Biomedical subjects
Publications and source records attributed to A K Panders.
Patients with oral cancer are usually treated in cancer units. Surgery and radiotherapy are the most important treatment modalities, as has been discussed in this review article. The prognosis of small cancers, that have not yet produced metastatic lymph nodes is excellent. Therefore, early diagnosis is of vital importance.
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A case of an ameloblastic fibroma in the mandible is presented. The ameloblastic fibroma is a benign neoplasm belonging to the group of mixed odontogenic tumours. Enucleation is the treatment of choice. Recurrence of the tumour is very rare, but follow up is necessary. Fewer than 75 cases are described in the literature. An additional case is presented with radiographic signs of calcification which could not be identified on histopathological examination.
The most pronounced oral symptoms in Sjögren's syndrome are a dry sensation of the mouth and difficulties in swallowing and speech. Besides these patients do no sleep well and may complain about burning mucous membranes, rampant caries and candidosis. Rampant caries can be prevented by optimal oral hygiene and frequent applications of a neural 1% sodium fluoride gel. Prophylaxis of candidosis can be obtained by meticulous oral hygiene and removal of predisposing factors (e.g. poor dentures). For the other oral signs of Sjögren's syndrome only a symptomatic treatment is possible, because damage of salivary gland tissue is progressive and irreversible. Good results can be obtained by applying a mucin-containing saliva substitute, which has been shown to reduce the dry an burning sensation of the mouth as well as to improve chewing, swallowing, speech and sleeping. When applied by an atomizer it wets the oral cavity for about 30 min. A continuous wetting can be obtained using intra-oral artificial saliva reservoirs.
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Synovial chondromatosis of the temporo-mandibular joint is a rare affection, characterized by the formation of cartilage particles in the synovial membrane. These particles can break through and enter the joint compartments. The diagnosis must be considered for patients who complain of slowly progressive swelling, pain, and crepitus in the region of the temporo-mandibular joint. When the changes are not visible on plain X-rays due to absence of ossification, important diagnostic information can be obtained by a technetium 99m (99m Tc) bone scan and a computerized tomography (CT) sialogram. The diagnosis can be established only by histopathologic examination of surgically removed particles or resected synovial membrane. Discussed are 25 cases of histopathologically verified chondromatosis of the temporo-mandibular joint reported in the literature, as well as 3 new cases seen and treated at the University Hospital Groningen since 1970. A good clinical result can be obtained by removal of all particles and synovectomy. Condylectomy is seldom required.
A case of unilateral condylar hyperplasia combined with synovial chondromatosis of the temporomandibular joint (TMJ) is presented. Clinical and radiographic findings were consistent with an active unilateral hyperplasia. A high condylectomy was performed. During the operation numerous cartilaginous particles discharged from the TMJ and so it became clear that the patient was also suffering from chondromatosis. Both conditions were confirmed by histological examination.
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A review of the literature on treatment of chronic osteomyelitis of the jaws shows that hyperbaric oxygen is often recommended as an adjunct in treatment of this disease. Definite criteria to indicate this treatment and to evaluate the results have not been reported. The results of hyperbaric oxygen treatment of chronic osteomyelitis of the jaws in 16 patients are presented. In contrast to the good results reported in the literature, only 7 of our patients could be considered as cured. The reasons for this discrepancy are discussed. Our results, as well as the data from the literature, indicate that a combined antibiotic and surgical approach is the treatment of choice in chronic suppurative osteomyelitis. However, in chronic diffuse sclerosing osteomyelitis and in patients in whom decortication and antibiotic therapy have failed, hyperbaric oxygen treatment in combination with antibiotics and surgery seems to be indicated.
Apparent viscosities at different shear rates were measured for 3 types of saliva substitutes: (a) mucin-containing saliva; (b) substitutes based upon carboxymethylcellulose (CMC), and (c) solution of polyethylenoxide (PEO). The apparent viscosities were compared with those of human whole saliva. Human whole saliva and mucin-containing saliva substitutes appeared to be similar in their rheological properties. Both types of solution are viscoelastic solutions and adjust their apparent viscosities to their biological functions. Preparations containing CMC or PEO are non-Newtonian liquids. From this study it is concluded that mucin-containing saliva substitutes appear to be the best substitutes for natural saliva, as far as rheological properties are concerned.