International journal of oral surgery最新文献

The Hajdu-Cheney syndrome or acro-osteolysis syndrome is a rare disease. Only 18 well-documented cases are described in the literature. Presentation of cases in the oral surgical literature is rare. The syndrome is characterized by dissolution of terminal phalanges of the hands and feet, dolichocephaly, open cranial sutures, multiple wormian bones, absence of frontal sinuses, wide open sella turcica, progressive basilar invagination, early loss of teeth, short stature and characteristic facies. Inheritance is most likely autosomal dominant. 3 patients are presented, 2 of them are mother and son, the latter (case 2) being the youngest patient reported to date. The parents of the 3rd patient were consanguineous, raising the possibility of genetic heterogeneity. Dental, surgical and genetic aspects are discussed.

Fractures of the coronoid process occur infrequently. In the present study, 52 cases of fracture of the coronoid process are presented and analysed and the relèvent literature is reviewed. Coronoid fractures constituted 2.9% of all facial fractures. Of the 52 cases, 12 were isolated coronoid fractures (23%), whereas in the remaining 40 cases, coronoid fractures coexisted with other maxillofacial injuries. The clinical picture, diagnosis and therapeutic modalities of coronoid fractures are discussed.

The purpose of the present study was to identify factors which might influence the success of autotransplantion, such as root development, root resorption, pulp condition and tooth eruption. The material consisted of 100 human premolars transplanted in 87 patients. The observation period ranged from 3–18 years, with a mean value 6.3 years. Clinical and radiographic examinations were performed. The transplanted premolars were divided into 7 stages of root development. At the final control, 93 teeth remained and 7 teeth were extracted. Periodontal healing without root resorption was related to stage of root development. It decreased from 93% in teeth with ¾ root development to 37% in teeth with fully developed roots. Inflammatory root resorption was seen in 7 cases and replacement root resorption in 12 cases. Pulp revascularization was observed in 100% in stages with initial root development to ½ root development and decreased to 0% for teeth with fully developed roots. Pulp obliteration was observed in all cases with revascularized pulp tissue. The gingival condition was similar to contralateral, not transplanted premolars or adjacent teeth. Root growth increased with the stage of root development at the time of transplantation.

It is concluded that transplantation of premolars with ½–¾ root development provides a good chance of pulp survival, limited risk of root resorption and ensures sufficient final root length, and is thus recommended.

Cherubism is a benign, hereditary giant cell lesion of the jaws, that appears in children as a bilateral painless swelling, between the ages of 2 and 5 years and progresses until puberty, when it spontaneously regresses. It normally requires no treatment. We had the chance to operate on a 5-year-old boy with cherubism 8 years ago, and used homogenous bone grafts to replace the diseased tissue to avoid pathological fracture of the mandible. Since then we have been following the patient, witnessing the gradual involvement of other sites in the jaws and the displacement of teeth and tooth germs.

Arthroscopy of the temporomandibular joint (TMJ) is evaluated on an autopsy material, 2 different types of arthroscope — one with a rod-lens system and one with a so-called Selfoc system — were used and compared regarding diagnostic accuracy. On 54 cadavers, it was found that the upper joint compartment may be punctured with accuracy and without damage to vital tissues. Landmarks on the skin facilitating clinical arthroscopy were defined in relation to a guideline from tragus to lateral canthus. A further 49 TMJ specimens were investigated with arthroscopy. The findings are in good agreement with subsequent observations made during dissection. Regarding arthrotic changes, 100% diagnostic accuracy was achieved with both types of arthroscope. Regarding remodelling changes, the diagnostic accuracy was approximately 57%. No significant difference was noticed between the 2 arthroscopes. Photographic documentation with the rod-lens arthroscope was found to be of superior quality.

Psychological factors are involved in TMJ dysfunction but much previous research has tried to identify single personality factors. Multiple factors, however, are involved. These can be divided into 2 main groups: external social factors and the innate psychiatric state of the patient. The concepts involved and their measurement by life events and illness behaviour questionnaires are discussed. The clinical importance of this to the oral surgeon is emphasised, in relation to the patient who fails to respond to conservative therapy and for whom TMJ surgery is planned. Some of these difficult patients may be less well socially integrated than the majority of TMJ patients.