Dale A Baur

Case Western Reserve University | CWRU · Department of Oral and Maxillofacial Surgery

Hurler syndrome is a rare genetic lysosomal storage disorder with a wide range of manifestations and complications ranging from musculoskeletal deformities to cardiac and corneal problems. The life expectancy of diagnosed patients does not usually exceed 10 years of age due to the associated cardiac problems. However, depending on the complication...

Bony reconstruction of the oral cavity can be performed using a variety of methods: autograft, allograft, and xenograft. Prior to selecting any grafting technique, the defect must be analyzed and the appropriate graft can be chosen by assessing maxilla vs. mandible, anatomic sub-region, amount and type of soft tissue envelope, and ultimate reconstr...

Background The aim of this review was to discuss the current and newly emerging antiresorptive medications and their potential implications for dental surgeries. Types of Studies Reviewed The authors searched PubMed (MEDLINE), Cochrane, Embase, and other electronic databases for articles related to osteonecrosis of the jaw and medication-related o...

Objective To review evidence-based recommendations for the safe perioperative management of patients undergoing endodontic microsurgery who are currently taking antiplatelet or anticoagulant medications. Using a PICO format (population, intervention, comparison, and outcome) a scientific question was asked: In patients taking anticoagulant or antip...

A porous scaffold/implant is considered a potential method to repair bone defects, but its mechanical stability and biomechanics during the repair process are not yet clear. A mandibular titanium implant was proposed and designed with layered porous structures similar to that of the bone tissue, both in structure and mechanical properties. Topology...

Background The objective of the study was to validate biomechanical characteristics of a 3D-printed, novel-designated fixation plate for treating mandibular angle fracture, and compare it with two commonly used fixation plates by finite element (FE) simulations and experimental testing. Methods A 3D virtual mandible was created from a patient’s CT...

Introduction: Body dysmorphic disorder (BDD) is an obsessive-compulsive related disorder characterized by an individual's preoccupation with the appearance of at least 1 perceived physical flaw. The bodily concerns held by individuals with BDD are largely unnoticeable, if at all, to other individuals. Those living with BDD are compelled to engage...

A case report of the 5-year treatment path of a female patient with Nemaline Rod Myopathy treated by the Department of Oral and Maxillofacial Surgery and the Department of Craniofacial Orthodontics at the Case Western Reserve University in Cleveland, Ohio is presented. Myopathic patients present with disease-specific facies that requires extensive...

Keratocystic odontogenic tumors (KCOTs) are locally aggressive odontogenic neoplasms with recurrence rates of up to 60%. Approximately 5% of KCOTs are associated with nevoid basal cell carcinoma (Gorlin) syndrome and 90% of these show genomic inactivation of the PTCH1 gene encoding Patched 1. Sporadic KCOTs reportedly have PTCH1 mutations in 30% of...

In maxillofacial surgery, there is a significant need for the design and fabrication of porous scaffolds with customizable bionic structures and mechanical properties suitable for bone tissue engineering. In this paper, we characterize the porous Ti6Al4V implant, which is one of the most promising and attractive biomedical applications due to the s...

Purpose: The purpose of this study was to evaluate a long-debated question in the field of whether the success of reconstructing mandibular defects with nonvascularized bone grafts (NVBGs) is dependent on the length of the graft. Materials and methods: The inclusion criteria were patients who had received NVBGs, such as anterior or posterior ili...

Purpose: To evaluate our surgical outcomes by comparing our surgical plan to the outcome of the surgery and evaluate our efficacy using Virtual Surgical Planning and Medical Modeling software. Our aim is to determine the quality and validity of Virtual Surgical Planning when comparing pre-surgical plans with post-surgical outcomes. Patients and Met...

Background: Our long-term goal is to design and manufacture a customized graft with porous scaffold structure for repairing large mandibular defects using topological optimization and 3D printing technology. The purpose of this study is to characterize the mechanical behavior of 3D printed anisotropic scaffolds as bone analogs by fused deposition...

Background: For large mandibular defects, surgical reconstruction using microvascular fibular grafts has advantages over other alternatives in terms of blood supply and good quality of grafted bone. However, the fibular segment is usually lower in height than that of the original mandible, meaning that the vertical positioning of the fibular graft...

