Faculty Bibliography

One of the enduring lessons of cities is the essential relationship between grey infrastructure (e.g., streets and buildings) and green infrastructure (e.g., parks and open spaces). The design and management of natural resources to enhance human health and well-being may be traced back thousands of years to the earliest urban civilizations. From the irrigation projects of the Indus Valley and the aqueducts of the Roman Empire to integrated systems of landscaped urban parks and street trees in contemporary times, humans have sought to harness the capacity of nature to advance city life. This article presents a systems science framework that delineates critical relationships between grey and green elements of cities and human health and well-being by modeling the complex, dynamic problem of asthma in socioeconomically disadvantaged city neighborhoods. By understanding the underlying structure of urban spaces and the importance of social interactions, urban planners, public health officials, and community members may capitalize on opportunities to leverage resources to improve the health and well-being of urban populations and promote social justice and health equity

Purpose: The purpose of this study was to test the hypothesis that all-ceramic crown core-veneer system reliability is improved by modifying the core design and as a result is comparable in reliability to metal-ceramic retainers (MCR). Finite element analysis (FEA) was performed to verify maximum principal stress distribution in the systems. Materials and Methods: A first lower molar full crown preparation was modeled by reducing the height of proximal walls by 1.5 mm and occlusal surface by 2.0 mm. The CAD-based preparation was replicated and positioned in a dental articulator for specimen fabrication. Conventional (0.5 mm uniform thickness) and modified (2.5 mm height, 1 mm thickness at the lingual extending to proximals) zirconia (Y-TZP) core designs were produced with 1.5 mm veneer porcelain. MCR controls were fabricated following conventional design. All crowns were resin cemented to 30-day aged composite dies, aged 14 days in water and either single-loaded to failure or step-stress fatigue tested. The loads were positioned either on the mesiobuccal or mesiolingual cusp (n = 21 for each ceramic system and cusp). Probability Weibull and use level probability curves were calculated. Crack evolution was followed, and postmortem specimens were analyzed and compared to clinical failures. Results: Compared to conventional and MCRs, increased levels of stress were observed in the core region for the modified Y-TZP core design. The reliability was higher in the Y-TZP-lingual-modified group at 100,000 cycles and 200 N, but not significantly different from the MCR-mesiolingual group. The MCR-distobuccal group showed the highest reliability. Fracture modes for Y-TZP groups were veneer chipping not exposing the core for the conventional design groups, and exposing the veneer-core interface for the modified group. MCR fractures were mostly chipping combined with metal coping exposure. Conclusions: FEA showed higher levels of stress for both Y-TZP core designs and veneer layers compared to MCR. Core design modification resulted in fatigue reliability response of Y-TZP comparable to MCR at 100,000 cycles and 200 N. Fracture modes observed matched with clinical scenarios.

Approximately half of head and neck carcinomas arise from the oral cavity. Imaging plays an essential role in the preoperative evaluation of oral cavity carcinomas. MR imaging is particularly advantageous in the evaluation of the oral cavity, with better depiction of the anatomy in this region and reduction of dental artifacts compared with CT. MR is also the preferred imaging modality for the evaluation of bone marrow invasion and perineural tumor spread, which are findings critical for treatment planning. Advanced MR imaging techniques may potentially better delineate true tumor extent, determine lymph node metastases, and predict treatment response.

Bone repair and regeneration is a dynamic process that involves a complex interplay between the (1) ground substance; (2) cells; and (3) milieu. Each constituent is integral to the final product, but it is often helpful to consider each component individually. While bone tissue engineering has capitalized on a number of breakthrough technologies, one of the most valued advancements is the incorporation of mesenchymal stem cells (SCs) into bone tissue engineering applications. With this new idea, however, came new found problems of guiding SC differentiation. Moreover, investigators are still working to understand which SCs source produces optimal bone formation in vitro and in vivo. Bone marrow-derived mesenchymal SCs and adipose-derived SCs have been researched most extensively, but other SC sources, including dental pulp, blood, umbilical cord blood, epithelial cells reprogrammed to become induced pluripotent SCs, among others, are being investigated. In Part II of this review series, we discuss the variety of cell types (e.g., osteocytes, osteoblasts, osteoclasts, chondrocytes, mesenchymal SCs, and vasculogenic cells) important in bone tissue engineering.

Bone repair and regeneration is a dynamic process that involves a complex interplay between the (1) ground substance, (2) cells, and (3) milieu. While each constituent is integral to the final product, it is often helpful to consider each component individually. Therefore, we created a two-part review to examine scaffolds and cells' roles in bone tissue engineering. In Part I, we review the myriad of materials use for in vivo bone engineering. In Part II, we discuss the variety cell types (e.g., osteocytes, osteoblasts, osteoclasts, chondrocytes, mesenchymal stem cells, and vasculogenic cells) that are seeded upon or recruited to these scaffolds. In Part III, we discuss the optimization of the microenvironment. The biochemical processes and sequence of events that guide matrix production, cellular activation, and ossification are vital to developing successful bone tissue engineering strategies and are thus succinctly reviewed herein.

Repair of full thickness defects in the lower eyelid following extirpation of malignant tumors presents a challenge to the reconstructive surgeon. There are several techniques to choose from, depending on the defect's size and location.

Synkinetic movements comprise abnormal involuntary contractions of one or more facial muscle groups which follow the desired contraction of another facial muscle group. They are frequently encountered in patients with long standing facial paralysis and seriously affect their psychological status due to the impairment of their facial appearance, function and emotional expressivity. PATIENTS AND METHODS: Eleven pediatric patients (2 male and 9 female) presenting with post-facial paralysis synkinesis were included in the study. Mean age was 10.3 +/- 4 years and mean denervation time 72.5 months. RESULTS: Patients underwent the following types of treatment: - Cross facial nerve grafting (CFNG) and secondary microcoaptations with botulinum toxin injection which had an improvement of 100% (3 in the 3 grade synkinesis scale) (n = 2). - Cross facial nerve grafting (CFNG) and secondary microcoaptations without botulinum toxin injection which had an improvement of 66%(2 in the 3 grade synkinesis scale) (n = 5). - CFNG and direct muscle neurotization with (n = 2) or without (n = 1) botulinum toxin injection where the improvement was 33%. - Contralateral nasalis muscle myectomy was performed in one patient along with CFNG and secondary microcoaptations which resulted in 66% synkinesis improvement. Biofeedback was invariably undertaken by all patients. Postoperative improvement in eye closure and smile was also noted in the respective cases treated for synkinesis ranging from 25 to 50%, with all patients achieving optimum functional return. CONCLUSION: CFNG with secondary microcoaptations and botulinum toxin injections was found to be a very efficient surgical modality addressing post-facial palsy synkinesis with high improvement in facial function and symmetry. Facial neuromuscular re-education contributes considerably in the treatment.