Faculty Bibliography

This study evaluated the effect of a bioactive ceramic coating, in the nanothickness range, onto a moderately rough surface on the osteogenic behavior of human bone cells. The cells were harvested from the mandibular mental region and were cultured over Ti-6Al-4V disks of different surfaces: as-machined (M), alumina-blasted/acid etched (AB/AE), and alumina-blasted/acid-etched + 300-500 nm thickness amorphous Ca- and P-based coating obtained by ion beam-assisted deposition (Nano). The culture was then evaluated regarding cell viability, adhesion, morphology, immunolocalization of osteopontin (OPN) and alkaline phosphatase (ALP). The results showed that the surface treatment did not interfere with cell viability. At 1 day, AB/AE and Nano showed higher adhesion than the M surface (p < 0.001). Higher adhesion was observed for the M than the Nano surface at 7 days (p < 0.005). The percentage of cells showing intracellular labeling for OPN at day 1 was significantly higher for the Nano compared to M surface (p < 0.03). The percentage of ALP intracellular labeling at 7 days was significantly higher for the AB/AE compared to the M surface (p < 0.0065); no differences were detected at 14 days. Our results suggest that the presence of a thin bioactive ceramic coating on a rough substrate did not favor the events related to in vitro osteogenesis. (c) 2010 Wiley Periodicals, Inc. J Biomed Mater Res, 2010.

OBJECTIVES/HYPOTHESIS: Compliance to intensive multiweek radiation therapy (RT) regimens in head and neck cancer (HNC) patients is challenging, particularly among medically underserved patients with fewer financial and social resources. Treatment prolongation reduces local control and overall survival rates, making adherence to treatment a key factor in optimal outcome. We evaluated factors affecting compliance in medically underserved patients who received RT for HNC in a large municipal hospital setting in New York City. STUDY DESIGN: Retrospective review. METHODS: Treatment records of patients treated between July 2004 and August 2008 were reviewed. Number of and reasons for missed treatments were identified. Several demographic, toxicity, and treatment variables were analyzed for impact on compliance. RESULTS: Eighty consecutive HNC patients who underwent RT with a 5- to 7-week regimen were identified. Thirty-two patients (40%) missed no treatments, 36 (45%) missed one to six treatments, six (8%) missed seven to 14 treatments, two (3%) missed more than 14 treatments, and four (5%) did not complete treatment. Reasons for missed treatments were hospitalization (31% of events) and toxicity (20%). Patients with percutaneous endoscopic gastrostomy tube were more likely to miss treatments (P = .01, chi(2) test). No other variable showed a significant association with missed treatments (chi(2) test). CONCLUSIONS: Intensive RT for HNC can be delivered with very good adherence within a medically underserved population. Eighty-five percent of patients completed treatment with 0 to 6 days of interruption. Efforts to further improve adherence in this population are ongoing

BACKGROUND: Precise control of the position of the midface through distraction with the rigid external distraction (RED) device has been a challenge. The present RED device with wire attachments to the intraoral dental splint and to the skeletal bone plates allows for flexibility in the vertical plane of the osteotomized Le Fort III segment. This tends to rotate the midface in a counterclockwise direction with inferior movement of the posterior nasal spine. OBJECTIVES: To report the development of a rigid distraction splint attachment to the RED device that permits precise control of the position of the midface during the latency period and through the activation and consolidation phases. METHODS: This paper describes the appliance design and the clinical application of a new device in controlling the position of the midface during distraction. Placement of the device and application of the desired force vectors are discussed. Patients treated by this modified device are illustrated to document the planned midface position after Le Fort III midface advancement. RESULTS: Examination of predistraction and postdistraction cephalograms of 2 patients treated with the new device showed advancement with minimum inferior displacement of the midface during all phases of the distraction process. CONCLUSIONS: The new device prevents undesired inferior movement of the posterior midface immediately after osteotomy and helps to stabilize the midface during the latency period. The device enables directional control of the distraction vectors, resulting in more predictable midface position at the end of treatment

