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At least 847 records · Page 47Linked to original sources
PubMed2004

[Replacement of the ascending aorta with conservation of the aortic valve. Results of 50 cases using the Tirone David procedure].

Aortic valve sparing operations are now widely accepted for ascending aortic aneurysm surgery. We herein report our experience of the Tirone David procedure in larger indications. From January 1997 to August 2003, 50 Tirone David procedure have been performed on 36 male and 14 female (mean age: 60 +/- 15). Five patients presented a Marfan disease and 4 acute dissections. Grade III or IV aortic insufficiency was frequent (40%). Aortic diameter was not particularly dilated, ranging from 44 to 78 mm (mean: 57 +/- 10 mm). Mean ejection fraction: 57 +/- 10%. Mean left ventricular end diastolic diameter =63 +/- 7 mm. An associated mitral valve repair and 1 coronary bypass were necessary. Mean cross clamp and bypass times =94 min and 122 +/- 28 min respectively. There was one in-hospital mortality. Secondary mortality affected 2 patients (non-cardiac deaths), for a cumulative follow-up of 946 months. During follow-up continence control was always excellent, only 1 bicuspid valve had an aortic insufficiency >grade II. Tirone David procedure gave satisfactory results as regards both aortic ectasia and aortic regurgitation control. We consider it feasible even in case of aortic dissection but caution is required when facing bicuspid aortic valves.

Adult↗
PubMed2006

[MBT straight wire for Class II division I malocclusion cases].

OBJECTIVE: To evaluate the therapeutic effects of MBT straight wire on extraction case of Class II division I. METHODS: Thirty-six class II division I malocclusion patients were treated with MBT straight wire by extracting 4 bicuspid premolars or 2 maxillary bicuspid premolars. The X-ray cephalograms were analyzed before and after the treatment of MBT straight wire. RESULTS: After the treatment, the overjet was reduced by 6.04 mm (P < 0.01); U1-NA was reduced by 15.43 degrees (P <0.01); and U1-NA (mm) was reduced by 4.71 mm (P <0.01). ANB was significantly reduced (P < 0.05). CONCLUSION: MBT straight wire not only shortens the operation but also shows superior effect for Class II division I malocclusion cases.

Adolescent↗
PubMed2006

Aortic root replacement in cardiac dextroversion.

Adult cardiac surgery in patients with malrotation of the heart is rare. A 60 year-old lady, with known cardiac dextroversion, presented with dyspnoea and pre-syncopal attacks. Echocardiographical and radiological investigation confirmed the dextroversion, with clockwise rotation of the heart through its longitudinal axis. This resulted in the right ventricular outflow tract and pulmonary artery being wrapped anteriorly around the aorta, with posterior displacement of the right atrium. The presence of a heavily calcified, bicuspid aortic valve and dilated ascending aorta was also demonstrated. At surgery, venous cannulation was established by rotating the heart anticlockwise and access to the aortic valve gained with a more superior oblique aortotomy. In the presence of a dilated ascending aorta with a calcified, bicuspid aortic valve, the aortic root was replaced with a valved conduit. To the authors' knowledge, this is the first report of an aortic root replacement in a patient with cardiac dextroversion.

Aorta, Thoracic↗
PubMedDate not supplied

[Extreme aortic coarctaction, severe aortic regurgitation and heart failure relieved immediately after stent aortoplasty, and complete resolution through Bental/de Bono surgical repair].

When aneurysm of the root of aorta, bicuspid aorta valve and coarctation coexist, surgical repair involves technical problems. We present the case of a patient in whom initial correction of the coarctation was made by means of interventional treatment, with an impressive and practically immediate resolution of heart failure. In a second intervartional, the aortic root pathology was corrected through the Bentall and de Bono's surgical technique. We present the short- and mid-term results. In addition this case demostrates the little well-know fact, that the patients with bicuspid aorta also have cystic media degeneration of the wall of the aorta.

Adult↗
PubMed1991

Long-term stability of treatment results in cleft lip and palate patients.

The stability of the orthodontic and prosthetic results of the treatment of 18 individuals with isolated cleft of the palate, 18 subjects with a complete unilateral and 8 with a complete bilateral cleft was evaluated in an eight-year follow-up period. The subjects were examined at the age of 19 years, after completed orthodontic and surgical treatment, and again at the age of 27 years. After the first examination the majority of the individuals with a complete cleft had at the age of 20 to 21 years been treated with a fixed bridge which was only minimally extended. The width of the upper dental arch at the second bicuspid decreased slightly in the subjects with an isolated cleft of the palate and in those with a bilateral cleft. In the subjects with a unilateral cleft there was a slight decrease of the upper dental arch widths at both bicuspids and at the first molar. In the subjects with complete clefts the slight decrease in upper dental arch widths was accompanied by a slight increase of the number of posterior teeth in cross-bite. The total number of teeth in cross-bite was small, however. On the whole, the upper dental arch was relatively stable during the follow-up period. This was found in the group with bilateral clefts, reconstructed with 5-8 unit bridges, as well as in the subjects with a unilateral cleft who had received no or only minimally extended reconstructions and in the group with an isolated cleft of the palate (no bridge).

