Veerasathpurush Allareddy

The costochondral graft (CCG) is a well-established reconstruction modality for the temporomandibular joint (TMJ), particularly for the growing patient. Donor site complications such as pneumothorax have been reported, but only in isolated reports or small case series or single-center studies, precluding understanding of the true risks. This retrospective cross-sectional study used the National Inpatient Sample database, a large-scale database of hospitalizations in the United States, for the years 2020 to 2022, to calculate the estimated nationally representative frequency of thoracic complications in the United States. Between 2020 and 2022, there were 235 weighted hospitalizations related to CCG (57.4% female; mean age: 16.9 y). The mean hospital length of stay and hospital charges were 11.5 days and $177,235 (2022 US dollars), respectively. There were 15 weighted hospitalizations with thoracic complications, with a weighted frequency of 6.4%. Within the limitations of the analysis of a 3-year nationally representative sample, the estimated frequency of thoracic complications in the United States was nontrivial, at 6.4%. Knowledge of the risk can guide the clinician during clinical decision-making, from consideration of viable alternatives to implementing risk mitigation strategies.

Introduction: Pediatric traumatic dental injuries are serious conditions that require extensive care for the best emotional and physical outcomes. The purpose of this study is to provide updated national estimates on traumatic dental injuries in the pediatric population presenting to hospital‐based emergency department (ED) during the years 2021–2022. Methods: This study utilized the Nationwide Emergency Department database (NEDS) for the years 2021 and 2022. All ED visits with a diagnosis (primary or secondary) of traumatic dental injuries were included. Nationally representative estimates were computed. Results: There were 64,631 ED visits attributed to traumatic dental injuries in the pediatric population in the years 2021 and 2022. The majority were male (60.8%) and the predominant ethnicity white (46.0%). The most common external cause of injuries were falls (36.4%) with the most frequent age group being 2 years old (9.9%). The mean hospital ED charge per visit was $3988 (SE 192.86) and the total hospital ED charges across the entire United States was $252,287,648 during this time period. Conclusions: The study found that hospital ED charges have increased compared to past years. The frequency of traumatic dental injuries present in the ED for the pediatric population has remained high. It is important to highlight the use of the ED for these injuries since the ED provides less comprehensive care at a higher cost.

Background: Oral appliance therapy (OAT) is a widely used treatment for obstructive sleep apnea; however, titration approaches remain variable and lack standardization across clinical practice. Existing evidence is largely derived from academic or specialty sleep centers, with limited data on how titration strategies are implemented and perform in real-world dental settings. Objective: This study aims to evaluate real-world titration approaches for OAT within a dental practice-based research network and to assess their impact on treatment effectiveness and patient-centered outcomes. Methods: This prospective, multisite, observational feasibility study will enroll approximately 60 adult patients with physician-diagnosed obstructive sleep apnea receiving OAT from 10 dental practitioners within the South Texas Oral Health Network, with each practitioner enrolling up to 6 patients. Practitioners will apply either standard signs-and-symptoms–based titration or enhanced multimethod positioning titration, as per their usual clinical practice. Clinical, dental, and titration characteristics will be collected at baseline and follow-up visits over an approximately 8-week titration period. The primary outcome is mean disease alleviation, calculated as the product of physiologic efficacy (change in apnea–hypopnea index derived from multinight home sleep apnea testing) and objective adherence (hours of nightly oral appliance use captured via an embedded compliance tracker). Secondary outcomes include daytime sleepiness, sleep-related quality of life, patient satisfaction, oral appliance–related side effects, and bruxism. Descriptive analyses and generalized estimating equation models will be used to account for clustering of patients within practitioners. Results: The study was funded on June 17, 2025, and received Institutional Review Board approval from the University of Texas Health Science Center at San Antonio as the single reviewing Institutional Review Board (STUDY00001750), with site-specific approval obtained from the University of Illinois Chicago (SITE00000057). Study start-up activities, including development of data systems and coordination with device vendors, were completed between September and December 2025. Practitioner training was conducted between December 2025 and February 2026. As of March 2026, 7 dentists have been enrolled and have initiated patient recruitment. Participant recruitment began in late 2025 and is projected to continue through January 2027. Data analysis is anticipated in 2027, with study findings expected to be disseminated thereafter. Conclusions: This study will generate preliminary, real-world evidence on oral appliance titration strategies and their relationship to treatment effectiveness and patient outcomes in community dental practices. Findings will inform the design of future interventional trials and support the development of evidence-based guidance for OAT titration.