PURPOSE: The objective of the present study was to evaluate the biomechanical fixation and bone-to-implant contact (BIC) of plateau root form implants of varied surfaces. MATERIALS AND METHODS: Plateau root form implants, 3.5 mm in diameter, 8 mm in length, with 4 surfaces (n = 16 each)--machined, alumina-blasted/acid-etched, alumina-blasted/acid-etched plus nanothickness bioceramic coating, and plasma-sprayed calcium-phosphate--were used. They were bilaterally placed at the distal femur of 16 New Zealand rabbits and remained in place for 2 and 4 weeks in vivo. After euthanizing the rabbits, the implants were subjected to torque to interface fracture and were subsequently processed as nondecalcified approximately 30-microm-thickness slides for histomorphologic analysis and BIC determination. Statistical analysis was performed using analysis of variance at the 95% level of significance, considering implantation time and implant surface as independent variables and the torque-to-interface fracture and BIC as dependent variables. RESULTS: The torque-to-interface fracture was significantly affected by the implant surface (P < .001) but was not affected by the implantation time (P > .20). The implantation time and implant surface had significant effects on the BIC (P < .04 and P < .001, respectively). The greatest torque-to-interface fracture and BIC was observed for the plasma-sprayed calcium-phosphate. CONCLUSION: The implant surface significantly influenced early bone healing around plateau root form implants.

PURPOSE: This report describes and evaluates the efficacy of a novel procedure, direct corneal neurotization using contralateral, supraorbital, and supratrochlear nerves in patients with unilateral facial palsy and corneal anesthesia. METHODS: The charts of 6 patients were thoroughly reviewed. Evaluated outcome parameters included corneal sensibility, improvement in best-corrected visual acuity, blink reflex, donor deficit, synesthesia, long-term corneal health, several psychosocial measures, and overall patient satisfaction. RESULTS: The mean age at time of surgery in our study was 41.7 +/- 9.07 years. Average time from denervation to surgery was 7.00 +/- 8.56 years with an average follow-up time of 16.3 +/- 2.42 years. After surgery, all 6 eyes showed improvement of corneal sensibility, visual acuity, and corneal health and remained free of ulcers without adjunctive surgical treatment. Average time to sensibility was 2.80 +/- 2.17 years, and average corneal sensibility improved from 2.00 +/- 4.47 mm before surgery to 27.8 +/- 22.6 mm after corneal neurotization (P < 0.016). CONCLUSIONS: Direct neurotization of the cornea using the contralateral, supraorbital, and supratrochlear branches of the ophthalmic division of the trigeminal nerve seems to be an effective method for restoration of corneal sensibility in patients with unilateral facial palsy and anesthetic cornea. This procedure preserves ocular anatomy and cosmesis while restoring function by improving corneal health and visual acuity and by reestablishing the blink reflex

Metallic ion release has raised concerns for the utilization of titanium and titanium alloys in implant dentistry. As an alternative, yttriastabilized tetragonal zirconia (Y-TZP) has been considered the material of choice due to its favorable biological and mechanical properties. Zirconia has been shown both in vitro and in vivo experiments to exhibit desirable osseointegration, cell metabolism, and soft tissue response. According to the mechanical testing of unaged Y-TZP onepiece implants, catastrophic failure of ceramic implants in anterior esthetic regions is unlikely. The utilization of a one-piece Y-TZP implant might be an option to fulfill the esthetic and mechanical needs in oral implant treatments when esthetics is the major concern.

Hemangiopericytoma (HPC) is a rare vascular tumor arising from contractile cells around blood vessels, with the potential for malignant degeneration. Up to 10% of HPC occurs in children. Standard therapy for this tumor is surgical excision. We report the case of a 6-month-old infant with giant HPC involving the hand. Chemotherapy resulted in a decrease in tumor size, allowing for salvage of most of the hand and fingers. Preoperative chemotherapy should be considered in the care of HPC tumors involving the upper extremity in children

Ongoing and breakthrough pain is a primary concern for the cancer patient. Although the etiology of cancer pain remains unclear, animal models of cancer pain have allowed investigators to unravel some of the cancer-induced neuropathologic processes that occur in the region of tumor growth and in the dorsal horn of the spinal cord. Within the cancer microenvironment, cancer and immune cells produce and secrete mediators that activate and sensitize primary afferent nociceptors. Pursuant to these peripheral changes, nociceptive secondary neurons in spinal cord exhibit increased spontaneous activity and enhanced responsiveness to three modes of noxious stimulation: heat, cold, and mechanical stimuli. As our understanding of the peripheral and central mechanisms that underlie cancer pain improves, targeted analgesics for the cancer patient will likely follow