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Biomedical subjects

A L Sisk

Publications and source records attributed to A L Sisk.

At least 37 records · Page 2Linked to original sources

Comparative implant research in dogs: prosthodontic protocol using two-stage ceramic endosseous dental implants.

This report describes one phase of a long-term comparative implant investigation involving 20 of 120 endosseous implants placed in 30 adult mongrel dogs. Fixed prostheses involving 16 of the 20 (4 control implants) two-stage ceramic endosseous implants have been provided using routine prosthodontic procedures and the limited prosthetic components available for the Bioceram Series II implant system. The prostheses have proven to be functional with minimal maintenance. To date, after 1 year of follow-up, 2 of the two-stage implants have exhibited problems caused by fracture of the hexagonal collar. None of the implants to date has been lost and none of the fixed prostheses has required re-cementation or any other type of maintenance other than normal hygiene. Clinical evaluation suggests continued implant and prosthesis serviceability after 1 year in function.

Aluminum Oxide↗

Long-acting local anesthetics in dentistry.

Long-acting local anesthetics have proved to be effective for the suppression of both intraoperative and postoperative pain. They are useful for lengthy dental treatments and for prevention of severe pain following many types of surgical procedures. Although the currently available long-acting local anesthetics for dentistry have minimal side effects in the doses usually employed, there are potential problems. Bupivacaine, for example, can cause significant cardiac depressant and dysrhythmogenic responses. Etidocaine has less pronounced effects on the cardiovascular system, but its use may be associated with inadequate control of intraoperative bleeding. A new long-acting local anesthetic, ropivacaine, appears to offer advantages over either of the currently used long-acting agents.

Amides↗

Vasoconstrictors in local anesthesia for dentistry.

Addition of a vasoconstrictor to a local anesthetic may have several beneficial effects: a decrease in the peak plasma concentration of the local anesthetic agent, increase in the duration and the quality of anesthesia, reduction of the minimum concentration of anesthetic needed for nerve block, and decrease of blood loss during surgical procedures. The addition of a vasoconstrictor to a local anesthetic may also have detrimental effects. A review of the literature indicates that vasoconstrictor concentrations in local anesthetics marketed for dental use in the United States are not always optimal to achieve the purposes for which they are added. In most cases, a reduced concentration of vasoconstrictor could achieve the same goal as the marketed higher concentration, with less side-effect liability.

Amides↗

Long-term memory of acute postsurgical pain.

The long-term memory of acute postoperative pain intensity was evaluated in a population of patients who had undergone the removal of impacted third molar teeth. The results suggest a positive correlation between experienced and remembered intensities of postsurgical pain for up to 3 years after surgery. They also suggest that males and females do not differ significantly in their reports of postsurgical pain intensity, nor do they differ significantly in their memories of pain intensity. Pain recall using verbal pain descriptors was more reliable than recall with visual analog scales. Patient reports of intensity of past postsurgical acute pain, particularly those reports obtained with verbal descriptors, may be useful in the planning of treatment and in the selection and evaluation of analgesic regimens.

Adult↗

Dental implants retrieved from humans: a diagnostic light microscopic review of the findings in seven cases of failure.

With the increased use of dental implant systems, an increase in the number of implants removed from patients has also been observed. This investigation attempted to elucidate some underlying causal determinants of implant failure employing light microscopic analyses. Valuable data can be obtained from implants retrieved from patients. Implant success is predicted on proper patient selection and treatment planning, careful surgical procedures, careful prosthodontic management, and continued oral hygiene maintenance.

Aged↗

When a patient with a bleeding disorder needs dental work. How you can work with the dentist to prevent a crisis.

Patients with bleeding disorders need close cooperation between their physician and their dental practitioner to receive safe, comprehensive dental care. When indicated, physicians must advise a compromised treatment plan to avoid deep injections or surgical procedures that may initiate a bleeding crisis in patients at risk. The conditions most commonly seen that require special consideration are long-term use of antithrombotic agents, platelet dysfunction caused by chronic renal failure, and congenital clotting factor deficiencies. Even these patients may undergo a high-risk procedure, such as periodontal surgery, with adequate precautions and preparation.

Blood Coagulation Disorders↗

A comparison of preoperative and postoperative naproxen sodium for suppression of postoperative pain.

Using a within-subject, crossover experimental design, this study compared the efficacies of a nonsteroidal anti-inflammatory drug, naproxen sodium, 550 mg, administered either 30 minutes preoperatively or 30 minutes postoperatively to 36 patients undergoing the removal of impacted third molar teeth. Pain intensity was assessed postoperatively for 8 hours. Treatment with naproxen sodium, 550 mg, 30 minutes following completion of surgery was just as effective as presurgical administration in controlling postoperative pain. Administration of naproxen sodium in the immediate postoperative period may be indicated for optimum postoperative analgesia for patients in whom preoperative oral intake is contraindicated.

Adolescent↗

Scanning electron microscopic studies of the oral tissue responses to dental implants.

