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At least 1,747 records · Page 97Linked to original sources
PubMed2001

External skeletal fixation in the management of equine mandibular fractures: 16 cases (1988-1998).

Fifty-three cases of equine mandibular fractures were managed surgically from 1988-1998, of which 16 (30%) were repaired by external skeletal fixation (ESF). Three surgical methods were utilised: transmandibular 4.76 or 6.35 mm Steinmann pins incorporated into fibreglass casting material or nonsterile dental acrylic (methyl methacrylate - MMA) bars reinforced with steel; transmandibular 9.6 mm self-tapping threaded pins +/- 4.76 or 6.35 mm Steinmann pins incorporated into MMA bars reinforced with steel; and 4.5 mm or 5.5 mm ASIF cortical bone screws incorporated into MMA bars reinforced with steel or a ventral MMA splint. Fourteen horses were presented to the hospital for fixator removal at an average of 56.2 days. At removal, fractures were stable and occlusion of incisor and cheek teeth was considered adequate. Complications of the procedure occurred in 3 horses. Two horses with persistent drainage and ring sequestra from pin tracts required curettage 4 or 5 months after ESF removal. A third horse required replacement of the original fibreglass ESF with MMA bars to regain access to open, infected wounds. Another horse required removal of the second premolar at the time of fixator removal because the tooth root had been damaged in the original injury. ESF for the surgical management of mandibular fractures in horses has produced good results, with incisive and cheek tooth alignment reestablished in all horses. Horses that were managed via ESF had a rapid return to full feed and did not require any supplementation via nasogastric tube or oesophagostomy to maintain bodyweight or hydration status.

Animals↗
PubMed1996

Environmental effects on laser Doppler pulpal blood-flow measurements in man.

The increasing number of experiments using laser Doppler flowmetry in man for pulpal blood-flow recordings leads to questioning of the experimental recording conditions. The present study focused on three points: the design of the laser probe holder, the isolation of the tooth, and the influence of the recording site. A rigid polyurethane splint used in addition to different isolation devices (cotton roll, metal shield, rubber dam) was compared with a silicone splint. The silicone resulted in significantly higher values (+341%) than the polyurethane splint. The combination of the polyurethane splint with isolation devices decreased, in all cases, the flux values. The polyurethane/rubber-dam combination was the most efficient in individualizing the pulpal blood flow (-69% decrease). Recordings on non-vital teeth confirmed the hypothesis that there was periodontal contamination of the recorded flow, as the signal was abolished when using the polyurethane/rubber-dam combination. Cervical recording sites gave significantly higher values than occlusal sites (+42%). It is concluded that, in man, the part played by the periodontium may have been underestimated in previous recordings of pulpal blood flow. The use of a rubber dam in combination with a rigid splint to enhance the validity of recordings is proposed.

Dental Pulp↗
PubMed1976

Posterior bilateral condylar displacement: its diagnosis and treatment.

One type of condylar displacement (posterior bilateral) was discussed as an etiologic factor in TMJ dysfunction. Joint noise, tenderness on muscle palpation, and acute TMJ pain are all considered signs of TMJ dysfunction. Any joint noise is considered to be an early dysfunctional symptom because of its higher incidence in association with palpable muscle pain or acute TMJ dysfunction. Sometimes the joint noise will immediately precede acute muscle pain and/or fluctuate with the painful symptoms. The treatment of bilateral posterior condyle displacement has been described. The mandibular anterior teeth were shortened and the maxillary posterior occlusion adjusted so that the mandible could be respositioned in an anterior position without increasing the vertical dimension of occlusion. A silver-plated maxillary cast was obtained and mounted on a semiadjustable articulator (Hanau) with a face-bow. The mandibular cast was mounted in the dysfunctional (retruded) centric relation. The articulator was moved into a protrusive position by the amount of anterior correction that is needed to reposition the condyles into the middle of the fossae symmetrically on both sides. The original TMJ radiographs provide the necessary information for this clinical judgment. Acrylic resin was placed in the space created between the condylar sphere and stop on the articulator. An acrylic resin temporary repositioning prosthesis constructed on the metal cast has two functions. It provides a therapeutic trial for the anterior condylar respositioning, and it holds the mandible in the therapeutic position while TMJ radiographs confirm the corrective position of the condyles in the fossae. After a successful 6 to 8 week trial period with remission of symptoms, a gold prosthesis was constructed on the same cast in the same therapeutic position. It remains to be seen whether, after several years, the condylar suspension system changes from a dysfunctional centric relation to a new functional centric relation in which the patient can no longer return to the posterior displaced condylar position in the fossa. Only with painstaking observations, accurate TMJ radiographs, complete documentation, and after-care can a more scientific approach to the diagnosis and treatment of TMJ dysfunctional pain syndrome be achieved.

Acrylic Resins↗
PubMed1977

Intermaxillary fixation following mandibular resection.

This report concerns 14 patients who were treated by use of immediate intermaxillary fixation after segmental resection of the mandible to eradicate cancerous lesions. Mandibular resection usually produces problems in surgical and prosthetic reconstruction. The use of intermaxillary fixation during the first 6 postoperative weeks will reduce the degree of deviation. In mandibular resection for edentulous patients, the original dentures were used postoperatively with slight modification or no modification at all. With fixation and encouragement of early functional movement of the mandible, the dentulous patients showed a lesser degree of deviation. Some of the patients of the latter group used guide flange prostheses during the postoperative period to return the mandible to the centric position. Edentulous patients who deviated slightly were fitted with a maxillary ramp which guided the mandibular segment, after the initial contact, into the proper centric relation.

