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Biomedical subjects

A Vissink

Publications and source records attributed to A Vissink.

At least 73 records · Page 4Linked to original sources
PubMed2001

Parotid and submandibular/sublingual salivary flow during high dose radiotherapy.

It was studied whether differences in acute radiosensitivity exist between parotid and submandibular/sublingual glands. The results revealed that salivary flow rates decreased dramatically during the first 2 weeks of radiotherapy. Neither recovery nor significant differences were observed between the production of saliva from the parotid and submandibular/sublingual glands during the 13 weeks observation period.

Adult↗
PubMed2001

Maxillary bone grafting for insertion of endosseous implants: results after 12-124 months.

Insertion of endosseous implants in the atrophic maxilla is often complicated because of lack of supporting bone. Augmentation of the floor of the maxillary sinus with autogenous bone graft has been proven to be a reliable treatment modality, at least in the short term. The long-term clinical and radiographic outcome with regard to the grafts, the implants and satisfaction of the patients with their implant-supported overdenture was studied in 99 patients. The sinus floor was augmented with bone grafts derived from the iliac crest (83 subjects, 162 sinuses, 353 implants), the mandibular symphysis (14, 18, 37), or the maxillary tuberosity (2, 2, 2). Before implant installation, the width and height of the alveolar crest were increased in a first stage procedure in 74 patients, while in the other 25 patients augmentation and implant installation could be performed simultaneously (width and height of the alveolar crest >5 mm). Perforation of the sinus membrane occurred in 47 cases, which did not predispose to the development of sinusitis. Loss of bone particles and sequestration were observed in one (diabetic) patient only, in whom a dehiscence of the oral mucosa occurred. A second augmentation procedure was successful in this patient. Symptoms of transient sinusitis were observed in 3 patients. These symptoms were successfully treated with decongestants and antibiotics. 2 other patients developed a purulent sinusitis which resolved after a nasal antrostomy. In all cases, the bone volume was sufficient for implant insertion. 32 of 392 inserted Brånemark implants (8.2%) were lost during the follow-up. After the healing period of the bone grafts, no sinus pathology was observed. The patients received implant-supported overdentures (72 patients) or fixed bridges (27 patients). Overall, the patients were very satisfied with the prosthetic construction. We conclude that bone grafting of the floor of the maxillary sinus floor with autogenous bone for the insertion of implants is a reliable treatment modality with good long-term results.

Adolescent↗
PubMed2001

Morbidity of chin bone harvesting.

The chin is a very common donor site for autogenous bone grafts. The aim of this retrospective study was to evaluate long-term morbidity of the donor site following chin bone graft harvesting. One to three years after grafting of local bone defects of the anterior maxilla with chin bone, 21 patients were recalled for objective assessment of any residual morbidity at the harvesting area. Morbidity as well as satisfaction of the patients were evaluated by a survey of the medical record, a mail-in questionnaire, and a standardized physical examination. The outcome of this study showed that there was good acceptance of the chin bone harvesting procedure. The objective morbidity was low, but subjectively almost half of the patients reported a changed (decreased) sensibility in the harvesting area. This subjective change in sensibility did not result in noteworthy complaints or discomfort by the patients, however. Although bone harvesting from the chin is generally considered as a good option for reconstruction of local bony defects, the patients should be informed about the potential hazard of a changed sensibility in the chin region.

Adolescent↗
PubMed2001

Morbidity from parotid sialography.

OBJECTIVE: Sialography is commonly used for the diagnosis of Sjögren's syndrome, although its invasive nature is often regarded as a serious drawback for routine usage. The aim of this study was to evaluate the morbidity and acceptability of parotid sialography using oil-based contrast fluid. STUDY DESIGN: Twenty-four consecutive sialographic procedures were evaluated in terms of morbidity and the patient's acceptance of the procedure, assessed with a standardized questionnaire. Information was also obtained by recording relevant physical parameters during the procedure. RESULTS: There was good acceptance of the sialographic procedure, and the morbidity was low. No signs of overfilling or false route were observed in any of the sialograms. On average, 0.74 mL of contrast fluid was infused with a velocity of 0.01 mL/s. The whole procedure was completed within 12 minutes. CONCLUSIONS: Parotid sialography appears less invasive than is often thought. It had a low morbidity rate and was well accepted by the patients.

