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PubMed1982

Management of mandibular fractures using biphasic pins and mandibular splints.

Often the otolaryngologist is asked to manage the patient with facial trauma. Mandibular fractures make up 20 to 39% of all facial trauma cases, and thus necessitate a diversified and complete set of management tools. We have selected two seldom discussed modes of therapy for the complicated jaw fracture to present in this paper: 1. external fixation of Joe-Morrison Hall biphasic pins, and 2. mandibular dental appliances--splints. The advantage of the biphasic pin apparatus is that the fracture can be repaired and stabilized at a point remote from the infected fracture site. The high risk patients, endentulous patient, and patients with fractures from gunshot wounds all prove to be more easily managed by using the external appliances. The splint technique eliminates medial or lingual tip rotation and resultant postoperative malocclusion. Endentulous patients, pediatric patients, and those with multiple facial trauma also benefit from this procedure.

Acrylic Resins↗
PubMed2006

Orthodontic tooth movement after inhibition of cyclooxygenase-2.

INTRODUCTION: The purpose of this study was to compare the effects of a conventional nonsteroidal anti-inflammatory drug, diclofenac (Voltaren [Novartis, Barcelona, Spain]), and a specific cyclooxygenase-2 (COX-2) inhibitor, rofecoxib (Vioxx [MSD, Madrid, Spain]), on the inhibition of dental movement induced with a coil-spring orthodontic apparatus in rats. METHODS: Tooth movement was measured on the lateral cranial teleradiographs of 42 male Wistar rats in 6 experimental groups: (1) 50-g coil spring and 2 rofecoxib injections of 1 mg per kilogram of body weight; (2) similar orthodontic procedure and 2 diclofenac injections of 10 mg per kilogram of body weight; (3) the same orthodontic treatment and 0.9% saline-solution injections; and (4), (5), and (6) 100-g coil appliance and the same pharmacological treatment as 1, 2, and 3, respectively. RESULTS: The difference in tooth movement, measured in the control animals after 10 days of 50 or 100 g of orthodontic force application, was not statistically significant. Reduction in tooth movement in 50-g traction groups reached statistically significant differences; both rofecoxib or diclofenac were effective in inhibiting dental movement. The comparison of the 3 groups treated with 100 g of force also reached statistical significance. Both rofecoxib and diclofenac significantly inhibited dental movement, partially in the case of rofecoxib and totally in the case of diclofenac. Nevertheless, no statistically significant difference was found between the effects of rofecoxib and diclofenac. CONCLUSIONS: There is no substantial advantage in using selective COX-2 inhibitors compared with nonspecific COX inhibitors to avoid interference with tooth movement during orthodontic treatment in rats.

Animals↗
PubMed1997

Fine structure of the cap enameloid and of the dental epithelial cells during enameloid mineralisation and early maturation stages in the tilapia, a teleost.

Morphological features of the cap enameloid and dental epithelial cells were investigated by light and transmission electron microscopy during the various stages of enameloid mineralisation and early maturation in the tilapia. The pattern of mineralisation along collagen fibrils in the enameloid differed from that in the dentine. Many matrix vesicles were found in the predentine and in the enameloid, suggesting that they may be involved in the initial mineralisation in both regions. Most of the organic matrix disappeared from the cap enameloid during mineralisation and maturation. The disappearance of the organic matrix could be divided into 2 stages. Initially a fine network-like matrix, which probably consisted of glycosaminoglycans and extended between collagen fibrils, began to disappear. At the same time, fine crystallites and electron-dense, fine granular material covered the collagen fibrils as mineralisation of the enameloid began. In the second stage, the maturation of the enameloid, the collagen fibrils degenerated completely and disappeared from the cap enameloid, being replaced by large numbers of large crystals. At the mineralisation stage, the numbers of lysosomal bodies tended to increase in the inner dental epithelial (IDE) cells, which contained a well developed Golgi apparatus and rough endoplasmic reticulum (rER). At the early stage of maturation, a ruffled border was noted at the distal ends of the IDE cells, which contained many mitochondria and lysosomal bodies, but less rER. These features suggest that the cells actively absorb the organic matrix, which includes collagen fibrils, in the cap enameloid. The outer dental epithelial (ODE) cells were translucent cells that contained well developed labyrinthine canalicular spaces from the onset of the mineralisation stage to the middle stage of maturation. The IDE and ODE cells were clearly involved in the mineralisation of the cap enameloid at the mineralisation and maturation stages.

Animals↗
PubMed1975

[Transfer of 45Ca during amelogenesis studied by autoradiography and electron microscopy].