Purpose: The objective of this study was to compare the accuracy of the Cavalieri's principle and 3D reconstruction in predicting the volume of a bony defect. Materials and methods: Defects of the same approximate size were created on nine artificial mandibles. The actual volume of the defect on each mandible was measured by water displacement,...

Objectives: This study aimed to evaluate and report the outcomes associated with the management of patients who were treated surgically for medication-related osteonecrosis of the jaw (MRONJ). Methods: Demographic and medical profiles of patients with a diagnosis of MRONJ were created. The type of surgical treatment, complications, and treatment...

Purpose: The aim of this study was to conduct a retrospective evaluation of the volumetric, cross-sectional surface area and the linear airway changes in healthy subjects undergoing orthognathic surgery. Materials and methods: A total of 10 patients were included in this study and categorized into two groups. The first group consisted of five pa...

The success of osseointegration is influenced by several factors that affect bone metabolism and by certain systemic medications. Selective serotonin reuptake inhibitors have been previously suggested to be among these medications. This study aims to investigate the association between systemic intake of SSRIs and failure of osseointegration in pat...

Purpose: Currently, there is a concern at the national level of the overuse of both prescription and nonprescription opioid use. The purpose of this study was to identify whether the use of the intravenous (IV) formulation of acetaminophen (Ofirmev; Mallinckrodt Pharmaceuticals, Staines-upon-Thames, United Kingdom) is an effective tool in the redu...

Objective: To investigate the stress distribution to the mandible, with and without impacted third molars (IM3s) at various orientations, resulting from a 2000-Newton impact force either from the anterior midline or from the body of the mandible. Materials and methods: A 3D mandibular virtual model from a healthy dentate patient was created and...

Background The purpose of this study was to design a customized fixation plate for mandibular angle fracture using topological optimization based on the biomechanical properties of the two conventional fixation systems, and compare the results of stress, strain and displacement distributions calculated by finite element analysis (FEA). MethodsA thr...

Background Langerhans cell histiocytosis (LCH) is a rare disorder of the reticuloendothelial system with unknown etiology. This report aims to present a case of LCH with diffuse involvement of the oral cavity and to raise awareness of the distinguishing features of this diagnostically challenging entity. Case Report A 26-year-old male patient pres...

Objectives The aim of this study is to assess the clinical relevance of the utilization of vital Lugol’s iodine staining in detection of oral cancer and dysplastic lesions as well as demarcation of the extent of these lesions. Materials and methods A prospective, cross-sectional, hospital-based study was performed in Khartoum Teaching Dental Hospit...

Background: The aim of this study was to simulate stress and strain distribution numerically on a normal mandible under physiological occlusal loadings. The results were compared with those of mandibles that had an angle fracture stabilized with different fixation designs under the same loadings. The amount of displacement at two interfragmentary...

The purpose of this study was to evaluate patient-reported outcome measures of quality of life (QoL) for patients with end-stage temporomandibular joint (TMJ) disease who have undergone TMJ prosthetic replacement. The records of 36 patients who had undergone alloplastic total joint replacement procedures were analyzed. Patients were treated using e...

There is no secret to achieving successful results with lower belpharoplasties; as is the case with any surgical procedure, proper patient evaluation and development of a comprehensive, anatomic-based treatment plan are prerequisites for success. For situations in which a patient has little lid laxity and pseudoherniated periorbital fat, transconju...

Fibrous dysplasia (FD) is a benign fibro-osseous lesion that typically behaves as a painless, slowly expanding tumor. On rare occasion, however, FD will undergo malignant transformation. When sarcomatous change occurs, osteosarcoma is the typical variant, followed by chondrosarcoma and fibrosarcoma. The incidence of malignant change varies from 1-4...

First bite syndrome (FBS) refers to intense pain in the parotid region, which coincides with the first bite of every meal, gradually subsides over the next several bites, but returns with the first bite of the next meal. The definitive diagnosis can be readily established by the characteristic onset of pain after the first bite of every meal. Pain...

Role of Virtual Surgical Planning in Increased Predictability of Orthognathic Surgery

Multiple myeloma exhibits varied clinical and radiographic presentations; therefore, awareness of suspicious oral lesions in patients with history of the disease is critical for proper diagnosis and treatment. This report illustrates a case where a patient with multiple myeloma initially presented with oral manifestations of the disease. Oral clini...

