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Biomedical subjects

A Vissink

Publications and source records attributed to A Vissink.

At least 37 records · Page 2Linked to original sources

Implantology and the severely resorbed edentulous mandible.

Patients with a severely resorbed edentulous mandible often suffer from problems with the lower denture. These problems include: insufficient retention of the lower denture, intolerance to loading by the mucosa, pain, difficulties with eating and speech, loss of soft-tissue support, and altered facial appearance. These problems are a challenge for the prosthodontist and surgeon. Dental implants have been shown to provide a reliable basis for fixed and removable prostheses. This has resulted in a drastic change in the treatment concepts for management of the severely resorbed edentulous mandible. Reconstructive, pre-prosthetic surgery has changed from surgery aimed to provide a sufficient osseous and mucosal support for a conventional denture into surgery aimed to provide a sufficient bone volume enabling implants to be placed at the most optimal positions from a prosthetic point of view. The aim of this paper is to review critically the literature on procedures related to the severely resorbed edentulous mandible and dental implant treatment. The study includes the transmandibular implant, (short) endosseous implants, and reconstructive procedures such as distraction osteogenesis, augmentation of the mandibular ridge with autogenous bone, and bone substitutes followed by the placement of implants. The number of patients participating in a study, the follow-up period, the design of the study, the degree of mandibular resorption, and the survival rate of the dental implants all are considered evaluation parameters. Although numerous studies have described the outcome results of dental implants in the edentulous mandible, there have been few prospective studies designed as randomized clinical trials that compare different treatment modalities to restore the severely resorbed mandible. Therefore, it is not yet possible to select an evidence-based treatment modality. Future research has to be focused on long-term, detailed follow-up clinical trials before scientifically based decisions in treating these patients can be made. This will contribute to a higher level of care in this field.

Alveolar Bone Loss↗

Rhino-sinusitis related to endosseous implants extending into the nasal cavity. A case report.

Rhino-sinusitis may develop as a result of an altered airflow in the nasal cavity causing irritation of the nasal mucosa. A patient is presented who developed recurrent rhino-sinusitis complaints following placement of endosseous implants in the maxilla. Inspection of the nasal floor revealed that two implants had perforated the floor of the nasal cavity. The part of the implants protruding in the nasal cavity was surgically resected via an endonasal approach whereupon the rhino-sinusitis complaints disappeared.

Aged↗

The use of implant retained mandibular prostheses in the oral rehabilitation of head and neck cancer patients. A review and rationale for treatment planning.

Surgical treatment of malignancies in the oral cavity (tongue, floor of the mouth, alveolus, buccal sulcus, oropharynx) often results in an unfavourable anatomic situation for prosthodontic rehabilitation. The outcome is a severe disturbance of oral functioning despite the improved surgical techniques for reconstruction that are currently available. Radiotherapy, which often is applied postsurgically, worsens oral functioning in many cases. Main problems that may hamper proper prosthodontic rehabilitation of these patients include a severe reduction of the neutral zone, an impaired function of the tongue, and a very poor load-bearing capacity of the remaining soft tissues and mandibular bone. Many of these problems can, at least in part, be diminished by the use of endosseous oral implants. These implants can contribute to the stabilisation of the prostheses and intercept the main part of the occlusal loading. Surgical interventions after radiotherapy are preferably avoided because of compromised healing, which may lead to development of radionecrosis of soft tissues and bone as well as to increased implant loss. If surgical treatment after radiotherapy is indicated, measures to prevent implant loss and development of radionecrosis have to be considered e.g. antibiotic prophylaxis and/or pre-treatment with hyperbaric oxygen (HBO). To avoid this problem, implant insertion during ablative surgery has to be taken into consideration if postoperative radiotherapy is scheduled or possibly will be applied. This approach is in need of a thorough pre-surgical examination and multidisciplinary consultation for a well-established treatment planning. The primary curative intent of the oncological treatment and the prognosis for later prosthodontic rehabilitation have to be taken into account too.

Dental Implantation, Endosseous↗

[Vicryl Rapide versus Safil Quick. A prospective comparison of two fast resorbing suturing materials].

Currently, there are two fast-resorbing suturing materials on the Dutch market, viz. Vicryl Rapide and Safil Quick. The aim of this study was to compare the clinical suitability of both suturing materials, which was defined as minimal discomfort or pain for the patient, good knot security and tensile strength, predictable resorption, minimal tissue response, and good wound healing. In a group of 120 patients (60 patients randomized in each group), who were referred for apectomy, the clinical suitability of Vicryl Rapide and Safil Quick as fast-resorbing suturing materials was prospectively studied. The results showed that the tested materials were equivalent with regard to most aspects of their clinical suitability.

Absorption↗

[Swelling of lips as a first sign of acromegaly].

A 65-year-old female patient with swelling of lips and submandibular glands was referred to the department of Oral and Maxillofacial Surgery of an academic hospital. The patient was worried about her changed appearance and her general fatigue. This condition had not changed during the last six months, although she slept more. Despite extensive investigations her complaints could not be diagnosed as of oral or maxillofacial origin. She thereupon was referred to the department of internal Medicine to screen for an endocrine aetiology. Laboratory tests were positive for acromegaly.

