Biomedical subjects
Publications and source records attributed to B H Hendler.
Various materials have been used to repair orbital defects. This article advocates the use of autogenous conchal cartilage, especially in the repair of large posttraumatic defects, where contour, biocompatibility, and strength are most important. The technique for harvesting the cartilage is reviewed, and a case demonstrating its successful use is reported.
A new pulsed midinfrared laser has become available for use in arthroscopic surgery of the temporomandibular joint (TMJ). This article reviews holmium:YAG (yttrium-aluminum-garnet) laser physics, its tissue effects, and reports initial experience with its use in TMJ arthroscopy. Because the Ho:YAG laser can precisely and rapidly resect cartilaginous tissues with only moderate necrosis, can function in a saline environment, and can be transmitted through conventional optical fibers, it has the potential of becoming a useful and adaptable system for TMJ arthroscopic surgery.
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A 34-year-old black man underwent a left hemimandibulectomy with disarticulation for eradication of an extensive ameloblastoma. The resected mandible was immediately reconstructed by means of a titanium crib with an attached artificial condyle, which was overpacked with particulate bone removed from the iliac crest. Postoperative function and esthetics have been satisfactory. Histopathologic examination of the lesion disclosed an ameloblastoma with some features similar to those of a calcifying odontogenic cyst.
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Odontogenic myxoma is a tumor of primitive mesenchyme, probably derived from the dental apparatus. Surgical management of this benign but locally aggressive tumor is either by curettage or en bloc resection. Two cases of odontogenic myxoma of the mandible are reported. In one case, en bloc resection. Two cases of odontogenic myxoma of the mandible are reported. In one case, en block resection with immediate reconstruction was undertaken. In the second case, the neoplasm was thoroughly curetted. The first case was studied by electron microscopy. Six ultrastructural studies of seven odontogenic myxomas have been previously reported. The ultrastructural features of odontogenic epithelium that may be present in myxomas of the jaws have been examined by electron microscopy once before. Our observations are in agreement with those of other workers who suggest that the connective tissue cell is the proliferating component of the tumor and is very similar to a fibroblast but has enough ultrastructural and functional features to deserve the term myxoblast. The majority of the tumor cells are metabolically active and secretory and there is adequate evidence that the tumor matrix consists of large amounts of mucopolysaccharides. It is reasonable, therefore, to conclude that myxoblasts secrete the mucoid matrix that is so characteristic of odontogenic myxomas. Unlike normal or neoplastic fibroblasts, the myxoblasts are not engaged in abundant synthesis of banded collagen throughout the entire lesion.
A case of necrotizing mediastinitis that caused death in a 38-year-old man has been reported. The cause of his infection was proved, both radiographically and clinically, to be dental infection associated with the lower molars and their supporting structures. A diffuse cellulitis involving the submandibular, masticator, and parapharyngeal spaces ensued. Sudden onset of severe pleuritic chest pains and a 100% pneumothorax of the left lung developed, which ultimately led to his death.
A four-week hospital-based program offers a comprehensive course for dental students in the evaluation and management of medical emergencies. The program first emphasizes medical evaluation with the taking of accurate, comprehensive patient histories and the performance of physical examinations; information about supportive care, including intravenous techniques and airway maintenance, is given. The diagnostic signs and treatment of common medical emergencies, as taught in the program, are described.
Inpatient hospital dentistry has been reviewed. The expanding role of the hospital as a focal point for dental treatment of the healthy as well as medically compromised patient has been emphasized. A portion of this article has been devoted to admission and discharge procedures for the dental inpatient. The hospital chart is seen as the only instrument and record of the patient management and thus the various parts of the chart have been outlined. A review of the common laboratory tests useful to dentist and physician alike is included in this section. It is hoped that the material contained herein will serve as a guide to the general dentist or specialist who may utilize the hospital to admit patients.
High resolution computed tomography (CT) has been a mainstay in the preoperative evaluation of odontogenic lesions. Unsurpassed bony detail is complemented by exquisite delineation of the soft tissue mass itself. Our experience with these lesions is presented. Selected illustrations are supplemented by pathologic review.
High-resolution computed tomography (CT) is evolving as the most valuable radiographic study when detailed information about the status of the temporomandibular joint is needed. High-resolution CT is faster, less invasive, and in most cases much more accurate than other imaging modalities used in the past. Erosive, hypertrophic, and ankylosing arthropathies are illustrated, as are condylar dislocations secondary to acute trauma, chronic trauma, and neoplasm. A detailed discussion of the common problem of the anterior displaced meniscus is undertaken.