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Biomedical subjects

A Sclaroff

Publications and source records attributed to A Sclaroff.

At least 19 recordsLinked to original sources
PubMed2000

Dental implantation for restoration of posttraumatic deformities: avulsion injuries.

Soft and hard tissue defects of the cranio- and maxillofacial area, especially after an avulsion injury, are challenging to reconstruct. Sophisticated soft and hard tissue transfer techniques have allowed satisfactory reconstruction of the gross anatomic structure. However, these methods do not allow optimal restoration of fine anatomic detail or function. The advent of dental implants and modified dental implants for craniofacial applications has allowed maximization of cosmetic and functional restoration. Prosthodontists are capable of fabricating subunits of the cranio- and maxillofacial area with fine detail, reproducing the coloring, texture, and idiosyncrasies of a patient's native skin. Dental implant technology has allowed these prostheses to be bone anchored, yielding a reproducible and stable attachment. This method of attachment in turn allows flexibility in the design of the prosthesis, to maximize restoration, and imparts an increased sense of confidence to the patient. Illustrated are six examples demonstrating the versatility of dental implants in the reconstruction of avulsion injuries of the cranio- and maxillofacial complex.

Alveolar Process↗
PubMed1994

Immediate mandibular reconstruction and placement of dental implants. At the time of ablative surgery.

The outcomes of surgical reconstruction for patients who have undergone extensive tumor resection of the mandible and associated soft tissue have been less than desirable for many reasons: lack of cancer cure, radiation problems, as well as inadequate functional reconstructive results. These patients traditionally have undergone multiple surgical procedures for restoration of the surgical deformity. With the advent of new donor sites and successful transfer of microvascular hard and soft tissue, one can restore the largest defects created during cancer excision. Combining these techniques with biocompatible dental implants and reconstructive bone plates, technology has advanced to the point of predictable outcomes. The restoration of appearance, mandibular function, and mastication is mandated by patients. Dental implants are now placed in vascularized bone reconstruction of the mandible immediately at the time of ablative surgery. This obviates the need for additional surgical reconstructive procedures, adjunctive hyperbaric oxygen therapy, and problems associated with the placement of dental implants in irradiated tissue.

Adult↗
PubMed1994

Fibular and iliac crest osteomuscular free flap reconstruction of the oral cavity.

A method for reconstruction of oral cavity soft tissues using segmentally or axially supplied free muscle flaps harvested as a unit with their bone components is presented. Both fibular/soleus and iliac crest/internal oblique free flaps are documented, and the pros and cons of each donor site are presented. Twenty-one patients, 17 with cancer or osteoradionecrosis and 4 with benign or congenital conditions of the mandible, have undergone this operation. Ten bone grafts were simultaneously embedded with osseointegrated implants. All free flaps except one survived and resulted in a smoothly mucosalized oral lining. Six patients have had their implants successfully uncovered, all of whom are wearing prostheses. Four other patients are using tissue-borne prostheses. Transfer of free, nonbulky muscle flaps for mucosalized oral soft-tissue reconstruction is feasible in selected patients using first the fibular and, second, the iliac donor site; this soft-tissue technique also contributes to prosthetic dental rehabilitation.

Adolescent↗
PubMed1990

Clinical evaluation of a single crystal sapphire tooth implant in human beings.

Single crystal sapphire implants are commercially prepared ceramics of aluminum oxide. These endosseous implants have been placed in patients at Washington University since 1978. The course of patients has been followed closely with periodic clinical and radiographic evaluations. Sapphire is well tolerated by hard and soft tissue and provides excellent abutments for fixed partial dentures.

Aluminum Oxide↗
PubMed1990

Invasive aspergillosis of the maxilla in an immunocompromised patient.

Patients who are immunocompromised have a high susceptibility to infection, which can be fatal. Studies have shown that patients receiving chemotherapeutic and adjunctive medications have inhibited inflammatory response to microbes, particularly those increasing the potential for the development of invasive infection. Aspergillus is a fungus often found in the atmosphere. Colonization of Aspergillus in the upper respiratory tract is common. In the immunocompromised patient, Aspergillus flavus is found to be the most frequent fungus cultured in the maxillary sinus. Because of the depressed immunologic state of the patient, A. flavus can differentiate into hyphal forms producing toxins that destroy epithelial tissues. Penetration of Aspergillus into connective and vascular tissue produces thrombosis and ultimately necrosis of hard and soft tissue.

Aged↗
PubMed1987

Functional alveolar reconstruction in a patient with total mandibular replacement.

Alveolar reconstruction in a case of total mandibular replacement is presented. The placement of hydroxylapatite bone substitute and the staple bone plate into a previously grafted area demonstrates that the properties of transplanted bone are similar to natural bone. Furthermore, the safety and effectiveness of the utilization of these biomaterials in areas of previous osseous reconstruction is documented. An awareness of biologic tissue response may have also contributed to successful functional restoration. In addition, a major question about the functions of the muscles of mastication arises.

Adult↗
PubMed1986

Secondary management of the premaxilla in bilateral cleft lip and palate patients.

Bilateral clefts of the palate pose difficult and unique problems in surgical rehabilitation. The premaxilla traditionally has been a controversial subject with a historic lack of uniformity in treatment protocol. Based on a review of facial growth and the evolution of premaxillary cleft surgery, principles of management and secondary reconstruction of the premaxilla are discussed. Timely surgical intervention combining osteotomies and bone grafting in conjunction with closure of soft tissue defects is shown to result in satisfactory functional and aesthetic results.

Bone Transplantation↗
PubMed1985

Cavernous lymphangioma of the lip: report of case.

Lymphangiomas are benign lymphatic growths secondary to developmental aberration. They are generally found in young patients. However, they may be undiagnosed or improperly treated, as in this case, and appear as the patient grows older. The isolated location of the lesion in the upper lip and the age of the patient are unusual; few cases have been reported in the literature. Complete surgical excision resulted in restoration of normal anatomic contour of the lip.

Adult↗
PubMed1982

Variable expressivity of the multiple nevoid basal cell carcinoma syndrome.

Four cases of multiple nevoid basal cell carcinoma syndrome are presented. No one component of the syndrome is present in all patients; instead, the many malformations associated with the syndrome have variable expressivity. The triad of jaw cysts, basal cell epitheliomas, and skeletal anomalies is well known, whereas other aspects, such as intracranial calcifications, hypertelorism, mental retardation, ectopic calcification, cleft lip and palate, cutaneous cysts, and palmar and plantar dyskeratosis, are more subtle and easily overlooked.

Adolescent↗