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PubMed2001

Rotated subcondylar process fracture in the growing animal: an experimental study in rats.

Unilateral, rotated subcondylar fractures were surgically induced in young rats under general anaesthesia. A decrease in body weight was observed in the fractured animals, with recovery at the end of the experimental period. A tendency of deviation of the mandible to the fracture side was noticed on axial radiographs, but without significant difference between experimental and sham-operated animals. Histological data initially demonstrated acute inflammation along the articular capsule and adjacent muscle fibres. Within 2 weeks, exuberant callus formation occurred. Neither devitalized bone ends nor intra-articular granulation tissue were seen. After 1 month, the temporomandibular joint presented characteristics of normality, with the condylar process centralized into the temporal fossa, interposed by the articular disc. These results were preserved after 3 months. We concluded that rotational subcondylar fractures in young rats heal by callus formation, with simultaneous and prompt repositioning of the condyle.

Animals↗
PubMed2001

Use of cultivated osteoprogenitor cells to increase bone formation in segmental mandibular defects: an experimental pilot study in sheep.

The hypothesis of the present experimental pilot study was that autogeneous cultivated osteoprogenitor cells in porous calcium phosphate scaffolds can increase bone formation in segmental defects of the mandible. The autogenous osteoprogenitor cells of eight sheep were cultivated from bone biopsies from the iliac crest and seeded into cylindrical scaffolds of pyrolized bovine bone of an overall length of 35 mm and 13 mm in diameter. Segmental defects of 35 mm length were created unilaterally in the mandibles of the animals. Reconstruction was performed using cylinders with cultivated osteoprogenitor cells in four animals and empty scaffolds in the remaining four sheep, which served as controls. After 5 months, the mandibles were retrieved and the reconstructed areas were analyzed by qualitative and quantitative histology in serial undecalcified thick-section specimens. There was significantly more bone formation in the group that had received scaffolds with cultivated bone cells (P=0.028). Bone formation was present in 34.4% of the evaluated cross-sectional units in the seeded scaffolds, while it was found in 10.4% in the control group. Although the spatial distribution of bone formation was significantly different across the scaffold in both groups, osteoprogenitor cells appeared to have increased bone formation, particularly in the centre of the defect when compared to the control group. It is concluded that the repair of segmental defects of the mandible can be enhanced by the transplantation of autogenous osteoprogenitor cells in a porous calcium phosphate scaffold.

Animals↗
PubMed2002

Patient-centred outcome measures in oral medicine: are they valid and reliable?

The present study evaluates the performance of patient-centred outcome measures in the oral medicine setting in patients with oral lichen planus. The study included 48 patients with a histologically confirmed diagnosis of oral lichen planus who completed a questionnaire incorporating two patient-centred outcome measures: the 16-item UK Oral Health Related Quality Of Life Measure (OHQOL-UK) and 14-item Oral Health Impact Profile (OHIP-14). They subsequently underwent an oral examination and rated the pain they experienced on a visual analogue scale (VAS). The impact of oral health on their life quality was considerable with physical, social and psychological consequences. Both OHQOL-UK (P<0.01) and OHIP-14 scores (P<0.01) were associated with clinical findings; demonstrating criterion validity. Patient rating of pain experienced (on a VAS) correlated with OHQOL-UK scores (P<0.01) and OHIP-14 (P<0.01); demonstrating construct validity. The mean inter-item correlation for OHQOL-UK was 0.93 and was 0.90 for OHIP-14; demonstrating high internal consistency reliability. Our results suggest both OHQOL-UK and OHIP-14, patient-centred outcome measures perform well in patients with oral lichen planus, demonstrating validity and reliability. This implies patient-centred outcome measures may be utilized in both oral medicine and oral and maxillofacial surgery to assess patient needs and opinions.

Adult↗
PubMed2002

Allogeneic bone grafting of calvarial defects: an experimental study in the rabbit.

The purpose of this study was to investigate the incorporation of fresh frozen irradiated membranous allogeneic bone grafts into critical size calvarial defects in the rabbit. Fifteen rabbits had calvarial defects prepared. Twelve rabbits received allogeneic grafts and three received autogenous bone grafts. The rabbits were sacrificed at 9 and 12 months postoperatively, and the specimens were examined radiologically, histopathologically and with fluorescence microscopy. Neovascularization, bone marrow regeneration and new bone formation was evident throughout the grafts however revitalization of the entire graft was incomplete at 12 months. This study revealed that the FFI membranous grafts were well incorporated into rabbit calvarial defects.

Animals↗
PubMed2002

Partial inferior turbinectomy during secondary alveolar bone grafting.

