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Developing 'climate smart forestry' (CSF) indicators in mountain forest regions requires collection and evaluation of local data and their attributes. Genetic resources are listed among the core indicators for forest biological diversity. This study is a report on the evaluation of the standing genetic diversity within and across 12 pure beech stands (Fagus sylvatica L.) established within the CLIMO (CLImate Smart Forestry in Mountain Regions) project, using nuclear microsatellite markers. The sampling sites were set along the species' distribution range, including the Balkan region and extending towards the Iberian Peninsula. Cores or leaves from 20 to 23 old, mature trees per plot were sampled for DNA analysis. Genetic diversity indices were high across the range ([H.sub.E] = 0.74-0.81) with the highest in the Bosnian Mountains. Genetic divergence increased significantly with the geographical distance (Mantel test: r = 0.81, p < 0.001). Most of the stands exhibited an excess of heterozygotes, with the highest value at the Hungarian site ([H.sub.O]/[H.sub.E] = 1.177), where beech persists close to the eastern xeric limit of the species' distribution. STRUCTURE revealed within-region differentiation in the Balkan Peninsula, where the Bulgarian stand was the most outstanding. The genetic parameters of each stand could be assessed as a resource for CSF indicators interpreted especially at the local level. Key words: Fagus sylvatica, heterozygosity, F statistics, geographical groups, environmental variables. Le developpement d'indicateurs de foresterie intelligente face au climat (FIFC) dans les regions forestieres montagneuses exige la collecte et revaluation de donnees locales et de leurs attributs. Les ressources genetiques sont considerees comme des indicateurs de base pour la diversite biologique de la foret. Cette etude est un rapport sur revaluation de la diversite genetique actuelle dans et parmi 12 peuplements purs de hetre commun (Fagus sylvatica L.) etablis dans le cadre du projet CLIMO (CLIMO (<>) a l'aide de marqueurs microsatellites nucleaires. Les sites d'echantillonnage ont ete etablis le long de l'aire de repartition de l'espece, incluant la region des Balkans et se prolongeant vers la peninsule iberique. Des carottes ou des feuilles prelevees sur 20 a 23 vieux arbres matures par place echantillon ont ete echantillonnees pour l'analyse de l'ADN. Les indices de diversite genetique etaient eleves ([H.sub.E] = 0,74-0,81) a travers l'aire de repartition; les plus eleves ont ete observes dans les montagnes de Bosnie. La divergence genetique augmentait significativement avec la distance geographique (test de Mantel : r = 0,81, p < 0,001). La plupart des peuplements avaient un exces d'heterozygotes : le site hongrois, ou le hetre persiste pres de la limite xerique orientale de l'aire de repartition de 1'espece, avait la valeur la plus elevee ([H.sub.O]/[H.sub.E] = 1,177). STRUCTURE a revele une differenciation au sein de la region dans la peninsule des Balkans, ou un peuplement bulgare etait le plus remarquable. Les parametres genetiques de chaque peuplement pouvaient etre evalues en tant ressource pour les indicateurs de FIFC interpretes particulierement a l'echelle locale. [Traduit par la Redaction] Mots-cles: Fagus sylvatica, heterozygotie, statistique F, groupes geographiques, variables environnementales., 1. Introduction Forests play an important role in the mitigation of the effects of climate change. Therefore, climate smart forestry (CSF) may significantly invigorate the positive effects of forests and [...]

