Oceanic SACZ produces an abnormally wet 2021/2022 rainy season in South America.

The oceanic South Atlantic Convergence Zone (SACZ) has played a major role during South America's 2021/2022 summer extreme rainy season, being responsible for more than 90% of the precipitation in some regions of Southeast Brazil and in some regions of the Southwestern Atlantic Ocean (SWA). The summer of 2021/2022 was unique and rare and considered an abnormally humid season as verified by official Brazilian Institutes. First, the unusual number of cases of SACZ episodes (seven), was the highest recorded in the last decade. Second, all the cases that occurred were oceanic SACZ that assumed characteristics of an Atmospheric River and produced an excessively anomalous amount of precipitation during this period. Excess precipitation along with the regions located in mountainous and very uneven relief, which by orographic effects favors high precipitation volumes, were responsible for amplifying the observed impacts, such as landslides and floods that caused several losses to society. We also showed the main effects of coupling and interaction between the waters of the surface layer of the SWA and the atmosphere. Our learning from this study ends with the unprecedented results of how the marine atmospheric boundary layer (MABL) is locally modulated by the sea surface temperature (SST) that lies just below it. Until the present moment, we emphasize that this important mechanism has not been widely highlighted in the literature, showing that even though the ocean is colder than before oceanic SACZ is established, it is still warmer than the overlying air, thus, the ocean continues to be an active source of heat and moisture for the atmosphere and enhances the MABL instability process.

Oceanic eddy-induced modifications to air-sea heat and CO2 fluxes in the Brazil-Malvinas Confluence.

Sea surface temperature (SST) anomalies caused by a warm core eddy (WCE) in the Southwestern Atlantic Ocean (SWA) rendered a crucial influence on modifying the marine atmospheric boundary layer (MABL). During the first cruise to support the Antarctic Modeling and Observation System (ATMOS) project, a WCE that was shed from the Brazil Current was sampled. Apart from traditional meteorological measurements, we used the Eddy Covariance method to directly measure the ocean-atmosphere sensible heat, latent heat, momentum, and carbon dioxide (CO2) fluxes. The mechanisms of pressure adjustment and vertical mixing that can make the MABL unstable were both identified. The WCE also acted to increase the surface winds and heat fluxes from the ocean to the atmosphere. Oceanic regions at middle and high latitudes are expected to absorb atmospheric CO2, and are thereby considered as sinks, due to their cold waters. Instead, the presence of this WCE in midlatitudes, surrounded by predominantly cold waters, caused the ocean to locally act as a CO2 source. The contribution to the atmosphere was estimated as 0.3 ± 0.04 mmol m-2 day-1, averaged over the sampling period. The CO2 transfer velocity coefficient (K) was determined using a quadratic fit and showed an adequate representation of ocean-atmosphere fluxes. The ocean-atmosphere CO2, momentum, and heat fluxes were each closely correlated with the SST. The increase of SST inside the WCE clearly resulted in larger magnitudes of all of the ocean-atmosphere fluxes studied here. This study adds to our understanding of how oceanic mesoscale structures, such as this WCE, affect the overlying atmosphere.

Cortical and Subcortical Control of Swallowing-Can We Use Information From Lesion Locations to Improve Diagnosis and Treatment for Patients With Stroke?

Purpose Swallowing is a complex process, mediated by a broad bilateral neural network that spans from the brainstem to subcortical and cortical brain structures. Although the cortex's role in swallowing was historically neglected, we now understand, especially through clinical observations and research of patients with stroke, that it substantially contributes to swallowing control. Neuroimaging techniques (e.g., magnetic resonance imaging) have helped significantly to elucidate the role of cortical and subcortical brain areas, in general, and the importance of specific areas in swallowing control in healthy individuals and patients with stroke. We will review recent discoveries in cortical and subcortical neuroimaging research studies and their generalizability across patients to discuss their potential implications and translation to dysphagia diagnosis and treatment in clinical practice. Conclusions Stroke lesion locations have been identified that are commonly associated across patients with the occurrence and recovery of dysphagia, suggesting that clinical brain scans provide useful information for improving the diagnosis and treatment of patients with stroke. However, individual differences in brain structure and function limit the generalizability of these relationships and emphasize that the extent of the motor and sensory pathology in swallowing, and how the patient recovers, also depends on a patient's individual brain constitution. The involvement of the damaged brain tissue in swallowing control before the stroke and the health of the residual, undamaged brain tissue are crucial factors that can differ between individuals.