Adolescent↗
PubMedDate not supplied

[From the mixed dentition to the permanent dentition: how to manage space while guiding eruption?].

In the mixed dentition, when there is a discrepancy between the bony structures and the teeth, in certain cases, serial extractions are performed in order to guide the eruption of permanent teeth and obtain a correct occlusal function. The treatment consists in the extraction of primary teeth and then of first bicuspids. The choice of the first tooth to be extracted is based upon the position of the crowns of the permanent teeth and their degree of root maturation. Then the first bicuspid is extracted as soon as or prior to its eruption. This interceptive treatment has limited indications which need to be respected in order to preserve the child's future dental health. This treatment is indicated for Class I malocclusions with severe crowding or moderate crowding associated with bi-maxillary protrusion.

Child↗
PubMed1991

Valvuloplasty for aortic insufficiency.

Twenty-eight consecutive patients underwent aortic valvuloplasty for aortic insufficiency caused by leaflet prolapse. The technique involved triangular resection of the free edge of the prolapsing leaflet, annular plication at the commissure, and resection of a raphe when present in bicuspid valves. Mean age of the patients was 46.8 +/- 14.4 years. Twenty-six (92.7%) were male. Seventy-five percent of the patients had a bicuspid aortic valve; the remaining valves were tricuspid. The extent of aortic insufficiency was 3.6 +/- 0.8 by aortography, 3.1 +/- 0.1 by preoperative Doppler echocardiography, and 3.4 +/- 0.7 by intraoperative Doppler echocardiography. The amount of aortic insufficiency decreased from 3.4 +/- 0.7 to 0.6 +/- 0.5 intraoperatively, immediately after repair (p less than 0.001). Mean transvalvular gradient by echocardiography was 12.9 +/- 6.8 mmHg. There was one death in a patient who had an intraoperative cerebral vascular accident. Mean follow-up was complete at 6.9 months. One patient had a cerebral vascular accident and one patient required reoperation for recurrent aortic insufficiency caused by partial suture line dehiscence. In 15 patients with late echocardiograms, aortic insufficiency did not progress (0.7 +/- 0.6 in the hospital and 0.8 +/- 0.5 late). Aortic valve repair for aortic cusp prolapse effectively eliminates aortic insufficiency without causing aortic stenosis. At early follow-up the repair has been stable.

Adult↗
PubMed1990

[Respecting apical foramina in the endodontic treatment of confluent canals].

Many dental components (lower incisors, mesial roots of the lower molars, upper bicuspids, the mesiobuccal root of the upper bicuspids, the mesiobuccal root of the upper first molars) have two root canals at cavity level to which two main canals correspond. These two canals either have two separate apical foramina or they merge in the apical third and have a single apical foramen. The endodontist's failure to recognize the latter anatomical characteristic results in deformation of the shared portion of the root canal and laceration of the apical foramen. This in turn leads to disappearance of the tapering cone shape, which acts as a "stop" for the filling material during condensation.

Dental Cavity Preparation↗
PubMed1990

[Disorders of the cardiovascular system in Turner's syndrome].

A group of 22 adults with Turner's syndrome, mean age 29.6 years, was subjected to a careful examination by one-dimensional, two-dimensional, pulsed and coloured Doppler echocardiography. The purpose was to assess the incidence and character of congenital and acquired abnormalities of the cardiovascular system which occur within the framework of this defined genetic syndrome. A quite normal echocardiographic finding was recorded in 13 patients, i. e. in 59.1%. In the remainder a wide spectrum of abnormalities was found such as prolapse of the mitral valve (in 13.6%), bicuspid aortal valve with a medium regurgitation (4.5%), hypoplasia of the coronary cusp of the aortal valve (4.5%), dilatation of the ascending aorta with a residual significant stenosis at the site after operation of coarctation of the thoracic aorta (4.5%), subaortal defect of the interventricular septum (4.5%) and slight left ventricular hypertrophy in patients with arterial hypertension (9.1%). Echocardiographic examination in Turner's syndrome makes early diagnosis of abnormalities of the cardiovascular system possible, incl. quantification of the haemodynamic impact. Some of these pathological changes (bicuspid aortal valve, dilatation of the root of the aorta) are for a long time clinically silent but may be nevertheless associated with serious complications. An echographic diagnosis made in time may be of decisive importance for the prevention of complications.

