The ideal shape of the female jaw angle: An online survey.

The aim of this study was to determine the characteristics of an attractive white female jaw angle in the three dimensions. An online survey of photographs of celebrities and laypeople was used to rate their attractiveness using 6 questions and a 3-item Likert scale. If ≥ 80% of participants rated a model as having attractive aesthetic features, it was considered attractive. The following features were considered important: a gonial angle in profile of 125.5° and in anterior view of 142°, an intergonial-interzygomatic width ratio of 0.83 and the vertical position of the jaw angles at the level of the stomion or upper lip. Surgeons can use these consensus criteria to help design a jaw angle implant, define orthognathic surgical strategies, or shape the angle using injectables.

Comparison of Bioelectrical Impedance Analysis (BIA)-Derived Parameters in Healthy Volunteers and Critically Ill Patients.

OBJECTIVE: To compare bioelectrical impedance analysis (BIA)-derived parameters in healthy volunteers and critically ill patients and to assess its prognostic value in an ICU patient cohort. DESIGN: Retrospective, observational data analysis. SETTING: Single centre, tertiary-level ICU (Ziekenhuis Netwerk Antwerpen, ZNA Stuivenberg Hospital). PATIENTS: 101 patients and 101 healthy subjects, participants of International Fluid Academy Days. MEASUREMENTS AND MAIN RESULTS: Compared to healthy volunteers, both male and female ICU patients had significantly higher values for total body water (TBW), extracellular water (ECW), extracellular fluid (ECF), plasma, and interstitial fluid volumes. The phase angle was significantly lower and the malnutrition index was significantly higher in ICU patients, regardless of gender. Non-survivors in the ICU had significantly higher extracellular water content (ECW, 50.7 ± 5.1 vs. 48.9 ± 4.3%, p = 0.047) and accordingly significantly lower intracellular water (ICW, 49.2 ± 5.1 vs. 51.1 ± 4.3%, p = 0.047). The malnutrition index was also significantly higher in non-survivors compared to survivors (0.94 ± 0.17 vs. 0.87 ± 0.16, p = 0.048), as was the capillary leak index (ECW/ICW). CONCLUSIONS: Compared to healthy volunteers, this study observed a higher malnutrition index and TBW in ICU patients with an accumulation of fluids in the extracellular compartment. ICU non-survivors showed similar results, indicating that ICU patients and a fortiori non-survivors are generally overhydrated, with increased TBW and ECW, and more undernourished, as indicated by a higher malnutrition index.

The Therapeutic Landscape of Salivary Gland Malignancies-Where Are We Now?

Salivary gland malignancies (SGMs) account for less than 5% of new diagnoses in head and neck tumors. If feasible, surgery is the preferred treatment modality. Nevertheless, some malignancies have a tendency of recurrence, with possible distant metastasis. Alternative treatment strategies, such as primary radiation or chemotherapeutics, often present low response rates. As a result, there is an unmet need for novel therapeutic approaches. Nowadays, target-based therapies (e.g., small inhibitors and immunotherapy) are used by the medical oncologist for possible treatment of advanced SGMs. Based on recent published trials, some novel treatments may provide additional disease control for some patients. However, sample sizes are small, the general findings are unsatisfactory, and a lot of uncertainties remain to be elucidated. Nevertheless, research shows that patients do not benefit from blind administration of systemic treatments and therefore a more personalized approach is highly needed. The aim of this review paper is to summarize the most recent advances in the biological understanding and molecular pathways of salivary gland cancers, the association of these pathways with the current treatments used and their implications for more personalized targeted-based therapies.

Additively manufactured titanium scaffolds and osteointegration - meta-analyses and moderator-analyses of in vivo biomechanical testing.

INTRODUCTION: Maximizing osteointegration potential of three-dimensionally-printed porous titanium (3DPPT) is an ongoing focus in biomaterial research. Many strategies are proposed and tested but there is no weighted comparison of results. METHODS: We systematically searched Pubmed and Embase to obtain two pools of 3DPPT studies that performed mechanical implant-removal testing in animal models and whose characteristics were sufficiently similar to compare the outcomes in meta-analyses (MAs). We expanded these MAs to multivariable meta-regressions (moderator analysis) to verify whether statistical models including reported scaffold features (e.g., "pore-size", "porosity", "type of unit cell") or post-printing treatments (e.g., surface treatments, adding agents) could explain the observed differences in treatment effects (expressed as shear strength of bone-titanium interface). RESULTS: "Animal type" (species of animal in which the 3DPPT was implanted) and "type of post-treatment" (treatment performed after 3D printing) were moderators providing statistically significant models for differences in mechanical removal strength. An interaction model with covariables "pore-size" and "porosity" in a rabbit subgroup analysis (the most reported animal model) was also significant. Impact of other moderators (including "time" and "location of implant") was not statistically significant. DISCUSSION/CONCLUSION: Our findings suggest a stronger effect from porosity in a rat than in a sheep model. Additionally, adding a calcium-containing layer does not improve removal strength but the other post-treatments do. Our results provide overview and new insights, but little narrowing of existing value ranges. Consequent reporting of 3DPPT characteristics, standardized comparison, and expression of porosity in terms of surface roughness could help tackle these existing dilemmas.

