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Biomedical subjects

A Vissink

Publications and source records attributed to A Vissink.

At least 91 records · Page 5Linked to original sources

Early radiation effects on muscarinic receptor-induced secretory responsiveness of the parotid gland in the freely moving rat.

Although the salivary glands have a low rate of cell turnover, they are relatively radiosensitive. To study the possible mechanism behind this inherent radiosensitivity, a rat model was developed in which saliva can be collected after local irradiation of the parotid gland without the use of anesthetics or stressful handling. Saliva secretion was induced by the partial muscarinic receptor agonist pilocarpine (0.03-3 mg/kg) with or without pretreatment with the beta-adrenoceptor antagonist propranolol (2.5 mg/kg), or the full muscarinic receptor agonist methacholine (0.16-16 mg/min), and measured during 5 min per drug dose before and 1, 3, 6 and 10 days after irradiation. The maximal secretory response induced by pilocarpine plus propranolol was increased compared to that with pilocarpine alone but did not reach the level of methacholine-induced secretion, which was about five times higher. One day after irradiation a decrease in maximal pilocarpine-induced secretion was observed (-22%) using the same dose of pilocarpine that induces 50% of the maximal response (ED(50)), in both the absence and presence of propranolol, indicating that the receptor-drug interaction was not affected by the radiation at this time. The secretory response to methacholine 1 day after irradiation, however, was normal. At day 3 after irradiation, the maximal methacholine-induced secretion was also affected, whereas pilocarpine (+/-propranolol)-induced maximal secretion decreased further. At day 6 after irradiation, maximal secretory responses had declined to approximately 50% regardless of the agonist used, whereas ED(50) values were still unaffected. No net acinar cell loss was observed within the first 10 days after irradiation, and this therefore could not account for the loss in function. The results indicate that radiation does not affect cell number or receptor-drug interaction, but rather signal transduction, which eventually leads to the impaired response. We hypothesize that the early radiation effect, within 3 days, may be membrane damage affecting the receptor-G-protein signaltransfer. Later critical damage, however, is probably of a different nature and may be located in the second-messenger signal transduction pathway downstream from the G protein, not necessarily involving cellular membranes.

Adrenergic beta-Antagonists↗

Vertical distraction of the severely resorbed mandible. The Groningen distraction device.

In this paper, both the surgical procedure and the clinical results of a novel distraction device to augment a severely resorbed anterior edentulous mandible are described. The distraction device is non-voluminous, and consists of two distraction screws and one guide screw. Two months after the last day of distraction, both distraction screws are replaced by endosseous implants and the guide screw is removed. Three months after implantation, the prosthetic treatment can be started. So far three patients have been treated. In all patients, the severely resorbed mandible (mandibular height in the canine region: 5, 6 and 7 mm, respectively) could be sufficiently enlarged to enable reliable insertion of endosseous implants with a length of at least 12 mm. No complications occurred. Biopsies taken from the distraction site revealed formation of lamellar bone parallel to the distraction vector. From this preliminary study it is concluded that the Groningen vertical distraction device has the potential for reliable augmentation of the anterior segment of a severely resorbed edentulous mandible to enable insertion of endosseous implants with adequate length and primary stability.

Aged↗

[Interface between dentistry and otorhinolaryngology].

In this paper some relevant pathological aspects on the interface of dentistry and ENT surgery are discussed. A major part of the field of ENT surgery is not available for direct inspection and/or evaluation. Therefore, ENT pathology is often overseen or not detected at an early stage. Because of frequent patient-dentist contact, also in healthy patients, dentists can play an important role in early detection of ENT pathology. The combination of specific anatomic knowledge of the ENT region and a proper anamnesis are potent tools for a dentist to suspect ENT pathology, even in not easily accessible areas like the hypopharynx and oesophagus.

Dentistry↗

[Hypersalivation, lesions of oral mucosa and generalized fatigue].

In case of a combination of hypersalivation and mucosal disease that rapidly progresses towards becoming indisposed, one has to consider an underlying general disease. In this paper a patient with these complaints, who visited the emergency department of the Groningen University Hospital, is described. The patient appeared to be suffering from a specific form of erythema multiforma, viz. the syndrome of Stevens-Johnson.

