Biomedical subjects

Edward Ellis

Publications and source records attributed to Edward Ellis.

30 records · Page 2Linked to original sources

PubMed2004

Calcifying odontogenic cyst with ameloblastic fibroma: report of three cases.

Although it is a rare event, odontogenic tumors such as ameloblastoma, ameloblastic fibroma (AF), ameloblastic fibro-odontoma, and odontoma have been reported associated with calcifying odontogenic cyst (COC). There are only four cases of COC with AF cited in the English literature. However, three of these four cases were either included in a review of a series of cases or reported as an abstract, and limited clinical and histological information was provided. We present three additional cases of COC with AF and discuss the management for this combined lesion. Because COC is known for its histologic diversity and variable clinical behavior, and the clinical significance of an association of COC with AF is still unknown, we think it is valuable to report COC with AF with detailed clinical and pathological documentation.

Adolescent↗

PubMed2004

Biopsychosocial differences between high-risk and low-risk patients with acute TMD-related pain.

BACKGROUND: The aim of this study was to use a biopsychosocial perspective to characterize patients who were identified as being at high risk, or HR, of progressing from acute to chronic jaw-related pain. METHODS: The authors classified 74 subjects as being at HR or low risk, or LR, according to the predictive algorithm. They used a variety of functional and biopsychosocial measures to evaluate subjects. RESULTS: The HR group had significantly higher levels of self-reported pain as measured by the Characteristic Pain Inventory and significantly higher levels of depression as measured by the Beck Depression Inventory-II. They were 11 times more likely to have a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, or DSM-IV, Axis I clinical diagnosis, and more than three times as likely to have a DSM-IV Axis II personality disorder. Logistic regression analyses identified variables that differentiated, with 77 percent accuracy, the HR and LR patients. CONCLUSIONS: Overall, the HR subjects had more psychopathology than did the LR subjects, used poorer coping styles and had greater self-reported pain. Six psychosocial factors alone enabled the authors to correctly classify 77 percent of the subjects as being in the HR group. CLINICAL IMPLICATIONS: Future research, in conjunction with the above findings, may enable the authors to determine, with greater certainty, if patients who are more anxious are at greater risk of developing chronic pain. If so, this provides further evidence of the need for early detection of patients at risk of developing chronic pain and the need to refer them for adjunctive care, such as cognitive-behavioral intervention.

Adaptation, Psychological↗

PubMed2003

Recurrent left mandibular enlargement.

A 35-year old African-American female presented with a painful enlargement of the left face in the area of the posterior mandible and ramus extending to the submandibular area. She also complained of some difficulty swallowing along with mobility and supereruption of the mandibular left first molar tooth. See if you can make the diagnosis.

Adult↗

PubMed2003

Factors influencing childhood influenza immunization.

Following the launch of a publicly funded influenza immunization program for all residents of Ontario over the age of 6 months, we evaluated 203 parents of children who presented to our emergency department between January and March of the following year (2001). Overall, 54 (27%) of the children had been vaccinated. Parents of non-immunized children were more likely to believe that immunization resulted in a flu-like illness (42% v. 17%; p = 0.001), caused side effects that were more severe than having influenza (36% v. 17%; p = 0.010) and weakened the immune system (52% v. 24%; p < 0.001). Parents of both immunized and non-immunized children incorrectly identified gastrointestinal symptoms as symptoms of influenza. The primary reason for deciding against immunization was the belief that their child was not at risk. After adjustment, children with a chronic disease were more likely than those without a chronic disease to be immunized (adjusted odds ratio [OR] 4.7, 95% confidence interval [CI] 1.8-12.6). Children of parents who discussed immunization with a physician were more likely to be immunized than those who had not discussed immunization with a physician (OR 6.8, 95% CI 2.4-19.2).

Attitude to Health↗

PubMed2003

Jaw kinematics during mastication after unilateral fractures of the mandibular condylar process.

