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Biomedical subjects

L B Kaban

Publications and source records attributed to L B Kaban.

At least 127 records · Page 7Linked to original sources
PubMed1982

Chin trauma: a clue to associated mandibular and cervical spine injury.

Chin trauma, mandibular fracture, and cervical spine injury are often progressive components of a single injury pattern. Knowledge of a commonly occurring sequence of damage in patients who have sustained minor head trauma helps to minimize diagnostic omissions and provides a rational basis for deciding how extensive the patient's evaluation should be. Chin laceration associated with underlying skeletal damage has been described previously, but its diagnostic significance seldom has been appreciated. This report describes representative patients with fractures of the cervical spine and of the mandible secondary to chin trauma and suggests a protocol for efficient diagnosis.

Adult↗
PubMed1982

Assessment of mandibular growth by skeletal scintigraphy.

Accurate assessment of facial skeletal growth remains a major problem in craniomaxillofacial surgery. Current methods include 1) comparisons of chronologic age with growth histories of the patient and the family, 2) hand-wrist radiographs compared with a standard, and 3) serial cephalometric radiographs. Uptake of technetium-99m methylene diphosphonate into bone is a reflection of current metabolic activity and blood flow. Therefore, scintigraphy with this radiopharmaceutical might serve as a good method of assessing skeletal growth. Thirty-four patients, ranging in age from 15 months to 22 years, who were undergoing skeletal scintigrams for acute pathologic conditions of the extremities, were used to develop standards of uptake based on age and skeletal maturation. The results indicate that skeletal scintigraphy may be useful in evaluation of mandibular growth.

Adolescent↗
PubMed1982

Temporomandibular joint dysfunction with facial pain in children.

Temporomandibular joint dysfunction with myofascial pain, a well-known clinical disorder in adults, is reported in children. In a series of 400 patients, 40 children less than 16 years of age were seen. Of these pediatric patients, 35% had a reactive depression as primary psychopathology. The multifactorial nature of the disorder is described. The need to differentiate this syndrome from recurrent otitis media and other pain syndromes is emphasized. A combined medical, oral surgical, and psychiatric management program is outlined.

Adjustment Disorders↗
PubMed1981

Application of the biological principle of induced osteogenesis for craniofacial defects.

Demineralised bone implants were used for cranio-maxillofacial reconstruction and construction in 34 patients, 28 with congenital deformities and 6 with acquired defects. The patients' ages ranged from 15 months to 59 years (mean 18 years). In 33 cases, the implants were obtained from cadaver femurs; in 1 case, the implant was prepared from the patient's own skull. Early healing was assessed by clinical and radiographic examination and, when appropriate, by biopsy. Longer follow-up will be required to determine whether resorption has been avoided. The clinical advantages are rapid union, healing of large defects, avoidance of harvesting procedures, and the potentially unlimited supply of banked material.

Adolescent↗
PubMed1981

Use of demineralized allogeneic bone implants for the correction of maxillocraniofacial deformities.

Two major problems in maxillocraniofacial surgery are the limited amount of fresh autogenous bone, the standard material for bone grafting, and the resorption of the grafted bone. Experimental studies with demineralized, devitalized bone matrix have shown induction of endochondral ossification. Fifty-five demineralized allogeneic implants have been used in 44 patients over the past two years for a variety of congenital (n = 37) and acquired (n = 7) defects. The allogeneic bone was obtained from cadavers, prepared as powders, chips or blocks, and was demineralized. After having been sterilized by irradiation, they were used to augment contour, fill defects, or construct bone within soft tissue. Of implanted sites that could be evaluated by physical examination, 31 of 31 were solid by three months. By radiographic examination three of 19 were healed by three months, and an additional 11 were positive by six months. Induced bone was seen in four of four biopsy specimens. Infection occurred in four of 44 patients (9%), comparable with conventional grafts. Implant resorption occurred in four instances. Allogeneic demineralized implants offer several advantages over conventional bone grafting, such as avoidance of a harvesting operation, ease of manipulation, and potentially unlimited material in banked form. In addition, healing by induced osteogenesis may bypass the resorption seen with healing of mineral-containing grafts.

Adolescent↗
PubMed1981

Induced osteogenesis in the repair of experimental mandibular defects in rats.

In order to investigate the repair of mandibular defects, we have devised a nonhealing model in the ramus of the rat mandible. The large full thickness defects, devoid of periosteum, were filled with demineralized bone powder (DBP), lyophilized bone chips, and un-demineralized bone powder (BP) or were irrigated with Ringer's lactate. Healing was judged by gross and histologic examination and by incorporation fo 45 calcium into hydropyapatite. DBP produced more rapid and complete healing than did BP or lyophilized chips. DBP did not undergo appreciable resorption prior to bone formation and was a more potent osteogenic stimulus than was BP or lyophilized chips.