The successful formulation of particulate dispersions is often hindered by the presence of charged species dissolved in solution. If present at high enough concentrations, these species can reduce the screening length between particles to near zero, allowing rapid coagulation and destabilization. The addition of a mixture of ionic and nonionic surfactants has been shown in a previous publication (B. J. Palla and D. O. Shah, 2000, J. Colloid Interface Sci.223, 102) to stabilize alumina particles in the presence of high concentrations of charged species. The mechanism has been explained as enhanced adsorption of a nonionic surfactant using a strongly adsorbing ionic surfactant as a binding agent. In this work, the various factors that influence this stabilization mechanism are examined in detail. The factors are then verified by showing the same results for two different chemical environments, both of which are model slurries for chemical mechanical polishing (CMP) of metal surfaces. The stabilizing ability of the surfactant system is found to increase with increasing hydrophobicity of the nonionic surfactant and increasing hydrophobicity of the ionic surfactant. The effect of surfactant concentration on stabilizing ability is shown to have an optimum concentration range for a number of surfactants. The effect of the ratio of ionic to nonionic surfactant is also investigated for both chemical environments and is shown to have significant effects on stabilizing ability. All of the results are then compiled to present a concise picture of the factors that influence the stabilizing ability of mixed surfactant systems for high-ionic-strength slurries. [Copyright &y& Elsevier]

A previously healthy 16-year-old male presented with a two day history of persistent epigastric pain. His physical examination was significant for tenderness in the left hypochondriac region with a palpable spleen 2cm below the left sub-costal margin. A CT scan of the abdomen showed a splenic infarct. Heterophile and EBV VCA IgM antibody test were positive. This is a rare case of infectious mononucleosis presenting with splenic infarct in an adolescent male without comorbidities. Keywords: infectious mononucleosis; splenic infarct.

Objective: Interfacility emergency department transfers (IETs) for maxillofacial trauma and infections are prevalent in the United States, with significant implications for health care costs. Limited availability of oral and maxillofacial surgeons (OMS) exacerbates unnecessary transfers and associated expenses. This study aimed to determine the incidence and costs of OMS IET., Study Design: A retrospective cohort study was performed for maxillofacial trauma and infection IET at the University of Illinois Health main hospital via electronic medical record query for terms "infection [or] trauma [and] transfer." Inclusion criteria required presentation from January 1, 2022 to June 30, 2022; emergency department (ED)-ED transfer; and or consultation by OMS. Distance transferred, insurance type, location of treatment, weekend presentation, and associated costs were collected., Results: One thousand ninety-nine records were identified, including 46 trauma IET and 122 infection IET. Costs ranged from $2,683,918.90 to $7,984,912.89, indicating ∼$1.5 billion annual expenditure across US OMS programs. Three trauma IET required urgent treatment; no infection IETs were "emergent." Trauma IET averaged 20.7 + 17.1 miles and infection IET 22.0 + 17.4 miles for transfer distance. Among trauma IET, 28 were treated in the operating room (OR), 10 had outpatient follow-up, and 8 had ED treatment. Among infection IETs, 57 received ED treatment, 56 received OR treatment, and 9 received antibiotics/no treatment., Conclusions: Maxillofacial trauma and infection IET impose significant health care costs. Increased funding for OMS training may mitigate the shortage and improve patient care. Further research is needed for better triaging and reimbursement strategies., Competing Interests: DECLARATION OF INTERESTS M.S. is founder and manager of OCA Holdings, LLC (Chicago, IL), producer of the Oral Capnography Accessory. No compensation or resources were provided by OCA Holdings, LLC for the conduction of this research. B.P., and N.F.C. have no commercial associations, current and within the past 5 years, including grants, patent licensing arrangements, consultancies, stock or other equity ownership, advisory board memberships, or payments for conducting or publicizing the study that might pose a potential, perceived or real conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: Patients exposed to a combination of antiresorptive medication and radiotherapy of the head and neck area developing necrosis of the jaw in the course of treatment are extremely rare. Therefore, the aim of this study was to identify the outcome and complications in this highly vulnerable patient cohort., Study Design: Seventeen patients who received both antiresorptive treatment and radiotherapy (medication-related osteonecrosis of the jaw/osteoradionecrosis = the [MRONJ/ORN] group) in the head and neck area were enrolled in this study. Included patients were treated in our department between 2005 and 2022. Four hundred twenty-four patients with MRONJ (the MRONJ group) and 138 patients with ORN of the