Adult↗
PubMed2001

Sialometry and sialochemistry: diagnostic tools for Sjögren's syndrome.

BACKGROUND: The common occurrence of xerostomia in Sjögren's syndrome (SS) as well as the easy accessibility of saliva supports the use of sialometry and sialochemistry in the diagnosis of SS. Collection and analysis of whole saliva (oral fluid) is currently the routine technique for sialometry, despite the fact that it is rather inaccurate and impure. OBJECTIVE: To assess the value of glandular sialometry and sialochemistry as diagnostic instruments in SS. METHODS: In a group of 100 consecutive patients referred for diagnosis of SS, glandular secretory flow rates and a spectrum of salivary components (sodium, potassium, chloride, calcium, phosphate, urea, amylase, total protein) were assessed. The patients were classified as positive or negative for SS according to the revised European classification criteria. RESULTS: Patients with SS differed clearly from those who tested negative for SS, showing lower submandibular/sublingual (SM/SL) flow rates and an appreciably changed salivary composition of parotid and SM/SL saliva. Besides changes in salivary flow rate and composition, distinct sialometric profiles were observed, characteristic of either early or late salivary manifestation of SS, or of the xerogenic side effects of medication. CONCLUSIONS: Glandular sialometry and sialochemistry are not only useful tools for differentiating SS from other salivary gland disease in clinical practice, but they also have great potential as diagnostic criteria for SS, showing distinct sialometric and sialochemical changes as well as profiles. Being simple, safe (non-invasive), and sensitive (early disease detection), they have three major advantages over other oral tests for SS.

Adult↗
PubMed2001

[Oral medicine].

Oral medicine is the discipline in dentistry which deals with diagnosis and non-surgical treatment of lesions and diseases of the oral tissues, particularly those of a systemic, multiorgan or drug-induced nature. In the Netherlands, the oral and maxillofacial surgeon is usually the one who takes care of oral medicine. In the dental curriculum in the Netherlands oral medicine is not taught as a separate discipline, but is included in the courses of oral and maxillofacial surgery, oral pathology, periodontology and also, amongst others, in the course of biochemistry. In the Netherlands it is not a recognised speciality and it is questionable whether there really is a need for it. In the medical curriculum and in the training program for family doctors only a very few hours on oral diseases is included. Since many patients with oral diseases see their family doctor first, an extension of the numbers of hours on oral diseases in general and, more specific, in oral medicine, in the medical curriculum is recommended.

Curriculum↗
PubMed2001

[Diagnosis and therapy of non-odontogenic orofacial infections].

This article discusses the non-odontogenic inflammations of the oral mucosa, connective tissue, bone and temporomandibular joint. Their occurrence, course and treatment are related to the patient's immune status, and to microbial and environmental factors, as is always the case with infectious processes. The article concerns peculiarly several clinical and therapeutic consequences of non-dontogenic orofacial infections.

Candidiasis, Oral↗
PubMed2001

[Vesiculobullous lesions of the oral mucosa].

In general practice, the dentist can be confronted with a vesiculobullous lesion of the oral mucosa. In many cases the lesion can be classified as recurrent herpes labialis, but many other causes can induce a vesiculobullous lesion of the oral mucosa and perioral skin as well. This article gives an overview of the various vesiculous and bullous lesions of the oral mucous membranes. Special attention is given to the possible causes and their treatment.

Blister↗
PubMed2001

[Disorders of taste and smell].

Disorders of taste and smell not only are uncomfortable to the person involved, e.g. because of an impaired hedonic and sensory experience of food or the continuous presence of a nasty taste, but can also result in loss of body weight and may have a negative influence on the quality of life. In this article both the physiology of chemosensory function and dysfunction of taste and smell are discussed as well as some clinical consequences and their treatment.

Ageusia↗
PubMed2001

[Oral complications of anorexia nervosa, bulimia nervosa and other metabolic disorders].

Eating disorders like anorexia nervosa and boulimia nervosa may have consequences for both the oral tissues and the salivary glands. In the oral cavity these eating disorders result frequently in dental erosion, but also in dental caries. The salivary glands are regularly swollen without pain; a hypofunction in the salivary secretory process may develop resulting in dry mouth feelings. In this paper these aspects will be reviewed and illustrated with patient cases.

Adult↗
PubMed2000

Horizontal osteotomy for reconstruction of the narrow edentulous mandible.

