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Biomedical subjects

A N Goss

Publications and source records attributed to A N Goss.

At least 37 records · Page 2Linked to original sources
PubMed2001

The effect of gap arthroplasty on temporomandibular joint ankylosis: an experimental study.

The aim of this study was to demonstrate the functional and anatomical changes after gap arthroplasty release of unilateral temporomandibular joint (TMJ) ankylosis. Five adult sheep weighing an average of 57 kg were used. All right joints were operated. Ankylosis was induced in the right TMJ by articular damage, disk removal and placement of a bone graft plus immobilization wire. At 3 months the gap arthroplasty were performed. All TMJs were examined functionally, radiologically, macroscopically and histologically. Functionally, the range of jaw movements decreased following induction of ankylosis (P<0.0001), increased immediately on release but was reduced again at 3 months after release (the vertical movement, no statistically significant difference; the right movement, P<0.001; the left movement, P<0.0001). Histologically, all operated joints showed fibrous adhesions across the gap, and further, the articular surface was irregular with osteophytes and with bony islands in the gap. This appearance is more consistent with a fibrous reankylosis than a functioning pseudo joint. This study shows that the gap arthroplasty for TMJ ankylosis did not restore the TMJ functionally and histologically to the preexisting state.

Analysis of Variance↗
PubMed2001

Obstructive sleep apnoea: a review of the orofacial implications.

Obstructive sleep apnoea is a complex multifactorial condition produced by a combination of anatomical and physiological factors. There is a significant associated mortality and morbidity to obstructive sleep apnoea. There is an at least 25 per cent increased mortality from cardiovascular disease when obstructive sleep apnoea patients are compared to age and gender matched healthy people. Obstructive sleep apnoea sufferers also have a much higher industrial and motor vehicle accident rate. Management of the condition should be undertaken by a multidisciplinary team including respiratory physicians, sleep laboratory technicians, otorhinolaryngologists, oral and maxillofacial surgeons and dental specialists. The diagnostic and therapeutic interactions of team members are the key to successful treatment. The treatment regime utilises nasal continuous positive airway pressure devices, mandibular advancement splints and soft and hard tissue surgery. This review provides the dental practitioner with an introduction to obstructive sleep apnoea with particular emphasis on the orofacial aspects.

Cephalometry↗
PubMed2001

The influence of experimentally induced osteoarthrosis on articular nerve fibers of the sheep temporomandibular joint.

AIMS: To study the effect of experimentally induced osteoarthrosis, or non-inflammatory degenerative changes, on the innervation of the sheep temporomandibular joint (TMJ) through the use of indirect immunohistochemistry and image analysis quantification. METHODS: Bilateral condylar scarification was performed in 8 sheep, which were killed at 16 weeks post-operation; 3 unoperated sheep served as controls. Tissues from 8 osteoarthrotic joints and 4 control joints were processed for the immunostaining with antisera for protein gene product 9.5 (PGP 9.5), substance P (SP), calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY), vasoactive intestinal peptide (VIP), and tyrosine hydroxylase (TH). An additional 10 joints were decalcified to study the morphologic changes induced by the condylar abrasion. RESULTS: Osteoarthrotic changes were commonly seen in the anterior and lateral regions of the joint and included fibrosis, peripheral osteophyte formation, cysts, and erosion of articular surfaces. In the osteoarthrotic joints, the distribution of PGP 9.5-, CGRP-, and SP-immunoreactive (IR) nerve fibers was similar to that observed for control joints in the capsule, synovium, and capsule/disc junction. There were statistically detectable decreases in the percent surface area of IR nerve fibers in the capsule for both PGP 9.5 and CGRP in arthrotic joints compared with control joints. The lateral and anterior regions of the capsule had greater density of PGP 9.5- and CGRP-IR nerve fibers than other parts of the capsule in both control and arthrotic joints, and the medial capsule was poorly innervated in all joints. Immunostaining for substance P was always weaker. CONCLUSION: This study suggests that while inflammatory arthritis has a marked influence on the density of sensory and autonomic nerve fibers in synovium in a variety of joints in different species, experimentally induced non-inflammatory osteoarthrosis in the sheep TMJ also leads to a depletion of the density of nerve fibers in the capsule, especially in the lateral part of the joint. Further work is required to determine whether other parts of the joint, such as synovium and marrow, respond differently to experimentally induced osteoarthrosis.

