Deutsche Zeitschrift fur Mund-, Kiefer- und Gesichts-Chirurgie最新文献

Since June 1987 a total of 102 patients undergoing elective operations have donated autologous blood for a later possible retransfusion. Although autologous transfusion was time-consuming, nearly all patients accepted this method because they received the safest of all possible transfusions. This way, preoperative psychological anxieties could be reduced and it was made easier for the patients to decide in favor of the operation. Severe somatic pains caused by blood donation were not observed.

Fibromatosis colli is a benign tumor of infancy, and although prognosis is usually good, it is the most frequent cause of congenital torticollis. The clinical picture, sonography, or, if required, CT scans, permit a clear diagnosis. Invasive diagnostic and therapeutic measures should be avoided and restricted to those cases, where a malignancy is suspected with good reason or where local complications due to bulk shifts and compression are anticipated. Even after the usually spontaneous remission of the tumor torticollis may develop later on so that accompanying exercise therapy should be provided from infancy to school age.

Aspergillus falls into the class of hyphae-forming molds and is ubiquitous. It is known as a facultatively pathogenic opportunist. It is incorporated by breathing in spores from the air and develops its pathogenicity only in predisposed subjects with a weakened systemic or local defense mechanism. While systemic mycosis involves a weakening of the defense condition by an underlying disease, immune suppressant therapy, metabolic disorder or the like, isolated antral affections usually appear in otherwise healthy subjects. Our observations in one case are presented.

Based on the Helkimo index we assessed the success of conservative and conservative-surgical forms of treatment for mandibular fractures in a total of 166 patients. The control group consisted of 50 probands. The Helkimo dysfunction index, which is based on various criteria, showed dysfunction in 81.9% of the patients with only slight functional impairment in 57.2% of these cases. 18.1% of the patients were clinically symptom-free. A comparison with the probands revealed no major differences in dysfunction between the two groups. Significant differences were observed only in the case of 2 isolated criteria (maximum mandibular protrusion, muscle pain). Severe dysfunction, however, was more common in the fracture patients. Based on the Helkimo occlusion index disorder were noted in 91.7% of the patients, while severe occlusion disorder were observed particularly in patients with combined mandibular body and condyle fractures (40.0%). In the control group a more favorable occlusion index was found to be due mainly to the greater number of present and/or occluding teeth. The Helkimo index, particularly the dysfunctionindex, is a very useful instrument for assessing the success of treatment measures in mandibular fracture cases. It should be more commonly used to improve the possibilites of objective comparisons between patients from different hospitals.

Electron spin resonance was used to measure out 160 tooth root surfaces. These data represent a measure for wound area sizes after tooth extractions. A comparison of these values with clinical data results in a correlation between the size of wound area and the frequency of inflammatory healing disorders after tooth extractions.

Preventive edema protection using Serrapeptase after standardized one-stage osteotomy procedures of 4 third molars was verified by means of an opto-electronic measuring instrument. This measuring technique proved to be a sensitive tool for demonstrating the efficacy of Serrapeptase in reducing postoperative edema. Although statistically significant, the reduction of soft tissue swelling was only approximately 15% when compared with a patient group without Serrapeptase medication.

Isolated from an osteosarcoma specimen from a 15-year-old girl and assayed by implantation, partly purified lyophilized bone morphogenetic protein (BMP) induced heterotopic ossification in the mouse quadriceps. The apparent molecular weight was 18 kDa. Osteosarcoma-derived BMP induced the same process of bone development as human BMP from normal bone matrix.

In 105 patients with composite resections of the mandible different reconstructive approaches were studied. In 63% the defect was bridged with metal plates alone, in 15% free grafts, and in 22% microvascular bone grafts were used. The high failure rate of free grafts (48%) was contrasted by the low rate (8%) of vascularized grafts lost. Resorption of vascularized grafts was not observed where the anastomoses remained patent.

In this clinical study the position of the mandibular condyles of 40 patients treated for malocclusion by surgical splitting of the mandibular ramus alone or combined with Le Fort I osteotomies was studied on lateral linear TMJ tomograms. Linear tomograms of the right and left TMJ with the mandible closed were taken from each patient prior to surgery and 6 months postoperatively. The postoperative changes in condylar position wee assessed in terms of direction and amount. Condylar displacements were found in 89% of the examined joints, most of them were less than 2mm. All types and combinations of displacement occurred, however, general trends in direction depending on the type of treatment could not be established with statistical significance. The type of surgical correction, its direction and amount did not seem to have an effect on the direction and amount of condylar displacement resulting. A comparison of the measured values with data in the literature showed that the amount of condylar displacement was markedly less--this seemed to be attributable to our precise evaluation method and a more sophisticated surgical technique.

In an experimental study reconstructive miniplates consisting of 1.0 mm thick stainless steel and 1.27 mm thick pure titanium were comparatively examined. Plate stress trials showed better results for stainless steel in tension, and at the same time better results for titanium plates in bending trials over the edge and the plane. In lever trials of second order titanium plates showed equal or better results when used for reconstructing lower jaw specimens and plastic models. Our experimental results lead to the conclusion, that the plates tested can guarantee exercise stability of lower jaw reconstructions during the primary healing phase. Considering their more favorable E-modulus and better biocompatibility the new titanium miniplates with the dimensions mentioned are superior the stainless steel miniplates in the fixation of lower jaw grafts.