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Biomedical subjects

D B Tuinzing

Publications and source records attributed to D B Tuinzing.

At least 19 recordsLinked to original sources

Orthognathic surgery for mentally retarded patients.

The surgical treatment of mentally retarded children for esthetic reasons is discussed. In mentally retarded adults a facial deformity can give rise to functional problems; in some cases a facial deformity can stigmatize the mental state. In selected cases orthognathic surgery may offer a solution for either problem. Two cases are reported.

Adult

Intra- and early postoperative complications of the Le Fort I osteotomy. A retrospective study on 410 cases.

The results of a retrospective study of the complications that occurred in 410 Le Fort I osteotomies performed in the Department of Oral and Maxillofacial Surgery of the Free University Hospital, Amsterdam, the Netherlands, are presented. The complication rate was 9.0%. In the discussion, our results are compared with the literature.--Suggestions are made on how to avoid these complications.

Fistula

Condylar atrophy and osteoarthrosis after bimaxillary surgery.

Radiographic evidence of condylar atrophy was seen in 12 patients out of 206 patients who underwent surgical orthodontic treatment. All 12 patients had the same dentofacial deformity, high-angle mandibular retrognathia (Class II open bite), and all but one had bimaxillary surgery. The etiologic factors are discussed. The dentofacial deformity is considered to be the main reason for condylar resorption, but orthognathic surgery is supposed to stimulate the progress of the disease by increased loading, disk displacement, and immobilization.

Atrophy

The influence of the Le Fort I osteotomy on nasal airway resistance.

Pre- and postoperative rhinomanometric measurements were done on 13 patients by whom a Le Fort I osteotomy was performed. The claim that Le Fort I osteotomies may produce deleterious respiratory effects in the form of an increase in nasal airway resistance was investigated. The results are discussed.

Adult

Eminectomy and discoplasty for correction of the displaced temporomandibular joint disc.

Eminectomy with or without a subsequent discoplasty was performed on 30 patients (36 joints) with internal derangement of the temporomandibular joint (TMJ) confirmed either arthrographically or with magnetic resonance imaging. The importance of the inclination of the TMJ eminence and the therapeutic value of eminectomy are discussed. The TMJs were clinically evaluated before and at least 1 year after surgery in respect to opening function and symptoms. The results were promising (86.8% of the patients felt better). In five patients with a preoperative diagnosis of anterior disc displacement with reduction, only an eminectomy was performed. In these five cases eminectomy alone was sufficient to restore normal TMJ function.

Adolescent

Inclination of the temporomandibular joint eminence and anterior disc displacement.

The articular eminence angle of 179 temporomandibular joints (TMJ) with anterior disc displacement (ADD) in 179 patients was measured and compared with 200 left and 200 right joints of 400 young adults without TMJ dysfunction. A steeper inclination of the posterior slope of the articular eminence, with a mean difference compared to the control group of 14.5 degrees, was seen in joints with ADD. In the group of 179 joints with ADD of the TMJ, no difference was seen in the mean articular eminence angle between joints with an ADD with reduction, and an ADD without reduction, between conservatively or surgically treated joints, or between joints with different presumed causes of ADD.

Adolescent

Correction of deep overbite. A modified splint permitting rapid extrusion of posterior teeth.

The use of a modified splint in the surgical-orthodontic treatment of Class II deep overbite deformities is presented. The splint permits a reduction of the preoperative orthodontic treatment-time because hardly any (time consuming) levelling of the dental arch is indicated while the time of postoperative orthodontic treatment is shortened, because of the possibility of continuing orthodontic treatment during the intermaxillary fixation period. The clockwise rotational movement which occurs with this treatment modality has, additionally, a favourable effect on the anterior facial height and in many cases on the position of the chin. Finally the intake of food during the immobilization period is facilitated.

Humans

Temporomandibular joint symptoms in orthognathic surgery.

Pre and postoperative TMJ-symptoms were observed in the various dentofacial deformities of 480 patients operated on because of a dysgnathia. Preoperative TMJ-symptoms were seen in 16.2% of the 480 patients. After surgery 66% of the preoperatively symptomatic patients reported fewer or no TMJ-symptoms. On the other hand 11.5% of preoperatively asymptomatic patients developed TMJ-symptoms after surgery. Although not statistically proven, a tendency was seen to more TMJ-symptoms in low and normal angle patients in comparison with high angle patients. The chance is high, however, that TMJ-symptoms in low and normal angle mandibular retrognathism patients will improve after surgery. The chance of developing TMJ-symptoms in high angle, absolute mandibular retrognathism patients, operated on by means of bimaxillary surgery, is considerable.

Cohort Studies

Superior repositioning of the maxilla by a Le Fort I osteotomy: a review of 26 patients.

Following surgical procedures in 25 patients, a study was made of the stability of the maxilla after superior repositioning. In cases of open bite, as well as in cases of absolute maxillary hyperplasia or relative mandibular deficiency, a slight overcorrection that led to a stable occlusion was observed. The use of miniplates for stabilization of the maxilla is discussed briefly.

Facial Bones