The effects of physical photostimulable phosphor plate artifacts on the radiologic interpretation of periapical inflammatory disease. Publication date: Available online 6 November 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Trevor ST Thang, Anil Kishen, Massieh Moayedi, Pascal N Tyrrell, Wenda Zhao, Susanne Perschbacher Objective To evaluate how physical photostimulable phosphor (PSP) plate artifacts, such as those created by scratches, phosphor degradation, and surface peeling, affect the radiologic interpretation of periapical inflammatory disease. Methods A novel technique was developed to digitally superimpose 25 real PSP artifact masks over 100 clinical CMOS periapical images with known radiologic interpretations. These images were presented to 25 general dentists who were asked to state their radiologic interpretation, their confidence in their interpretation, and their opinion on whether the plates should be discarded. Statistical analyses were conducted by using random intercept mixed models for repeated measures and chi-square tests of the pooled data. Results No statistically significant adverse effect on interpretation was seen, even at severe artifact levels. There was a statistically significant decrease in the clinicians’ confidence and an increase in discard proportions when interpreting images with severe PSP plate artifacts (p < 0.05). Conclusion While diagnostic efficacy was unaffected, clinicians’ confidence decreased and proportionally more clinicians opted to discard sensors when interpreting images with severe artifacts. Future studies on the effect of artifacts on other dental diseases are recommended to determine the effect on diagnostic efficacy. Ultimately, these results can guide recommendations for PSP plate quality assurance.

American Academy of Oral Medicine: 75 Years of Bringing Medicine and Dentistry Back Together Publication date: Available online 6 November 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Martin T. Tyler, Craig S. Miller, Peter B. Lockhart, Lauren L. Patton

Changes in mandibular and articular dynamics associated with surgical versus nonsurgical treatment of mandibular condylar fractures: A systematic review with meta-analysis Publication date: Available online 5 November 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Luana Cardoso Cabral, Giovanna Morais Alves, Lair Mambrini Furtado, Alfredo Júlio Fernandes Neto, Paulo Cézar Simamoto Júnior Abstract Objective To evaluate the mandibular and articular dynamics and the presence of complications associated with surgical or nonsurgical treatment of condylar fractures. Study Design Clinical trials that compared open reduction internal fixation (ORIF) and maxillomandibular fixation (MMF) in patients with condylar fractures were included. We performed an electronic search of PubMed, Scopus, Cochrane Library, Web of Science, and Latin American and Caribbean Health Sciences (LILACS) databases starting from February 2017 and updated in January 2019 and found 467 articles. The authors evaluated the methodological quality using criteria from Cochrane's Collaboration Tool. Results After independent screening of abstracts, we assessed 88 articles in full text; 9 studies were included for qualitative synthesis; but only 8 were included for the meta-analysis. Four studies were considered to have high risk of bias and five were considered to have low risk. The risk ratio [RR=0.20; 95% confidence interval (CI)=0.13 to 0.32] was observed for complications. The quality of evidence, using GRADE software, was considered low for maximum mouth opening and protrusive movement, and moderate for lateral excursion movement and complications. Conclusion This review suggests that MMF and ORIF are effective. However, surgical treatment presented higher objective parameters. The nonsurgical treatment presented a high index of complications, such as malocclusion, pain, and deviation.

Does the amount of mandibular setback during bimaxillary surgery correlate with the degree of surgical relapse? Publication date: Available online 5 November 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Namiaki Takahara, Atsushi Kimura, Nobuyoshi Tomomatsu, Koichi Nakakuki, Tetsuya Yoda Objective To investigate postoperative horizontal relapse of the mandible in terms of the effects of the magnitude of mandibular setback movement and ramus inclination after Le Fort I osteotomy and sagittal split ramus osteotomy. Study Design A retrospective study of patients who underwent orthognathic surgery for mandibular prognathism was performed. Postoperative relapse at point B was analyzed with regard to the magnitude of mandibular setback and the ramus inclination. Serial cephalograms were used to measure surgical changes and evaluate postoperative relapse. Results Nineteen men and 31 women (mean age: 23.1 years) were retrospectively enrolled. Mean surgical backward movement of the mandible at point B was 8.2 mm, mean ramus inclination was 3.56°, and mean relapse 1 year postoperatively was 0.95 mm (11.6%). Horizontal relapse of the mandible was significantly correlated with the magnitude of mandibular setback (r = -0.52, p = 0.007) and ramus inclination (r = 0.48, p = 0.014). Conclusions Increased horizontal mandibular relapse after bimaxillary surgery was associated with greater mandibular setback movement and increased proximal segment clockwise rotation. Mandibular relapse after bimaxillary surgery may be minimized via adequate control of intraoperative clockwise rotation of the proximal segment.

We Have a “Ring Around the Collar” Problem Publication date: Available online 5 November 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Mark W. Lingen

Neck nodal recurrence and survival of clinical T1-2N0 oral squamous cell carcinoma in comparison of elective neck dissection versus observation: A meta-analysis Publication date: Available online 5 November 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Hongshi Cai, Yue Zhu, Cheng Wang, Yadong Zhang, Jinsong Hou ABSTRACT Objective The clinical management of the neck of patients with oral squamous cell carcinoma (OSCC) who are at T1-2 and clinically node-negative neck (cN0) continues to be controversial. We systematically reviewed the literature to assess the outcomes of elective neck dissection (END) and neck observation (OBS) on the prognosis of patients with cT1-2N0 OSCC. Study Design PubMed, Embase, and Cochrane Library were searched for studies related to END and OBS in patients with cT1-2N0 OSCC. Mantel–Haenszel method was used to pool odds ratios (OR) for neck nodal recurrence and hazard ratios (HR) for survival. Results END reduced the risk of neck nodal recurrence (OR, 0.45, 95% Confidence Interval [CI] 0.32-0.63, p < 0.00001) in cT1-2N0 OSCC. The disease-free survival (DFS) (HR, 0.52, 95% CI 0.42-0.63, p < 0.00001) was significantly higher in patients treated with END. However, END failed to significantly improve overall survival (HR, 0.83, 95% CI 0.67-1.04, p = 0.10) and disease-specific survival (HR, 0.87, 95% CI 0.48-1.57, p = 0.65) compared with management by neck observation. Conclusions A reduction in neck nodal recurrence and an increase in DFS might support the need for END in early-stage OSCC with clinically N0 neck.

