group seven (out of 21; 33.33%) presented complications. There is no statistical difference between the three groups regarding the type of fractures, mean age, gender ratio. The worst radiographic and stiffness results in the first group were found (p=0.006). The second group showed better bone healing (p=0.049), better performance in functional recovery measured by AFAS (p=0.039). Conclusion Ion resonance and bromelain-vitamin C group showed better outcomes to improve the functional outcome; it allows reduction of complications, consequently, an early return to quality life, and a corresponding improvement of the quality of life. [ABSTRACT FROM AUTHOR]

Introduction: Prosthodontic rehabilitation after reconstruction with microvascular revascularized free flaps following ablative tumor surgery is challenging due to the altered anatomical and functional conditions. The aim of this retrospective study was to determine whether the type of graft and the type of peri‐implant tissue have an effect on peri‐implant inflammatory parameters and implant survival. Materials and Methods: Patients who received a free flap reconstruction with subsequent implant‐prosthetic rehabilitation between 2010 and 2022 were retrospectively included. The primary outcome variable was the probing depth (PPD) at a minimum of 1 year after completion of prosthetic restoration. Predictive variables were type of free flap, emergence profile, and history of radiation. Results: Seventy‐one patients after free flap reconstruction were included in the analysis. At a minimum of 24 months after implant insertion the primary outcome, PPD showed no clinically relevant differences between the types of free flaps used. The emergence profile through a skin island resulted in an increase in BOP compared to native mucosa in the descriptive analysis (p‐value >.05). The analysis showed a 5‐year implant survival of 96.2% (95% CI: 0.929–0.996) in cases without irradiation and 87.6% (95% CI: 0.810–0.948) with irradiation of the region evaluated (p‐value.034). Conclusion: Flap and associated soft tissue type had no significant effect on 5‐year implant survival or peri‐implant inflammatory parameters. However, the large heterogeneity of the patient population indicates that further prolonged studies are required for a more differentiated assessment of the long‐term success. [ABSTRACT FROM AUTHOR]

A 50-year-old man presented for evaluation of a periscapular mass. Biopsy suggested a low-grade chondrosarcoma; however, the resected specimen revealed a grade 2 chondrosarcoma with a low-grade dedifferentiated mesenchymal component. The mass multiply recurred as chondrosarcoma without a dedifferentiated component before the patient developed lung metastases of chondrosarcoma without a dedifferentiated component 11 years after the initial diagnosis and died of disease. This is one of the first reported cases of a dedifferentiated chondrosarcoma with low-grade dedifferentiated component. While overall prognosis may be better than in typical dedifferentiated chondrosarcoma, this tumor demonstrated numerous local recurrences as well as metastasis. [ABSTRACT FROM AUTHOR]