Physical drivers of the summer 2019 North Pacific marine heatwave.

Summer 2019 observations show a rapid resurgence of the Blob-like warm sea surface temperature (SST) anomalies that produced devastating marine impacts in the Northeast Pacific during winter 2013/2014. Unlike the original Blob, Blob 2.0 peaked in the summer, a season when little is known about the physical drivers of such events. We show that Blob 2.0 primarily results from a prolonged weakening of the North Pacific High-Pressure System. This reduces surface winds and decreases evaporative cooling and wind-driven upper ocean mixing. Warmer ocean conditions then reduce low-cloud fraction, reinforcing the marine heatwave through a positive low-cloud feedback. Using an atmospheric model forced with observed SSTs, we also find that remote SST forcing from the central equatorial and, surprisingly, the subtropical North Pacific Ocean contribute to the weakened North Pacific High. Our multi-faceted analysis sheds light on the physical drivers governing the intensity and longevity of summertime North Pacific marine heatwaves.

Predictability of US West Coast Ocean Temperatures is not solely due to ENSO.

The causes of the extreme and persistent warming in the Northeast Pacific from the winter of 2013/14 to that of 2014/15 are still not fully understood. While global warming may have contributed, natural influences may also have played a role. El Niño events are often implicated in anomalously warm conditions along the US West Coast (USWC). However, the tropical Pacific sea surface temperature (SST) anomalies were generally weak during 2014, calling into question their role in the USWC warming. In this study, we identify tropical Pacific "sensitivity patterns" that optimally force USWC warming at a later time. We find that such sensitivity patterns do not coincide with the mature SST anomaly patterns usually associated with ENSO, but instead include elements associated with ENSO SST precursors and SST anomalies in the central/western equatorial Pacific. El Niño events that produce large USWC warming, irrespective of their magnitude, do project on the sensitivity pattern and are characterized by a distinct evolution of the North Pacific atmospheric and oceanic fields. However, even weak tropical SST anomalies in the right location, and not necessarily associated with ENSO, can significantly influence USWC conditions and enhance their predictability.

Mesoscale ocean fronts enhance carbon export due to gravitational sinking and subduction.

Enhanced vertical carbon transport (gravitational sinking and subduction) at mesoscale ocean fronts may explain the demonstrated imbalance of new production and sinking particle export in coastal upwelling ecosystems. Based on flux assessments from 238U:234Th disequilibrium and sediment traps, we found 2 to 3 times higher rates of gravitational particle export near a deep-water front (305 mg C⋅m-2⋅d-1) compared with adjacent water or to mean (nonfrontal) regional conditions. Elevated particle flux at the front was mechanistically linked to Fe-stressed diatoms and high mesozooplankton fecal pellet production. Using a data assimilative regional ocean model fit to measured conditions, we estimate that an additional ∼225 mg C⋅m-2⋅d-1 was exported as subduction of particle-rich water at the front, highlighting a transport mechanism that is not captured by sediment traps and is poorly quantified by most models and in situ measurements. Mesoscale fronts may be responsible for over a quarter of total organic carbon sequestration in the California Current and other coastal upwelling ecosystems.

Novel 3-dimensional analysis to evaluate temporomandibular joint space and shape.