This study compared the mandibular kinematics during mastication of patients treated for unilateral fractures of the mandibular condylar process with those of control subjects. We used a Sirognathograph (Siemens, Bensheim, Germany) to record the chewing cycles of 81 male patients with unilateral condylar process fractures while they chewed a constant bolus unilaterally on the same side as the fracture and on the opposite side. Recordings were made at 6 weeks, 6 months, 1 year, and 2 years after treatment. Similar chewing cycles were recorded for 15 male controls (Class I dental and Class I skeletal occlusion) without fractures of the condylar process. The chewing cycles of both groups were analyzed with a custom computer program, and the duration, excursive ranges, and 3-dimensional cycle shape were compared at each time interval with multilevel linear modeling statistics. Fracture patients had significantly slower chewing cycles, with significantly less maximum excursion toward the working side during the closing phase and significantly greater excursion toward the balancing side during the opening phase than the controls. The opening pathway of the incisors showed greater differences between patients and controls than the closing pathways. Differences in chewing cycle shape persisted for up to 2 years, especially when chewing was on the side opposite the fracture. Unilateral condylar process fractures produce long-lasting changes in chewing cycle duration and chewing cycle shape of adults.

Adult↗

PubMed2003

Treatment considerations for comminuted mandibular fractures.

PURPOSE: We sought to assess the methods of treatment used and outcomes for a large sample of patients with comminuted fractures of the mandible. PATIENTS AND METHODS: The records of all patients who were identified as having comminuted fractures of the mandible over a 10-year period with sufficient follow-up were collected and analyzed for demographic information, treatment rendered, and outcomes. Standard descriptive statistics and nonparametric statistics were used to analyze the data. RESULTS: A total of 196 patients (167 males and 29 females) with 198 comminuted fractures met the inclusion criteria. The mandibular body was the most commonly affected region. Approximately half were sustained in altercations. Gunshot wounds created fractures that were more comminuted than other causes. The comminuted regions were treated by closed reduction and maxillomandibular fixation (MMF) in 35 fractures, open reduction with stable internal fixation in 146 fractures, and 17 were treated with external pin fixation. For those patients treated with open reduction, a single reconstruction bone plate was used in the majority of cases (114). For those patients treated open, 98 were treated using an intraoral approach and 52 were treated using an extraoral approach. The mean follow-up was 140.6 days. Complications occurred in 26 fractures (13%). The complications were malocclusion in 8 fractures and nonocclusal (ie, infection, nonunion, etc) in 18 fractures. There was a statistically significant relationship between the development of complications and the degree of fragmentation (P <.05). There was also a significant relationship between treatment and the development of complications (P <.05). Patients treated with external pin fixation had a 35.2% complication rate compared with a 17.1% complication rate for patients undergoing closed treatment with MMF, or patients treated with open reduction and stable internal fixation (10.3%). However, patients treated with external pin fixation had more severe injuries. CONCLUSIONS: The results of this study show that, when possible, the use of open reduction and stable internal fixation is associated with a low complication rate. However, not all comminuted fractures are amenable to this treatment, and in those, alternatives such as closed reduction with MMF or the application of external pin fixation may be necessary.

Adolescent↗

PubMed2003

Bond strength for orthodontic brackets contaminated by blood: composite versus resin-modified glass ionomer cements.

PURPOSE: The purpose of this study was to evaluate and compare the shear bond strengths of a self-cured glass ionomer versus composite cement for bonding of stainless steel buttons with various enamel surface and setting conditions. MATERIALS AND METHODS: Stainless steel orthodontic buttons were bonded using composite material under 3 different enamel and setting conditions: 1) conditioned and dry enamel surface, 2) conditioned and precontamination of the enamel surface with blood before bonding, 3) conditioned and immediate blood contamination postbonding and were compared with 3 different enamel conditions and setting for bonding with the glass ionomer cement: 1) nonconditioned and wet enamel surfaces, 2) nonconditioned and blood contamination of enamel before bonding, and 3) nonconditioned and immediate blood contamination postbonding. The brackets were bonded to 109 recently extracted teeth and allowed to set in a moist plastic container for 24 hours. They were subsequently tested in shear mode with a universal testing machine. The maximum bond strength and the site of bond failure were recorded. In addition, the location of the bond failure was studied. RESULTS: Composite was capable of sustaining greater forces than the resin-modified glass ionomer materials. Hence, it took more force to debond a bracket cemented with composite than with resin-modified glass ionomer. The effect of contamination was similar in both of the materials, and the magnitude of the decrease in bond strength was nearly of the same proportion. The postcontamination values were not significantly different from the uncontaminated bond strength for either material. The type of bond failure was significantly different for the different materials, and there were significant differences among the treatment conditions. CONCLUSION: Composite resin had significantly greater shear strength than resin-reinforced glass ionomer cement. Both materials showed a significant decrease in bond strength when precontaminated with blood. The postcontamination values were not significantly different from the uncontaminated bond strength for either material.