Acute Disease↗

[Syndromes 19. Fetal alcohol syndrome].

Foetal alcohol syndrome is a syndrome with a rather high incidence. It is characterized by mental retardation, growth deficiency, a striking facial appearance (a.o. short palpebral fissures, short, upturned nose, hypoplastic philtrum, hypoplastic maxilla). Malocclusion and a disturbed facial growth may occur. Mental retardation can interfere with dental treatment.

Child, Preschool↗

[Syndromes 20. Tuberous sclerosis complex].

Tuberous sclerosis complex (TSC) is an autosomal dominantly inherited disease. It is clinically a very variable disorder. Hamartomas can develop in many different organs, including the skin, kidneys, heart and brain. Diagnosis of patients with minimal expression of the disease can be very difficult. The dentist can contribute to the (early) diagnosis of the disease.

Amelogenesis Imperfecta↗

Morbidity and complications of bone grafting of the floor of the maxillary sinus for the placement of endosseous implants.

Placement of endosseous implants in the atrophic maxilla is often limited because of a lack of supporting bone. A technique to augment the floor of the maxillary sinus with autogenous bone graft seems to be a new reliable treatment modality. The morbidity and complication rate of augmentation of the maxillary sinus floor was studied in 75 patients. The sinus floor was augmented with iliac crest (n = 65, 128 sinuses, 276 implants), mandibular symphysis (n = 8, ten sinuses, 21 implants), or maxillary tuberosity grafts (n = 2, two sinuses, two implants). The width of the alveolar crest had to be reconstructed in 52 patients, while in the other 23 patients augmentation and implantation were performed simultaneously. Perforation of the sinus membrane occurred in 45 patients, but this did not predispose them to the development of sinusitis. Loss of bone particles and sequesters were observed in one (diabetic) patient only, in whom a mucosal dehiscence occurred. A second augmentation procedure was successful. Symptoms of transient sinusitis were observed in two of the seven patients with a predisposition for sinusitis. These symptoms were successfully treated with decongestants and antibiotics. One patient developed a purulent sinusitis which resolved after a nasal amrostomy. The bone volume was sufficient for insertion implants in all patients. Twenty of 299 patients (6.7%) in whom Brånemark implants had been inserted were lost to follow-up (mean, 32 months); no sinus pathology was observed. The patients received implant-supported overdentures (58 patients) or fixed bridges (17 patients) and experienced no complaints with regard to the grafts or implants. We conclude that the morbidity and complication rate of bone grafting of the floor of the maxillary sinus floor with autogenous bone is low.

Adolescent↗

Helicobacter pylori and ammonia concentrations of whole, parotid and submandibular/sublingual saliva.

The aim of this study was to determine the ammonia concentration in whole, parotid and submandibular/sublingual saliva of healthy volunteers using the indophenol direct method. It also investigated the hypothesis that higher saliva ammonia concentrations are associated with the presence of Helicobacter pylori (H. pylori) in the oral cavity. In healthy volunteers, the mean ammonia concentration of whole saliva (2574 mumol/l) was significantly higher (P < 0.0001) than the mean ammonia concentration of both parotid (238 mumol/l) and submandibular/sublingual (355 mumol/l) saliva. In whole saliva, no difference in ammonia concentration was found between healthy controls and dyspeptic patients (mean ammonia values 2574 and 2489 mumol/l respectively, P = 0.7). In addition, no significant differences were observed in the salivary ammonia concentration between dyspeptic patients with and without H. pylori carriage. It is concluded that the ammonia concentration in parotid and submandibular/sublingual saliva does not differ, but is significantly lower than the ammonia concentration of whole saliva. This difference is not due to carriage of H. pylori with its strong urease activity. Therefore, the determination of ammonia in whole saliva is an inappropriate screening test for patients being at risk for (chronic) gastritis and peptic ulcer disease.

Adult↗

Complications of internal fixation of maxillofacial fractures with microplates.

