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Biomedical subjects

J S Hermann

Publications and source records attributed to J S Hermann.

36 records · Page 2Linked to original sources

Acquired Brown's syndrome of inflammatory origin. Response to locally injected steroids.

In a recent large series of tendon sheath syndrome, Brown reported only five cases of the pure acquired type that were not intermittent and in which the patients did not undergo spontaneous recovery. The origin of acquired Brown's syndrome is varied and includes trauma of the orbit, direct trochlear trauma, orbital or muscle surgery, frontal sinusitis or sinus surgery, and inflammation of the superior oblique tendon and sheath, namely a stenosing tenosynovitis. The differential diagnosis and possible causes of the acquired Brown's syndrome were reviewed, and two cases of presumptive tenosynovitis of the superior oblique tendon and sheath are presented in detail. In both cases, the condition of each patient was notably improved by a series of direct injections of methylprednisolone acetate into the trochlear region. This form of treatment for acquired Brown's syndrome of inflammatory origin has never, to my knowledge, been reported in the literature.

Adolescent↗

Antipodean squint.

Strabismic cases which are exotropic fixing with one eye, and esotropic fixing with the other eye are rare and a result of anisometropia, unequal accommodation, paresis or restriction, and previous ocular muscle surgery. Three cases of antipodean squint are reported without known etiology factor. An extensive survey of experts in the field of strabismus was unable to document other similar cases where a cause could not be determined.

Accommodation, Ocular↗

Surgical therapy of convergence insufficiency.

Fourteen cases of intractable convergence insufficiency were surgically treated by resection of both medial rectus muscles. All 14 patients showed dramatic relief of severe asthenopic symptoms. Temporary diplopia due to consecutive esotropia is a necessary part of this surgery and is relieved by fresnel prisms. Exophoria at near will return, occasionally to the original angle of deviation, but the symptoms do not return. The preoperative symptoms can be of severity out of proportion to the deviation. Bimedial resection is a most efficacious surgical method for treatment of intractable convergence insufficiency.

Accommodation, Ocular↗

Masked bilateral superior oblique paresis.

Masked bilateral superior oblique paresis which was unsuspected occurred in 9 out of 57 cases. In every case of superior oblique paresis, bilaterality should be presumed until proven otherwise. Maximum attention on multiple examinations should be utilized to elicit the slightest contralateral inferior oblique overaction.

Adolescent↗

Lateral ridge augmentation and implant placement: an experimental study evaluating implant osseointegration in different augmentation materials in the canine mandible.

The present study investigated the osseointegration of dental implants with a titanium plasma-sprayed surface (TPS) in regenerated and native bone in an experimental dog study. Initially, lateral bone defects were created in the alveolar ridge on both sides of the mandible. Two months later, lateral ridge augmentation was performed with (1) autogenous corticocancellous block grafts, (2) autogenous corticocancellous block grafts and e-PTFE membrane, (3) tricalcium phosphate particles and e-PTFE membrane, or (4) canine-derived demineralized freeze-dried bone allograft particles and e-PTFE membrane. After 4 months, membranes were removed, and non-submerged titanium implants were placed in regenerated bone (test implants) and in native bone (control implants). Two months later, the animals were sacrificed and non-decalcified orofacial sections were evaluated histometrically. All implants demonstrated high percentages (59% to 75%) of bone-to-implant contact, with no significant differences across the various treatment groups. The different grafting techniques did not significantly influence the location of first bone-to-implant contact and the horizontal bone width at the most coronal bone level.

Alveolar Ridge Augmentation↗

Crestal bone changes around titanium implants: a methodologic study comparing linear radiographic with histometric measurements.

