http://www.head-face-med.com The latest research articles published by Head & Face Medicine 2009-06-29T00:00:00Z This is an RSS newsfeed from BioMed Central It is intended to be used with an RSS reader. For more information about RSS newsfeeds from BioMed Central, visit http://www.biomedcentral.com/info/about/rss/ Background: The purpose of this study was to examine a human fetus with combined holoprosencephaly and cyclopia by means of histology and 3-D reconstruction to determine the structure and extent of the malformation. Methods: The head from a human fetus at 20 weeks gestation and a diagnosis of holoprosencephaly and cyclopia was investigated histologically and three-dimensionally reconstructed with CAD techniques. The cranial bones, blood vessels, nerves, eye and brain anlagen were reconstructed. Results: The 3-D reconstruction revealed both severe malformation and absence of the facial midline bones above the maxilla, and a malformation of the maxilla and sphenoid bone. The mandible, posterior cranial bones, cranial nerves and blood vessels were normal. A synophthalmic eye with two lenses was found. The prosencephalon was a single small protrusion above the diencephalon. No nasal cavity was present. Above the single eye a proboscis was found. Conclusions: The absence of the facial midline bones above the maxilla and the presence of a proboscis as a nose-like structure above the cyclopic eye both mean that there was a developmental defect in the fronto-nasal facial process of this fetus. http://www.head-face-med.com/content/5/1/14 Wolfgang Arnold Veronika Meiselbach Head & Face Medicine 2009, 5:14 2009-06-29T00:00:00Z doi:10.1186/1746-160X-5-14 Head & Face Medicine 1746-160X 5 14 2009-06-29T00:00:00Z PDF The aim of the present study was to analyze the osteogenic potential of a biphasic calcium composite material (BCC) with a negative surface charge for maxillary sinus floor augmentation. In a 61 year old patient, the BCC material was used in a bilateral sinus floor augmentation procedure. Six months postoperative, a bone sample was taken from the augmented regions before two titanium implants were inserted at each side. We analyzed bone neoformation by histology, bone density by computed tomography, and measured the activity of voltage-activated calcium currents of osteoblasts and surface charge effects. Control orthopantomograms were carried out five months after implant insertion. The BCC was biocompatible and replaced by new mineralized bone after being resorbed completely. The material demonstrated a negative surface charge (negative Zeta potential) which was found to be favorable for bone regeneration and osseointegration of dental implants. Ralf Smeets Andreas Kolk Markus Gerressen Oliver Driemel Oliver Maciejewski Benita Hermanns-Sachweh Dieter Riediger Jamal Stein Head & Face Medicine 2009, 5:13 2009-06-13T00:00:00Z doi:10.1186/1746-160X-5-13 Head & Face Medicine 1746-160X 5 13 2009-06-13T00:00:00Z PDF Several grafting materials have been used in sinus augmentation procedures including autogenous bone, demineralized freeze-dried bone (DFDBA), hydroxyapatite, β-tricalcium phosphate (β-TCP), anorganic deproteinized bovine bone and combination of these and others. Up to now a subject of controversy in maxillofacial surgery and dentistry is, what is the most appropriate graft material for sinus floor augmentation.PurposeThe aim of this study is to provide a body of evidence-based data regarding grafting materials in external sinus floor elevation concerning the fate of the augmented material at the histomorphological level, through a meta-analysis of the available literature.Materials and methodsThe literature searches were performed using the National Library of Medicine. The search covered all English and German literature from 1995 until 2006. For analyzing the amount of bone the parameter "Total Bone Volume" (TBV) was assessed. TBV is determined as the percentage of the section consisting of bone tissue. Results: In a relatively early phase after implantation the autogenous bone shows the highest TBV values. Interestingly, the different TBV levels approximate during the time. After 9 months no statistically significant differences can be detected between the various grafting materials. Conclusion: From a clinical point of view, the use of autogenous bone is advantageous if a prosthetic rehabilitation (with functional loading) is expected within 9 months. In other cases the use of anorganic deproteinized bovine bone in combination with autogenous bone seems to be preferable. Donor side morbidity is ignored in this conclusion. http://www.head-face-med.com/content/5/1/12 Jorg Handschel Melani Simonowska Christian Naujoks Rita Depprich Michelle Ommerborn Ulrich Meyer Norbert Kubler Head & Face Medicine 2009, 5:12 2009-06-11T00:00:00Z doi:10.1186/1746-160X-5-12 Head & Face Medicine 1746-160X 5 12 2009-06-11T00:00:00Z XML Background: Cleft palate craniofacial teams have evolved across the globe in the last 20 years in compliance with the interdisciplinary concept of management of oro-facial clefts. An interdisciplinary care allows a coordinated treatment protocol for the patient. The objective of this study was to evaluate oro-facial cleft care in Nigeria with particular emphasis on the compliance of the practitioners to the team