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Biomedical subjects

L Krekmanov

Publications and source records attributed to L Krekmanov.

16 recordsLinked to original sources

Soft tissue response to genioplasty procedures.

The soft tissue response to genioplasty procedures was studied in 65 patients. The patients were divided into four groups depending on the direction of the genioplasty. In 17 patients straight anterior repositioning was made (group I), in 12 patients posterior repositioning of the chin (group II), in 19 patients vertical reduction of the chin (group III) and in group IV superior-anterior repositioning of the chin. The predictability of the procedures varied. The soft tissue response was equal to the bone movement in the anterior repositioning but less predictable in the posterior direction or when combined with vertical reduction.

Adolescent

Transverse surgical correction of the maxilla. A modified procedure.

A modified surgical procedure to expand as well as reduce the width of the hard palate is described. Instead of a single sagittal osteotomy in the midline of the palate, multiple sagittal osteotomies are performed parallel to each other and maintaining the periosteal attachment to each of the fragments. The hard palate is thereby moveable and can be reduced in a transverse direction as well as expanded. The expansion will, however, be limited to the height of the curvature of the palate. Minor complications with the method are described. Long-term postoperative follow-up shows stable results with the method.

Adult

Posterior repositioning of the entire maxilla without postoperative intermaxillary fixation. A clinical and cephalometric study.

In 30 patients posterior repositioning of the entire maxilla has been performed. No postoperative intermaxillary fixation (IMF) has been applied. The surgical procedure is described and data given on the distance of repositioning. Results of cephalometric analysis indicate good long-term stability after surgery. We concluded that omitting IMF not only enhances patient comfort, but has no deleterious effect on postoperative stability of the maxilla.

Adolescent

Adverse effects on the brain in connection with isoflurane-induced hypotensive anaesthesia.

As a marker of brain cell injury, adenylate kinase (AK) was measured in cerebrospinal fluid (CSF) in 10 patients given anaesthesia with isoflurane-induced hypotension for corrective surgery of dentofacial deformities. Nine out of 10 patients displayed a marked increase in CSF-AK postoperatively compared with preoperative values. The postoperative mean value displayed a 400% increase compared to the corresponding preoperative value. This difference was statistically significant (P = 0.001). The rise in CSF-AK was most probably the result of an enhanced efflux of AK into CSF subsequent to a presumed hypoxic injury to brain cells.

Adenylate Kinase

Sagittal split osteotomy of the mandible without postoperative intermaxillary fixation. A clinical and cephalometric study.

A modified sagittal split technique has been evaluated in 42 dentate patients, in whom no postoperative intermaxillary fixation was used. Twenty-three patients had mandible set-back performed and 19 patients mandibular advancement. The method makes possible a safe split osteotomy under controlled conditions. The design of the osteotomy and screw osteosynthesis counteracts relapse. Omitting intermaxillary fixation facilitates postoperative handling of the patient and promotes rehabilitation.

Adolescent

Maxillary osteotomies without postoperative intermaxillary fixation (anterior, superior and inferior repositioning of entire maxilla). A clinical and cephalometric study.

Surgical correction of maxillary anomalies with anterior-superior or anterior-inferior repositioning of the segment was performed in 50 patients. The maxillary segment was stabilized by means of steel wires as horizontal mattress sutures, which, in all cases, gave very good primary stability. In case of insufficient bone contact miniplates were used. Postoperatively no rigid intermaxillary fixation (IMF) was applied. There are several advantages to not using intermaxillary fixation: 1) It is possible to carry out immediate postoperative inspection of the location of the condyles and thereby confirm that the segments are in the expected position. 2) Segment fixation is not disturbed by mandibular movements during recovery from general anaesthesia. 3) Manipulations by the anaesthesiologist immediately after surgery are not interfered with. 4) For the patient there is better postoperative comfort with no breathing, talking or feeding problems. 5) Minor corrections of intercuspation by means of orthodontic elastics are possible. These can act in the required direction and will not disturb the masticatory function. Masticatory function was resumed immediately after surgery and was usually normalized within 2-3 weeks. Cephalometric analysis revealed no significant relapse subsequent to surgery. Thus we conclude that omitting IMF, among other advantages, enhances patient comfort and has no negative effect on the postoperative stability of the maxilla.

Adolescent

Orthognathic surgery without the use of postoperative intermaxillary fixation. A clinical and cephalometric evaluation of surgical correction of mandibular and maxillary deformities.

