The Showcases of Dental History - A Time Machine in Miniature at the University of Puerto Rico: Part I.

The evolution of 20-year-old dental museum-like showcases located in the lobby and the main hallway of the School of Dental Medicine, Puerto Rico (PR) are described along with important professionals who impacted on this development.

The Showcases of Dental History - A time machine in miniature at the University of Puerto Rico: Part II - The Exhibits.

The University of Puerto Rico School of Dentistry was established in 1957. Over the years, it has played an important role in Puerto Rico's healthcare system. That legacy is displayed through the walls of the School of Dentistry. In Part 1, the evolution of 20-year-old dental museum-like showcases located in the lobby and the main hallway of the school were described along with important professions who impacted on this development. In this paper, we will describe in detail the items available at the museum.

Facial Injuries in the National Basketball Association.

BACKGROUND: Sport injuries can negatively impact physical and psychological aspects of athletes. There is a gap in the literature regarding facial trauma present in basketball. PURPOSE: The purpose of this study is to identify and describe facial trauma present in the National Basketball Association (NBA). STUDY DESIGN, SETTING, SAMPLE: This is a retrospective cohort study in which the sample (n = 206) consists of players that missed games due to facial injuries in the NBA, the data were collected from a public access online resource. INDEPENDENT VARIABLE: The predictor variables were player position (center, point guard, shooting guard, small forward, and power forward), team conference (Eastern/Western), and if played games occurred in playoff season. MAIN OUTCOME VARIABLES: The primary outcome variable was the injury location (upper, middle, and lower facial third), and the secondary outcome was type of injury (soft tissue/bone fracture). COVARIATES: Player's age, height, weight, and body mass index were collected. ANALYSES: χ2 and logistic regression were calculated to determine associations between predictor and outcome variables. Logistic regression was used to determine if variables were predictive for injury. Odds ratio was also computed for significant results. P value less than .05 (95% confidence interval) was considered statistically significant. RESULTS: A total of 206 players missed games due to facial injuries, and a total of 212 injuries were quantified. The mean age of the injured players was 27.24 ± 4.06 years, mean height (centimeters) was 201 ± 59.31 cm, mean weight (kilograms) was 99.48 ± 12.41 kg, and body mass index was 24.52 ± 1.75 kg/m2. Of the 212 injuries, none of them occurred in the upper facial third, 158 (75%) were in the middle third, and 54 (25%) were in the lower third; 151 of them were fractures (61%) and 61 were soft tissue injuries (29%). Most injuries were concentrated in centers (23%) and power forwards (23%). The most common fracture occurred in the nasal bones (39.2%), and most soft tissue injuries occurred in the eye globes (25%). Almost all injuries occurred during regular season games (97%), and the Eastern conference was slightly predominant (52%). CONCLUSION AND RELEVANCE: Significant facial trauma in the NBA has risen in recent years. The player's position, height, and weight were the primary factors associated with facial trauma in the NBA.

Parkland's 12-Minute Tracheotomy: Is It Reproducible?

Tracheotomy is a procedure in which an incision is made on the anterior aspect of the neck to access the trachea, where a stoma is created to serve as either independent airway or as a site of insertion for a cannula. Surgeons must be proficient in this technique. The purpose of this paper is to reproduce, with slight modifications, the Parkland 12-minute checklist tracheotomy. A quality-improvement initiative was designed. The primary outcome variable was the time required by a resident to perform a tracheotomy. Time was recorded from incision to presence of a capnography wave. Sixteen patients (11 males, 5 females; mean age, 60.87; age range, 38-89) were included. The average time was 11.50 minutes. Factors related to prolonged time included bleeding and thyroid gland in the midway. The employment of the Parkland checklist proved to be reliable, efficient, and a safe guide to perform a tracheotomy in a teaching setting.

Maxillofacial Trauma Patterns in Bare-Knuckle Fighting.

