Klinisk hovedbudskap Forbeining av tyggemuskulatur, kjent som ossifiserende myositt, kan inntreffe etter lokalt traume i munnhulen, også etter administrasjon av lokalanestesi. Tilstanden er svært sjelden, men må vurderes som en differensialdiagnose for pasienter med vedvarende gapebesvær etter en invasiv prosedyre i munnhulen.

Key Clinical Message Traumatic myositis ossificans of the temporal muscle can occur following local trauma. The diagnosis could be considered for patients presenting with therapy‐resistant trismus after intraoral procedures. Abstract A female in her 30s developed ossification of the temporal muscle attachment after local trauma during dental treatment, resulting in an inability to open her mouth. Following surgical treatment and physical therapy acceptable mouth opening and masticatory function was achieved.

This article describes a woman in her forties who spontaneously developed facial pain 19 years after double-jaw orthognathic surgery. The focus of her pain was the left side of the face, including the temporomandibular joint (TMJ). Conservative treatment was initiated, including several occlusal splints, in addition to injections with local anesthesia, botulinum toxin, and corticosteroids, with limited effects. Surgical treatments with arthroscopy and discectomy, and ultimately a TMJ prosthesis, improved the patient's joint function but did not reduce pain. The question is whether the degenerated joint was due to progression of the original disease process or to multiple surgical procedures.

Hovedbudskap Permanente hjørnetannsanlegg bør lokaliseres når pasienten har en tannalder tilsvarende 10 år og ved tegn til ektopisk erupsjon bør pasienten henvises til kjeveortoped Ekstraksjon av melkehjørnetann kan vurderes dersom den permanente hjørnetannen er palatinalt beliggende, og ekstraksjon ved 10-11 års alder øker sannsynligheten for spontankorreksjon Aktiv fremføring er tidkrevende, men har høy suksessrate og lite komplikasjoner CBCT kan være et nyttig diagnostisk verktøy, særlig for kartlegging av eventuelle rotresorpsjoner på permanente incisiver, og i forkant av aktiv fremføring av retinerte hjørnetenner med komplisert anatomisk lokalisasjon CBCT undersøkelser bør begrenses til tilfeller der funn har betydning for og vil kunne endre behandlings­planen

A healthy woman in her 60s presented to her general dentist for a routine check-up. Examination of the oral cavity revealed a small non-pigmented tumour at the gingival margin of the right maxilla, unknown to the patient ([figure 1A][1]). The vascularised tumour measured 5×6 mm and was slightly

Purpose: Osteoradionecrosis of the jaw is a therapy-resistant condition that may occur after treatment for head and neck cancer. The aim of this study was to investigate the incidence of osteoradionecrosis in patients with oropharyngeal cancer in relation to tooth extraction prior to radiation therapy. Methods: Patients who had undergone radiation therapy for oropharyngeal cancer 5-10 years earlier were included and evaluated for the development of osteoradionecrosis (n = 75). Results: Among the 75 patients, 62 had molar teeth present in the >50 Gy radiation field and 36 of those patients had teeth extracted prior to radiation therapy. Extraction of molars before radiotherapy significantly increased the risk of developing osteoradionecrosis (P < 0.05). There were no identifiable statistically significant correlations between the time from tooth extraction and the start of radiation therapy, the number of teeth in the radiation field, smoking habits, human papillomavirus-status, gender, age or tumor location and the development of osteoradionecrosis. Conclusion: Tooth extraction prior to radiation therapy increases the risk of developing osteoradionecrosis. For patients with good oral hygiene and absence of dental disease, avoidance of tooth extraction in the radiation field could therefore reduce the risk of complications.

Hovedbudskap Mindre defekter på størrelsen med en tannrot kan tilhele spontant og kan håndteres uten kirurgisk behandling Større defekter bør lukkes ved hjelp av lokale bløtvevsplastikker Infeksjonsfrihet i sinus ved og etter lukning er viktig for å unngå ny fistel Slimhinneavsvellende nesedråper anbefales i tilhelingsfasen, eventuelt i kombinasjon med peroral antibiotikabehandling

HovedbudskapKomplikasjoner etter kjevebrudd forekommer hyppig.Infeksjoner, sensibilitetsendringer og subjektive bittforandringer er de vanligst rapporterte komplikasjonene.Brudd i tannbærende deler av underkjeven er forbundet med høy risiko for postoperativ infeksjon.