INTRODUCTION: The purpose of this study was to present and validate a novel semiautomated method for 3-dimensional evaluation of the temporomandibular joint (TMJ) space and condylar and articular shapes using cone-beam computed tomographic data. METHODS: The protocol for 3-dimensional analysis with the Checkpoint software (Stratovan, Davis, Calif) was established by analyzing cone-beam computed tomographic images of 14 TMJs representing a range of TMJ shape variations. Upon establishment of the novel method, analysis of 5 TMJs was further repeated by several investigators to assess the reliability of the analysis. RESULTS: Principal components analysis identified 3 key components that characterized how the condylar head shape varied among the 14 TMJs. Principal component analysis allowed determination of the minimum number of landmarks or patch density to define the shape variability in this sample. Average errors of landmark placement ranged from 1.15% to 3.65%, and none of the 121 landmarks showed significant average errors equal to or greater than 5%. Thus, the mean intraobserver difference was small and within the clinically accepted margin of error. Interobserver error was not significantly greater than intraobserver error, indicating that this is a reliable methodology. CONCLUSIONS: This novel semiautomatic method is a reliable tool for the 3-dimensional analysis of the TMJ including both the form and the space between the articular eminence and the condylar head.

Correlation of Airway Volume With Orthognathic Surgical Movement Using Cone-Beam Computed Tomography.

PURPOSE: Orthognathic surgery can induce changes in airway volume. The aim of this study was to determine whether there is a correlation of surgical movement of the maxilla or mandible to airway volume changes. MATERIALS AND METHODS: This was a prospective cohort study and the sample was composed of patients undergoing single-jaw orthognathic procedures from 2004 through 2007. Cone-beam computed tomograms were obtained before surgery (T0), immediately after surgery (T1), and at least 6 months after surgery (T2). The airway was segmented from 3-dimensional images and identified as the whole airway, consisting of the naso-, oro-, and hypopharynx. The volumetric percentage of change of the airway between time points was compared and correlated to the surgical movements using paired t test and cubic regression analysis. The level of statistical significance was set at a P value less than or equal to .05. RESULTS: The sample was composed of 33 patients. Sixteen patients underwent maxillary advancement with mean advancement of 5.4 mm (3 to 8 mm), 13 underwent mandibular advancement with mean advancement of 8.0 mm (5 to 15 mm), and 4 underwent mandibular setback of 4.0 mm. For maxillary advancement at T1, volume percentages of change for the whole airway and the naso-, oro-, and hypopharynx were 18.4 (P ≤ .05), 53.8 (P ≤ .05), 26.3, and 5.5%, respectively, and at T2, the changes were 10.0, 46.7 (P ≤ .05), 6.8, and 1.0%, respectively. For mandibular advancement at T1, volume percentages of change were 34.6 (P ≤ .05), 26.1, 54.1 (P ≤ .05), and 17.4%, respectively, and at T2, the changes were 15.0 (P ≤ .05), -3.7, 23.5 (P ≤ .05), and 12.1%, respectively. There were no meaningful long-term airway changes with mandibular setback. CONCLUSION: The study results suggest that there might be an anatomic limit to pharyngeal airway expansion associated with single-jaw orthognathic surgery.

Cone-beam computed tomographic comparison of surgically assisted rapid palatal expansion and multipiece Le Fort I osteotomy.

PURPOSE: To examine and compare the skeletal and dental effects of surgically assisted rapid palatal expansion (SARPE) and multipiece Le Fort osteotomy using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This was a prospective cohort study. Patients underwent SARPE or multipiece Le Fort I osteotomy to address maxillary transverse deficiency. CBCT scans were taken preoperatively, immediately postoperatively or after retention, and at least 6 months postoperatively. Four landmark measurements and ratios of dental-to-skeletal change were used to follow skeletal and dental widths in the posterior and anterior maxillary regions. Wilcoxon signed-rank test and Wilcoxon 2-sample rank-sum test were used to compare the landmark measurements and the ratio of dental-to-skeletal change for the 2 surgeries. A P value less than .05 was statistically significant. RESULTS: Thirteen patients (mean, 28.3 yr old; 7 women) were enrolled: 9 were treated by multipiece Le Fort I osteotomy and 4 were treated by SARPE. The ratios of dental-to-skeletal expansion in the posterior maxilla for the Le Fort procedure and SARPE were 0.70 ± 0.41 and 25.20 ± 15.8, respectively, and the dental-to-skeletal relapses were 1.17 ± 0.80 and -3.63 ± 3.70, respectively. The ratios of dental-to-skeletal expansion in the anterior maxilla for the Le Fort procedure and SARPE were 0.58 ± 0.38 and 31.80 ± 59.4, respectively, and the dental-to-skeletal relapses were 2.25 ± 3.41 and 4.86 ± 8.10, respectively. CONCLUSION: There was greater correlation between dental and skeletal changes in the multipiece Le Fort procedure, indicating bodily separation of the segments, whereas the SARPE showed noteworthy dental and skeletal tipping. Dental relapse was greater than skeletal relapse for these 2 procedures.