Scanning electron microscopy (SEM) and its associated technologies have proven invaluable in elucidating the interfacial oral tissue responses to dental implants. Since the dental implant must extend from the mandibular or maxillary jaw, through the oral mucosa, and into the oral cavity, these tissue responses include epithelium, connective tissue and bone. The continual occlusal forces acting upon these tissues reinforce the dynamic character of these tissue responses. Immediately upon implantation, a healing phase begins as a response to the implanted biomaterial. Following this immediate response a longer healing phase occurs, beginning approximately 1 week after implantation, resulting in the modeling of bone to the implant as well as the formation of epithelial attachment to the implant. This later, delayed healing continues throughout the lifetime of the implant since these tissues must die and be replaced by similar tissues. Current dental research employing scanning electron microscopy is now documenting these tissue responses. This paper reviews, in detail, SEM observations of these tissue responses.

Animals↗

Ultrastructural investigations of the bone and fibrous connective tissue interface with endosteal dental implants.

The interface between the tissues of the oral cavity and ceramic and titanium cylindrical endosteal dental implants was investigated with correlated light microscopy, transmission electron microscopy and scanning electron microscopy. This study suggested that mandibular bone can directly interface and form an intimate association with one-stage endosteal dental implants. This potential attachment matrix is composed of a composite of calcified bone, and an osteoid unmineralized matrix in association with an apparent osteogenic connective tissue. Further, results from this study suggested that at a level inferior to the junctional epithelium, and superior to the level of crestal bone, fibrous connective tissue can attach to the dental implant. This non-loadbearing attachment of gingival connective tissue could, by contact inhibition, prevent apical epithelial migration. In association with previously documented epithelial attachment, such apical support and connective tissue attachment appears to suggest that endosteal dental implants can be adequately maintained in the oral cavity.

Animals↗

Comparison of preoperative and postoperative diflunisal for suppression of postoperative pain.

Despite the demonstrated therapeutic advantage of preoperatively administered nonsteroidal anti-inflammatory agents (NSAIAs) in suppressing postoperative pain, clinicians are reluctant to administer these drugs orally before surgical procedures performed using sedation or general anesthesia. Using a within-subject, crossover experimental design, this study compared the analgesic efficacies of an NSAIA, diflunisal 1,000 mg, administered either 30 minutes preoperatively or 30 minutes postoperatively to 20 patients undergoing the removal of impacted third molars. Pain intensity was assessed preoperatively and postoperatively for eight hours using category-rating and visual analog scales. Treatment with diflunisal 30 minutes after completion of surgery proved to be just as effective in suppressing postsurgical pain as presurgical administration. Administration of an NSAID in the immediate postoperative period may be indicated for optimum postoperative analgesia for patients in whom preoperative oral intake is contraindicated.

Adolescent↗

Comparison of etidocaine and lidocaine for control of intra- and post-operative bleeding and pain.

Etidocaine hydrochloride, an amide-type of local anesthetic with prolonged duration of action, was evaluated and compared with the standard local anesthetic lidocaine to determine its efficacy of action and its effect on bleeding during and following the removal of impacted mandibular third molar teeth. The findings indicate that 1.5% etidocaine hydrochloride with 1:200,000 epinephrine, in comparison with 2% lidocaine with 1:100,000 epinephrine, produces anesthesia comparable to that obtained with lidocaine but results in greater measured intraoperative blood loss.

Acetanilides↗

Evaluation of the Akinosi mandibular block technique in oral surgery.

The Akinosi mandibular block technique for administration of local anesthesia was compared with conventional nerve block techniques in patients undergoing the removal of impacted third molars using a within-subject experimental design. Success rates were equivalent, and both techniques resulted in acceptable quality of anesthesia. Buccal nerve anesthesia was achieved with the Akinosi technique in 80% of cases. The Akinosi technique appears to be a successful alternative to traditional mandibular block techniques for oral surgery.

Anesthesia, Dental↗

Complications following removal of impacted third molars: the role of the experience of the surgeon.

The incidence of complications associated with the removal of impacted third molars in a group of 500 patients treated by oral surgery faculty were compared with the incidence of complications in 208 patients treated during the same period by residents of oral and maxillofacial surgery. The results show that complications were more numerous after the removal of third molars classified as partial bony or complete bony impactions, and that less-experienced surgeons had a significantly higher incidence of such complications.

Adolescent↗

Intramuscular hemangioma of the mentalis muscle.

Hemangiomas of skeletal muscle are relatively uncommon and often difficult to diagnose. In the head and neck, the masseter and trapezius muscles are most commonly reported as being involved. The cause of these lesions is unknown, although theories of development include trauma and abnormal sequestration of embryonic tissue. Treatment has included corticosteroids, sclerosing agents, radiation therapy, embolization, and surgical excision. A review of the literature and the first case report of hemangioma involving the mentalis muscle are presented.

Adolescent↗

Evaluation of methylprednisolone and flurbiprofen for inhibition of the postoperative inflammatory response.

The ideal anti-inflammatory agent for use in third molar surgery should control pain, reduce swelling and trismus, and have no unwanted side effects. This investigation evaluated and compared the efficacy of corticosteroids, nonsteroidal anti-inflammatory agents, and placebo for reduction of the acute postoperative inflammatory response and its undesirable sequelae in patients undergoing the surgical removal of impacted third molars. Corticosteroids appeared to have maximal effect in controlling edema but had minimal analgesic effects. Nonsteroidal anti-inflammatory agents appear to be effective analgesics. A combination of these agents may be necessary to control the sequelae of oral surgical procedures most effectively.

Adolescent↗