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Biomedical subjects

A Vissink

Publications and source records attributed to A Vissink.

At least 55 records · Page 3Linked to original sources
PubMed2004

[A cystic lesion in the mandibular angle].

A 27-year-old male patient was referred by his dentist to a department of Oral and Maxillofacial Surgery, because of a radiolucent lesion in the mandibular angle. There were no clinical signs or symptoms. The orthopantomogram showed a sharp, demarcated, oval (1.5 x 2.5 cm), unilocular radiolucency caudal of the mandibular canal. Additional radiographic evaluation (CT scan, sialogram) revealed an oval depression in the lingual cortex of the mandible filled with salivary gland tissue. The diagnosis Stafne defect was made. At radiographic follow-up after 1 year, no progression of the lesion was seen. Treatment is not needed.

Adult↗
PubMed2004

[An unnecessary endodontic treatment and extraction due to defective diagnosis].

A 22-year-old male patient was referred by his dentist to a department of Oral and Maxillofacial Surgery because of recurrent swelling of the oral mucosa of unknown origin in region 17. One year before, molar 17, although clinically sound but showing an apical radiolucency, was endodontically treated. Eight months ago, molar 17 was removed because of recurrent complaints. Clinical examination revealed a fistula with purulent drainage in region 17. Radiographic examination revealed the cause, viz. a follicular cyst originating from the right wisdom tooth located in the maxillary sinus. Thus, the persisting complaints in region 17 were not related to molar 17, but related to a chronically inflamed follicular cyst originating from an impacted third molar.

Adult↗
PubMed2003

[Bilateral swelling of the parotid glands as part of a systemic disease].

In four patients, a man aged 34 years and three women aged 35, 32 and 55 years respectively bilateral swelling of the parotid glands was caused by systemic disease i.e. HIV-salivary gland disease, mucosa-associated lymphoid-tissue (MALT) lymphoma, sarcoidosis with coexisting Sjögren's syndrome, and sialosis and hypothyroidism, respectively. The HIV patient was treated with antiretroviral therapy, the first two women were treated expectantly and the third woman was given a thyroid hormone supplement which resulted in regression of the bilateral parotid enlargement. Bilateral enlargement of the parotid glands is not necessarily caused by infection, it can also be of systemic origin. Minimal invasive investigations of the salivary glands, such as sialography, measurement of salivary secretion rate (sialometry) and analysis of salivary composition (sialochemistry) can offer valuable information about the origin of the parotid gland swelling. Histopathological investigation of an incision biopsy of the parotid gland is an easy way to confirm the diagnosis. The morbidity associated with parotid biopsy is negligible.

Adult↗
PubMed2003

Oral sequelae of head and neck radiotherapy.

In addition to anti-tumor effects, ionizing radiation causes damage in normal tissues located in the radiation portals. Oral complications of radiotherapy in the head and neck region are the result of the deleterious effects of radiation on, e.g., salivary glands, oral mucosa, bone, dentition, masticatory musculature, and temporomandibular joints. The clinical consequences of radiotherapy include mucositis, hyposalivation, taste loss, osteoradionecrosis, radiation caries, and trismus. Mucositis and taste loss are reversible consequences that usually subside early post-irradiation, while hyposalivation is normally irreversible. Furthermore, the risk of developing radiation caries and osteoradionecrosis is a life-long threat. All these consequences form a heavy burden for the patients and have a tremendous impact on their quality of life during and after radiotherapy. In this review, the radiation-induced changes in healthy oral tissues and the resulting clinical consequences are discussed.

Cranial Irradiation↗
PubMed2003

Prevention and treatment of the consequences of head and neck radiotherapy.