Three-dimensional longitudinal changes in craniofacial growth in untreated hemifacial microsomia patients with cone-beam computed tomography.

INTRODUCTION: The purpose of this study was to evaluate the concept that the affected and contralateral sides do not grow at the same rate in patients with hemifacial microsomia. Changes in the cranial base, maxilla, mandible, and occlusal plane were evaluated on 3-dimensional images from cone-beam computed tomography data in untreated patients. METHODS: Six patients were classified as having mandibular Pruzansky/Kaban type I, IIA, or IIB hemifacial microsomia. Cone-beam computed tomography (MercuRay; Hitachi, Tokyo, Japan) scans were taken before orthodontic treatment during both growth and postpuberty periods. RESULTS: The cranial base as defined by the position of the mastoid process was in a different position between the affected and contralateral control sides. The nasomaxillary length or height was shorter on the affected side for all 6 patients with hemifacial microsomia regardless of its severity, and it grew less than on the contralateral control side in 5 of the 6 patients. The occlusal plane angle became more inclined in 4 of the 6 patients. The mandibular ramus was shorter on the affected side in all patients and grew less on the affected side in 5 of the 6 patients. The mandibular body grew slower, the same, or faster than on the control side. CONCLUSIONS: The cranial base, position of the condyle, lengths of the condyle and ramus, and positions of the gonial angle and condyle can vary between the affected and contralateral control sides of patients with hemifacial microsomia, with the ramus and nasomaxillary length usually growing slower than they grow on the control side. These results suggest that many factors affect the growth rate of the craniofacial region and, specifically, the mandible in patients with hemifacial microsomia.

Coral reef habitat response to climate change scenarios.

Coral reef ecosystems are threatened by both climate change and direct anthropogenic stress. Climate change will alter the physico-chemical environment that reefs currently occupy, leaving only limited regions that are conducive to reef habitation. Identifying these regions early may aid conservation efforts and inform decisions to transplant particular coral species or groups. Here a species distribution model (Maxent) is used to describe habitat suitable for coral reef growth. Two climate change scenarios (RCP4.5, RCP8.5) from the National Center for Atmospheric Research's Community Earth System Model were used with Maxent to determine environmental suitability for corals (order Scleractinia). Environmental input variables best at representing the limits of suitable reef growth regions were isolated using a principal component analysis. Climate-driven changes in suitable habitat depend strongly on the unique region of reefs used to train Maxent. Increased global habitat loss was predicted in both climate projections through the 21(st) century. A maximum habitat loss of 43% by 2100 was predicted in RCP4.5 and 82% in RCP8.5. When the model is trained solely with environmental data from the Caribbean/Atlantic, 83% of global habitat was lost by 2100 for RCP4.5 and 88% was lost for RCP8.5. Similarly, global runs trained only with Pacific Ocean reefs estimated that 60% of suitable habitat would be lost by 2100 in RCP4.5 and 90% in RCP8.5. When Maxent was trained solely with Indian Ocean reefs, suitable habitat worldwide increased by 38% in RCP4.5 by 2100 and 28% in RCP8.5 by 2050. Global habitat loss by 2100 was just 10% for RCP8.5. This projection suggests that shallow tropical sites in the Indian Ocean basin experience conditions today that are most similar to future projections of worldwide conditions. Indian Ocean reefs may thus be ideal candidate regions from which to select the best strands of coral for potential re-seeding efforts.

