The Jaws Are Different The Most Unique Bones in the Human Skeleton © Photo: Michel Manomivibul, used with artist’s permission Start of Discussion Dedication Resources Copyright Dr. Bouquot

Dr. Bouquot, Bisphosphonate ONJ Special Thanks and Prayers to the Men and Women Who Sacrifice to Keep Us Free Cheat Lake Cheat Lake Cheat Canyon Cooper’s Rock Col. Jeff Swisher, from Morgantown, West Virginia

Dr. Bouquot, Soft Tissue Tumors January, 2009 Lectures By Bouquot © Dr. J.E. Bouquot, Morgantown, WV © Copyright Notice Lecture Aids/Handouts This presentation is, essentially, the modern version of a handout. It is intended for participants attending lectures/courses given by the author. Designated owners of the photographic images retain the copyrights for those images. You are welcome to use this presentation for your own study or study with other health professionals. However, permission is NOT given for the publication of these photos in electronic or any other format for profit or for public viewing. Note: Dr. Bouquot is affiliated with West Virginia University & the University of Texas. While every attempt has been made to be accurate, the information and ideas in this presentation are not necessarily the views of these institutions.

Dr. Bouquot, Oral Cancer, Precancer Jerry Bouquot, DDS, MSD, DABOMP, FAAOMP, FICD, FACD, FADI, FRSM Director of Research, The Maxillofacial Center for Education & Research Adjunct Professor & Past Chair, West Virginia University & University of Texas, Houston 1,650+ talks in 50 states and 27+ countries 320+ publications, with 6,000+ citations Born & raised: St. Paul, Minnesota (just another Minnesota Swede) St. Olaf College, Minnesota (BA, psychology, biology) University of Minnesota (DDS, MSD in oral pathology) Mayo Clinic: Bone Pathology Fellowship Royal College of Dent., Copenhagen, Denmark: Oral Path Fellowship Chair (18 yrs), Oral & Maxillofacial Pathology, WVU Chair (8 yrs), Diagnostic & Biomedical Sciences, University of Texas Senior Visiting Scientist, Mayo Clinic, Rochester, Minnesota Dental Director, West Virginia Bureau for Public Health Consultant, Pittsburgh Children’s Hospital; NY Eye and Ear Infirmary Osteonecrosis Scientific Advisory Board, Novartis Pharmaceuticals Board of Directors (national), American Cancer Society Executive Council, Amer. Academy of Oral & Maxillofacial Pathology President, American Board of Oral & Maxillofacial. Pathology President, Eastern Society of Teachers of Oral Pathology President, Western Society of Teachers of Oral Pathology President, Organization of Teachers of Oral Diagnosis President (6 times), American Cancer Society, West Virginia Division Career Development Award, American Cancer Society Outstanding Teacher Award, West Virginia University (8 times) Heebink Award for Service to Humanity, West Virginia University Scholar’s Walk (Two bronze plaques), West Virginia University St. George National Award, American Cancer Society W. Robert Biddington Distinguished Lecturer, West Virginia University Robert B. Bridgeman Distinguished Dentist Award, WV Dental Assoc. Arkansas Traveler Award, from Governor of Arkansas Fleming & Davenport Award for Original Research, University of Texas Distinguished Alumnus Award, University of Minnesota Pioneering Teaching & Research Award, University of Texas Gorlin Visiting Professor, University of Minnesota Honorary Life Member, International Association of Oral Pathologists 2004 1980 1973

Dr. Bouquot, Oral Cancer, Precancer Part 1 of 3 For More Information: The Neville Book Used in almost all U.S. dental schools; one of most popular books in dentistry, 1,350+ pictures (in color), published by Elsevier Authors: Brad Neville (Medical University of South Carolina) Douglas Damm (University of Kentucky) Carl Allen (Ohio State University) Jerry Bouquot (Maxillofacial Center, West Virginia) 1995 – 1st edition 2002 – 2nd edition 2008 – 3rd edition 2016 – 4th edition (available in 2015) (Bouquot not an author) Most popular oral pathology textbook in history

