Search PubMed⌕ Search

Biomedical subjects

K Oikarinen

Publications and source records attributed to K Oikarinen.

At least 19 recordsLinked to original sources
PubMed2004

Neurosensory deficits after bilateral sagittal split ramus osteotomy of the mandible--influence of soft tissue handling medial to the ascending ramus.

Deficits in the neurosensory function (NF) of the inferior alveolar nerve (IAN) are often encountered after bilateral sagittal split osteotomy of the mandible. A prospective follow-up study was performed to examine the long-term effect of especially gentle handling of the soft tissues on the medial side of the ascending ramus. After the initial incision, the soft tissues of the ramus were either retracted extremely gently and minimally (test side) or, as was the earlier routine, more widely (contralateral control side). NF was tested with 2-point discrimination (2-PD) and vitality scanner tests (VST) preoperatively and four times postoperatively up to 1 year. Patients' subjective sensations were also assessed. The results showed a difference between the sides, which was most distinct at the 6-month follow-up (P=0.028) measured with VST, while 2-PD did not show any statistical differences. Our findings support the earlier intraoperative neurophysiologic reports that dissection trauma to the IAN around the mandibular foramen may cause NF deficits in the IAN even before the actual splitting of the mandible. Therefore, minimal distraction of the soft tissues in the ramus is indicated. Higher age is an evident risk factor, and subjective sensation correlates with 2-PD in the lower lip.

Adipose Tissue↗
PubMed2001

Increased lifetime prevalence of dental trauma is associated with previous non-dental injuries, mental distress and high alcohol consumption.

The purpose of the study was to assess the lifetime prevalence of dental injuries and risk factors involved in a general population-based birth cohort. The study population consisted of 5737 subjects who had participated in a health survey at the age of 31 years. Altogether 52% of the participants were women. This partly computer-based health survey included two questionnaires on previous dental and non-dental injuries, general health, occupational status and lifestyle. The current study was based on these questionnaires. The lifetime prevalence of dental fractures was 43% and the lifetime prevalence of dental luxations and exarticulations 14%. Men more commonly had dental injuries than women. Particularly mental distress and a history of previous injuries were shown to increase the risk for dental injuries. Furthermore, overweight and high alcohol consumption were positively associated with a high lifetime prevalence of tooth trauma. Regular physical activity decreased trauma occurrence. Socioeconomic status further affected the lifetime prevalence of dental injuries. The conclusion of the study was that personal, social and physical factors played a role in the occurrence of dental trauma.

Adult↗
PubMed2001

Incidence of complications and problems related to orthognathic surgery: a review of 655 patients.

PURPOSE: This retrospective report evaluates the incidence of pre-, intra-, and postoperative complications of orthognathic surgery and their significance to the patient. PATIENTS AND METHODS: The clinical records and radiographs of 655 patients operated on in Vaasa Central Hospital, Finland during a 13-year period between 1983 and 1996 were examined. The total number of operations was 689. All notes referring to problems or complications from the orthodontic phase to the varying postoperative follow-up times were gathered and analyzed. RESULTS: The most common complication was a neurosensory deficit in the region innervated by the inferior alveolar nerve; mild in 32% of patients (183 of 574 patients with an osteotomy in the mandible) and disturbing in 3% of patients (18/574). The most serious complication was severe intraoperative bleeding in 1 patient necessitating major blood transfusions and later embolization of the internal maxillary artery. There were no fatal complications. The incidence of other problems was low, and there were very few patient complaints. CONCLUSIONS: Despite the great variety of severe complications reported in the literature, their frequency seems to be extremely low, and orthognathic surgery treatment can be considered to be a safe procedure.

Adolescent↗
PubMed2001

Repeatability of 5 clinical neurosensory tests used in orthognathic surgery.

Many patients undergoing orthognathic surgery experience some degree of neurosensory impairment as a normal consequence of surgery. This may also occur as a complication after mandibular third molar surgery. The condition is usually reversible, but it may also be permanent. Neurosensory tests are essential in making decisions regarding the nature of the nerve injury, the potential for recovery, and the possible need for secondary microneurosurgical intervention. The aim of this study was to evaluate the repeatability of 5 clinical neurosensory tests assessing the neurosensory function of the inferior alveolar nerve (IAN). Twenty healthy subjects (9 males, 11 females) ranging in age from 21 years to 27 years participated in this study. The methods of assessment were light touch (LT), 2-point discrimination (2-P), pin tactile discrimination (PIN), thermal discrimination, and sensibility (ST) testing of the mandibular teeth with a vitality scanner. All the measurements were evaluated by 2 examiners and repeated at an interval of 6 months. In the statistical analysis, intraexaminer and interexaminer variability, as well as the variability between the 2 observations at a 6-month interval, were calculated. All the subjects reacted positively to LT and thermal discrimination in every observation. For the 2-P and PIN tests, intraexaminer variability was smaller than interexaminer variability, and repeatability of the 2 observations at 6 months was also good. Repeatability of ST was best at incisors, but it was not numerically very accurate at any site. However, all teeth that reacted positively to the vitality scanner in the first observation also reacted positively in the second observation; this instrument thus provides a more meaningful measurement of neurosensory function as a positive/negative assessment than as a numeric value.