PURPOSE: The aim of this retrospective study was to evaluate the complications of open reduction and internal fixation of maxillofacial fractures with microplates. PATIENTS AND METHODS: In 44 patients with maxillofacial trauma, fractures of the maxillofacial skeleton were treated by open reduction and internal fixation using a 1.0-mm and 1.5-mm microsystem. Simultaneously occurring fractures of the mandible or frontozygomatic suture were treated with a 2.0-mm miniplate system. Perioperative and postoperative complications were traced using patient charts, operation reports, and radiographs. The average follow-up was 46.8 months (range, 31 to 54 months). RESULTS: A total of 124 1.0-mm microplates and 546 1.0-mm microscrews, and 17 1.5-mm microplates and 75 1.5-mm microscrews, was used. The perioperative complication rate was 1.2% for the 1.0-mm screws (use of four emergency screws, breakage of one screw in the dense frontozygomatic suture area, and an insertion of a screw in a premolar root). The postoperative complication rate was 0.8% for the 1.0-mm screws (screw dislocation without clinical implication). No complications were observed with the 1.5-mm system. Plate-related infection did not occur. All fractures healed well. Three patients asked for plate removal because of a vague, persisting pain in the treated area. After removal, only one patient was free of pain. A loose 1.5-mm screw was found in this patient. CONCLUSION: The overall complication rate for microsystems was 2.0%. Both microsystems proved to be a reliable modality to fix fractures of the maxillofacial skeleton. Complications can be considered incidental and of neglectable clinical significance.

Adolescent↗

Results of intentional replantation of molars.

PURPOSE: This study evaluated the treatment outcome of intentional replantation of molars. PATIENTS AND METHODS: Twenty-nine patients were treated with intentional replantation because conventional apicoectomy was not possible. The success rate was judged by clinical and radiographic parameters. RESULTS: One molar (3%) had to be removed because of pain and mobility 4 weeks postsurgery, and three molars (11%) had to be removed during the first year because of periodontal problems. Four molars (14%) showed periodontal problems or root resorption, but are still in function and causing no obvious problems to the patients. Twenty-one molars (72%) were successfully treated. CONCLUSION: Intentional replantation is a reliable and predictable treatment for those cases in which conventional apicoectomy is hampered because of anatomic limitations or patient factors.

Adult↗

Primary sialoangiectasia--a diagnostic pitfall in Sjögren's syndrome: case report.

A case of primary sialoangiectasia, which in this case was initially misdiagnosed as Sjögren's syndrome, is described. Other diseases, including HIV infection, psoriatic arthritis, and acute parotitis, may cause glandular changes similar to the changes found in the syndrome. Therefore, sialography must be combined with other methods of assessment of the oral cavity when suspicion is high for Sjögren's syndrome. Properly applied, sialography provides essential information regarding the severity of glandular damage and the progression of the disease.

Diagnosis, Differential↗

[Local bone augmentations for the use of implants].

Placement of endosseous implants is often restricted because of lack of supporting bone, limiting placement of implants of adequate length in a prosthodontically optimal position. Several surgical procedures have been described to create sufficient volume of bone for placement of implants. In this paper, various techniques are described for harvesting intraoral bone grafts for augmentation of a localized defect of the alveolar ridge.

Alveolar Bone Loss↗

[The effect of drugs on the orofacial area].

The oral and maxillofacial region is affected by the negative side effects of a wide variety of endogenic and exogenic factors including drugs. Drugs are commonly used to treat oral and maxillofacial diseases, but more often the oral and maxillofacial region is affected by the side effects of drugs and home-remedies on the orofacial tissues taken by the patient himself or prescribed by a dentist or physician. In this paper both factors are described which the dentist has to consider when he prescribes a drug as well as the oral and maxillofacial side effects of a variety of drugs.

Age Factors↗

[Syndromes 16. Osteogenesis imperfecta].

Osteogenesis imperfecta consists of a group of hereditary connective tissue diseases with fragility of the bone as a general feature. Frequently occurring other characteristics are blue sclerae, opalescent teeth, hearing loss, disorders of the skeleton, and hyperextensibility of the joints. Obliteration and the unusual shape of the pulp chambers may interfere with dental treatment.

Humans↗