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Biomedical subjects

E Ellis

Publications and source records attributed to E Ellis.

At least 181 records · Page 10Linked to original sources

Mobility of the mandible following advancement and maxillomandibular or rigid internal fixation: an experimental investigation in Macaca mulatta.

This study examined the postsurgical range of mandibular motion following sagittal advancement osteotomy in Macaca mulatta when either maxillomandibular or rigid osseous fixation were used. Seventeen adult female Macaca mulatta underwent sagittal advancement osteotomy of approximately 4 to 6 mm. Six had 6 weeks of maxillomandibular fixation and eleven had rigid osseous fixation with no maxillomandibular fixation. Mandibular range of motion was measured by the change in the angle of the posterior aspect of the mandibular ramus from a closed-mouth and an open-mouth cephalogram. Parametric tests were used to statistically analyze the results. The results of this investigation showed that the animals who did not undergo maxillomandibular fixation maintained a greater range of motion in the early postsurgical period and obtained preoperative mobility by 12 weeks postsurgery. The animals who underwent six weeks of maxillomandibular fixation showed statistically significant decreases in range of motion when compared to the rigid fixation group at each period of time postsurgery, with significant reductions from preoperative values at 12 weeks postsurgery.

Animals↗

A comparison of stimulated bite force after mandibular advancement using rigid and nonrigid fixation.

This study evaluated maximum stimulated molar bite force following advancement of the mandible in 17 adult Macaca mulatta using rigid and nonrigid fixation techniques. Cephalometric analysis was also performed to determine the amount of proximal segment rotation. Analysis of the bite force showed the animals whose mandibles were advanced using rigid fixation to have significantly greater bite force at six weeks postsurgery when compared to those animals who underwent mandibular advancement and six weeks of maxillomandibular fixation. By the ninth postoperative week, there was no longer any significant difference between the two groups, indicating a rapid recovery of muscle function in the animals whose mandibles were immobilized following advancement. Both groups, however, had significant decreases in bite force at 12 weeks postsurgery when compared to preoperative values. Neither group had a significant amount of proximal segment rotation from the surgery.

Animals↗

Stability of simultaneous maxillary intrusion and mandibular advancement: a comparison of rigid and nonrigid fixation techniques.

This study examines the short-term stability of bimaxillary surgery following Le Fort I impaction with simultaneous bilateral sagittal split osteotomies and mandibular advancement using two standard techniques of postsurgical fixation. Fifteen adults had skeletal plus dental maxillomandibular fixation, and fifteen adults had rigid internal fixation using bone plates in the maxilla and bicortical bone screws between the proximal and distal segments in the mandible. The group with rigid internal fixation did not undergo maxillomandibular fixation. Radiographic cephalograms were analyzed during the postsurgical period to evaluate skeletal and dental stability. There was no statistical difference in postsurgical stability with rigid internal fixation or skeletal plus dental maxillomandibular fixation other than the vertical position of the maxillary molar; the skeletal plus dental maxillomandibular fixation group had a significant amount of postsurgical intrusion of the maxillary molar when compared with the rigid internal fixation group. Although the other measures showed no statistically significant difference between the experimental groups, the amount of variability in postsurgical stability in the group with skeletal plus dental maxillomandibular fixation was greater than that found in the group with rigid internal fixation.

Bone Plates↗

Adaptation of the suprahyoid muscle complex to large mandibular advancements.

The purpose of this study was to provide quantitative data concerning the changes and adaptations that take place within the suprahyoid complex to larger mandibular advancements. Mandibular advancement of 6.5 mm was performed on 12 adult rhesus monkeys. Six underwent maxillomandibular fixation (MMF) using the dentition, six underwent MMF using the dentition plus skeletal suspension wires. Mandibular position and changes in the length of the various anatomic regions of the suprahyoid complex were evaluated cephalometrically with the aid of radiopaque bone, muscle, and tendon markers implanted preoperatively. Relapse of the mandible in the dental MMF animals was 27% of the advancement, whereas there was none in the dental plus skeletal MMF group. Results of adaptations within the suprahyoid complex showed that 1) the suprahyoid complex was elongated slightly less than the mandible, and 2) the major adaptations (lengthening) occurred at the muscle-bone interface, the muscle-tendon interface, and within the belly of the anterior digastric muscle. On the basis of these results, it was concluded that adaptations within the suprahyoid complex to mandibular lengthening occur first at the connective tissue attachments of the muscle, and then within the muscle belly itself. The methods of dealing with the potentially distracting forces from the stretch within the suprahyoid complex are discussed.

Adaptation, Physiological↗

Maxillomandibular growth 2 years after mandibular advancement surgery with and without suprahyoid myotomy in juvenile Macaca mulatta.