jaw were enrolled as two control groups (the ORN group). Demographic data, lesion localization, date of primary diagnosis, clinical symptoms, type of therapy (surgical or non-surgical), details on antiresorptive treatment, outcome, and complications were recorded., Results: Pathological fractures, continuity resection, and recurrence appear more often in patients who receive a combination of antiresorptive treatment and radiotherapy in the head and neck area compared with patients undergoing only one of these treatments. There was a statistically significant difference (P < .001) between the MRONJ/ORN group and the MRONJ group and the MRONJ/ORN group and the ORN group considering recurrence, fracture, and continuity resection. Patients with ORN combined with MRONJ have a 4-times higher risk for developing recurrence compared with patients with MRONJ and a 1.5-times higher risk for recurrence compared with patients with ORN. Jaw fracture and continuity resection appear more often in patients with MRONJ/ORN., Conclusions: Patients under antiresorptive therapy in combination with radiation therapy in the head and neck area have a higher risk for developing complications in case of osteonecrosis of the jaw. Therefore, a strict follow-up care schedule is highly recommended., Competing Interests: DECLARATIONS OF INTEREST None., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

In clinical practice, diagnosis of suspected carious lesions is verified by using conventional dental radiography (DR), including panoramic radiography (OPT), bitewing imaging, and dental X-ray. The aim of this study was to evaluate the use of magnetic resonance imaging (MRI) for caries visualization. Fourteen patients with clinically suspected carious lesions, verified by standardized dental examination including DR and OPT, were imaged with 3D isotropic T2-weighted STIR (short tau inversion recovery) and T1 FFE Black bone sequences. Intensities of dental caries, hard tissue and pulp were measured and calculated as aSNR (apparent signal to noise ratio) and aHTMCNR (apparent hard tissue to muscle contrast to noise ratio) in both sequences. Imaging findings were then correlated to clinical examination results. In STIR as well as in T1 FFE black bone images, aSNR and aHTMCNR was significantly higher in carious lesions than in healthy hard tissue (p < 0.001). Using water-sensitive STIR sequence allowed for detecting significantly lower aSNR and aHTMCNR in carious teeth compared to healthy teeth (p = 0.01). The use of MRI for the detection of caries is a promising imaging technique that may complement clinical exams and traditional imaging., (© 2024. The Author(s).)

Short dental implant placement has become a more popular surgical option for the reconstruction of the dentoalveolar region. In this article, we briefly discuss the considerations that the clinician must take into account when considering the use of short dental implants., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) and primary cutaneous mucinous carcinoma (PCMC) are rare low-grade neoplasms thought to arise from apocrine glands that share many histological features and are proposed to be on a single histopathologic continuum, with EMPSGC as the in situ form that may progress to the invasive PCMC. Management involves a metastatic workup and either wide local excision (WLE) with greater than 5 mm margins or Mohs micrographic surgery (MMS) in anatomically sensitive areas. We present 2 cases of EMPSGC and 3 cases of PCMC and review their clinical and histopathologic features, differential diagnoses, and treatment.

Objectives: Maxillary sinus mucositis is frequently associated with odontogenic foci. Periapical inflammation of maxillary molars and premolars cannot be visualized directly using radiation-based imaging. The purpose of this study was to answer the following clinical question: among patients with periapical inflammatory processes in the maxilla, does the use of magnetic resonance imaging (MRI), as compared to conventional periapical (AP) and panoramic radiography (OPT), improve diagnostic accuracy?, Methods: Forty-two subjects with generalized periodontitis were scanned on a 3 T MRI. Sixteen asymptomatic subjects with mucosal swelling of the maxillary sinus were enrolled in the study. Periapical edema was assessed using short tau inversion recovery (STIR) sequence. Apical osteolysis and mucosal swelling were assessed by MRI, AP, and OPT imaging using the periapical index score (PAI). Comparisons between groups were performed with chi-squared tests with Yates' correction. Significance was set at p < 0.05., Results: Periapical lesions of maxillary premolars and molars were identified in 16 subjects, 21 sinuses, and 58 teeth. Bone edema and PAI scores were significantly higher using MRI as compared to OPT and AP (p < 0.05). Using the STIR sequence, a significant association of PAI score > 1 and the presence of mucosal swelling in the maxillary sinus was detected (p = 0.03)., Conclusion: Periapical inflammation and maxillary mucositis could be visualized using STIR imaging. The use of MRI may help detect early, subtle inflammatory changes in the periapical tissues surrounding maxillary dentition. Early detection could guide diagnostic criteria, as well as treatment and prevention., (© 2023. The Author(s).)

