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Biomedical subjects

P Cascone

Publications and source records attributed to P Cascone.

At least 19 recordsLinked to original sources
PubMed1999

Condylar fractures during growth: follow-up of 16 patients.

Fractures of the mandibular condyle represent 20% to 35% of all mandibular fractures. There are several clinical variants of this type of fracture that give rise to different problems in relation to their classification and treatment. A sample of 16 patients (of a total of 280 patients examined and treated from 1985 through 1995) with mono- and bilateral, displaced and decomposed, condylar fractures that occurred during growth were examined by the authors, who assessed, by a 2-year follow-up, the relevant clinical, functional, and instrumental parameters. On the basis of the data gathered by this study, a plan was drawn up for treating these patients that takes into account the different situations, such as either a nonsurgical or surgical treatment (by the use of condylectomy or external rigid fixation), and points out the advantages and disadvantages of each method.

Adolescent↗
PubMed1999

Temporomandibular joint biomechanical restrictions: the fluid and synovial membrane.

The authors analyze the functions of the synovial membrane and the chemical-physical properties of synovial fluid. In particular they evaluate the role played by synovial fluid in the complex mechanism of the temporomandibular joint. Every single part that belongs to the temporomandibular joint, together with the stomatognathic apparatus, plays a specific and particular role according to the dynamics and to the preservation of the correct temporomandibular joint physiology. The physiological postural and functional relationship between the various parts of the temporomandibular joint is guaranteed by a number of biomechanical restrictions that lead and influence the regular execution of the articular movements. The most involved biomechanical restrictions in the temporomandibular joint are the temporomandibular ligament, the lateral disc ligament, the bilaminar zone or retrodiscal tissue, the synovial membrane, and the synovial fluid.

Biomechanical Phenomena↗
PubMed1999

Debonding of adhesively restored deep Class II MOD restorations after functional loading.

PURPOSE: To assess debonding due to functional loading at the cervical dentin margins of deep Class II MOD restorations prepared with a variety of adhesive restoratives in endodontically-treated teeth. MATERIALS AND METHODS: MOD preparations and endodontic treatment were carried out on extracted sound maxillary premolars. The cavities were restored with seven material combinations: Three different resin-based composites (RBC) (Z100, Herculite XRV or Clearfil RP with their respective bonding systems); two bonded amalgam combinations (Valiant with Superbond D or with Panavia 21) and two sandwich combinations [the RBC Tetric with the polyacid-modified RBC (compomer) Compoglass or Z100 with the resin-modified glass ionomer Fuji II LC]. For each group, half of the samples were exposed to mechanical functional loading and the other half served as control. Imperfect bond formation and debonding due to loading was determined by dye penetration. In addition, the dye penetration scores were correlated with the cusp fracture strengths of similarly prepared restorations of a previous study. RESULTS: After functional loading, the RBC in combination with hybridizing dentin bonding agents showed better preservation of marginal integrity than the sandwich restorations, which in turn performed better than the amalgam restorations (P < 0.05). Debonding correlated with reduction in fracture resistance. Under the conditions of this study, debonding of adhesive MOD restorations by functional loading can best be prevented by using RBC in combination with hybridizing dentin-bonding systems.

Analysis of Variance↗
PubMed1998

Orbital hemangiopericytoma: case report of a long-term recurrency.

Among tumors concerning the orbit, hemangiopericytoma is one of the most unusual forms. This tumor has a vascular origin and usually appears as a fleshy, well-circumscribed mass, characterized by slow growth and lack of soreness. Its biological traits include a mostly benign nature, a potential malignancy, and, most of all, a highly frequent recidivation. This study of double recidivation shows this can occur even after a long lapse of time and the new tissue can acquire malignant traits. Finally, we describe the modes of the surgical approach, which aims at intervening the most radical cases to reduce recidivation to a minimum.

Bone Plates↗
PubMed1998

Prenatal diagnosis: evolution in craniofacial surgery.