In the BouquotToGo Dropbox Folder The BouquotToGo Files In the BouquotToGo Dropbox Folder Part 2 of 3 A collection of >100 Power Point presentations with >3,600 copyright-free photos, mostly clinical, of oral lesions. This collection was first made available in 1995 and has been continuously updated and added to since then. Representative presentations: The 53 Most Common Oral Lesions (a clinical atlas of >500 photos The Must Know Oral Lesions (a differential diagnosis aid; > 500 photos) Troubled Bones (Inflammatory & ischemic bone disorders; >1,100 photos The Jaws are Different (discussion of why the jaws are the most unique of all human bones) The CD Johnson Collection (oral lesions found in an Urgent Care Clinic; >500 photos) Cone beam CT Diagnosis If links don’t work: email a request to bouquot@aol.Com Dropbox link to BouquotToGo folder: Https://www.Dropbox.Com/sh/umu7o3jce1p5vz6/aabhfyrerju165xbu1ykudzta?Dl=0

in a major way, as one of Dr. Bouquot’s Part 1 of 3 Oralpath.com/maxillofacialcenter.com The most popular Oral Pathology websites www.oralpath.com (2,700,000 hits in 2010; started: 1998) Note: These have not been touched since 2004! They are presently being improved and updated in a major way, as one of Dr. Bouquot’s retirement hobby www.maxillofacialcenter.com (3,676,000 hits in 2010; started 1997)

Dr. Bouquot, The Abused Mouth University of Texas, Houston, 2010 Dedicated to Two Exceptional Individuals This Seminar is dedicated to Dr. Bouquot’s mentors: Dr. Robert Gorlin, Minneapolis, Minnesota (right), Dr. Jens Pindborg, Copenhagen, Denmark (left), premier experts in teaching, clinical research, and the diagnostic arts

The Jaws Are Different They are the Most Unique Bones in the An MFCenter Moment The Jaws Are Different They are the Most Unique Bones in the Human Skeleton The Jaw Law: The jaws have a greater number and a greater variety of diseases than all other bones of the human skeleton combined © Photo: Painting by Michel Manomivibul, used with permission J. E. Bouquot, DDS, MSD, FAAOMP, FICD, FACD,FADI, FRCM (UK) Director of Research, The MFCenter for Education & Research, Morgantown, WV Adjunct Professor & Past Chair, University of Texas, Houston Adjunct Professor & Past Chair, West Virginia University, Morgantown, WV

The jawbones are vital We live in a world of aesthetics, right? What would you look like without the facial bones?

The Jaws are different 19 unique features Ameloblastic fibroma Bisphosphonate related osteonecrosis Periapical infection Intraosseous salivary hamartoma Fractured mandible Periodontal infection 1. More tumors & cysts than all other bones combined 3. More infections than all other bones combined 4. More trauma than all other bones combined 2. Only bones with epithelium (odontogenic & salivary) 5. More exposed bone than

The Jaws are different 19 unique features 7. More implants than all other bones combined 8. Closer to surface than any other bones 6. More radiation than any other bones 9. The only bones with “stuff” placed next to them 10. The only bones routinely getting vasoconstrictors Osteoradionecrosis Cocaine osteonecrosis Smokeless tobacco keratosis Dental implants Local anesthesia with vasoconstrictor

The Jaws are different 19 unique features cli The Jaws are different 19 unique features 12. Faster turnover than any other bones (10-20x faster) 14. More focal osteoporosis than any other bones 11. More cortical “bumps” than all other bones combined 13. The only bones with central fibrous scar tissue Buccal exostoses Torus mandibularis Focal osteoporotic marrow defect Periapical scar New bone formation around PA granuloma Intramedullary fibrous scar 15. The bones most likely to contain infection walled off by constantly recreated new bone

The Jaws are different #17 = the most unique thing of all 17. The only bones with large sensory nerves 16. The only bones with lymphatics 18. with teeth/open covering 19. More internal voids than any other bones Trigeminal Nerve Gasserian Ganglion Location of 85%+ of all neuralgias Brain uses 40% of its sensory input activity interpreting signals from trigeminal nerve Ischemic bone cavitation in dried mandible

Nasal and Paranasal Sinuses They are awfully close to jawbones Ethmoid Frontal Nasal Maxillary Odd fact: Local infection within 30 days before a stroke has been found in 2 studies to be the #1 risk factor for stroke; 80% of the infections are oral/sinuses - How? Hypercoagulation states? Direct bacterial metastasis? Periapical infections can spread to sinus lining Odd fact: A small % of us have roots sticking into sinuses, sometimes with bare roots Sinusitis can affect underlying sinus wall Corticosteroid-induced osteonecrosis can result from asthma nasal sprays

J. E. Bouquot and J. E. Bouquot 1973 Dr. Bouquot: Cell injury and death J. E. Bouquot and J. E. Bouquot 1973