Purpose: Persistent trigeminal neuropathy (PTN) is associated with high rates of depression, loss of work, and decreased quality of life (QoL). Nerve allograft repair can achieve functional sensory recovery in a predictable manner; however, it bears significant upfront costs. In patients suffering from PTN, is surgical repair with allogeneic nerve graft, when compared to non-surgical therapy, a more cost-effective treatment option?, Materials and Methods: A Markov model was constructed with TreeAge Pro Healthcare 2022 (TreeAge Software, Massachusetts) to estimate the direct and indirect costs for PTN. The model ran for 40 years with 1-year-cycles on a 40-year-old model patient with persistent inferior alveolar or lingual nerve injury (S0 to S2+) at 3 months without signs of improvement, and without dysesthesia or neuropathic pain (NPP). The 2 treatment arms were surgery with nerve allograft versus non-surgical management. There were 3 disease states, functional sensory recovery (S3 to S4), hypoesthesia/anesthesia (S0 to S2+), and NPP. Direct surgical costs were calculated using the 2022 Medicare Physician Fee Schedule and verified with standard institutional billing practices. Non-surgical treatment direct costs (follow-up, specialist referral, medications, imaging) and indirect costs (QoL, loss of employment) were determined from historical data and the literature. Direct surgical costs for allograft repair were $13,291. State-specific direct costs for hypoesthesia/anesthesia were $2,127.84 per year, and $3,168.24 for NPP per year. State-specific indirect costs included decreased labor force participation, absenteeism, and decreased QoL., Results: Surgical treatment with nerve allograft was more effective and had a lower long-term cost. The incremental cost-effectiveness ratio was -10,751.94, indicating surgical treatment should be utilized based on efficiency and cost. With a willingness-to-pay threshold of $50,000, the net monetary benefits of surgical treatment are $1,158,339 compared to $830,654 for non-surgical treatment. With a standard threshold incremental cost-effectiveness ratio of 50,000, the sensitivity analysis shows that surgical treatment would remain the preferred choice based on efficiency even if surgical costs were doubled., Conclusion: Despite high initial costs of surgical treatment with nerve allograft for PTN, surgical intervention with nerve allograft is a more cost-effective treatment option when compared to non-surgical therapy., (Copyright © 2023 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Objectives: To assess and compare the diagnostic performance of CT-like images based on a three- dimensional (3D) T1-weighted spoiled gradient-echo sequence (3D T1 GRE) with CT in patients with acute traumatic fractures of the mandible., Materials and Methods: Subjects with acute mandibular fractures diagnosed on conventional CT were prospectively recruited and received an additional 3 T MRI with a CT-like 3D T1 GRE sequence. The images were assessed by two radiologists with regard to fracture localization, degree of dislocation, and number of fragments. Bone to soft tissue contrast, diagnostic confidence, artifacts, and overall image quality were rated using a five-point Likert-scale. Agreement of measurements was assessed using an independent t-test., Results: Fourteen subjects and 22 fracture sites were included (26 ± 3.9 years; 4 females, 10 males). All traumatic fractures were accurately detected on CT-like MRI (n = 22, κ 1.00 (95% CI 1.00-1.00)). There was no statistically significant difference in the assessment of the fracture dislocation (axial mean difference (MD) 0.06 mm, p = 0.93, coronal MD, 0.08 mm, p = 0.89 and sagittal MD, 0.04 mm, p = 0.96). The agreement for the fracture classification as well as the inter- and intra-rater agreement was excellent (range κ 0.92-0.98 (95% CI 0.96-0.99))., Conclusion: Assessment of mandibular fractures was feasible and accurate using CT-like MRI based on a 3D T1 GRE sequence and is comparable to conventional CT., Clinical Relevance: For the assessment of acute mandibular fractures, CT-like MRI might become a useful alternative to CT in order to reduce radiation exposure particularly in young patients., (© 2022. The Author(s).)

