International journal of oral surgery最新文献

Chronic osteomyelitis of the jaws has a varied clinical appearance and an unclear etiology. In a retrospective study based on case histories and histological material from 24 patients with chronic osteomyelitis, no specific correlation could be found between clinical symptoms and morphological changes in bone. In 10 patients, bacteria were found in certain foci such as osteocytic lacunae of necrotic bone and dentinal tubules of embedded tooth fragments. In these foci, the bacteria probably escaped the immunological response as well as the antibiotic tretment. From these foci, the bacteria might maintain an inflammatory reaction in the surrounding bone. In some patients, the mandibular canal seemed to be a pathway for the spreading of the inflammatory process.

In an experimental double blind, cross-over study in monkeys, the reactions of the periodontal tissue after periodontal ligament injection of local anaesthetic solution were investigated. Lidocaine 20 mg/ml with adrenaline 12.5 μ/ml and mepivacaine 30 mg/ml were used, and the injection times were 5 or 20 s.

Histopathological analysis showed cell damage in the tissues near the injection areas immediately after the experimental procedure. In the specimens obtained one week after the periodontal ligament injections, the tissues were found to be normal.

The cavity surface of 9 jaw cysts was studied in the scanning electron microscope. The material comprised 5 radicular, 2 residual, 1 dentigerous and 1 globulomaxillary cyst. The surface morphology varied from smooth to ruffled within the same cyst, and between cysts. Interepithelial spaces, some of which contained migrating leukocytes, were frequently observed. Bacteria occurred in 1 cyst (dentigerous) only, and included rods, filaments and spirochetes. Crystals of various morphology were seen in 6 of the cysts.

Oral submucous fibrosis is defined as a collagen disease. The major immunoglobulin profile of 10 patients of oral submucous fibrosis (OSF) is estimated by radial immunodiffusion technique. The possible existence of autoimmune phenomena is expressed. It was observed in the present study that the severity of oral submucous fibrosis was directly proportional to the estimated elevated levels of major immunoglobulins. This may be taken as an indicator to know the gravity of this oral condition and also to evaluate the various related gammopathies and their possible management. It is anticipated that the knowledge of the immunoprofile would open new avenues for exploration of the condition from a new dimension.

The incidence of autosomal dominantly inherited Van der Woude's syndrome among Finnish patients with cleft lip and palate CL(P) and with isolated cleft palate (CP) is approximately 2.5%. The incidence of conical elevation of the lower lip (CE) is 39% in CP and 0.8% in CL(P) patients. A pathogenetic similarity of sinuses and CE's was noted. The following classification was used to study associations between sinuses and CE's: (1) sinus; bilateral, unilateral, atypical; (2) CE: bilateral, unilateral; (3) median depression of the lower lip (MD); (4) combined sinus and CE; (5) combined CE and MD. According to the classification developed, a group of 77 sinus patients and 156 CE and/or MD patients was classified in subgroups of CL(P), CP, Pierre Robin anomalad (PR) and non-cleft subjects. The findings were: the sinus was bilateral on 52%, unilateral in 34% and atypical in 14%; the CE without associated sinus was bilateral in all cases; the sinus was associated with CE in 77% of all sinus subjects. The highly increased incidence of the CE in the CP (92%) and in the CL(P) (61%) sinus groups compared to the incidences of CE in these groups in general (39% and 0.8%) shows a close relationship between these 2 disorders of the lower lip, but the similarity of the genetic etiology still remains unclear.

Data covering 205 children hospitalized for fractures of facial bones in 1971–1982 are presented. In individual types of fractures affecting the lower and middle third of the face, the mechanism of injury is followed up, and the period of time elapsed from the moment of injury to admission to the clinic is registered; results of particular treatment are recorded. New methods of treatment which proved to have a positive effect in practice are described. The necessity of a complex approach to the treatment of children with injuries of the orofacial region is stressed.

A case of injury to the facial nerve as a complication to sagittal split osteotomy is reported.

The necessity of an area of attached gingiva around penetrating implants was examined in 26 patients. It was demonstrated that plaque corneal in the major factor in avoiding inflammatory reactions.

Verrucous carcinoma is a well-defined variant of the squamous cell carcinoma. Although it is reported to be rare in the Scandinavian countries, 16 cases have been diagnosed in the Southern part of Norway from 1975 to 1982. The clinical and histological characteristics were investigated. The most common site of occurrence was the mandibular alveolar ridge. The average age was 71 years, and unlike most other series of verrucous carcinoma, there was a female predominance and use of tobacco seemed to be the exception. The patients mainly complained of ill-fitting dentures. Adequate surgical excision appears to be the treatment of choice.

The validity of traditional cephalometric techniques for orthognathic surgical diagnosis and planning remains controversial. This not only reflects the fact that the linear and angular parameters combine size and shape together, but the techniques also generally rely upon non-homologous datum points, with the resultant data being of dubious mathematical significance. In order to circumvent these problems, the technique of medial (symmetric) axis transformation was used to compare mandibular shapes derived from lateral cephalographs of patients with various anomalies. This technique centers on defining the central (medial) axes of mandibular form and is based on equal weighting of points defining the peripheral border independent of cephalographic orientation. Measurement of the derived medial axes and their relative orientation described marked changes in mandibular shape resulting from pathosis and surgical intervention. However, further research is required to ascertain whether this specific technique for the description of biologic shape facilitates orthognathic surgical diagnosis and planning.