Biomedical subjects
Publications and source records attributed to A T Indresano.
The principles of three-dimensional computerized tomography are discussed. An unusual case of an iatrogenically induced coronoid obstruction is presented with the three-dimensional computerized tomograph as an integral tool in its diagnosis.
Sialolithiasis may be the most common disease of the salivary glands in patients more than 20 years of age. Approximately 19% of sialoliths occur in the parotid gland. Of these, only up to 71% can be successfully diagnosed radiographically. The remaining 29% provide a diagnostic dilemma. Xeroradiography, because of its tissue-edge enhancement, can distinguish tissue margins of different density more dramatically than can conventional imaging and is an invaluable aid in the diagnosis of nonradiopaque sialoliths.
A neodymium:yttrium aluminum garnet (Nd:YAG) laser beam was introduced by a quartz fiber passed arthroscopically into the superior joint space of the temporomandibular joints (TMJ) of five mongrel dogs, with one joint serving as a control without laser wounds. Immediate postoperative death and examination of the disc grossly and histologically revealed different patterns for contact and noncontact burn wounds. The wounds exhibited signs of thermal coagulation necrosis similar to those reported in other tissues. The potential implications of the adaptation of the Nd:YAG laser to TMJ arthroscopic surgery are discussed.
Two cases of infected total temporomandibular joint replacements are reported. The WBC count, erythrocyte sedimentation rate, and temperature were within normal limits, but erythema, edema, and pain provided the initial clue to the infection. Ultrasonography ultimately revealed a fluid collection and allowed aspiration of the fluid-filled cavity, providing a diagnosis and directing antibiotic therapy.
One hundred temporomandibular joints (64 patients) were examined arthroscopically. Complications from the procedure were low (4%). Eighty joints (50 patients) received superior compartment sweep and lavage. Patients with anteriorly displaced nonreducing discs (closed lock) had the highest success rate (83%) from this procedure when evaluated 9 to 30 months later.
Three cases of temporomandibular joint disc replacement with a polymer glenoid fossa prosthesis, followed by rapid condylar degeneration, are reported. The relationship between this degeneration and a consistent foreign body reaction to fragments caused by implant wear is postulated.
Twenty-nine alveolar ridges were augmented with porous block hydroxylapatite (HA). Sixty-five percent of the implants had to be partially or totally removed within one year. Thirty-eight percent of the patients had significant delay in receiving their dentures because of delayed healing.
A case history of a patient with metastatic renal cell carcinoma who had been asymptomatic is presented. The report emphasizes the need for consideration of any lesion in the maxillofacial region, as it may be the first definitive sign of a primary cancer.
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A simpler technique for fabricating a prong denture has been described. The prong denture was placed in the mouth of a patient with an atrophic maxilla, who was suffering from ALS, a disabling motor disease. The patient was unable to manage a conventional denture. With the insertion of a prong denture, the patient experienced greatly increased retention and function of his maxillary prosthesis and a more favorable attitude toward himself and his disease.
This investigation considered circulatory changes in the distal segment of an anterior maxillary osteotomy produced in nine rabbits. Blood flow in the distal pulp, alveolar bone, and mucosa was measured using hydrogen washout. The results showed a decrease in blood flow in all tissues with a mucosal rebound within 30 min.
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This investigation involved quantitating blood flow in rabbit mandible using the hydrogen washout technique. The animal was ventilated with a H2/O2 gas mixture. Hydrogen concentration was monitored by surgically implanted platinum electrodes. The Fick principle was used to interpret the H2 washouts. The following mean flows were obtained: Cortical bone, 4.49 ml/100g/min; condylar bone, 8.22 ml/100g/min; and alveolar bone, 18.33 ml/100g/min. This technique proved repeatable and compared well with other studies.
A pilot project was undertaken to assess the feasibility of providing dental care for the mentally handicapped patient on an outpatient basis. The advantages, both immediate and long-term, to patients and practitioners are discussed.
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A patient with Sturge-Weber disease was treated for a facial infection. Particular attention is given to oral histopathologic changes, and the special care needed for patients with this disease is outlined.
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