45Ca transfer through the stratum intermedium and the secreting ameloblasts towards enamel has been studied by quantitative electron microscopical autoradiography in tooth-germs of newborn cats following intravenous injection of the isotope. Two transfer pathways were demonstrated. The relatively more important direct path passed through the stratum intermedium and ameloblast intercellular spaces and reached the enamel directly. The second pathway consisted in an intracellular transfer through the ameloblasts. 45Ca penetrated the cell through its basal pole. The mitochondria were the most highly labeled organelles at the different experimental time intervals studied. A maximum of radioactivity was respectively noticed at 30 min and 1 h in the endoplasmic reticulum and the Golgi apparatus. A total absence of silver grains was noted over the secretory ameloblastic bodies. At 6 h, the highest labeling was observed over enamel and especailly over the inner enamel along the enameldentin junction.

Ameloblasts↗
PubMed1990

[Pulse oximetry for noninvasive oxygen monitoring during dental treatment in children with congenital heart disease].

Children with congenital heart disease (CHD) are prone to present abrupt changes in cardiovascular functions which cause hypoxic spells or acute heart failure, so that oxygen monitoring during dental treatment is of great importance in cyanotic CHD patients. Monitoring of arterial oxygen saturation (SpO2) by pulse oximetry has several advantages, including rapid response time, freedom from skin injury, self-calibration and continuous readout of the SpO2 value. In these studies, SpO2 was measured in 68 pediatric patients (55 were CHD children and 13 were normal children) during dental treatment at the Pediatric Dentistry, Hokkaido University Dental Hospital. In all of the normal patients, SpO2 did not desaturate less than 95%. On the other hand, SpO2 ranged from 56% to 98% in CHD patients, and in 22% (n = 12) of these, SpO2 desaturated below 80%. All of the SpO2 less than 80% patients had been diagnosed as cyanotic CHD. Classification of CHD cases (n = 144, the total number of measurements) on the pattern of the SpO2 variation revealed that in 11% (n = 16) of the CHD cases, SpO2 decreased during dental treatment. Twelve of these 16 cases could not readily accept dental treatment. We suggest that behavior management is the most important factor in CHD patients for keeping SpO2 stable. Motion artifact of the SpO2 value, which was easily evoked when a patient bent his elbow or shook his finger, often made the pulse oximetry useless. In our studies, the SpO2 value sometimes became inaccurate in fearful infants or handicapped patients. Pulse waveform displayed on the front panel of pulse oximetry was useful to identify the motion artifact. We conclude that pulse oximetry is an appropriate apparatus for continuous arterial oxygen monitoring in pediatric patients during dental treatment as far as motion artifact is effectively eliminated.

Artifacts↗
PubMed2001

A device for feline head positioning and stabilization during magnetic resonance imaging.

Minimization of head movement and reproduction of standard head positions are essential for reliable brain functional magnetic resonance imaging. Devices for stabilization and alignment of feline preparations are not available currently. We describe a system that involves minimal surgery, allows for both acute and chronic atraumatic positioning, and has the potential to be used for unanesthetized animals. The device uses non-metallic materials and stabilizes the head by means of an apparatus that fixes the head with nylon screws and dental cement in the frontal sinuses. Application of the head-stabilizing device decreases head movements by more than a factor of ten. Anatomical images show that this device provides 3 dimensional head placement at a precision comparable to that of a stereotactic frame, i.e. within 1 mm.

Animals↗
PubMed2004

Potential applications of Erbium:YAG laser in periodontics.

OBJECTIVES: Since lasers were introduced for the treatment of oral diseases, there has been considerable advancement in technology. As a result, numerous laser systems are currently available for oral use. Neodymium:Yttrium-Aluminum:Garnet (Nd:YAG), carbon dioxide (CO(2)) laser and the semiconductor Diode lasers have already been approved by the US Food and Drug Administration for soft tissue treatment in oral cavity. The Erbium:YAG (Er:YAG) laser was approved in 1997 for hard tissue treatment in dentistry and recent studies have reported positive results. This suggests that the Er:YAG laser system is a promising apparatus, which will be able to revolutionize and improve dental practice, in particular periodontal treatment. In this mini-review, we would like to describe the positive characteristics of the Er:YAG laser which indicate its potential as a new treatment modality in periodontics. MATERIALS AND METHODS: Recent findings are summarized briefly to evaluate the potential of the Er:YAG laser for clinical application in periodontics. RESULTS: The Er:YAG laser possesses suitable characteristics for oral soft and hard tissue ablation. Recently, it has been applied for effective elimination of granulation tissue, gingival melanin pigmentation and gingival discoloration. Contouring and cutting of bone with minimal damage and even or faster healing can also be performed with this laser. In addition, irradiation with the Er:YAG laser has a bactericidal effect with reduction of lipopolysaccharide, high ability of plaque and calculus removal, with the effect limited to a very thin layer of the surface and is effective for implant maintenance. CONCLUSION: The Er:YAG laser seems to be an effective tool for periodontal therapy, however, further clinical and basic investigations are required to confirm its clinical application.