Prognostic value of bioelectrical impedance analysis for assessment of fluid overload in ICU patients: a pilot study.

INTRODUCTION: The non-invasive analysis of body fluid composition with bio-electrical impedance analysis (BIA) provides additional information allowing for more persona-lised therapy to improve outcomes. The aim of this study is to assess the prognostic value of fluid overload (FO) in the first week of intensive care unit (ICU) stay. MATERIAL AND METHODS: A retrospective, observational analysis of 101 ICU patients. Whole-body BIA measurements were performed, and FO was defined as a 5% increase in volume excess from baseline body weight. RESULTS: Baseline demographic data, including severity scores, were similar in both the fluid overload-positive (FO+, n = 49) patients and in patients without fluid overload (FO-, n = 52). Patients with FO+ had significantly higher cumulative fluid balance during their ICU stay compared to those without FO (8.8 ± 7.0 vs. 5.5 ± 5.4 litres; P = 0.009), VE (9.9 ± 6.5 vs. 1.5 ± 1.5 litres; P < 0.001), total body water (63.0 ± 9.5 vs. 52.8 ± 8.1%; P < 0.001), and extracellular water (27.0 ± 7.3 vs. 19.6 ± 3.7 litres; P < 0.001). The presence of 5%, 7.5%, and 10% fluid overload was directly associated with increased ICU mortality rates. The percentage fluid overload (P = 0.039) was an independent predictor for hospital mortality. CONCLUSIONS: A higher mortality rate in ICU-patients with FO was observed. FO is an independent prognostic factor because neither APACHE-II, SOFA, nor SAPS-II significantly differed on admission between survivors and non-survivors. Further research is needed to confirm these data prospectively and to evaluate whether BIA-guided deresuscitation in the subacute phase will improve mortality rates.

A 2-year prospective case series on volumetric changes, PROMs, and clinical outcomes following sinus floor elevation using deproteinized bovine bone mineral as filling material.

BACKGROUND: A sinus floor augmentation may be indicated when a lack of hard tissue impedes implant placement. Although clinically successful, evidence supporting the long-term three-dimensional stability of the grafted volume is scarce. Second, evidence on the patient's acceptance of this type of treatment is limited. PURPOSE: First is to evaluate the changes in graft volume after lateral wall sinus lifting based on superimposed cone beam computed tomography (CBCT) images and then to assess patient-reported outcome measures (PROMs) and clinical outcomes. MATERIALS AND METHODS: Partially edentulous patients in need of a sinus lift and fixed reconstruction on at least two neighboring implants were selected for a prospective case series. Lateral wall sinus augmentation was performed using deproteinized bovine bone mineral (DBBM) as the only filling material. Volumetric changes were quantified on the basis of a preoperative CBCT and three postoperative CBCTs (at 2 weeks, 3 months, and 2 years). PROMs and clinical parameters were registered. RESULTS: Twenty-two patients (7 males, 15 females; mean age 59 years) participated of which three patients dropped out during the follow up. Graft volumes amounted to 1418.26 mm3 at 2 weeks, 1201.21 mm3 at 3 months, and 1130.13 mm3 at 2 years postoperative pointing to a relative graft volume stability of 79.7%. Swelling was the leading symptom during the first week. A peak in visual analogue scale scores was observed for pain, swelling, and hematoma the day of surgery and 1 day postoperation with a statistically significant decline between days 3 and 7. Hemorrhage and nose bleeding occurred in 18.2% and 27.3% of the subjects, respectively. About 95.5% of the subjects would undergo the treatment again. All implants integrated successfully and demonstrated healthy clinical conditions. CONCLUSION: Lateral wall sinus augmentation using DBBM as the only filling material is a viable treatment concept given limited graft resorption, good patients' tolerance, and clinical outcomes.