Analysis of Variance↗
PubMed2000

Synovial chondromatosis of the temporomandibular joint.

We report two cases of temporomandibular joint (TMJ) synovial chondromatosis, one of which was in the early stage and treated arthroscopically. The second was more advanced and recurred after removal of the free bodies, and so required condylectomy and synovectomy.

Adult↗
PubMed2000

Effect of limited jaw motion on ankylosis of the temporomandibular joint in sheep.

The purpose of this study was to investigate the effect of limited movement of the jaw on ankylosis of the temporomandibular joint (TMJ). Eighteen adult sheep were divided into two groups. In Group 1, the temporal and condylar articular surfaces were removed together with the disc on the right. In Group 2, we did the same procedures but in addition the jaw movements were limited by a wire. One sheep was killed just after the operation, four at one month, and four at three months, in each group. The range of jaw movements preoperatively and at the time of death were recorded. The joints were examined radiologically, macroscopically, and histologically. We used a scoring system to assess the radiological changes and histological extent of ankylosis. At one month, the joint spaces were filled with fibrous tissue, but a small joint space existed in all four joints in Group 1. In Group 2, there was full ankylosis in two joints and partial ankylosis in two joints. At three months, similar ankylotic changes were seen in both groups. The histological score for ankylosis at one month showed that those in Group 2 were significantly more ankylosed than in Group 1 (P<0.01). The range of jaw movements was more limited at one month in Group 2, both vertically and to the left, and was significantly decreased in both groups (P<0.01) at three months. Limitation of jaw motion hastens the progress of TMJ ankylosis.

Analysis of Variance↗
PubMed2000

Matrix metalloproteinase and tissue inhibitor of metalloproteinase in serum and lavage synovial fluid of patients with temporomandibular joint disorders.

We measured matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMP) in temporomandibular joint (TMJ) disorders. All patients were fully investigated, by visual analogue pain scores, plain radiographs and double-contrast arthrotomograms. The patients were grouped according to whether or not they were in pain. There were 35 patients with painful joints; 16 painless crepitating joints and 10 with chronic closed locked joints. A further group of 9 volunteers with no symptoms of TMJ abnormalities were used as controls. We found that synovial fluid concentration of MMP-3 was significantly increased (1117.2 (164.0) ng/ml) (P< 0.05) in the painful group compared with controls (436.2 (94.8) ng/ml) and with the two groups with painless TMJ (475.0 (113. 0) ng/ml/crepitation, and 516.0 (115.1) ng/ml/closed locked joints). MMP-1 and TIMP-1 were not recordable in most joints, and the serum concentrations of MMP-1, MMP-3, and TIMP-1 were similar to those in controls in all groups. There was no correlationship between MMP-3 concentration and joint morphology as shown by plain radiographs and double contrast arthrotomograms. These findings indicate that the synovia of painful joints are inflamed.

Adolescent↗
PubMed2000

Hepatitis C infection and associated oral health problems.

Hepatitis C infection is widespread throughout the community. This study aimed to assess the status of oral health of persons infected with hepatitis C. DMFT and CPITN indices were recorded at a clinic providing priority dental care for people with hepatitis C infection. The data were compared with information from an existing survey of general dental patients. Social impact was assessed using a modified Oral Health Impact Profile questionnaire. The DMFT index differed significantly between hepatitis C and general patients. The number of decayed and missing teeth was greater in those infected with hepatitis C for all patients aged between 25 and 50 years. Although there was no significant difference in CPITN categories for subjects evaluated, a marked trend for poor periodontal health was noted for those individuals with hepatitis C. Salivary flow was reduced in 50 per cent of hepatitis C infected subjects. Social impact was significantly affected with 71 per cent of hepatitis C subjects reporting painful aching in the mouth and 56 per cent having difficulty in relaxing. In conclusion, the results from the project strongly indicate an urgent need for priority delivery of dental care for people with hepatitis C infection.

