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Biomedical subjects

M F Dolwick

Publications and source records attributed to M F Dolwick.

At least 19 recordsLinked to original sources
PubMed2003

Five-year retrospective evaluation of temporomandibular joint arthrocentesis.

This retrospective study is aimed to evaluate the long-term outcome of arthrocentesis for the treatment of temporomandibular joint (TMJ) internal derangements, and to document the impact of patient, time and symptom-related factors on the outcome of the procedure. Thirty-four patients (48 joints) who underwent TMJ arthrocentesis were included in this study. The scores for preoperative maximal mouth opening, and VAS scores for pain and dysfunction were compared with the follow-up scores obtained by the questionnaire and clinical examination. Several factors that may affect the long-term outcome of arthrocentesis are further evaluated. Statistical evaluation of the baseline and follow-up data was made by linear regression analysis and paired t-test. The mean follow-up period was 22 months. There was a significant (P< 0.001) increase in the maximal mouth opening (MMO) postoperatively that held during the longer term follow-up period. The pain and dysfunction levels at the follow-up were significantly (P< 0.001) lower than the preoperative values. Twenty-six per cent of patients were pain free and also showed a total relief in dysfunction at the follow-up. Although both preoperative and follow-up pain scores were higher in patients with bruxism, there was not a significant difference in the outcome when compared with non-bruxers. However, there was a greater reduction in dysfunction with improvement in MMO in non-bruxers. The duration of symptoms before arthrocentesis has not been found to affect the outcome. Also, there were no significant differences between the results of follow-up when comparing the shorter follow-up time results (<20 months) and longer term results. Arthrocentesis for the treatment of TMJ internal derangements offers favourable long-term stable results with regard to increasing maximal mouth opening, and reducing pain and dysfunction.

Adolescent↗
PubMed1999

Retrieval of a broken needle in the pterygomandibular space.

BACKGROUND: Dental needle breakage can be a devastating experience for both practitioners and patients. The authors describe the surgical management for localizing a broken dental needle in the pterygomandibular space and how to prevent needle breakage. CASE DESCRIPTION: The authors present the case of a 35-year-old man who had a chief complaint of pain and the ability to feel a broken needle during mandibular movements after receiving an inferior alveolar nerve block from his general dentist before dental treatment. Surgical management involved localizing the broken needle using radiographs and removing the broken needle under general anesthesia. CLINICAL IMPLICATIONS: Preventing needle breakage is important, as it can be a traumatic experience for the patient. Practitioners should establish the patient's cooperation by explaining to him or her what to expect before injection. Practitioners also should routinely inspect dental needles before administering injections and minimize the number of repeated injections using the same needle.

Adult↗
PubMed1997

The role of temporomandibular joint surgery in the treatment of patients with internal derangement.

Surgery of the temporomandibular joint (TMJ) has made considerable progress, although significant failures have plagued this field in recent years. Despite the controversies, surgery of the TMJ continues to have a small but important role in the management of specific temporomandibular disorders. This article presents an overview of TMJ surgery. It is concluded that careful case selection is the most important aspect for a successful outcome.

Arthroplasty↗
PubMed1996

A re-evaluation of the importance of disc position in temporomandibular disorders.

During the 1970s there was a resurgence of interest in disc displacement as being central to the pathology of internal derangement. Since then it has been proposed that a displaced disc can result in pain, mandibular dysfunction, degenerative joint disease and mandibular growth disturbances. Two decades later, and with the introduction of sophisticated investigations and treatment modalities, doubts have emerged as to true pathological significance of disc position. Evidence derived from clinical observations, autopsy material, imaging studies and surgical findings has failed to establish strong support for the central role of disc displacement in internal derangement of the temporomandibular joint.

Cartilage, Articular↗
PubMed1996

Temporomandibular disorders. Part 3. Surgical treatment.

Surgery of the temporomandibular joint has a small but nonetheless important role in the overall management of temporomandibular disorders. Appropriate case selection is the mandatory requirement for successful surgical intervention in order to achieve the desired outcome of treatment, such as relief of symptoms and improved function. In this, the third article in the series, a general overview of the current surgical treatment modalities for temporomandibular disorders will be presented.

Arthroscopy↗
PubMed1995

Temporomandibular joint arthrocentesis and lavage for the treatment of closed lock: a follow-up study.

OBJECTIVES: Temporomandibular joint (TMJ) arthrocentesis and lavage, first described in the North American literature in 1991, is a simplified method used for the treatment of severe, limited mouth opening. The purpose of this study is to evaluate the efficacy of this technique as a treatment for closed lock of the TMJ. DESIGN: Forty-six patients with persistent closed lock of the TMJ of acute onset were treated by TMJ arthrocentesis and lavage with manipulation in an out-patient setting. Clinical data was collected in the form of visual analogue scales for pain and chewing ability, and measurements of maximum mandibular opening before and after treatment. RESULTS: On follow-up ranging from 6 to 30 months, jaw opening and mandibular function had significantly improved (p < 0.001), and pain had substantially decreased in all but one patient as a result of this procedure. CONCLUSION: TMJ arthrocentesis and lavage is recommended as a simple alternative to more invasive TMJ procedures as an effective technique for the treatment of acute persistent closed lock of the TMJ.

Adult↗
PubMed1995

Temporomandibular disorders. 1. Clinical evaluation.

The treatment of temporomandibular disorders continues to provide dental practitioners with a difficult challenge that has yet to overcome numerous major obstacles. In this, the first of a series of three articles, an overview of the current understanding of the diagnosis of temporomandibular disorders will be presented. The subsequent two articles will present an overview of the management strategies that have appeared in the literature in recent years.