The objective of the study was to correlate different orthognathic surgical procedures with operating time and blood loss, reported from an accredited resident training institution. Ninety-five patient records were evaluated retrospectively. Individual blood volume, percent blood volume lost (BVL), and estimated blood loss (EBL) for each patient we...

Volumetric changes of the alveolar ridge after socket preservation with various techniques have been investigated frequently. However, changes in bone density and quality of bone within the extraction sockets have seldom been studied. The purpose of this study was to evaluate the bone quality of grafted versus non-grafted socket sites prior to dent...

Eagle's Syndrome (ES) refers to a symptomatic anomaly due to elongation of the styloid process or mineralization of the styloid complex. If not diagnosed timely and treated properly, elongation of the styloid process or the hyper-mineralization of the stylohyoid ligament may eventually lead to complete ossification of the stylohyoid complex. Non-sp...

The objective of this study was to retrospectively evaluate and report the associated factors with the diagnosis and management of 24 patients with chronic osteomyelitis of the mandible seen at the authors' institution during the past several years. Only cases of chronic osteomyelitis of the mandible not associated with antiresorptive medications o...

Osteonecrosis of jaws (ONJ) is a chronic disease characterized by necrotic bone from any number of causes. ONJ can also occur due to several systemic and local factors which compromise blood flow within the bone. Among anti-resorptive medications, a very low risk of ONJ development is associated with oral bisphosphonates used for the management of...

Ameloblastic carcinoma and ghost cell odontogenic carcinoma are rare malignancies arising in odontogenic epithelium within the jaws. Gardner syndrome is a multifaceted autosomal dominant condition which results in multiple dentofacial anomalies along with premalignant colon polyp formation and tumor formation of the skin and other organs. We report...

Introduction Pain and anxiety control is critical in dental practice. Moderate sedation is a useful adjunct in managing a variety of conditions that make it difficult or impossible for some people to undergo certain dental procedures. The purpose of this study was to analyze the sedation protocols used in 3 dental specialty programs at the Case Wes...

Objectives: This study evaluated halitosis in patients suffering from hepatic disease. Material and methods: Twenty-five patients (12 males and 13 females) aged between 16 and 73 years who had undergone treatment for liver disease were included in this study. Three halimeter recordings were performed to measure methyl mercarptan and hydrogen sul...

Reconstructing defects of the oral mucosa or skin of the lower one-third of the face can be accomplished by a variety of techniques. This article presents two versions of the platysma myocutaneous flap, which is a reliable, axial pattern, pedicled flap capable of providing excellent one-stage reconstruction of such defects. As discussed herein, the...

The middle meningeal artery is in close proximity to the medial aspect of the temporomandibular joint (TMJ). A major potential complication of surgery in the area of the TMJ is possible severance of the middle meningeal artery. An understanding of the relationship of the middle meningeal artery to easily identifiable landmarks lateral to the TMJ ca...

Vascular malformations have devastating cosmetic effects in addition to being associated with pain and bleeding. Sclerotherapy has been used as an effective therapeutic modality for the management of vascular malformations. The purpose of this case series is to describe our clinical experience of using sodium tetradecyl sulphate (STS) 3 % in the tr...

PURPOSE: Injury to the marginal mandibular nerve (MMN) can occur in numerous surgeries involving incisions near the inferior border of the mandible. Injury to this nerve can cause considerable cosmetic and functional deformities. A thorough knowledge and understanding of the anatomic pathway of the MMN is important to avoid permanent nerve damage....

Although needle breakage is a rare event in dentistry, the occurrence can cause significant distress to the patient and the clinician. Taking appropriate measures to prevent this mishap is best. However, when this event occurs, appropriate planning and retrieval of the needle can lessen the detrimental effects. In this report, we document the migra...

The objective of this study was to evaluate the efficacy of a novel tooth/bony-supported virtual splint design to control the maxillary vertical, rotational, and anteroposterior intraoperative movements. A tooth/bone-borne splint was designed to position the osteotomized maxilla intraoperatively. Lateral cephalometric radiographs were obtained 1 we...

Acute dislocation of the temporomandibular joint (TMJ) is a relatively common occurrence; chronic long-term dislocation is rare. Variance in the duration of dislocation and anatomical considerations make the treatment for long-standing dislocation complex and controversial. This paper attempts to review the literature associated with chronic TMJ di...

An 18-year-old man with a noncontributory medical history presented with a soft tissue mass in the floor of the mouth that interfered with feeding and speech. The mass had developed gradually during the past few years. A history of trauma was denied. No bruit could be heard on auscultation or surrounding the mass. Three weeks after an incisional bi...