PURPOSE: The purpose of this study is to analyze patterns and trends of maxillofacial injuries in bare-knuckle fighting. Results comparisons with other combat sports are provided in the Discussion section. MATERIALS AND METHODS: The study design is a retrospective cohort study. Data were collected by a single ringside physician who participated in all bouts. Predictor variables were number of rounds and final fight result (ie, knockout, technical knockout, and decision). The primary outcome variable was the frequency of maxillofacial injury, and secondary outcome variables were type of injury (laceration/fracture) and traumatic brain injury. The chi-square test was used to determine if there was any statistical significance between the predictor variables. RESULTS: Study sample consisted in fighters who suffered maxillofacial injuries during the matches from June 2018 to March 2022 (n = 177). A total of 177 fighters sustained maxillofacial trauma in 301 matches, and a total of 211 maxillofacial injuries were identified. Of the 211 injuries, 184 were lacerations and 27 were fractures. Proportionally more injuries occurred in matches that lasted 5 rounds (33%), and a significant association was found between the number of rounds fought and the frequency of injury (P < .00001). From a total of 107 technical knockouts, 74% of them caused at least 1 injury; from 96 knockouts, 60% caused at least 1 injury; and from 89 fights that ended in decision, 83% of them caused at least 1 injury. A statistically significant association was found between final fight result and frequency of injury (P < .00001). P value less than 0.05 (95% confidence interval) was considered statistically significant. CONCLUSIONS: Maxillofacial injuries were predominantly associated with longer fights and fights which result were knockout/technical knockout. Traumatic brain injury was associated with knockout results, which mostly occurred in the first and second rounds.

Maxillofacial Trauma in the Ultimate Fighting Championship.

PURPOSE: The Ultimate Fighting Championship (UFC) is an American mixed martial art (MMA) company. This study aims to characterize patterns and trends of maxillofacial injuries in MMA. MATERIALS AND METHODS: The study design is a retrospective cohort study. Study sample consisted of fighters that suffered injuries during the matches from January 2015 to December 2019 (N = 259). The Athletic Commissions and corresponding fighting regulatory departments from 16 states and 24 countries were screened for medical reports released by UFC ringside physicians. Predictor variables were sex, weight division, injury location, injury type, and fight outcome (i.e., Technical Knockout/Knockout, Submission, Decision). Primary outcome variables were need for medical suspension and duration of medical suspension, secondary outcome variable was frequency of injury. Chi-square test was used to determine any statistical significance between predictor variables. One-way analysis of variance was used to determine any statistically significant differences between medical suspension times, sex, injury location, type of injury, weight divisions and fight outcome throughout the years. P value less than .05 (95% confidence interval [CI]) was considered statistically significant. RESULTS: A total of 259 fighters suffered injuries. Of the 319 total injuries, 291 (91.2%) occurred in male fighters, and 28 (8.8%) in females. Middle facial third injuries were the most common for both males and females; lower facial third injuries were proportionally similar. The male weight division with the longest medical suspensions were the light heavyweight (110.68 days) and welterweight (108.25 days) (P < .10166); the female weight division with the longest medical suspension was strawweight (88.92 days) and shortest was bantamweight (81.75 days) (P < .921123). CONCLUSIONS: Upper and midface trauma was predominant with fractures concentrated in the light heavyweight and welterweight divisions. Medical suspensions duration were longer in the light heavyweight and welterweight divisions.

The Morpho-Functional Three-Dimensional Analysis for Zygomatic Implants: A Clinical Tool With Surgical Implications.

ABSTRACT: Zygomatic implants (ZIs) have been used successfully for the rehabilitation of jaws with severe atrophy for the past 2 decades. The development of computed tomography, three-dimensional (3D) analysis software, and stereolithographic models has positively impacted the development of preoperative planning. This article describes the protocol developed by the Department of Oral and Maxillofacial Surgery of El Bosque University, Bogotá, Colombia, through 10 years of experience, for the installation of ZIs, covering from the times when the implants were placed through intraoperative guidance, until now, in which drilling guides developed by computer-aided design and computer-aided manufacturing are used, without neglecting in their design multiple factors that must be considered. To date, this protocol for the treatment of patients with atrophic jaws through ZIs includes a detailed clinical examination, in which variables such as bone and dental relationship between the jaws, oral opening and dynamic interaction between soft cervicofacial tissues are considered. It also includes a 3D computed tomography planning for the design and preparation of surgical guides whose insertion patterns must be executable during surgery. Together, clinical and imaging analysis converge in what it has been called morpho-functional 3D planning.

