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Biomedical subjects

M F Dolwick

Publications and source records attributed to M F Dolwick.

At least 37 records · Page 2Linked to original sources

Arthroscopic lavage and lysis of the temporomandibular joint: a change in perspective.

Arthroscopic surgery was applied to correct various disorders of the temporomandibular joint (TMJ). Lysis and lavage of the upper TMJ compartment proved of value in patients with anterior disc displacement without reduction ("closed lock"), because it increased the range of mouth motion and alleviated pain in the TMJ. Because this beneficial arthroscopic intervention did not encompass repositioning the disc, its surgical relocation when attempting to overcome dysfunction and pain in the TMJ is questioned.

Adult↗

Panoramic radiography for temporomandibular joint arthrography: a description of arthropanoramograms.

TMJ arthrograms done with panoramic radiography, i.e., arthropanoramography, can demonstrate intracapsular disk displacement and perforation pathoses. These views are very practical for inferior synovial cavity arthrograms performed in the dental operatory since panoramic radiographic machines have become common in modern dental practices. Specific advantages of arthropanoramography include the decreased financial cost and decreased radiation exposure to the patient. Arthropanoramography does not replace tomography or videofluoroscopy in TMJ arthrography. It is, however, described as a simple alternative to the more conventional forms of arthrography.

Cartilage, Articular↗

Incidence of oxygen desaturation during oral surgery outpatient procedures.

The frequency, severity, and duration of oxygen desaturation during oral surgical procedures in outpatients was measured. Sixty patients divided into six groups received either lidocaine; lidocaine, diazepam, and meperidine; lidocaine, diazepam, meperidine, and headphone music; lidocaine, diazepam, meperidine, and nitrous oxide; lidocaine, diazepam, meperidine, methohexital, and nitrous oxide; or lidocaine and nitrous oxide. Forty-three percent of the 30 patients who did not receive supplemental oxygen experienced clinically significant oxygen desaturation (greater than 5%) with a mean duration of 4.6 minutes. Only 13% of the patients who received supplemental oxygen had significant desaturation ranging from ten seconds to 12.3 minutes with a mean duration of 1.4 minutes. An unexpected finding was hypoxia in patients receiving only lidocaine anesthesia.

Adolescent↗

Temporomandibular joint fibrous ankylosis following orthognathic surgery: report of eight cases.

Undue pressure on the temporomandibular joint consequent to orthognathic surgery may result in fibrous ankylosis in the joint. Occurrence of this disorder may increase with the use of rigid internal fixation combined with 6 to 8 weeks of maxillomandibular fixation. Proper intraoperative placement of the proximal mandibular segment is the key to prevention of this complication, especially in high-risk joints.

Adolescent↗

Temporomandibular joint arthrography without fluoroscopy.

An arthrographic technique for the temporomandibular joint that can be performed in a dental surgical room is described. This technique utilizes a dental radiographic unit and extraoral cassettes for visualization of the needle tip in the inferior synovial space for arthrography. The radiographic visualization is combined with tactile discernment of the needle tip on the mandibular condyle. The successful application of these two methods makes fluoroscopy unnecessary. After an initial success rate of 81% (34 of 42 attempts), we have used the technique successfully in more than 100 cases. Most of the problems encountered with this technique can be attributed to initial operator inexperience. This technique is not suggested as a replacement for fluoroscopy. However, it is a convenient, economical technique that can be used in the dental surgical room by trained clinicians when arthrography is indicated to determine meniscal-condylar relationships and meniscal perforations.

Arthrography↗

Estrogen receptors in the temporomandibular joint of the baboon (Papio cynocephalus): an autoradiographic study.