The location of the primary tumor or lymph node metastases dictates the inclusion of the oral cavity, salivary glands, and jaws in the radiation treatment portals for patients who have head and neck cancer. The clinical sequelae of the radiation treatment include mucositis, hyposalivation, loss of taste, osteoradionecrosis, radiation caries, and trismus. These sequelae may be dose-limiting and have a tremendous effect on the patient's quality of life. Most treatment protocols to prevent these sequelae are still based on clinical experience, but alternatives based on fundamental basic and clinical research are becoming more and more available. Many of these alternatives either need further study before they can be incorporated into the protocols commonly used to prevent and treat the radiation-related oral sequelae or await implementation of these protocols. In this review, the various possibilities for prevention and/or treatment of radiation-induced changes in healthy oral tissues and their consequences are discussed.

Anti-Bacterial Agents↗
PubMed2003

[The ideal endodontic posts. A review of the literature].

Extensive research has been done regarding endodontic posts. In the majority of cases, only a few aspects are investigated. A literature review was performed regarding the various aspects that have to be considered when selecting a particular endodontic post for clinical application. The dentist has to realize that the ideal endodontic post (still) does not exist for all clinical situations. Most important is to achieve both a durable and a predictable result, sparing as much as possible of the root itself. Based on the literature, data presenting the requirements for an 'ideal' endodontic post are formulated.

Crowns↗
PubMed2003

[Behçet's syndrome].

A dentist referred a 35-year-old woman to the department of oral and maxillofacial surgery because of recurrent aphtous-like changes of the oral mucosa and persisting pain. She also experienced similar complaints about her eyes and genitals. This combination of symptoms was suspect for Behçet's disease.

Adult↗
PubMed2003

[Sjögren' syndrome: a progressive disease].

Sjögren's syndrome is an auto-immune disease resulting in, among other problems, serious eye and mouth dryness. The course of the disease, especially from an early towards a later phase, is largely unknown. The purpose of this study was to evaluate the symptoms and salivary gland function of Sjögren's syndrome patients, in order to gain insight in the possible progression of the disease. Forty-three patients were followed during a mean period of 3.5 years. Patients with a longer duration of oral symptoms showed more subjective complaints and less salivary flow when compared to patients with recent oral complaints. The differences in both the subjective and objective signs disappeared almost completely during follow-up. From this study it was concluded that Sjögen's syndrome is a progressive disease when diagnosed early. By asking specific questions the dentist can play an important role in early diagnosing the syndrome.

Disease Progression↗
PubMed2003

[Spontaneous blood blister formation swellings of the oral mucosa].

An 88 year-old man was hospitalized because of bullous pemphigoid of the skin with detectable autoantibodies against type XVII collagen. During his stay in the hospital, he developed easily bleeding hemorrhagic bullous lesions of the oral mucosa, which were thought to be an oral manifestation of bullous pemphigoid. A thorough blood examination showed acquired haemophilia A, related to the development of autoantibodies against factor VIII.

Aged↗
PubMed2003

A randomized prospective clinical trial on the effectiveness of three treatment modalities for patients with lower denture problems. A 10 year follow-up study on patient satisfaction.

Treatment of lower denture complaints of patients with an edentulous mandible with a height of at least 15 mm can consist of meticulous construction of a new set of dentures (CD), construction of a new set of dentures following preprosthetic surgery to enlarge the denture-bearing area (PPS), or construction of an implant-retained mandibular overdenture (IRO). The aim of this prospective randomized controlled clinical trial was to evaluate the satisfaction of the above mentioned treatment modalities in resolving lower denture related complaints. Ninety edentulous patients (Cawood class IV and V, mean mandibular height 20.7 +/- 2.7 mm) were randomly assigned to one of these treatment modalities. The main outcome parameters were denture satisfaction and chewing ability, which were assessed using validated self-administered questionnaires focusing on denture-related complaints and problems with chewing different types of food. These parameters were measured before treatment, and 1, 5 and 10 years after treatment. Differences among the three groups were tested by applying a one way analysis of variance and a Tukey's test for multiple comparison. At the 1 year evaluation, significantly better scores were observed in the two surgical groups (IRO, PPS) than in the CD group (P<0.05). At 5 year evaluation the 'complaints of the lower denture' showed a significantly better score in the IRO group when compared to the PPS and CD groups (P<0.05). No significant differences were observed between the PPS and CD group. At 10 year evaluation, the intention to treat analysis revealed no significant differences between the three groups, while a per protocol analysis showed that the IRO group was the most satisfied. From this study it is concluded that both on the short and long term denture satisfaction appears most favourable in the IRO group when compared to the PPS and CD groups. Implant-retained overdentures are, therefore, a favourable treatment modality for edentulous patients with lower denture problems.