Pseudomyogenic Hemangioendothelioma: A Rare Vascular Tumor of the Oral Cavity.

Pseudomyogenic hemangioendothelioma is a vascular neoplasm that presents a borderline biological behavior, intermediate between entirely benign hemangiomas and highly malignant angiosarcomas. Up to date, only 1 case of this entity has been reported in the oral cavity.

The Oral and Maxillofacial Surgery Residency Program at the University of Puerto Rico: A Historical Perspective.

A former Spanish colony, Puerto Rico has been an unincorporated US territory since 1898 when Spain relinquished all claims over it under the terms of the Treaty of Paris. Half a century later, Universidad de Puerto Rico created the School of Dental Medicine, which began activities in 1957. In 1961, Lowell E. McKelvey became Dean of the School and in 1963 he established the Oral and Maxillofacial Surgery advanced specialty education program following the US model. Created as a 36-month program with 2 residents per year, currently it is a 48-year program accepting 3 residents annually. The purpose of this paper is to review the history of this CODA-accredited program and to analyze the circumstances under which this program was developed.

From Cystostomy to Active Decompression: The Surgeons' Battle Against Odontogenic Cysts.

Odontogenic cysts represent a challenge for oral and maxillofacial surgeons. Treatment options include resective surgery and conservative approaches. The purpose of this paper is to review the history of marsupialization/decompression and other techniques based on similar principles.

Distraction Sugosteogenesis: Its Biologic Bases and Therapeutic Principles.

PURPOSE: Recently, the terms sugosteogenesis and distraction sugosteogenesis have been introduced to the scientific literature. While the former describes a biologic phenomenon, the latter refers to the clinical technique which relies on the accelerated normal bone healing process that takes place at the osseous walls surrounding a cystic cavity when active negative pressure is applied. The purpose of this study is to provide the biologic bases and the therapeutic principles of this emerging technique. Employing well-stablished biologic principles, clinical evidence from analogous techniques, emerging experimental data, and circumstantial evidence, this study presents the possible mechanism of action of the evacuator for odontogenic cysts (Evocyst), a closed, vacuum-like drain system intended to treat cystic conditions using negative pressure. METHODS: A review of the literature was done. Keywords for the Medline search were: marsupialization, decompression, odontogenic cysts, effects of negative pressure on bone, and negative pressure wound therapy. In addition, relevant publications from the reference list of the retrieved studies were considered. The matches were evaluated for relevance and analyzed accordingly. Clinical reports used to illustrate the concept of distraction sugosteogenesis were performed following the Declaration of Helsinki on medical protocol and ethics. RESULTS: Currently, the standard of care to manage odontogenic cystic lesions includes marsupialization, enucleation and curettage, decompression, and surgical resection. However, there is a need for an alternative option in which the entity could be treated while promoting bone formation. With large odontogenic cystic conditions treated in a short period of time, distraction sugosteogenesis appears to be a choice. CONCLUSION: The application of negative pressure to osseous cells produces a stretching that creates mechanical cues that trigger signaling pathways, promotes fluid flow, and enhances angiogenesis. All of them, combined, may explain sugosteogenesis. The clinical application of such parameters may explain the good clinical results obtained with the Evocyst.

Active Intracystic Negative Pressure Could Induce Osteogenesis.

Based on previous findings, the author introduces the term "sugosteogenesis," a biological phenomenon that occurs by using the Evocyst, a device that exerts active intracystic negative pressure. The term "sugosteogenesis" comes from the Latin word "sugo-," meaning "suck," and Greek words "osteo-," meaning "bone," and genesis, "origin."

Atrophic Mandible Fractures: Are Bone Grafts Necessary? An Update.

