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Biomedical subjects

B N Epker

Publications and source records attributed to B N Epker.

At least 91 records · Page 5Linked to original sources
PubMed1981

The influence of mandibular advancement via modified sagittal split ramus osteotomy on the masticatory musculature.

The modification of the sagittal split ramus osteotomy have been introduced to optimize vascularity to the proximal segment and minimize the influence of the masticatory musculature on relapse following the surgical-orthodontic correction of mandibular deficiency. The biologic basis for increased vascularity in comparison to conventional techniques has been proved. This study was done to evaluate the influence of the modified sagittal split ramus osteotomy on the masticatory musculature following surgical advancement of the mandible. The kinesiometric and electromyographic findings in five adults who underwent surgical advancement of the mandible reveal that surgical advancement of the mandible via modified sagittal split ramus osteotomy does not significantly influence muscles of mastication.

Adult↗
PubMed1981

Surgical inferior repositioning of the maxilla: treatment considerations and comprehensive management.

Surgical inferior repositioning of the hypoplastic or vertically deficient maxilla is discussed with respect to various relevant treatment considerations, and a specific regimen for comprehensive management is recommended. Treatment considerations for persons with true vertical maxillary deficiency include esthetic, functional, and neuromuscular factors. Primary among these factors are the relationship between the maxillary incisor and the upper lip, the physiologic interocclusal space, and the masticatory bite force. A regimen for the comprehensive management of these factors is recommended to ensure skeletal stability. These measures include a careful surgical technique, transplantation of viable autogenous bone, critical evaluation of the physiologic interocclusal space, and elimination of destructive masticatory forces to the maxilla during healing of the graft by an intraoral skeletal fixation appliance. Adherence to these fundamental biologic principles ensures predictability to the inferiorly repositioned maxilla.

Adult↗
PubMed1981

Prolonged apnea after orthognathic surgery due to atypical cholinesterase.

Prolonged apnea (9 hours) after elective orthognathic surgery occurred in a healthy adult female. The patient had previously undergone multiple general anesthetics without any adverse reactions or complications. Measurement of the patient's serum postoperatively confirmed both a qualitative and quantitative defect in the cholinesterase enzyme. The genetic background for an atypical cholinesterase phenotype is briefly reviewed. Treatment modalities for this rare condition are also discussed.

Adult↗
PubMed1981

Ophthalmologic considerations in maxillofacial trauma. Anatomy and diagnostic evaluation.

The high incidence of orbital involvement in facial injuries necessitates a thorough ophthalmologic evaluation in virtually all cases. This article will provide the oral and maxillofacial surgeon with a review of the anatomy of the eye and ocular adnexa and present a systematic method of conducting and interpreting an ophthalmologic examination.

Conjunctiva↗
PubMed1981

Musculoskeletal adaption to surgical advancement of the mandible.

This study was carried out in order to evaluate musculoskeletal adaption to surgical advancement of the deficient mandible. 10 adult individuals with mandibular deficiency were studied before and 3 months after surgical advancement of the mandible via lateral cephalometric radiography, kinesiometry, and electromyographic instrumentation. 10 adult controls were studied at the same intervals, but underwent no surgery. The data was entered into a DEC System-10 computer for morphometric comparison and statistical analysis. The results of this investigation demonstrate that musculoskeletal adaptions occur within the stomatognathic system following surgical advancement of the mandible. 3 months following surgery, the clinical and physiological rest positions of the mandible as well as the masticatory electromyographic activity were unchanged in both the control and the surgery groups. The rapid, functional adaptions that occurred in the surgery group are apparently due to changes in posterior ramus-mandibular body relations and neuromuscular adaption within the masticatory and suprahyoid musculature.

Adaptation, Physiological↗
PubMed1981

Lesch-Nyhan syndrome: surgical treatment in a case with lip chewing. A case report.