The present series of investigations was performed in order to study the clinical and cephalometric long-term postoperative stability of the maxilla and mandible after surgical correction of jaw abnormities. The patients studied had maxillary or mandibular anomalies, alone or in combination with each other. Standardized surgical methods for correction of jaw deformities were used. Rigid postoperative intermaxillary fixation was omitted in all cases. Masticatory function was recommended immediately after surgery and was increased at the patient's own pace. Patients were able to eat all kinds of food 2-4 weeks postoperatively, independent of type of surgical procedure. The clinical results were good. Intraoperative complications, such as bleeding, unpredictable segment fracture during the splitting procedure, and damage to the neurovascular bundle or roots were negligible. The incidence of postoperative infections was very low. Such infections were limited to the region close to the osteosynthesis material and cleared up as soon as the wires or screws were removed. Paresthesia of the lower lip was seen with the sagittal split procedure especially when it was combined with genioplasty, but disappeared within one year. Standardized pre- and postoperative clinical and roentgenological recordings were made. In order to evaluate the postoperative stability of the osteotomized jaw segments cephalometric analysis of headfilms taken preoperatively, immediately postoperatively and at least one year after surgery was performed. There were no clinically significant postsurgical changes in the position of the maxilla, either in solitary procedures or in bimaxillary corrections. With mandibular advancement the mandible had moved slightly upwards and with setback surgery there was a slight post-surgical forward-upward movement. Omission of postoperative intermaxillary fixation, in combination with swelling or difficulties in nasal breathing, disturbed the tight intercuspidation immediately after surgery. The small changes seen were thought to be the result of tighter inter-cuspidation at the follow-up registration than on the day after surgery.

Adult

Simultaneous correction of maxillary and mandibular dentofacial deformities without the use of postoperative intermaxillary fixation. A clinical and cephalometric study.

Simultaneous correction of maxillary and mandibular anomalies was performed in 23 patients. The maxillary segment was stabilized by means of steel wires as horizontal mattress sutures, which, in all cases, gave good stability. A modified sagittal split has been applied in all cases. The method makes a safe split osteotomy possible under controlled conditions. The design of the osteotomy and the screw osteosynthesis counteract relapse. Postoperatively, no rigid intermaxillary fixation (IMF) was used. Masticatory function was started from the 1st postoperative day and in most cases was normalized 2-3 weeks after surgery according to the patients own judgement. Cephalometric analysis was performed on 15 patients by a superimposition technique. There was an overall good postoperative stability of the maxilla and mandible in the horizontal and vertical planes. We conclude that omitting IMF has no negative effect on the postoperative stability of the fragments.

Adolescent

Insect bite associated Kaposi's sarcoma with oral lesions.

A case of Kaposi's sarcoma with oral, pharyngeal and extremity lesions is reported. The first lesion appeared on the spot of an insect bite on the left leg during a stay in the Mediterranean area. Possible viral transmission by this route is discussed.

Aged

Miniplate osteosynthesis of infected mandibular fractures.

Miniplate osteosynthesis in cases of infected mandibular fractures in patients with reduced healing capacity and lack of cooperation has been evaluated. Thirty seven patients with 42 potentially infected mandibular fractures were treated by internal fixation with miniplates. Healing occurred in all cases. Postoperative infection was noted in 9 patients. Aspects of healing and indications for the method are discussed.

Adolescent

Orthognathic surgery with no postoperative intermaxillary fixation.

In 113 patients orthognathic surgery was performed. Both maxillary, mandibular and combined procedures were used. Intermaxillary fixation was avoided in all cases. It was found that the procedures presented offer a safe correction of the jaw with minimal complications during surgery and in the postoperative period. Preliminary data suggest that the stability of the segment is in good accordance with procedures with intermaxillar fixation.

Adolescent

Postoperative complications after surgical removal of mandibular third molars. Effects of penicillin V and chlorhexidine.

A random material of 112 patients, was investigated after surgical removal of impacted lower third molars. 2 experimental groups and 1 control group were studied. Prophylactic medication with penicillin V combined with preoperative rinsing using 0.2% chlorhexidine gluconate (Hibitane) was found to reduce postoperative symptoms, when compared with preoperative rinsing alone. In both cases, patients were compared with the control group.

Adolescent

Effect of application of cold dressings on the postoperative course in oral surgery.

The effect of external application of local cold on swelling, trismus, temperature and pain postoperatively in surgical removal of impacted mandibular third molars was studied in a cross-over study comprising 45 patients. The patients were treated postoperatively with cold dressings after the first or the second operation. There were no significant differences in swelling, trismus, temperature or postoperative pain between the 2 groups of operations. It is concluded that the external application of cold after the surgical removal of impacted mandibular third molars does not appear to improve the postoperative course, either on a short or long term basis.

Adolescent