Prenatal diagnosis of craniomaxillofacial malformations permits early surgery, before 6 months of life and possibly, in the near future, in utero, thereby obtaining the best aesthetic and functional results. Increased knowledge of embryology has largely improved the diagnosis of craniomaxillofacial anomalies, their classification, and therapeutic protocols. We analyzed nine pregnancies (one twin) in which cleft lip and palate (CLP)--isolated or associated with, for example, holoprosencephaly, hypertelorism, and micrognathia--was diagnosed by ultrasonography. Only one fetus of these pregnancies was later operated on in our unit. This patient, with 7 years follow-up, represents our clinical case. For these cases, early diagnosis of CLP allowed informed parental choice regarding the continuation or termination of the affected pregnancy and planning of surgical procedures to correct the malformation. This is demonstrated by the presented clinical case involving an infant operated on within 6 months with success.

Child↗
PubMed1998

[Arthrocentesis of the temporomandibular joint. Long-term results].

BACKGROUND: The studies carried out by Nitzan et al. (1991) to the assumption that the simple washing of the upper compartment of the temporo-mandibular joint, without introducing the arthroscope, associated to the application of a bite at night was sufficient to obtain a pain relieving effect and an improvement in the joint functionality in cases of internal derangement of TMJ. The purpose of this work is to assess the long-term results obtained in our department by using only the arthrocentesis without the association of other therapeutic procedures for evaluating the benefit brought by the simple washing of the upper compartment of the joint. METHODS: A sample of 10 patients subjected to arthrocentesis with an average follow-up of 23.8 months was examined. The evaluation of the patients was based on a clinical analysis and a series of instrumental tests including orthopanoramic X-rays, stratigraphies, RNM in some cases and an electrognatographic test. The parameters taken into consideration were maximum opening, articular noises, local pain in the articular region, the occurrence or not of headache. RESULTS AND CONCLUSIONS: In our opinion arthrocentesis is a method of simple application, well accepted by patients, leading to a clear improvement of symptoms, as far as pain relieving effect and functionality are concerned, thanks to the possibility to drain by washing the constituents of the inflammation and the mediators of pain; this method may be applied routinely, as therapeutic support, in those patients with clinical histories of condilo-meniscal uncoordination and presenting limitations in the opening of the mouth and articular pains.

Adolescent↗
PubMed1998

Progressive systemic sclerosis: rare localization of the maxillofacial district.

The authors focus on a case of scleroderma, or progressive systemic sclerosis. Scleroderma is a disease of unknown cause, characterized by an abnormal synthesis of connective tissues that causes a sclerosis of the skin involving organs and systems at various levels. It may appear in different forms and may involve, although not frequently, the maxillofacial district. The authors examined a 21-year-old woman who had been diagnosed with systemic progressive sclerosis in 1994. The patient showed a strong limitation of oral aperture, evidenced by an electrognathographic test, and osseous changes. Panoramic and full-mouth intraoral radiographs showed a complete agenesis of coronoid processes on both sides, whereas the angles and the rising branches of the mandibular and periodontal ligaments appeared normal. The patient was diagnosed as having maxillofacial localization of scleroderma with involvement of coronoid processes bilaterally.

Adult↗
PubMed1997

Paranasal sinus mucocele: diagnosis and treatment.

Several controversies still exist regarding the etiopathogenesis, diagnosis, and type of surgical treatment used in response to paranasal sinus mucocele. We wish to contribute to the standardization of therapeutic treatment for paranasal sinus mucocele by reporting our clinical experience in "open surgery." This analysis considers 53 patients--23 males and 30 females (age range: 11-80 years)--affected by frontoethmoidal or sphenoidal sinus mucocele whom we have surgically treated. Patients were classified according to age, sex, previous surgical treatment in the nasal area, symptoms, and acute visual difficulties; 15 patients showed disease in the frontal area, 28 in frontoethmoidal area, and 10 in the posterior ethmoidal or sphenoidal area (or both); in 18 patients the disease had reached the intracranial region. Transfacial approaches were used in all patients who did not show evidence of disease in the intracranial region. Of all the incisions performed 18 were coronal, 16 were paralateral, and 4 were through upper eyebrow approaches; a transnasal endoscopic approach was used in only 1 patient in whom the intracranial region was affected by disease. All patients showed satisfying functional and aesthetic results during and after recuperation.