Acromegaly↗

[Oral surgery in general dental practice 1. Preface].

Delegation of basic dental treatment to well-trained oral hygienists, dental nurses, and dental technicians will result in more time for the general practitioner to treat more specialized dental problems. In two issues of this journal, some surgical treatments which can be delivered by a dentist with special skills on this topic, are discussed. This first issue concentrates on the treatment of odontogenic abscesses, the removal of teeth and roots, the treatment of a perforation of the maxillary sinus floor, and apectomies.

Delivery of Health Care↗

[The odontogenic abscess. Aetiology, treatment and involvement in the orofacial region].

Odontogenic infections are a common problem in daily practice. Occasionally, an odontogenic infection evolves an abscess. This article discusses the aetiology, the treatment and the involvement of odontogenic abscesses in the oro-facial region. Their occurrence, course and treatment are depending on the patient's immune response, and on microbial and environmental factors.

Abscess↗

[Dentoalveolar surgery for the dentist: removal of teeth and root tips].

The indication for surgical removal of teeth or roottips is often made in dental practice. In some cases a general practitioner will decide to perform the surgical procedure himself, while in other cases he will refer the patient to an oral and maxillofacial surgeon. Level of difficulty of the treatment and the experience, the time available, the availability for postoperative care, and the personal interest of the dentist are factors involved in decision making. It is likely that with increased experience, the dentist will be able to perform more complicated treatments. This article supports this process. Surgical removal of teeth and roottips is systematically described, with emphasis on technical aspects. Presurgical management, removal of singlerooted and multirooted teeth, woundcare and postoperative management are the subjects covered.

Decision Making↗

[Dentoalveolar surgery for the dentist: removal of third molar].

In contrast to removal of other teeth and roottips, a third molar is mostly removed for preventive reasons. There is still debate about the correct indications for removal of third molars. As soon as the decision to remove a third molar surgically is made, the dentist has to decide between performing the surgical procedure himself or referring the patient to an oral and maxillofacial surgeon. Level of difficulty of the treatment and experience, available time, availability for postoperative care, and personal interest of the dentist are issues influencing this decision. This article describes systematically the indications, for instance using preoperative radiodiagnostics, the factors determining the technical surgical plan, as well as the practical surgical procedures.

Decision Trees↗

[Oral surgery in general dental practice 2. Preface].

In two issues of the journal, some surgical treatments which can be delivered by a dentist with special skills on this topic, are discussed. This second issue concentrates on interventions occurring less frequently or not treated by every dentist in general practice. It concerns dental traumas, eruption disorders, removal of a hypertrophied frenulum of the upper lip and reconstructive preprosthetic surgery. Finally, some complications of dentoalveolar surgery are discussed.

Delivery of Health Care↗

[Dentoalveolar traumatology].

The dentist will be confronted unexpectedly with a dentoalveolar trauma patient. This patient has to be seen immediately and has to be treated adequately. The risk of overlooking trauma-related signs when examining these patients, can be minimized by following a strict protocol. This article describes a protocol for examination and treatment of a patient with a dentoalveolar trauma. The prognosis after treatment of the trauma is discussed. Also some recommendations regarding aftercare and prevention are presented.

Alveolar Process↗

[Eruption disturbances].

Eruption disturbances of teeth should not be considered as a curiosity. Acquaintance with these phenomena should form a substantial component of the dentist's, orthodontist's and oral and maxillofacial surgeon's basic expertise. Early detection of these disturbances followed by treatment in due time, can minimise progressive negative effects, such as the development of severe malocclusion. Treatment modalities are described.

Child↗

[Reconstructive preprosthetic surgery 1. Corrections of soft tissues and bone].

The aim of reconstructive preprosthetic surgery is the creation of an environment of hard and soft tissue which is favourable to the function of an aesthetically optimal prosthesis, with or without oral implants. In this paper, various preprosthetic surgical treatments for correcting soft and hard tissues are discussed.

Alveolar Bone Loss↗

[Reconstructive preprosthetic surgery 2. Pre-implantologic surgery].

Reconstructive preprosthetic surgery is, amongst others, aimed at the creation of an environment which is favourable to the construction of an implant supported prosthesis. Not in all cases the pre-existent volume of bone is sufficient to place an implant in the planned position. In this paper various techniques to augment local bone defects for reliable implant placement are described.

Alveolar Bone Loss↗

[Research methods in dentistry 2. Methods for determining the flow rate of saliva].

For patients with complaints of either hyposalivation or hypersalivation, or saliva with altered properties, the secretory flow rate can be determined in an easy way to study whether abnormalities are detectable. It is most simple to measure the flow rate of whole saliva. After collection of saliva the oral fluid can be analyzed on rheological properties, such as viscosity and elasticity and also on pH and its chemical composition. Oral fluid is the combined fluid in the oral cavity mainly composed of glandular salivas, and in addition crevicular fluid and serum exsudate. For collection of oral fluid it is of crucial importance to standardize the conditions. The diverse collection methods and their application for patient research with oral complaints are described.

Humans↗