Adolescent↗
PubMed2000

Survey of Australian and New Zealand Oral and Maxillofacial Surgery trainees and recent specialists--workforce issues.

This study examined Oral and Maxillofacial Surgeon (OMS) workforce issues in relation to current training in Australia and New Zealand. Earlier findings identified that there was a requirement of approximately 6 additional OMS specialists per year in Australia and one per year in New Zealand to maintain an adequate level of supply in the profession. It was found in this study that through to the early part of the next decade the number of OMS entering the Australian workforce is appropriate (5.9 per annum), but there would appear to be concerns about the sufficiency of the number entering the New Zealand workforce (0.7 per annum). In addition, the study also found possible maldistribution in the location of intended future practices, with possible shortages outside of the metropolitan areas.

Australia↗
PubMed2000

The effect of an intra-articular bone fragment in the genesis of temporomandibular joint ankylosis.

The aim of this study was to examine the effect of an intra-articular bone fragment on the genesis of temporomandibular joint (TMJ) ankylosis. Twenty-two adult sheep had a unilateral operation of removal of the temporal and condylar articular surfaces, plus discectomy with or without insertion of an intra-articular bone fragment. Functionally, radiologically, macroscopically and histologically, in the group with the intra-articular bone fragment, the joints showed more advanced ankylosis both at one and three months after the operation, as compared to the group with no intra-articular bone. This study shows that the bone fragment increases the extent of ankylosis in the sheep model. The clinical significance of the various experimental findings of this study and others in the same series is presented.

Animals↗
PubMed2000

Survey of Australian and New Zealand Oral and Maxillofacial Surgery trainees and recent specialists--education and experience.

This study examined the demographic characteristics, educational background and attitudes toward training of all recent OMS specialists and all current trainees in Australia and New Zealand in 1996. The early nineties is a key period as it marks the transition from an essentially dentally based speciality (85% dental degree in 1990); to recent specialists with an increasing number with both medical and dental degrees (33% dual degree 1990-1996); to predominantly dual degree training (84.4% dual in 1996). Current trainees had more extensive experience in pathology, preprosthetic and reconstructive surgery. They were also strongly critical of the length and cost of training.

Adult↗
PubMed2000

Hyperbaric oxygen in the therapeutic management of osteoradionecrosis of the facial bones.

This paper reviews all 17 cases of facial bone osteoradionecrosis (ORN) which were treated in Adelaide, South Australia, in a nine-year period (1987 1996). This was 1.2% of all cases of head and neck cancer treated with radiotherapy (RT). Fourteen cases received treatment following the Marx principles of staging and the protocols of hyperbaric oxygen plus or minus surgery. The three exclusions were two patients who died of recurrent cancer before treatment was complete and one who declined treatment. The eleven cases of mandibular ORN occurred within a few years of the initial RT treatment. All except one occurred after surgical trauma, with dental extractions being the factor in nine cases. All responded to HBO, with or without surgery depending on stage. The three cases of temporal bone ORN were all of late spontaneous onset. All were stage I and all responded to HBO alone. This study shows that the incidence of ORN in Adelaide is low, probably through use of conservative doses of RT and good preventative protocols. The treatment with HBO plus or minus surgery was effective.

Aged↗
PubMed2000

Malignancy of the parotid gland with primary symptoms of a temporomandibular disorder.

The purpose of this case report is to highlight the possibility that malignant neoplasms of the deep lobe of the parotid gland may present as a temporomandibular disorder (TMD). Two patients who were eventually diagnosed with deep-lobe parotid tumors were retrospectively analyzed clinically, radiographically, and pathologically. For the first patient, there was a prolonged delay in establishing the correct diagnosis; for the second patient the delay was shorter. This was done primarily by computed tomographic examination. Despite aggressive surgical, radiotherapeutic, and chemotherapeutic treatment, both patients died from their malignant disease. All clinicians who treat TMD must be aware of the rare possibility of deep-lobe parotid tumors presenting as a TMD.