Generally, endosseous implants can be placed according to a nonsubmerged or a submerged technique and in 1-piece or 2-piece configurations. Recently, it has been shown that peri-implant crestal bone reactions differ significantly radiographically as well as histometrically under such conditions and are dependent on a rough/smooth implant border in 1-piece implants and on the location of a microgap (interface) between the implant and the abutment/restoration in 2-piece configurations. The purpose of this study was to evaluate whether standardized radiography as a noninvasive clinical diagnostic method correlates with peri-implant crestal bone levels as determined by histometric analysis. Fifty-nine implants were placed in edentulous mandibular areas of 5 foxhounds in a side-by-side comparison in both submerged and nonsubmerged techniques. Three months after implant placement, abutment connection was performed in the submerged implant sites. At 6 months, all animals were sacrificed, and evaluations of the first bone-to-implant contact (fBIC), determined on standardized periapical radiographs, were compared to similar analyses made from nondecalcified histology. It was shown that both techniques provide the same information (Pearson correlation coefficient = 0.993; P < .001). The precision of the radiographs was within 0.1 mm of the histometry in 73.4% of the evaluations, while the level of agreement fell to between 0.1 and 0.2 mm in 15.9% of the cases. These data demonstrate in an experimental study that standardized periapical radiography can evaluate crestal bone levels around implants clinically accurately (within 0.2 mm) in a high percentage (89%) of cases. These findings are significant because crestal bone levels can be determined using a noninvasive technique, and block sectioning or sacrifice of the animal subject is not required. In addition, longitudinal evaluations can be made accurately such that bone changes over various time periods can be assessed. Such analyses may prove beneficial when trying to distinguish physiologic changes from pathologic changes or when trying to determine causes and effects of bone changes around dental implants.

Alveolar Process↗

Evaluation of three different dental implants in ligature-induced peri-implantitis in the beagle dog. Part I. Clinical evaluation.

The purpose of this study was to clinically evaluate experimental peri-implant breakdown. Hydroxyapatite-coated, titanium plasma-sprayed, and machined titanium-alloy surfaces were investigated. Eighty-four implants were placed in 14 beagle dogs. Pocket probing depths and clinical attachment level and mobility measurements were made. Dogs were sacrificed at 3 and 6 months. All experimental implants showed a significant loss in clinical attachment level (P < .05). Increased pocket probing depths for experimental implants occurred during the first 2 months, after which a plateau was reached. At the 3- and 6-month evaluation, pocket probing depths at experimental implants were significantly increased (P < .05). No differences among the three implant types were noted for clinical attachment levels and pocket probing depths. In general, greater mobility was found with the titanium-alloy implants than with hydroxyapatite-coated and titanium plasma-sprayed implants (P < .025). In addition, mobility measurements were significantly greater for experimental titanium-alloy implants during the first 3 months (P < .05). Clinical attachment level measurements were most sensitive to peri-implant status. All implants were equally susceptible to ligature-induced peri-implant breakdown. Consequently, meticulous oral hygiene and regular maintenance care are prerequisites for successful implantology.

Alloys↗

Evaluation of three different dental implants in ligature-induced peri-implantitis in the beagle dog. Part II. Histology and microbiology.

The purpose of this study was to evaluate experimental peri-implant breakdown microbiologically, radiographically and histologically. Hydroxyapatite-coated, titanium plasma-sprayed, and titanium alloy surfaces were investigated. Eighty-four implants were placed in 14 beagle dogs. Standardized radiographs and microbiologic samples (DNA) were obtained. Dogs were sacrificed at 3 and 6 months. Undecalcified histologic sections were prepared. Thickness of hydroxyapatite coating, changes in crestal bone height, and marginal changes in osseointegration were measured. Vertical bone loss was computed. Radiographs were analyzed using computer-assisted densitometric image analysis (CADIA). Microbial analysis (DNA) did not clearly favor any of the examined surfaces. CADIA did not show differences among implant surfaces. No significant differences among the three implants were noted for histometry, except the experimental titanium plasma-sprayed surface showed an increase in vertical bone loss 6 months (P < .05). Thickness of hydroxyapatite was decreased in active peri-implantitis sites (P < .05). Clinical attachment level was shown to be the most sensitive clinical parameter for detecting histologic changes. All implants were equally susceptible to peri-implantitis.

Aggregatibacter actinomycetemcomitans↗