Adult↗
PubMed2000

Factors affecting neurosensory disturbance after mandibular bilateral sagittal split osteotomy.

PURPOSE: The current study evaluated the incidence of subjective neurosensory disturbances after bilateral sagittal split osteotomy (BSSO) in relation to gender, age, indication for osteotomy, magnitude of mandibular movement, degree of manipulation of the inferior alveolar nerve at operation, side of the mandible operated, and complications during and after surgery. PATIENTS AND METHODS: Thirty patients (60 sides) who had undergone a BSSO were followed up for 1 year after operation. The patients were classified into different groups according to gender, age, indication for osteotomy, magnitude of mandibular movement, degree of manipulation of the nerve, and complications during or after surgery. A self-administered questionnaire was used at every follow-up to evaluate the sensations in the mental region. RESULTS: A statistically significant positive correlation was found between subjective neurosensory loss and the patient's age (P = .039), magnitude of mandibular movement (P = .044), and degree of manipulation of the nerve (P = .0007). However, no significant correlation was found between disturbances of sensation and gender, indication for osteotomy, side of the operated mandible, or intraoperative and postoperative complications. Even if all patients evaluated their sensation as "normal" 1 year postoperatively, 31% of them reported slightly altered sensation in the mental region. CONCLUSIONS: After BSSO, a prolonged neurosensory deficit is strongly related to age, the intraoperative magnitude of mandibular movement, and the degree of manipulation of the inferior alveolar nerve. However, a long-term sensory loss is very rare, and patients seem to adapt to a mild neurosensory deficit and report sensory function as "normal" despite slightly altered sensation.

Adolescent↗
PubMed2000

Prediction of recovery from neurosensory deficit after bilateral sagittal split osteotomy.

OBJECTIVE: To observe the suitability of different combinations of readily available tests to predict recovery from a neurosensory deficit after bilateral sagittal split osteotomy (BSSO). STUDY DESIGN: Thirty patients scheduled for BSSO were examined before surgery and 4 days, 3 weeks, 3 months, 6 months, and 1 year after surgery. At each follow-up, the patients self-evaluated the subjective neurosensory deficit of the lower lip and chin of both sides. Neurosensory function was also measured by tests consisting of light touch, 2-point discrimination, pin tactile discrimination, thermal discrimination, and sensibility testing of the mandibular molars. The positive predictive values (PPV) of each test for recovery from the neurosensory deficit were calculated. Furthermore, different tests were combined, and the PPVs for recovery from the neurosensory deficit of these combinations were analyzed. RESULTS: A positive response to sensibility testing of the mandibular first and second molars 4 days and 3 weeks after surgery was related to a PPV of 100% and 87%, respectively, for full recovery from sensation loss at 1 year. However, none of the tests alone could reliably predict recovery from the neurosensory deficit after BSSO. When 3 different tests were combined, the best results were achieved by the combinations of a light test or a 2-point discrimination test and a pin tactile test with the sensibility testing of mandibular molars. CONCLUSIONS: Sensibility testing of mandibular molars can be used to predict recovery from the neurosensory deficit after BSSO. The best positive predictive ability can be achieved by combining a mechanoceptive test, a nociceptive test, and sensibility testing of mandibular molars.

Adolescent↗
PubMed2000

Effects of orthognathic surgery on temporomandibular joint dysfunction. A controlled prospective 4-year follow-up study.

A prospective follow-up study was performed to examine the influence of contemporary orthognathic treatment on signs and symptoms of TMJ dysfunction. Sixty consecutive patients were examined once preoperatively and twice postoperatively, and Helkimo's Anamnestic and Dysfunction Indices (Ai and Di) were determined. The prevalence of headache was also assessed. The average follow-up was 4 years from the initial examination. A group of 20 patients with a similar type and grade of dentofacial deformity, who did not wish to have surgery or other occlusal therapy, served as a control group. The majority (73.3%) of the patients had signs and symptoms of TMJ dysfunction (TMD) in the initial phase. At final examination the prevalence of TMD had been reduced to 60% (P=0.013). There was a dramatic improvement in headache: initially 38 (63%) patients reported that they suffered from headache, but at the final visit only 15 (25%) did so. It is concluded that functional status can be significantly improved and pain levels reduced with orthognathic treatment. The risk for new TMD is extremely low. No association, however, could be shown between TMD and the specific type or magnitude of dentofacial deformity.

