Enhancing Distraction Osteogenesis With Carbon Fiber Reinforced Polyether Ether Ketone Bone Pins and a Three-Dimensional Printed Transfer Device to Permit Artifact-Free Three-Dimensional Magnetic Resonance Imaging.

OBJECTIVES: To: (1) design an artifact-free 3D-printed MR-safe temporary transfer device, (2) engineer bone-pins from carbon fiber reinforced polyether ether ketone (CFR-PEEK), (3) evaluate the imaging artifacts of CFR-PEEK, and (4) confirm the osteointegration potential of CFR-PEEK, thus enhancing 3D-planning of bony advancements in hemifacial microsomia using sequential magnetic resonance imaging (MRI). STUDY DESIGN: Engineered CRF-PEEK bone pins and a 3D printed ex-fix device were implanted into a sheep head and imaged with MRI and computed tomography . The osseointegration and bony compatibility potential of CFR-PEEK was assessed with scanning electron microscopy images of MC3T3 preosteoblast cells on the surface of the material. RESULTS: The CFR-PEEK pins resulted in a signal void equivalent to the dimension of the pin, with no adjacent areas of MR-signal loss or computed tomography artifact. MCT3 cells adhered and proliferated on the surface of the discs by forming a monolayer of cells, confirming compatibility and osseointegration potential. CONCLUSION: A 3D printed transfer device could be utilized temporarily during MRI to permit artifact-free 3D planning. CFR-PEEK pins eliminate imaging artifact permitting sequential MRI examination. In combination, this has the potential to enhance distraction osteogenesis, by permitting accurate three-dimensional planning without ionizing radiation.

What the general dental practitioner needs to know about HPV-related oropharyngeal malignancy.

The rates of oropharyngeal squamous cell carcinoma have continued to rise secondary to the increasing prevalence of the human papillomavirus (HPV). HPV-related disease is typically found in younger patients who do not have the traditional risk factors for malignancy. General dental practitioners (GDPs) often examine patients regularly and may therefore have an opportunity to identify oropharyngeal malignancies at an early stage. However, many GDPs are unfamiliar with oropharyngeal anatomy, pathology and clinical examination. This review summarises the key points in identifying patients with oropharyngeal malignancy who necessitate urgent referral.

Magnetic resonance imaging-based tumor volume measurements predict outcome in patients with squamous cell carcinoma of the mandible.

OBJECTIVE: The objectives of this study were to determine the benefit of pretreatment magnetic resonance imaging (MRI)-based tumor volume (Tv) measurements in patients presenting with squamous cell carcinomas (SCCs) involving the oral cavity subsites most frequently associated with mandibular bone invasion. STUDY DESIGN: A 10-year retrospective study of all patients undergoing surgical resection for primary SCC of the retromolar trigone, mandible, or floor of mouth (with bone involvement) was completed. In total, 62 patients met the inclusion criteria, and Tv measurements completed on their pretreatment MRI. RESULTS: Tumor volume was significant at predicting all-cause survival and disease-free survival at 5 years. Tv stratification to correlate with the TNM staging system resulted in down-staging in 40 of the 62 cases. CONCLUSIONS: Tumor volume was a more useful predictor of outcome than the current clinical or pathologic TNM staging, considering the automatic up-staging of tumors involving mandibular bone to T4 tumors.

The nasolabial approach: a potential alternative to the lip-splitting incision for maxillectomy.

First described by Weber and later modified by Fergusson, the Weber-Fergusson incision has undergone numerous modifications, but the fundamental approach to maxillectomy has largely remained the same. We report the potential benefit of a nasolabial incision for partial maxillectomy. The incision is hidden within the nasolabial fold and obviates the need for division of the upper lip, which may undergo atrophy and shortening after radiotherapy.

Angioleiomyoma of the hard palate: report of a case and review of the literature and magnetic resonance imaging findings of this rare entity.

Angioleiomyomas are benign solitary smooth muscle tumors originating in the tunica media of vessels. They are rarely encountered within the oral cavity, and the number of reported cases specifically involving the hard palate remains small. A 39-year-old man presented with a 2-cm painless swelling on the left anterior hard palate. The mass had been present for ≈ 5 years before presentation, during which time it had slowly enlarged. Magnetic resonance imaging (MRI) showed a uniform signal pattern with T1 signal intensity slightly higher than surrounding soft tissues and marked hyperintensity on T2-weighted sequences. Although the MRI characteristics of angioleiomyomas affecting the extremities have previously been reported, this is the first reported case describing the MRI features of an oral-cavity angioleiomyoma. In view of the inability to differentiate angioleiomyoma from other pathologies with similar MRI features, simple local excision for definitive histopathologic diagnosis remains recommended.

Deformity of the tongue in an infant: Riga-Fede disease.

Riga-Fede is the rare condition of benign ulceration caused by repetitive trauma to the lingual tissues by the teeth in children younger than two years of age. The differential diagnosis includes infective and neoplastic conditions. Histological diagnosis is required when the symptoms fail to resolve with standard management. The case involving an 11-month-old girl who presented with ulceration of the tongue, resulting in a reasonable defect of the tongue tip, is reported in the present article. Following excisional biopsy, the lesion healed without subsequent recurrence. Riga-Fede disease should be considered in infants presenting with oral ulceration. Extraction of the offending teeth should be considered when associated with failure to thrive or failed conservative management.

Ewings sarcoma of the zygoma reconstructed with a gold prosthesis: a rare tumor and unique reconstruction.

INTRODUCTION: Ewings sarcoma (ES) is a rare tumor, most commonly encountered within the long bones during the first 20 years of life. CASE REPORT: We report the sixth case of ES of the zygoma, occurring in a 31-year-old male, and presenting a unique reconstructive opportunity. Diagnosis and preoperative planning were aided by CT/MR coregistration. Surgical reconstruction using 3D reconstructed CT images to produce an anatomically correct model provided the basis for a gold prosthesis construction. DISCUSSION: Delayed definitive reconstruction provided opportunity for adequate tumor recurrence surveillance, and definitive histological diagnosis. The artefact produced on MR imaging from gold implants is minimal, permitting the unrestricted identification of potential future recurrence. CONCLUSION: This case highlights the benefits of coregistration of radiological imaging, and custom-made gold prostheses providing the advantage of artefact-free MR imaging, which should be considered in patients requiring resection of zygomatic tumors and subsequent reconstruction.