Biomedical subjects
Publications and source records attributed to H Niederdellmann.
This article addresses the potential sources of morbidity associated with the sagittal split ramus osteotomy. Refinements in the instrumentation and technique are described; these enhance the exactness of the procedure, thereby minimizing the complications and improving the stability of the surgical result.
The rationale for the use of fibre-optic transillumination in the location of residual roots is discussed and the technique is described.
The bone lid method introduced by Lindorf (1974) was compared with a conservative procedure leaving a small defekt in the malar buttres. The operation is partly done with an endoscope. The results of 60 operated maxillary sinuses show a higher incidence of dysesthesia and postoperative discomfort in the bone lid method. Thus this method should in our opinion be reserved to special indications.
In a clinical post-treatment evaluation during the past 3 years the wound healing of bone defects after substitution with a pyrolized xenogenic bone graft was observed in 90 patients. In most cases we found that wound healing was impaired and that the material did not show any osteointegration. As a result, inflammatory reactions of the bone with loss or demarcation of the bone graft occurred. Although some authors have reported a stimulation of osteogenesis after implantation of pyrolized bone graft, we cannot confirm their view.
Our presented modified method of registration of somatosensory evoked potentials enables us to measure the extent of large nerve injuries in an objective and quantitative way.
A clinical follow-up of 238 patients confirmed the good results of root amputation with titanium pin for apical closure. An analysis of reoperations because of failure of primary surgery rendered similarly good results. Therefore the use of a titanium pin will not impair the success of secondary surgery for root amputation which shows good results most of the time anyway.
The use of collagen as a bone substitute was examined in a clinical study involving 70 patients. In a standardized operation impacted mandibular third molars were removed simultaneously. Collagen fleece was implanted in one osseous defect while the other defect was packed with iodoform gauze. Postoperative pain, swelling and complications were analyzed. There were significant differences between the two methods. The use of collagen fleece to obturate bony defects following surgical removal of impacked molars appeared to be of no advantage. On the contrary, there was a considerably higher rate of postoperative bleeding and complications. This could probably be related to the poor stability of the implanted material.
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This article provides the clinical evaluation of a simple but effective method of maxillomandibular fixation that eliminates the morbidity attendant to the conventional methods of maxillomandibular fixation. The indications have been defined on the basis of the clinical experience with this technique.
Various methods have been advocated for the treatment of fractures of the angle of the mandible, emphasizing the complexity of the problem. A functionally stable osteosynthesis can be achieved in such fractures with a solitary lag screw. This technique meets the principles of rigid internal fixation and achieves maximum stability with a minimum of implant material. It obviates the need for maxillomandibular fixation, as well as the morbidity associated with the conventional methods of treatment. A review is presented of 50 patients who were treated by this method. The data show that the procedure is an effective and predictable modality of treatment with a low rate of morbidity.
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In a clinical study on postoperative nutrition the effects of a industrially prepared native physiological diet were compared with hospital-made nasogastric tube diet in patients who underwent maxillo-facial surgery. Of particular interest were tolerance, healing process, side effects and laboratory parameters. Contents and practicability of the industrially prepared diet fulfilled the expectations. Moreover, the advantage of availability at any time, exact balance and dosage, sterility and stability is evident. Despite lower input of industrially made diet decrease in bodyweight did not differ in both groups. There was also no evident diet-related difference in laboratory parameters. Although some patients felt heart burn, early satiation and subjective rejection against a 'sterile bottled diet', the use of the tested industrially prepared native physiological diet seems to be convenient especially in hospitals where fabrication of balanced nasogastric tube diet is not possible. Our suggestions for improvement of acceptance have already been taken into consideration by the manufacturer.
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We report 9 subjects from 2 families with the syndrome of cerebral gigantism, seven of the patients also had jaw cyst basal cell naevoid syndrome. Neurological, radiological, somatic and biochemical features of this hitherto unreported association are described. Neurological symptoms included mild hydrocephalus, ventricular malformation, cerebellar syndrome, intracranial calcification, oculomotor disturbances, EEG abnormalities and rarely, mild peripheral nervous disorders. A disturbance of calcium metabolism appears to be a prominent feature of the genetically determined nonprogressive syndrome.
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