Resolvin D1 (RvD1) is a pro-resolving lipid mediator of inflammation, endogenously synthesized from omega-3 docosahexaenoic acid. The purpose of this study was to investigate the effect of RvD1 on bone regeneration using a rat calvarial defect model. Collagen 3D nanopore scaffold (COL) and Pluronic F127 hydrogel (F127) incorporated with RvD1 (RvD1-COL-F127 group) or COL and F127 (COL-F127 group) were implanted in symmetrical calvarial defects. After implantation, RvD1 was administrated subcutaneously every 7 days for 4 weeks. The rats were sacrificed at weeks 1 and 8 post-implantation. Tissue samples were analyzed by real-time reverse transcriptase-polymerase chain reaction and histology at week 1. Radiographical and histological analyses were done at week 8. At week 1, calvarial defects treated with RvD1 exhibited decreased numbers of inflammatory cells and tartrate-resistant acid phosphatase (TRAP) positive cells, greater numbers of newly formed blood vessels, upregulated gene expression of vascular endothelial growth factor and alkaline phosphatase, and downregulated gene expression of receptor activator of nuclear factor-κB ligand, interleukin-1β and tumor necrosis factor-α. At week 8, the radiographical results showed that osteoid area fraction of the RvD1-COL-F127 group was higher than that of the COL-F127 group, and histological examination exhibited enhanced osteoid formation and newly formed blood vessels in the RvD1-COL-F127 group. In conclusion, this study showed that RvD1 enhanced bone formation and vascularization in rat calvarial defects.

A 55 year-old woman presented with an invasive hemangioma of the hard palate. One year after partial surgical excision there was no sign of recurrency or oroantral fistulation. No malignant cells could be identified.

Objective. The objective of this study was to compare the outcome of surgical and conservative treatment approaches for medication-related osteonecrosis of the jaw. Study Design. Publications in Medline, The Cochrane Library, EMBASE, and PubMed (non-indexed articles) and by Health Technology Assessment organizations were searched. Quality of evidence in primary studies were assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) and the level of bias in systematic reviews by a measurement tool to assess systematic reviews (AMSTAR). Results. Quality assessment identified 3 primary studies with moderate GRADE score. Moderate risk of bias was found in 7 systematic reviews and low risk of bias in 3. Nine studies were included in the meta-analysis, where 62.1% healing was reported after surgical treatment (144 of 232 included patients) and 28.8% healing was reported after conservative treatment (38 of 132 included patients). Moderate heterogeneity was found among the included studies (P = .02). The overall odds ratio for resolution of osteonecrosis after surgical versus conservative treatment was 1.25 (95% confidence interval, 0.24-2.26) and was not statistically significant. Conclusion. Slightly better outcomes are reported after surgical treatment, in particular for advanced disease stages, but there is a lack of standardized treatment protocols and outcome measures. Overall, the quality of evidence is poor, and the majority of studies have a low evidence certainty rating and high risk of bias.

A promising alternative to current treatment options for degenerative conditions of the temporomandibular joint (TMJ) is cartilage tissue engineering, using 3D printed scaffolds and mesenchymal stem cells. Gelatin, with its inherent biocompatibility and printability has been proposed as a scaffold biomaterial, but because of its thermoreversible properties, rapid degradation and inadequate strength it must be crosslinked to be stable in physiological conditions. The aim of this study was to identify non-toxic and effective crosslinking methods intended to improve the physical properties of 3D printed gelatin scaffolds for cartilage regeneration. Dehydrothermal (DHT), ribose glycation and dual crosslinking with both DHT and ribose treatments were tested. The crosslinked scaffolds were characterized by chemical, mechanical, and physical analysis. The dual-crosslinked scaffolds had the highest degree of crosslinking and the greatest resistance to hydrolytic and enzymatic degradation. Compared to the dual-crosslinked group, the ribose-crosslinked scaffolds had thinner printed strands, larger pore surface area and higher fluid uptake. The compressive modulus values were 2 kPa for ribose, 37.6 kPa for DHT and 30.9 kPa for dual-crosslinked scaffolds. None of the crosslinking methods had cytotoxic effects on the seeded rat bone marrow-derived mesenchymal stem cells (rBMSC). After 4 and 7 d, the dual-crosslinked scaffolds exhibited better cell proliferation than the other groups. Although all scaffolds supported chondrogenic differentiation of rBMSC, dual-crosslinked scaffolds demonstrated the lowest expression of the hypertrophy-related collagen 10 gene after 21 d. The results show that 3D printed gelatin scaffolds, when dually crosslinked with ribose and DHT methods, are not toxic, promote chondrogenic differentiation of rBMSC and have potential application in tissue engineering of TMJ condylar cartilage.