Adult↗
PubMed2002

Sialometry and sialochemistry: a non-invasive approach for diagnosing Sjögren's syndrome.

BACKGROUND: Analysis of salivary variables has frequently been proposed as a diagnostic tool for Sjögren's syndrome (SS). Because univocal salivary reference values are lacking, it is currently rather difficult to use sialometry and sialochemistry for diagnosing SS unless major changes have occurred in salivary secretion and composition. OBJECTIVE: To define reference values of several salivary variables, which offer a possible new and non-invasive means of diagnosing SS. METHODS: Cut off points were selected from receiver operating characteristic curves of gland-specific sialometrical and sialochemical variables, which have proved to be potentially relevant for diagnosing SS in a previous study-that is, sodium, chloride, and phosphate concentration in stimulated parotid and submandibular/sublingual (SM/SL) saliva, unstimulated and stimulated SM/SL flow rates, and lag phase of parotid secretion, respectively. By combining the most discriminating variables, two different diagnostic approaches for SS were applied in a group of 100 patients and subsequently evaluated in a second group of 20 patients. The first approach was to combine variables by applying their cut off points into sets of criteria for a positive diagnosis of SS. The second approach was to construct a logistic regression model that predicts the true state of a patient (SS or non-SS). From both approaches, the tests with highest likelihood ratio combined with the smallest number of rejected cases were selected for clinical use. RESULTS: The most accurate test combined the stimulated SM/SL flow rate and parotid sodium and chloride concentration as salivary variables for diagnosing SS; it had a sensitivity of 0.85 and a specificity of 0.96. The selected tests proved equally accurate in the second group of patients. CONCLUSIONS: Because the proposed non-invasive diagnostic tools can be easily applied, do not need a laboratory other than for routine blood testing, and are very accurate, gland-specific sialometry and sialochemistry may eventually replace other, more invasive, diagnostic techniques for diagnosing SS.

Adult↗
PubMed2001

Treatment outcome of bone-anchored craniofacial prostheses after tumor surgery.

BACKGROUND: Percutaneous endosseous implants have acquired an important place in the prosthetic rehabilitation of patients with craniofacial defects. The objective of this study was to evaluate the clinical outcome of the use of endosseous implants in the orbital and auricular region as well as to assess the satisfaction of patients with implant-retained craniofacial prostheses after tumor surgery. METHODS: The clinical outcome and patient satisfaction of implant-retained prostheses in the auricular and orbital region were evaluated in a group of 26 patients with facial defects after tumor surgery by using standardized questionnaires and a clinical assessment. Twelve patients (n = 31 implants) received the implants during ablative tumor surgery, from which 7 patients (n = 20 implants) were treated with radiation therapy after surgery (mean, 65 grays [Gy]). Fourteen patients (n = 44 implants) received the implants after the tumor surgery, from which 5 patients (n = 21 implants) were irradiated after ablative surgery (mean, 54.4 Gy), but before implant placement. RESULTS: No implants were lost in patients who had not undergone irradiation (100%), whereas 5 implants were lost in the irradiated group (87.8%). The overall implant survival rate was 93.3%. The peri-implant tissues had a healthy appearance, and no cases of osteoradionecrosis occurred. When compared with patients treated with conventional adhesive retained facial prostheses, satisfaction was higher in patients treated with implant-retained facial prostheses. CONCLUSIONS: From this study, it is concluded that implant-retained facial prostheses are better tolerated than adhesive retained prostheses and offer an improvement in the quality of life. Radiotherapy is not a contraindication for the use of osseointegrated implants in the maxillofacial region, but the loss of implants is higher than in nonirradiated sites.

Adult↗