approach concept. Methods: A snapshot survey was conducted among specialists that attended the Pan African Congress on Cleft Lip and Palate, at the International Institute of Tropical Agriculture, Nigeria in February 2007.ResultSixty three respondents successfully completed and returned the questionnaire for analysis. Mean age of respondents was 43.5 years and the range was 38–62 years.Male to female ratio was 2.7:1. Oral and Maxillofacial Surgeons and Plastic Surgeons constituted the majority of respondents (38.1% and 22.2%) respectively. Only 47.6% (n = 30) of the specialists belonged to cleft teams. Majority of Oral and Maxillofacial Surgeons and Plastic Surgeons belonged to cleft teams (70% and 63.3% respectively) while speech pathologists and orthodontists were less represented (20% and 36.7% respectively) in teams. Conclusion: Findings from this study suggests that interdisciplinary care for the cleft patient does not appear to have been fully embraced in Nigeria. This may be a result of several reasons ranging from non availability of the requisite specialists, the relatively young age of cleft care practice in this part of the world to the poor state of infrastructure. http://www.head-face-med.com/content/5/1/11 Victor Akinmoladun Obitade Obimakinde Head & Face Medicine 2009, 5:11 2009-05-10T00:00:00Z doi:10.1186/1746-160X-5-11 Head & Face Medicine 1746-160X 5 11 2009-05-10T00:00:00Z XML Background: The immunological response to solid tumours is insufficient. Therefore, tumour specific antigens have been explored to facilitate the activation of the immune system. The cancer/testis antigen class of MAGE-A antigens is a possible target for vaccination. Their differential expression profiles also modulate the course of the cancer disease and its response to antineoplastic drugs. Methods: The expression profiles of MAGE-A2, -A3, -A4, -A6 and -A10 in five own oral squamous cell carcinoma cell lines were characterised by rt-PCR, qrt-PCR and immunocytochemistry with a global MAGE-A antibody (57B) and compared with those of an adult keratinocyte cell line (NHEK). Results: All tumour cell lines expressed MAGE-A antigens. The antigens were expressed in groups with different preferences. The predominant antigens expressed were MAGE-A2, -A3 and -A6. MAGE-A10 was not expressed in the cell lines tested. The MAGE-A gene products detected in the adult keratinocyte cell line NHEK were used as a reference. Conclusion: MAGE-A antigens are expressed in oral squamous cell carcinomas. The expression profiles measured facilitate distinct examinations in forthcoming studies on responses to antineoplastic drugs or radiation therapy. MAGE-A antigens are still an interesting aim for immunotherapy. http://www.head-face-med.com/content/5/1/10 Urs Muller-Richter Albert Dowejko Tobias Reuther Michael Kochel Johannes Kleinheinz Torsten Reichert Oliver Driemel Alexander Kubler Head & Face Medicine 2009, 5:10 2009-04-09T00:00:00Z doi:10.1186/1746-160X-5-10 Head & Face Medicine 1746-160X 5 10 2009-04-09T00:00:00Z XML ObjectivePatients suspected of having swallowing disorders, could highly benefit from simple diagnostic screening before being referred to specialist evaluations. The article analyzes various instrumental methods of dysphagia assessment, introduces surface electromyography (sEMG) to carry out rapid assessment of such patients, and debates proposed suggestions for sEMG screening protocol in order to identify abnormal deglutition.Data sourcesSubject related books and articles from 1813 to 2007 were obtained through library search, MEDLINE (1949–2007) and EMBASE (1975–2007). Methods: Specifics steps for establishing the protocol for applying the technique for screening purposes (e.g., evaluation of specific muscles), the requirements for diagnostic sEMG equipment, the sEMG technique itself, and defining the tests suitable for assessing deglutition (e.g., saliva, normal, and excessive swallows and uninterrupted drinking of water) are presented in detail. SEMG is compared with other techniques in terms of cost, timing, involvement of radiation, etc. Results: According to the published data, SEMG of swallowing is a simple and reliable method for screening and preliminary differentiation among dysphagia and odynophagia of various origins. This noninvasive radiation-free examination has a low level of discomfort, and is simple, time-saving and inexpensive to perform. The major weakness of the method seems to be inability for precise diagnostic of neurologically induced dysphagia. Conclusion: With standardization of the technique and an established normative database, sEMG might serve as a reliable screening method for optimal patient management but cannot serve for proper investigation of neurogenic dysphagia. http://www.head-face-med.com/content/5/1/9 Michael Vaiman Ephraim Eviatar Head & Face Medicine 2009, 5:9 2009-02-20T00:00:00Z doi:10.1186/1746-160X-5-9 Head & Face Medicine 1746-160X 5 9 2009-02-20T00:00:00Z XML A rare case of aneurysmal bone cyst (ABC) located in the mandibular condyle in a 10-year-old boy is presented. The patient came to our attention for a sudden swelling in the right temporomandibular region, the mouth opening was not reduced.A rapid growing mass, depicting soft tissue invasion, in the right condyle of the mandible was found. Clinically