Background Injury to the marginal mandibular nerve (MMN) can occur in numerous surgeries involving incisions near the inferior border of the mandible. Injury to this nerve can cause both significant cosmetic and functional deformities. A thorough knowledge and understanding of the anatomical pathway of the MMN is important in order to avoid permane...

Arterial pseudoaneurysms are rare in oral and maxillofacial surgery, but when they occur, quick recognition and management is necessary to avoid devastating consequences. The authors report a case of a pseudoaneurysm of the external carotid artery that developed after open reduction and internal fixation of a mandibular condyle fracture.

The purpose of this study was to determine the utility of cone beam computed tomographic (CBCT) imaging in assessing the volume of alveolar cleft defects in patients undergoing secondary cleft repair. Fourteen patients with unilateral clefts were analyzed in a retrospective study. Preoperative CBCT imaging of patients preparing to undergo secondary...

Intraoperative identification of the facial nerve is an essential component of parotid gland surgery. Failure to visualize the facial nerve during the procedure can result in significant complications such as facial palsy. Several anatomic landmarks are used clinically to identify the facial nerve trunk; however, most of these structures have varia...

The purpose of this case report is to present cephalometric changes in the craniofacial region and volumetric changes in the oropharyngeal region of a patient diagnosed with obstructive sleep apnea syndrome after maxillomandibular advancement and genial tubercle advancement surgeries. Cone beam computed tomographic images were used to evaluate ceph...

Tracheotomy is a surgical procedure that dates back to early history and medical advancement. The oral and maxillofacial surgeon routinely operates around the airway and should be able to master this procedure by adhering to the surgical principles outlined in this article.

To establish a rat mandibular fracture model and investigate the short- and long-term effects of recombinant parathyroid hormone (PTH 1-34) on mandibular fracture healing in rats. A controlled unilateral mandibular fracture was created surgically in 29 male Sprague-Dawley rats and then stabilized using an external fixation device. The rats were div...

Teeth, periodontium, and supporting alveolar bone are frequently involved in trauma and account for approximately 15% of all emergency room visits. The cause of the dentoalveolar trauma varies in different demographics but generally results from falls, playground accidents, domestic violence, bicycle accidents, motor vehicle accidents, assaults, al...

Distal ischemic necrosis of surgical flaps remains a challenging problem for the reconstructive surgeon. Recent studies have shown that either sildenafil or vascular endothelium growth factor (VEGF) treatment significantly improves ischemic skin flap viability. In this study, the effect of the combination of sildenafil and VEGF165 was evaluated on...

Piercing of various parts of the body has gained tremendous popularity among adolescent and adult populations in recent years. There are no exact statistical reports on the number of body piercings being performed in the United States. One study among 481 college students in New York revealed that 42% of men and 60% of women had body piercing. In t...

Distal ischemic necrosis of the flap remains an unsolved, challenging problem. Phosphodiesterase (PDE) inhibitors, which include the drug sildenafil, are a relatively new class of U.S. Food and Drug Administration-approved medications whose effect on tissue viability has not been widely explored. The vasodilatory effects of these drugs have the pot...

The purpose of this study was to evaluate the effect of hyperbaric oxygen therapy on bone regeneration during distraction of irradiated rabbit mandibles. Twenty New Zealand white rabbits were randomly sub-divided into 4 groups. Group 1 served as control, group 2 received preoperative radiation therapy, group 3 received pre- and postoperative hyperb...

Nuclear medicine studies often play a significant role in the diagnosis and treatment of oral and maxillofacial diseases. While not commonly used in everyday dental practice, the dental provider should have a conversational knowledge of these imaging modalities and understand the indications and limitations of these studies. The purpose of this rev...

The midfacial degloving approach has been used as a surgical approach to gain access to regions of the midface that would otherwise require external incisions. This article describes the role of this technique for various maxillary lesions. Thirteen patients underwent the midfacial degloving technique for 8 maxillary benign lesions and 5 malignant...

Reconstructing extirpative defects of the oral cavity or face frequently presents a significant challenge to the surgeon. This article discusses two versions of the platysma myocutaneous flap that have proved to be reliable and versatile methods for reconstructing defects of the oral cavity, lower face, and ear. The advantages of these regional axi...