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Biomedical subjects

B Padwa

Publications and source records attributed to B Padwa.

3 recordsLinked to original sources
PubMed2001

Hypodontia in hemifacial microsomia.

OBJECTIVE: The purpose of this study was twofold: (1) to describe the patterns of missing teeth in patients with hemifacial microsomia (HFM) and (2) to compare the prevalence of missing teeth in subjects with HFM with a group of unaffected subjects. STUDY DESIGN: A descriptive study was conducted comparing HFM subjects with a group of patients selected from an orthodontic clinic. METHODS: The prevalence of missing teeth was assessed by evaluation of panoramic radiographs. At the time of the study, records of 125 patients with HFM were available from the Craniofacial Center at Boston's Children's Hospital. Seventy-six met inclusion criteria for radiographic analysis of hypodontia. Fifty-two patients met inclusion criteria into the comparison study in which the prevalence of hypodontia was compared with a group of patients from the Department of Orthodontics at Harvard School of Dental Medicine. A Fisher's exact test was conducted to test the hypothesis that HFM patients have a greater prevalence of missing teeth than individuals without the anomaly. A chi-square test for trend was conducted to determine whether hypodontia was more prevalent with increasing severity of the mandibular deformity in HFM. RESULTS: Hypodontia was more common among HFM patients (26.9%) versus the comparison group in which no missing teeth were recorded (p < .0001). Additionally, the degree of hypodontia was correlated with the grade of mandibular hypoplasia (p = .024). CONCLUSION: Hypodontia was found to be more prevalent in patients with HFM than in comparison subjects, possibly indicating an etiologic link between the two conditions.

Adolescent↗
PubMed1995

Mandibular subluxation as an adjunct to exposure of the distal internal carotid artery in endarterectomy surgery. Technical note.

The location of the carotid artery bifurcation and the distance atherosclerotic disease extends distally in the internal carotid artery (ICA) are two factors that contribute to the technical difficulty of carotid endarterectomy. When the bifurcation is high (above C-3) or the disease extends distally, standard approaches may not provide adequate exposure for dissection of plaque or for arteriotomy repair. A simple method of mandibular subluxation is described for added exposure of the distal carotid artery. The criteria for use of this method include: a carotid bifurcation at or above C-2; disease extending to within 2 cm of the skull base; and a small-caliber distal ICA lumen with the expectation of a patch graft extending close to the skull base. In dentulous patients, the mandible is subluxed by attaching an intradental wire from the ipsilateral mandibular bicuspid to an intradental wire around the contralateral maxillary bicuspid. In edentulous patients, a wire is placed around the ipsilateral mandible and secured to a wire placed through the anterior nasal spine. The entire preoperative subluxation requires 10 to 15 minutes under anesthesia and an additional 1 to 2 minutes postoperatively to remove the wires. A single skin suture and an absorbable intraoral suture were placed in some edentulous patients. This technique has been evaluated over a 15-month reference period during which 115 carotid endarterectomies were performed. The criteria stated above were met in seven cases (six patients, 6%) and jaw subluxation was performed preoperatively. An additional 1 to 2 cm of distal exposure was obtained by using this technique and endarterectomy proceeded without complication. A slight "shift" of the standard anatomical landmarks occurred due to the movement of the mandible, which was easily recognized. There were no significant postoperative complaints related to the subluxation; specifically, no temporomandibular joint pain, no other postoperative pain, and no tooth damage were encountered. It is concluded that this relatively simple approach to mandibular subluxation provided significant added exposure to the distal ICA without notably increasing operative time. In addition, there was no morbidity and little additional care was needed when compared with other more radical approaches to high carotid artery exposure.

Aged↗