The treatment of large bone defects still poses a major challenge in orthopaedic and craniomaxillofacial surgery. One possible solution could be the development of personalized porous titaniumbased implants that are designed to meet all mechanical needs with a minimum amount of titanium and maximum osteopromotive properties so that it could be combined with growth factor-loaded hydrogels or cell constructs to realize advanced bone tissue engineering strategies. Such implants could prove useful for mandibular reconstruction, spinal fusion, the treatment of extended long bone defects, or to fill in gaps created on autograft harvesting. The aim of this study was to determine the mechanical properties and potential of bone formation of light weight implants generated by selective laser melting (SLM). We mainly focused on osteoconduction, as this is a key feature in bone healing and could serve as a backup for osteoinduction and cell transplantation strategies. To that end, defined implants were produced by SLM, and their surfaces were left untreated, sandblasted, or sandblasted/acid etched. In vivo bone formation with the different implants was tested throughout calvarial defects in rabbits and compared with untreated defects. Analysis by micro computed tomography (CT) and histomorphometry revealed that all generatively produced porous Ti structures were well osseointegrated into the surrounding bone. The histomorphometric analysis revealed that bone formation was significantly increased in all implanttreated groups compared with untreated defects and significantly increased in sand blasted implants compared with untreated ones. Bone bridging was significantly increased in sand blasted acid-etched scaffolds. Therefore, scaffolds manufactured by SLM should be surface treated. Bone augmentation beyond the original bone margins was only seen in implant-treated defects, indicating an osteoconductive potential of the implants that could be utilized clinically for bone augmentation purposes. Therefore, designed porous, lightweight structures have potential for bone regeneration and augmentation purposes, especially when complex and patient-specific geometries are essential. This article has been peer-reviewed and accepted for publication, but has yet to undergo copyediting and proof correction. The final published version may differ from this proof. 2 AbstractThe treatment of large bone defects still poses a major challenge in orthopaedic and cranio-maxillofacial surgery. One possible solution could be the development of personalized porous titanium-based implants designed to meet all mechanical needs with a minimum amount of titanium and maximum osteopromotive properties so that it could be combined with growth factor loaded hydrogels or cell constructs to realize advanced bone tissue engineering strategies. Such implants could prove useful for mandibular reconstruction, spinal fusion, the treatment of extended long bone defects, or to fill in gaps created upon autograft harvesting. The aim of this study was t...

BackgroundSentinel lymph node (SLN) detection and biopsy is gaining popularity in the treatment of Head and Neck cancer. Various methods in this regard have been described, each with their respective advantages and disadvantages. The aim of this paper was to evaluate the potential application of Indocyanin Green (ICG) in the mapping and detection of sentinel lymph nodes (SLN) in cancers of the head and neck.MethodsPatients with oropharyngeal cancer and N0 neck who were scheduled for primary tumor ablation as well as a neck dissection were selected. One milliliter of Indocyanin green was injected around the tumor and the sentinel node detection was performed by aiming the infra red video camera on the cervical area. When no detection was possible transcutaneously, a cervical incision was made, a sub-platysmal flap raised and further detection was done to visualize the fluorescing lymph nodes.ResultsDetection of cervical SLN was only possible when 5 mm or less tissue covered the sentinel lymph node. Accurate and clear detection of the lymph drainage pattern and SLN was possible. There is some uptake in other tissues such as the submandibular gland which is easily distinguishable from lymphatic tissue.ConclusionIndocyanin green fluorescence is a potential valuable potential tool in the detection of SLN in patients with oropharyngeal cancer which warrants further investigation.

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Fibrous dysplasia is a rare bone disease caused by an abnormal proliferation of fibrous tissue in bone. We retrospectively evaluated eight patients (female to male ratio 3:1, mean age 22.5 years, range 10-32) with a monostotic form who were treated between 1996 and 2006. Two each were affected in the lower jaw, the upper jaw, the midface, and the frontoparietal region. Most patients were referred because of a painless swelling. Biopsy specimens from two patients were examined, six patients had modelling osteotomies, two of whom had further operations because of progressive enlargement. There was no visual impairment or malignant transformation. Fibrous dysplasia should be treated as conservatively as possible, but in cases of functional disturbance that results from malignant transformation, or from the involvement of the optic foramen or the foramen magnum, an immediate operation is needed. Disfigurement can be another reason for operation. When there is a risk of malignant transformation, follow-up of patients is recommended. AbstractFibrous dysplasia is a rare bone disease caused by an abnormal proliferation of fibrous tissue in bone.We retrospectively evaluated eight patients (female-male ratio: 3:1, mean age 22,5 years, range 10-32) with a monostotic form who were treated between 1996 -2006 Two each were affected in the lower jaw, the upper jaw, the midface, and the frontoparietal region.Most patients were referred because of a painless swelling. Biopsy specimens from two patients were examined six patients had modeling osteotomies, two of whom had further operations because of progressive enlargement. There was no visual impairment or malignant transformation.Fibrous dysplasia should be treated as conservatively as possible, but in cases of functional disturbance results from malignant transformation, or from the involvement of the optic foramen or the foramen magnum, an immediate operation is needed.Disfigurement can be another reason for operation.When there is a risk of malignant transformation, follow-up of patients is recommended.2

IntroductionOf the many different factors associated with an increased risk for oral squamous cell carcinoma (SCC), tobacco and alcohol seem to be the most studied. The aim of the current study was to evaluate the clinicopathologic characteristics of patients without the mentioned risk factors.Patients and MethodsOut of 278 patients (159 male and 119 female patients) with oral SCC, 67 patients had no history of tobacco or alcohol use. The minimum follow-up time was 12 months.ResultsOf the 67 patients, 45 (67.2%) were women, and the mean age was 70 years. The most common tumor sites were mandibular alveolar ridge (22) and maxilla (18). Fifteen patients experienced a recurrence, and 10 developed lymph node metastases during the follow-up period.ConclusionThe group of patients with no tobacco and alcohol use tends toward a higher proportion of females, a higher proportion of patients over 70 years, and a higher number of oral maxillary SCC.