Adolescent↗
PubMed1990

Distal internal carotid exposure: a simplified technique for temporary mandibular subluxation.

Distal internal carotid artery exposure can be technically demanding even for experienced vascular surgeons. Although a variety of techniques have been described to facilitate such exposure, temporary mandibular subluxation has emerged as the simplest and least debilitating approach. Current techniques for maintaining temporary mandibular subluxation during distal internal carotid artery procedures, including maxillomandibular arch bar fixation and circummandibular/transnasal wiring, have been time consuming and associated with complications. Over the last 4 years a new simplified technique of temporary mandibular subluxation fixation has been used in 14 patients requiring distal internal carotid exposure. Indications for operation included extended carotid endarterectomy (8), carotid body tumor excision (2), repair of distal internal carotid artery trauma (2), and repair of postendarterectomy pseudoaneurysm (2). Among patients with healthy teeth, unilateral temporary mandibular subluxation was maintained by interdental wiring from the ipsilateral mandibular bicuspids to the contralateral maxillary bicuspids. In edentulous patients or those with chronic periodontal disease, temporary mandibular subluxation was maintained with diagonal wiring between maxillary and mandibular Steinmann pins. No instances of malocclusion, dental injury, or local infection were observed. Transient postoperative cranial nerve dysfunction was observed in three patients. Transient ipsilateral temporomandibular joint pain occurred in three patients. Two patients developed permanent cranial nerve injuries unrelated to temporary mandibular subluxation. These data suggest that temporary mandibular subluxation by diagonal interdental/Steinmann pin wiring is safe, expeditious, and effective in facilitating exposure of the distal internal carotid artery.

Bone Nails↗
PubMed1989

[Stress distribution analysis of a loaded fixed bridge by finite element method].

The fixed bridge is a common prosthesis widely used in clinical dentistry. In order to design an ideal fixed bridge which can provide the best protection of the abutments, we must study the stress distribution of alveolar bone, when the fixed bridge is under the loading. In this article, we report the application of the finite element method to examine the stress distribution of the alveolar bone of fixed bridge abutments. We have made seven vertical loading models and two oblique loading models. A quantitative analysis result has been obtained and the stress distribution result drawn up by a computer. The results of this analysis are as follows: 1. Under the seven vertical loadings, the bearing compress stress on the mesial apex of the second bicuspid is large. In this area the compress stress is largest, when the vertical loading is applied on the two-abutment tooth and pontic, the sigma 2 is -120.0 but the stress of alveolar bone of the molar is uniform. 2. Under the oblique loading, by the mesial apex of bicuspid are borne the tensile stress and compress stress, the latter is larger than the former, and the sigma 2 is -75.0. 3. The molar is an ideal abutment tooth for the fixed bridge.

Alveolar Process↗
PubMed1989

[Etiology of gingival recessions].

About every third patient of our department suffers from gingival recessions (g. r.): 1980, 1985, 1986, 1987 altogether 1039 patients from 4022. People at the age of 20-25 years are mainly affected: 44.4% of these patients in the age-group of 20-25 years suffer from g. r., 28.3% of patients suffering from l.P.a. are 20-25 years old. Patients diseased with g. r. (N = 60) show functional disturbances (79% at the 1st bicuspid, 72% at the 2nd bicuspid) during their occlusion movements to a great extent. Patients afflected by g.r. (N = 20) show in comparison to healthy people a smaller diameter of the canin's apical basis both in upper and lower jaw, a smaller circumference of the alveolar crest as well as an upper canin-crown which is turned out from the teeth arcus in a more labial direction. Prevention of g. r. involves individual oral health education to protect the vestibular gingiva from chronic brushing-trauma, an early follow-up, and a functional adjustment.

Adolescent↗
PubMed1989

[Periodontal response to orthodontic treatment].

Monkeys bicuspids were subjected to experimental periodontitis inducing pockets with bifurcation involvement. Light continuous extrusive and intrusive forces were then applied on these bicuspids. The extrusive forces were applied on 3 monkeys; bone apposition was obtained. The intrusive forces were applied on 4 monkeys after pocket surgery and careful root surface scaling. A meticulous hygiene program was then maintained. In these conditions new attachment was gained through intrusion.

Animals↗
PubMedDate not supplied

Comparative circulating serum levels of mepivacaine with levo-nordefrin and lidocaine with epinephrien.