Using an autoradiographic method, the temporomandibular joint (TMJ) complex of five aged female baboons was studied for the presence of receptors for estradiol-17 beta. The study was performed in an effort to learn more of the pathophysiology of this joint and in an attempt to provide a scientific basis to explain the reported preponderance of women who seek and undergo treatment for signs and symptoms referable to the TMJ. This experiment revealed that the TMJ complex contains numerous cells with receptors for estrogen, particularly the articular surface of the condyle, articular disk, and capsule. Muscles of mastication contained relatively fewer receptors. As a result, one may postulate a role for the sex steroid hormones in the maintenance, repair, and/or pathogenesis of the TMJ. Additional studies are necessary to fully determine the significance of hormone receptors in this site and any correlation between diseases of the TMJ and the endocrine status of affected patients.

Aging↗

Pneumomediastinum and subcutaneous cervical emphysema during third molar extraction under general anesthesia.

A case of pneumomediastinum and subcutaneous cervical emphysema during the extraction of third molars under general anesthesia has been presented. The most likely cause was pulmonary barotrauma secondary to a faulty expiratory valve. This emphasizes the need for the proper preoperative check of all anesthetic equipment. Although pneumomediastinum and subcutaneous cervical emphysema are usually self-limiting conditions with rapid recovery, the patient must undergo close observation for the possible development of serious complications.

Adult↗

Silicone-induced foreign body reaction and lymphadenopathy after temporomandibular joint arthroplasty.

Eight patients with previously placed silicone temporomandibular joint (TMJ) implants were operated on again. Excised tissues from in and around the joint were histologically evaluated. In one case, a parotid lymph node was also examined. All specimens revealed fragmented, amorphous, refractile, but nonbirefringent, irregularly spherical foreign material consistent with fragmented silicone. Granulomatous inflammation and multinucleated giant cells were associated with the silicone material. These findings demonstrated that silicone may not be a totally inert material and that its biomechanical properties are not ideal for use in the TMJ.

Arthroplasty↗

Monocular blindness developing 7 days after repair of zygomaticomaxillary complex fracture. A clinical report.

Blindness following zygomaticomaxillary complex (ZMC) fracture and surgical repair is an unfortunate and uncommon complication. A review of the literature reveals fewer than 25 cases of monocular blindness resulting from zygomaticomaxillary fracture or repair. The case presented here is that of a man who was assaulted with a baseball bat and suffered a mildly displaced ZMC fracture. On admission, the patient had light perception only in his left eye. During his convalescence, vision in his left eye gradually improved to the point of allowing him to read a newspaper without difficulty. Then, 9 days after the injury (7 days after surgical repair), the patient awoke with complete blindness of the left eye. The possible mechanisms for such loss of vision are discussed.

Adult↗

The effects of orthognathic surgery on mandibular range of motion.

A prospective study of 55 orthognathic surgical patients was done to determine the effects of surgery on mandibular range of motion. None of the patients had oral physiotherapy during the course of the study. Nineteen patients had mandibular osteotomies, 21 had maxillary osteotomies, and 18 had two-jaw operations. Maximal interincisal opening (MIO), right and left lateral excursion, and protrusive measurements were obtained preoperatively and at six or more months following surgery. MIO was significantly reduced in both categories of mandibular osteotomies. A sagittal split osteotomy to advance the mandible was associated with the greatest mean reduction of 29%, while a vertical subcondylar osteotomy to set the mandible back had a mean reduction of 10%. Likewise, decreases in MIO were noted with combined surgical procedures. Le Fort I and sagittal split osteotomies were associated with a mean decrease in MIO of 28%, while Le Fort I and vertical subcondylar osteotomies had a mean decrease of 9%. Minimal change in MIO were noted with isolated maxillary osteotomies. These results are similar to the findings of other investigators and indicate the critical need for a sound postoperative rehabilitation program following orthognathic procedures to prevent hypomobility.

Adult↗

Computed tomography of the temporomandibular joint meniscus.

Fifteen patients with temporomandibular joint dysfunction were examined by computed tomography using standard CT techniques. The data obtained were evaluated and correlated with arthrographic findings or surgical observations. CT scans may become a valid alternative to the often painful procedure of arthrography for assessment of temporomandibular joint pathology if the potential pitfalls are avoided.

Adult↗