Aluminum Silicates↗
PubMed2006

Occlusion, sternocleidomastoid muscle activity, and body sway: a pilot study in male astronauts.

The modifications induced by microgravity on the coordinated patterns of movement of the head, trunk, and limbs are reported on extensively. However, apparently there is little data on the masticatory muscles. In normal gravitational conditions, information from the neck and stomatognathic apparatus play a role in maintaining the body's balance and equilibrium. The current pilot study used normal gravity conditions to investigate the hypothesis of a functional coupling between occlusion and neck muscles and body postural oscillations. The immediate effect of modified occlusal surfaces on the contraction pattern of the sternocleidomastoid muscles during maximum voluntary clenching and on the oscillation of the center of foot pressure was analyzed in 11 male astronauts (aged 31-54 yrs). All subjects were healthy and free from pathologies of the neck and stomatognathic apparatus. Occlusal splints were prepared using impressions of their dental arches. The splints were modeled on the mandibular arch, had only posterior contacts, and were modified to obtain a more symmetric, standardized contraction of the masseter and temporalis muscles during teeth clenching. Surface EMG activity of the sternocleidomastoid muscles was recorded during a maximal voluntary clench with and without the splint. Sternocleidomastoid potentials were standardized as percent of the mean potentials recorded during a maximum contralateral rotation of the head, and the symmetry of the EMG waves of left- and right-side muscles was measured. Body sway was assessed with and without the splint, either with eyes open or closed. The variations of the center of foot pressure were analyzed through bivariate analysis, and the area of the 90% standard ellipse was computed. Within each visual condition (eyes open or closed), the difference between the areas of oscillation measured with and without the splint was computed. Muscular activity was more symmetric with the splint. The area of oscillation of the center of foot pressure was larger without the splint than with the splint, both with eyes open and eyes closed. The modifications, induced by the occlusal splint in the sternocleidomastoid muscles' symmetry, and center of foot pressure differential area with closed eyes, were significantly related (p < 0.05): the larger the increment in muscular symmetry, the smaller the area of oscillation with the splint as compared to without the splint. A functionally more symmetric maxillo-mandibular position resulted in a more symmetric sternocleidomastoid muscle contraction pattern and less body sway. Modifications in the contraction of the masticatory muscles may therefore affect the whole body.

Adult↗
PubMed1975

[Rational cleaning of instruments by means of ultrasonics].

The author presents an ultrasonic cleaning program which is the result of more than 3 years of experience with the 2-litre ultrasonic cleaning apparatus of the VEB Elektromat Dresden. It is based on a classification of the kinds of contaminations occurring most frequently in general stomatological practice to which cleaning solutions were assigned which have been chosen empirically and which have been found to be effective. With a view to more rational utilization, the author points to the employment of inserted receptacles in a double-bath method and gives suggestions for a more general use of this cleaning apparatus in medicine.

Dental Instruments↗
PubMed1990

[The image quality of extraoral x-ray pictures].

A check was made on 594 X-ray examinations of ambulant oral surgery patients (= 1378 single pictures in several radiographic techniques). A good quality had 72% of the pictures. A decreased quality had 23% of them. A diagnosis was still possible. 5% of pictures were useless. Radiographic techniques were used in 8% of the 594 X-ray examinations with not optimal methods for the intended aim. In these cases it were better to change to other methods (other focussing or other apparatus).

Dental Clinics↗
PubMed2006

Meniere's disease may be caused by common intraosseous dental pathology--Diagnosis using the comparative compression sign.

Meniere's disease has been ascribed to a disturbance of the vestibular apparatus or its connections within the Central Nervous System. Several hypotheses have been advanced regarding its aetiopathogenesis, but treatments based on these hypotheses have often not produced the desired results. Two cases are described where common intraosseous pathology within the lower half of the functional face, i.e. within the mandible and maxillae, was shown to be the cause of Meniere's disease. Together, these cases contributed to the chance discovery of the comparative compression sign which, when able to be elicited, may be considered pathognomonic for a dental origin of the condition. It is suggested that, in addition to other hypothesized causes involving the vestibular apparatus and the CNS, Meniere's disease and vertigo may also be caused by common, readily-identifiable intraosseous dental pathology. These unexpected findings open up a new field for future research.

Adult↗