The orthodontic-oral surgery interface: 2. Orthodontics and orthognathic surgery.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to P Banks.
Explore the source record for details and available documents.
Changes in soft tissue morphology induced by surgery are generally analysed using midline profiles only, derived from photographs and cephalometric radiographs. Full face photographs supplement these records. Soft tissues and their changes can be measured in three dimensions using stereophotography. This report described how the three dimensional changes produced by facial surgery were measured for a patient undergoing surgery to the mandible.
This paper discusses the significance of the surgical anatomy of the adult cleft deformity in reconstruction. The essential asymmetry of the unilateral cleft is explained and methods suggested for reconstruction in three categories of cases; those with simple alveolar defects; those with additional retroposition of the maxillae; and those with vertical maxillary deficiency. The indications for two-stage osteotomies are presented. Finally a new surgical approach for osteotomy of the premaxilla in bilateral clefts is described and illustrated.
Explore the source record for details and available documents.
Neonatal administration of 6-hydroxydopamine to rat pups was used to deplete brain noradrenaline in the locus coeruleus projection system to less than 5% of normal and the response to barbiturate and non-barbiturate anaesthetics examined. The sleeping time in response to administration of thiopentone, pentobarbitone, methohexitone or hexobarbitone was markedly increased in 6-hydroxydopamine-treated rats, as it was for the non-barbiturates chloral hydrate and diisopropylphenol. The sleeping time for other non-barbiturates such as althesin, ketamine and ethyl carbamate (urethane) was not affected in noradrenaline-depleted rats. Similarly, an index of the evoked potential, recorded in the primary somatosensory cortex to supramaximal electrical stimulation of the forepaw, decreased more markedly with increasing doses of thiopentone in 6-hydroxydopamine-treated rats than in controls. Potentiation of the effect of diisopropylphenol on the evoked cortical response was also seen in noradrenaline-depleted rats while the effect of althesin did not differ. It is suggested that brain noradrenaline pathways originating from the locus coeruleus may play an important role in the duration and depth of anaesthesia resulting from barbiturate and some related agents.
A newly developed method for cutting the cerebellar peduncles in neonatal rats has allowed the study of the development of cerebellar beta-adrenergic receptors in the absence of noradrenergic afferents. Cutting the cerebellar peduncles of neonatal animals did not affect the pattern of development of the beta-adrenergic receptors, nor their final numbers. Pedunclectomy induced a decline in the ability of slices of cerebellar cortex to accumulate [3H]noradrenaline although high-affinity noradrenaline uptake, was never completely abolished. It is suggested that the remaining high-affinity noradrenaline uptake cannot be attributed to noradrenergic fibres from the locus coeruleus.
Evidence based on the ability to accumulate [3H]noradrenaline by a mechanism sensitive to desmethylimipramine suggests that there is a period of hyperinnervation of the cerebellum by noradrenergic fibres around the beginning of the second postnatal week. Different developmental profiles for specific noradrenaline uptake and noradrenaline content indicate that invasion of the tissue by noradrenergic fibres precedes their full acquisition of transmitter. Developmental increases in the density of beta-receptors and adenyl cyclase responsiveness to isoproterenol lags behind those of the presynaptic components and does not begin until the hyperinnervation is declining around day 12.
Post-condylar cartilage grafts have been used to advance the mandible in 15 patients who have been followed up for periods varying from 5 to 37 months. Operative morbidity is minimal, but early displacement of the cartilage block occurred in two patients. Temporomandibular function appears unaffected, with condylar remodelling only demonstrated in two cases. Significant skeletal relapse has not been identified, but post-operative changes in incisor position usually occur and may prejudice the clinical result. Careful supervision is required to ensure orthodontic stability.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Subapical osteotomy of the anterior mandible was carried out on 10 adult Macaca Irus monkeys with and without open bite. Teeth were extracted at 8 weeks, 12 weeks, 24 weeks and 1 year after surgery and the pulps examined histologically. No normal pulps were found. Progressive fibrosis and calcification was noted in all teeth. Patent pulp blood vessels were found up to 24 weeks after surgery. Pulp damage to teeth distal to the osteotomy site was found in 50% of cases. Control teeth extracted from the opposing jaw at the same intervals were all found to have normal pulps.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.