This study examined the characteristics and outcome of patients undergoing partial inferior turbinectomy during secondary alveolar bone grafting. Thirty-three of 55 patients with cleft lip and palate or cleft lip and alveolus who underwent secondary alveolar bone grafting concurrently received partial inferior turbinectomy to ensure that the height of the nasal floor was similar on the cleft side and non-affected side. At the time of surgery, patients who underwent turbinectomy were significantly older than those who did not undergo the procedure. The proportion of patients who underwent turbinectomy was significantly higher among patients with cleft lip and palate than among those with cleft lip and alveolus. These differences apparently reflected the developmental stage of the inferior turbinate and the relative severity of alveolar and palatal defects. In most patients who underwent partial inferior turbinectomy, postoperative X-ray films revealed excellent bone formation at the graft site. Our findings suggest that partial inferior turbinectomy during secondary alveolar bone grafting is a very useful procedure that facilitates dissection to the height of the nasal floor, reconstruction of the mucosal nasal floor, and formation of a sufficient bone bridge. It also promotes alveolar cleft closure, especially in patients with wide bone defects.

Adolescent↗
PubMed2002

A comparative study of sevoflurane sedation with nitrous oxide sedation for dental surgery.

This study compares the use of inhalation sedation using sevoflurane (group S) with inhalation sedation using nitrous oxide (group N) in patients undergoing bilateral extraction of third molar teeth under local anaesthesia. The study was designed as a cross-over study. Seventeen ASA I, day surgery patients were studied. Patients were randomly allocated to receive either 8 l/min 50% nitrous oxide in oxygen (group N) or same flow of 1% sevoflurane (group S) for the first procedure. Each patient then had the alternate method of sedation for the second procedure. There were no significant differences between the methods in patient co-operation and surgeon's satisfaction with sedation. Psychomotor tests were comparable in both groups. The patients were significantly more sedated in the group S compared to group N (P=0.004). Significantly more patients complained of an unpleasant odour group S (P<0.01) but none withdrew from the study for this reason. No adverse cardiorespiratory effects resulted from sevoflurane or nitrous oxide sedation. Both methods gave good amnesia during the procedure. There was high acceptance of both methods and the patients rated the technique as equally satisfactory. We conclude that inhalation sedation with sevoflurane is a suitable alternative method to nitrous oxide sedation.

Adult↗
PubMed2001

Effectiveness of a new perforated 0.15 mm poly-p-dioxanon-foil versus titanium-dynamic mesh in reconstruction of the orbital floor.

Introduction: In recent years a new perforated PDS (poly-p-dioxanon) foil (0.15 mm) has become available and has not yet been proven to be successful in reconstruction of the orbital floor after blow-out-fractures in randomized studies. The main aim of this clinical trial is to compare this new PDS foil with titanium dynamic mesh (0.3 mm) (TD), which is well established in reconstruction of the orbital floor. Patients and Methods: In a prospective multicentre randomized trial, conducted between 1997 and 1998, out of 42 patients with fractures of the orbital floor, 28 patients needing material for reconstruction were randomized to receive either PDS foil or TD. In a comprehensive preoperative and postoperative protocol patients were monitored by the surgeon, radiologist and ophthalmologist with a postoperative follow-up of least 6 months. Results: Maximum defects of the orbital floor were comparable in both groups (PDS group: 13.3 mm, TD group: 13.9 mm). In both groups the surgical procedure was well tolerated, and functional and cosmetic results were evaluated as satisfactory by all patients. Ophthalmological evaluation, performed up to 6 months postoperatively, revealed double vision or vertical strabismus in nine patients (five PDS group, four titanium group). This was not confirmed subjectively in each single patient. Also ex- or enophthalmos, registered in seven patients of the PDS and four of the TD group (mainly +/-1 mm) were not considered as relevant by the patients. Conclusion: The new 0.15 mm perforated PDS foil was comparable to 0.3 mm titanium mesh concerning functional and cosmetic outcome. Obviously, persisting ophthalmometric disorders were compensated very well in both groups. PDS foil is felt to be the preferred material since it is bioresorbable and more convenient to handle. Copyright 2001 European Association for Cranio-Maxillofacial Surgery.

Journal Article↗
PubMed2005

[The effect of haemoglobin levels on prognosis and quality of life of patients with bronchial carcinoma].

As a consequence of tumour and therapy related effects anaemia is a particularly frequent occurrence in patients with lung cancer. The ensuing symptoms such as dyspnoea, fatigue and decreased general health reduce their quality of life and can impede if not altogether prevent an effective cytostatic therapy. A positive outcome after oxygen-dependent anti-tumour therapy, for example radiation therapy or various cytostatic treatments as well, can be reduced or even put at risk when tumour tissue is hypoxic. In order to treat anaemia, recombinant human erythropoietin can be used beside blood transfusions. Erythropoietins are well tolerated and allow for a long-lasting, gradual increase of Hb-levels, which cannot be achieved via transfusions. Furthermore, transfusion risks such as intolerance reactions or disease transmission can also be avoided. The various studies presented here evaluated the impact of anaemia treatment with erythropoietins on the need for transfusions and quality of life of patients with lung cancer over the last few years. They all agreed in their conclusion that both parameters can be improved with erythropoietin therapy. It turned out that the patients' quality of life improved most when Hb levels reached around 12 g/dl . Studies examining the impact of anaemia treatment on a patient's prognosis also showed positive effects in the majority of cases. In order to investigate this issue, our Heidelberg work group has designed a prospective, randomised phase-III study on NSCLC patients, which will be explained in detail further down.