Background and Purpose: Treatment of oral squamous cell carcinoma (OSCC) is based on clinical exam, biopsy, and a precise imaging-based TNM-evaluation. A high sensitivity and specificity for magnetic resonance imaging (MRI) and F-18 FDG PET/CT are reported for N-staging. Nevertheless, staging of oral squamous cell carcinoma is most often based on computed tomography (CT) scans. This study aims to evaluate cost-effectiveness of MRI and PET/CT compared to standard of care imaging in initial staging of OSCC within the US Healthcare System., Methods: A decision model was constructed using quality-adjusted life years (QALYs) and overall costs of different imaging strategies including a CT of the head, neck, and the thorax, MRI of the neck with CT of the thorax, and whole body F-18 FDG PET/CT using Markov transition simulations for different disease states. Input parameters were derived from literature and willingness to pay (WTP) was set to US $100,000/QALY. Deterministic sensitivity analysis of diagnostic parameters and costs was performed. Monte Carlo modeling was used for probabilistic sensitivity analysis., Results: In the base-case scenario, total costs were at US $239,628 for CT, US $240,001 for MRI, and US $239,131 for F-18 FDG PET/CT whereas the model yielded an effectiveness of 5.29 QALYs for CT, 5.30 QALYs for MRI, and 5.32 QALYs for F-18 FDG PET/CT respectively. F-18 FDG PET/CT was the most cost-effective strategy over MRI as well as CT, and MRI was the cost-effective strategy over CT. Deterministic and probabilistic sensitivity analysis showed high robustness of the model with incremental cost effectiveness ratio remaining below US $100,000/QALY for a wide range of variability of input parameters., Conclusion: F-18 FDG PET/CT is the most cost-effective strategy in the initial N-staging of OSCC when compared to MRI and CT. Despite less routine use, both whole body PET/CT and MRI are cost-effective modalities in the N-staging of OSCC. Based on these findings, the implementation of PET/CT for initial staging could be suggested to help reduce costs while increasing effectiveness in OSCC., (© 2022. The Author(s).)

Purpose: With the outbreak of COVID-19, residency programs for the 2020 to 2021 OMS interview cycle were forced to quickly adapt to a new method of assessing candidates-virtual interviewing-for the first time. The purpose of this study is to describe applicants' perspectives regarding the advantages and disadvantages of the virtual interview process through an online descriptive survey., Methods: This cross-sectional study utilizes a descriptive survey sent to the 2020 to 2021 interview cycle applicants of the University of Illinois at Chicago Oral and Maxillofacial Surgery (UIC OMS) residency program. The survey consisted of questions employing both scaled and open-ended designs. The questions were fabricated to extrapolate applicants' perceived advantages and disadvantages of virtual interviewing compared to their expectations of in-person interviewing by focusing on interactions, number of interviews received/attended, and overall applicant satisfaction. Descriptive statistics were computed for each variable for data analysis., Results: In the 2020 to 2021 UIC OMS residency cycle, there were 288 applications. A total of 102 surveys were collected (response rate = 35.4%). Respondents attended more interviews during the virtual format due to accessibility (64.7%), and cost savings (63.7%). 42.2% of applicants felt they did not present themselves as well during the virtual interview as they would have in person and 46.1% felt they did not have a good understanding of the culture of the program after the interview. 49.0% of all participants do not feel that virtual interviews should continue in the future., Conclusions: Virtual formats would allow access to a greater number of interviews; however, they lack the ability to promote effective interaction between applicants, residents, and faculty members. The results of the study show that although applicants agreed that interviews were more accessible this year, they felt that the "personal" interaction was lacking and they could not present themselves effectively with the virtual format. Ultimately, almost half (49%) of the respondents do not wish for virtual interviews to continue in the future., (Copyright © 2021 The American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Maize is sensitive to cold injury, especially during germination. Since cold causes oxidative stress, compounds that promote the accumulation of free radical forms, such as the reactive aldehyde (RA) methylglyoxal (MG), may be suitable to trigger a systemic defense response. In this study, maize seeds were soaked in MG solution for one night at room temperature, before germination test at 13°C. The exogenous MG enhanced the germination and photosynthetic performance of maize at low temperature. Transcriptome analysis, hormonal, and flavonoid profiling indicated MG-induced changes in photosystem antenna proteins, pigments, late embryogenesis abundant proteins, abscisic acid (ABA) derivatives, chaperons, and certain dihydroflavonols, members of the phenylpropanoid pathway. MG-response of the two maize cultivars (A654 and Cm174) were somewhat different, but we recorded higher endogenous hydrogen peroxide (H 2 O 2 ) and lower nitric oxide (NO) level in at least one of the treated genotypes. These secondary signal molecules may provoke some of the changes in the hormonal, metabolic and gene expression profile. Decreased auxin transport, but increased ABA degradation and cytokinin and jasmonic acid (JA) synthesis, as well as an altered carbohydrate metabolism and transport (amylases, invertases, and SWEET transporters) could have promoted germination of MG-pretreated seeds. While LEA accumulation could have protected against osmotic stress and catalase expression and production of many antioxidants, like para-hydroxybenzoic acid (p-HBA) and anthocyanins may have balanced the oxidative environment for maize germination. Our results showed that MG-pretreatment could be an effective way to promote cold germination and its effect was more pronounced in the originally cold-sensitive maize genotype., (© 2021 Scandinavian Plant Physiology Society.)