ROLE OF CRYOTHERAPY IN TRIGEMINAL NEURALGIA WITH CERTAIN MODIFICATTIONS: A LONG TERM PROSPECTIVE STUDY Publication date: Available online 5 November 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Dr. Vishal Bansal, Dr Apoorva Mowar, Dr. Prajesh Dubey, Dr. Saloni Gupta Abstract Objective This study entails application of cryosurgery with certain modifications as a treatment modality for patients diagnosed with trigeminal neuralgia refractory to pharmacological treatments. Study Design 49 patients diagnosed with trigeminal neuralgia were treated with cryosurgery which included 13 infra-orbital, 18 inferior alveolar nerve, 17 mental nerve, and 1 supra-orbital nerve with closed, curved type of cryoprobe with nitrous oxide, at temperature of -98degree C, and pressure 70 kg/cm2 or 100 psi. Results Pain free interval was observed to be less than 18 months for 4.08% patients, in the range of 36 to 40 months for 48.97% patients, 48-52 months for 32.65% patients and more than 52 months in 14.28% patients. All the patients experienced loss of fine and crude sensation for a time period of 6 to 24 months. Conclusion Cryotherapy can be deduced to be a safe and economic modality which can be repeated if required.

Vascularized Ameloblastoma: A Case Report and Clinicopathologic Review of 18 Cases From The Literature Publication date: Available online 26 October 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Esther L.B. Childers, Lekidelu Taddasse-Heath, Andrea Bonnick, Tammey Naab Abstract The notable features of ameloblastoma do not typically include prominent vascularity. However, rarely, vascular ameloblastoma has been described under a variety of names. We present a case of vascularized ameloblastoma that had a bloody return on FNA. The English literature had a total of 16 reports (18 cases) of vascular or hemangioma-like ameloblastoma. The clinical, pathologic and radiographic features of the 19 cases are examined, but further study and more cases are needed. The recognition of this variation of ameloblastoma is important for clinicians to note that FNA with a bloody return does not exclude ameloblastoma from diagnostic consideration. We suggest the term vascularized ameloblastoma to avoid any suggestion of a vascular neoplasm.

Upper Cervical Spine Abnormalities as a Radiographic Index in the Diagnosis and Treatment of Temporomandibular Disorders Publication date: Available online 25 October 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Ji Rak Kim, Jung Hwan Jo, Jin Woo Chung, Ji Woon Park Abstract Objective To investigate clinical characteristics and treatment outcomes of patients with temporomandibular disorders (TMD) according to the presence of upper cervical spine abnormalities and craniofacial morphology. Study Design Clinical examinations were conducted on 43 TMD patients. Upper cervical spine characteristics (fusion, posterior arch deficiency, and craniofacial morphology) reflecting head and neck posture were evaluated on lateral cephalograms. Condylar bone changes in the temporomandibular joint were evaluated using cone beam computed tomography. Clinical characteristics and treatment outcomes following 1 year of conservative therapy were statistically analyzed between groups according to the presence of upper cervical spine abnormalities. Results Pain on neck muscle palpation was more frequent in patients with cervical fusion (p=0.019) and with either fusion or posterior arch deficiency (p=0.004) before treatment. Patients with posterior arch deficiency had smaller comfortable mouth opening ranges than those without the deficiency (p=0.044) before treatment, and smaller comfortable (p=0.020) and maximum (p=0.021) mouth opening ranges after treatment. PAD patients also had mouth opening limitation (p=0.028) and pain on masticatory muscle palpation (p=0.014) more frequently after treatment than patients without the deficiency. Conclusion Associations exist between upper cervical spine characteristics and treatment outcomes in TMD patients, suggesting such parameters as a possible radiographic index in TMD diagnosis and treatment.

Calcifications in the neck region of patients with carotid artery stenosis: A computed tomography angiography study of topographic anatomy Publication date: Available online 15 October 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Oya Barut, Jan Ahlqvist, Maria Garoff, Elias Johansson, Magnus Johansson, Per Wester, Eva Levring Jäghagen Abstract Objectives To map the vertical locations of calcified carotid plaques (CCPs), osseous anatomical structures, and calcified soft tissues in the area of the carotid artery, determine to what extent CCPs are superimposed on the cervical spine in coronal images, and analyze differences between men and women. Study Design Computed tomography angiography (CTA) scans were studied in 79 patients. CCPs were discovered in 152 of the total 158 neck sides. Evaluations were performed using sagittal and coronal reformatted CTA images utilizing maximum intensity projection. Results Most of the calcified anatomical structures studied, including the carotid bifurcation, were found in close relation to the level of the third and fourth cervical vertebrae. In the coronal view, all or most of the areas of the CCPs were superimposed on the cervical spine in 22/44 (50.0%) neck sides with CCP in women and in 37/108 (34.2%) in men (P=0.070). Conclusions The carotid bifurcation is in close proximity to various calcified anatomical structures. This should be taken into account when diagnosing CCPs in panoramic radiographs (PRs). In the coronal view, CCPs and the cervical spine are often superimposed; thus, coronal images are not recommended for confirmation of putative carotid calcifications diagnosed on PRs.