PURPOSE: The management of atrophic mandibular fractures poses a challenge because of anatomic variations and medical comorbidities associated with elderly patients. The purpose of this article is to review and update the literature regarding the management of atrophic mandible fractures using load-bearing reconstruction plates placed without bone grafts. MATERIALS AND METHODS: We performed a review of the English-language literature looking for atrophic mandibular fractures with or without continuity defects and reconstruction without bone grafts. Included are 2 new patients from our institution who presented with fractures of their atrophic mandibles and had continuity defects and infections. Both patients underwent reconstruction with a combination of a reconstruction plate, recombinant human bone morphogenetic protein 2, and tricalcium phosphate. This study was approved as an "exempt study" by the Institutional Review Board at the University of Kentucky. This investigation observed the Declaration of Helsinki on medical protocol and ethics. RESULTS: Currently, the standard of care to manage atrophic mandibular fractures with or without a continuity defect is a combination of a reconstruction plate plus autogenous bone graft. However, there is a need for an alternative option for patients with substantial comorbidities. Bone morphogenetic proteins, with or without additional substances, appear to be a choice. In our experience, successful healing occurred in patients with a combination of a reconstruction plate, recombinant human bone morphogenetic protein 2, and tricalcium phosphate. CONCLUSIONS: Whereas primary reconstruction of atrophic mandibular fractures with reconstruction plates supplemented with autogenous bone graft is the standard of care, in selected cases in which multiple comorbidities may influence local and/or systemic outcomes, bone morphogenetic proteins and tricalcium phosphate can be used as a predictable alternative to autogenous grafts.

Colombian Dental Literature During the Twentieth Century.

Colombia is one of the Latin American countries in which both research and academic writing are considered virgin areas. The dental profession is not the exception. The purpose of this paper is to construct a database of the dental books written in Colombia from the mid-1800s to 1900s and to analyze those books according to the decades in which they were published. The first book published in Colombia on Dentistry was Odontotecnia u observaciones sobre la estructura, fisiología, anatomía y enfermedades de los dientes (Dental Techniques or Observations on the Structure, Physiology, Anatomy and Dental Diseases), written by American dentist Joseph Watson ver Valen and released in Bogotá in 1849. In 150 years, a total of 72 dental books were found, most of which were published in Bogotá and Medellin.

Decompression of Odontogenic Cystic Lesions: Past, Present, and Future.

Tumors and cystic lesions of the jawbones have been described since the late 1600s and it took another 200 years for classification systems to appear in the medical, surgical, and dental literatures. In the late 1800s, Carl Partsch introduced cystostomy, a method by which the cyst is converted into a pouch by suturing its lining to the mucosa of the oral cavity. The purpose of this article is to analyze the history, present, and future of cystic conditions of the jaws and decompression, a modality of treatment that during the past few years has regained the attention of oral and maxillofacial surgeons and pathologists owing to its relative simplicity and effectiveness compared with other conservative options.

An Innovative Decompression Device to Treat Odontogenic Cysts.

The author presents an innovative device to decompress odontogenic cystic lesions of the jawbones. Its use and characteristics are described.

Odontogenic Mixoma in a Ten-Year-Old Patient.

Odontogenic myxomas are benign, rarely seen intraosseous tumors arising from the embryonic connective tissue associated to tooth formation. The authors present the case of a 10-year-old patient affected by this entity.

Francisco Martinez de Castrillo: An Early Spanish Author.

Francisco Martinez de Castrillo was a pioneer Spanish dental author who wrote and published Coloquio Breve y Compendioso Sobre la Materia de la Dentadura y Maravillosa Obra de la Boca, the first book published ever in the Spanish language. However, his life and work is largely unknown to the history of the dental profession.

Cystic Conditions of the jawbones: A Review of Early Classification Systems.

Cystic conditions of the jawbones were recognized long before the establishment of the American Academy of Oral Pathology (AAOP) in 1948, but it was around this time when they were studied, characterized, and classified. The history of the classification systems implemented by oral pathologists to study the cystic conditions of the maxillary bones is intimately related with the birth of oral and maxillofacial pathology as a specialty of dentistry. The purpose of this paper is to review the early classification systems proposed for the cystic conditions of the jawbones.