Purpose: Computer-assisted surgery (CAS) was implemented rapidly, and recent concerns have been raised regarding its safety and its effect on surgical outcomes. We wanted to understand the impact CAS has on the surgical margin status when used for the resection of ameloblastoma., Materials and Methods: We performed a 10-year retrospective cohort study at a single institution. Subjects were identified by surgical logs and chart query. Histopathologic reports were examined for margin status. We compared surgical technique (CAS and non-CAS) with the surgical margin (≤5 mm vs >5 mm). Other variable outcomes included previous treatment, histologic type, time from imaging to surgery, and recurrence. Bivariate analysis was performed to determine significance., Results: A total of 31 subjects were identified (12 females; 19 males) with a mean age of 34.5 (standard deviation [SD] ± 19.1) years. Fifteen subjects were included in the CAS group and 16 subjects in the non-CAS group. No statistically significant difference was identified between the CAS and non-CAS group when surgical margins were defined as less than or equal to 5 mm and greater than 5 mm (P = .5368). The average distance from surgical margin to lesion was 9.6 mm (SD ± 5.1) in the CAS group and 8.5 mm (SD ± 5.6) in the non-CAS group (P = .2590). However, the non-CAS group had 1 positive margin and a total of 6 margins of less than or equal to 2 mm compared with zero margins of less than or equal to 2 mm in the CAS group (closest margin 3 mm)., Conclusions: The use of CAS and cutting guides based on predetermined surgical margins did not compromise the margin status in surgical resections of ameloblastoma. The use of CAS could potentially decrease the occurrence of close or positive margins., (Copyright © 2020 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: Although rates of COVID-19 have remained low among US dentists, the authors aimed to determine the risk of there being COVID-19 in patients seeking oral health care., Methods: The authors performed a retrospective chart review of all emergency department consultations from June 1, 2020, through December 31, 2020. They used Pearson correlation coefficients to compare rates with citywide prevalence (P < .05)., Results: The authors located 203 encounters with 149 tests and 10 cases of COVID-19. Cases were strongly correlated with the citywide positivity rate (r = 0.9147; P = .0039). All patients who tested positive were asymptomatic and afebrile, and one-half (50%) visited a dentist within a week of consultation., Conclusions: The rate of COVID-19 in a population seeking oral health care reflects the community positivity rate. Asymptomatic or presymptomatic patients pose risks to providers, staff members, and other patients., Practical Implications: Dentists should remain vigilant during the ongoing COVID-19 pandemic, even with vaccination rollout. The Centers for Disease Control and Prevention maintains an accessible website with easy access to each state's positivity rate and caseload., (Copyright © 2021 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Purpose: The pathophysiology and treatment of medication-related osteonecrosis of the jaws (MRONJ) remain unclear after nearly two decades of recorded observation and discussion. The purpose of this study was to assess outcomes of surgical resection of MRONJ in patients exposed to denosumab., Materials and Methods: A literature review was performed in conjunction with experts at the University of Illinois at Chicago Library. The primary outcome of interest was surgical success defined by maintenance of complete mucosal closure without bone exposure and infection after surgical resection. Secondary interests included demographics, MRONJ stage, location of the focus of osteonecrosis, and the primary underlying disease necessitating antiresorptive treatment. Statistical analysis was performed by χ 2 , analysis of variance, or t test (P < .05 and b = 0.2 or a power of 0.8)., Results: A total of 70 articles were identified and 14 met inclusion criteria. Twenty patients were included (13 women; 7 men); age 61.8 years ± 12.9 (range 19 to 77); and MRONJ stage I (40.0%), II (35.0%), and III (25.0%). Most cases occurred in the mandible (65.0%), followed by the maxilla (30.0%). The success rate of surgical intervention for MRONJ secondary to denosumab was in 16 of 20 (80.0%) patients. Stage I MRONJ lesions achieved mucosal closure in 100% of patients, stage II in 71.4%, and stage III in 60.0%. The surgical success rate was 83.3% in the maxilla and 76.9% in the mandible., Conclusions: The surgical success rate for MRONJ secondary to denosumab was 80.0%, similar to that reported in bisphosphonates of 85 to 95%; however, more evidence must be reported and analyzed., (Copyright © 2020 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