Predicting tooth-size discrepancy: A new formula utilizing revised landmarks and 3-dimensional laser scanning technology.

INTRODUCTION: The goal of this study was to develop a more accurate formula to forecast tooth-size discrepancies in patients based on not only the size of the whole teeth but also functional arch components derived from normal cusp-fossa interdigitation that should be obtained as the final treatment goal. METHODS: A total of 141 dental casts from Dr Larry Andrews' collection of "normal occlusions" that never received orthodontic treatment were scanned with an Ortho Insight 3D Laser Scanner (Motion View Software, Chattanooga, Tenn). Individual tooth sizes and portions of tooth sizes were measured with the Motion View Software. For each set of models, potential tooth-size discrepancies were calculated by using both the original Bolton analysis and the new Johnson/Bailey analysis developed by this team at the University of California at San Francisco (UCSF). Six tooth-size discrepancy ratios were computed and included the Bolton (2) and the new (4) Johnson/Bailey analysis ratios for the anterior arch component, posterior arch component, and overall ratio of the maxillary and mandibular arches. The Johnson/Bailey analysis utilized different landmarks and groups of teeth. It consequently divided the maxillary segment by the mandibular segment, in contrast to the Bolton ratios, which divided the mandibular sums by the maxillary totals. RESULTS: The Bolton anterior segment ratio ranged from 70.68 to 84.81, with a mean of 77.91 (SD, 2.43) (3.1%). The Bolton overall ratio ranged from 86.19 to 96.62, with a mean of 91.64 (SD, ±1.74) (1.8%). The Johnson/Bailey posterior discrepancy ratio ranged from 0.98 to 1.23, with a mean of 1.10 (SD, ±0.04) (3.6%). Its anterior discrepancy ratio ranged from 0.91 to 1.14, with a mean of 1.03 (SD, ±0.04) (3.9%). The Johnson/Bailey overall discrepancy ratio ranged from 0.98 to 1.15, with a mean of 1.06 (SD, ±0.03) (2.8%). CONCLUSIONS: Two methods were used to forecast tooth-size discrepancies between opposing arches in a sample with clinically acceptable occlusions. The new approach provided more specific ratios utilizing more clinically relevant functional arch components derived from dental cusp-fossa interdigitation.

Climatic control of upwelling variability along the western North-American coast.

The high biological production of the California Current System (CCS) results from the seasonal development of equatorward alongshore winds that drive coastal upwelling. While several climatic fluctuation patterns influence the dynamics and biological productivity of the CCS, including the El Niño-Southern Oscillation (ENSO), the Pacific Decadal Oscillation index (PDO) and the North Pacific Gyre Oscillation (NPGO), the mechanisms of interaction between climatic oscillations and the CCS upwelling dynamics have remained obscure. Here, we use Singular Spectral Analysis (SSA) to reveal, for the first time, low-frequency concordance between the time series of climatic indices and upwelling intensity along the coast of western North America. Based on energy distributions in annual, semiannual and low-frequency signals, we can divide the coast into three distinct regions. While the annual upwelling signal dominates the energy spectrum elsewhere, low-frequency variability is maximal in the regions south of 33°N. Non-structured variability associated with storms and turbulent mixing is enhanced at northerly locations. We found that the low-frequency signal is significantly correlated with different climatic indices such as PDO, NPGO and ENSO with the correlation patterns being latitude-dependent. We also analyzed the correlations between this upwelling variability and sea surface temperature (SST) and sea level pressure (SLP) throughout the North Pacific to visualize and interpret the large-scale teleconnection dynamics in the atmosphere that drive the low-frequency coastal winds. These results provide new insights into the underlying mechanisms connecting climatic patterns with upwelling dynamics, which could enhance our prediction and forecast capabilities of the effects of future oceanographic and climatic variability in the CCS.

Three-dimensional analysis of the airway with cone-beam computed tomography.

