International journal of oral surgery最新文献

Temporomandibular joint sounds have been viewed as signs of different pathological changes. However, the correlation between joint sounds on the one hand and function and morphology of the joint on the other, are not well documented. We have therefore presurgically recorded sound from 35 operated joints with disc displacement and have studied arthrographically and during surgery the position, function and configuration of the disc as well as arthrotic changes. 12 joints were silent, 12 elicited reciprocal clicking, 3 single clicking, and 8 crepitation. Joints with reciprocal clicking consistently showed disc displacement with reduction and silent and crepitating joints showed disc displacement without reduction. AU joints with reciprocal clicking as well as most silent joints demonstrated non-arthrotic articular surfaces, whereas crepitation was recorded in both arthrotic and non-arthrotic joints. Our results implied that crepitation is a rather unreliable sign of arthrosis. Reciprocal clicking can be considered as an accurate sign of reduction of anteriorly displaced discs. However, neither the degree of displacement nor the degree of deformation of the disc could be disclosed by analysis of the sound. This information can only be obtained by further examination, such as arthrotomography.

Complete closure of oroantral communication was achieved in 16 out of 17 patients using a single application of Tissucol. The wound healing was uneventful. The need of inserting the sealant mixture above the floor of the antrum in order to protect the clot from air flow was pointed out. Tissucol was safely applied even in cases with severely damaged buccal or palatal mucosa or after a failure of the buccal sliding flap technique.

11 edentulous patients (mean age 71.2 years) with oral or oropharyngeal malignancies were examined clinically and microbiologi-cally before, during, and after receiving tumoricidal radiation doses (26.4–74 Gy) towards the head and neck regions. The effect of a supervised oral hygiene program and a saliva substitute (Va-OraLube) was studied. The 9 patients who survived the observation period, showed increased xerostomia and mucositis related to increased radiation. Radionecrosis or oral infections were not observed. The patients wore their dentures throughout the observation period and preferred to use the saliva substitute. The initial number of acidophilic bacteria was high, Candida albicans were present in low numbers and enteric bacteria occurred more frequently than normally. There was a reduction of micro-organisms after introduction of the hygiene program. It is concluded that careful planning of the radiotherapy, preradiation oral examination, denture control and instruction and an effective oral hygiene program are essential for the reduction of oral complications in edentulous patients receiving tumoricidal radiotherapy to the head and neck regions.

Cysts in jaws are generally excised by Partsch II when they are small. When they are large, they are excised by Partsch I to form a paranasal sinus in an oral cavity, or by an operation based on Caldwell-Luc's method to form it from nostrils, as Partsch II forms dead space after the operation and the cyst increases by the pressure of intracystic fluid. However, with Partsch I, the bone needs many days to regenerate, and since a surgical ciliated cyst of the maxilla is often formed after an operation of the maxillary sinus, Partsch I is not necessarily a good method. Therefore, in order to control cyst inflammation, the irrigation of cyst cavities was repeated, as it is held that prostaglandin-like (PG-like) substances are generated in the cyst walls when a cyst is inflamed by bacterial infection; prostaglandin E₂ (PGE₂) especially acts on the resorption of bone and enlarges the cyst. As a result of repeated irrigations, infection of the cyst cavities disappeared simultaneously with decreasing the pressure of intracystic cavities, the values of thiobarbituric acid, Prostaglandin E, Prostaglandin F_2α (TBA, PGE, PGF_2α), and the free radical intensity at g=2.003 decreased. The bone regenerated around the cyst walls, and finally the cyst diminished in size. In the case of the viscous cyst fluids, a solution containing hyaluronidase enabled complete disappearance. It would be better to apply Partsch II after the cyst has become smaller through irrigation. After the irrigational method, irregular formation and tendency toward malignancy could be found in none of the cyst wall cells.

This report is a comparative study of the treatment results after secondary and late secondary bone-grafting in cleft-palate patients with residual cleft in the alveolar process, operated with surgical technique as described by Krantz Simonsen¹⁷. 293 bone-grafted cleft-palate patients are included in the study. Marginal bone-level, periodontal state of teeth adjacent to the cleft-region, recurrence of oro-nasal fistula together with possibility of total dental rehabilitation (i.e., morphology of alveolar process in cleft region and amount of attached gingiva) have been used for evaluation of the treatment results. The best results are seen in the youngest group of patients, and based on the results of the present study, bone-grafting is recommended immediately before eruption of the canine in the cleft-region.

Congenital epulis is not a common lesion. 2 rare neonatal multiple cases are reported. The treatment of choice of these lesions is radical excision during early infancy.

Modern orthognathic surgical techniques can complement orthodontic treatment of children and adolescent patients. A wide variety of deformities can be surgically corrected at a young age and examples selected from more than 100 treated pediatric patients are presented. As with all surgical procedures, the risks of surgery and anesthesia must be weighed against the benefits which are expected to result from the outcome of the surgery.

This paper reports a patient with malignant fibrous histiocytoma of the maxilla who developed DIC during the 12-month observation of the hemostatic course, and a case of squamous cell cancer of the tongue associated with post-operative DIC. The triggers in these 2 cases were malignant tumor, infection, shock and operation. Heparin and aprotinin were administered in both cases. Hemostatic improvement was obtained in case 2, but neither cases were cured. The etiology, diagnosis and treatment of DIC are discussed.

An endosteal implant which had been functional had to be removed from the mandible after 13 months; this implant was made available for investigation in the scanning electron microscope. It was seen that an ankylotic bond between bone and implant had been achieved under natural loading conditions.