Acrylic Resins↗

PubMed2003

Assessment of internal orbital reconstructions for pure blowout fractures: cranial bone grafts versus titanium mesh.

PURPOSE: To assess the adequacy of internal orbital reconstruction in pure blowout fractures using either cranial bone grafts or titanium mesh implants. PATIENTS AND METHODS: The preoperative and postoperative true coronal computed tomography (CT) scans of 58 patients with unilateral pure orbital blowout fractures were included in the study. Demographic data and measurements of the pretreatment size of the defects were tabulated. The accuracy of reconstruction was assessed subjectively by 1 surgeon by scoring the position of the implant/graft, repositioning of orbital soft tissues, and assessment of orbital volume using the uninjured side for comparison. The cross-sectional area of the anterior, middle, and posterior regions of the reconstructed defect was statistically compared with the same locations on the uninjured orbits by scanning the CT scans and calculating the number of pixels within the selected CT slices. A comparison of the accuracy of reconstructions for those reconstructed with cranial bone graft and those with titanium mesh was statistically performed using parametric (for subjective analyses) and nonparametric tests (for cross-sectional area data). RESULTS: Thirty-eight cases were classified as fractures of the orbital floor, 4 as isolated medial wall fractures, and 16 as combined floor/medial wall fractures. There was a statistically significant difference in the surgeon's subjective ratings of adequacy of reconstructions between titanium mesh and bone-grafted groups. Orbits reconstructed with titanium mesh were more accurate than those reconstructed with bone (P <.001). Overall, there was no significant difference in cross-sectional areas between the reconstructed and uninjured orbits in the middle and posterior regions of the defects, but the anterior region showed significantly smaller cross-sectional areas in the reconstructed orbits (P <.001). CONCLUSIONS: Although there was great individual variability and both materials could be successfully used, the orbits reconstructed with titanium mesh showed better overall reconstructions than those reconstructed with bone grafts.

Adolescent↗

PubMed2002

Tracheotomy versus endotracheal intubation for airway management in deep neck space infections.

PURPOSE: The aim of the present study was to compare costs and outcomes for patients with deep neck infections who were treated with either tracheotomy or endotracheal intubation. MATERIALS AND METHODS: The charts of 85 patients with deep neck space infections were retrospectively studied. Requirements for inclusion in the study were incision and drainage in the operating room, involvement of more than 1 deep anatomic space, impending airway compromise, and maintenance of a postoperative artificial airway. The 85 patients were divided into 2 groups based on the type of airway used for treatment. Group 1 (n = 34) included patients who received a tracheotomy, and group 2 (n = 51) included patients whose airways were maintained with endotracheal intubation until the swelling had resolved sufficiently for extubation. RESULTS: Patients in group 1 had a shorter overall hospital stay (4.8 vs 5.9 days, NS) and spent less time in the intensive care unit (1.1 vs 3.1 days, P <.05). The overall incidence of complications was 6% for group 1 and 10% for group 2. The rate of complications secondary to loss of airway was 3% for group 1 and 6% for group 2. Average costs associated with intensive care resources were 5 times greater and overall hospital stay costs were 60% greater for group 2. CONCLUSIONS: Although both methods of airway control are useful and have a unique set of complications, the use of tracheotomy allowed earlier movement to a noncritical care unit and was associated with fewer intensive care costs and less overall cost of hospitalization. Tracheotomy may therefore provide better utilization of critical care resources in this group of patients.