INTRODUCTION: In this study, using a cone-beam computed tomography system, we evaluated the airways of 30 adults. METHODS: The shapes of the 3-dimensional volume of the airway were analyzed and compared among the subjects by using surface superimposition software techniques. RESULTS: The airway had the greatest variability in the hypopharynx, in the region below the epiglottis, and above the vocal folds. Moderate variation was apparent at the nares, behind the soft palate, and at the base of the tongue. Conservation of form was seen at the central portion of the nasal airway surrounding the inferior turbinate. CONCLUSIONS: The potential for comparing the shape of the airway among subjects is possible.

Student-led courses to teach cone beam CT in the predoctoral dental curriculum.

Cone beam computed tomography (CBCT) provides a new method to evaluate the craniofacial region. The goal of our project was to introduce into the predoctoral dental curriculum a student-initiated, student-led introduction to CBCT and how to use it, with minimal expenditure of financial resources. A third-year student worked with two faculty members to design a course in which a small number of third-year students would lead a small group of second-year students. The first approach involved each small group of second-year dental students discussing one clinical case in which the patient's CBCT record was included. Representatives of each of the ten small groups presented the patient and that patient's clinical problem (e.g., an impacted tooth) to the entire class as well as demonstrating the superiority and limitations of using CBCT in clinical dentistry. The second approach also used small-group meetings led by third-year dental students, but paired two second-year dental students as a team to present the patient's CBCT data in the small-group setting. There were five teams each presenting a different type of patient as assessed only from the CBCT data. The first model focused on the problem (e.g., an impacted tooth), while the second model focused on how to evaluate and use CBCT scans to determine the patient's primary problem. Based on surveys conducted at the end of each course, the majority of students felt they had gained a better understanding of CBCT.

Comparison of pharyngeal airway changes on plain radiography and cone-beam computed tomography after orthognathic surgery.

PURPOSE: The purpose of the present prospective study was to develop a 3-dimensional analysis of the airway using cone-beam computed tomography (CBCT) and to determine whether changes in the airway before and after orthognathic surgery correlate on 2-dimensional lateral cephalogram and 3-dimensional CBCT images. MATERIALS AND METHODS: Patients requiring orthognathic surgery during 2004 to 2005 were recruited for the present study. Lateral cephalograms and CBCT scans were obtained at 3 points: preoperatively, within 1 month postoperatively, and after 6 months postoperatively. The nasopharynx, oropharynx, and hypopharynx were segmented on both the radiograph and the CBCT scan for each patient in a repeatable manner at each point. For the lateral cephalogram, linear measurements in the middle of each of the 3 segments were obtained. For the CBCT, volumetric measurements of each of the 3 segments were obtained. The intrarater variability was assessed, and Pearson's correlation was used to compare the 2 imaging modalities. RESULTS: A total of 20 patients scheduled for orthognathic surgery were recruited for the present study. Of the 20 patients, 13 were female and 7 were male. The mean age at surgery was 23.85 years (range 14 to 43). Of the 20 patients, 6 underwent maxillary advancement only, 8 underwent mandibular advancement with or without genioplasty, and 6 underwent 2-jaw surgery or mandibular setback. We examined the entire cohort without separation into procedure or examination point and found a weak, but statistically significant, correlation between the linear and volume measurements in the nasopharyngeal and oropharyngeal regions but not in the hypopharyngeal region (r = 0.43, P < .002; r = 0.49, P < .0002; r = 0.16, P = .26, respectively). The maxillary advancement group (n = 6) demonstrated a correlation between the linear and volume measurements in the nasopharyngeal region (r = 0.53, P = .03). The mandibular advancement with or without genioplasty group (n = 8) showed a correlation in the nasopharyngeal and oropharyngeal regions (r = 0.55, P < .02, and r = 0.46, P = .05, respectively). For the combination/setback procedures (n = 6), a correlation was found in the oropharyngeal region (r = 0.64, P < .01). All other comparisons between the linear and volume measurements did not correlate. Additionally, no correlations were found between the linear and volumetric change in airway size between 6 months postoperatively and preoperatively, except for the oropharyngeal region (r = 0.67, P < .01). CONCLUSION: We present a method of measuring the airway that could be used for both 2-dimensional and 3-dimensional images. It includes segmentation of the pharyngeal airway into its nasopharyngeal, oropharyngeal, and hypopharyngeal components. Correlations were found between the linear and volumetric measurements of the segmented airway in patients who had undergone orthognathic surgery; however, the correlations were generally weak.