Humans↗
PubMed1995

Temporomandibular disorders. 2. Non-surgical treatment.

There are many treatment modalities for temporomandibular disorders (TMD), most of which are effective in controlling symptoms, at least in the short term. The non-surgical treatment of temporomandibular disorders continues to be the most effective way of managing over 80 per cent of patients who present with symptoms of temporomandibular pain and dysfunction. In this, the second article in the series, a general overview of the current non-surgical treatment strategies for TMD will be presented.

Dental Occlusion, Balanced↗
PubMed1994

Morbidity from anterior ilium bone harvest. A comparative study of lateral versus medial surgical approach.

The morbidity of bone harvest was compared between anterior lateral and medial surgical approaches in a randomized prospective study. Forty consecutive patients, each requiring a minimum 40 cc of loose corticocancellous bone for maxillofacial reconstruction, were randomly placed into two equal groups. Morbidity vectors assessed included bone volume, blood loss, length of surgery, length of hospital stay, incidence of seroma, incidence of anterior thigh paresthesia, postoperative pain, and gait disturbance. The results demonstrated no significant difference in morbidity between these two approaches; therefore selection of either approach is the surgeon's personal preference. A thorough understanding of the osseous anatomy of the anterior ilium and its muscular attachments, a good surgical technique, an efficient surgical team, and a continuous flow of required surgical instruments are essential to reduce the morbidity of bone harvest.

Adult↗
PubMed1994

Is there a role for temporomandibular joint surgery?

In North America, surgery of the temporomandibular joint (TMJ) has made considerable progress, although significant failures have plagued this field in recent years. In spite of the controversies, surgery of the TMJ continues to have a small, but nonetheless, important role in the management of specific temporomandibular disorders (TMD). A general overview of the current thinking in TMJ surgery is presented with the clear message that careful case selection is the most essential ingredient for a successful outcome.

Arthroscopy↗
PubMed1992

Prevalence and variance of temporomandibular dysfunction in orthognathic surgery patients.

Seventy-five patients were studied retrospectively to assess the prevalence and variance of temporomandibular dysfunction in an orthognathic surgery population. Preoperatively, 49.3% of the sample presented with temporomandibular dysfunction. After orthognathic surgery, of the symptomatic patients, 89.1% had improved temporomandibular function after surgery, 2.7% were unchanged, and 8.1% had increased symptoms. Of the patients asymptomatic prior to surgery, 7.9% developed temporomandibular dysfunction postoperatively. Temporomandibular dysfunction was significantly more prevalent in patients with a Class II skeletal deformity than in those with a Class III deformity, and temporomandibular function generally improved in both groups postsurgically.

Adolescent↗
PubMed1992

Oral and maxillofacial surgical therapy for the older adult.

Older adults can present with a wide range of oral and maxillofacial diseases and conditions, and many of these are best treated surgically. One of the distinguishing features of geriatric surgery is the large percentage of older adults who have medical conditions that must be planned for perioperatively. Good communication between the surgeon and the primary care physician is important for this perioperative management. Orofacial infections, the most common of which are odontogenic in origin, require some form of surgical treatment and may or may not require treatment with antibiotics. Preprosthetic and reconstructive surgery may be necessary to treat the sequelae of oral and maxillofacial fractures, the sequelae of tooth loss, or surgical defects incurred during the treatment of cancer, osteomyelitis, osteoradionecrosis, or disorders of the TMJ.

Aged↗
PubMed1991

An alternative explanation for the genesis of closed-lock symptoms in the internal derangement process.

Clinical and surgical data on 194 operated joints (135 patients) were used to substantiate a new concept challenging the presumed natural history of temporomandibular internal derangement (ID). A number of findings were incompatible with the traditional depiction of a progressive process based on gradual changes in disc position and shape. These findings were a lack or correlation between increasing age and the stages of the process; the percentage of patients in the third stage (closed lock) with limited opening (less than 25 mm) too severe to be caused solely by a nonreducible, displaced disc; the unexpectedly high incidence (greater than 50%) of normally shaped discs in the third stage of the process. A specific condition of severe and stubborn limited maximal mouth opening caused by total cessation of gliding, liable to occur at any age and unrelated to disc shape or position, which responds successfully to simple treatment by lavage and lysis, pressured injection, or arthrocentesis, was discerned. Lack of gliding was attributed to adherence of the disc to the fossa by a reversible effect such as a vacuum and/or decreased volume of synovial fluid of high viscosity. This condition was deemed worthy of an independent identity, dissociated from disc displacement, as a causative factor in the second and third stages of ID, and particularly as an aid to accurate diagnosis and treatment.

Adolescent↗
PubMed1991

Facial erysipelas: report of a case and review of the literature.

The diagnosis of erysipelas is usually made clinically. Features that help distinguish erysipelas are acute onset, erythema, warmth, edema, pain, fever, and isolated regional involvement with clearly demarcated margins. High ASO titers and response to penicillin therapy are reassuring. Simple uncomplicated erysipelas or cellulitis in adults can usually be treated on an outpatient basis. Extensive facial involvement with fever and a toxic appearance warrants hospitalization. Facial cellulitis or erysipelas in children, unless quite limited, requires hospitalization because of the high risk of Hemophilus influenzae infection and sepsis. Hospitalized patients should show visible signs of resolution and be afebrile for at least 24 hours prior to discharge. They should be maintained on oral antibiotic therapy at home for an additional 7 to 10 days.

Adult↗