There is conflict in the literature on whether continued and harmonious growth occurs after mandibular advancement in growing persons. The studies available are difficult to interpret because of the differing age ranges and the questionable growth potential inherent within the mandibular deficient patient. This study was performed to isolate the major question of interest to clinicians: Does the mandibular advancement surgical procedure inhibit future growth in a normally growing person? Six juvenile male Macaca mulatta monkeys were divided equally into two experimental groups. Group MAA had mandibular advancement surgery of approximately 4 mm. Group MAD had a similar surgical procedure with detachment of the suprahyoid musculature. All underwent 4 to 5 weeks of maxillomandibular fixation. Serial computerized cephalograms with the aid of bone markers were used to analyze the changes during a 2-year follow-up period. The postsurgical changes of the two experimental groups were compared statistically with control growth data on a large sample of normal Macaca mulatta animals available in our laboratory. The results showed the following. (1) There were significant short-term differences in the stability of the mandibular advancement between experimental groups. Group MAA (suprahyoid musculature attached) experienced significant relapse during the period of maxillomandibular fixation. Group MAD (suprahyoid musculature detached) experienced no relapse. (2) During the 2-year follow-up period after fixation, the rate and amount of mandibular growth in both experimental groups were not significantly different from age-matched controls or from each other. (3) At the end of the 2-year experimental period, the advanced mandibles were longer than the mandibles in age-matched controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Stability of the mandible following advancement: a comparison of three postsurgical fixation techniques.

This study examines short-term stability of the mandible following mandibular advancement surgery by means of three standard techniques of postsurgical fixation. Twenty-two adult female rhesus monkeys (Macaca mulatta) underwent sagittal ramus advancement osteotomy of approximately 4 to 6 mm. Six animals had dental maxillomandibular fixation alone. Six animals had dental plus skeletal maxillomandibular fixation with circummandibular wires connected to pyriform aperture wires. Ten animals had rigid internal fixation with bicortical bone screws between the proximal and distal segments without maxillomandibular fixation. Radiographic cephalograms with the aid of tantalum bone markers and dental amalgams were analyzed during the first 6 postoperative weeks to evaluate skeletal and dental stability. Rigid internal fixation and the use of dental plus skeletal maxillomandibular fixation were both equally effective in the prevention of postsurgical relapse. However, in the animals in which only dental maxillomandibular fixation was used, statistically significant changes (relapse) occurred when compared with either of the other groups.

Animals↗

Stability of the mandible after advancement and use of dental plus skeletal maxillomandibular fixation: an experimental investigation in Macaca mulatta.

This study examined short-term stability of the mandible following advancement surgery and the use of skeletal suspension wires plus dental maxillomandibular fixation. Twenty-four adult female Macaca mulatta underwent bilateral sagittal ramus osteotomy and advancement of approximately 6 mm. All animals had dental maxillomandibular fixation secured by bonding the upper and lower teeth together with an orthodontic composite resin. In half of the animals, the use of circummandibular wires connected to pyriform aperture wires were additionally applied. Tantalum bone markers were placed and cephalograms analyzed during the first six postoperative weeks to evaluate skeletal stability. A statistically significant mean horizontal relapse at the mandibular symphysis occurred in the group without the skeletal wires, whereas no relapse occurred in the group with the skeletal wires. A significant difference in the vertical displacement of the anterior mandible occurred, with an inferior movement of the symphysis in the group without skeletal wires, and a superior movement of the symphysis in the group with skeletal wires. The results of this study indicate that the use of skeletal suspension wires is advantageous in the prevention of horizontal and vertical skeletal relapse.

Animals↗

Histologic analysis of costochondral and sternoclavicular grafts in the TMJ of the juvenile monkey.

Variability in growth response of the mandible after replacement of the mandibular condyle with the costochondral junction of a rib (CCJ) is common. Other donor graft sites that are more similar to the mandibular condyle might be more suitable for mandibular condylar replacement. Previous studies have shown the histomorphologic and developmental similarities between the sternoclavicular joint (SCJ) and temporomandibular joint (TMJ). The purpose of this study was to evaluate histologically short-term adaptations within the TMJ after replacement of the mandibular condyle with the autogenous sternal head of the clavicle, and to compare these adaptations with autogenous CCJ and mandibular condyle (surgical control) transplants. Bilateral vertical ramus osteotomies were performed in 12 juvenile Macaca mulatta with the left condyle being immediately replaced and the right condyle removed and replaced with either the sternal head of the clavicle or costochondral junction of a rib. All grafts were stabilized with maxillomandibular fixation for five weeks. Two animals in each group were killed at five, 11, and 17 weeks postsurgery and prepared for histologic analysis. The results indicate that: 1) incorporation of all grafts into the recipient site occurred and all animals had good mandibular function and occlusion throughout the follow-up period; 2) the clavicular and mandibular condylar grafts were incorporated sooner than the CCJ grafts; 3) clavicular graft changes resembled those of the condylar grafts histologically while the costal grafts remained inert and unchanged; and 4) a new condylar process with cartilage similar to that of a normal mandibular condyle regenerated in the costal graft animals from cells presumably contributed by the periosteum of the mandibular ramus and TMJ capsule.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Adaptation of the suprahyoid muscle complex to mandibular advancement surgery.

