[Bone reconstruction of mandibular defects with and without continuity defects].
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Biomedical subjects
Publications and source records attributed to O Schwartz.
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13 patients suffering from local atrophy or loss of the alveolar process of the jaws were treated by subperiosteal implantation of allogenous, decalcified, sterilized dentin with the purpose of augmentation of the alveolar process. All patients, including 9 donors of dentin were ABO-, Rh-, and HLA tissue typed. Anti-donor cell-mediated immunity (CMI) and humoral-mediated immunity (HMI) of the patients were monitored during the first 6 postoperative months. The CMI and HMI were assessed by means of the leucocyte migration test (LMT) and the complement dependent microlymphocytotoxicity test (CDC) with donor leucocytes as antigen and target cells, respectively. Compared to 66 normal non-transplanted controls, the leucocyte migration inhibition against desintegrated donor leucocytes as antigen was significantly increased for 2 of the recipients during the control period. 1 of these recipients showed a simultaneous HMI reaction 6 weeks after implantation. The remaining CMI and HMI values of the recipients were within normal range. These results were not correlated with the histocompatibility match grades of the donor recipient pairs. The present investigation supports the suggestion that implantation of allogenous, decalcified and sterilized dentin occasionally is capable of eliciting a measurable alloimmune response.
Cryopreservation is clinically relevant in storage of teeth for transplantation or replantation. The effect of cryopreservation was studied by histometric analysis of 60 teeth replanted in 10 green Vervet monkeys. The following cryopreserving agents were examined: 5% and 10% dimethylsulfoxide (DMSO) and 10% glycerol. Furthermore, 2 types of freezing method were compared: automatic biological freezing (Cryoson) and a simplified freezing device of Sperling. Cryopreserved teeth were stored for 1 week at - 196 degrees before replantation. The histometric analysis carried out 8 weeks after replantation showed that 5% DMSO had the best effects in protecting the periodontal ligament (PDL) during cryopreservation. This medium induced no replacement resorption and secured a considerable extent of normal periodontal ligament compared to the control teeth replanted immediately without cryopreservation. 10% DMSO and 10% glycerol also preserved the PDL but with a lower degree of survival and a higher degree of ankylosis. 10% DMSO exposed at 0 degree C followed by immediate replantation did not induce any pathological effect on the PDL. All cryopreserved teeth showed some degree of inflammatory resorption. However, this could be due to the expected necrosis of the pulp tissues of the frozen teeth because of the lack of diffusion of cryoprotectant agent into the pulp of mature teeth.
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The granular cell tumor is an uncommon benign lesion with a predilection for the oral cavity. Fourteen tumors from 13 patients have been reviewed with a follow-up period ranging from 7 months to 21 years with an average of 7.1 years. Women were affected twice as often as men, and the age of the patients varied from 14 to 75 years. Eleven of the lesions were located on the tongue, the remaining on the lower lip, sublingual papilla, and the buccal mucosa. Multiple lesions were found in one patient.The tumors varied in size from 3 to 25 mm in diameter and were all firm to hard in consistency. All the lesions were treated by local excision. Pseudoepitheliomatous hyperplasia of the overlying epithelium was seen in four patients. In spite of a possible inadequate removal of 10 of the lesions where granular cells extended to the margin of excision, no recurrence was seen. A simple but deep local excision is the recommended treatment.
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