Animals↗
PubMed1981

The role of CT scan in diagnosis of TMJ ankylosis: report of case.

Computed tomography was found to be useful in identifying complete, unilateral, fibro-osseous ankylosis of the temporomandibular joint in a case of mandibular hypomobility. The scan had increased sensitivity and reliability in studying hard and soft tissues of the TMJ and gave the patient less radiation exposure than conventional tomography or arthrotomography. The current report incorporates the CT scan into a radiographic protocol for the diagnosis of mandibular hypomobility and identifies situations in which conventional tomography can be omitted.

Adult↗
PubMed1981

Three-dimensional approach to analysis and treatment of hemifacial microsomia.

Based on our experience with 40 patients with hemifacial microsomia (first and second branchial arch deformity), we have developed a three-dimensional analytic approach to the skeletal deformity. The sagittal plane x-ray views (lateral cephalogram and panorex) demonstrate the anatomy of the temporomandibular joint as well as the shape and height of the mandibular rami. The frontal plane is demonstrated by the anterio-posterior (A-P) cephalogram, which shows the discrepancy in ramus height and the abnormal arc of mandibular rotation toward the affected side. The transverse plane is evaluated with a submental vertex radiograph, which shows the shape of the mandibular body and medial displacement of the temporomandibular joint. Three-plane radiographic analysis demonstrates the total anatomic distortion and the abnormal growth vectors. We hypothesize that abnormal mandibular growth is of primary importance in this deformity. Application of this analysis has influenced the timing of intervention and the design of corrective procedures.

Adult↗
PubMed1981

Temporomandibular joint dysfunction: an occasional manifestation of serious psychopathology.

Temporomandibular joint dysfunction is multifactorial in etiology. In many patients, psychological factors contribute to the development of symptoms. This is a retrospective study of 25 patients who had temporomandibular joint dysfunction and facial pain as an early sign of significant primary psychopathology. The diagnoses were: acute depression, manic-depressive illness, hysteria, and schizophrenia. Diagnosis of the underlying psychopathology and recognition of its role in the etiology of temporomandibular joint symptoms permitted more effective treatment.

Adult↗
PubMed1980

Draining skin lesions of dental origin: the path of spread of chronic odontogenic infection.

Draining skin lesions in the face are a common problem in head and neck surgery. The differential diagnosis includes various types of skin infection as well as infected tumor. Often overlooked is the possibility of a chronically infected tooth. The patients in this report illustrate cutaneous drainage in five locations from different teeth. The anatomic basis for these drainage tracts and the diagnostic workup have been described. We advise that these patients have a dental evaluation.

Adolescent↗
PubMed1980

Orbital cellulitis of dental origin: differential diagnosis and the use of computed tomography as a diagnostic aid.

This report illustrates the spread of odontogenic infection to the orbit and the usefulness of the CT scan for the differential diagnosis of periorbital vs orbital cellulitis and abscess. It shows the necessity for close follow-up of patients with odontogenic infection so that life-endangering complications may be treated promptly. Finally, this patient illustrates the fact that, in some cases, a dental infection may be so virulent that drainage through the tooth and antibiotics do not provide control. Tooth removal and prompt incision and drainage are required for adequate treatment.

Adolescent↗
PubMed1979

Trismus after injection of local anesthetic.

Persistent pain at the site of injection is the most common complication of local anesthesia in the oral cavity. The complication of trismus after local anesthetic injection is rare and may be prevented by the use of short needles for maxillary posterior injections, and by the avoidance of multiple injections in a short period time. Once trismus develops, its progression to chronic hypomobility and fibrous ankylosis may be prevented by the early institution of treatment consisting of heat, analgesics, muscle relaxants, and exercises.

Anesthesia, Dental↗
PubMed1979

Twenty year experience in maxillocraniofacial surgery. An evaluation of early surgery on growth, function and body image.

We have analyzed 404 patients with a wide variety of maxillary and craniofacial deformities. These do not include head and neck cancer patients as generally defined. Satisfaction has been high as judged by the patients, surgeons and psychiatrists. The complication rate has been significant, approximately 30%, the most common being infection or loss of bone grafts. As experience accumulated, the concept of earlier operative intervention has emerged as an aid in unlocking growth potential, diminishing secondary deformity and improving the development of body image.

Blindness↗