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Biomedical subjects

George M Kushner

Publications and source records attributed to George M Kushner.

7 recordsLinked to original sources
PubMed2006

Cone beam computed tomographic findings in refractory chronic suppurative osteomyelitis of the mandible.

AIMS: To report the imaging features of osteomyelitis of the mandible in various two-dimensional multiplanar and three-dimensional reformations using cone beam computed tomography (CBCT). METHODS: The images were 12-bit DICOM files acquired with a 10cm field of view and voxel resolution of 0.4mm. Two-dimensional multiplanar reformatted reconstructions included coronal, "panoramic" (variable thickness), and serial cross-sections. Three-dimensional reconstructions included surface renderings. Images were presented to referring oral and maxillofacial surgeons in "real time" immediately after acquisition. RESULTS: The features of mandibular osteomyelitis seen on CBCT included: a peripheral sclerotic rim, cortical layering (involucrum), central loss of trabecular pattern with internal round radiolucent resorptive tracts, minimal jaw expansion, and reduction of the alveolar cortex. Sequestra were occasionally evident. The history and presentation of each case on CBCT were consistent with osteomyelitis of the mandible; however, the clinical differential diagnosis in each case had included malignancy. The definitive diagnosis was confirmed by histological examination of biopsy specimens. Two of the three cases were patients who had been treated with bisphosphonates. CONCLUSION: CBCT facilitated comprehensive and dynamic imaging of the jaws based on surgical consultation, rather than inflexible imaging protocols. CBCT images guided operative planning.

Aged↗
PubMed2006

Maxillary sinus augmentation.

Attention to the principles of bone grafting, bone healing, and maxillary sinus physiology as well as anatomy is critical to the successful placement of dental implants in the posterior maxilla. The integration of these principles must take into account the restorative dental requirements and the patient's autonomy in guiding implant reconstruction. As in so many clinical disciplines, additional research is needed to provide better guidance for clinicians. Despite some gaps in our knowledge, however, sinus augmentation procedures have proven to be safe and effective and have permitted the placement of implants in sites that would have otherwise been impossible to treat. This article summarizes techniques and technologies related to maxillary sinus augmentation.

Alveolar Ridge Augmentation↗
PubMed2006

The use of immediate bone grafting in reconstruction of clinically infected mandibular fractures: bone grafts in the presence of pus.

PURPOSE: Current approaches to the treatment of infected mandibular fractures include antibiotics, drainage, immobilization of the segments, and debridement followed by secondary bone grafting of residual defects once the infection is resolved and the wound healed. Over the past 30 years, the time from debridement to grafting has diminished from several months to a few weeks. We present our experience with a treatment model managing clinically infected fractures of the mandible with antibiotics, debridement, rigid internal fixation, and immediate autogenous bone grafting. MATERIALS AND METHODS: In this retrospective study, we present a series of 43 patients who demonstrated clinical/laboratory findings consistent with infection in one or more mandibular fractures (50 infected fractures). These patients underwent a combination of incision and drainage, fracture debridement, rigid internal fixation, and immediate bone grafting of the resulting defect in a single stage. Both transoral and transfacial approaches were used. RESULTS: Of the 50 fractures, 43 showed both resolution of infection and bony union of fractures with long-term follow-up of 2 months to 4 years. Four fractures developed recurrent infection but proved to have bony union and were successfully treated by hardware removal only. Three other patients were deemed failures with persistent infection, loss of graft, nonunion, and need for retreatment. Each of these patients was afflicted with underlying immunocompromise. CONCLUSIONS: Although careful patient selection is a must, immediate bone grafting of infected mandibular fractures, when used in conjunction with rigid internal fixation and appropriate intraoperative debridement, is an effective treatment modality which allows a single surgical procedure and dramatically shortens the course of treatment.

Adult↗