Gelatin has emerged as a biocompatible polymer with high printability in scaffold-based tissue engineering. The aim of the current study was to investigate the potential of genipin-crosslinked 3D printed gelatin scaffolds for temporomandibular joint (TMJ) cartilage regeneration. Crosslinking with genipin increased the stability and mechanical properties, without any cytotoxic effects. Chondrogenic differentiation of human bone marrow-derived mesenchymal stem cells (hBMSC) on the scaffolds were compared to cell pellets and spheres. Although hBMSC seeded scaffolds showed a lower expression of chondrogenesis-related genes compared to cell pellets and spheres, they demonstrated a significantly reduced expression of collagen (COL) 10, suggesting a decreased hypertrophic tendency. After 21 days, staining with Alcian blue and immunofluorescence for SOX9 and COL1 confirmed the chondrogenic differentiation of hBMSC on genipin-crosslinked gelatin scaffolds. In summary, 3D printed gelatin-genipin scaffolds supported the viability, attachment and chondrogenic differentiation of hBMSC, thus, demonstrating potential for TMJ cartilage regeneration applications.

Total joint prostheses are a viable treatment option after removal of malignancies invading the temporomandibular joint, even when adjuvant radiation therapy is required.

Objective. In the present study, we assessed the rate of complications and morbidity after mandibular setback with bilateral intraoral vertical ramus osteotomy (IVRO). Study Design. In total, 133 patients were included. The prevalence of neurosensory disturbance (NSD), surgical site infection (SSI), and other complications were registered 2 months and 1 year after surgery. The correlations between complications and age, sex, American Society of Anesthesiologists classification, body mass index, blood loss, and operative time were evaluated. Results. NSD was reported for 6.8% of the patients (9 of 133) 2 months after surgery (3.8% of the operated sites). The prevalence was significantly higher in female patients (P < .05). Two patients described persistent unilateral reduced sensibility after 1 year (1.5%). In total, 0.8% of the operated sites (2 of 266) had persistent NSD after 1 year. None of the patients required prolonged hospitalization, and 95.5% (127 of 133) were discharged the day after surgery. None of the patients experienced severe bleeding, and only 1 patient developed SSI. There were no significant correlations between patient-specific or intraoperative parameters evaluated and registered complications. Conclusions. This study shows that IVRO is a safe surgical technique associated with a low complication rate. IVRO can be an alternative technique for mandibular setback in patients who can tolerate postoperative maxillomandibular fixation. (Oral Surg Oral Med Oral Pathol Oral Radiol 2021;131:638-642)

Injection phobia and dental anxiety can, in severe cases, lead to avoidance of necessary treatment. The aim of this pilot study was to investigate self-reported injection phobia and dental anxiety among individuals with tattoos and/or piercings. The Injection Phobia Scale-Anxiety (IPSA) short form and the Modified Dental Anxiety Scale (MDAS) questionnaires were applied. Both the total IPSA and MDAS scores were significantly higher for individuals with tattoos in comparison with a control group (P < 0.001), suggesting a need for anxiety-reducing measures and facilitated treatment for this group of patients.

AbstractAimMandibular orthognathic surgery has been considered a risk factor for developing temporomandibular dysfunction (TMD). A prospective follow‐up study was initiated to examine the correlation between two surgical techniques for mandibular advancement and setback on mandibular range of movement and temporomandibular joint symptoms.Materials and methodsThirty‐four patients who underwent mandibular orthognathic surgery were included. Twenty patients were operated with the intraoral vertical ramus osteotomy (IVRO) technique and subsequent rigid maxillomandibular fixation (MMF) for 6 weeks; 14 were operated with the bilateral sagittal split osteotomy (BSSO) with internal osteosynthesis. The patients completed a questionnaire regarding subjective symptoms and were examined 1 day before, and 1 year after surgery. Evaluations of tenderness upon muscular and articular palpation, assessment of mandibular mobility and calculation of the Helkimo index were performed.ResultsMean maximum mouth opening was reduced one year after surgery for both experimental groups. The BSSO‐group also experienced reduced laterotrusive and protrusive movements. No statistically significant differences within or between the groups were found for the Helkimo clinical dysfunction score. Both groups reported no differences in TMD‐related symptoms before and after surgery, and no differences were found between the groups.ConclusionsMaximum mandibular movement was slightly reduced for both surgical techniques. Assisted mouth opening, laterotrusive and protrusive mandibular movements were reduced after BSSO, and maximum mouth opening was reduced after IVRO. However, the differences were small and both groups were well within the normal range. None of the groups experienced changes in TMD‐related symptoms.

A healthy man in his thirties experienced a 'practical joke' during a party when some friends exchanged his alcohol-containing drinking bottle with a potassium hydroxide cleaning agent. The agent, a drain cleaner, had a pH of 14 according to the producer. The unfortunate consumer managed to spit

A 46-year-old woman with biopsy-verified pulmonal sarcoidosis presented with submucosal noduli of the lower lip ([figure 1][1]). The noduli had, according to the patient, first appeared 6 months earlier. The lip was tender to traumatic biting and varied in size. The lesion and nearby small