Cross-sectional human mandibular morphology as assessed in vivo by cone-beam computed tomography in patients with different vertical facial dimensions.

INTRODUCTION: The goal of this study was to look at mandibular cortical bone in live patients using cone-beam computed tomography (CBCT) to determine differences in cortical plate thicknesses and mandibular cross-sectional height and width in patients with different vertical facial dimensions. METHODS: A total of 111 scanned patients were used. Of these subjects, 43 were included in the average vertical facial dimension group (average face), 34 in the high vertical facial group (long face), and 34 in the low vertical facial group (square short face). Cross-sectional slices of the mandible were developed with the cone-beam scans to evaluate the cortical bone between the dentition at 13 locations. Each section was then measured at 8 sites, which included 1 height and 2 width measures of the cross-sectional area and 5 cortical plate thicknesses. An analysis of variance (ANOVA) with a posthoc Bonferroni statistical analysis was used with a significance level of P  ≤0.0167. RESULTS: The long-face group had slightly more narrow cortical bone than the other 2 facial groups at a few selected sites of the mandible. The height of the cross-sectional area of the mandible in the long-face group was shorter posteriorly than in the other 2 groups and became greater toward the symphysis. CONCLUSIONS: Mandibular height and width differed more than cortical bone thickness among the 3 types of subjects with different vertical facial dimensions, but statistically significant differences were evident is some sites for cortical bone thickness.

A comparison of simulated jaw dynamics in models of segmental mandibular resection versus resection with alloplastic reconstruction.

STATEMENT OF PROBLEM: Composite mandibular resection resulting in mandibular discontinuity can alter jaw motion, occlusal forces, and mastication, whether or not the jaw is reconstructed. The biomechanical events associated with these changes are difficult to assess clinically and, therefore, are not well documented or researched. PURPOSE: The purpose of this study was to model movements of a mandible with a discontinuity defect, and to compare them to movements of a mandible with its continuity restored by alloplastic reconstruction. MATERIAL AND METHODS: Computational models were created with a novel simulation platform. The variables designed into the models included gravity, external forces, and jaw muscle activity. Each jaw was observed at rest, when opened by external force or by muscle drive, and during the generation of unilateral occlusal force on the nonoperated side. Scarring was simulated with springlike forces. Outputs included individual muscle forces and torques, as well as mandibular incisor and condylar motions. RESULTS: Both models displayed plausible resting postures, and jaw opening with deviation toward the defect side when scarring was simulated. Opening caused by downward force on the incisors differed from that due to muscle activation. Jaw rotations during unilateral molar contact on the unaffected side were muscle specific and influenced by mandibular discontinuity. CONCLUSIONS: Plausible jaw movements after hemimandibulectomy and/or alloplastic reconstruction could be predicted by dynamic modeling. The effect of soft tissue forces on jaw posture and movements varied with the condylar support available. In both models, different opening trajectories were produced by external force on the jaw and by jaw muscle activation. Mandibular rotation during unilateral molar contact depended on which muscles were activated, and the availability of bilateral condylar support.

Sensory input pathways and mechanisms in swallowing: a review.

Over the past 20 years, research on the physiology of swallowing has confirmed that the oropharyngeal swallowing process can be modulated, both volitionally and in response to different sensory stimuli. In this review we identify what is known regarding the sensory pathways and mechanisms that are now thought to influence swallowing motor control and evoke its response. By synthesizing the current state of research evidence and knowledge, we identify continuing gaps in our knowledge of these mechanisms and pose questions for future research.