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Biomedical subjects

B L Eppley

Publications and source records attributed to B L Eppley.

At least 127 records · Page 7Linked to original sources
PubMed1990

Modifications in the surgical correction of trigonocephaly.

A modified technique for the surgical correction of trigonocephaly is presented. The technical modifications are designed both to increase the stability of fixation of the supraorbital bar and lateral canthal advancements and to increase interorbital distance and anterior cranial fossa volume when utilized in those patients who exhibit the full expression of trigonocephaly, including midline ridging, bifrontal recession, hypotelorbitism, shortened anterior cranial fossa, deficient projection of lateral orbit, and bitemporal narrowing. It is a modification of the supraorbital bar remodeling/advancement procedure as originally described by Marchac with the introduction of a nasofrontal osteotomy and superior osteotomy bone graft and midline miniplate fixation of the supraorbital bar to the nasofrontal junction. Its use in 20 patients has been favorable.

Bone Plates↗
PubMed1990

Evaluation of HTR polymer as a craniomaxillofacial graft material.

An experimental animal study was undertaken to evaluate the potential use of HTR polymer as a craniomaxillofacial reconstructive material. Its properties of marked hydrophilicity, a negative surface charge, and extensive porosity combined with a calcium graft coating suggested favorable osteoconductive properties. Four sites of the rabbit craniomaxillofacial skeleton were evaluated by placement of both inlay and onlay implants. Postoperative assessment at 60, 120, and 240 days consisted of histologic evaluation by tetrachrome staining of calcified sections. At 60 days, extensive osseous ingrowth into the inlay implants had occurred extending up to 2000 microns. The onlay implants, however, exhibited more limited ingrowth extending only 100 to 200 microns into the material. Over the ensuing 120- and 240-day postoperative periods, the average depth of bony ingrowth did not progress in either the inlay or onlay specimens over that observed at 60 days. Differences also were noted between the inlayed skeletal sites, with increased marrow at the recipient site resulting in increased bony ingrowth. The material appears to be biocompatible, with no evidence of infection, inflammatory reaction, or bone resorption observed around any of the implants. The implants exhibited a significant osteoconductive capability that was most manifest when implants were exposed to bleeding cortical/marrow surfaces as inlay grafts.

Analysis of Variance↗
PubMed1990

An evaluation of calvarial and iliac donor sites in alveolar cleft grafting.

A clinical study evaluating the use of calvarial (two different techniques of harvest) versus iliac donor bone in secondary unilateral alveolar cleft reconstruction based on clinical and radiographic assessment was conducted. Both iliac bone and the Hudson brace harvested calvarial bone resulted in high rates of radiographic evidence of osseous continuity between the maxillary segments and clinical resolution of the alveolar cleft defect. Calvarial bone obtained with the craniotome had a lower rate of success that was statistically different from the other two groups. The utilization of calvarial bone and the implications of harvest technique on graft transfer biology are discussed.

Alveolar Process↗
PubMed1989

Effect of different surgical repair modalities on regeneration of the rabbit mandibular nerve.

A study was designed to evaluate the ability of the rabbit mandibular nerve to regenerate when exposed to crush and resection injuries, as well as to determine how differently sized resection injuries healed when repaired with either autogenous grafts or laminin-lined collagen tubulization. The nerve demonstrated a regenerative capacity over a 1-cm defect, with morphology and function that approximated normals, but could not span a 2-cm gap defect unaided. Crush injuries produced findings that were inferior to both those in normal nerves and in those with resections. In 1-cm defects, both grafting and tubular repairs produced similar results, with substantial recovery of neural function after 16 weeks. In 2-cm defects, autogenous grafting was superior to tubulization by both morphologic and functional assessment. Replacement of the lateral cortex of the mandible after nerve repair was shown to be unnecessary. The implications of these findings as they relate to nerve injury and repair in humans is discussed.

Animals↗
PubMed1989

Surgical repair of defects in the rabbit temporomandibular joint disc: a comparison of various techniques.

A study was designed to evaluate the effects of different types of repair (suture vs. graft), donor graft tissues (dermis vs. fascia), and methods of graft fixation (sutured vs. laser-assisted) on excisional defects of the rabbit TMJ disc made anterior to the retrodiscal tissue. Groups created to compare the different variables were assessed at 30 and 90 days postoperatively by macroscopic and histologic methods, microangiography, and mechanical strength testing. Without repair, all excisional defects of the disc failed to heal. Suturing of the reapproximated margins did not appear to promote healing or provide much strength beyond the properties of the suture material. Dermal grafts, fixed by suturing, induced healing by becoming incorporated into the disc, restoring discal continuity, and approximating normal disc strength. The use of laser-assisted tissue welding for dermal graft fixation was found to be inadequate and was subsequently abandoned. Fascial grafts could be fixed into position by both suture and laser-assistance, but consistently failed to exhibit successful transplantation and promote healing at the disc site.

Animals↗
PubMed1989

Facial nerve graft repair: suture versus laser-assisted anastomosis.

An experimental study was conducted to evaluate the effectiveness of laser-assisted versus conventional suture repair of facial nerve grafts in the rabbit. Electrophysiologic assessment of function revealed no significant difference between the two techniques. Histological differences were apparent, however, early postoperatively from the effects of heat energy on the perimeter of fascicular morphology. At a later stage, this effect had disappeared. The laser technique was also associated with an apparent decreased escape and entrapment of axons.

Anastomosis, Surgical↗
PubMed1989

Single stage repair of the median cleft lip deformity in holoprosencephaly.