Lesch-Nyhan Syndrome (LNS) is a biochemical disorder characterized by a virtually complete deficiency of an enzyme of purine metabolism, hypoxanthineguanine phosphoribosyltransferase. This sex-linked recessive inborn error of metabolism is characterized clinically by: hyperuricaemia, excessive production of uric acid, certain characteristic neurological features including self-mutilation, choreoathetosis, spasticity and mental retardation. This paper will review the clinical, biochemical and genetic features of Lesch-Nyhan Syndrome and report a case in which repeated lip chewing resulted in destruction of the lower lip and the need for surgical intervention.

Child↗
PubMed1981

Neuromuscular adaptation to surgical superior repositioning of the maxilla.

This study was designed to evaluate neuromuscular adaption to orthognathic surgery. Fifteen adults were evaluated before and three months after surgical superior repositioning of the maxilla via computerized morphometric, kinesiometric, and electromyographic instrumentation. The findings of this study suggest that immediate and complete adaptation mediated by the central nervous system is followed gradually by delayed and partial compensatory adaptation within the muscles, tendons, and bones of the stomatognathic system.

Adaptation, Physiological↗
PubMed1981

[Surgical removal of surplus vertical bone in the maxilla (author's transl)].

Excess length of the anterior part of the face secondary to maxillary vertical excess is called the Long Face Syndrome. It consists of a combination of neuromuscular, skeletal, occlusal, and functional characteristics. This syndrome is best corrected functionally and esthetically by surgical superior repositioning of the maxilla. Complete mobilisation of the maxilla is easily achieved by the surgical technique of downfracture. The results using this technique are excellent and very stable.

Facial Muscles↗
PubMed1980

Surgical superior repositioning of the maxilla: what to do with the mandible?

During superior repositioning of the maxilla (SRM), the mandible autorotates forward and upward at pogonion, with the condyle as the center of rotation. Thus, in each instance when planning surgical superior repositioning of the maxilla one must decide, on the basis of esthetics and cephalometric prediction criteria, the magnitude of autorotation and the contribution of this rotation toward the desired occlusal and esthetic result. In many instances the maxilla can be moved somewhat posteriorly or anteriorly, and thus simultaneous mandibular surgery is not required to achieve the desired result. In some cases, however, simultaneous mandibular advancement or set-back is required to achieve the desired occlusal and esthetic result. This article discusses the specifics of making the decision regarding what to do with the mandible when superiorly repositioning the maxilla.

Adolescent↗
PubMed1980

Hemifacial microsomia: an anesthetic airway problem.

Hemifacial microsomia is a rare congenitally acquired dentofacial deformity characterized by unilateral hypoplasia of the hard and soft tissues of the face and cranium. Associated anomalies of the vertebrae and hypopharynx cause perioperative airway management to be difficult. The case of a patient with severe heimfacial microsomia, cervical spine fusion, and temporomandibular joint ankylosis is presented, with special emphasis on anesthetic airway management. A device to aid fiberoptic nasolaryngoscopy when difficult endotracheal intubations are encountered is described.

Adult↗
PubMed1980

Total maxillary surgery.

The use of total maxillary surgery in the correction of various dentofacial and craniofacial deformities has become commonplace. Indeed, with current surgical techniques it is possible independently or simultaneously to reposition the maxilla in a superior, transverse, anterior, or posterior direction. By segmentalization of the maxilla under direct vision it is further possible to independently and simultaneously reposition portions of it in different planes of spaces. This paper will not attempt a detailed historical review, rather it will emphasize the current state of the art of total maxillary surgery.

Bone Transplantation↗
PubMed1980

Modified maxillary submucosal vestibuloplasty.

The literature during the past few decades is replete with methods to improve denture retention and stability. The maxillary submucosal vestibuloplasty is a relatively simple, yet effective method of increasing the functional alveolar ridge with a minimum of postoperative morbidity. This article presents a modification of the maxillary submucosal vestibuloplasty originally described by OBWEGESER. The procedure is indicated for edentulous patients who experience unsatisfactory denture retention and stability due to muscle and mucosal attachments located near the maxillary alveolar crest, have adequate bone height, and healthy vestibular mucosa. The modifications presented herein provide improved surgical exposure, improved vestibular depth, and a comfortable, hygienic and esthetic removable interim prosthesis.

Denture Design↗