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Biomedical subjects

D E Tolman

Publications and source records attributed to D E Tolman.

45 records · Page 3Linked to original sources
PubMedDate not supplied

Maxillary antral-nasal inlay autogenous bone graft reconstruction of compromised maxilla: a 12-year retrospective study.

During a 12-year period (1984-1996), 118 maxillary inlay autogenous bone grafts and 248 commercially pure titanium threaded root-form endosseous implants were placed in 54 consecutively treated patients with compromised maxillary bone. In this retrospective clinical study, 3 groups of patients were reviewed, group selection being based on anatomic location and surgical access to the recipient site. Group 1 included patients with bone grafts placed in the antrum floor via an intraoral antrostomy exposure, group 2 included patients with bone grafts placed in the nasal floor via an anterior intraoral nasotomy exposure, and group 3 included patients with bone grafts placed in the antral and nasal floor via an intraoral Le Fort I osteotomy downfracture exposure. Each patient received an implant-supported dental prosthesis. For the combined 3 groups, survival rates were 87% for endosseous implants and 100% for autogenous bone grafts. The success rate for the dental prostheses in the 3 groups was 95%. Sixty-nine dental prostheses functioned a mean of 57.1 months, whereas 3 prostheses required remaking because of implant loss. Of the medical and mechanical risk factors tabulated in this study, current use of nicotine, history of sinusitis, molar site implant placement, and shorter implant lengths had the most influence on implant failure.

Adolescent↗
PubMedDate not supplied

Patients with reconstruction of craniofacial or intraoral defects: development of instruments to measure quality of life.

Patients with reconstruction of craniofacial or intraoral defects experience a profound impact on their quality of life (QOL). This impact on QOL is influenced by the patients' medical conditions and the treatment interventions. Instruments to measure general QOL have been available for many years. A major criticism of QOL instruments is that too often the questions are not specific to the particular problems of a disease or condition. A search of the literature regarding QOL measurement for patients with maxillofacial implant-supported prostheses produced a short list of instruments, none of which were sufficiently developed or suited to the patients involved in reconstructive treatment. This study was designed to develop pretreatment and posttreatment questionnaires for measuring QOL for patients with reconstruction of a craniofacial defect and patients with reconstruction of loss of specific intraoral structures utilizing an implant-supported prosthesis (e.g., severe resorption of the maxilla or mandible or both). The goal was to develop brief, targeted instruments for this specific patient population. The produced instruments were sensitive and easy to administer and score, and no disruption of clinical care occurred with the administration of the questionnaires. The instruments were used with equal success both in face-to-face interviews and via mail.

Dental Implantation, Endosseous↗
PubMedDate not supplied

Reconstructive procedures with endosseous implants in grafted bone: a review of the literature.

A review of the literature, provided by a MEDLINE search from 1976 through April 1994 and review of selected journals published from April 1994 to November 1994, relative to reconstructive procedures of the mandible and maxilla in which endosseous implants have been placed in grafted bone was conducted. This review revealed that 591 patients received 733 grafts in which 2,315 implants were placed. The types of grafts reported were block, autogenous bone (nonvascularized or vascularized), and particulate with a variety of materials. Results of these grafts are presented with the different implant systems utilized. Wound dehiscence seems to have the most deleterious effect on implant survival rate.

Bone Transplantation↗
PubMedDate not supplied

Advanced residual ridge resorption: surgical management.

With the introduction of osseointegration by Dr P.-I. Brånemark, reconstruction of advanced residual ridge resorption has become a successful procedure in patients for whom previous methods had been disappointing. For reconstruction of the maxillae an onlay, nasal and/or antral inlay, labial and/or buccal onlay, or interpositional bone graft with osseointegrated implants used to provide support for both the graft and the prosthesis can be used. The maxillary and mandibular onlay bone grafts and the nasal and/or antral inlay bone grafts are discussed.

Alveolar Bone Loss↗
PubMedDate not supplied

Bone-anchored craniofacial prosthesis study.

A prospective study involving 24 centers and 145 patients was conducted to evaluate the long-term osseointegration survival rate for titanium implants anchoring a craniofacial prosthesis (auricular, orbital, or nasal) and to evaluate the long-term retention and stability of the prosthesis. Of 452 implants placed, 19 were lost (overall survival rate of 96%). Of the 145 patients, 115 were evaluated (remained active) throughout the study period and were followed-up for at least 30 months. The results of the study suggest that the bone-anchored craniofacial prosthesis system is a viable alternative to conventional reconstructive surgery and offers significant improvement in the quality of life when compared with the support systems previously available for these types of prostheses.

Adolescent↗
PubMedDate not supplied

Bone-anchored craniofacial prosthesis study: irradiated patients.

A prospective study involving 24 treatment centers and 145 patients was conducted to evaluate the long-term osseointegration success rate for titanium implants anchoring a craniofacial prosthesis (auricular, orbital, and nasal), and to evaluate the long-term retention and stability of the prosthesis. Twenty patients (14%) in this study had received prior irradiation therapy, and 60 implants were placed in these 20 irradiated patients. Nine of the 60 implants were lost (85% survival rate). Although the few patients and few implants may not allow for conclusions to be drawn, analysis and review of the data on these irradiated patients may assist in reliable and valid comparisons to be made with other published studies.

Adult↗
PubMedDate not supplied

Complex craniofacial reconstruction using an implant-supported prosthesis: case report with long-term follow-up.

In complex craniofacial reconstruction involving an implant-supported prosthesis, problems such as tumor recurrence may require additional surgical resection. The solution to such recurrence may be autogenous bone grafting or additional implant placement or both (after resection of the tumor) and revision of the prosthesis. Tumor recurrence was seen during an 11-year, 8-month follow-up of a 58-year-old woman who had had an extensive mid-face defect. The various treatments, including extraoral and intraoral prostheses, provided the patient with an acceptable quality of life without interruption in use of the prostheses.

Bone Transplantation↗
PubMedDate not supplied

Mandibular endosseous implants and autogenous bone grafting in irradiated tissue: a 10-year retrospective study.

Nineteen patients received tumoricidal doses of radiation and subsequently underwent mandibular endosseous implant reconstruction, followed by dental rehabilitation with complete arch fixed osseoprostheses. Eight of the 19 patients also underwent autogenous bone graft reconstruction for mandibular discontinuity. A surgical and prosthetic protocol for irradiated head and neck oncology patients is presented. The 10-year retrospective study of 19 consecutively treated patients revealed an endosseous implant survival of 99%, dental osseoprosthesis continuous service of 100%, and successful bone graft reconstruction of 89%.

Adult↗