Adolescent↗
PubMed1996

Therapeutic planning in synovial chondromatosis of the temporomandibular joint.

Synovial chondromatosis is a benign monoarticular arthropathy characterized by metaplastic cartilaginous foci developed in the synovial membrane. We present a review of the literature and report on five additional cases of synovial chondromatosis of the temporomandibular joint. Radiographic examination by computed tomographic scan allowed us to identify this disease as articular chondromatosis; however, a definitive diagnosis can be made only by histopathologic examination. In all cases surgical treatment led to the complete remission of symptomatology and to the functional recovery of the joint. Diagnosis and surgical therapy are discussed.

Adult↗
PubMed1995

Use of rigid external fixation in fractures of the mandibular condyle.

In this article the use of a rigid external fixation system is proposed for the early treatment of condylar fractures. This method offers the advantage of not damaging the articular structures during reduction and allows early mobilization for a rapid recovery. In our Centre 28 patients have been treated with the rigid external fixation system, with good functional results. Of these 15 men and 13 women, 22 had a monocondylar fracture and 6 had a bicondylar fracture. In all the cases there was complete recovery of the occlusal stituation and of the mouth opening; no patient surgically treated with this method has ever presented problems of a local or general nature. The purpose of this report was to evaluate the use of external fixation for the treatment of extracapsular condylar fractures with luxation of the fragment out of the glenoid cavity.

Adolescent↗
PubMed1994

Long-term control of the stability of skeletal structures in Class II dentoskeletal deformities after surgical-orthodontic therapy.

This study analyzes long-term findings in a group of 10 patients with Class II dentoskeletal malrelationship and who have undergone orthognathic surgical procedures. Changes in cephalometric values relative to the bony structures of the upper jaw and of the mandible are discussed in detail. Patients were reexamined on average, 5.8 years after surgery to show possible modification of the skeletal regions in patients who underwent surgical-orthodontic treatment for malformation of the facial continuum. For each case we made a cephalometric analysis of the lateral cephalograms, as well as the superimposition of tracings relative to the various stages of treatment: at the end of preoperative orthodontic treatment, after surgery, and at the long-term control. Cephalometric values for all patients who took part in this long-term control were recorded and a structural assessment was made.

Adolescent↗
PubMed1993

[The diagnosis and surgical therapy of maxillofacial malformations. The statistical considerations].

In this report the authors develop a thorough statistic analysis upon the past 12-year activity (1980-1991) of the University of Rome, Department of Maxillo-Facial Surgery, in the field of the diagnosis and treatment of congenital or acquired maxillofacial malformations. They point out, in particular, the high frequency rate of bimaxillary osteotomy use in the surgical treatment of dentoskeletal malformations, that are the most frequent malformations in maxillofacial clinical practice. They also point out how wide the use of the rigid internal fixation technique in this surgical field has become.

Adult↗
PubMed1992

[Technical principles of solid tridimensional modeling with computerized tomography for the study of maxillofacial diseases].

3DCT allows the solid modeling of body structures from contiguous slices. The 3D images are free to rotate on the x, y, and z axes. It is possible to evidentiate structures with various densities by means of threshold operators, which allow a 3D model of both soft tissues and bones to be obtained. Shading operations allow image quality to be improved by varying the elementary units to surface units ratio. Implemented 3D rendering reduces the spatial edges by means of anti-aliasing functions. The 3D images allow the study of the complexity of maxillofacial bony structures, and they are especially useful in both surgical planning and in postoperative follow-up. We studied 58 patients with maxillofacial diseases (34 traumatic, 14 malformations, 4 dysplastic, and 6 neoplastic). In most cases (96.5%), we obtained high-quality images, which allowed both the site and the extension of the lesions to be evaluated, together with their relationships to adjacent structures. In 65% of traumatic cases, the 4 basic views thoroughly demonstrated lesion spread, while in the extant 35% of cases cutting operations and rotatory translations were necessary. In all malformation cases a clear visualization of somatic asymmetries was obtained. In both dysplastic and neoplastic cases, the best lesion evidence was obtained in superficial lesions with cortical bone involvement. This technique was always easy and quick to perform, with no need for supplemental dose exposure to the patient.

