Benign Non-Odontogenic Pathology in Children.

This article provides a comprehensive overview of benign non-odontogenic pathologies. Bone-derived lesions like osteoma, osteoid osteoma, osteoblastoma, and osteochondroma are discussed in detail, emphasizing their radiographic features, locations, and treatment strategies. Cartilage-derived lesions such as chondroma, chondroblastoma, and chondromyxoid fibroma are also examined, noting their typical presentation and management approaches. The article then delves into fibroconnective tissue lesions. Mesenchymal and vascular lesions are detailed regarding their clinical and radiographic characteristics and treatment options. Lastly, nerve-derived lesions like schwannoma and neurofibroma are covered, providing insights into their association with diseases like neurofibromatosis and preferred management strategies.

Porcine Urinary Bladder Extracellular Matrix for the Salvage of Fibula Free Flap Skin Paddle: Technical Note and Description of a Case.

This report establishes a novel application of a commercially available porcine urinary bladder extracellular matrix, MatriStem (ACell, Inc., Columbia, MD), in the salvage of partial loss of the skin paddle of a fibula osteoseptocutaneous free flap that was utilized for mandibular reconstruction.

Dysphagia Caused by Diffuse Idiopathic Skeletal Hyperostosis.

Diffuse idiopathic skeletal hyperostosis, or Forestier disease, is a relatively common disease in the elderly population. Although reported in the orthopedic and rheumatology literature, it has not, to date, been reported in the maxillofacial or dental literature. It is a disease entity that often presents with head and neck symptoms that might go unrecognized by the consultant oral and maxillofacial surgeon.

Paramedian forehead flap.

The paramedian forehead flap (PMFF) is a versatile flap with a robust vascular supply that is well suited for reconstruction of complex or large nasal defects. Although a 2-stage technique is most common, a single-stage procedure involving tunneling the proximal pedicle and 3-stage procedures involving tissue expansion, vascular delay, and flap tailoring after inset before pedicle division have also been described. This article describes a traditional 2-stage technique and presents the case of a patient with a posttraumatic nasal deformity reconstructed with a PMFF.

Factors associated with converting scientific abstracts to published manuscripts.

PURPOSE: The objective of this study was to identify factors associated with the conversion of scientific abstracts to publications in peer-reviewed journals. METHODS: This was a retrospective study of abstracts presented by members of the Massachusetts General Hospital Department of Oral and Maxillofacial Surgery between 2000 and 2010. Predictor variables were categorized as abstract- or author-specific. The outcome variable was conversion of an abstract presented at a meeting to a published manuscript. Descriptive, bivariate, and multiple regression statistics were computed. P < 0.05 was significant. RESULTS: The sample was composed of 122 abstracts presented at meetings. Ninety abstracts (73.8%) were published in a peer-reviewed literature within 5 years of presentation. The mean time between presentation to publication was 21.9 ± 17.3 months (median, 19.0 months; range, 0-99 months). In bivariate analyses, study design, number of prior publications by the presenting author, and number of prior publications by the senior author were associated with time to publication (P < 0.06). In a multiple Cox proportional hazards model, higher levels of evidence (hazard ratio, 1.2; 95% confidence interval, 1.04-1.3; P = 0.006) and volume of prior publications by the senior author (hazard ratio, 1.007; 95% confidence interval, 1.003-1.011; P < 0.001) were associated with shorter publication times. CONCLUSIONS: Time to publication of scientific abstracts is associated with study quality, prior research experience by the presenting author, and senior author identity and experience.

Direct cellular vs. indirect pager communication during orthopaedic surgical procedures: a prospective study.

BACKGROUND: Cellular phone use within the hospital setting has increased as physicians, nurses, and ancillary staff incorporate wireless technologies in improving efficiencies, cost, and maintaining patient safety and high quality healthcare [11]. Through the use of wireless, cellular communication, an overall improvement in communication accuracy and efficiency between intraoperative orthopaedic surgeons and floor nurses may be achieved. METHODS: Both communication types occurred while the surgeon was scrubbed in the operating room (OR). Indirect communication occurred when the pager call was answered by the OR circulating nurse with communication between the surgeon, circulating nurse, and floor nurse. Direct communication consisted of cell phone and Jabra Bluetooth BT200 wireless ear piece used by the surgeon. The surgeon answered the floor nurse's cellular call by phone ring-activated automatic answering. The study was conducted during scheduled orthopaedic procedures. An independent observer measured time variables with a stop-watch while orthopaedic nurses randomly called via pager or cell phone. The nurses asked for patient caregiver confirmation and answers to 30 different patient-care questions. RESULTS: Sixty trials were performed with 30 cell and 30 page communications. Direct cellular communication showed a better response rate than indirect page (Cell 100%, Page 73%). Indirect page communication allowed a 27% and 33% error rate with patient problem and surgeon solution communications, respectively. There were no reported communication errors while using direct wireless, cellular communication. When compared to page communications, cellular communications showed statistically significant improvements in mean time intervals in response time (Cell = 11s, Page = 211s), correct patient identification (Cell = 5s, Page = 172s), patient problem and solution time (Cell = 13s, Page = 189s), and total communication time (Cell = 32s, Page = 250s) (s = seconds, all P < 0.001). Floor nurse satisfaction ratings (dependent on communication times and/or difficulties) were improved with direct cellular communication (Cell = 29 excellent, Page = 11 excellent). Intraoperative case interruptions (defined as delaying surgical progress) were more frequent with indirect page communication (10 page v. 0 cell). CONCLUSION AND SIGNIFICANCE: Our study demonstrates that direct wireless communication may be used to improve intraoperative communication and enhance patient safety. Direct wireless, cellular intraoperative communication improves communication times, communication accuracy, communication satisfaction, and minimizes intraoperative case interruption. As a result of this study, we hope to maintain our transition to direct wireless, cellular intraoperative orthopaedic communication to reduce medical errors, improve patient care, and enhance both orthopaedic surgeon and nursing efficiencies.

Analysis of factors that modify susceptibility and rate of progression in amyotrophic lateral sclerosis (ALS).

We conducted case-control and prospective longitudinal studies to examine risk factors and predictors of disease progression for ALS. Ninety-five subjects with ALS and 106 healthy control subjects were enrolled. All subjects completed a risk factor questionnaire at enrollment. The ALS subjects were prospectively followed for one year to define factors that influence the rate of disease progression, measured by rate of change in percent predicted forced vital capacity (%FVC) and the ALS functional rating scale (ALSFRS) score. The association of each potential risk factor with ALS was determined using univariate logistic regression. A random slope model was used to determine the association of each risk factor with disease progression. The demographic characteristics of ALS subjects and controls at enrollment did not differ. Significant risk factors for ALS included reported exposure to lead (p = 0.02) and pesticides (p = 0.03). Disease progression was faster in the ALS subjects having bulbar onset and a shorter time period between onset of symptoms and diagnosis. Pertinent variables not associated with either causation or progression of ALS included physical activity, cigarette smoking and a history of physical trauma or other clinical disorders.

Methamphetamine abuse: medical and dental considerations.

Amphetamines are central nervous system stimulants with high abuse potential and intense physiological and psychological effects. Abuse of methamphetamine--a methyl derivative of amphetamine--has grown to epidemic proportions across the United States. Due to the characteristic signs of methamphetamine abuse that appear in the oral cavity dentists should have a heightened awareness of the medical and dental issues surrounding this dangerous behavior. Moreover, recognition and proper referral to treatment should be a part of every provider's plan for preventing the devastating psychological, oral, and overall systemic effects of methamphetamine abuse.