Adolescent↗
PubMed1998

Occlusal and temporomandibular joint disorders in patients with unilateral condylar fracture. A prospective one-year study.

Adult dentate patients with unilateral condylar fractures were followed up for one year after injury. Patients were interviewed about subjective complaints, and mandibular excursions and function of occlusion and temporomandibular joints (TMJs) were recorded. Radiological characteristics were assessed from panoramic and Towne's views and compared between patients with occlusal disorders and patients without. During follow up, mandibular deviation on opening towards the fractured side was more pronounced in cases with marked reduction of ramus height and condylar dislocation. This restriction of translation movement of the fractured joint was also seen radiologically in one-third of cases while in two-thirds of the fractured condyles, malpositioning was observed when compared with the healthy side. In patients (39%) having subjective symptoms such as TMJ pain, altered occlusion or ability to bite only unilaterally, and objectively verified occlusal interferences, a marked reduction of the ramus height on the fractured side was observed. In such cases nonoperative treatment of condylar fractures may be compromised.

Adolescent↗
PubMed1998

Comparison of different tests assessing neurosensory disturbances after bilateral sagittal split osteotomy.

Different methods of assessing functional impairment of the inferior alveolar nerve after sagittal split osteotomy were compared with subjective reports. Thirty patients were tested preoperatively as well as after four days, three weeks, three months, six months, and one year of follow up. All the patients underwent bilateral mandibular ramus sagittal split osteotomy. The sensation of the mandibular teeth was assessed by an electric vitality scanner. Other neurosensory assessments included light touch, two-point discrimination, tactile discrimination, and thermal discrimination. It was shown that electric sensibility-testing of mandibular teeth is a useful method for evaluating neurosensory disturbance after sagittal split osteotomy, and it correlated even better with the patient's subjective evaluation than the other tests used in this study.

Adolescent↗
PubMed1998

Comparison of four bone collectors designed for oral and maxillofacial surgery--an in vitro study.

Four bone collectors designed for oral and maxillofacial surgery were compared in an in vitro study. Two commercially available bone collectors (Osseus Coagulum Trap, Quality Aspirators and Frios, Friatec) with mesh sizes of 0.17 x 0.17 and 0.44 x 2.40 mm, respectively and models developed by the authors with mesh sizes of 0.355 x 0.355 or 0.50 x 0.50 (Model I) and 0.80 x 0.80 (Model II) were tested. All collectors are designed to be connected to the suction device. Five dissected pig mandibles were used to determine the harvesting capacity during drilling and suctioning for 30 s. All collectors harvested bone quite effectively, but the highest amount of bone chips was harvested by Model I which had been designed by the investigators.

Analysis of Variance↗
PubMed1998

[Conceptual system of health portrait].

The purpose of this paper is to introduce a nursing science perspective to health research. The perspective is outlined using the following key concepts: life control, life situation, health and health choices, resources, and process of change. This conceptual system of health portrait includes concepts used to study health in nursing science. It also reflects a research approach by using empirical examples. As a starting-point, life control is assumed to be reflected in the life situation as well as in health and health choices. As a consequence, life control is also related to each individual's resources in everyday life. Further attention is given to the assessment of the process of change pertaining to health choices during the person's course of life. As an empirical example of the application of the "health portrait" conceptual system, a research project titled Health portrait of adolescents in Kainuu is presented. This project aims to develop an instrument for measuring life control, health and life situation, to evaluate this instrument and to analyze life control data elicited from adolescents. Another aim of this paper is to assess how well an instrument created on the basis of the nursing science and the method of interventive interview used here served as tools for analysing life control and health in the health checkups of school-aged adolescents. On the basis of the knowledge obtained through these analyses we will develop further the conceptual system of health portrait, which could be used as a guideline in health research.

Adolescent↗
PubMed1997

A method of harvesting corticocancellous bone chips for reconstructive maxillofacial surgery.

A method is described to harvest bone chips for maxillofacial surgery with large burs and a special collecting net connected to a suction device. Three nets and four burs were tested in vitro on a pig mandible to determine the optimal combination. All burs produced bone chips of rather similar sizes. The midsized net (hole diameter 0.5 mm) collected most bone chips during a 1-min drilling.

Animals↗