Anemia↗
PubMed1952

AMAZONIA.

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Humans↗
PubMed2002

Graphical literacy: the quality of graphs in a large-circulation journal.

STUDY OBJECTIVES: We sought to characterize the quantity and quality of graphs in the Journal of American Medicine (JAMA), contrasting articles published in 1999 with those published in 2000 after the addition of a dedicated tables and figures editor. We also sought to compare the quality of graphs in JAMA with the quality of graphs in Annals of Emergency Medicine. METHODS: Two reviewers independently assessed all graphs in original research articles from 12 randomly chosen issues of JAMA, 6 each from 1999 and 2000, using a standardized abstraction form. We noted graph type, clarity, and completeness and identified internal discrepancies. We examined the graphs and articles to observe discrepancies with text, to observe efficiency of graph presentation, and to determine whether the graph portrayed unaggregated data. Results were compared with results from a previously published study of graphs from 18 consecutive issues of Annals of Emergency Medicine beginning in January 1998. RESULTS: The 12 JAMA issues contained 56 research articles, with 64 graphs in the 37 articles that had graphs (28 in 27 1999 articles, 36 in 29 2000 articles). Simple bar or point charts (63%) predominated. We rarely encountered internal errors (8%), contradictions with text (3%), numeric distortion (6%), lack of visual clarity (5%), nonstandard graphing conventions (11%), or extraneous decoration (0%). Graphs generally defined all symbols (98%), but 31% were not self-explanatory; that is, despite knowing the study's design and reading the figure's legend, we could not unambiguously interpret the graph. Fourteen percent contained redundancies. Graphs infrequently portrayed by-subject data (9%) or advanced features (15%) such as pairing, symbolic dimensionality, or small multiples. Forty-eight percent (21/44) of graphs did not illustrate the underlying distribution, 48% (26/54) did not depict important covariates, and 67% (14/21) did not portray pairing inherent in the data. There were no differences between 1999 and 2000 graphs, although we noted more graphs in the 2000 issues. Graph quality was similar in Annals of Emergency Medicine and JAMA, but graphs were more common in the original research articles in JAMA. Although univariate displays predominated in both publications, there were more bivariate displays in Annals of Emergency Medicine but fewer advanced graphic features. CONCLUSION: The graphs in JAMA were similar to those in Annals of Emergency Medicine and, although generally clear and without errors, often failed to depict detailed data. Authors and editors could improve data presentations by incorporating graphic formats that depict stratified, detailed data.

Journalism, Medical↗
PubMed2001

Postsurgical growth changes in the mandible of adolescents with vertical maxillary excess growth pattern.

This case-control study investigates the effects of superior maxillary repositioning by LeFort I osteotomy on adolescent mandibular growth. A total of 15 growing patients (average age, 12.8 years) with vertical maxillary excess who had undergone maxillary surgery were compared with matched untreated control subjects. Lateral cephalograms were evaluated and superimposed to describe the presurgical (1.6 years), surgical, and postsurgical (4.0 years) changes. During the presurgical period, comparisons of traditional measures and mandibular modeling changes showed no significant differences between the 2 groups. During surgery, the maxilla was impacted approximately 3 mm anteriorly and 1 mm posteriorly, which caused a 3.2 degrees autorotation of the mandible. During the postsurgical period, there was no change in the vertical growth pattern of the surgical patients, with the vertical facial heights increasing the same as the control subjects and the mandible rotating backwards. Although there was no inhibition of mandibular growth in the patients postsurgically, there was a decrease in horizontal maxillary growth compared with control subjects. There were clear postsurgical changes in the mandibular modeling and condylar growth, which were indicative of adaptive compensations for surgical mandibular repositioning and autorotation. It is concluded that early maxillary impaction does not normalize or inhibit the vertical maxillary excess growth pattern; mandibular modeling and condylar growth undergo adaptive changes in response to repositioning.

Adaptation, Physiological↗
PubMed2001

Modified composite or conventional glass ionomer for band cementation? A comparative clinical trial.

The time to first failure, the position of band failure at deband, and the change in enamel white spot lesions of teeth bonded with a modified composite or a conventional glass ionomer were compared in a randomized half-mouth trial over the full course of orthodontic treatment. One hundred forty band pairs were cemented in 98 subjects. Overall band failure rates of 5% and 2.8% were recorded for the modified composite and the conventional glass ionomer, respectively, with no significant difference found between their times to first band failure. At the end-of-treatment deband, the position of band failure was predominantly at the enamel-cement interface for the modified composite and at the band-cement interface for the conventional glass ionomer (P <.001). A comparison of changes in mean enamel white spot lesion scores during treatment did not reveal significant differences between the cement groups (P =.16).

Adolescent↗