[Treatment of pan-facial fractures].
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Biomedical subjects
Publications and source records attributed to W Schilli.
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An irradiation phantom was used to measure dose increases using the backscatter of different materials (titanium, steel, lead, aluminium). Telecobalt-60 and 8-MV photons were used for the irradiation. The irradiation dose was measured by means of a defined X-ray film blackening. The most important parameter was to find out whether under simulated conditions, undesirable hot spots occur. We were able to demonstrate that a 12.5 to 16% increase in the radiation dose can be observed for titanium and steel at a distance of 0.45 mm from the metal specimen. A comparison between titanium and steel did not demonstrate a relevant advantage for titanium. Therefore, adjuvant percutaneous radiation therapy should not have any influence on the life of the implant, if the soft tissue layer is of sufficient thickness. The available literature is reviewed and presented in tables.
In a series of scanning electron microscopic studies, the reaction of osteogenic cells to hydroxylapatite (HA) implant materials was investigated in culture and following implantation. Tissue components as found in normal rat and dog bone were identified at the interface in both test systems. In vivo, implant bed cells showed an intimate contact with the HA surfaces. Osteoblasts deposited organic matrix and bone mineral in direct apposition to HA, with no evidence of encapsulation or granulation tissue. The development of such a direct spatial relationship appears to involve mechanisms more encompassing than epitaxis.
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Miniplate osteosynthesis has proven to be an invaluable aid when used in severe cranio-maxillo-facial trauma and has thus eliminated the necessity for external fixation devices. Primary exact anatomical reduction, and fixation of the fragments with miniplates, gives both good aesthetic and functional results.
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Cleft patients who have undergone surgery often show considerable inhibition in the sagittal development of the mid-face after completed growth. This is partly attributed to scar contraction in the lip region following surgery. The present investigation deals with the etiological factors involved in the development disturbances caused by the cleft in the maxilla of 100 cleft patients. Particular attention was paid as to the unfavourable effect of the operated cleft lip. This was tested electromyographically and correlation between the electromyographic and the skeletal measurements was sought. Electromyographic changes in lip activity during orthodontic treatment was also investigated. The effect of these changes is discussed.
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The principles and techniques of rigid plate and screw fixation for fractures of the mid and upper face are presented. These techniques offer advantages for the repair of fractures in these area, as well as for the stabilization of planned osteotomies.
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The necessity of an area of attached gingiva around penetrating implants was examined in 26 patients. It was demonstrated that plaque corneal in the major factor in avoiding inflammatory reactions.
An endosteal implant which had been functional had to be removed from the mandible after 13 months; this implant was made available for investigation in the scanning electron microscope. It was seen that an ankylotic bond between bone and implant had been achieved under natural loading conditions.
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