Expected blood levels of common local anesthetics have been reported for numerous types of injections. Comparative levels of mepivacaine and lidocaine after dental injection have been only partially evaluated. A study was designed to compare the circulating serum level of 36 mgs. of mepivacaine with 1:20,000 levonordefrin (M) and 36 mgs. of lidocaine with 1:100,000 epinephrine (L) in 1.8 cc dental cartridges after standardized's bilateral maxillary infiltrations. Each of five subjects received 1.8 cc of (L) to the left maxillary second bicuspid and 1.8 cc of (M) to the right maxillary second bicuspid at a rate of one cc per minute. The serum was sampled before the injections and at 5, 15, 30, 60, 90, 120 and 240 minute intervals after the injections and analyzed by gas liquid chromatography. The results indicated that the serum level of (M) peaked at 30 minutes, 0.37 μg/ml of serum and (L) had peaks at 15 and 30 minutes, 0.22 μg/ml of serum. This difference was statistically significant, (p <.01) at all times sampled with (M) always resulting in a higher serum level. Serum levels persisted throughout the four hour test period.

Adult↗
PubMed1988

Sudden death and left ventricular outflow disease.

Aortic stenosis is a well-recognized cause of sudden death, but in our experience, it is uncommon as the sole cause of sudden death. The most common overall cause of AS is the calcified congenitally bicuspid valve. There is an increased incidence of subaortic stenosis in relatives of patients with subaortic stenosis, although Mendelian inheritance has not been reported. Supravalvular AS may be an autosomal dominant with variable penetrance, it may be sporadic, or it may be one of the manifestations of Williams' syndrome. The principal mechanisms of sudden death in AS appear to be due to (1) activation of left ventricular baroreceptors which causes reflex bradycardia and cardiac arrhythmias, or (2) arrhythmias as complications of LVH. Myocardial ischemia has been anatomically proven and may be due to diastolic compression of intramural coronary arteries. Aortic dissection occurs with increased frequency in patients with a bicuspid aortic valve. Heart block can result from calcification of the bundle of His in AS of any cause. Supravalvular AS may be complicated by adherence of an aortic valve cusp to the aorta resulting in coronary ostial stenosis, and coronary narrowing by intimal hyperplasia. AS at any level may lead to IE, which has been responsible for occasional sudden deaths.

Aged↗
PubMed1988

Heart disease in Turner's syndrome.

Fifty-five consecutive patients with Turner's syndrome and different karyotypes underwent full cardiological evaluation (physical examination, electrocardiogram, chest X-ray and echocardiogram). Congenital heart disease was found in 17%. When compared with the general population, a significantly higher incidence was present only for aortic coarctation and partial anomalous pulmonary venous drainage (p less than 0.001). Among cardiac anomalies in Turner's syndrome patients, aortic malformations (aortic coarctation, aortic stenosis, bicuspid aorta) are the most frequent, followed by partial anomalous pulmonary venous drainage, the incidence of which has been much higher than that previously reported. We have observed that the most severe malformations are preferably found in 45,X, while the ring pattern is characterized by a very high incidence of bicuspid aorta. No anomaly was found in the patients with X isochromosome.

Adolescent↗
PubMed1985

Types of aortic stenosis in surgically removed valves.

In 109 specimens of aortic valves removed surgically from adults for isolated or dominant aortic stenosis, five types of valve were encountered. In order of decreasing frequency the types were as follows: calcification of congenitally bicuspid aortic valves (48.6%); calcification of a normally tricuspid aortic valve without commissural fusion, the so-called senile type of aortic stenosis (27.6%); calcification of an acquired bicuspid valve (12.8%); the fibrous (rheumatic)-type valve (10.1%); and calcification of congenitally unicuspid valves (0.9%). In the overall study men were more commonly represented than women by a ratio of 3:2. In only the senile type were women more commonly represented than men.

Adult↗
PubMed1986

[The calcified aortic valve. A morphologic study].

A histological study of 92 stenosed and calcified aortic valves is conducted to work out criteria with which to distinguish postrheumatic from degenerative calcification. The microscopic picture of a calcified aortic valve is fairly uniform and independent of a history of rheumatic fever. Thick walled and narrow muscular arteries with prominent elastic laminae are the only feature distinguishing calcified valves after rheumatic fever from valves showing degenerative calcification. This uniform morphology of the calcified aortic valves suggests a uniform process. The term "degenerative calcification" is used if this process occurs in an elderly patient, but a (histologically) nearly identical calcification is observed in younger people after rheumatic endocarditis or with congenitally bicuspid aortic valves. It is concluded that the basic process is the same (degenerative calcification) but that this degenerative process occurs earlier in patients with bicuspid valves or after rheumatic endocarditis.

Aged↗