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Biomedical subjects

L G Mercuri

Publications and source records attributed to L G Mercuri.

At least 19 recordsLinked to original sources
PubMed1999

Considering total temporomandibular joint replacement.

Patients with very advanced degenerative disease, ankylosis, post-traumatic condylar destruction, and multi-operated patients may be candidates for joint replacement with fossa and condylar prostheses. Great advances have been made in developing biocompatible materials, improved designs for patient-fitted prostheses. These devices have treated internal derangement cases after multiple surgical and nonsurgical treatment failures, as well as restoring form and function following the removal of failed Vitek Proplast-Teflon (Houston, Texas) containing temporomandibular joint implants. This paper will provide practitioners dealing with complex, debilitated, functionless temporomandibular joint (TMJ) patients with information related to this treatment modality. They will then be able to address the indications for the use of alloplastic temporomandibular joint replacement devices, the devices presently available, the surgery involved in their placement, possible complications of implantation and post-operative outcomes and expectations with patients who would benefit from the implantation of these devices.

Arthroplasty, Replacement↗
PubMed1998

Central mucoepidermoid carcinoma.

A case of central mucoepidermoid carcinoma of the mandible is presented along with a review of the literature. The histogenesis of this tumor and the histologic similarity of the predominantly cystic low-grade central mucoepidermoid carcinoma to the glandular odontogenic cyst are discussed.

Carcinoma, Mucoepidermoid↗
PubMed1995

Custom CAD/CAM total temporomandibular joint reconstruction system: preliminary multicenter report.

PURPOSE: The purpose was to test the outcome of a custom computer assisted design/computer assisted manufactured (CAD/CAM) total temporomandibular joint (TMJ) reconstruction system. PATIENTS AND METHODS: There were 215 patients (13 males and 202 females); the average age at reconstruction was 40.9 +/- 10.3 years (range, 15 to 77 years). There were 363 joints placed, 296 bilateral and 67 unilateral. The patients had TMJ problems for an average of 10.3 +/- 7.0 years (range, 1 to 44 years), and had undergone a mean of 5.4 +/- 4.8 (range, 0 to 28) prior unsuccessful surgeries. Preoperative and postoperative data were collected for up to 48 months using a standardized data collection format. Subjective data related to pain, function of the lower jaw, and diet, were obtained using a visual analogue scale. Objective measures of mandibular range of motion were made directly on the patient preoperatively and postoperatively. RESULTS: Preliminary analysis of these data reveals a statistically significant decrease in pain, an increase in function, and improvement in diet (P < .0001) from the preoperative measurements to 1 and 2 years postoperatively. There was also improvement in mandibular vertical range of motion. The number of previous surgeries was a strong predictor of postoperative pain, function, and diet scores, as well as of maximal interincisal opening. A life table analysis of failures indicates good durability of the prosthesis over time. CONCLUSION: These preliminary data indicate that this custom CAD/CAM total TMJ reconstruction system seems to be useful in the treatment of the multiply operated, and/or anatomically mutilated TMJ.

Adolescent↗
PubMed1992

Measurement of the heat of reaction transmitted intracranially during polymerization of methylmethacrylate cranial bone cement used in stabilization of the fossa component of an alloplastic temporomandibular joint prosthesis.

Temporomandibular joint alloplastic fossa replacements have always been difficult to stabilize because of the variability of the anatomy in the area both in normal and especially in pathologic states. Total joint reconstruction and stabilization in orthopedic surgery have been aided by the use of methylmethacrylate, which is used both as a cementing substance and as a filler material when there are voids between the implant and the basilar bone. The concept of the use of a filler material to aid in the stabilization of the alloplastic temporomandibular joint fossa is attractive, but of concern because of the exothermic reaction this material undergoes as it sets in proximity to the middle cranial fossa. This study was designed to measure the temperature gradient that exists in such a procedure when used with cadaver specimens. The results indicate that the heat of reaction was not significantly transmitted intracranially in the cadavers studied. However, I recommend care in the use of this material for this purpose with patients.

Bone Cements↗
PubMed1992

Outcome assessment in oral and maxillofacial surgery advanced education programs.

Outcome assessments are becoming a standard by which predoctoral and postdoctoral advanced dental educational programs are being evaluated internally and externally. This article presents an overview of the process of development of an outcome assessment document for oral and maxillofacial surgery residency programs and provides an example of its value in the evaluation of two different types of oral and maxillofacial surgery programs.

Adult↗
PubMed1986

Pneumatization of the articular eminence of the temporal bone: prevalence, development, and surgical treatment.

Routine panoramic radiographs of 784 patients were evaluated retrospectively for the presence of pneumatization of the articular eminence of the temporal bone (PAT). The radiographs of eight patients showed signs of PAT. These eight patients ranged in age from 32 to 69 years, and four patients had bilateral involvement of the temporal bone. The use of tomography is recommended before surgical procedures involving the eminence to determine the extent of the pneumatization.

Adult↗
PubMed1985

The relationship between blood ordered and blood administered in orthognathic surgery: a retrospective study.

A retrospective study was performed to determine the appropriateness and efficiency of preoperative blood ordering practices in orthognathic surgery. Results obtained showed that preoperative blood typing and crossmatching should be performed on patients who will be receiving combined maxillary and mandibular osteotomies with iliac crest grafts. Patients receiving all other types of osteotomies should have only preoperative blood typing and screening. This will serve to reduce cost to the patient, blood wastage, and the laboratory work load.

Adolescent↗
PubMed1985

Intraoral vertical subcondylar osteotomy: a national survey.

The results of a national survey pertaining to the IVSO are presented and the findings are contrasted with the literature on the procedure. It was found that the IVSO is a popular procedure for mandibular setback, that the value of determining the mandibular divergence angle is equivocal, that the Stryker oscillating saw is the most popular instrument for performing the osteotomy, that most operators leave the segments unfixed, and that the intraoral approach to the correction of mandibular prognathism is preferred. There were no geographic trends noted.

Humans↗
PubMed1984

Psychological factors in adjustment to orthognathic surgery.

The psychological adjustment of 30 orthognathic surgery patients was evaluated before and on three occasions after surgery. Results of preoperative testing showed the group to be well adjusted, and there were no major changes in psychological functioning as a result of surgery. Motivation for surgery included both functional and esthetic goals, and the majority of patients were satisfied with the results of surgery. The patient's perception of the surgeon was significantly related to pre- and postoperative adjustment. Two of the measures used, the Health Opinion Survey and the Impact Message Inventory, have potential as brief early screening devices to identify patients who may experience problems in psychological adjustment to orthognathic surgery.

Adolescent↗
PubMed1983

Anxiety, information, interpersonal impacts, and adjustment to a stressful health care situation.

Forty patients scheduled for dental extraction surgery were given either specific or general preparatory information, and this information was presented in either a personalized or relatively impersonal fashion using nonverbal cues. Changes in state anxiety over the course of the experiment were accounted for by individual differences in the Dental Anxiety Scale. The most important determinant of adjustment during surgery was the congruence between specificity of information received and individual differences in preference for information as measured by the Information subscale of the Krantz Health Opinion Survey (KHOS; Krantz, Baum, & Wideman, 1980). Findings with the KHOS and the Dental Anxiety Scale are examples of the growing importance of situation-specific personality-trait measures. The finding that high levels of presurgery anxiety are associated with poor adjustment is discussed in terms of Janis's (1958) model. Patients' perceptions of information-giver hostility and dominance were also significantly (inversely) related to adjustment; the differential impact of informational versus interpersonal variables is discussed in terms of moderating characteristics of health care settings.

Adaptation, Psychological↗