The aim of this retrospective study was to evaluate the applicability of a horizontal osteotomy procedure for reconstruction of a narrow edentulous mandible in order to enable insertion of implants. In 7 edentulous patients a narrow inferior alveolar ridge was reconstructed with autogenous bone grafts harvested by a horizontal osteotomy procedure (mean width of the top of the alveolar crest before grafting 1.3 +/- 0.3 mm, after grafting 5.6 +/- 0.6 mm). Insertion of endosseous implants (10 Brånemark implants, 8 ITI Bonefit implants) was performed 3 months after the grafting procedure. Implant supported overdentures were fabricated 3 months after implantation. At regular time intervals a standardized clinical and a radiographic evaluation was performed. All grafted sites showed sufficient bone volume for insertion of the implants at the moment of implantation. At time of evaluation (mean 37 +/- 14.6 months, range 14-68 months) all implants and overdentures functioned well. None of the patients showed a disturbed sensitivity of the lip or chin region. It is concluded that reconstruction of a narrow edentulous mandible with autogenous bone grafts harvested by an intraoral horizontal osteotomy was shown to be a reliable preimplantology procedure with potential applicability in this group of patients.

Adult↗
PubMed2000

Effectiveness of three treatment modalities for the edentulous mandible. A five-year randomized clinical trial.

Currently, 3 treatment options are available for patients with denture complaints and an edentulous mandible with a height of at least 15 mm: 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), and construction of an implant-retained mandibular overdenture (IRO). The aim of this study was to evaluate patient satisfaction and subjective chewing ability of edentulous patients treated with one of these treatment modalities. Ninety edentulous patients (Cawood class IV and V, mean mandibular height 20.7 mm) were randomly assigned to receive 1 of these 3 groups. Denture satisfaction and chewing ability were assessed using questionnaires focusing on denture-related complaints and problems chewing different types of food were assessed before treatment, and 1- and 5-years after treatment. At the 1-year evaluation, significantly better scores were observed in the 2 surgical groups (IRO, PPS) than in the CD group. 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. No significant differences were observed between the PPS and CD group. From this study it is concluded that both in 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 satisfactory treatment modality for edentulous patients with problems with their lower denture, even in cases of not severely resorbed mandibles.

Analysis of Variance↗
PubMed2000

Etiology and management of mandibular fractures associated with endosteal implants in the atrophic mandible.

Mandibular fractures can occur with the insertion of endosseous implants. Four patients whose mandibles were fractured with the removal or insertion of mandibular endosseous implants are described. Three of the patients required an autogenous bone graft to repair the fracture, and 1 patient was managed with a reconstruction plate. Strategies for prevention and treatment of this uncommon complication are discussed.

Aged↗
PubMed2000

Radiation induced cell loss in rat submandibular gland and its relation to gland function.

PURPOSE: To understand early and late radiation-induced loss of function of the submandibular gland, changes in cell number were documented and correlated with data on gland function. Modulation of the radiation effect by sialogogues was used to investigate possible mechanisms of action. MATERIALS AND METHODS: Rats were irradiated with a single dose of 15 Gy of X-rays after pre-treatment with either saline, the muscarinic receptor agonists methacholine or pilocarpine, the adrenergic receptor agonist phenylephrine or methacholine plus phenylephrine. Before and 1-240 days after irradiation, submandibular saliva flow rate was measured. At the same time points and from comparable animals submandibular glands were carefully extirpated, weighed and prepared for light microscopic examination. RESULTS: Soon after irradiation (<30 days) no significant loss of cells was observed, whereas the gland function was severely compromised. Sialogogue pre-treatment attenuated the radiation-induced loss of gland function. At later intervals a considerable loss of acinar cells and to a lesser extent loss of granular convoluted tubule cells were observed. Gland function subsequently declined slowly. Pre-treatment with sialogogues gave transient protection against cell loss and loss of gland function. CONCLUSIONS: The lack of cell loss observed soon after irradiation indicates that the observed reduction in gland function was caused by a compromised functioning of the acini. The later loss of cells is probably due to death of cells that normally proliferate, leading to a further reduced secretory capacity. Protection of gland morphology and function by sialogogues at later times must therefore involve resistance of progenitor cells to radiation-induced cell death.

Adrenergic alpha-Agonists↗