Carcinoma, Squamous Cell↗
PubMed1991

Stabilization of the craniomandibular therapeutic relationship with etched porcelain bonded restorations: a clinical report.

The major advantage of this technique is sustaining the preexisting therapeutic position of the mandible during the restorative phase with minimal error in the occlusal scheme despite the type of restorative material. This clinical report demonstrated the conservative nature of bonding etched porcelain to tooth structure while concomitantly stabilizing the mandible to the maxillary dental arch.

Acid Etching, Dental↗
PubMed1988

Changes in mandibular position during treatment with disk-repositioning onlays: a roentgen stereophotogrammetric study.

Seven patients with temporomandibular joint disk displacement were treated with disk-repositioning onlays, and changes in the mandibular position were studied by means of roentgen stereophotogrammetry. A wide range of changes in mandibular position was seen at cementation of the onlays and during the observation period. On an average, recapturing of the disk and cementation of the onlays lowered the mandible by 2.5 mm and protruded it by 0.5 mm. During the observation period of 7 months the mandible had a tendency to resume its original position. The relapse was 80% in the sagittal plane, 70% in the transverse plane, and 12% in the vertical plane. It was concluded that disk-repositioning onlays can be used to lower the mandible with a relatively small relapse. Changes in the horizontal plane, however, seem to be less stable.

Adolescent↗
PubMed1998

Endovascular treatment of carotid artery occlusion in progressive stroke syndromes: technical note.

OBJECTIVE AND IMPORTANCE: We describe two patients, with progressing neurological deficits, who showed improvement after revascularization of their carotid arteries using stents. CLINICAL PRESENTATION: One patient presented clinically with the symptoms of a middle cerebral artery territory stroke. Angiography demonstrated total occlusion of the right internal carotid artery (ICA), with evidence of clot from the origin of the ICA to the middle cerebral artery trifurcation. The second patient presented with bilateral ICA occlusions and evidence of a progressing left hemispheric deficit; she was receiving therapeutic levels of heparin at the time of deterioration of her condition. INTERVENTION: Thrombolysis and stenting successfully recanalized the occluded vessels, and the deficits of the first patient were reversed. With the second patient, a dissected carotid loop was encountered. Straightening of the loop with a wire and stenting of the carotid artery using two stents allowed revascularization of the left hemisphere and resolution of most of the deficits of this patient. CONCLUSION: This report demonstrates the technical feasibility of placing stents in high-risk patients with carotid artery occlusions from either dissection or atherosclerosis. Both patients sustained much smaller infarctions than would have been expected if the carotid artery territory had been infarcted. We report on the technical feasibility of reopening acutely closed ICAs by using endovascular methods.

Adult↗
PubMed1978

Analysis of the effects of treatment on some reflexes of human jaw elevator muscles.

Electromyographic analysis was carried out prior to occlusal equilibration for patients who had some form of TMJ dysfunction and again after treatment. The results were compared with similar analyses for patients without any symptoms of dysfunction (controls) and for patients who had been wearing some kind of occlusal appliance as treatment for dysfunction. The parameters measured were the period of minimal activity (inactive phase of jaw elevators sometimes referred to as the inactive phase), the duration of muscle contraction before tooth contact (DMC), the period of muscle activity after tooth contact (latency), the inhibitory response, and the duration of the clench phase of the temporal and masseter muscles. In general the pathological series had longer cycles, longer DMC, longer clench phases and less significant correlation coefficients than the controls. The results indicated a dominance of the closing muscles in the pathological groups over the other parameters of the cycle during metronome monitoring. Also, the controls and the POST equilibration group yielded readily to cortical command. The parameters of the cycle in the POST-equilibration group were facilitated as compared to the other groups.

Adult↗
PubMed1988

Loci and characteristics of EMG silent periods during masticatory mandibular movements in rats.

Frontal plane mandibular movements and the associated superficial masseter EMG signals of six 39-day-old rats were simultaneously recorded and digitized at a rate of 1 kHz by the optoelectronic method in order to investigate the loci and attributes of masseteric silent periods during mastication of hard (pellets) and soft (slurry) food items. The marked silent periods, defined as cessations of EMG activity during the slow-close (SC) phase of single chewing cycles, were analyzed for their (1) onset and offset durations relative to physiological centric occlusion (PCO), (2) frontal vertical (FV) and frontal horizontal (FH) loci relative to PCO, and (3) FV and FH velocities and accelerations of masticatory mandibular movements in relation to PCO. The start (SSP) and end (ESP) of silent period loci relative to PCO moved superiorly as sequences of pellet mastication progressed. All silent period attributes during slurry consumption were significantly different (p less than or equal to 0.01) from pellet attributes: Slurry SSP and ESP loci were closer to PCO than were pellet loci; durations of silent period loci during pellet mastication were more variable than were slurry durations. FV distance and velocity values for pellets were greater than with pellets. Although FV velocities during both pellet and slurry mastication decreased at ESP relative to SSP values, their FH velocities at ESP actually increased relative to SSP velocities. Loci attributes of EMG silent periods appeared largely dependent on the consistency of the food item being masticated.

Animals↗