The purpose of this study was to evaluate a magnetic resonance imaging (MRI) protocol for direct visualization of the inferior alveolar nerve in the setting of mandibular fractures. Fifteen patients suffering from unilateral mandible fractures involving the inferior alveolar nerve (15 affected IAN and 15 unaffected IAN from contralateral side) were examined on a 3 T scanner (Elition, Philips Healthcare, Best, the Netherlands) and compared with 15 healthy volunteers (30 IAN in total). The sequence protocol consisted of a 3D STIR, 3D DESS and 3D T1 FFE sequence. Apparent nerve-muscle contrast-to-noise ratio (aNMCNR), apparent signal-to-noise ratio (aSNR), nerve diameter and fracture dislocation were evaluated by two radiologists and correlated with nerve impairment. Furthermore, dislocation as depicted by MRI was compared to computed tomography (CT) images. Patients with clinically evident nerve impairment showed a significant increase of aNMCNR, aSNR and nerve diameter compared to healthy controls and to the contralateral side (p < 0.05). Furthermore, the T1 FFE sequence allowed dislocation depiction comparable to CT. This prospective study provides a rapid imaging protocol using the 3D STIR and 3D T1 FFE sequence that can directly assess both mandible fractures and IAN damage. In patients with hypoesthesia following mandibular fractures, increased aNMCNR, aSNR and nerve diameter on MRI imaging may help identify patients with a risk of prolonged or permanent hypoesthesia at an early time.

Myositis ossificans traumatica (MOT) is a focal reactive ossification of muscle that typically occurs secondary to a single acute high-impact trauma or multiple chronic low-grade traumas. The disease is often limited to a single muscle and can occur throughout the body. Ossification of the muscles in the head and neck region is extremely rare but can occur after falls, motor vehicle accidents, blunt force trauma, or surgical procedures such as extractions and local infiltration. The purpose of this paper is to present the case of a seven-year-old girl with trismus and calcification within her medial pterygoid muscle. To our knowledge, this is the youngest known reported case of MOT of the head and neck region.

Objectives: We sought to identify oral symptoms found in hyperparathyroidism and compare their rate of occurrence, as well as potential variations in sequelae between primary, secondary, and tertiary hyperparathyroidism., Materials and Methods: Database searches were performed through EMBASE and PubMed, with a continual handsearch for relevant articles. PRISMA guidelines were followed., Results: Two hundred five articles including 245 patients were analyzed with data extraction. The average age was 34.02 years old (age range 1-83), with 91 male and 154 female patients (1:1.7 M/F ratio). Patients presented with symptoms including facial asymmetry or swelling (167/214 cases; 78.0%), oral pain (30/214; 14.0%), systemic symptoms (25/214; 11.7%), referrals or incidental findings (16/214; 7.5%), and neuropathy (6/214; 2.8%) independently and in combination together. Bony pathology occurred most often in the mandible (100/245 cases; 40.8%), while 72 cases were in the maxilla (29.4%) and 73 cases in both jaw bones (29.8%)., Conclusions: Our data collection identifies a wide variation in the presentation of hyperparathyroidism. In order to be more certain of oral maladies from hyperparathyroidism, studies with large patient populations need to be conducted at healthcare centers to clarify the oral outcomes of hyperparathyroidism., Clinical Relevance: What was thought to be a characteristic finding of HPT, mandibular radiolucency occurred in only a minor portion of cases. Furthermore, the pathognomonic sign of HPT on radiograph, loss of lamina dura, was only the third most common presentation. Bone pathology was most commonly reported in literature, but should not be assumed the only oral sequelae of hyperparathyroidism.