Bone Diseases↗
PubMed1992

[Neuromuscular assessment and postural examination in patients with TMJ condylo-meniscal incoordination].

The neuromuscular system plays a primary role in the development of a myofascial syndrome of the temporomandibular joint. Patients suffering from this disease very often show changes in muscular functions. In biomechanical clinical pictures of temporomandibular myofascial syndrome the motor apparatus is involved only in the second stage. In order to determine the efficiency of the motor apparatus and to schedule a physiotherapeutic treatment program to improve condylar-meniscus coordination of the joint, an analysis of muscular function associated with postural examination has been performed, and this with a view to evidence possible skeletal changes, with particular regard to the spine. The study has been carried out in a group of healthy individuals in front of an other group of patients affected by the pathology mentioned.

Adolescent↗
PubMed1991

[A statistical evaluation of the surgical therapy of TMJ condyle-disk incoordination].

Biomechanical pathology of the TMJ occurs most frequently in 4 clinical variants: anterior dislocation of the jaw, reciprocal click, closed lock, osteoarthrotic degeneration. The aim of this study was to evaluate the efficacy of TMJ surgery, using statistical comparative analysis, in resolving condylo-meniscal incoordination. Eighty-one patients were included in the study who had been treated surgically for various symptoms of condylo-discal incoordination from 1982 to 1989, assessing a series of objective and subjective parameters and making a statistical comparison of results.

Age Factors↗
PubMed1991

[Magnetic resonance in condylo-meniscal incoordination pathology of the temporomandibular joint. Indications, diagnostic accuracy and optimization of study techniques].

Up to 28% of the population is affected with pathologic conditions involving the temporo-mandibular joint (TMJ), most of them related to uncoordinated disk motion. To date, these pathologies have been evaluated by means of different diagnostic tools, the latest of which is MR imaging. The authors examined with low-field (0.2 T) MR imaging 15 normal volunteers and 20 patients suffering from temporo-mandibular joint disk dysfunction. The study was aimed at comparing the results obtained with low-field MR imaging with literature data on the subject. A standard technique employing low-field MR imaging was also assessed on normal subjects for the management of the patients with TMJ pathologies. The pathological TMJs were then evaluated, each of them examined with arthroscopy and/or surgery. MR imaging was capable of identifying the meniscus in all cases, together with its morphology, signal, location, and movements during opening and closure of the mouth. Disk dislocation were always correctly identified. The point of re-capture in the cases with spontaneous reduction was easily ascertained. The simultaneous imaging of both the right and the left TMJs allowed the joints to be compared at the same degree of mouth opening, so that motion asymmetries were easily detected. High agreement was observed between MR, arthroscopic and surgical findings. Our experience points to MR imaging as the examination of choice in the evaluation of TMJ diseases. The best results are obtained when both joints are simultaneously imaged, on the sagittal and coronal planes, during opening and closure of the mouth, and possibly in a cine-animation display format.

Arthroscopy↗
PubMed1990

[Functional dynamics of the TMJ. Importance of the lateral capsular ligament].

On the base of some papers previously published on the anatomy and physiology of the Tmj the Authors have studied the intracapsular dynamics of the cranio mandibular articulation. The intracapsular movements are guided by some biomechanical restrictions that have been cautiously studied and analized. The biological advantages of the presence of the meniscus between the two articular surfaces is clearly stated. The role of the lateral capsular ligament in stabilizing the disk over the condyle head is clearly demonstrated on the base of previous studies both on the microscopic and macroscopic anatomy of the ligament and the capsule. According to the Authors the disk is stabilized over the condyle head by the lateral capsular ligament, the temporomandibular ligament and by the histological structure of the meniscus that permits its compression and distorsion during the mandibular movements. The disk distorsion increases the anatomical correspondence between the intracapsular structures.

Humans↗