Principles of Exodontia.

Exodontia services comprise the largest portion of clinical practice for most oral and maxillofacial surgeons in the United States. This article is an overview of the principles of exodontia including the physics principles underlying the appropriate use of dental elevators and forceps. Failure to understand the instrumentation and the physics principles being used can cause prolonged operative time, iatrogenic injury to the patient, and unnecessary fatigue and/or injury to the provider. Advances in materials, technology, and innovative design have produced interesting new instruments for exodontia. New instruments including periotomes, piezosurgery, physics forceps, and vertical extraction systems are introduced and reviewed.

Comparison of treatment outcomes associated with early versus late treatment of mandible fractures: a retrospective chart review and analysis.

PURPOSE: We conducted outcomes assessment for all patients who had undergone treatment of mandible fractures at Tufts Medical Center across the 2 specialties of oral and maxillofacial surgery and otolaryngology. The aim of the present study was to determine whether a correlation existed between the development of postoperative complications and late treatment of mandible fractures (defined as treatment provided >48 hours after the time of injury). PATIENTS AND METHODS: All patients with mandible fractures treated at Tufts Medical Center between January 1, 2003 and January 1, 2008, underwent chart review to document the relevant data, including the time of fracture, time of treatment, and complications recorded during postoperative follow-up. The only patients included in the review were those who had follow-up data with good documentation. RESULTS: Our dataset included 92 patients, with a mean age of 28.74 years. The injury scores, compared between the early and late treatment and complication and noncomplication groups, were equivocal. Of our 92 treated patients, 19 (20.7%) had ≥1 postoperative complication. Of the 19 patients with any complication, 10 had undergone early treatment and 9 had been treated after 48 hours. Of our late treatment group, 25% developed ≥1 complication. The overall complication rate for the early group was 18%. CONCLUSIONS: Our study did not reveal a statistically significant difference in the development of postoperative complications after mandible fracture repair between the early and late treatment groups. Our study seemed to have a result similar to that of some of the earlier studies investigating the same variable.

A novel, high-throughput workflow for discovery and identification of serum carrier protein-bound peptide biomarker candidates in ovarian cancer samples.

BACKGROUND: Most cases of ovarian cancer are detected at later stages when the 5-year survival is approximately 15%, but 5-year survival approaches 90% when the cancer is detected early (stage I). To use mass spectrometry (MS) of serum proteins for early detection, a seamless workflow is needed that provides an opportunity for rapid profiling along with direct identification of the underpinning ions. METHODS: We used carrier protein-bound affinity enrichment of serum samples directly coupled with MALDI orthagonal TOF MS profiling to rapidly search for potential ion signatures that contained discriminatory power. These ions were subsequently directly subjected to tandem MS for sequence identification. RESULTS: We discovered several biomarker panels that enabled differentiation of stage I ovarian cancer from unaffected (age-matched) patients with no evidence of ovarian cancer, with positive results in >93% of samples from patients with disease-negative results and in 97% of disease-free controls. The carrier protein-based approach identified additional protein fragments, many from low-abundance proteins or proteins not previously seen in serum. CONCLUSIONS: This workflow system using a highly reproducible, high-resolution MALDI-TOF platform enables rapid enrichment and profiling of large numbers of clinical samples for discovery of ion signatures and integration of direct sequencing and identification of the ions without need for additional offline, time-consuming purification strategies.