Objectives: Several diagnostic tools have been developed to assess benign and potentially malignant disorders of soft tissues. In this study, we aimed to assess the value of the VELscope ® (Visually Enhanced Light Scope) imaging device as a technical tool to investigate malignant lesions of the oral cavity., Material and Methods: In this retrospective study we analyzed the photographs of 90 patients who suffered from malignant oral soft tissue lesions or carcinoma in situ (CIS) from 2008 to 2014 in the Clinic of Oral and Maxillofacial Surgery of LMU in Munich., Results: In 85.6% of the cases fluorescence quenching/loss could be detected. The average value for the colour red shows a significant difference in pathologic and physiologic tissues (p = 0.007) with a higher median for pathologic tissues. For the colours green and blue our measurements show significantly higher values in the healthy tissue (p < 0.001.). The shade of red showed significantly higher values for pathologic tissues when compared to all three colours (p < 0.001). Furthermore, the shades of green and blue showed significantly lower values in the pathologic tissue (p < 0.001)., Conclusion: In the near future, VELscope ® could help to a greater extent than visual observation alone in identifying the margins of tumor resections. VELscope ® still lacks the ability to identify the overall risk level of oral lesions., (Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Objective: Bone marrow-derived mesenchymal stem cells (MSCs) and adipose-derived mesenchymal stem cells (ASCs) currently represent a promising tool for the regeneration of large bony defects. Therefore, it is pivotal to find the best cell source within the body and the best conditions for in vitro cellular expansion. This study compared cellular response of MSCs and ASCs from a porcine animal in normoxic (21% O2) and hypoxic (2% O2) cell culture conditions via 2D and 3D experimental settings., Materials and Methods: The effect of constant exposure to hypoxia on primary pig stem cells was evaluated by two methods. First, a cumulative population doublings (cumPD) over a period of 40 days, a metabolic activity assay in both 2D and 3D beta-TCP-PHB scaffolds, followed by analysis of osteogenic differentiation potential in cell monolayers., Results: Our results displayed enhanced cell culture proliferation in 2% O2 for both MSCs and ASCs, with impaired osteogenic differentiation of MSCs. The impact of constant hypoxia on porcine MSCs and ASCs exhibited a statistically significant decrease in osteogenic differentiation under hypoxic conditions with the MSCs., Conclusions: Our data suggest that MSCs and ASCs expanded in hypoxic culture conditions, might be more suitable for use in the clinical setting where large cell numbers are required. When differentiated in normoxic conditions, MSCs showed the highest osteogenic differentiation potential and might be the best choice of cells with consideration to bone repair., (Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Background: This article represents the first systematic review entirely dedicated toward a disease called oral ulceration with bone sequestration (OUBS). We performed this review in order to further define and outline this disease. A secondary interest was to recognize the prevalence and importance of OUBS in relation to other oral disorders accompanied by ulceration and bone exposure., Material and Methods: The systematic review was registered with PROSPERO (registration number CRD42015024294) and performed in cooperation with Harvard's Countway Library. Searches were built using MeSH terms and proximity operators previously mentioned in OUBS descriptions. Database searches were performed through EMBASE, Medline, and PubMed, followed by a handsearch of bibliographies for relevant articles. Articles were assessed against eligibility and inclusion criteria centering on bone exposure without known etiologic cause. We sought to gather information on patient age, sex, anatomical location, clinical presentation, and comorbidities. PRISMA guidelines were followed., Results: The searches identified 766 records total. Despite considerable inspection, we found only 8 articles qualifying for our review. In the 8 articles, there were a total of 24 patients fulfilling the criteria of OUBS. Although some abstracts mentioned idiopathic nature, most authors presented clinical cases with probable causes to ulceration and sequestration. The mean age of these patients was 43.21 ± 11.94 years. The male to female ratio was 3:1. The predominant area of occurrence was the mandible (n = 23, 95.8%)., Conclusion: The representation of OUBS in the literature remains scarce. More data must be generated and gathered on the concept of OUBS so as to determine the true incidence and importance of this disease. Despite rare occurrences of conditions characterizing OUBS, the recent discussion of this topic in the scientific community calls for more knowledge to be brought forth, with great benefit to patients suffering from ulcerative diseases and osteonecrosis., (Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)