and radiographically it resembled to a malignant lesion. The surgical excision of the mandibular condyle allowed a complete removal of the lesion. The histological examination revealed a pseudocystic expanding osteolytic lesion containing blood-filled space separated by connective tissue and many osteoclastic giant cells, which was a conventional vascular ABC.The ABC is an infrequent bone lesion which can only be found very rarely at the craniofacial skeleton. There have been described about 160 cases of ABC originated in the molar region or in upper maxilla and even more rare is the location of this cyst in the mandibular condyle. Only 6 cases were reported in the literature to date.A complete surgical resection of this osteolytic lesion is the treatment of choice considering its high recurrence rate. The condyle was not replaced with any graft. Therefore a functional device was used after surgery to overcome the lack of the condyle and to stimulate the growth of the ramus. http://www.head-face-med.com/content/5/1/8 Sandro Pelo Giulio Gasparini Roberto Boniello Alessandro Moro Pier Francesco Amoroso Head & Face Medicine 2009, 5:8 2009-02-16T00:00:00Z doi:10.1186/1746-160X-5-8 Head & Face Medicine 1746-160X 5 8 2009-02-16T00:00:00Z XML Background: Sleep bruxism has been described as a combination of different orofacial motor activities that include grinding, clenching and tapping, although accurate distribution of the activities still remains to be clarified. Methods: We developed a new system for analyzing sleep bruxism to examine the muscle activities and mandibular movement patterns during sleep bruxism. The system consisted of a 2-axis accelerometer, electroencephalography and electromyography. Nineteen healthy volunteers were recruited and screened to evaluate sleep bruxism in the sleep laboratory. Results: The new system could easily distinguish the different patterns of bruxism movement of the mandible and the body movement. Results showed that grinding (59.5%) was most common, followed by clenching (35.6%) based on relative activity to maximum voluntary contraction (%MVC), whereas tapping was only (4.9%). Conclusion: It was concluded that the tapping, clenching, and grinding movement of the mandible could be effectively differentiated by the new system and sleep bruxism was predominantly perceived as clenching and grinding, which varied between individuals. http://www.head-face-med.com/content/5/1/7 Hidehiro Yoshimi Kenichi Sasaguri Katsushi Tamaki Sadao Sato Head & Face Medicine 2009, 5:7 2009-02-11T00:00:00Z doi:10.1186/1746-160X-5-7 Head & Face Medicine 1746-160X 5 7 2009-02-11T00:00:00Z XML Background: Alterations of the binding epitopes of bone morphogenetic protein-2 (BMP-2) lead to a modified interaction with the ectodomains of BMP receptors. In the present study the biological effect of a BMP-2 double mutant with antagonistic activity was evaluated in vivo. Methods: Equine-derived collagenous carriers were loaded with recombinant human BMP-2 (rhBMP-2) in a well-known dose to provide an osteoinductive stimulus. The study was performed in a split animal design: carriers only coupled with rhBMP-2 (control) were implanted into prepared cavities of lower limb muscle of rats, specimens coupled with rhBMP-2 as well as BMP-2 double mutant were placed into the opposite limb in the same way. After 28 days the carriers were explanted, measured radiographically and characterized histologically. Results: As expected, the BMP-2 loaded implants showed a typical heterotopic bone formation. The specimens coupled with both proteins showed a significant decreased bone formation in a dose dependent manner. Conclusion: The antagonistic effect of a specific BMP-2 double mutant could be demonstrated in vivo. The dose dependent influence on heterotopic bone formation by preventing rhBMP-2 induced osteoinduction suggests a competitive receptor antagonism. http://www.head-face-med.com/content/5/1/6 Uwe Klammert Joachim Nickel Kristian Wurzler Christoph Klingelhoffer Walter Sebald Alexander Kubler Tobias Reuther Head & Face Medicine 2009, 5:6 2009-02-02T00:00:00Z doi:10.1186/1746-160X-5-6 Head & Face Medicine 1746-160X 5 6 2009-02-02T00:00:00Z XML We introduce a hypothesis which presumes that damage to the vomeronasal organ during a Le Fort I osteotomy of the maxilla for the purpose of orthognathic surgical treatment of congenital or acquired jaw deformities affects the patient's social life in terms of the selection of mates and establishment of relationships. The vomeronasal organ is chemosensory for pheromones, and thus registers unconscious olfactory information which might subsequently act on the limbic system of an individual and influence the selection of mates. We believe it is connected to an inhibitory feedback mechanism which is responsible for the exclusion of inappropriate mates. When the vomeronasal organ is removed or damaged during a maxillary osteotomy, the inhibitory function is lost, the patient loses the involuntary ability to exclude inappropriate mates, may become less committed to an existing mate, or even become promiscuous. http://www.head-face-med.com/content/5/1/5 Rene Foltan Jiri Sedy Head & Face Medicine 2009, 5:5 2009-01-22T00:00:00Z doi:10.1186/1746-160X-5-5 Head & Face Medicine 1746-160X 5 5 2009-01-22T00:00:00Z XML