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Biomedical subjects

W Schilli

Publications and source records attributed to W Schilli.

At least 19 recordsLinked to original sources

Comparison of transcutaneous incisions used for exposure of the infraorbital rim and orbital floor: a retrospective study.

One hundred and five patients were investigated for functional and aesthetic impairments following treatment of orbital trauma through subciliary, mid-lower eyelid, or infraorbital incisions. The progress of impairments with time was assessed, and the merits and shortcomings of each of the three approaches were established. The results showed that impairments persisting up to 6 months postoperatively have virtually not receded even after 6 years. The infraorbital incision showed the highest frequency of impairments, followed by the subciliary incision. The mid-lower eyelid incision showed the best results, with an impairment frequency well below those of the other two approaches. This approach seems to combine the advantages of the infraorbital incision with the unnoticeable scar formation associated with the subciliary incision.

Adolescent

[Severe atrophy of the alveolar ridge in edentulous patients. Combined treatment using bone grafts and screw implants].

In cases of advanced alveolar ridge atrophy, when the bone available for endosseous implants is not sufficient, endosseous implants are combined with augmentation of the alveolar ridge by means of autologous bone transplants. Depending on the type of atrophy found, the authors use three different surgical procedures: onlay technique, sandwich technique and alveolar extension technique. In all cases functional loading of the implants was performed by way of an entirely implant-supported bridgework. Results to date indicate that initial postoperative resorption is followed by a virtual standstill once the implants have been loaded.

Alveolar Process

[Nasal intubation for frontobasal fractures?].

In most cases the surgical management of craniofacial fractures involves a correction of the occlusion. This requires nasal intubation. In a frontobasal fracture with simultaneous CSF fistula, nasal intubation is thought to increase the risk of meningitis. An analysis of the records of 160 patients with frontobasal fractures and CSF fistulae revealed that the route of intubation had no influence on the post-operative complication rate. Nasal intubation is therefore not contraindicated in frontobasal fractures with CSF fistulae.

Cerebrospinal Fluid Rhinorrhea

Photoelastic experiments on the implantation of a bone graft into the mandible with stable compression osteosynthesis.

The implantation of a bone graft into the mandible was simulated in photoelastic model tests. Problems posed by the lingual and alveolar areas untouched by the plate are discussed. The tests showed that in both problem areas enough interfragmentary pressure can be built up using a five-hold DC (dynamic compression) plate with a short implant and two four-hole DC plates with a long implant, whenever the metal plates have dynamic compression holes (DC), are prebent and the screws are in converging position. This is a prerequisite for a rapid revascularization of the implanted bone graft and primary bone healing. These tests and our clinical experience showed that with small implants using a five-hold plate and with long implants using two four-hole plates, and physiologically stressing the bone implant, the principles of stable compression osteosynthesis without intermaxillary immobilization have proved themselves.

Biomechanical Phenomena

[Preventive removal of displaced teeth].

Using the data acquired from our catamnestic survey, we were able to establish a broad catalogue of complications involved with impacted and displaced teeth. Given these complications, it is not medically responsible to leave impacted and displaced teeth in the jaw, even if they are asymptomatic. The risks increase considerably with age. Late operative removal of such teeth can be a dangerous intervention due to local complications such as abscesses, cysts, osteomyelitis, tumors, systemic diseases, and age-related changes in the cardiovascular system.

Adult

[Swellings in the maxillofacial region (author's transl)].

The most frequent swellings in the maxillofacial region can be traced to odontogenic inflammations. Chronic dental foci exacerbate and break through the soft tissue layer surrounding the jaw. There the purulent material quickly spreads along the muscular pocket and simulates a phlegomonous inflammation. Inflammations of the individual soft part niches have characteristic symptoms. Because of the loose interconnections the infectious material can spread very quickly into the parapharyngeal space and from there downwards into the mediastinum or upwards into the base of the skull. Because of the danger of an advance in these spaces, it will be necessary to incise the swellings on time.

Adolescent

[Standardized apical titanium pin for plugging the root canal during apicoectomy].

A new procedure for apical closure after apical root resection with a metal filling is presented which is easy to handle with appropriately standardized equipment and ensures exact apical closure. By conical preparation of the whole root, a standardized metal peg which resists distortion can be used for anchoring the crown prosthesis without further preparation. Temporarily a standardized guttapercha peg can be used for closure. Even if renewed work on the root becomes necessary later, the apical metal closure remains firm because of its wedging.

Apicoectomy

[Organic foreign bodies in the maxillary sinus].

A case was reported in which a foreign body was identified in the maxillary sinus during the course of a radiologic dental examination. The foreign body proved to be a calculus. Analysis of the calculus revealed no foreign body responsible for the crystallization. The possibility of local formation of a calculus of the maxillary antrum was discussed.

Aged

Compression osteosynthesis.

Nearly all types of mandibular fractures have been treated successfully by compression osteosynthesis. Special instruments are required, the bone must be treated correctly, the fragments must be reduced exactly, and the plate must be adapted exactly. Basically, only lag screws are used when there is a lamellar fracture and when a large surface permits support; the dynamic compression plate with oblique lateral screw holes is indicated when the fracture runs transversely. The dynamic compression plate with oblique lateral holes and the additional inlay portion is indicated in oblique fractures and when the alveolar process is weak.

Adult

[Metal plate osteosynthesis and wire osteosynthesis for the treatment of periorbital fractures in an experimental study].

With consideration of the special situation in periorbital fractures, the fundamental differences between wire and metal plast osteosynthesis was demonstrated on the basis of mathematical calculations, mechanical considerations and tension optical experiments. We further report on the different behaviour of both methods of osteosynthesis in tension experiments which demonstrate the distinct superiority of the metal plate.

Biomechanical Phenomena