A single stage repair of the median cleft lip in holoprosencephaly is presented. The use of a superiorly-based pedicle from the nasal lobule/columellar remnant for columellar creation and a free skin graft from excess horizontal lip tissue for philtral reconstruction, in addition to medial rotation of the lateral lip segments, permits complete repair in one procedure. Such an approach offers the advantage of a reduction in number of procedures and anaesthetic exposure in the severely medically compromised holoprosencephalic patient.

Abnormalities, Multiple↗
PubMed1989

Tumor vascular permeability factor stimulates endothelial cell growth and angiogenesis.

Vascular permeability factor (VPF) is an Mr 40-kD protein that has been purified from the conditioned medium of guinea pig line 10 tumor cells grown in vitro, and increases fluid permeability from blood vessels when injected intradermally. Addition of VPF to cultures of vascular endothelial cells in vitro unexpectedly stimulated cellular proliferation. VPF promoted the growth of new blood vessels when administered into healing rabbit bone grafts or rat corneas. The identity of the growth factor activity with VPF was established in four ways: (a) the molecular weight of the activity in preparative SDS-PAGE was the same as VPF (Mr approximately 40 kD); (b) multiple isoforms (pI greater than or equal to 8) for both VPF and the growth-promoting activity were observed; (c) a single, unique NH2-terminal amino acid sequence was obtained; (d) both growth factor and permeability-enhancing activities were immunoadsorbed using antipeptide IgG that recognized the amino terminus of VPF. Furthermore, 125I-VPF was shown to bind specifically and with high affinity to endothelial cells in vitro and could be chemically cross-linked to a high-molecular weight cell surface receptor, thus demonstrating a mechanism whereby VPF can interact directly with endothelial cells. Unlike other endothelial cell growth factors, VPF did not stimulate [3H]thymidine incorporation or promote growth of other cell types including mouse 3T3 fibroblasts or bovine smooth muscle cells. VPF, therefore, appears to be unique in its ability to specifically promote increased vascular permeability, endothelial cell growth, and angio-genesis.

Amino Acid Sequence↗
PubMed1988

Surgical treatment of internal derangements of the temporomandibular joint: evaluation of two techniques.

One hundred ten cases of internal derangement of the temporomandibular joint were treated by high condylectomy (47) and eminectomy (63) in combination with discorrhaphy and disc repair. Preoperative and postoperative findings (greater than 24 months follow-up) relating to mandibular mobility, pain, and stability of occlusion were compared. Both procedures resulted in a reduction in symptoms, but differences in postoperative findings were observed. Each procedure resulted in increased translation, with eminectomy patients exhibiting greater opening distances at endstage evaluation. In addition, a greater incidence of residual deviation to the affected side occurred in the majority of high condylectomy patients. Although pain was reduced in both groups, less residual pain was observed in the eminectomy group. Alteration in maxillomandibular centric relation was a rare finding, seen only in two high condylectomy patients. Possible factors contributing to these differences are discussed.

Adolescent↗
PubMed1988

Enhancement of angiogenesis by bFGF in mandibular bone graft healing in the rabbit.

The effectiveness of basic fibroblast growth factor (bFGF) as an in vivo angiogenic factor was evaluated in autogeneic bone grafts to the rabbit mandible. Block cortical grafts harvested from the ilium were implanted into sites in the mandibular ramus or body. The basic fibroblast growth factor was continuously introduced over a period of 14 days through subcutaneous osmotic pumps. Increased vascularity, as assessed by vessel number and depth of penetration into the grafts, was noted at 10 days postoperatively in the bFGF stimulated side as compared to contralateral control grafts. At the fourteenth postoperative day, bFGF administration was discontinued and a decrease in angiogenesis was noted over the ensuing 2 weeks so that after 1 postoperative month, little difference could be detected between the stimulated and nonstimulated grafts. Assessment of osseous healing at the 1 month postoperative interval using triple fluorochrome labeling did not reveal evidence of accelerated osteogenesis on the previously stimulated side.

Angiography↗
PubMed1988

Collagen tube repair of the mandibular nerve: a preliminary investigation in the rat.

A technique for repair of the inferior alveolar nerve of the rat involving a collagen tube conduit with laminin gel lining was compared with unguided regeneration in both large and small nerve gaps. No significant morphologic differences were noted between the groups with small defects. With large defects, however, only the tubular repairs were effective in restoring neural continuity. The implications of the results of this study are discussed.

Animals↗
PubMed1988

Bilateral nasopalatine ducts of the premaxilla.

An unusual case involving the development of patency of the nasopalatine ducts after orthopedic expansion of the premaxilla in a young child is described. The embryogenesis, clinical presentation and surgical repair is discussed.

Child↗
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

Radiographic and surgical evaluation of internal derangements of the temporomandibular joint.

A prospective study of 287 patients who underwent temporomandibular surgery for disc dysfunction was conducted. The patients were evaluated by combinations of polydirectional tomography, microfocus magnification, and arthrographic radiographic modalities. Abnormalities of the hard and soft tissue structures of the joints were determined radiographically and compared with the findings of surgical examination. Polydirectional tomography and microfocus magnification compared favorably with each other, as well as in their ability to show the actual abnormalities. Arthrography had a high degree of correlation with actual pathologic disc alterations, except for the 15% incidence of false-positive findings of perforation. The combination of either polydirectional tomography or microfocus magnification with arthrography is recommended for complete evaluation of the painful temporomandibular joint that shows evidence of limited range of motion.

Adolescent↗