Adult↗

PubMed2002

Use of a 2.0-mm locking plate/screw system for mandibular fracture surgery.

PURPOSE: In this study, we examined the use of a 2.0-mm locking bone plate/screw system in mandibular surgery. PATIENTS AND METHODS: All patients who were treated with a 2.0-mm locking bone plate/screw system during an 8-month period for fractures of the mandible or other defects of the mandible were prospectively studied. Ease of use of locking plate/screw system, characteristics of the fractures and defects, and complications were tabulated. RESULTS: A total of 80 fractures in 59 patients were treated with the 2.0-mm locking plate/screw system. One hundred two 2.0-mm locking plates were applied to the 80 fractures; 58 fractures received 1 plate and 22 fractures received 2 plates. There were no intraoperative difficulties associated with their application. Fracture reductions were considered to be excellent in all cases. At the latest follow-up, all fractures had healed, but 2 patients had slight malocclusions. Six patients developed postsurgical infections. Only 1 patient required hospitalization for treatment of the infection; all others were managed in the outpatient clinic. Four patients required removal of their plates for varying reasons. CONCLUSIONS: The use of a 2.0-mm locking plate/screw system was found to be simple and to provide sound fixation in all cases.

Adolescent↗

PubMed2002

Outcomes of patients with teeth in the line of mandibular angle fractures treated with stable internal fixation.

PURPOSE: This study examines the relationship between postoperative infection and/or need for plate removal with the presence and management of teeth in the line of mandibular angle fractures. METHODS: Data were collected on patients treated by intraoral open reduction and internal fixation for fractures of the mandibular angle during an 8-year period. Outcome variables were postoperative infection and need for removal of the bone plate(s). The relationships of demographic variables, teeth in the line of fracture, and management of teeth in the line of fracture were analyzed using standard statistical methods. RESULTS: Four hundred two patients had sufficient follow-up for inclusion in the study. A tooth was present in the fracture line 85% of the time. Teeth in the fracture were removed in 75% of the fractures that contained teeth. Postoperative complications occurred in 19% of the sample. Fractures not containing teeth at the time of fracture had a 15.8% rate of postoperative infection compared with 19.1% for patients who had teeth in the fracture (P = NS). For angle fractures associated with a tooth, when the tooth was retained, the incidence of infection was 19.5%. When the tooth was removed, the incidence was 19.0% (P = NS). CONCLUSIONS: There is an increased risk for postoperative complications when a tooth is present, but the increase is not statistically significant. The incidence of postoperative infection and/or the need for plate removal is not affected by whether the tooth in the fracture is removed.

Adolescent↗

PubMed2002

Growth of the mandible after replacement of the mandibular condyle: an experimental investigation in Macaca mulatta.

PURPOSE: The study goal was to investigate growth of the mandible after temporomandibular joint reconstruction in juvenile monkeys. MATERIALS AND METHODS: Sixteen juvenile monkeys (Macaca mulatta) were used as experiment subjects. Animals were equally divided into 4 experimental groups based on the method of temporomandibular joint reconstruction after bilateral condylar excision via extraoral vertical ramus osteotomies. Group Condyle animals had their condylar segments immediately replaced to serve as surgical controls. Group Bone animals were reconstructed with a bony strut. Group sternoclavicular joint (SCJ) animals were reconstructed with the sternal end of their clavicles. Group costochondral junction (CCJ) animals were reconstructed with costochondral junction of ribs. Standardized lateral cephalometric radiographs with the aid of tantalum bone markers were used to evaluate mandibular growth. Twenty animals were used as controls and were allowed to grow undisturbed for an 18-month period (Group Control). RESULTS: All animals showed good mandibular function and a Class I molar relationship after an 18-month follow-up period. Statistical and graphic comparisons showed no significant difference in mandibular growth among any of the groups. CONCLUSIONS: The results of this investigation suggest that, within the limits of this model, the choice of autograft for condyle replacement may be irrelevant.

Analysis of Variance↗