Adult↗
PubMed1999

Short-term effect of the use of a frozen-stored disc allograft for repair of the osteoarthritic sheep temporomandibular joint: a preliminary report.

PURPOSE: The purpose of this experimental study was to evaluate the initial effect of a frozen-stored disc allograft on the osteoarthritic sheep temporomandibular joint (TMJ). MATERIALS AND METHODS: Bilateral osteoarthritis was induced in the TMJ of four sheep. Three months later, unilateral discectomy and frozen-stored disc allograft replacement were performed. The donor disc had been obtained from a healthy animal at killing. The disc was stored in a deep freezer at -70 degrees C for 1 month and thawed just before grafting. The contralateral joints were undisturbed and served as a control at 3 months. At 6 months after the initial procedure, 3 months after the repair, the four sheep were killed. RESULTS: All four grafted discs were perforated and displaced. In the repaired joints, the condylar articular surface was partly denuded in some areas, and part of the surface showed fibrous repair. The control joints showed osteoarthritic changes. CONCLUSION: Frozen-stored disc allograft is not a satisfactory interpositional material in the osteoarthritic sheep TMJ.

Animals↗
PubMed1999

A sheep model for temporomandibular joint ankylosis.

PURPOSE: The purpose of this study was to develop an animal model for temporomandibular joint (TMJ) ankylosis. MATERIALS AND METHODS: Five sheep had removal of the temporal and condylar articular surface plus discectomy in the right TMJ; the left side was used as a control. One sheep was killed just after operation and four at 3 months. The joints were examined histologically, and a scoring system was developed to evaluate the extent of the ankylosis. The range of jaw movement was compared between preoperatively and 3 months. RESULTS: Two sheep lost 4% of their body weight by 3 months. The range of jaw movement, particularly to the left, decreased at 3 months (P < .001). The joint spaces were filled with fibrous tissue and cartilage-like tissue. Development of new bone from the damaged temporal and condylar surfaces was seen, but full bony fusion did not occur. The average histologic score of a zone was 4.9 on the degree-of-ankylosis scale and 1.7 on the degree-of-calcification scale. There were statistically significant differences between the operated and control TMJs for both changes (P < .0001). CONCLUSION: Fibrous ankylosis occurs rapidly after removal of the TMJ articular surfaces and the disc. This model can be further developed to isolate relative factors in the development of ankylosis and in evaluation of different treatment methods.

Animals↗
PubMed1999

The role of the disk in sheep temporomandibular joint ankylosis.

OBJECTIVE: The purpose of this study was to determine the role of the disk in intraarticular ankylosis of the temporomandibular joint. STUDY DESIGN: Twelve adult sheep were divided into 2 groups. In group 1, removal of the temporal and condylar articular surfaces was performed on the right temporomandibular joint and the disk was maintained; in group 2, removal of the articular surfaces and diskectomy were performed on the right temporomandibular joint. One sheep from each group was killed just after surgery and 5 sheep from each group were killed at 3 months. The joints were examined radiologically, macroscopically, and histologically. The range of jaw movements was recorded preoperatively and at sacrifice. RESULTS: Each of 2 sheep in group 2 had lost 4% of their body weight by 3 months; all of the other sheep maintained or increased their weight. The range of jaw motion to the right was significantly lower in group 2 than in group 1 (P<.01). In group 1, fibrous repair of the articular surface and regeneration of the condylar head was seen. In group 2, each of the joints showed a total fibrous ankylosis with some calcification. There was a statistically significant difference in radiologic score between the groups (P<.0001). Histologic scores for group 1 demonstrated significantly lower scores on the degree of ankylosis scale and degree of calcification scale (P<.0001). CONCLUSIONS: This study showed that the presence of the disk prevented the development of fibrous intraarticular ankylosis of the temporomandibular joint.

Animals↗