The suprahyoid musculature has been implicated as one of the major factors responsible for relapse after mandibular advancement surgery. Previous studies have also indicated that the muscle and connective tissues comprising the suprahyoid complex must adapt to increased length brought about by mandibular advancement for skeletal stability to be achieved. The purpose of this study was to provide quantitative data concerning the immediate changes and long-term adaptations that take place within the suprahyoid complex over a 2-year period after mandibular advancement. Mandibular advancement was performed on ten adult Macaca mulatta monkeys with and without suprahyoid myotomy (n = 5/group). Six animals were used as controls. Mandibular length and changes in the length of the various anatomic regions of the suprahyoid complex were evaluated radiographically with the aid of radiopaque bone, muscle, and tendon markers implanted preoperatively. The results for the nonmyotomy group showed that the suprahyoid complex was elongated approximately two thirds the amount of mandibular lengthening, the major immediate adaptations within the suprahyoid complex after the surgical procedure occurred at the muscle-bone interface and the muscle-tendon interface, the change in length at the muscle-tendon junction was maintained throughout the 2-year follow-up period, indicating that significant long-term adaptations took place primarily at that location, and no significant short-term changes or long-term adaptations were seen within the anterior digastric muscle or the intermediate digastric tendon. Within the myotomy group, it was found that the suprahyoid complex recoiled immediately after myotomy such that the anterior belly of the digastric muscle became separated from the advanced distal mandibular segment by more than twice the amount of mandibular lengthening, the anterior digastric muscle remained essentially at this posterior position throughout the 2-year follow-up period, and though not significant, there was a trend for a decrease in the length of the anterior digastric muscle belly. On the basis of these results, it was concluded that both short-term changes and long-term adaptations to lengthening of the suprahyoid complex as a result of mandibular lengthening occur primarily within the connective tissues comprising the muscle-tendon and muscle-bone interfaces, not within the muscle fibers themselves.

Adaptation, Physiological↗

Multicentre evaluation of disposable visual measuring device to assay theophylline from capillary blood sample.

A device using enzyme immunochromatography to indicate visually theophylline concentration in a small capillary blood sample was evaluated for precision and accuracy at four hospitals. Preliminary studies indicated sensitivity as low as 2.5 micrograms/ml, and accuracy and precision matched those in test samples ranging from 5 to 30 micrograms/ml. Absence of theophylline was also reliably detected. Paired samples of capillary and venous blood from 214 patients were used to compare this method with four standard laboratory assays. Correlations with the standard assays were 0.93-0.97, slopes 1.00-1.27, and y intercepts -1.91-0.46. The within-run coefficients of variation on twenty replicate patient sample analyses at the four hospitals were 5.1-9.7% and between-run coefficients of variation on a 15.9 microgram/ml control 5.7-9.4%. This disposable device for theophylline monitoring, which can be done within 15 min at the patient's side without instruments, is sufficiently accurate to replace laboratory analysis for routine therapeutic drug monitoring.

Analysis of Variance↗

Double-blind evaluation of etodolac (200 mg, 400 mg) compared with zomepirac (100 mg) and placebo on third molar extraction pain.

This controlled, single dose study has demonstrated that compared with placebo, substantial analgesia is obtained with 200 and 400 mg doses of etodolac. The analgesic effects of both doses of etodolac were not notably different from each other or significantly different from zomepirac, a proven analgesic. With respect to safety, both doses of etodolac were well tolerated, with no reports of serious or dose related adverse side effects.

Acetates↗

Histologic comparison of the costochondral, sternoclavicular, and temporomandibular joints during growth in Macaca mulatta.

The costochondral joint (CCJ) is commonly used to replace defective mandibular condyles in children for the restoration of normal temporomandibular (TMJ) growth and function. However, continued and harmonious growth following rib grafting is the exception rather than the rule. This may be due to the differences in the growth characteristics of the costal cartilage and the condyle. A joint that is similar both developmentally and structurally to the TMJ is the sternoclavicular joint (SCJ). The purpose f this study was to describe histologically the SCJ and CCJ during growth in Macaca mulatta and to compare the histomorphologic features with those of the TMJ. Costochondral and sternoclavicular joints were obtained from infant, juvenile, adolescent, and adult Macaca mulatta. The histologic sections were compared with mandibular condyles of the same ages available in our laboratory. The results indicate that the TMJ and SCJ are very similar morphologically throughout the growth period. The clavicular head contained layers of cartilage typical of the mandibular condyle, i.e., articular, prechondroblastic, chondroblastic, hypertrophic, and endochondral ossification layers, at each age during growth. Like those in the condyle, the hypertrophic cartilage cells were arranged in an apparently random, noncolumnar fashion. The CCJ, however, did not resemble the condyle but appeared to be more similar to the growth plate in a long bone epiphysis during growth. The results of this investigation indicate that the SCJ may be more suitable for mandibular condylar replacement than the CCJ.

Age Factors↗