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Purpose: The purpose of this clinical study was to evaluate the sensitivity and specificity of cervical sentinel lymph node biopsy after mapping with indocyanine green fluorescence (ICG) for imaging early-stage oral cancer., Patients and Methods: A sentinel lymph node biopsy (SLNB) was performed during a selective neck dissection (SND) in 20 patients with oral squamous cell carcinoma (OSCC, cT1 or cT2, N0 status). The sentinel lymph nodes (SLN) were identified using an infrared video camera after ICG injection. Lymph nodes were examined histologically. The endpoint of this study was to investigate the rate of false-negative results in SLNB., Results: Sentinel lymph nodes could be detected after 8.1 min (range 1-22 min). In eight out of 20 cases, lymph node metastases were found during histopathological evaluation of the neck dissection specimen. In four cases a metastasis could be found in the detected SLN (sensitivity 50%). In the other four cases metastases were found in different lymph nodes. Specificity was 100%, positive predictive value 100%, and negative predictive value 75%., Conclusion: In this study, reliability of sentinel lymph node biopsy after ICG imaging could not be verified, as there were false-negative results in 50% of the cases. Therefore, SND can still be recommended as for patients with cT1 or cT2 OSCC, and a N0 neck status., (Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Background: CAD/CAM reconstruction plates have become a viable option for mandible reconstruction. The aim of this study was to determine whether CAD/CAM plates provide higher fatigue strength compared with conventional fixation systems., Material and Methods: 1.0 mm miniplates, 2.0 mm conventional locking plates (DePuy Synthes, Umkirch, Germany), and 2.0 mm CAD/CAM plates (Materialise, Leuven, Belgium/DePuy Synthes) were used to reconstruct a polyurethane mandible model (Synbone, Malans, CH) with cortical and cancellous bone equivalents. Mastication was simulated via cyclic dynamic testing using a universal testing machine (MTS, Bionix, Eden Prairie, MN, USA) until material failure reached a rate of 1 Hz with increasing loads on the left side., Results: No significant difference was found between the groups until a load of 300 N. At higher loads, vertical displacement differed increasingly, with a poorer performance of miniplates (p = 0.04). Plate breakage occurred in miniplates and conventional locking plates. Screw breakage was recorded as the primary failure mechanism in CAD/CAM plates. Stiffness was significantly higher with the CAD/CAM plates (p = 0.04)., Conclusion: CAD/CAM plates and reconstruction plates provide higher fatigue strength than miniplates, and stiffness is highest in CAD/CAM systems. All tested fixation methods seem sufficiently stable for mandible reconstruction., (Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)